Newswise What gets the leader of the NIH jazzed?

Speaking to a packed West Pavilion auditorium March 6, Francis Collins, M.D., Ph.D., director of the National Institutes of Health, shared his picks of 10 areas of particular excitement and promise in biomedical research. (Watch the full talk here.)

In nearly every area, UAB scientists are helping to lead the way as Collins himself noted in several cases. At the conclusion of his talk, Collins addedhis advice for young scientists. Here is Collins top 10 list, annotated with some of the UAB work ongoing in each area and ways that faculty, staff and students can get involved.

1. Single-cell sequencing

[see this section of the talk here]

I am so jazzed with what has become possible with the ability to study single cells and see what they are doing, Collins said. They have been out of our reach now we have reached in. Whether you are studying rheumatoid arthritis, diabetes or the brain, you have the chance to ask each cell what it is doing.

Single-cell sequencing and UAB:Collins noted that Robert Carter, M.D., the acting director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, was a longtime faculty member at UAB (serving as director of the Division of Clinical Immunology and Rheumatology). For the past several years, UAB researchers have been studying gene expression in subpopulations of immune cells inpatients with rheumatoid arthritis.

Join in:Researchers can take advantage of the single-cell sequencing core facility in UABsComprehensive Flow Cytometry Core, directed by John Mountz, M.D., Ph.D., Goodwin-Blackburn Research Chair in Immunology and professor in the Department of Medicine Division of Clinical Immunology and Rheumatology.

Learn more:Mountz and other heavy users of single-cell sequencing explain how the techniqueslet them travel back in time and morein this UAB Reporter story.

2. New ways to see the brain

[See this section of the talk here]

The NIHsBRAIN Initiativeis making this the era where we are going to figure out how the brain works all 86 billion neurons between your ears, Collins said. The linchpin of this advance will be the development of tools to identify new brain cell types and circuits that will improve diagnosis, treatment and prevention of autism, schizophrenia, Parkinsons and other neurological conditions, he said.

Brain tech and UAB:Collins highlighted thework of BRAIN Initiative granteeHarrison Walker, M.D., an associate professor in the Department of Neurology, whose lab has been developing a more sophisticated way to understand the benefits of deep brain stimulation for people with Parkinsons and maybe other conditions, Collins said.

Join in:UABs planned new doctoral program in neuroengineering would be the first of its kind in the country.

Learn more:Find out why neuroengineering is asmart career choicein this UAB Reporter story.

3. Induced pluripotent stem (iPS) cells

[See this section of the talk here]

Researchers can now take a blood cell or skin cell and, by adding four magic genes, Collins explained, induce the cells to become stem cells. These induced pluripotent stem (iPS) cells can then in turn be differentiated into any number of different cell types, including nerve cells, heart muscle cells or pancreatic beta cells. The NIH has invested in technology to put iPS-derived cells on specialized tissue chips. Youve got you on a chip, Collins explained. Some of us dream of a day where this might be the best way to figure out whether a drug intervention is going to work for you or youre going to be one of those people that has a bad consequence.

iPS cells at UAB:Collins displayed images of thecutting-edge cardiac tissue chipdeveloped by a UAB team led by Palaniappan Sethu, Ph.D., an associate professor in the Department of Biomedical Engineering and the Division of Cardiovascular Disease. The work allows the development of cardiomyocytes that can be used to study heart failure and other conditions, Collins said.

Join in:UABs biomedical engineering department, one of the leading recipients of NIH funding nationally, is a joint department of the School of Engineering and School of Medicine. Learn more about UABsundergraduate and graduate programs in biomedical engineering, and potential careers, here.

Learn more:See howthis novel bioprinterdeveloped by UAB biomedical researchers is speeding up tissue engineering in this story from UAB News.

4. Microbiome advances

[See this section of the talk here]

We have kind of ignored the fact that we have all these microbes living on us and in us until fairly recently, Collins said. But now it is clear that we are not an organism we are a superorganism formed with the trillions of microbes present in and on our bodies, he said. This microbiome plays a significant role not just in skin and intestinal diseases but much more broadly.

Microbiome at UAB:Collins explained that work led by Casey Morrow, Ph.D., and Casey Weaver, M.D., co-directors of theMicrobiome/Gnotobiotics Shared Facility, has revealed intriguing information abouthow antibiotics affect the gut microbiome. Their approach has potential implications for understanding, preserving and improving health, Collins said.

Join in:Several ongoing clinical trials at UAB are studying the microbiome, including a studymodifying diet to improve gut microbiotaand an investigation of the microbiomes ofpostmenopausal women looking for outcomes and response to estrogen therapy.

Learn more:This UAB News storyexplains the UAB researchthat Collins highlighted.

5. Influenza vaccines

[See this section of the talk here]

Another deadly influenza outbreak is likely in the future, Collins said. What we need is not an influenza vaccine that you have to redesign every year, but something that would actually block influenza viruses, he said. Is that even possible? It just might be.

Influenza research at UAB:Were probably at least a decade away from a universal influenza vaccine. But work ongoing at UAB in the NIH-fundedAntiviral Drug Discovery and Development Center(AD3C), led by Distinguished Professor Richard Whitley, M.D., is focused on such an influenza breakthrough.

Join in:For now, the most important thing you can do to stop the flu is to get a flu vaccination. Employees can schedule afree flu vaccination here.

Learn more:Why get the flu shot? What is it like? How can you disinfect your home after the flu? Get all the information atthis comprehensive sitefrom UAB News.

6. Addiction prevention and treatment of pain

[See this section of the talk here]

The NIH has a role to play in tackling the crisis of opioid addiction and deaths, Collins said. The NIHs Helping to End Addiction Long-term (HEAL) initiative is an all-hands-on-deck effort, he said, involving almost every NIH institute and center, with the goal of uncovering new targets for preventing addiction and improving pain treatment by developing non-addictive pain medicines.

Addiction prevention at UAB:A big part of this initiative involves education to help professionals and the public understand what to do, Collins said. The NIH Centers of Excellence in Pain Education (CoEPE), including one at UAB, are hubs for the development, evaluation and distribution of pain-management curriculum resources to enhance pain education for health care professionals.

Join in:Find out how to tell if you or a loved one has a substance or alcohol use problem, connect with classes and resources or schedule an individualized assessment and treatment through theUAB Medicine Addiction Recovery Program.

