United States Hospitals Supplement 2023 - Middle East Health

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November-March-April December 2023 2017

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Biomedical research in the United States World-leading scientists make science fiction real

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UNITED STATES HOSPITALS 2

United States biomed research turns science fiction into reality

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Mayo Clinic: Best U.S. hospital has unique model of care

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Baptist Health Miami Neuroscience Institute: Meningiomas are often only discovered by chance

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Cedars-Sinai: Defining Excellence in Healthcare on the Global Stage

12 MUSC Shawn Jenkins Children’s Hospital: Expert paediatric care in a healing environment 14 NewYork-Presbyterian: Providing a direct connection to first-class medical care 16 The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute: Research-based cancer care attracts patients from around the world

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United States biomed research turns science fiction into reality The United States pours a lot of money into healthcare research every year, particularly through the National Institutes of Health, which invested close to US$48 billion in research 2023. This research funding from the public sector, and untold amounts in the private sector, enable the U.S. to maintain its position as the global leader in healthcare.

It is especially interesting to observe progress in fields of healthcare that just a short while back looked like science fiction, but are now fast becoming real and are bound to have a profound impact on healthcare in the future – fields such as artificial intelligence, regenerative medicine and the rapidly advancing innovations in brain computer interface technolgy.

Regenerative medicine is a field that aims to harness the body’s innate capacity to repair and regenerate damaged tissues and organs. Through the convergence of advanced

technologies, such as stem cell research, tissue engineering and genetic editing, researchers are steadily moving closer to the realization of regenerative therapies that can repair or replace damaged organs, alleviate suffering, and extend the quality and duration of human life.

Similarly, the field of brain-computer interfaces (BCI) is gaining significant momentum and recognition. BCIs serve as a bridge between the human brain and technology, allowing humans to directly communicate with and control devices and artificial limbs.

BCIs also have the potential to restore neural functions in individuals with disabilities.

Here we look at just a few examples of recently published research in these fields by researchers based in the United States, to give an indication of some of the incredible advances that are being made. There is a quiet revolution going on behind the scenes of public-facing healthcare, which looks set to burst into the limelight in the next few years, turning healthcare science fiction into reality, and providing cures and therapies that could barely be imagined just a few years ago.

Neurons, the main cells that make up our brain and spinal cord, are among the slowest cells to regenerate after an injury, and many neurons fail to regenerate entirely. While scientists have made progress in understanding neuronal regeneration, it remains unknown why some neurons regenerate and others do not.

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Using single-cell RNA sequencing, a method that determines which genes are activated in individual cells, researchers from University of California San Diego School of Medicine have identified a new biomarker that can be used to predict whether or not neurons will regenerate after an injury. Testing their discovery in mice, they found that the biomarker

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was consistently reliable in neurons across the nervous system and at different developmental stages. The study was published October 16, 2023 in the journal Neuron [1].

“Single-cell sequencing technology is helping us look at the biology of neurons in much more detail than has ever been possible, and this study really demonstrates

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New biomarker predicts whether neurons will regenerate

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UC San Diego Health Sciences

Continued from page 2 that capability,” said senior author Binhai Zheng, PhD, professor in the Department of Neurosciences at UC San Diego School of Medicine. “What we’ve discovered here could be just the beginning of a new generation of sophisticated biomarkers based on single-cell data.”

The researchers focused on neurons of the corticospinal tract, a critical part of the central nervous system that helps control movement. After injury, these neurons are among the least likely to regenerate axons – the long, thin structures that neurons use to communicate with one another. This is why injuries to the brain and spinal cord are so devastating.

“If you get an injury in your arm or your leg, those nerves can regenerate and it’s often possible to make a full functional recovery, but this isn’t the case for the central nervous system,” said first author Hugo Kim, PhD, a postdoctoral fellow in the Zheng lab. “It’s extremely difficult to recover from most brain and spinal cord injuries because those cells have very limited regenerative capacity.

Once they’re gone, they’re gone.”

The researchers used single-cell RNA sequencing to analyze gene expression in neurons from mice with spinal cord injuries. They encouraged these neurons to regenerate using established molecular techniques, but ultimately, this only worked for a portion of the cells. This experimental setup allowed the researchers to compare sequencing data from regenerating and non-regenerating neurons.

Further, by focusing on a relatively small number of cells – just over 300 –

Hugo Kim, PhD (left) designed and executed the single-cell RNA sequencing experiments under the supervision of Binhai Zheng, PhD (right).

the researchers were able to look extremely closely at each individual cell.

“Just like how every person is different, every cell has its own unique biology,” said Zheng.

“Exploring minute differences between cells can tell us a lot about how those cells work.”

Using a computer algorithm to analyze their sequencing data, the researchers identified a unique pattern of gene expression that can predict whether or not an individual neuron will ultimately regenerate after an injury. The pattern also included some genes that had never been previously implicated in neuronal regeneration.

