Using Big Data and Cloud Computing in Treating Ocular Tuberculosis
Photo Credit via Flickr A cloud-based platform called Cognito Forms was used by the Collaborative Ocular Tuberculosis Study in its quest to find a cure for ocular tuberculosis, according to Priyankar Bhunia of OpenGov Asia. COTS developed its own data entry templates that used dropdown menus but minimized the use of free text fields to avoid the use of jargon (one person enters right eye but another uses RE).It also had embedded logic to minimize keystrokes by altering the questions related to data entry.For example, if a patient says only one eye is involved, then all entry fields for the other eye is disabled. There are also embedded prompts to support relevant criteria during data entry such as making anonymous patient data when entered into the form.The instructions specified how to categorize patients without having to identify them.Researchers would have access to the identity of their patients that is not accessible to researchers from other sites. Data processing and analytics were also incorporated into the template and a program for automating data processing was developed using the R program and Microsoft Excel. Dr.Rupesh Agrawal, COTS lead researcher, said the template enabled them to get data from 25 research centers located in 10 countries.The data led to the publication of their first report on JAMA Ophthalmology. The use of the Cognito Forms fostered global cooperation and master the limitations of current scientific explanations for ocular tuberculosis.Other advantages include better coordination of a multinational clinical study and standardized data collection to extract meaningful information on the said eye disease. The results of the study included new discoveries that challenge existing theories about the disease.For instance, geographic locations affected the way patients narrated their conditions.The research also found out that a certain type of uveitis in the back of the eye was a strong indicator of ocular tuberculosis and that polymerase chain reaction was very effective in diagnosing ocular TB. Also, 80 percent of patients who participated in the study were cured of the disease after being subjected to anti-tubercular medication.
President Trump's Economic Vision Eliminates Immigrants from the Equation
▲(사진제공=Flickr) President Donald Trump's Economic Report recommended a range of policies meant to add workers, assuring that the combination of policy changes and complementary conditions can attract 1.7 million more workers and propel growth by one-tenth percentage point yearly over the next decade. However, the report eliminated immigration from the equation since the president's immigration initiative will generate a decrease in labor supply and the economy's long-term growth possibilities. CNBC reported that the recent years have seen the decrease in the US labor force participation with demography as one of the reasons for the decline.The past decade saw the members of the baby boom generation hit the age of 62, the age where workers can retire and accept Social Security benefits. Displacement via technology and foreign trade and the influx of reliance on disability payments by people with health concerns were the other factors that economists credited for the said labor force participation decline. The report mentioned that policies which are geared towards increasing the labor force participation rate will yield an impact on long-run economic progress.At present, however, immigration was credited as the biggest source of increased labor supply. The National Academy of Science once estimated that immigrant workers were the catalysts behind the $2 trillion of America's $18 trillion economy, while Pew Research Center believed that the mix of new and old immigrants will generate the growth in the working-age population. Former Council of Economic Advisers chairman Jason Furman cautioned that decreasing legal immigration in half will decrease economic progress by more than the recent tax cuts will increase, but present chairman Kevin Hassett refuted that increasing the proportion of higher-skilled immigrants will negate the economic efforts made by decreasing the number of additional immigrants.
Apple Watch Can now do Winter Sport Tracking
Photo by: StockSnap via Pixabay In a bid to broaden the capabilities of the Apple Watch from just being a fitness tracker, Apple has given third-party app developers access to winter sports tracking, according to Monica Chin reporting for Mashable. Several apps such as snoww, Slopes, Squaw Alpine, Snocru and Ski Tracks are developing updates that will allow Apple Watch to record metrics associated with skiing and snowboarding performance.These metrics include total vertical descent and distance, number of runs, average and maximum speeds, total time spent and calories burned. Apple’s latest move was lauded by the heads of several app development companies.Among them is Eddie Healey, founder of snoww, who said he risked getting cold hands, dropping a glove or a cellphone when he wanted to check his stats on a chairlift.On the other hand, Slopes founder Curtis Herbert said his users found it wonderful that they do not have to take off their gloves and take out their cellphones to check on stats and notifications. Previously, an iPhone was used to monitor the performance of skiers and snowboarders who found it cumbersome carrying and operating a cell phone together with the ski poles. Credit towards activity rings is now given to skiing and skateboarding enthusiasts, whose workout information are recorded on Apple’s Health app.Siri integration is offered by several apps, enabling users to use their voices to start and stop tracking.Several also have interesting features, such as tracking friends or their children in the same ski area or listing the chairlifts and trails that skiers have already used. Apple had rolled out the application programming interface for such tracking with the watchOS 4.2 in December 2017.But the catch is that tracking can only be done with the Apple Watch Series 3, which features a barometric altimeter.
#NeverAgain makes Twitter Relevant Again
Photo by: geralt via Pixabay The NeverAgain hashtag serves as a fitting reminder about what Twitter and social media were supposed to be in the first place, according to Nick Bilton, writing for Vanity Fair. People do not realize that most social media platforms were not created to do good in the world as their main aim.Facebook was started so that its developer could get dates with girls while Twitter was started for a way to locate friends in a bar or concert.It was not until the 2009 Iranian elections that world realized that social media platforms can become vehicles for change. But the students who survived the Florida high school mass shooting incident have used Twitter and traditional broadcast media to vent their ire and disgust about guns, the National Rifle Association, and the Republican politicians who support the trade association.They have started social media campaigns exhorting Americans not to vote for politicians who receive donations from the NRA.They have organized marches and protests to assert that they are not giving up. Their media aptitude is phenomenal because it took just hours for the NeverAgain hashtag to become a trending topic on Twitter.It took only a week for their GoFundMe page to collect US$2.5 million in donations.They have caused major corporations such as MetLife, First National Bank, Hertz and Avis to rescind their tie-ups with the NRA. Among these students is David Hogg who tweeted that students should not go to Florida for spring break until gun legislation has been passed.Another student, Jaclyn Corin has created the hashtag #WHATIF and a video that asked what if politicians valued children’s lives more than dollars.A third student, Emma Gonzalez, has seen her Twitter account followed by a million people after making an emotional speech lambasting US President Donald Trump, the US Congress, and the NRA.She hoped that the Florida shooting incident would be the last mass shooting incident.
