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Archive for November 9, 2012

Braised Brisket

Braised Brisket

Ingredients

  • 1 5-pound beef brisket, preferably flat-cut, halved crosswise
  • 2 tablespoons kosher salt
  • 1 dried ancho chile
  • 1 cup all-purpose flour
  • 4 tablespoons olive oil, divided
  • 10 garlic cloves
  • 2 cups hot coffee
  • 2 cups tomato juice
  • 1/2 cup dry red wine
  • 1/4 cup balsamic vinegar
  • 1/4 cup fresh lime juice
  • 1/4 cup reduced-sodium soy sauce
  • 1 teaspoon freshly ground black pepper
  • 1 teaspoon granulated garlic
  • 1 teaspoon onion powder
  • 1 teaspoon Worcestershire sauce
  • Chopped flat-leaf parsley
  • Finely grated lemon zest
  • Ingredient Info

    Dried ancho chiles are available at Latin markets, specialty foods stores, and many supermarkets.

Preparation

  • Preheat oven to 300°. Season brisket with salt; let sit at room temperature for 1 hour.
  • Meanwhile, place ancho chile in a small bowl. Cover with hot water; let stand to soften, about 30 minutes. Drain, reserving soaking liquid. Stem, seed, and mince chile.
  • Place flour in a 13x9x2-inch baking dish. Heat 2 tablespoons oil in a large skillet over medium-high heat. When oil begins to smoke, dredge 1 piece of brisket in flour; shake off excess. Add to skillet and cook until deep golden brown, about 4 minutes per side. Place fat side up in a large deep roasting pan. Repeat with remaining 2 tablespoons oil and brisket.
  • Reduce heat to medium. Add garlic; stir until beginning to brown, about 3 minutes. Add coffee, next 9 ingredients, and minced chile with soaking liquid to skillet; increase heat and bring to a boil. Pour over brisket in pan. Cover pan tightly with foil.
  • Braise brisket until tender, about 3 hours. Uncover and let cool slightly. Chill until cold, then cover and chill overnight. DO AHEAD Brisket can be made 3 days ahead. Keep chilled.
  • Discard fat from surface of braising liquid. Transfer brisket to a cutting board and thinly slice against the grain. Return brisket to roasting pan. Set pan over 2 burners at medium heat. Cover; simmer until heated through. Transfer brisket to a platter. Sprinkle parsley and lemon zest over. Pour pan juices into a pitcher and serve alongside.

Bonappetit

Insect-eating sundew plant heals wounds

Close up of Sundew planet (Copyright: SPL)(Copyright: SPL)

A killer plant with a cunning trick could one day be routinely used in a series of medical procedures, research shows.

The sundew plant is aptly named. Each leaf is covered with tiny hairlike-tentacles, on the tip of which is a drop of what looks like morning dew. In the sun, these droplets glisten and gleam, but they also conceal a carefully laid trap.

What appears to be dew is actually a sticky adhesive, and any insect that alights on a sundew leaf will promptly find itself stuck. As it struggles to escape, the plant’s tentacles and leaves curl around the insect, before the carnivorous plant slowly digests its prey.

But now, the sundew may have a role to play in rebuilding bodies as well as dismantling them. Research, carried out by Mingjun Zhang, a biomedical engineer at the University of Tennessee, Knoxville, has shown the plant’s sticky adhesive may be suitable for a variety of cutting-edge medical procedures, including tissue engineering and chronic wound healing.

The emerging field of tissue engineering represents a new approach for replacing or repairing damaged body parts. The idea is to deliver a teeming mass of healthy, say, nerve, bone, or muscle cells to the site of a nerve, bone, or muscle injury, and hope the new cells integrate themselves into the body as healthy, functional tissue.

But doctors can’t just inject a solution of cells into the body and expect new tissue to grow. Cells do best when they have a surface to adhere to a “scaffold” to which they can anchor themselves as they proliferate and differentiate. So in tissue engineering procedures, cells are applied to one of these scaffolds—which come in a variety of materials and forms, including sponges, meshes, films, and gels. Then the whole construct is implanted or injected into the body. As the cells begin to multiply, the scaffold provides a literal support structure, facilitating cell growth and communication. Eventually, the biodegradable scaffold disintegrates into the body, leaving behind a sheet of brand new tissue.