“It’s like a molecular fingerprint for regenerating neurons,” said Zheng.

To validate their findings, the researchers tested this molecular fingerprint, which they named the Regeneration Classifier, on 26 published single-cell RNA sequencing datasets. These datasets included neurons from various parts of the nervous system

and at different developmental stages.

The team found that with few exceptions, the Regeneration Classifier successfully predicted the regeneration potential of individual neurons and was able to reproduce known trends from previous research, such as a sharp decrease in neuronal regeneration just after birth.

“Validating the results against many sets of data from completely different lines of research tells us that we’ve uncovered something fundamental about the underlying biology of neuronal regeneration,” said Zheng. “We need to do more work to refine our approach, but I think we’ve come across a pattern that could be universal to all regenerating neurons.”

Reference: 1. doi: https://doi.org/10.1016/ j.neuron.2023.09.019

A research paper published recently in Science Translational Medicine[1] presents a significant breakthrough in the area of skin regeneration and wound healing by researchers at the Wake Forest Institute for Regenerative Medicine (WFIRM). The study, titled “Bioprinted Skin with Multiple

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Cell Types Promotes Skin Regeneration, Vascularization, and Epidermal Rete Ridge Formation in Full-Thickness Wounds,” shows the successful development of bioprinted skin that accelerate wound healing, support healthy extracellular matrix remodeling, and provide optimism for complete

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wound recovery. Anthony Atala, M.D., director of WFIRM and Adam Jorgensen, M.D., Ph.D., post-doctorate researcher at WFIRM, co-led the study.

Skin regeneration has long been studied with hopes of providing burn victims, wounded soldiers, and those with skin disContinued on page 9

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Wound healing research produces full thickness human bioprinted skin

Mayo Clinic

Best U.S. hospital has unique model of care Patients from more than 150 countries travel to Mayo Clinic for treatment

Mayo Clinic is the world’s largest integrated, not-for-profit medical group practice.

Newsweek magazine ranks Mayo Clinic as the best hospital in the world. Additionally, U.S. News & World Report has ranked it No. 1 in more specialties than any other hospital in the U.S. for seven consecutive years. Mayo Clinic has locations in Rochester, Minnesota, Phoenix, Arizona and Jacksonville, Florida in the United States and a speciality clinic in London, England.

What sets Mayo Clinic apart from other hospitals is Mayo Clinic’s Model of Care.

Dr. Mohamad Bydon, Professor of Neurosurgery at Mayo Clinic and Executive Medical Director for Europe, the Middle East, India, Africa and International Academic Affairs, describes the Mayo Clinic Model of Care as “a set of principles that have guided our organization since its earliest days. They are the reason patients come to Mayo. Many healthcare facilities offer high-quality care, but these principles set Mayo Clinic apart.”

The Mayo Clinic Model of Care The Mayo Clinic Model of Care is defined by high-quality, compassionate medical care delivered in a multispecialty, integrated academic institution. The primary focus, meeting the needs of the patient, is accomplished by embracing the following core elements (attributes) as the practice continues to evolve.

According to Dr. Bydon: “Our team approach means that you’ll never have to search for answers alone. The Mayo Clinic team will be hand-picked according to the patient’s unique needs. It will likely include specialists within and across departments to evaluate the patient’s condition from fresh perspectives.”

“Plus, you and your patient’s team have access to more than 4,700 Mayo Clinic physicians and scientists on three campuses. If there’s a question, alternate ideas, and emerging research are just a phone call – or hallway – away. At Mayo Clinic, our approach leads to more answers and more happy endings for patients than anywhere else.”

Under the Mayo Clinic Model of Care,

Dr. Mohamad Bydon, Professor of Neurosurgery at Mayo Clinic and Executive Medical Director for Europe, the Middle East, India, Africa and International Academic Affairs.

patient care begins with an unhurried examination with time to listen to the patient. From there, a physician takes personal responsibility for directing patient care over time in a partnership with the local physician. Collegial, cooperative staff teamwork with multispecialty integration is utilized, and a team of specialists is available and appropriately used.

Mayo Clinic believes in the highestquality patient care provided with compassion and trust, respect for the patient, family and the patient’s local physician.

A decisive diagnosis and treatment can be determined through a comprehensive, timely and efficient assessment.

The right answers Effective treatment depends on getting the right diagnosis as soon as possible.

Dr. Bydon explains: “Our specialists have a long history of recognizing and treating complex medical problems that go undiagnosed elsewhere. Uncommon conditions are simply common at Mayo.”

“We also understand that when it comes to your patient’s health, you and your patient are an expert, too. As a valuable part of your healthcare team, you’re encouraged to share your story and ask questions.”