National Rifle Association Exec blames Democrats for Exploiting Parkland Shooting Incident
▲(사진제공=Flickr) National Rifle Association executive vice president Wayne LaPierre believes that the Democrats are exploiting the Parkland shooting incident for political purposes.In a speech that he made at the Conservative Political Action Conference, LaPierre asked for an increase in school security, criticized the FBI's "rogue" leadership, and attacked the Democrats for encouraging a "socialist" agenda. NBC News reported that LaPierre's statements came the day after President Donald Trump and his company established plans to curb mass shootings by scaling up the national background-check system, upgrading the age for buying weapons to 21, and permitting some teachers and school officials to possess firearms on campuses. LaPierre also went to criticize the FBI's failure to prevent the Valentine's Day shooting that killed 17 people and called out the corruption that has been lurking within the ranks. Meanwhile, NRA spokeswoman Dana Loesch observed that race and ratings were the catalysts that prompted major media establishments to cover mass shootings, while LaPierre supported Loesch's statement by saying that NRA's critics hate the group, the Second Amendment, and the individual freedom. Vice President Mike Pence said that Americans "mourn with those who mourn and grieve with those who grieve", and he also lauded the president's call for the Congress to fortify its background checks and for government regulators to limit bump stocks that can hasten semi-automatic weapon fire. The vice president mentioned that he is praying for God's wisdom that all authority figures will be able to find a way to come together with American solutions to deal with this evil and expressed that the shooting aftermath was triggered at a time when America has been dealing with too much division and anger.
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Don't hurt or kill that snake - call Acres
Photo: Dr. Raju Kasambe Mr Kalai Vanan Balakrishnan found this paradise tree snake taped to the carpet in a Buona Vista office.It took him about 10 minutes to remove the tape from the reptile.PHOTO: ACRES Charmaine Ng When Acres' deputy chief executive, Mr Kalai Vanan Balakrishnan, arrived in Buona Vista last week to remove a paradise tree snake from an office, he did not expect to see the 50cm-long snake taped to the carpet with industrial tape. The adult snake also had a bleeding wound on its back as someone had tried to impale it. "People are usually afraid of snakes and that's okay.But by doing this, you're really asking for trouble - the animal will feel scared and threatened, and things can go wrong," said Mr Kalai, 31, who was a wildlife rescuer for about four out of his seven years at Acres. Acres does not keep numbers on cases of wildlife abuse but Mr Kalai, who still helps with rescues when manpower is short, has been noticing more of such incidents. This is particularly so for reptiles such as snakes, as well as birds.For every 10 calls related to snakes, Mr Kalai estimated that up to two are abused.Acres once responded to a snake-rescue call from a pre-school only to find a dead young spitting cobra.Someone had stacked at least three cardboard boxes on top of the reptile, which was 30cm to 40cm long, killing it. Ms Anbarasi Boopal, who is also Acres' deputy chief executive, said such actions stem from inadequate education on the native wildlife. "Singapore is creating a lot of greenery and it's never going to be just butterflies and flowers.There's going to be lizards, snakes." Acres often gets calls about sightings of animals where a rescue is not necessary, she said.Last year, it received about 55 such calls a month, including sightings of small snakes on trees and monitor lizards in community gardens. To curb this, Acres is ramping up efforts to educate the public on what to do when they encounter some of the common wildlife here. Earlier this year, for example, it started working closely with and educating property managers of town councils, who are usually the first responders when the public encounter wildlife in a housing estate. Acres said it hopes the campaign will help reduce misconceptions about Singapore's wildlife. Photo: Dr. Raju Kasambe
Medical Consultants Brought Down By Audit
Photo: NeuPaddy / Pixabay A revenue probe looked into several hundred companies found 61 million euros in tax and linked it to medical consultants, according to the Public Accounts Committee. Revenue officers report that doctors paid nannies using their companies, and one case in particular had a child being paid for web work that breached pertinent tax rules.Some of the improper practices they discovered were the use of firms to offset personal expenses like household costs, paying nannies, freelancing children, etc. Niall Cody, chairman of the Revenue Commissioners, said that there was a case in which expenses were used to compensate a child for work done on a website, and the explanation given was because the child was “proficient in IT and the consultant wasn’t.” The TDs were given to understand the probe into consultants’ tax affairs started in 2010 following the routine audit of a medical consultant who qualified as a high-wealth individual.Cody speaks of there being liabilities identified, and the issues challenged had to do with the incorporation of a private practice securing an overall tax reduction. There are many legal ways to go about arrangements like these, but in this case, concerns were about the details of transactions between the companies themselves and their consultants.The evidence did not adequately support the transactions being commercial transactions.
Stanford Students Protest Obamacare Repeal
Photo by: Bill Branson White coats covered the steps at a Stanford University medical school building yesterday as part of the ProtectOurPatients campaign, a grassroots protest in defense of the Affordable Care Act. “We are covering our medical center with our coats to symbolically represent the need for coverage for our patients," says medical student Julie Barzilar. “This doesn’t just affect coverage, it affects people in our community,” said protester Alvaro Amorin said. “I don’t think this is America.We have better morals.We have better values.” Amorin’s sister and mother, who live in San Mateo near the Stanford campus, depend on the ACA for coverage. Several students carried signs that said “#DoNoHarm” and “Whitecoats for coverage.” They cheered together and chanted their concern regarding the Trump administration's plan to repeal Obamacare. Estimates say that 32 million American will lose their health insurance if the ACA is repealed.It’s also estimated that forty-three thousand people will die each year if there is a repeal. The demonstration was organized through the Stanford Medicine Facebook page, and protesters shared photos on Instagram. “Politics shouldn’t be a part of it," said second-year medical student Jon Sole. "The fact that politics can harm people this way is wrong.Oftentimes [change] comes at the cost of those most vulnerable.”
tDCS is Proceeding to Help Treat MS
Image: Wikimedia Commons Researchers have identified a promising new therapy for treatment of the symptoms of multiple sclerosis. Multiple sclerosis afflicts 250,000 to 350,000 people in the United States.A degenerative disease of the nervous system, MS is uncurable.However, researchers are finding ways to ameliorate its impact on vision, mood, and concentration.Among the most promising therapies is a new technology: transcranial direct current stimulation. TDCS has been shown in trials to effect improvements in some of the symptoms of multiple sclerosis. The procedure was created by professor Marom Bikson of City College of New York.It consists of a low-amplitude current that travels through a set of electrodes placed on the patient's scalp. This current is thought to stimulate the brain's cortex, enabling neurons to signal to each other more easily.This improves neural connectivity and cognitive learning, leading to rehabilitation benefits for people suffering from multiple sclerosis. Participants in a study of 25 patients were asked to play computer games to assess cognitive skills such as problem-solving abilities, attention, information processing, response time, and working memory skills. After 10 at-home TDCS treatments, the participants were found to have improved response time and problem-solving skills. TDCS targets the brain's dorsolateral prefrontal cortex, a region associated with fatigue, depression, and cognition. Sensitive, computerized measurements of complex attention showed that the TDCS group had much greater improvements compared with a control group. Though the study could not find differences in attention span or standard cognitive measures, the current results are sufficiently promises to fuel enthusiasm for further studies.