Learn more:Discover some of the many ways that UAB faculty and staff aremaking an impact on the opioid crisisin this story from UAB News.

7. Cancer Immunotherapy

[See this section of the talk here]

We are all pretty darn jazzed about whats happened in the past few years in terms of developing a new modality for treating cancer we had surgery, we had radiation, we had chemotherapy, but now weve got immunotherapy, Collins said.

Educating immune system cells to go after cancer in therapies such as CAR-T cell therapy is the hottest science in cancer, he said. I would argue this is a really exciting moment where the oncologists and the immunologists together are doing amazing things.

Immunotherapy at UAB:I had to say something about immunology since Im at UAB given that Max Cooper, whojust got the Lasker Awardfor [his] B and T cell discoveries, was here, Collins said. This is a place I would hope where lots of interesting ideas are going to continue to emerge.

Join in:The ONeal Comprehensive Cancer Center at UAB is participating in a number of clinical trials of immunotherapies.Search the latest trials at the Cancer Centerhere.

Learn more:Luciano Costa, M.D., Ph.D., medical director of clinical trials at the ONeal Cancer Center, discusses the promise ofCAR-T cell therapy in this UAB MedCast podcast.

Assistant Professor Ben Larimer, Ph.D., is pursuing a new kind of PET imaging test that could give clinicians afast, accurate picture of whether immunotherapy is workingfor a patient in this UAB Reporter article.

8. Tapping the potential of precision medicine

[See this section of the talk here]

The All of Us Research Program from NIH aims to enroll a million Americans to move away from the one-size-fits-all approach to medicine and really understand individual differences, Collins said. The program, which launched in 2018 and is already one-third of the way to its enrollment goal, has a prevention rather than a disease treatment approach; it is collecting information on environmental exposures, health practices, diet, exercise and more, in addition to genetics, from those participants.

All of Us at UAB:UAB has been doing a fantastic job of enrolling participants, Collins noted. In fact, the Southern Network of the All of Us Research Program, led by UAB, has consistently been at the top in terms of nationwide enrollment, as School of Medicine Dean Selwyn Vickers, M.D., noted in introducing Collins.

Join in:Sign up forAll of Usat UAB today.

Learn more:UABs success in enrolling participants has led to anew pilot study aimed at increasing participant retention rates.

9. Rare diseases

[See this section of the talk here]

Rare Disease Day, on Feb. 29, brought together hundreds of rare disease research advocates at the NIH, Collins said. NIH needs to play a special role because many diseases are so rare that pharmaceutical companies will not focus on them, he said. We need to find answers that are scalable, so you dont have to come up with a strategy for all 6,500 rare diseases.

Rare diseases at UAB: The Undiagnosed Diseases Network, which includes aUAB siteled by Chief Genomics Officer Bruce Korf, M.D., Ph.D., is a national network that brings together experts in a wide range of conditions to help patients, Collins said.

Participants in theAlabama Genomic Health Initiative, also led by Korf, donate a small blood sample that is tested for the presence of specific genetic variants. Individuals with indications of genetic disease receive whole-genome sequencing. Collins noted that lessons from the AGHI helped guide development of the All of Us Research Program.

Collins also credited UABs Tim Townes, Ph.D., professor emeritus in the Department of Biochemistry and Molecular Genetics, for developing the most significantly accurate model of sickle cell disease in a mouse which has been a great service to the [research] community. UAB is now participating in anexciting clinical trial of a gene-editing technique to treat sickle cellalong with other new targeted therapies for the devastating blood disease.

Join in:In addition to UABs Undiagnosed Diseases Program (which requires a physician referral) and the AGHI, patients and providers can contact theUAB Precision Medicine Institute, led by Director Matt Might, Ph.D. The institute develops precisely targeted treatments based on a patients unique genetic makeup.

Learn more:Discover how UAB experts solved medical puzzles for patients by uncovering anever-before-described mutationandcracking a vomiting mysteryin these UAB News stories.

10. Diversity in the scientific workforce

[See this section of the talk here]

We know that science, like everything else, is more productive when teams are diverse than if they are all looking the same, Collins said. My number one priority as NIH director is to be sure we are doing everything we can to nurture and encourage the best and brightest to join this effort.

Research diversity at UAB:TheNeuroscience Roadmap Scholars Programat UAB, supported by an NIH R25 grant, is designed to enhance engagement and retention of under-represented graduate trainees in the neuroscience workforce. This is one of several UAB initiatives to increased under-represented groups and celebrate diversity. These include several programs from theMinority Health and Health Disparities Research Centerthat support minority students from the undergraduate level to postdocs; thePartnership Research Summer Training Program, which provides undergraduates and especially minority students with the opportunity to work in UAB cancer research labs; theDeans Excellence Award in Diversityin the School of Medicine; and the newly announcedUnderrepresented in Medicine Senior Scholarship Programfor fourth-year medical students.

Join in:The Roadmap program engages career coaches and peer-to-peer mentors to support scholars. To volunteer your expertise, contact Madison Bamman atmdbamman@uab.eduorvisit the program site.

Learn more:Farah Lubin, Ph.D., associate professor in the Department of Neurobiology and co-director of the Roadmap Scholars Program,shares the words and deeds that can save science careersin this Reporter story. In another story, Upender Manne, Ph.D., professor in the Department of Pathology and a senior scientist in the ONeal Comprehensive Cancer Center, explains how students in the Partnership Research Summer Training Program gethooked on cancer research.

Originally posted here:
Looking to the future with Dr. Francis Collins - Newswise

By Barbara Goldberg

PHILADELPHIA, March 12 (Reuters) - On a follow-up visit after Sophie Cortellino's life-saving cardiac procedure, Dr. Anna Gelzer was delighted and family members were relieved to see her responding so well. Sophie agreed, her tail wagging excitedly.

As the 9-year-old boxer lay on a metal table, Gelzer tried to push up her heart rate as part of a stress test following the procedure in August - a ventricular ablation for an arrhythmia, or irregular heartbeat, the first performed on a dog in the United States.

"You want a cookie?!" Gelzer teased. "Want to go for a walk?!"

The jagged line tracing Sophie's heartbeat on a monitor spiked dramatically but she lay calm and alert, and Gelzer grinned with satisfaction.

Sophie is one of countless aging American dogs undergoing cardiac treatments, stem cell transplants, tracheal stents, pacemakers and other sophisticated, expensive procedures to prolong their lives.