Safe, efficient care – all in one place You won’t wait weeks or even days for answers. If your patient has a test in the morning, your patient’s doctor will have the results that afternoon. In fact, most initial visits to Mayo Clinic take less than a week.

That doesn’t mean we rush care. Specialist appointments at Mayo Clinic are actually longer than average. The professionals on the care team will take the time they need to sit down and really talk with the patient. Thorough, thoughtful and comprehensive evaluations and consultations are built right into the patient itinerary.

We ensure every patient gets the personalized attention and individual care needed – so they can heal faster and return to the activities and people they love most.

Referring physicians Mayo Clinic is committed to collaborating with referring physicians, medical institutions, and medical licensure boards. Every year, patients from more than 150 countries travel to Mayo Clinic for care. International patients receive timely diagnoses and specialty care in a place designed to feel a little more like home.

• To refer a patient or learn more, visit: www.MayoClinic.org

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Baptist Health Miami Neuroscience Institute

Baptist Health South Florida, one of America’s preeminent healthcare organizations.

Meningiomas are often only discovered by chance An interview with Michael McDermott, M.D., neurosurgeon and chief medical executive of Baptist Health Miami Neuroscience Institute, about meningiomas and what you should know.

Meningiomas represent about 1 out of 3 primary brain and spinal cord tumors.

They are the most commonly diagnosed primary brain tumors in adults. And although they evolve in the meninges, the layers of tissue that surround the outer part of the brain and spinal cord, they are referred to as brain tumors.

The vast majority of meningiomas are benign, but these tumors can grow slowly and, if left undiscovered, can be severely disabling and life-threatening depending on their location. About 10 to 15 percent of meningiomas are malignant, or cancerous.

Michael McDermott, M.D., a neurosurgeon and the chief medical executive of

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Miami Neuroscience Institute, is a worldrenowned leader in neurosciences, with a clinical expertise in the field of meningioma surgery.

“I would say that the greatest proportion of meningiomas are discovered by chance,” explains Dr. McDermott. “Because of the wide availability of modern imaging, particularly with magnetic resonance imaging (MRI), studies are done for other reasons.

That’s why these tumors are frequently discovered.”

Most meningiomas are usually discovered after an MRI or CT scan that someone may undergo after complaining of headaches or seizures, or possibly after a

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head injury. Since meningiomas are commonly slow-growing tumors, they often do not cause noticeable symptoms until they grow to certain size. In extreme cases, these tumors can alter a person’s behavior and mood.

In the following Q&A, Dr. McDermott provides more insight into meningiomas, including symptoms, risk factors and treatments.

What should people know about meningiomas?

“Meningiomas are the most common primary brain tumor in adults from over the age of 35 until death. Approximately 70

Michael McDermott, M.D., Neurosurgeon & Chief Medical Executive, Baptist Health Miami Neuroscience Institute

percent of these are low-grade and benignbehaving tumors. About 25 percent are a slightly higher grade, more aggressive and they need radiation therapy. They’re a very common tumor. They’re found frequently incidentally. For example, after a concussion, a CT scan is done for other reasons — and lo and behold — there’s a tumor and it’s a meningioma.

“Most of the meningiomas diagnosed do not require treatment. So, if the patient is asymptomatic, they don’t have symptoms specific to the tumor site and there’s no documented growth, then there’s no role for intervention. The patient can be safely observed.”

What are common symptoms associated with meningiomas?

“The most common symptoms for an adult patient with a brain tumor of any type are headaches, seizures, and progressive focal neurologic deficit. If the tumor overlies your motor cortex, you develop weakness on the other side. If it’s over your sensory cortex, you develop sensory symptoms. If it’s over your visual cortex, you develop visual symptoms. And then the other one is changing personality or behavior. That relates to the fact that the frontal lobe and temporal lobe are large parts of the brain and they control mood, insight, judgment, personality and behavior.

“If you have a big tumor pressing on your frontal lobe, you’ll have the so-called frontal lobe syndrome, which can encompass an apathetic and demotivational state, and depressed mood. Those are the kind of symptom complexes that the patients

Dr. McDermott, world-renowned leader in neuroscience.

show. A headache that’s present for two weeks, and is worse in the morning than the evening, and is associated with nausea and vomiting — that’s not normal.”

What are the top risk factors for meningiomas?

“Overwhelming, the majority, 90 percent or greater, are sporadic — meaning we don’t know why they occur. As I mentioned before, the majority are benign. But there are risk factors, such as prior radiation therapy exposure. With childhood leukemias, where the children are radiated prophylactically between the ages of three to seven. Now, there’s a national registry for those patients … understanding that there’s a 25-fold risk increase for the later development of meningioma.

“There are other associations with certain genetic syndromes, like neurofibromatosis (a genetic disorder that causes tumors to form on nerve tissue); non-causative links like breast cancer. Breast cancers are very common, and meningiomas are much less common. But they have similar genetic abnormalities. That doesn’t mean if you have breast cancer, you going to develop a meningioma, or vice versa.