The Celiac Surge
A rapid increase in the global incidence of the condition has researchers scrambling to understand the causes of the trend, and cope with the consequences. By Catherine Offord | June 1, 2017 2621 ISTOCK.COM/MACROVECTOR In 2015, gastroenterologist Edwin Liu set to work on a clinical and genetic data set that had been growing for more than 20 years.The data pertained to celiac disease, a lifelong condition involving bouts of severe gastrointestinal distress and other symptoms, triggered by ingestion of gluten proteins that are found in wheat and several other grains.In a two-decade collaboration with researchers at Children’s Hospital Colorado in Denver, Liu’s predecessors and colleagues at the University of Colorado kept track of 1,339 babies born in the city who were deemed at risk of developing the disease due to mutations in celiac-linked genes.The researchers carried out yearly tests to see whether or not the children developed the disease, hoping to better define the risk associated with each of the genetic variants. Not far into his analyses, however, Liu found something in the data that undermined a much larger assumption in the celiac field. “Usually, when we quote numbers for celiac disease, we’re quoting around 1 percent” prevalence in the US population, he says.But using data from this cohort along with estimated frequencies of each genotype across the Denver metro area to extrapolate the incidence of celiac disease to the general population, Liu found that the true prevalence of celiac disease had to be much greater—more than 3 percent by age 15. “It was a surprise,” he says. “These numbers are much higher than anything else quoted in the U.S.” Researchers reading the paper, which was published online earlier this year in Gastroenterology,1 were similarly taken aback. “If you look at the rates, it’s frightening,” says Joseph Murray, a celiac researcher at the Mayo Clinic in Rochester, Minnesota.Of course, the statistic could be specific to the Denver cohort, he notes, but it does fit in with similar trends reported both in the U.S.and around the world. Celiac symptoms, which include abdominal pain and distension, diarrhea and flatulence, nausea, and fatigue, are brought on by ingestion of gluten—a protein complex present in wheat, barley, and rye.Unlike food allergies, which are often primarily mediated by an overreaction of adaptive immune responses such as immunoglobulin E antibody production and mast cell activation, celiac disease engages both innate and adaptive immune pathways, and produces antibodies that target not only gluten, but the body’s own proteins.As a result, the disease is generally considered an autoimmune condition. (See illustration.) Triggered by even tiny amounts of gluten, these immunological attacks lead to T cell–mediated atrophy of the gut wall, which can be characterized via a biopsy of the small intestine for celiac diagnosis (see “Diagnosing Celiac Disease”). As the use of biopsy and other diagnostic methods have improved in recent decades, celiac disease has become easier to detect.So when the first reports of increasing numbers of celiac cases in the U.S.came out in the early 2000s, many researchers attributed the uptick to progress in disease recognition.But closer scrutiny of the data suggested there was more going on. “We weren’t just better at finding celiac disease,” Murray says. “There was a lot more of it to go around.” Around 40 percent of people have the genes predisposing them to celiac disease.The big question is why some people get it and others don’t.—Edwin Liu, University of Colorado By comparing blood samples taken from young adults in the Air Force around 1950 with matched samples from residents of a Minnesota county collected since 1995, for example, Murray’s group estimated an increase in prevalence from 0.2 percent to nearly 1 percent.2 Sweden, meanwhile, experienced what is now referred to as a celiac epidemic in the late 1980s and early 1990s, with one study estimating that as many as 3 percent of children born at the height of the epidemic had developed celiac disease by the age of 12—though rates dropped back down to just over 2 percent for children born in 1997.3 And several studies based on blood tests suggest increasing numbers of people are developing celiac disease in wheat-eating areas of northern India, with a prevalence in children of around 1 percent and some researchers warning of an impending epidemic there too. The cause of this apparently global trend remains a mystery, not least because, while the immunopathology of celiac disease has been studied for decades, just what causes people to develop the ailment in the first place remains unclear.Almost all diagnosed patients have mutations in at least one of the two genes coding for HLA-DQ, a membrane receptor on antigen-presenting cells that helps the immune system distinguish self from non-self and coordinate T-cell activity.But not everyone who has such risk genes gets celiac. “Around 40 percent of people have the genes predisposing them to celiac disease,” Liu explains. “The big question is why some people get it and others don’t.” Hypotheses abound, with many pointing the finger at a gluten-rich diet, but evidence to support these ideas remains far from conclusive. Getting to the bottom of this question will be necessary not only to curb the concerning trend, but also to help doctors better detect and manage the multifarious disease, for which the only current treatment is a gluten-free diet.In addition to celiac’s sometimes-debilitating symptoms, the disease is associated with a heightened risk for numerous conditions, including autoimmune diseases such as diabetes and hypothyroidism, and myriad other disorders, from infertility to small-bowel cancer.Overall, celiac patients have up to a twofold increased mortality risk compared with the general population. “The stakes are high,” says Murray. “If this disease has gone from being a truly rare disease in some geographies to being a common disease affecting 2 or 3 percent of children, that’s no longer a small disorder.” Why the rise? © ISTOCK.COM/MACROVECTOR One thing celiac researchers agree on is that the direct cause of the rise in the disease likely resides outside of our DNA. “Over decades, it’s just too quick for genetic changes to occur,” Liu says. “We have to assume that this is based on environmental factors.” There’s still little in the way of concrete answers as to what these factors might be, however. “I’ve heard every type of hypothesis that’s been thrown out there,” says Murray, “but most are them are not easily testable.” Some of the more unusual candidates blamed for triggering celiac disease include microwaves, plasticware, and diatomaceous earth—an abrasive powder applied to flour containers as an insecticide—although scientific evidence to incriminate these supposed culprits is scant.Other factors that have more reliably been tied to increased celiac risk in genetically predisposed infants include delivery by Caesarian section, and intestinal infections by pathogens such as reovirus (recently implicated in a mouse model)4—although their impacts are likely minor, Murray says. The role of gluten itself—the immediate trigger for the immune responses in celiac patients and therefore, researchers have long assumed, a crucial player in the epidemiology of the disease—has also remained frustratingly elusive.During the 2000s, for example, several observational studies pointed to a suite of dietary factors, including age of gluten introduction, as influencing the development of celiac disease.But the findings suffered a blow in 2014 when two randomized clinical trials failed to find any effect of the timing of