Owners of the dogs, many of whom have been around long enough to watch children grow up and provide support through countless family joys and traumas, are going to great lengths to prolong their lives, paying bills of up to $3,000 for stem cell therapy for arthritis and $7,000 for cardiac procedures like Sophie's.

"Dogs are like a person, a family member," said Gelzer, cardiology professor at the University of Pennsylvania's School of Veterinary Medicine in Philadelphia.

Nearly half of the nation's 77 million pet dogs are aged 6 or older, a 15 percent increase since 1987, according to the American Veterinary Medical Association.

Larger breed dogs are considered geriatric at 6 years old, smaller breeds at 7 years old.

Aging dogs contend with many of the same illnesses as elderly humans, including heart disease, diabetes and senility. Cancer ravages canines at roughly the same rate as humans, striking nearly half of all dogs over age 10, experts say.

In Sophie's case, it was an arrhythmia, a condition that has been treated successfully in humans.

In the procedure, a catheter was snaked through blood vessels into her heart's lower chamber, which pumps oxygen-rich blood to the body, and trouble spots were cauterized. Gelzer was joined in the operation by her counterpart who handles human patients, Dr. Cory Tschabrunn, on the Philadelphia campus.

LOYAL COMPANION

Karen Cortellino, a radiologist, recalled the time nearly a decade ago when she first met Sophie, an 8-month-old puppy who had been rejected by another family. Sophie has since helped celebrate Cortellino's son's college graduation and her daughter's law school commencement, and dressed up as a member of a family wedding party.

When Cortellino's elderly mother moved into their home in Montville, New Jersey, Sophie was her sole companion after others left each morning for work or school.

"They were the best of friends. My mom died last May and Sophie was there for that," Cortellino said. "I would definitely sacrifice what I needed to in order for Sophie to have any procedure that would help her live longer - but well."

When Sophie collapsed last summer and was diagnosed with an arrhythmia, Gelzer had just won a grant for a clinical trial to test canine ventricular ablations, so this procedure was free.

The eventual cost is likely to be $5,000-$7,000, Gelzer said, which Cortellino said she would be "absolutely" willing to pay if Sophie needs another one.

Her exam completed, Gelzer gladly accepted sloppy kisses from her patient.

"There is never a doubt that what we do is meaningful," Gelzer said. "You have to enjoy working with the animals and with the owners. I like both - very much." (Reporting by Barbara Goldberg Editing by Sonya Hepinstall)

Our Standards: The Thomson Reuters Trust Principles.

The rest is here:
Sit, stay forever: Americans willing to pay top dollar to ... - Thomson Reuters Foundation

In a talk at UAB on March 6, the NIH director shared his thoughts on exceptional opportunities for science and young scientists and highlighted several exciting UAB projects.

NIH Director Francis Collins, M.D., Ph.D., visited UAB on March 6. In addition to his public talk, Collins had breakfast with UAB medical students and met with groups of young researchers and other investigators across campus.Speaking to a packed University of Alabama at Birmingham audience March 6, Francis Collins, M.D., Ph.D., director of the National Institutes of Health, shared his picks of 10 areas of particular excitement and promise in biomedical research.

In nearly every area, UAB scientists are helping to lead the way as Collins himself noted in several cases. At the conclusion of his talk, Collins addedhis advice for young scientists. Here is Collins top 10 list, annotated with some of the UAB work ongoing in each area and ways that faculty, staff and students can get involved.

I am so jazzed with what has become possible with the ability to study single cells and see what they are doing, Collins said. They have been out of our reach now we have reached in. Whether you are studying rheumatoid arthritis, diabetes or the brain, you have the chance to ask each cell what it is doing.

Single-cell sequencing and UAB:Collins noted that Robert Carter, M.D., the acting director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, was a longtime faculty member at UAB (serving as director of the Division of Clinical Immunology and Rheumatology). For the past several years, UAB researchers have been studying gene expression in subpopulations of immune cells inpatients with rheumatoid arthritis.

Join in:Researchers can take advantage of the single-cell sequencing core facility in UABsComprehensive Flow Cytometry Core, directed by John Mountz, M.D., Ph.D., Goodwin-Blackburn Research Chair in Immunology and professor in the Department of Medicine Division of Clinical Immunology and Rheumatology.

Learn more:Mountz and other heavy users of single-cell sequencing explain how the techniqueslet them travel back in time and morein this UAB Reporter story.

The NIHsBRAIN Initiativeis making this the era where we are going to figure out how the brain works all 86 billion neurons between your ears, Collins said. The linchpin of this advance will be the development of tools to identify new brain cell types and circuits that will improve diagnosis, treatment and prevention of autism, schizophrenia, Parkinsons and other neurological conditions, he said.

Brain tech and UAB:Collins highlighted thework of BRAIN Initiative granteeHarrison Walker, M.D., an associate professor in the Department of Neurology, whose lab has been developing a more sophisticated way to understand the benefits of deep brain stimulation for people with Parkinsons and maybe other conditions, Collins said.

Join in:UABs planned new doctoral program in neuroengineering would be the first of its kind in the country.

Learn more:Find out why neuroengineering is asmart career choicein this UAB Reporter story.

Researchers can now take a blood cell or skin cell and, by adding four magic genes, Collins explained, induce the cells to become stem cells. These induced pluripotent stem (iPS) cells can then in turn be differentiated into any number of different cell types, including nerve cells, heart muscle cells or pancreatic beta cells. The NIH has invested in technology to put iPS-derived cells on specialized tissue chips. Youve got you on a chip, Collins explained. Some of us dream of a day where this might be the best way to figure out whether a drug intervention is going to work for you or youre going to be one of those people that has a bad consequence.

iPS cells at UAB:Collins displayed images of thecutting-edge cardiac tissue chipdeveloped by a UAB team led by Palaniappan Sethu, Ph.D., an associate professor in the Department of Biomedical Engineering and the Division of Cardiovascular Disease. The work allows the development of cardiomyocytes that can be used to study heart failure and other conditions, Collins said.

Join in:UABs biomedical engineering department, one of the leading recipients of NIH funding nationally, is a joint department of the School of Engineering and School of Medicine. Learn more about UABsundergraduate and graduate programs in biomedical engineering, and potential careers, here.

Learn more:See howthis novel bioprinterdeveloped by UAB biomedical researchers is speeding up tissue engineering in this story from UAB News.