‘Goldilocks effect’

Scaffolds need to meet many criteria, and engineers have spent a lot of time looking for just the right material. “This has been a major challenge,” says Zhang, whose lab specializes in bio-inspired engineering. As he scoured the natural world for a substance that might make a good cell scaffold, he began to think that the gluey, gelatinous substance secreted by sundews might fit the bill.

The material is natural and biodegradable, composed of a combination of sugars and acids. It is, of course, sticky, which means it should be able to tightly grip cells. And it’s highly elastic, which is crucial for tissue engineering; a scaffold has to be flexible enough to bend and stretch and shift as cells proliferate and tissues grow.

The more closely Zhang examined the sundew adhesive, the more suitable it seemed. For a study he published in 2010, he coated a silicon wafer with the sundew adhesive and let the material dry for 24 hours. Then he stuck the wafer under a microscope. What he saw thrilled him – the dried adhesive was composed of a complex network of nanofibers, linked and crosslinked to form a porous scaffold. What’s more, he discovered that the holes in the scaffold were a Goldilocks-like “just right” neither too large nor too small, but the perfect size for cell attachment. From a tissue engineering perspective, Zhang says, the structure left behind by the dried adhesive had “a beautiful morphology”.

Then it was time for an even bigger test. Zhang smeared the sundew material onto glass slides and seeded the adhesive with living cells derived from the brains of rats. Twenty-four hours later, he returned to the slides. The cells had attached; an average of 1250 cells had colonized each square millimeter of the adhesive. Around 98% of the cells were viable, and they were stuck on securely they stayed put even when Zhang tried to rinse them off. In a 2011 paper, Zhang showed that neurons attached to the sundew adhesive were capable of dividing and differentiating and that bone and skin cells also successfully adhere to the material.

The findings have convinced Zhang that the sundew adhesive is a good starting point for a variety of tissue engineering applications. He thinks engineers could modify and process the material into an implantable or injectable scaffold. Alternately, Zhang imagines brushing a mixture of liquid sundew adhesive and skin or stem cells onto the surface of a chronic, open wound. The sundew material would serve as a scaffold as the cells grew into a new, healthy layer of skin.

The sundew adhesive may also have a role to play in routine medical implant procedures, Zhang says. For instance, it could be brushed onto the surface of an artificial knee or hip, fostering a secure attachment between the implant and the living tissues surrounding it. Down the line, we may find that the best way to put human bodies back together is to borrow from a predatory plant. “Nature does beautiful things,” Zhang says. “We should definitely learn from that.”

BBC

Royal Marine stress training for Cardiff hospital staff


Staff have had training similar to that used by marines to deal with “mental rigours” of their day to day role

 
Techniques developed by the Royal Marines on how to deal with stress are being used by hospital staff working in an accident and emergency (A&E) unit.

It is part of a year-long pilot scheme at Cardiff’s University Hospital of Wales (UHW).

Staff have had training similar to that used by marines to deal with “mental rigours” of their day to day role.

It comes after 83% of A&E UHW staff said they needed more support to deal with work-related stress and anxiety.

A staff survey also revealed one in three said they had faced on-going difficulties at work and at home following traumatic experiences.

Under the scheme, which coincides with National Stress Awareness Day, staff can anonymously and confidentially report any problems to trained colleagues.

Wayne Parsons
Wayne Parsons suffered with post-traumatic stress after witnessing the death of two children

 
Staff will also be trained to spot potential signs of stress and anxiety in colleagues and deal with it appropriately.

Neil Roberts, a consultant clinical psychologist at Cardiff and Vale University Health Board said: “We think this is the first time that it has been used in an emergency medicine environment.

“It was developed by the Royal Marines and has been used by a number of police forces and fire services too and helps staff identify the signs of stress and trauma in colleagues and equips them to engage with them, offering support or helping them to access other support services within the health board, if needed.”