“There’s an association with thyroid tumors; an association with fertility treatments; and an and an association with a family history — like two first-degree rela-

tives with meningiomas — that might put you at a higher risk later in life for being diagnosed with one.”

What is the most common misconception that people may have about meningiomas?

“When you tell a patient that they have a benign tumor, they think that surgical treatment will be curative. But that’s not always the case and we have options for treatment. So, if we’re following a patient who’s asymptomatic, and they either become symptomatic or we have documented radiographic growth, then there’s a consideration for intervention or treatment.

“The different forms of treatment include surgery, radiation therapy or radiosurgery diagnosis. And each of those forms of treatment has a different risk profile.

Even 50 percent of benign tumors that are totally excised will recur25 years after diagnosis. So, the key thing is that if you treat a patient with a benign tumor, they have to be followed essentially for their lifetime to rule out recurrence.”

For more information or to schedule an appointment, call 786-596-2373, visit: BaptistHealth.net/Neuroscience or contact us at: International@BaptistHealth.net

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Cedars-Sinai

Defining Excellence in Healthcare on the Global Stage Cedars-Sinai is a global destination for world-class care amid top U.S. rankings There has never been a better time to consider Cedars-Sinai for patients with complex medical conditions or simply those who seek the best in expert medicine.

Cedars-Sinai was recognized as one of the best hospitals in the U.S. for the eighth year in a row in U.S. News & World Report’s “Best Hospitals 2023-24” Honor Roll.

Cedars-Sinai also ranked among the top five in six specialties (Cardiology, Heart & Vascular Surgery; Gastroenterology & GI Surgery; Orthopedics; Pulmonology & Lung Surgery; Neurology & Neurosurgery; and Urology). Eleven specialties ranked among the top in the U.S. This stature is what draws patients from every part of the world to Cedars-Sinai.

“We are currently caring for patients from more than 100 countries in several sought after specialties like heart, cancer, neurology, orthopedics, gastrointestinal diseases, transplantation and women’s health,” said Heitham Hassoun, MD, Vice President and Medical Director of Cedars-Sinai International.

Cedars-Sinai International: Personalized Care on a Global Scale Geography should never be an obstacle to receiving world-class healthcare services.

Cedars-Sinai International is continually making strides to reach more patients in more countries while also making it easier for them to seek care in Los Angeles, where it is based. Patients who come to Cedars-Sinai have access to the latest equipment, leading-edge research, renowned physicians and advanced therapies. But these are only a few aspects of top-quality care. Cedars-Sinai International strongly believes that healthcare is personal and that cultural traditions, approaches and beliefs are vital to a patient’s wellbeing.

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Cedars-Sinai Pavilion Building

A dedicated Patient Services team helps international patients navigate their care journey with appropriate cultural and language support. A range of concierge services is especially designed for patients who are traveling to the Los Angeles campus from abroad. Streamlining international referrals and working with insurers worldwide are just two of the ways Patient Services can provide key healthcare support to patients from abroad. They also manage administrative details, such as scheduling appointments and record review, and they can advise on travel, accommodations and activities to enhance a patient’s stay.

Patients and their families also have access to Cedars-Sinai’s International Lounge, an exclusive space with multiple areas for relaxation, a shared office, a communications room, a pantry, a prayer/meditation room and private rooms where they can meet with their coordinator and enjoy the time in between appointments.

“Los Angeles is one of the most diverse, dynamic cities on Earth, which gives us a head start in delivering culturally appropriate care,” said Dr. Hassoun, adding that some 10 languages are spoken at Cedars-Sinai International, including Arabic, Mandarin, Spanish, French and Cantonese. Other important touches, from specialized diets to access to appropriate clergy, help round out a personalized, dignified experience for the duration of the patient’s stay.

of the U.S. Through a variety of collaborative strategies, Cedars-Sinai offers a full spectrum of advisory and consulting services that help prospective partners around the world achieve their goals as the global healthcare environment evolves. From Mexico to Asia to the Middle East, providers come together through webinars, conferences and trade shows to share knowledge, ideas and visions for the future. Additionally, our growing incountry office presence (currently in Mexico City, soon in Singapore and more countries) provides patients and referring physicians the opportunity to learn more about Cedars-Sinai, gain access to our knowledge through second opinions and receive care in Los Angeles as the need arises.

Perhaps most importantly, strategic collaborations have been formed that already have led to new state-of-the-art facilities, such as The View Hospital in Qatar, an affiliation between Cedars-Sinai and Elegancia Healthcare, a subsidiary of Estithmar Holding. Not only is The View Hospital an extraordinary new offering for patients in the Gulf region and beyond, it also ushered in a new era of collaboration between Cedars-Sinai International and healthcare organizations in the Middle East. On the heels of The View Hospital’s grand opening in December, Cedars-Sinai had its largest-ever presence at Arab Health 2023.