We have kind of ignored the fact that we have all these microbes living on us and in us until fairly recently, Collins said. But now it is clear that we are not an organism we are a superorganism formed with the trillions of microbes present in and on our bodies, he said. This microbiome plays a significant role not just in skin and intestinal diseases but much more broadly.

Microbiome at UAB:Collins explained that work led by Casey Morrow, Ph.D., and Casey Weaver, M.D., co-directors of theMicrobiome/Gnotobiotics Shared Facility, has revealed intriguing information abouthow antibiotics affect the gut microbiome. Their approach has potential implications for understanding, preserving and improving health, Collins said.

Join in:Several ongoing clinical trials at UAB are studying the microbiome, including a studymodifying diet to improve gut microbiotaand an investigation of the microbiomes ofpostmenopausal women looking for outcomes and response to estrogen therapy.

Learn more:This UAB News storyexplains the UAB researchthat Collins highlighted.

Another deadly influenza outbreak is likely in the future, Collins said. What we need is not an influenza vaccine that you have to redesign every year, but something that would actually block influenza viruses, he said. Is that even possible? It just might be.

Influenza research at UAB:Were probably at least a decade away from a universal influenza vaccine. But work ongoing at UAB in the NIH-fundedAntiviral Drug Discovery and Development Center(AD3C), led by Distinguished Professor Richard Whitley, M.D., is focused on such an influenza breakthrough.

Join in:For now, the most important thing you can do to stop the flu is to get a flu vaccination. Employees can schedule afree flu vaccination here.

Learn more:Why get the flu shot? What is it like? How can you disinfect your home after the flu? Get all the information atthis comprehensive sitefrom UAB News.

The NIH has a role to play in tackling the crisis of opioid addiction and deaths, Collins said. The NIHs Helping to End Addiction Long-term (HEAL) initiative is an all-hands-on-deck effort, he said, involving almost every NIH institute and center, with the goal of uncovering new targets for preventing addiction and improving pain treatment by developing non-addictive pain medicines.

Addiction prevention at UAB:A big part of this initiative involves education to help professionals and the public understand what to do, Collins said. The NIH Centers of Excellence in Pain Education (CoEPE), including one at UAB, are hubs for the development, evaluation and distribution of pain-management curriculum resources to enhance pain education for health care professionals.

Join in:Find out how to tell if you or a loved one has a substance or alcohol use problem, connect with classes and resources or schedule an individualized assessment and treatment through theUAB Medicine Addiction Recovery Program.

Learn more:Discover some of the many ways that UAB faculty and staff aremaking an impact on the opioid crisisin this story from UAB News.

We are all pretty darn jazzed about whats happened in the past few years in terms of developing a new modality for treating cancer we had surgery, we had radiation, we had chemotherapy, but now weve got immunotherapy, Collins said.

Educating immune system cells to go after cancer in therapies such as CAR-T cell therapy is the hottest science in cancer, he said. I would argue this is a really exciting moment where the oncologists and the immunologists together are doing amazing things.

Immunotherapy at UAB:I had to say something about immunology since Im at UAB given that Max Cooper, whojust got the Lasker Awardfor [his] B and T cell discoveries, was here, Collins said. This is a place I would hope where lots of interesting ideas are going to continue to emerge.

Join in:The ONeal Comprehensive Cancer Center at UAB is participating in a number of clinical trials of immunotherapies.Search the latest trials at the Cancer Centerhere.

Learn more:Luciano Costa, M.D., Ph.D., medical director of clinical trials at the ONeal Cancer Center, discusses the promise ofCAR-T cell therapy in this UAB MedCast podcast.

Assistant Professor Ben Larimer, Ph.D., is pursuing a new kind of PET imaging test that could give clinicians afast, accurate picture of whether immunotherapy is workingfor a patient in this UAB Reporter article.

The All of Us Research Program from NIH aims to enroll a million Americans to move away from the one-size-fits-all approach to medicine and really understand individual differences, Collins said. The program, which launched in 2018 and is already one-third of the way to its enrollment goal, has a prevention rather than a disease treatment approach; it is collecting information on environmental exposures, health practices, diet, exercise and more, in addition to genetics, from those participants.

All of Us at UAB:UAB has been doing a fantastic job of enrolling participants, Collins noted. In fact, the Southern Network of the All of Us Research Program, led by UAB, has consistently been at the top in terms of nationwide enrollment, as School of Medicine Dean Selwyn Vickers, M.D., noted in introducing Collins.

Join in:Sign up forAll of Usat UAB today.

Learn more:UABs success in enrolling participants has led to anew pilot study aimed at increasing participant retention rates.

Rare Disease Day, on Feb. 29, brought together hundreds of rare disease research advocates at the NIH, Collins said. NIH needs to play a special role because many diseases are so rare that pharmaceutical companies will not focus on them, he said. We need to find answers that are scalable, so you dont have to come up with a strategy for all 6,500 rare diseases.

Rare diseases at UAB: The Undiagnosed Diseases Network, which includes aUAB siteled by Chief Genomics Officer Bruce Korf, M.D., Ph.D., is a national network that brings together experts in a wide range of conditions to help patients, Collins said.

Participants in theAlabama Genomic Health Initiative, also led by Korf, donate a small blood sample that is tested for the presence of specific genetic variants. Individuals with indications of genetic disease receive whole-genome sequencing. Collins noted that lessons from the AGHI helped guide development of the All of Us Research Program.

Collins also credited UABs Tim Townes, Ph.D., professor emeritus in the Department of Biochemistry and Molecular Genetics, for developing the most significantly accurate model of sickle cell disease in a mouse which has been a great service to the [research] community. UAB is now participating in anexciting clinical trial of a gene-editing technique to treat sickle cellalong with other new targeted therapies for the devastating blood disease.

Join in:In addition to UABs Undiagnosed Diseases Program (which requires a physician referral) and the AGHI, patients and providers can contact theUAB Precision Medicine Institute, led by Director Matt Might, Ph.D. The institute develops precisely targeted treatments based on a patients unique genetic makeup.

Learn more:Discover how UAB experts solved medical puzzles for patients by uncovering anever-before-described mutationandcracking a vomiting mysteryin these UAB News stories.

We know that science, like everything else, is more productive when teams are diverse than if they are all looking the same, Collins said. My number one priority as NIH director is to be sure we are doing everything we can to nurture and encourage the best and brightest to join this effort.

