A New Tool For Bone Regeneration

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When it comes to rebuilding bones, one of the tools in the orthopedic surgeon’s toolbox is bone grafts. This involves, to oversimplify it a bit, gluing particles of bone to where bone needs rebuilding. However, this comes with problems, most notably:

  • that the bone tissue and the adhesive “glue” need to be prepared separately and mixed in situ, which is fiddly, to say the least
  • that the resultant mixture mixed in situ will usually be unevenly mixed, resulting in weak bonding and degradation over time
  • having any more of one part or the other in any given site means that bone regeneration and adhesion become a “pick one” matter, when both are critically needed

You may be wondering: why can’t they mix them before putting them in?

And the answer is: because then either the glue will set the bone prematurely (and now we have a clump of bone outside of the body which is not what we wanted), or else the glue will have issues with setting in situ, and now we have bone tissue running down the inside of someone’s leg and setting somewhere else, which is also not what we want.

These kinds of problems may seem a little more “arts and crafts” than “orthopedic surgery”, but they are the kind of nitty-gritty real-life real challenges that actually get in the way of healing patients’ bones.

The new solution

Biomaterial research scientists have developed an injectable hydrogel (containing all the necessary ingredients* that uses light to achieve cross-linking of bone particles and mineralization without any of the above being necessary. In again oversimplified terms: they inject the hydrogel where it’s needed, and then irradiate the site with harmless visible light which instantly sets it in place. As to how the light gets in there: it’s just very shiny, like candling an egg to see inside, or like how you can still approximately see bright light even with your eyes closed.

*alginate (natural polysaccharide derived from brown algae), RGD peptide-containing mussel** adhesive protein, calcium ions, phosphonodiols, and a photoinitiator.

**unclear whether this would trigger a shellfish allergy. Probably kosher per “פיקוח נפש” and Talmud Yoma 85b, but we are a health science newsletter, not Talmudic scholars, so please talk to your Rabbi. Probably halal per Qur’an 5:4 and failing that, the same principle as previously mentioned, expressed in Qur’an 5:3 and 6:119, but once again, your humble writer here is no Mufti, so please talk to your Imam. As for if you are vegetarian or vegan, then that is for you to decide whether to take a “medications with animal ingredients are unfortunate but necessary” stance, as most do. This vegan writer would (she’d grumble about it, though, and at least try to find an acceptable alternative first).

Back to the more general practicalities…

How it works, in less oversimplified terms:

❝The coacervate-based formulation, which is immiscible in water, ensures that the hydrogel retains its shape and position after injection into the body. Upon visible light irradiation, cross-linking occurs, and amorphous calcium phosphate, which functions as a bone graft material, is simultaneously formed. This eliminates the need for separate bone grafts or adhesives, enabling the hydrogel to provide both bone regeneration and adhesion.❞

See the paper: Visible light-induced simultaneous bioactive amorphous calcium phosphate mineralization and in situ crosslinking of coacervate-based injectable underwater adhesive hydrogels for enhanced bone regeneration

“That’s great, but I was hoping for something I can do right now, ideally at home”

If getting glued back together was not on your bucket list, that’s understandable. There’s still a lot you can do for bone density; here’s a quick overview:

Too much information?

If that was too much information all at once, then we recommend this as your one-stop article:

The Bare-Bones Truth About Osteoporosis

Want more information?

We are but a humble newsletter and can only include so much per day, but we highly recommend this book we reviewed a little while back, which goes into everything in a lot more detail than we can here:

The Whole-Body Approach to Osteoporosis: How To Improve Bone Strength And Reduce Your Fracture Risk – by Keith McCormick

Enjoy!

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  • Leek vs Scallions – Which is Healthier?

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    Our Verdict

    When comparing leek to scallions, we picked the leek.

    Why?

    In terms of macros, scallions might have a point: scallions have the lower glycemic index, thanks to leek having more carbs for the same amount of fiber. That said, leek already has a low glycemic index, so this is not a big deal.