“As we continue to grow around the world, reach the top of healthcare rankings and find new ways to reach more patients,” said Dr. Hassoun, “one thing remains steadfast – our commitment to providing the finest care available and exceeding our patients’ expectations no matter where they are.”

Strategic Partnerships in Action To bring top-flight care closer to more people, Cedars-Sinai International’s Global Services team continually explores opportunities for collaboration with hospitals outside

Learn more: International Patients | Cedars-Sinai cedars-sinai.org/international Global Collaborations | Cedars-Sinai cedars-sinai.org/globalcollaborations

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Wake Forest Institute for Regenerative Medicine

Continued from page 4 orders opportunities at complete healing.

Available grafts are often temporary, or if permanent, have only some of the elements of normal skin, which often have a scarred appearance. The creation of full thickness skin has not been possible to date. This study involved the bioprinting of all six major primary human cell types present in skin combined with specialized hydrogels as a bioink. Multi-layered full thickness skin was created which contained all three layers present in normal human tissue: epidermis, dermis, and hypodermis. When transplanted in pre-clinical settings, the bioprinted skin formed blood vessels, skin patterns, and normal tissue formation. Additional arms of the study demonstrated improved wound closure, reduced skin contraction, and more collagen production to reduce scarring.

“Comprehensive skin healing is a significant clinical challenge, affecting millions of individuals worldwide, with limited options,” explained Dr Atala, who is the primary author on the paper. “These results show that the creation of full thickness human bioengineered skin is possible, and promotes quicker healing and more naturally appearing outcomes.”

By leveraging existing bioprinting technology to address these limitations, the team at WFIRM has shown that fully functional skin regeneration is possible. The bioengineered skin grafts offer a triple-layer structure for full-thickness wound coverage.

The Wake Forest Institute for Regenerative Medicine is recognized as an international leader in translating scientific discovery into clinical therapies, with many

Wake Forest Institute for Regenerative Medicine researchers use cells and hydrogels as bioinks to 3D print human skin

world firsts, including the development and implantation of the first engineered organ in a patient. Over 450 people at the institute, the largest in the world, work on more than 40 different tissues and organs.

A number of the basic principles of tissue engineering and regenerative medicine were first developed at the institute.

WFIRM researchers have successfully engi-

neered replacement tissues and organs in all four categories – flat structures, tubular tissues, hollow organs and solid organs – and 16 different applications of cell/tissue therapy technologies, such as skin, urethras, cartilage, bladders, muscle, kidney, and vaginal organs, have been successfully used in human patients. The institute is, part of Wake Forest University School of Medicine.

Reference: 1. doi: https://doi.org/10.1126/scitranslmed.adf7547

UCLA-led team finds a stem-cell derived mechanism that could lead to regenerative therapies for heart damage A UCLA-led team has identified an essential internal control mechanism that can promote the maturation of human stem cell-derived heart muscle cells, offering a deeper understanding of how heart muscle cells develop from their immature fetal stage to their mature adult form.

The findings, published in the peer-reviewed journal Circulation [1], could lead to new therapies for heart disease and cardiac damage.

The collaborative effort with Duke-NUS Medical School in Singapore and other institutions identified an RNA splicing regulator named RBFox1, which was considerably more prevalent in adult heart cells than in newborns, based on a preclinical

model. The sharp rise in RBFox1 during the maturation of heart cells was also confirmed through analyses of existing single-cell data.

“This is the first piece of evidence suggesting that RNA splicing control plays a vital role in postnatal heart cell maturation,” said study lead Jijun Huang, who conducted this research during his postdoctoral training in anesthesiology at UCLA. “While RBFox1 alone may not be

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UCLA-led team finds a stem-cell derived mechanism that could lead to regenerative therapies for heart damage

Continued from page 9 sufficient to push mature fetal heart muscle cells all the way to fully matured adult cells, our findings uncover a new RNAbased internal network that can substantially drive this maturation process beyond other available approaches.”

The transformation of heart muscle cells from birth until they reach full ma-

turity involves significant shifts in their structure, functionality, and physiological properties. The mechanisms overseeing this comprehensive maturation have been poorly understood thus far.

Although the precise mechanics associating RBFox1-mediated RNA splicing with ensuing maturation procedures and

characteristics still require further exploration, the study provides proof-of-concept that modulating RNA splicing can profoundly affect cardiomyocyte maturation. This newfound knowledge hints at future therapeutic applications, pending additional research to expand upon these initial findings.

Brain-computer interface (BCI) – an experimental technology that makes it possible to move robotic limbs using only one’s thoughts – holds promise to transform the lives of people with paralysis. But before BCI can make the leap from the lab to patients’ everyday lives, a nagging problem remains: how to coax the body to coexist, for the long haul, with the implants.