gluten introduction.5,6 The studies also found no evidence for a link with the duration of breast-feeding—a factor that had previously been touted as protective against developing celiac disease.Gastroenterologist Alessio Fasano of Massachusetts General Hospital, a coauthor on one of the publications, says researchers realized then that “the story is much more complex than we thought.” A more recent hypothesis is that the amount of gluten consumed, if not the timing, could play a role in triggering celiac disease in children.The US Food and Drug Administration (FDA) notes that wheat consumption increased rapidly in the second part of the 20th century as people began to eat less meat and consume increasing amounts of readily available, wheat-containing fast foods. (A more controversial idea is that the composition of wheat has changed significantly during this time—search “Frankenwheat.”) And rising incidence of celiac disease in South Asia tracks with the widening adoption of Westernized diets, although data on gluten consumption per se is lacking. Some evidence that these dietary changes could be tied to the rise in celiac disease comes from a retrospective 2016 study of Swedish infants, which suggested that genetically susceptible children consuming more than 5 grams of gluten per day—the equivalent of about one slice of whole wheat bread—before 2 years of age were up to two times more likely to develop celiac disease than those consuming less than that amount.7 “[The result] tells me that the amount of gluten matters,” says Murray. “I think we have to go back and revisit what’s happening with gluten—how much are we eating, and is it a potential risk factor?” Reactions to these findings have been mixed, however. “The evidence was fairly weak,” notes celiac researcher Detlef Schuppan of Johannes Gutenberg University Mainz in Germany.In terms of the global rise in celiac prevalence, “the amount of gluten ingested does not explain it,” he adds. IMMUNE IRRITATION IN THE GUT: In the small intestine, gluten proteins are broken down into their component glutenins and prolamins.In celiac patients, the prolamin component of wheat, gliadin, passes into the lamina propria, a layer of tissue underneath the intestinal epithelium, and is processed by an enzyme called tissue transglutaminase, and the resulting negatively charged gliadin peptides are picked up by antigen-presenting cells that display them for assessment by the immune system. See full infographic: WEB | PDF© JULIA MOORE Amidst uncertainty about gluten’s part in the celiac trend, many researchers are quick to point out that it’s not just our diet that has changed in the last century.One factor now under scrutiny across digestive diseases and beyond is humans’ usage of antibiotics and, consequently, the composition of bacteria making up the gut microbiome.Bacteria living in the gut play important roles in metabolism and in the regulation of immune responses to food, so for many researchers, these microbes are likely suspects in celiac disease pathogenesis.According to this line of thinking, “maybe the bugs we’ve now got are not as happy when they interact with gluten,” Murray says. “Or the results are not as good for us when these bugs interact with gluten as when our old bugs did.” See “The Sum of Our Parts” The last two decades have seen a number of observational studies report abnormal microbiome composition in the guts of celiac patients compared with healthy controls.Patients with celiac disease show a higher proportion of gram-negative bacteria such as Bacteroides and E.coli, for example, and some evidence suggests that those displaying gastrointestinal symptoms also have higher levels of Proteobacteria.Another bacterium, Helicobacter pylori, has been associated with protection from celiac disease, and declines in the number of adults carrying this microbe in their guts appear to have coincided with increases in the number of celiac cases in the U.S.—although research on this subject remains inconclusive. Whether these differences in microbiome composition are the cause or the consequence of celiac disease remains unanswered, says Bana Jabri, director of research at the University of Chicago Celiac Disease Center. “You could think about it in several ways,” she explains. “Maybe there’s a difference in the microbiota from the beginning, and this has a causative role.Or maybe what you’re seeing is just a secondary effect.At this point, we really don’t know.” Nevertheless, circumstantial evidence is accumulating to suggest more than a passive role for these microbes.For starters, it’s known that changes in the microbiota can induce different types of immune responses, and celiac patients often continue to show abnormal gut flora even after adopting a gluten-free diet.Additionally, Jabri’s group showed last year that mice engineered to overexpress interleukin-15—a cytokine involved in celiac disease pathogenesis—had restructured microbiota as well as altered production of certain fatty acids, mirroring precursors of intestinal inflammatory diseases in humans.8 “When you put all this together, you could say that there really is enough evidence to believe in a causative role for the microbiota,” says Jabri. “But the critical experiments still need to be done.” With so many factors being investigated, Liu says, it’s unlikely the explanation for an increase in celiac disease incidence will be simple. “I don’t think we’re going to be able to find a single environmental trigger,” he says. “It’s going to be a combination.” Murray takes a similar view. “There are so many things going on, so many moving parts,” he says. “The challenge for us as scientists is to reduce it down to testable hypotheses.” Damage control © ISTOCK.COM/MACROVECTOR While scientists grapple with how to explain the disease’s underlying causes, the rise in celiac prevalence is prioritizing the condition in the medical community and highlighting the need for improved diagnosis and management of existing cases.It’s worth remembering, says Murray, that celiac disease is a lifelong condition. “When you develop celiac disease, you can’t undevelop it,” he says. “You can heal it, by avoiding gluten, but you can’t put Humpty Dumpty together again.The immune system has changed.” For now, the only treatment is a gluten-free diet.But as the focus on celiac disease has intensified, so too has research on the effects of this intervention—and the results are not encouraging.Several studies suggest that celiac patients’ guts are unlikely to heal completely even on such a diet, and accidental ingestion of the ubiquitous protein is almost inevitable; even tiny amounts can trigger symptoms.Moreover, patients find the gluten-free regimen difficult to tolerate because it is isolating and often impractical.In 2011, University of Sheffield celiac researcher David Sanders and his team surveyed 310 people diagnosed with celiac disease who were following a gluten-free diet, and found that more than 40 percent were dissatisfied.9 “Most people eat three times a day, and with celiac disease, that’s a challenge,” says Sanders. “Every single day, this problem is right in front of [them].” To improve outcomes for patients with celiac disease, some scientists are exploring ways to tackle the celiac gut’s response to gluten and potentially restore tolerance.Celiac researcher and chief scientific officer of ImmusanT, Bob Anderson, for example, is expanding work he began during a postdoc at the University of Oxford to develop a vaccine that could help desensitize patients to gluten over a series of injections.The vaccine, Nexvax2, comprises three peptides—components of gluten taken from wheat, barley, and rye—that trigger an adaptive