    When it comes to vitamins, leek has more of vitamins B1, B2, B3, B5, B6, B9, E, and choline, while scallions have more of vitamins A, C, and K. Noteworthily, a cup of chopped leek already provides the daily dose of vitamins A and K, and the difference in levels of vitamin C is minimal. All in all, an easy 8:3 win for leeks here, even without taking that into account.

    In the category of minerals, leek has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and selenium, while scallions have a little more zinc.

    Both of these allium-family plants (i.e., related to garlic) have an abundance of polyphenols, especially kaempferol.

    Of course, enjoy whatever goes best with your meal, but if you’re looking for nutritional density, then leek is where it’s at.

    Want to learn more?

    You might like to read:

    The Many Health Benefits Of Garlic

    Take care!

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  • Navigating the health-care system is not easy, but you’re not alone.

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    Hello, dear reader!

    This is my first column for Healthy Debate as a Patient Navigator. This column will be devoted to providing patients with information to help them through their journey with the health-care system and answering your questions.

    Here’s a bit about me: I have been a patient partner at The Ottawa Hospital and Ottawa Hospital Research Institute since 2017, and have joined a variety of governance boards that work on patient and caregiver engagement such as the Patient Advisors Network, the Ontario Health East Region Patient and Family Advisory Council and the Equity in Health Systems Lab.

    My journey as a patient partner started much before 2017 though. When I was a teenager, I was diagnosed with a cholesteatoma, a rare and chronic disease that causes the development of fatty tumors in the middle ear. I have had multiple surgeries to try to fix it but will need regular follow-ups to monitor whether the tumor returns. Because of this, I also live with an invisible disability since I have essentially become functionally deaf in one ear and often rely on a hearing aid when I navigate the world.

    Having undergone three surgeries in my adolescent years, it was my experience undergoing surgery for an acute hand and wrist injury following a jet ski accident as an adult that was the catalyst for my decision to become a patient partner. There was an intriguing contrast between how I was cared for at two different health-care institutions, my age being the deciding factor at which hospital I went to (a children’s hospital or an adult one).

    The most memorable example was how, as a teenager or child, you were never left alone before surgery, and nurses and staff took all the time necessary to comfort me and answer my (and my family’s) questions. I also remember how right before putting me to sleep, the whole staff initiated a surgical pause and introduced themselves and explained to me what their role was during my surgery.

    None of that happened as an adult. I was left in a hallway while the operating theater was prepared, anxious and alone with staff walking by not even batting an eye. My questions felt like an annoyance to the care team; as soon as I was wheeled onto the operating room table, the anesthetist quickly put me to sleep. I didn’t even have the time to see who else was there.

    Now don’t get me wrong: I am incredibly appreciative with the quality of care I received, but it was the everyday interactions with the care teams that I felt could be improved. And so, while I was recovering from that surgery, I looked for a way to help other patients and the hospital improve its care. I discovered the hospital’s patient engagement program, applied, and the rest is history!

    Since then, I have worked on a host of patient-centered policy and research projects and fervently advocate that surgical teams adopt a more compassionate approach with patients before and after surgery.

    I’d be happy to talk a bit more about my journey if you ask, but with that out of the way … Welcome to our first patient navigator column about patient engagement.

    Conceptualizing the continuum of Patient Engagement

    In the context of Canadian health care, patient engagement is a multifaceted concept that involves active collaboration between patients, caregivers, health-care providers and researchers. It involves patients and caregivers as active contributors in decision-making processes, health-care services and medical research. Though the concept is not new, the paradigm shift toward patient engagement in Canada started around 2010.

    I like to conceptualize the different levels of patient engagement as a measure of the strength of the relationship between patients and their interlocutors – whether it’s a healthcare provider, administrator or researcher – charted against the duration of the engagement or the scope of input required from the patient.