Senior nurse Wayne Parsons suffered with post-traumatic stress after witnessing the death of two children.

“I don’t think you realise you’re under pressure,” he said.

“It tends to be other people who notice. You can see horrendous things, look after horrendous injuries, things that are everyday life in the emergency unit.”

TRAINING STAGES

  • Increase staff awareness of what might be signs of stress and trauma-type reaction
  • Practise in role play how they would deal with the situation as if it was a real life scenario
  • How to apply the model in the department’s working environment

Mr Parsons said it often takes an insignificant trigger for staff to “lose it”.

Too late

“So it’s a case of realising there’s a build up of stress and pressure on yourself I didn’t notice until it was too late,” he said.

“Had the scheme been in place I don’t think I would have needed to take the time off.”

Staff nurse Sue Wood has been put through the marine-style training. She was on duty when a driver went on a hit-and-run spree in Ely, Cardiff, last month, killing Karina Menzies and injuring 13 people.

“Thankfully those kinds of incidents are rare,” she said.

“But we see very difficult things on a daily basis, serious injuries like traffic accidents or someone being run over by a tractor.

“Getting on with it has always been the attitude in A&E, but it does affect us, we’re still human. We need to have a vent.”

Around 400 to 450 people a day attend A&E, according to staff.

Ewan Hilton, executive director of mental health charity Gofal welcomed the move by the hospital.

“Creating a culture where people feel confident to talk about their mental health and better informed to support each other can only be a positive thing for individual staff members, patients and the department as a whole,” he said.

“The Welsh government’s new strategy ‘Together for Mental Health’ makes it clear that every person, organisation and sector has an important role to play in improving mental health and wellbeing.

“As well as the obvious human and social costs, it is estimated that mental health problems cost the Welsh economy £7.2bn every year, and we encourage all employers to make staff mental health and wellbeing a priority.”

BBC

Fertility ‘predicted by mother’s age at menopause’

pregnant woman
Fertility peaks between 18 and 31 years of age, say experts

Women may be able to better gauge their own fertility based on the age their mother went through the menopause, a study has concluded.

Women whose mothers had an early menopause had far fewer eggs in their ovaries than those whose mothers had a later menopause, a Danish team found.

Women with fewer viable eggs have fewer chances to conceive.

The study, of 527 women aged between 20 and 40, was reported in the journal Human Reproduction.

Ovarian reserveResearchers looked at two accepted methods to assess how many eggs the women had – known as their “ovarian reserve” – levels of anti-Mullerian hormone (AMH) and antral follicle count (AFC).

Currently there is no test that can accurately predict fertility”

Dr Valentine Akande British Fertility Society

Women are born with all the eggs they will ever have. These are released from the ovary cyclically, usually one every month after puberty, until menopause.

The AFC and AMH give readings doctors an idea of how many yet-to-be released eggs remain in the ovary.

In the study of female healthcare workers, the researchers found both AMH and AFC declined faster in women whose mothers had an early menopause (before the age of 45) compared to women whose mothers had a late menopause (after the age of 55).

Average AMH levels declined by 8.6%, 6.8% and 4.2% a year in the groups of women with mothers who had early, normal or late menopauses, respectively.

A similar pattern was seen for AFC, with annual declines of 5.8%, 4.7% and 3.2% in the same groups, respectively.

Start youngPast research suggests there is about 20 years between a woman’s fertility starting to decline and the onset of menopause. So a woman who enters the menopause at 45 may have experienced a decline in her fertility at the age of 25.

Lead researcher Dr Janne Bentzen said: “Our findings support the idea that the ovarian reserve is influenced by hereditary factors. However, long-term follow-up studies are required.”

Also, having fewer eggs does not necessarily mean that the woman will go on to have fewer babies.

Dr Valentine Akande, a consultant gynaecologist and spokesman for the British Fertility Society, said the findings were helpful, but that women should not be overly concerned if their mother did have an early menopause.

“There is a huge amount of variation among women. Some will have more eggs and some will have less.

“Whilst it is assumed that lower egg number is associated with more challenges at getting pregnant this study did not look at that.