Research diversity at UAB:TheNeuroscience Roadmap Scholars Programat UAB, supported by an NIH R25 grant, is designed to enhance engagement and retention of under-represented graduate trainees in the neuroscience workforce. This is one of several UAB initiatives to increased under-represented groups and celebrate diversity. These include several programs from theMinority Health and Health Disparities Research Centerthat support minority students from the undergraduate level to postdocs; thePartnership Research Summer Training Program, which provides undergraduates and especially minority students with the opportunity to work in UAB cancer research labs; theDeans Excellence Award in Diversityin the School of Medicine; and the newly announcedUnderrepresented in Medicine Senior Scholarship Programfor fourth-year medical students.

Join in:The Roadmap program engages career coaches and peer-to-peer mentors to support scholars. To volunteer your expertise, contact Madison Bamman atmdbamman@uab.eduorvisit the program site.

Learn more:Farah Lubin, Ph.D., associate professor in the Department of Neurobiology and co-director of the Roadmap Scholars Program,shares the words and deeds that can save science careersin this Reporter story. In another story, Upender Manne, Ph.D., professor in the Department of Pathology and a senior scientist in the ONeal Comprehensive Cancer Center, explains how students in the Partnership Research Summer Training Program gethooked on cancer research.

In answer to a students question, Collins also shared his advice to young scientists. One suggestion: Every investigator needs to be pretty comfortable with some of the computational approaches to science, Collins said. Big data is here artificial intelligence, machine-learning. We can all get into that space. But its going to take some training, and it will be really helpful to have those skills.

Join in:UAB launched aMaster of Science in Data Scienceprogram in fall 2018.

Learn more:Discover how UAB researchers areusing machine-learning in their labsand toimprove cancer treatment. Those looking for a free introduction cantake advantage of the Data Science Clubfrom UAB IT Research Computing.

See the rest here:
Looking to the future with Dr. Francis Collins - UAB News

Some dog owners are paying bills of up to US$3,000 for stem cell therapy for arthritis and US$7,000 for cardiac procedures that some dogs require as they age. (Rawpixel pic)

PHILADELPHIA: On a follow-up visit after Sophie Cortellinos life-saving cardiac procedure, Dr Anna Gelzer was delighted and family members were relieved to see her responding so well. Sophie agreed, her tail wagging excitedly.

As the nine-year-old boxer lay on a metal table, Gelzer tried to push up her heart rate as part of a stress test following the procedure in August a ventricular ablation for an arrhythmia, or irregular heartbeat, the first performed on a dog in the United States.

You want a cookie? Gelzer teased. Want to go for a walk?

The jagged line tracing Sophies heartbeat on a monitor spiked dramatically but she lay calm and alert, and Gelzer grinned with satisfaction.

Sophie is one of countless ageing American dogs undergoing cardiac treatments, stem cell transplants, tracheal stents, pacemakers and other sophisticated, expensive procedures to prolong their lives.

Owners of the dogs, many of whom have been around long enough to watch children grow up and provide support through countless family joys and traumas, are going to great lengths to prolong their lives, paying bills of up to US$3,000 for stem cell therapy for arthritis and US$7,000 for cardiac procedures like Sophies.

Dogs are like a person, a family member, said Gelzer, cardiology professor at the University of Pennsylvanias School of Veterinary Medicine in Philadelphia.

Nearly half of the nations 77 million pet dogs are aged six or older, a 15% increase since 1987, according to the American Veterinary Medical Association.

Larger breed dogs are considered geriatric at six years old, smaller breeds at seven years old.

Ageing dogs contend with many of the same illnesses as elderly humans, including heart disease, diabetes and senility. Cancer ravages canines at roughly the same rate as humans, striking nearly half of all dogs over age 10, experts say.

In Sophies case, it was an arrhythmia, a condition that has been treated successfully in humans.

In the procedure, a catheter was snaked through blood vessels into her hearts lower chamber, which pumps oxygen-rich blood to the body, and trouble spots were cauterised.

Gelzer was joined in the operation by her counterpart who handles human patients, Drs Cory Tschabrunn, on the Philadelphia campus.Loyal companion

Karen Cortellino, a radiologist, recalled the time nearly a decade ago when she first met Sophie, an eight-month-old puppy who had been rejected by another family.

Sophie has since helped celebrate Cortellinos sons college graduation and her daughters law school commencement, and dressed up as a member of a family wedding party.

When Cortellinos elderly mother moved into their home in Montville, New Jersey, Sophie was her sole companion after others left each morning for work or school.

They were the best of friends. My mom died last May and Sophie was there for that, Cortellino said.

I would definitely sacrifice what I needed to in order for Sophie to have any procedure that would help her live longer but well.

When Sophie collapsed last summer and was diagnosed with an arrhythmia, Gelzer had just won a grant for a clinical trial to test canine ventricular ablations, so this procedure was free.

The eventual cost is likely to be US$5,000-US$7,000, Gelzer said, which Cortellino said she would be absolutely willing to pay if Sophie needs another one.

Her exam completed, Gelzer gladly accepted sloppy kisses from her patient.

There is never a doubt that what we do is meaningful, Gelzer said. You have to enjoy working with the animals and with the owners. I like both very much.

More here:
Dog lovers willing to pay top dollar to keep old dogs alive - Free Malaysia Today

As per the research conducted by Fast. MR, the report titled Canine Arthritis Treatment Market by Treatment Type (Non-steroidal anti-inflammatory Medications (NSAIDs), Opioids and Stem Cell Therapy), By Route of Administration (Oral, and Injectables), By Distribution Channel (Veterinary Hospitals and Clinics, Retail Pharmacies and Online Pharmacies) and By Region (North America, Europe, Asia Pacific, Latin America, Middle East and Africa) Global Market Size, Development, Growth and Demand Forecast, 2018-2027 provides current as well as future analysis of the market by evaluating the major applications, advantages, trends, and challenges. The report dives deeper to produce useful insights into Canine Arthritis Treatment Market such as major global regions and key competitors and strategies that can be used for the entry-level player too.