“There are two major challenges,” says Professor Takashi Kozai, associate professor of bioengineering at the University of Pittsburgh Swanson School of Engineering, who leads the BIONIC Lab (Bio-Integrating Optoelectric Neural Interface Cybernetics) < https://www.bioniclab.org/home >. For one, over time, scar tissue forms around the electrodes, which complicates the signal’s path to the nearest neuron and dampens the voltage. And for another, there’s a lot of variability in performance.

“Sometimes these devices work, and sometimes they don’t,” he says.

Overcoming these challenges will be a formidable feat from both the engineering and neurobiology perspectives. Luckily, Prof. Kozai lives right at the nexus of the two.

In May, Prof. Kozai was awarded a $3 million grant over five years from the National Institute of Neurological Disorders and Stroke.

The focus of the project is to gain a better understanding of a specific cell type, called oligodendrocytes, which he believes could play a key role in settling this unique human-versus-machine dilemma.

Oligodendrocytes form the insulative coating known as myelin, which makes neural connections in the brain much faster and more streamlined. Without this insulation, what’s left is a long line of naked axons straining to send impulses along jagged, roundabout paths.

That inefficiency, Prof. Kozai realized, doesn’t just cause a slowdown, but also means these neurons have to work much harder than their myelinated counterparts, wasting precious energy. “So oligodendrocytes are essentially energy savers,” he says.

If Prof. Kozai’s hunch is correct about oligodendrocytes – an historically understudied cell in his research specialty – this work could have broad implications for a number of debilitating conditions.

Historically, the thinking has been that the trouble with the BCI starts like this: As a result of electrode implantation, blood vessels are damaged, which sends plasma proteins flying off where they shouldn’t be. Their presence on the wrong side of the blood-brain barrier unleashes an assault of immune cells, called microglia. And in that fallout, neurons die.

But the team began observing that the friendly fire wasn’t the only problem; it was that these neurons, having been choked off from their blood supply, had simply starved to death. So Prof. Kozai wondered if they could somehow fortify the neurons against that starvation.

“That’s what pointed us toward the oligodendrocytes.”

With this new grant, Prof. Kozai is targeting certain progenitor cells that each have potential to give rise to either an

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Keying Chen / University of Pittsburgh

Human vs machine

Image of oligodendrocyte and myelin (green) in the brain next to an implanted microelectrode. Oligodendrocyte somas are denoted by white arrows, blood vessels are shown in red, and the microelectrode shank is outlined in blue.

oligodendrocyte or enemy number one: scar tissue. In a preliminary study [1], the team treated these cells with a drug to encourage the former. When administered before implant surgery, they found, the drug helped more neurons survive after the procedure.

The project will also probe oligodendrocyte health more generally, insights that could potentially expand our understanding of traumatic brain injury and stroke – which both involve a decrease in blood flow in the brain – as well as multiple sclerosis (MS) – an autoimmune onslaught on neurons that’s initially sparked by oligodendrocyte death.

Prof. Kozai’s group may be one of the first to have suggested that preserving oligodendrocytes could be a novel treatment against dementia in Alzheimer’s. In that disease, the focus has long been on the plaques that form in the brain.

“But there’s growing evidence that it’s actually the blood vessels that suffer first – the plaques form on the blood vessels before they form on the neurons,” Prof/ Kozai explains. Amid the ensuing blood loss, it’s possible the neurons are more vulnerable, unable to maintain a clean environment, “and that, in turn, leads to the plaque forming on the neurons”.

Reference: 1. doi (preprint) https://doi.org/10.1101/2023.01.31.526463

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MUSC Shawn Jenkins Children’s Hospital

Expert paediatric care in a healing environment Located on the East Coast in historical Charleston, South Carolina, U.S.A., the Medical University of South Carolina (MUSC) Shawn Jenkins Children’s Hospital (SJCH) has cared for patients and their families since the early 1900’s. This long history of providing expert care in over 27 specialties ensures a thoughtful approach to all complex or rare paediatric conditions and diseases.

Opened in February 2020, The MUSC Shawn Jenkins Children’s Hospital (SJCH) consists of over 250 beds and includes a Level 1 trauma centre, the state’s only paediatric burn centre and solid-organ and bone marrow transplant programmes, the state’s largest Level 4 neonatal intensive care unit, an advanced foetal medicine centre and a top-4 ranked U.S. News & World report children’s cardiology & cardiac surgery programme for two years in a row. Designed with input from over 200 providers and families passionate about building a healing environment, this new hospital provides unmatched attention and care to the patient and family experience.