immune response in celiac patients.Phase 1 results showed the vaccine to be safe, and Phase 2 trials are planned for later this year, Anderson says. “It’s a highly targeted approach to try to engage the bulk of the gluten-reactive T cells that play a pivotal role in causing and maintaining the disease,” he explains. There are less orthodox approaches in the works, too.In recent years, researchers in Australia have been investigating the idea that attacking the body with intestinal parasites could help mitigate the effects of autoimmune disease by “giving the immune system something to do,” says Sanders, who was not involved in the work.In 2014, the team reported results from 12 people with celiac disease who, after being experimentally infected with hookworm larvae—which then migrated to the gut and grew—could follow a normal diet with significantly reduced symptoms.10 The same researchers plan to launch a follow-up, double-blind randomized trial with 60 participants later this year, and have stated that the results could inform the future development of new, non-parasite–based therapies. Other experimental therapeutics for celiac disease would require patients to continue a gluten-free diet, but serve to reduce the severity of reactions to accidental exposure when taken before a meal.Baltimore-based pharmaceutical company Alba Therapeutics—cofounded by Fasano—has developed pills containing a synthetic peptide known as larazotide acetate, which inhibits a protein called zonulin that regulates epithelial-cell tight junctions.Zonulin is thought to increase the permeability of the gut, and is upregulated in people with celiac disease—factors that company researchers suggested could explain why the drug reduces gastrointestinal symptoms in celiac patients following gluten exposure.The therapy was licensed out for Phase 3 trials last year.Another experimental drug, developed by California-based Alvine Therapeutics and recently acquired by ImmunogenX, contains a mixture of two gluten-targeting proteases—one plant-derived and one derived from bacteria.The drug chops gluten molecules into successively smaller pieces, and reduced gut tissue damage in celiac patients who ingested small amounts of the protein in a Phase 2 trial. DIAGNOSING CELIAC DISEASE: A blood test can be used to screen for the presence of tissue transglutaminase antibodies, which can indicate celiac disease, but a diagnosis is only confirmed with an intestinal biopsy.Doctors take samples of the small intestine lining and quantify villous atrophy on a scale known as the Marsh Score from 0 to 4, where 0 represents normal villi covered with invaginations, and 1 through 4 denote increasing levels of atrophy.Stages 1 and 2 represent possible celiac disease, stage 3 signifies symptomatic celiac disease, and stage 4 reflects total atrophy. See full infographic: WEB | PDF© JULIA MOORE With these alternative treatments a long way from being available for general use, many health-care providers argue that improved diagnosis should be the priority, to help better understand and care for the increasing numbers of people living with celiac disease.In 2014, a team at the University of Nottingham reported significant progress in this area, estimating the rate of celiac diagnosis to have increased dramatically in the U.K.over the last two decades, with nearly one in four sufferers now being diagnosed.11“People in this field were clapping themselves on the back when that study came out,” says Sanders. “I think I clapped myself on the back too.But when I sat down and thought about it, I thought, that still means 75 percent of cases are undiagnosed.And that’s absurd, isn’t it?” Part of the delay in improvements has to do with medical practitioners “playing catch-up” with an expanding range of symptoms recognized as warning signs, Sanders adds.While traditionally linked to gastrointestinal symptoms such as diarrhea in children, celiac disease is increasingly being identified in older patients, many of whom don’t display telltale gastrointestinal symptoms but have conditions previously deemed unrelated, such as anemia and osteoporosis. “The types of presentations have changed,” agrees Murray, who published accounts of these nonclassic symptoms in US patients in the early 2000s. “It’s turned on its head the preconceived notion of what the disease should be.” Sanders also points to reticence among physicians about diagnosing the condition—a situation that, somewhat paradoxically, hasn’t been helped by the increasing popularity of gluten-free diets and publicity surrounding the “spectrum” of gluten-related disorders. (See “Grains of Truth.”) “There’s a lot of nihilism towards this condition, and I think it’s got a lot to do with the [treatment being a] gluten-free diet,” Sanders says. “If this was a tablet, nobody would argue, and physicians would say, ‘Oh, you have to take tablet X.’ But the word ‘diet’ has all sorts of connotations. . . .Even the medical fraternity can have quite derogatory views [of diet-based treatments].” There’s a lot of nihilism towards this condition, and I think it’s got a lot to do with the treatment being a gluten-free diet.Even the medical fraternity can have quite derogatory views of diet-based treatments.—David Sanders, University of Sheffield There’s related concern that public attention to gluten could undermine how celiac disease is detected, as people self-prescribe a gluten-free diet even without being diagnosed by a doctor. “Now, the latest trend is people avoiding gluten without having a diagnosis at all,” explains Murray. “I think that when it comes to counting and measuring and knowing what’s happening in the world with celiac disease, it’s going to be very hard to see that with this gluten-free train.” Last year, for example, researchers at Rutgers University highlighted an apparent stabilization in celiac diagnoses since 2009, but also noted a soaring number of people following gluten-free diets in the U.S.without having ruled out celiac disease, making it impossible to determine the true fluctuation in celiac prevalence.12 To get a stronger grip on the global prevalence of celiac disease and better help those who are diagnosed, researchers are keen to discourage people from self-treating for gluten-related disorders.For all ailments thought to be related to gluten consumption, “there needs to be a greater awareness of science as a discipline to examine these questions,” says Murray. “It doesn’t matter how high you pile anecdotes, that does not science make.” GRAINS OF TRUTH It’s not just celiac patients who have a difficult relationship with gluten.Thousands of Americans report symptoms following consumption of gluten-containing foods, including abdominal pain and other gastrointestinal problems, even once they have ruled out celiac disease as well as another grain intolerance, wheat allergy.But unlike celiac disease—in which patients’ symptoms are known to be directly triggered by consumption of gluten—the causes of non-celiac gluten sensitivity (NCGS) are far less understood, and some research even suggests that, in many patients, gluten might have nothing to do with it. In 2013, a team led by Peter Gibson at Monash University found that among 37 people with self-reported NCGS, 92 percent showed no gluten-specific symptoms when following a diet controlled by the researchers.A more recent Italian study of 35 people found similar results: two-thirds of people diagnosed with NCGS based on their symptoms showed no reaction to gluten when it was reintroduced following a gluten-free diet. But if gluten isn’t behind the symptoms of many NCGS patients, then what is?The answer may lie—at least partly—in a group of carbohydrates called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs).These carbohydrates, found in a range of foods from chickpeas to cottage cheese, trigger gastrointestinal symptoms, and in the Monash group’s 2013 study, the researchers showed that reducing FODMAP consumption improved symptoms in all participants. Meanwhile, gastroenterologist Detlef Schuppan of the Johannes Gutenberg University Mainz in Germany and his colleagues found that another component of wheat, amylase trypsin inhibitors (ATIs), can trigger an innate immune response in humans and mice—a result, the researchers noted in their paper, that could explain gastrointestinal symptoms in people with “so-called gluten sensitivity,” as well as potentially exacerbating celiac disease itself. From these and related findings, many scientists argue that the “gluten” in NCGS is misleading, and instead prefer “non-celiac wheat sensitivity.” For now, though, as researchers work to pin down the causes and the prevalence of this condition, the term sticks. Photo: Peggy Greb, USDA ARS, Wikimedia Commons