Get Latest Sample for Canine Arthritis Treatment Market @ https://www.fastmr.com/request-s/100

Overview

Canine arthritis is a result of inflammation of the joints, ligament damage, abnormal cartilage development, or damage caused by trauma in dogs. Usually arthritis problem associated with older dogs, however it may occur at early age of dogs, who are facing bone and joint development problem. Arthritis symptoms include stiffness, lameness, or limping after rest; appetite loss or unusual weight gain; inactivity and sleeping more; reluctance to walk, run or climb stairs; unusual urinating in the house; and irritability and other behavioural changes. Since past, According to the American Pet Products Association (APPA), the adoption of pet animal has been increased at a significant rate, about 68% of U.S. households own at least one pet, which adds up to 60.2 Mn dogs and 47.1 Mn dogs, among other animals. Hence, there is a push to increase the standard of living for pets, including higher quality veterinary products. Further, in 2018, US$72.56 Bn was spent on pets, out of which US$ 33.5 Bn was spent for over-the-counter (OTC) medicine in the U.S. Thus, rising companion animal ownership with increase in spending for pet health is creating a growing demand for canine arthritis drugs.

Rising preference of gynaecologist for genetic testing during pregnancy is expected to propel the canine arthritis treatment market growth.

Significant increase in veterinary therapeutic drugs and veterinary regenerative medicines approvals by FDA to repair damaged organs and tissues in animals is expected to drive the canine arthritis treatment market growth. For instance, in November 2018, Chanelle launched Osteopen (pentosan polysulphate sodium) in the UK and Irish markets. Osteopenia is a semi-synthetic polymer with anti-inflammatory properties and capable of modifying the metabolism of the joint structures, which in turn helps to regenerate damaged joint components and reduces the pain.

Furthermore, increase in prevalence of osteoarthritis in dogs will expected to create a demand for canine arthritis drugs market in near future. According to Veterinary Science Development news, one in four of 77.2 million pet dogs in the U.S. are diagnosed with some form of arthritis.

However, certain risks associated with canine arthritis treatment and lack of awareness may restrain the canine arthritis treatment market growth to some extent.

Canine Arthritis Treatment Market Regional Analysis

On the basis of region, North America is gaining significant traction in the canine arthritis treatment market. This is attributed to increase in consumer spending on pet and easy accessibility of treatment and diagnostic methods. There are about 26,000 small animal veterinary practices in the U.S., according to American Animal Hospital Association (AAHA) and the American Veterinary Medical Association (AVMA) which result in a significant increase in veterinary economy the country.

Europe also contribute noteworthy growth in canine arthritis treatment market owing to launch of new treatment by various pharmaceutical companies for canine arthritis. For instance, on March 2019, Medrego, the manufacturer of veterinary regenerative medicine in Northern Europe has launched new Stem Cell Therapy product-CaniCell which has shown tremendous effects on managing osteoarthritis and other degenerative diseases in dogs.

Key players operating in the canine arthritis treatment markets include, Eli Lilly and Company, Boehringer Ingelheim, Chanelle, Zoetis Inc., Medrego, Vetoquinol S.A., Bayer AG, Aratana Therapeutics Inc., Norbrook Laboratories Limited, VetStem Biopharma, and Dechra Pharmaceuticals Plc, and others.

Canine Arthritis Treatment Market-Taxonomy

By Treatment Type

-Non-steroidal anti-inflammatory medications (NSAIDs)

-Opioids

-Stem Cell Therapy

By Route of Administration

-Oral

-Injectables

By Distribution Channel

-Veterinary Hospitals and Clinics

-Retail Pharmacies

-Online Pharmacies

By Region

-North America

-Europe

-Asia Pacific

-Latin America

-Middle East and Africa

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Canine Arthritis Treatment Market Industry Analysis, Size, Share, Growth, Trends and Forecast 2018 2027 - Posts 99

Dr. Yava Jones-Hall, an associate professor in theDepartment of Veterinary Pathobiology (VTPB)at the Texas A&MCollege of Veterinary Medicine & Biomedical Sciences (CVM), is leading in the field of veterinary medicine as the only veterinarian selected for CrossTalks list of100 inspiring black scientists in America.

CrossTalk is the official blog of Cell Press, a leading publisher of more than 50 scientific journals across the life, physical, earth and health sciences.

We are very happy to see one of our high-caliber faculty members being recognized for their outstanding work, said Carol A. Fierke, Texas A&M University provost and executive vice president.

Jones-Hall is joined on the list by scientists from African, Afro-Caribbean, Afro-Latinx and African-American backgrounds ranging from assistant professors to department heads at universities across the country.

It was surprising and amazing to be selected, especially being a veterinarian, Jones-Hall said. It was nice to see veterinary medicine represented.

The list of inspiring black scientists was created to encourage current and future generations of scientists and emphasize the importance of diversity in the field. CrossTalk clarified that while there are many more than 100 black scientists in the U.S. deserving of recognition, the list was created to provide an example of the impact black scientists can have on America.

Diversity drives excellence in everything that we do as a team, including biomedical education and research, saidDr. Ramesh Vemulapalli, VTPB department head. We are very proud to have Dr. Jones-Hall on our faculty. She is a great role model to minority students aspiring to pursue a career in veterinary medicine.

I definitely see diversity in veterinary medicine as an important concept, Jones-Hall said. The reality is, the world is not homogenous. We need our students to be exposed to working with different types of people to have cultural sensitivity and understand that not everybody is like you. Also, once you have diversity within any program, you get diverse ideas.

While earning her Doctor of Veterinary Medicine (DVM) degree at the Tuskegee University College of Veterinary Medicine, Jones-Hall was introduced to the field of patholog they, study of the causes and effects of disease. Once she saw how seamlessly pathology combines with collaborative research, she was hooked.

As a veterinary pathologist, Im trained to understand disease in any organ in a multitude of species, Jones-Hall said. Whatever field of research an investigators in, I help them figure out how best a pathologist can tease out the data for them to see whats happening and how best to frame the research.

Considering herself a veterinary detective, Jones-Hall helps researchers look at clues in cells and body tissues to find the best way for the research to progress. Working on a variety of research topics, and never knowing what will come through the door next, are what make the field of pathology so appealing to her.

Jones-Hall joined the CVM from the Purdue University College of Veterinary Medicine last August and, as the sirector ofCVMs Histology Laboratory, began the project of creating a digital pathology program to increase the efficiency and accuracy of one of a pathologists typical jobs analyzing slides of cells to count those of the same kind.

Traditionally, pathologists would look at the slide under the microscope and give a subjective assessment of disease, Jones-Hall said. Digital pathology augments traditional pathology by allowing the pathologist to use computer-generated algorithms to assess disease. This gives objective, quantifiable, and repeatable results. Whereas it would take me weeks to look at hundreds of slides, I scan the slides to make a digital image and direct a computer program to find the cells of interest or disease state. Hundreds of slides can now be analyzed in hours instead of weeks.