MUSC Children’s Health Pediatric and Congenital Heart Center MUSC Children’s Health Pediatric and Congenital Heart Center located in SJCH performed over a dozen heart transplants last year and is on pace to exceed that number this year. Our surgical outcomes are among the very best in the United States and our Society of Thoracic Surgeons (STS) data consistently outperforms benchmarks. The third floor of our children’s hospital houses our heart centre and includes a paediatric cardiology intensive care unit.

Our team treats the full spectrum of heart disorders ranging from babies still in the womb to adults. With a team of experts, including three cardiac surgeons, seven cardiac anesthesiologists, and more than 20 cardiologists,

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MUSC Shawn Jenkins Children’s Hospital, Charleston, South Carolina

the MUSC Children’s Health Pediatric and Congenital Heart Center is among the largest paediatric heart programmes in the United States. We offer numerous sub-specialty programmes encompassing all types of heart disease.

Our depth and experience allow us to specialize in all areas of cardiology, including cardiac catheterization, cardiac critical care, echocardiography and advanced three-dimensional imaging, heart failure, arrhythmias and electrophysiology.

Paediatric neurosurgery MUSC Children’s Health neurosurgeons routinely perform life-saving and complex procedures that influence global care. Our innovative approach to resolving undiagnosed conditions results in a highly respected programme that offers safe and new techniques that families travel long distances to receive. The surgical team teaches their innovations to providers across the globe.

Paediatric orthopaedics Our paediatric orthopaedic team regularly cares for spina bifida, cerebral palsy, scoliosis and spinal deformity patients incorporating the latest robotic technology for enhanced surgical precision, shorter hospital stays, and fewer complications. Our three surgeons are all trained to safely perform the most complex skeletal procedures with excellent outcomes.

Obstetrical services Housed within the SJCH, the Pearl Tourville Women’s Pavilion (PTWP) seamlessly integrates children’s care and obstetrical services, thereby enhancing safety and improving outcomes in high-risk pregnancies. Working collaboratively with the advanced foetal

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The lobby at the MUSC Shawn Jenkins Children’s Hospital, Charleston, South Carolina

care centre for families expecting babies with complex congenital birth defects and medical problems, PTWP providers are one of only a handful of teams in the country able to offer couplet-care rooms, where newborns and mothers can recover together in an intensivecare setting. Our 80-bed NICU is one floor above the women’s pavilion for swift transport to our neonatal specialists.

Additionally, we offer excellent outcomes in paediatric cancer care, including bone marrow transplant, ear, nose and throat (ENT), burn care, and burn reconstructive surgery. Our ECMO programme is a platinum ELSO-designated hospital, one of 16 paediatric hospitals globally awarded this achievement. Our telehealth and technology allow you to stay in touch with your patient and our care teams.

We are changing what’s possible for patients and families across the country and the world.

• For more information, visit: https://musckids.org • To refer a patient, please contact our International Services Team at: https://muschealth.org/patients-visitors/ international-patients.

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NewYork-Presbyterian

NewYork-Presbyterian: Providing a direct connection to first-class medical care

NewYork-Presbyterian/Columbia University Irving Medical Center

When most people hear the term “GPS” – they might think of a ‘global positioning system’ that directs them to their desired destination. It is fitting, then, that GPS also stands for the Global Patient Services programme at NewYork-Presbyterian (NYP), which assists patients and their families throughout the Middle East and around the world to make it their destination – for state-of-the-art medical care and the best in patient experience.

NewYork-Presbyterian is the only academic medical centre in the United States affiliated with two world-class medical schools, Weill Cornell Medicine and Columbia University Vagelos College of Physicians and Surgeons.

Its longstanding reputation for clinical excellence has put the hospital at the forefront in terms of medical education, groundbreaking research, and patient-centric treatment.

NewYork-Presbyterian/Weill Cornell Medical Center

Global Services Program: 24/7 ‘concierge” service’ – for when it matters most Each year, more than 5,000 international patients travel to NewYork-Presbyterian with assistance from its Global Services Program, which gives them access to the hospital’s world-renowned Columbia University and Weill Cornell Medicine physicians.

NYP has a long history of caring for patients in the Middle East and North Africa, and our regional ‘ambassadors’ collaborate closely with local governments and private institutions in those regions to provide access to our services and making the entire process a smooth one for patients. Our GPS team of multilingual professionals is dedicated to assisting families, 24 hours a day, 7 days a week, to help manage the complex logistics involved in planning for care far from home, including: • scheduling physician visits and clinical appointments

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Our GPS team helps manage the complex logistics involved in planning for care far from home • escorting patients to appointments • explaining and interpreting medical information, instructions, and procedures • facilitating communication between physicians, administrators and patients • organizing global air ambulance, ground ambulance, or other emergency transport services for critically ill patients • helping to arrange for hotels or furnished apartments, including NYP’s onsite facilities • assisting families in understanding the cost of care Innovative treatments in these specialties and others: • Cancer Care: NYP is home to two major cancer centres – the National Cancer Institute-designated Herbert Irving Comprehensive Cancer Center at Columbia, and the Weill Cornell Medicine Meyer Cancer Center at NewYork-Presbyterian. Patients benefit from the latest anti-cancer drugs, targeted therapies, advanced radiation therapies, and emerging minimally-invasive surgical procedures.