Ignorance, Fascism, and the KKK
Not on Mike Signer’s watch. The steadfast Mayor from Charlottesville, Va.said “we reject this intimidation” pointing out the resemblance between the current torch-lit rally adding “intolerance is not welcome here.” Signer who once declared the city he leads and presides over as a “Capital of Resistance” in the wake of Donald Trump’s election and racist campaign rhetoric has now condemned the torch-lit rally of protestors that were upset because of the city’s removal of confederate monuments. Signer also said, "This event involving torches at night in Lee Park was either profoundly ignorant or was designed to instill fear in our minority populations in a way that harkens back to the days of the KKK." The archaic rally was led by Richard Spencer the front piece of the “alt-right” movement. At a rally earlier that day, he said “We will not be replaced from this world.Whites have a future.We have a future of power, of beauty, of expression." Many cities across the southern US have been debating the removal of Confederate symbols since a 2015 massacre at a black church in South Carolina by a self-avowed white supremacist gunman. The issue has, of course, entered into the Virginia governor's election, with Republican candidate Corey Stewart vowing not to remove any Confederate memorials if he is elected. I woke up today and my calendar said May 15th, 2017, but apparently, that was just a dream.
Wiretapping at The White House
Just over forty years after Watergate, it appears we may be at it again but do Americans even care? It seems in this day and age in which we live the general public could care less about privacy, respect for conversations that are only meant for two people, and so on. Richard Nixon would have been flogged if he did what George Bush Jr.did; he would have been hanged, after a flogging if he pulled what Donald Trump has implied, and done. Instead, we as Americans in these times seem to feel it’s o.k.to spy on each other. We feel it’s not safe to trust one another for fear of the powers that be will knock on the door late on a cold Wednesday night. It’s not unlike communist Russia in the early eighties. Pat Buchanan may possibly be attempting to weasel himself back into the national arena as far as politics go, but I think there is such a darkness in him that the Trump administration won’t answer his pounding on the White House doors. There are many reasons for this I know, but let's at least examine the parallels a bit. We have Sean Spicer the mouth-piece for our current President doing his best sidestep of everything he is asked. He would make Nixon proud in this for a little while, but then Nixon’s natural instincts of bullying and being a psychotic control would take over and Spicer would be out of a job or worse. Can you imagine Donald Trump and Pat Buchanan as a team? That might have truly started World War III. To some arguments, Pat Buchanan was a worse human being than Richard Milhous Nixon. I’m not sure the same can be said about Sean Spicer compared to Donald Trump, but they are definitely a team in one form or another. We are getting into murky waters here and when you are splitting Troglodyte hairs, things get really ugly. C’est la vie
Sessions on the warpath
These were Jeff Sessions’ exact words late in the afternoon on Friday during a speech in which he officially rolled out the blueprint for his own War on Drugs. It is his belief that prosecutors have not been able to do their job correctly because of former President Barrack Obama and Eric Holder’s policy on non-violent drug offenders. He will attempt to win this war by levying over 5,000 prosecutors across the United States to impose the harshest of charges made possible by current law to just about every person arrested for drugs, regardless of past criminal activity or lack thereof. Mr.Sessions claims that there will be some exceptions where applicable, but from his speech rhetoric, this concession doesn’t seem likely. There is a lot of red tape and several channels to gain approval for leniency, even if you are known as a non-violent offender with no gang record or drug trafficking past. “If you want to collect a drug debt, you can’t file a lawsuit in court.You collect it with the barrel of a gun.” It should be noted that civil liberties groups have emphatically been speaking out against these changes, and surely will not let this go quietly into the night. Are we really “Un-handcuffed from Washington?” That is the burning question of the hour in many circles across this great land of the United States of America.
Overturned, overhauled and wiped out
Jeff Sessions freshly appointed and already controversial attorney general under Donald J. Trump is wasting no time in overturning former Attorney General Eric Holder’s charging instructions to prosecutors across the country. Sessions believes that Holder’s memorandum stifled prosecutors and made them puppets of K Street and Washington as a whole. In a speech yesterday during a summit in Charleston, W.V. he explained his feeling on recreational drug use and what he believes is a rising violent epidemic to come if law enforcement doesn’t evoke tougher policies across the board. Falling short of Philippine President Rodrigo Duterte style enforcement, Sessions is steadfast in his need for reforming the Holder policy of being more lenient on non-professional, if you will, drug users that are not part of street gangs or trafficking rings. Sessions said “We will not look the other way; we will not be blind to your misconduct.” Advocates of Civil Liberties are outraged by this of course and feel this is a move toward fascist policies. The feeling from this sect is that families will be devastated and ruined similar to the War on Drugs heyday during the Ronald Reagan/Bush 41 era. They also remark on how minorities are acutely affected by such an overhaul in federal prosecuting power. This new directive will almost certainly increase prison population and boost revenue for private prisons. Sessions also wiped out Sally Yates’ instructions to the Justice Department to stop housing federal inmates in private prisons. He touched on the fact that he sees a different future for putting people behind bars. On his mini speaking tour across the country, Sessions made no bones about the fact that he thinks law enforcement needs to get back to the more aggressive tactics it once used if peace is to be maintained on his watch. He noted recent spikes in serious crime remarking that “The murder rate has surged 10 percent nationwide, the largest increase in murder since 1968, and we know that drugs and crime go hand in hand. They just do.”