Outside of the lab, Jones-Hall donates much of her spare time to volunteering for community outreach efforts and taking any opportunity she can to promote STEM careers, and specifically veterinary medicine, to disadvantaged youth.

She is also a member of Texas A&Ms STRIDE (Strategies and Tactics for Recruiting to Improve Diversity and Excellence) Committee, leading workshops for faculty members involved in faculty recruitment.

Diversity is important, in general, and its important to me, so Im willing to do more in order to improve the climate and increase everyones awareness she said.

Jones-Hall hopes that her recognition from CrossTalk can inspire others to spend their careers thinking not only of themselves, but also those who may not have had the same advantages.

The CVM is extremely proud of Dr. Jones-Hall for her accomplishments as an individual and as the only veterinarian to appear on the list of 100 inspiring black scientists, saidDr. Eleanor M. Green, the Carl B. King Dean of Veterinary Medicine. The work she does within and outside of the university will undoubtedly make a huge impact, both for the college and within the community, as she demonstrates the possibilities for budding scientists from all backgrounds.

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Researcher, Dr. Yava Jones Hall, named to a list of inspiring scientists - Jill Lopez

"When she said she wanted to give it out. We said to her, 'What do you want to do with it', and she said 'I want to give it to people who can't get some',"Petrina McGuire, Addyson's mother toldToday.

"That's when we came up with the pensioners cottages. We only live around the corner. That's when we decided to pack it in the cart and brought it around," she added.

On Sunday night, 86,174 people packed out the MCG to watch the Australian women's cricket team play in the Twenty20 World Cup final.

It broke records for being the highest ever attendance for a female sporting event in Australia. Ever.

THANK YOU AUSTRALIA!

Everyone at the MCG tonight has helped break the record for the highest ever attendance for a women's sporting event in Australia. pic.twitter.com/H2e3r3pfDn

Australian Women's Cricket Team ???? (@AusWomenCricket) March 8, 2020

The total beat the estimated 80,000 who watched Australia win the 1997 ODI World Cup final in Kolkata, the previous record.

This is huge.

A man in London, 40-year-old Adam Castillejo, has become the second person globally to be cured of HIV.

The Lancet HIV journal reports he was cured by a stem-cell treatment he received for a cancer he also had.

In 2011, Timothy Brown became the first person reported as being cured of HIV a few years after having a similar treatment.

BBC reports stem-cell transplants appear to stop the virus replicating inside the body by replacing the patient's own immune cells with donor ones that resist HIV infection.

A good news round-up wouldn't be complete without some animal news.

A pizza franchise in New York is warming hearts by raising awareness of shelter dogs in need of a home by putting their photos on pizza boxes.

Just Pizza & Wing Co. has teamed up withNiagara Society for the Prevention of Cruelty to Animals(SPCA) and it's already resulted in an adoption.

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From the loo roll girls to our women's cricket team: Just 7 good news stories to make you smile. - Mamamia

By Sisonke Mlamla Mar 2, 2020

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Cape Town - There were emotional scenes in the Wynberg Magistrates Court on Monday, as a 23-year-old man who confessed to murdering 12-year-old Sibusiso Dakuse in Hout Bay made his first appearance.

Marvin Minnaar, a basketball coach at Sentinel High School in Hout Bay, is accused of kidnapping Sibusiso before murdering him last week and was charged with murder. The State revealed that Minnaar made a full confession and was caught on video walking to the crime scene between the reeds on Kronendal Farm.

Hout Bay residents filled Court Four, where Minnaar made his brief appearance dressed in a red and white sweater with navy pants.

Sibusiso's mother Yonelisa Dakuse was overcome with emotion during court proceedings, and looked on as the accused was led down to the holding cells after his appearance.

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Minnaar is expected back in court on March 17 for his profile to be reviewed and for a regional court date to be set.

National Prosecuting Authority spokesperson Eric Ntabazalila said the investigation is continuing and the accused might be facing more charges. "His case has been postponed to March 17 for the State to get a full bail profile of the accused and for him to give instructions to his Legal Aid lawyer."

Ntabazalila said Minnaar hasn't applied for bail yet but if he does the State would oppose it, and added that the accused was charged with murder only for now.

Luthando Stokwe, Sibusiso's uncle said he wished for a thorough investigation of the case, and added: "Apparently Minnaar was not alone on this. He was with his friends."

A Grade 7 pupil at Sentinel Primary School - the same school where Minnaar works - Sibusiso went missing after leaving his Mandela Park home to play with his friends on Wednesday last week.

Police spokesperson Novela Potelwa said the suspect was arrested on Saturday. "He was the last person seen with the boy," she said.

Social Development MEC Sharna Fernandez said every time a child is murdered, the entire community is affected.

"Right now, several of our communities are facing immense trauma. Assisting these communities during this difficult time is the Social Development departments top priority."

Fernandez said over the past weekend two children, Sibusiso, who was recently enrolled in Kronendal Music Academy, and Reagan Gertse, a seven-year-old boy whose body was found in a Tulbagh river, were murdered.

"This while our communities are still mourning the death of Tazne van Wyk, the 8-year-old-girl from Elsies River, and the 7-year-old-girl, Emaan Solomons who was killed during a gang shooting."

"In most of these cases, the alleged perpetrators are people who were known to the children. This is why we appeal to the whole of society communities, government departments, and NGOs to partner with us in driving child protection 365 days a year," Fernandez said.

She said violence against children has crossed all boundaries in our society and is fast becoming normalised.

"Reports indicate that violence during childhood is widespread, with 42% of children reporting some form of maltreatment in the first national prevalence study."

[emailprotected]

Cape Argus

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WATCH: Sibusiso Dakuse's mom overcome with emotion as his alleged killer appears in court - IOL

A synopsis of the global canine stem cell therapy market with reference to the global healthcare pharmaceutical industry

Despite the economic and political uncertainty in the recent past, the global healthcare industry has been receiving positive nudges from reformative and technological disruptions in medical devices, pharmaceuticals and biotech, in-vitro diagnostics, and medical imaging. Key markets across the world are facing a massive rise in demand for critical care services that are pushing global healthcare spending levels to unimaginable limits.