• Cardiology: NYP is renowned for its latest interventional therapies and pioneering cardiac surgery techniques, including heart transplants. NewYork-Presbyterian is one of the leading centres in the United States for innovative treatment of

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adult heart conditions and for paediatric cardiology.

• Neurosciences: NYP continues to make clinical advances for conditions such as glioblastoma and complex epilepsy, as well as offering new applications for highintensity-focused ultrasound for neurological conditions.

• Orthopaedics: NYP treats patients of all ages, from newborns to older adults, for virtually every type of orthopaedic injury, disease, or disorder to relieve symptoms and restore comfort, function, and mobility.

• Paediatrics: For more than a decade, NewYork-Presbyterian has been at the forefront of more paediatric treatments than any other New York City metropolitan area.

NYP Global Patient Services Program NewYork-Presbyterian’s Global Patient Services Program starts you on your journey to the very best medical care that you or your loved one deserve.

For more information, contact: • Issam Ramadan Mob: +971 56 624 2588 Email: isr9012@nyp.org • NYP Main Office: +1 212 746 9100 Email: globalservices@nyp.org

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The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute

Research-based cancer care attracts patients from around the world The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James <https://cancer.osu.edu>) is dedicated to creating a cancer-free world by integrating scientific research with excellence in education and patient-centered care – a strategy that leads to better methods of prevention, detection and treatment.

Ohio State has been designated a National Cancer Institute (NCI) Comprehensive Cancer Center for nearly 50 years and is one of only a few centers funded by the NCI to conduct phase I, II and III clinical trials on novel anticancer drugs provided by the NCI. In its last three formal reviews for five-year re-designation, the university’s cancer program, embodied in the OSUCCC – James, has received the NCI’s highest descriptor of “exceptional”.

The OSUCCC – James has more than $125 million in active cancer-relevant research funding, and $70.4 million of that total – more than half – comes from the NCI. In 2023 alone, Ohio State cancer researchers received 27 new research grants totaling $15.8 million from the NCI. The OSUCCC – James has nearly 340 full or introductory cancer researchers who collectively represent 12 of the 15 colleges at Ohio State. Each researcher is a member of one of five multidisciplinary research programs: Cancer Control, Leukemia Research, Cancer Biology, Molecular Carcinogenesis and Chemoprevention, or Translational Therapeutics. In 2022, these researchers authored or co-authored 825 publications

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in peer-reviewed journals, including 174 in journals with impact factors of 10 or higher. Also, 98% of all articles published were collaborative, and over 96% were multi-institutional. In addition, OSUCCC – James researchers lead or assist with nearly 700 clinical trials offering the latest cancer treatments, some of which are available nowhere else.

Some 530 of these trials are interventional in focus.

Collaboration and integration As the cancer program’s 356-bed adult patient-care component, The James is the third-largest cancer hospital in the United States and one of the top cancer hospitals in the nation as ranked by U.S. News & World Report. With 21 floors and more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical care. Because early

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diagnosis is the key to successful cancer treatment, The James Cancer Diagnostic Center at the OSUCCC – James provides patients who may have cancer with direct, expedited access to diagnostic testing in a center that is open for same-day or nextday appointments.

The OSUCCC – James since 2014 has enrolled nearly 70,000 patients in a Total Cancer Care® (TCC) protocol for voluntarily sharing de-identified clinical data that advances cancer research and personalizes cancer care. The TCC protocol has been adopted by all 18 member institutions across the United States that constitute the Oncology Research Information Exchange Network (ORIEN), a research collaboration co-founded and coanchored by the OSUCCC – James and Moffit Cancer Center in Tampa, Florida.

Through ORIEN, TCC-consented patients across the nation donate clinical data for research that helps scientists better understand cancer at the molecular level.

Outstanding international reputation Because of its international reputation for providing outstanding research-based cancer care, the OSUCCC – James is regarded as a global destination of choice, serving patients from all 50 U.S. states, three U.S territories and 85 other countries.

The institution’s Destination Medicine Global Health Care team <https://cancer. osu.edu/destinationmedicine> is dedicated to ensuring that distance and language are no obstacles to receiving the internationally recognized cancer care available at Ohio State.

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Mayo Clinic is the top-ranked hospital in the USA. Mayo Clinic sets the standard as the best hospital in the USA. Our world-class experts from every medical specialty work together to give each patient exactly the care they need. Mayo Clinic is the global destination for patients with serious or complex conditions who need certainty, options, and hope.

– U.S. News & World Report 2023-2024

mayoclinic.org/top-ranked

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