“Un-handcuffed from Washington”
These were Jeff Sessions’ exact words late in the afternoon on Friday during a speech when he officially rolled out the blueprint for his own War on Drugs. It's his belief that prosecutors haven't been able to do their job correctly because of former President Barrack Obama and Eric Holder’s policy on non-violent drug offenders. He will attempt to win this war by levying over 5,000 prosecutors across the United States to impose the harshest of charges made possible by current law to just about every person arrested for drugs, regardless of past criminal activity or lack thereof. Mr. Sessions claims that there will be some exceptions where applicable, but from his speech rhetoric, this concession doesn’t seem likely. There's a lot of red tape and several channels to gain approval for leniency, even if you are known as a non-violent offender without gang record or drug trafficking past. Mass incarcerations are sure to rise again and private prisons will be in high demand. Sessions has written and voiced to prosecutors they will be given leeway to “have discretion” at times where “sentences would result in an injustice”, but in the same breath stated the future needs of the prison system need to be met (with more prisoners). Udi Ofer, director of the American Civil Liberties Union’s Campaign for Smart Justice maintains that “The American people have said with a clear voice that they want common-sense reforms to sentencing policy.” He also mentions we are falling back to Draconian like times and that he is disgusted by the thought of it, after all the progress we made in the last 20 years, socially and consciously. In the wake of all of this, we should ask ourselves one question. Are we really “Un-cuffed from Washington?”
A FRESH APPLE
A fresh out of the box new medicinal startup in San Francisco, Ca.demonstrates to us the future in the method for solutions utilizing associated instruments with A.I Forward, the assumed wellbeing startup of previous Wavii creator Adrian Aoun is the thing that Aoun sees as the fate of solution. "Envision a specialist's office that looks and feels more like an Apple Store than like a specialist's office," says Aoun. "In any case, go above and beyond and you have this sort of cool thing where you have the specialist's office that sort of learns after some time.You have something that shows signs of improvement after some time as it adapts increasingly about you, practically like everything else people are using, similar to Google and Facebook." Call it Intuitive Medicine maybe, or then again I.M. Forward has a best in class 3,500 square foot office completely outfitted with the most recent cutting edge therapeutic instruments and additionally an on location research center for quick testing and results.The cutting edge office somewhat resembles Star Wars. This entire experience is planned to improve specialist's basic care by giving them more data particularly in the decision making and diagnoses process. Aoun says “Imagine you’re an engineer on my team and I said ‘go write some code’ but when you hit compile you actually have to go wait a week, you’re going to fax your code off and the test results will come back a week later and then you get to know the results.” Forward will make the procedure extremely basic with moderate pricing for all.Patients will have boundless access to its med-staff with progressing observing utilizing sensors you can wear discretely and serenely alongside sustenance and wellbeing direction.What's more, in conclusion, every minute of everyday access to the therapeutic staff and the frameworks A.I.just for just $149 a month. This appears to be an amazing advancement in health care and this project could shape the future of medical offices and clinics.
Six Simple Tricks to Make Ironing Faster
Photo by: stevepb via Pixabay Lisa of oflifeandlisa.com offers six tricks to iron clothes faster. These are: 1.Placing a sheet of aluminum foil on the ironing board, which will reflect heat and steam when clothes are being ironed.This will reduce the ironing time as only side of clothes needs to be ironed. 2.Using a binder clip to keep pant legs in place and will not move during ironing, resulting in a crisper crease in pants.Binder clips can also be used with shirt sleeves and hems. 3.Placing a damp cloth over delicate clothing, and using a warm iron to remove the wrinkles. 4.Protecting shirt buttons from damage by putting a spoon over them while ironing. 5. Ironing sashes, ties, and collars with a clean flat iron. 6.Spraying a paper bag with a mixture of ¼ cup vinegar and ¾ cup water and used in removing tough wrinkles.The wrinkles disappear instantly when the bag is placed over a wrinkle and ironed with a warm iron. Adding fabric softener during the wash cycle is a good way of removing wrinkles. On the other hand, there are ways to remove wrinkles from clothes without having to use an iron or if one is not readily available, according to Perrie Samotin of stylecaster.com. These are: - A flat iron, the same device for straightening hair can also be used to smoothen clothes, claims Samotin. - A clothes dryer set to medium can be used in removing the wrinkles from small clothing items, such as handkerchiefs. - A metal pot that has been emptied of boiling water can be in straightening wrinkles in clothes. - A mattress.A wrinkled garment can be rolled like a burrito, and put under a mattress for an hour.Most of the wrinkles will be gone, once the garment is taken out after an hour. - Damp dryer sheets that are placed in dryers with wrinkled clothing inside. - A professional anti-wrinkle spray, which relies on fiber-relaxing technology and is safe to be used with any type of fabric. - A damp towel placed over wrinkled clothing and gently pressing down and smoothing the creases.
Can Listening to Podcasts Affect Your Child?
Photo by: NadineDoerle via Pixabay You know that you should limit your child’s exposure to technology, especially if he or she is still young.Based on research, having the television on as a background may have lasting negative effects on the child, especially if it is on for hours every day.The lights and noises from the television can distract the child from playing, which is considered as a valuable time for learning. “Watching TV can also make parents less likely to interact with young children, which is crucial for development, as well,” Kevin Loria wrote in his article for the Business Insider. On the other hand, the effects of listening to a podcast or audio storytelling may not be the same as watching TV.For Jenny Radesky, a pediatrician who specializes in child development, scientists are not that worried about the disruptive aspects of podcasts to kids. “Podcasts are often created to be seamless and pleasing to listen to, with less attention-grabbing features than TV,” Loria mentioned.This means that audio materials may not be able to distract a child while playing.However, there is a chance that you may be absorbed with the podcast, and you will have a hard time responding to your kid’s cues.But, the good thing about podcasts is that it can help you learn from the topics you are listening to.Also, you can always pause the audio material to attend to your child’s needs. Loria wrote that you may listen to podcasts to relieve stress or boredom, but this should not interrupt your bonding time with the child and eating meals together with your family.Also, interacting with your kid should make the most of your attention.