“Currently there is no test that can accurately predict fertility.

“The advice remains the same – the younger you start trying for a baby the more likely you are to be successful.”

He said, in general, women are most fertile between the ages of 18 and 31.

BBC

Concern over ‘souped up’ human race

Neural connections in brain
Medicine and technology can enhance the way our minds function, but at what cost?

A race of humans who can work without tiring and recall every conversation they’ve ever had may sound like science fiction, but experts say the research field of human enhancement is moving so fast that such concepts are a tangible reality that we must prepare for.

People already have access to potent drugs, originally made for dementia patients and hyperactive children, that boost mental performance and wakefulness.

Within 15 years, experts predict that we will have small devices capable of recording our entire life experience as a continuous video feed – a life log that we can reference when our own memory fails.

There are a range of technologies in development and in some cases already in use that have the potential to transform our workplaces – for better or for worse”

Prof Genevra Richardson Chairwoman of the steering committee of the joint report

Advances in bionics and engineering will mean we could all boast enhanced night vision allowing us to see clearly in the dark.

While it may be easy to count the potential gains, experts are warning that these advances will come at a significant cost – and one which is not just financial.

Potential harmFour professional bodies – the Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society – say that while human enhancement technologies might improve our performance and aid society, their use raise serious ethical, philosophical, regulatory and economic issues.

In a joint report, they warn that there is an “immediate need” for debate around the potential harms.

Chairwoman of the report’s steering committee Prof Genevra Richardson said: “There are a range of technologies in development and in some cases already in use that have the potential to transform our workplaces – for better or for worse.”

There may be an argument for lorry drivers, surgeons and airline pilots to use enhancing drugs to avoid tiredness, for example.

But, in the future, is there a danger that employers and insurers will make this use mandatory, the committee asks.

CoercionAs our population ages, it is accepted that we will all be expected to work further into old age.

Human enhancement could enable older workers to keep pace with younger colleagues.

But there is also the risk that those who fail to join the technological elite would be sidelined as dinosaurs, says Prof Jackie Leach Scully, professor of social ethics at Newcastle University’s Policy, Ethics & Life Sciences Research Centre.

‘Smart’ pills

pills
  • Improve memory and mental performance
  • One commonly used “smart” drug is modafinil (brand name Provigil), which is normally prescribed for sleep disorders
  • Another is the drug methylphenidate (brand name Ritalin), which is given to people with ADHD

Several surveys reveal that many students now use brain-enhancing “smart” pills to help boost their exam grades, which raises the question about whether colleges and universities should insist candidates are “clean” in the same way that Olympic athletes have to prove they are drug-free to compete.

Many people buy them over the internet, which is risky because they don’t know what they’re getting.

And we know little about their long-term effects on healthy, young brains.

Dr Robin Lovell-Badge, of the Medical Research Council and who chaired one of the workshop sessions that formulated the report, said: “It was clear from discussions that cognitive-enhancing drugs present the greatest immediate challenge for regulators and other policymakers.

“They are simple to take, already available without prescription, and are increasingly being used by healthy individuals.

“However, other forms of enhancement, including physical methods, will follow. Some were on show at the Paralympics, some are being explored by the military and others may become a serious option in the clinic in the not too distant future.

“It is good to see and to be excited by many of these developments, but there must be an equally watchful eye and care taken to ensure that the workforce can capitalise on the benefits, but not suffer the harms that could come about by their inappropriate use.”

BBC

Virtual reality surgery software to aid trainee surgeons

Virtual reality surgery
The interactive system allows medical students to perfect surgical techniques

The first virtual 3D surgical program to train doctors has been developed by the Golden Jubilee National Hospital.

Medical students can now practise surgical techniques on 3D models and animations instead of working on cadavers or dummies.

The interactive system allows students to repeat techniques several times, and at their own pace.

Potential future uses could include helping patients understand their diagnosis and treatment options.

Attending the launch, Health Secretary Alex Neil said: “This is a really exciting development which shows how new technology can be used to help improve care and treatment for Scottish patients.