A rapidly multiplying geriatric population; increasing prevalence of chronic ailments such as cancer and cardiac disease; growing awareness among patients; and heavy investments in clinical innovation are just some of the factors that are impacting the performance of the global healthcare industry. Proactive measures such as healthcare cost containment, primary care delivery, innovation in medical procedures (3-D printing, blockchain, and robotic surgery to name a few), safe and effective drug delivery, and well-defined healthcare regulatory compliance models are targeted at placing the sector on a high growth trajectory across key regional markets.

Parent Indicators Healthcare Current expenditure on health, % of gross domestic product Current expenditure on health, per capita, US$ purchasing power parities (current prices, current PPPs) Annual growth rate of current expenditure on health, per capita, in real terms Out-of-pocket expenditure, % of current expenditure on health Out-of-pocket expenditure, per capita, US$ purchasing power parity (current prices, current PPPs) Physicians, Density per 1000 population (head counts) Nurses, Density per 1000 population (head counts) Total hospital beds, per 1000 population Curative (acute) care beds, per 1000 population Medical technology, Magnetic Resonance Imaging units, total, per million population Medical technology, Computed Tomography scanners, total, per million population

Research Methodology

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XploreMR utilizes a triangulation methodology that is primarily based on experimental techniques such as patient-level data, to obtain precise market estimations and insights on Molecule and Drug Classes, API Formulations and preferred modes of administration. Bottom-up approach is always used to obtain insightful data for the specific country/regions. The country specific data is again analysed to derive data at a global level. This methodology ensures high quality and accuracy of information.

Secondary research is used at the initial phase to identify the age specific disease epidemiology, diagnosis rate and treatment pattern, as per disease indications. Each piece of information is eventually analysed during the entire research project which builds a strong base for the primary research information.

Primary research participants include demand-side users such as key opinion leaders, physicians, surgeons, nursing managers, clinical specialists who provide valuable insights on trends and clinical application of the drugs, key treatment patterns, adoption rate, and compliance rate.

Quantitative and qualitative assessment of basic factors driving demand, economic factors/cycles and growth rates and strategies utilized by key players in the market is analysed in detail while forecasting, in order to project Year-on-Year growth rates. These Y-o-Y growth projections are checked and aligned as per industry/product lifecycle and further utilized to develop market numbers at a holistic level.

On the other hand, we also analyse various companies annual reports, investor presentations, SEC filings, 10k reports and press release operating in this market segment to fetch substantial information about the market size, trends, opportunity, drivers, restraints and to analyse key players and their market shares. Key companies are segmented at Tier level based on their revenues, product portfolio and presence.

Please note that these are the partial steps that are being followed while developing the market size. Besides this, forecasting will be done based on our internal proprietary model which also uses different macro-economic factors such as per capita healthcare expenditure, disposable income, industry based demand driving factors impacting the market and its forecast trends apart from disease related factors.

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Standard Report Structure Executive Summary Market Definition Macro-economic analysis Parent Market Analysis Market Overview Forecast Factors Segmental Analysis and Forecast Regional Analysis Competition Analysis

Target Audience Production Companies Suppliers Channel Partners Marketing Authorities Subject Matter Experts Research Institutions Financial Institutions Market Consultants Government Authorities

Market Taxonomy

The global canine stem cell therapy market has been segmented into:

Product Type: Allogeneic Stem Cells Autologous Stem cells

Application: Arthritis Dysplasia Tendonitis Lameness Others

End User: Veterinary Hospitals Veterinary Clinics Veterinary Research Institutes

Region: North America Latin America Europe Asia Pacific Japan Middle East & Africa

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Canine Stem Cell Therapy Market Will Make a Huge Impact in Near Future - News Times

A collection of photos through a microscope by Rob Kesseler titled World Within on display in the Bioscience Research Building on March 3, 2020. (Joe Ryan/The Diamondback)

Views expressed in opinion columns are the authors own.

Science can sometimes seem incomprehensible. I would know. Even after three years of taking college-level science classes organic chemistry, neurobiology, you name it Im still stumped by some of the scientific literature out there. I can only imagine how non-scientists must feel.

Science needs to be more accessible to the public, and art has the potential to accomplish that. By conveying scientific information in a form thats easy to consume from photography to drawing and painting we can make science less intimidating and promote open discussion about important issues.

For instance, regular dwellers of the University of Marylands Bioscience Research Building may have noticed Worlds Within,an installation that displays artist Rob Kesselers micrographs of plant cells, pollen, seeds and other internal plant organs. Normally, the recurring patterns found in cells are difficult to view without a microscope. Through his art, however, Kesseler has made the natural worlds hidden geometry visible to anyone passing through the building. No need for lab equipment or elaborate jargon that requires a doctorate in biology to understand. Just one photo and youre hooked.

In addition to making science more inviting to general audiences, art can spark empathetic conversations about scientific problems. For example, I recently attended an exhibition at the Stamp Gallery called Neuro Blooms. Artist Leslie Holt uses embroidery threads and acrylic paint to recreate PET scans of brains experiencing different mental illnesses.

What I found so wonderful about Holts exhibit was the blending of science and art in an effort to destigmatize mental illness, something neither discipline can effectively do on its own. Even thoughone in five U.S. adults struggles with mental illnesses each year, many people dont consider them legitimate medical disorders. Theyre often judged as a make-believe feeling in someones head rather than a matter rooted in science. If we can visualize the science behind mental illness, perhaps we will be better equipped to offer acceptance and empathy to people with these conditions.

The visual element of these exhibitions conveys a much stronger message to general audiences than most scientific articles. And if you can reach a broader audience, you can make a bigger change. Art affects not just what we think about scientific issues, but also how we think about them. Just as Neuro Blooms visualizes the reality of otherwise invisible mental illnesses, Worlds Within demonstrates natures microscopic beauty in an unconventional way. And although esoteric terms and complex formulas certainly have a time and place, making scientific information purposefully hard to understand would be a public disservice.

I appreciate this universitys effort to display science-related art. These exhibitions represent a step toward increasing accessibility, especially for people who normally feel overwhelmed by science. As an educational institution, the university has a duty to promote sharing of ideas among diverse groups of people. Generating a balanced dialogue between the scientific community and the public is vital for maintaining perspective on both ends.

Allison Cochrane is a junior biology major. She can be reached atallisonc@umd.edu.

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UMD's science-related art is a positive interaction between STEM and humanities - The Diamondback