In Relationships, Trust Your Gut
Photo by: Free-Photos via Pixabay There are times that you feel that something is going to happen, and one of the signals is the unsettled feeling in your gut.If you are alone in an unfamiliar place and you feel it, you know that there is only one thing to, and that is to leave.The unsettling feeling in your gut may also be a factor in determining your current relationship. Many people say that you cannot choose who you fall in love with.It may be a saying for others or a warning for some people, but this is true. “Past science has shown we don’t always select relationship candidates who match what we proclaim to want and like,” Jenna Birch wrote in her article for the Well+Good.Most of the time, even people think that they are in a perfect relationship, they will feel that punch in their gut, but they will not do anything about it. Though logic and reason do not work in love, they can help you filter a toxic relationship from a healthy one.Even you say that you are compatible and there is chemistry between the two of you, “Deep in your gut, you feel the weight of information your subconscious has processed,” Birch mentioned. You may say that you have already found the one, but when the unsettling feeling in your gut kicks in, you know that you should do something about your relationship.Nowadays, there are many things that you have to consider before dating someone and relationships are more confusing than before. “We have chucked the scripts in an attempt to write our very own stories, reinventing partnership roles, and relationship trajectories,” Birch wrote. This is the time that you should not rely on old sayings about love, instead, you should make your own.You know yourself better than anybody else.So, you know what you want, who you want, and the love you deserve.
How to Remove the Six Common Party Stains
Photo by: Security via Pixabay Debra Johnson, home cleaning expert from Merry Maids, says stains from red wine, candle wax, chocolate, coffee, gravy, and cranberry sauce commonly occur during dinner parties, writes Maggie Winterfeldt of PopSugar. Red wine is a common staple in dinner parties, but it can be harsh on upholstery and carpets.To clean red wine stains, Johnson recommends pouring some club soda on a piece of microfiber or white cloth, and use it to blot the stain. To remove dried-up wine stains, mix a tablespoon of dishwashing liquid, a tablespoon of white vinegar and 2 cups of warm water, and blot it on the stain. The same solution can be used in removing coffee stains on carpets, using a microfiber or white cloth to remove the excess coffee. Candle wax drippings on a prized tablecloth can be removed by placing the tablecloth in a freezer and scraping the drippings later with a blunt butter knife. Alternatively, a sheet of wax paper can be placed on the stained portion of the linen, and iron and reverse side to move the spilled wax onto the sheet of wax paper. A solution of a tablespoon of dishwashing liquid and 2 cups of cold water can be used with a piece of cloth in blotting out chocolate stains.Blot the soiled area, and place an electric fan over it until the blot dries. Gravy stains on linens or clothes are best removed by using a laundry stain remover and cleaning the linens or clothes in a washing machine. Cranberry sauce spilled on the tablecloth by soaking the tablecloth for 15 minutes in a solution of half a tablespoon of mild liquid detergent, a tablespoon of vinegar and a quart of cool water.The tablecloth can be washed afterwards in cool water.
Are You really Covered?
Photo Credit via Pixabay So you think you are covered, but are you really? If you’re like the 93.5% of overpaying-underinsured individuals in 2012 reported by ACE Private Risks Services, chances are you aren’t as covered as you should be. Young people who are just starting out may find the idea of a blanket insurance attractive.For example, you can purchase a blanket health insurance wherein you can add your family as dependents.Another type would be the homeowner’s insurance, which would provide coverage for your personal property and your house itself.In short, you are “blanketing” several things under one policy. Trusted Choice reported that while blanket insurance is typically more expensive than individual plans, it’s easier to understand than having multiple types of insurance policies all over the place.But it may not be suitable for everyone, especially not for families on the higher end of the wealth scale. In 2012, ACE surveyed more than 600 insurance agents and brokers and found out that more than 58% believed that wealthy families were typically underinsured, more than 7% believed that family policyholders are typically overinsured, and more than 27% believed that these families are missing the opportunity to save their money. Too often, the problem lies in the fact that these families put their money in all the wrong places and not in the areas that they would need more. For example, Insurance Adviser Ari Fischman explained that affluent families often opt for more expensive policies with lower deductibles because of the idea that higher deductibles are always worse, when in fact these families typically write off insurance claims when it only cost them a few thousand dollars.In that sense, the lower deductibles are completely useless. Instead, other important assets like jewelry and fine art are underinsured. “What is adequate coverage in your 20s, with a starter home, young kids and, an inexpensive car, will be different than the coverage you need in your 50s, with an expensive home, wine collection, and expensive cars,” Investment Adviser Gary Ran wrote for Kiplinger. “For anyone who accumulates wealth over a lifetime, their insurance needs change.” Ran recommended signing up for insurance audit services to have an expert assessment if you’re properly covered, and if not, where you might downsize or upgrade. “It’s common to scoff at insurance; it often goes unused and doesn’t seem like something you need.But that’s the thing with insurance,” Ran added. “You don’t need [it] until you actually [do].And at that point, you really need to be properly covered.”
The Truth About Root Canal
Photo by: Kjerstin_Michaela via Pixabay Root canal is “a dental procedure to treat deep dental cavities” that have already progressed into the tooth’s roots, according to WellnessMama.com. In treating such dental cavity, the infected tooth pulp will be removed, cleaned, and filled with dental filling.While the tooth is retained, the tooth itself is considered dead because the living tissue inside it has already been replaced with dental filling materials. However, this procedure has been a controversial topic in the dental world, and the question remains: is root canal safe? First of all, the American Association of Endodontists said that “there is no evidence that root canals could be linked to cancer or any other inflammatory diseases.” On the other hand, it is said that root canal can cause infection inside and outside of the root canals, accumulation of cholesterol crystals, cystic lesions, and scar tissue healing of the root canal site. In addition, bacteria appear to linger even though the root canal procedure is already over.These bacteria can cause inflammation throughout the body and cause fever or cellulitis in the head and neck area in worse cases. However, if you reach to the point where you will be needing a root canal procedure, there are its pros and cons, but there are other options if you want: * Dental implants (tooth with cavity is removed and replaced with a metal implant) * Dental bridge * Partial denture (using a removable denture as a replacement for the extracted tooth) * Removal of infected teeth (as recommended by holistic health experts) Moreover, it is best to practice oral care to prevent any oral health issues and resorting to expensive and even painful dental procedures such as root canal.