Face transplant surgeons herald the dawn of “a new era in transplant surgery”

Surgeons for the firefighter Patrick Hardison, who last year underwent the most extensive face transplant in history, have heralded the dawn of a new era in transplant surgery after reporting extremely successful results from the procedure.

“We have entered a new era in transplant surgery,” said Dr Eduardo D Rodriguez, chair Hansjörg Wyss Department of Plastic Surgery at NYU Langone and lead surgeon of the 100-strong team that performed the transplant.

“The work being done, not only in face transplantation, but also in areas like hand, uterine, and penile transplantation, is pushing the boundaries of medicine and surgery and opening up new avenues to restore the lives of people like Patrick. It’s a very exciting time.”

Hardison, a former volunteer firefighter from Mississippi, the US, underwent the face transplant in August 2015, having suffered severe burns to his face and neck during a firefighting attempt 14 years previously.

The surgery, which involved the most extensive soft tissue face transplant in history, was somewhat of a new frontier for the field, meaning it was difficult to predict how well Hardison would recover. However, his recovery has been remarkable, far exceeding what his surgeons expected.

“We are amazed at Pat’s recovery, which has surpassed all of our expectations,” said Rodriguez.

Patrick Hardison's recovery over the past year, from immediately post-surgery (top left) to the start of August 2016 (bottom right). Above: Hardison has his eyes examined as part of a checkup

Patrick Hardison’s recovery over the past year, from immediately post-surgery (top left) to the start of August 2016 (bottom right). Above: Hardison has his eyes examined as part of a checkup

Transplant patients often experience some form of rejection, however Hardison not shown any such signs. His transplanted eye lids and blinking mechanisms have also begun to work fully, ensuring his eyesight has been preserved – by no means guaranteed prior to the surgery.

“Most significant is the lack of a rejection episode. We believe this has much to do with the methodical approach we took in the matching process to ensure that Patrick’s donor provided the most favourable match,” said Rodriguez. “Doing so also has allowed us to reduce the levels of certain medications that Pat takes to prevent rejection.”

The recovery has been so quick that the surgeons were able to commence a number of smaller procedures to complete the process considerably ahead of schedule. This included the removal of feeding and breathing tubes Hardison has relied on since his injury, as well as minor adjustments to his forehead, eyes, lips and chin.

Dr Eduardo Rodriguez, who led the 100-strong team to perform the face transplant. Images courtesy of NYU Langone

Dr Eduardo Rodriguez, who led the 100-strong team to perform the face transplant. Images courtesy of NYU Langone

Rodriguez and his colleagues have published extensive details of the case in a series of academic papers, allowing other surgeons to perform similar procedures in the future, and ultimately enabling face transplants to become a commonplace technique, rather than one worthy of international news coverage.

There have also been some efforts to improve access to such surgeries.

“Since last year’s face transplant, other initiatives have progressed,” explained Helen Irving, president and CEO of LiveOnNY, an organ recovery organisation operating in the greater New York Metropolitan area.

“To date, face transplants in the US have been supported, at least in part, by research funding. The US Department of Defense, in concert with transplant centers, is collaborating with insurance carriers to provide coverage for face transplantation. And here in New York, the state government is considering new legislation to strengthen opportunities for organ donation.”

New research claims a video game can improve doctors’ ability to recognise severe trauma in patients

New research has concluded a specifically-designed video game improves doctors’ ability to recognise when patients need to be transferred to a severe trauma centre.

The research, by the University of Pittsburgh School of Medicine and published today in the BMJ, revealed the game Night Shift was better at preparing doctors to recognise patients who needed higher levels of care than reading traditional educational materials.

This was the case even though doctors who were made to play the game, in which doctors play as a fictitious, young emergency physician treating severe trauma patients, enjoyed it less than those who were asked to read relevant materials.

“Physicians must make decisions quickly and with incomplete information. Each year, 30,000 preventable deaths occur after injury, in part because patients with severe injuries who initially present to non-trauma centres are not promptly transferred to a hospital that can provide appropriate care,” said the game’s creator Deepika Mohan, MD, MPH and assistant professor in Pitt’s departments of Critical Care Medicine and Surgery.

“An hour of playing the video game recalibrated physicians’ brains to such a degree that, six months later, they were still out-performing their peers in recognising severe trauma.”

Night Shift was designed by Mohan to tap into the part of the brain that uses pattern recognition and previous experience to make snap decisions by using subconscious mental shortcuts – a process called heuristics.

Doctors in non-trauma centres typically see only about one severe trauma per 1,000 patients. As a result, their heuristic abilities can become skewed toward obvious injuries such as gunshot wounds, and miss equally severe traumas such as internal injuries from falls.

On average, 70% of severely injured patients who present to non-trauma centres are under-triaged and not transferred to trauma centres as recommended by clinical practice.

“There are many reasons beyond the doctor’s heuristics as to why a severe trauma patient wouldn’t be transferred to a trauma centre, ranging from not having an ambulance available to a lack of proper diagnostic tools,” said Mohan.

“So, it is important to emphasize that recalibrating heuristics won’t completely solve the under-triage problem and that the problem isn’t entirely due to physicians’ diagnostic skills. But it’s heartening to know we’re on track to develop a game that shows promise at improving on current educational training.”

For the study, Mohan recruited 368 physicians from across the US who did not work at hospitals specialising in severe trauma. Half were assigned to play the game and half were asked to spend at least an hour reading the educational materials.

Participants then responded to questionnaires and completed a simulation that tested how often they “under-triaged,” or failed to send severe trauma patients to hospitals with the resources necessary to handle them.

Physicians who played the game under-triaged 53% of the time, compared with 64% for those who read the educational materials.

Six months later, Mohan reassessed the physicians and found that the effect of the game persisted, with those who played the game under-triaging 57% of the time, compared to 74% for those who had read the educational materials.

Multimedia courtesy of Schell Games.

Researchers believe modified CRISPR could be used without editing DNA

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Source: Gizmodo

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Source: BBC

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Source: Inverse

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Source: BBC

Steam stops accepting Bitcoin

When Valve first started accepting Bitcoin in April 2016 it was trading around $450 per coin. Today, with Bitcoin surging past $12,000 per coin, Valve has announced that "Steam will no longer support Bitcoin as a payment method on our platform due to high fees and volatility in the value of Bitcoin."

Source: Ars Technica

The maker of Budweiser beer reserves 40 Tesla electric trucks

Budweiser beer maker Anheuser-Busch has reserved 40 Tesla all-electric Semi trucks as it seeks to reduce fuel costs and vehicle emissions. The reservation is one of the largest publicly announced orders Tesla has received, while production of the trucks is scheduled to begin by 2019.

Source: Reuters