“I was delighted to visit the Golden Jubilee to see first-hand how this innovative technique will help to train our doctors of the future.

“I look forward to seeing how it develops, and how it can be rolled out further to train more doctors in more specialties.”

The training is currently being used within the Golden Jubilee’s Enhanced Recovery Programme, for teaching on knee anatomy and regional anaesthesia.

It could potentially be used for training in other specialties.

The project was developed by Dr Robert Robi Zimmer, a consultant anaesthetist at the hospital’s orthopaedic service, and a software development consultant.

Dr Zimmer said: “As a national resource for the NHS in Scotland, with our own specialist research and clinical skills facility, it is important that we are at the forefront in delivering new and innovative training programmes.

“The 3D training programme is currently in its infancy but the opportunities are limitless and that is something which will benefit patients across Scotland.

“We hope that it will improve people’s understanding and visualisation of the body’s anatomy and in the future can be taken from the training room to the consulting room to educate our patients about their condition and treatment.”

The Golden Jubilee National Hospital in Clydebank is home to regional and national heart and lung services, a major centre for orthopaedics and is also the flagship hospital for reducing waiting times in key elective specialties.

BBC

廖中萊:抽檢其中11樣本未出爐‧“金鳳凰31樣本安全"

(吉隆坡8日訊)衛生部長拿督斯里廖中萊表示,截至今午為止,當局在化驗金鳳凰(Ayamas)31份樣本的結果中發現,該產品不含氯霉素(Chloramphenicol)抗生素。

廖中萊說,這起事件在11月2日爆發後,他已馬上指示衛生部的食品安全組,到工廠索取15份樣本及市場16份樣本,進行化驗。

“今午為止,31份樣本經化驗不含氯霉素,不過,我們會繼續化驗餘下的11份樣本,並在過後公佈化驗報告。"廖中萊今日在下議院代表部門為2013年財政預算案的部門委員會辯論進行總結時表示,他已指示衛生總監拿督斯里哈山阿都拉曼,針對此事發表文告。

他指出,砂拉越獸醫局是於8月份索取金鳳凰品牌產品進行化驗,但是卻在11月份公佈化驗報告內容,指金鳳凰品牌產品含有過量抗生素。

未來與獸醫局合作化驗

他指出,未來衛生部將與獸醫局合作,針對所採集的樣本進行化驗。

“若有投報我們應該馬上展開調查,以及儘快公佈化驗報告,同時我們需要緊密監督。"

他表示,衛生部有本身的化驗食品系統,不過,衛生部日後將尋求獸醫局的合作。

針對公正黨務邊區國會議員李文材不滿砂州獸醫局拖延約3個月後才公佈化驗結果,並指這些含有過 量抗生素的金鳳凰品牌產品可能不僅流傳到砂州市場,也流傳到其他地方,將危害人體健康一事,廖中萊回應說,所有生產食品的廠商擁有一套標準作業程序,確保 所有產品具有高素質,而衛生部擁有本身的機制,以監督國內的食品廠商。

“衛生部通過食品安全組不時監督食品的源頭以及零售鏈,不過,若是從零售鏈展開調查可能為時已晚,因為產品已在市場出售。"

將鑑定中3大學醫學學術

衛生部長拿督斯里廖中萊透露,醫療技術認可委員會將拜訪3所中國大學醫學系以進行學術鑑定,希望能儘快承認有關大學的醫學文憑。

他表示,由衛生部、高教部、公共服務委員會、國家學術資格鑑定機構以及大馬醫藥理事會組成的醫療技術認可委員會,衛生部、高教部以及公共服務委員會將組團到中國拜訪3所大學。

較早前,廖中萊指出,我國有很多學生在中國唸醫學系,因此希望通過學術認可,讓這些畢業生能在返回大馬後提供最好的服務。

另一方面,廖中萊透露,人才機構已成功號召在國外服務的88名大馬醫生回國服務,相信在年杪將有更多大馬醫生返回大馬工作。

他指出,去年共有60名大馬醫生回流大馬,今年有28人,大部份的醫生是在私人醫院服務。

星洲日報

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