    Defining different levels of Patient Engagement

    Following the continuum, let’s begin by defining different levels of patient engagement. Bear in mind that these definitions can vary from one organization to another but are useful in generally labelling the level of patient engagement a project has achieved (or wishes to achieve).

    Patient involvement: If the strength of the relationship between patients and their interlocutors is minimal and not time consuming or too onerous, then perhaps it can be categorized as patient involvement. This applies to many instances of transactional engagement.

    Patient advisory/consulting: Right in the middle of our continuum, patients can find themselves engaging in patient advisory or consulting work, where projects are limited in scope and duration or complexity, and the relationship is not as profound as a partnership.

    Patient partnership: The stronger the relationship is between the patient and their interlocutor, and the longer the engagement activity lasts or how much input the patient is providing, the more this situation can be categorized as patient partnership. It is the inverse of patient involvement.

    Examples of the different levels of Patient Engagement

    Let’s pretend you are accompanying a loved one to an appointment to manage a kidney disease, requiring them to undergo dialysis treatment. We’ll use this scenario to exemplify what label could be used to describe the level of engagement.

    Patient involvement: In our case, if your loved one – or you – fills out a satisfaction or feedback survey about your experience in the waiting room and all that needed to be done was to hand it back to the clerk or care team, then, at a basic level, you could likely label this interaction as a form of patient involvement. It can also involve open consultations around a design of a new look and feel for a hospital, or the understandability of a survey or communications product. Interactions with the care team, administrators or researchers are minimal and often transactional.

    Patient advisory/consulting: If your loved one was asked for more detailed information about survey results over the course of a few meetings, this could represent patient advisory/consulting. This could mean that patients meet with program administrators and care providers and share their insights on how things can be improved. It essentially involves patients providing advice to health-care institutions from the perspective of patients, their family members and caregivers.

    Patient advisors or consultants are often appointed by hospitals or academic institutions to offer insights at multiple stages of health-care delivery and research. They can help pilot an initiative based on that feedback or evaluate whether the new solutions are working. Often patient advisors are engaged in smaller-term individual projects and meet with the project team as regularly as required.

    Patient partnership: Going above and beyond patient advisory, if patients have built a trusting relationship with their care team or administrators, they could feel comfortable enough to partner with them and initiate a project of their own. This could be for a project in which they study a different form of treatment to improve patient-centered outcomes (like the time it takes to feel “normal” following a session); it could be working together to identify and remove barriers for other patients that need to access that type of care. These projects are not fulfilled overnight, but require a collaborative, longstanding and trusting relationship between patients and health-care providers, administrators or researchers. It ensures that patients, regardless of severity or chronicity of their illness, can meaningfully contribute their experiences to aid in improving patient care, or develop or implement policies, pilots or research projects from start to finish.

    It is leveraging that lived and living experience to its full extent and having the patient partner involved as an equal voice in the decision-making process for a project – over many months, usually – that the engagement could be labeled a partnership.

    Last words

    The point of this column will be to answer or explore issues or questions related to patient engagement, health communications or even provide some thoughts on how to handle a particular situation.

    I would be happy to collect your questions and feedback at any time, which will help inform future columns. Just email me at [email protected] or connect with me on social media (Linked In, X / Twitter).

    It’s not easy to navigate our health-care systems, but you are not alone.

    This article is republished from healthydebate under a Creative Commons license. Read the original article.

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  • The Hidden Risk of Stretching: Avoiding Hamstring Injuries in Yoga

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    What is Yoga Butt

    Have you ever experienced a mysterious pain while stretching, or perhaps during yoga? You might be dealing with “yoga butt,” a common—although rarely discussed—injury. In the below video, the Lovely Liv from Livinleggings shares her journey of discovering, and overcoming, “yoga butt”.

    Dealing With Yoga Butt

    Yoga butt, or proximal hamstring tendinopathy, occurs when the hamstrings are overstretched without adequate strengthening. Many yoga poses help stretch the hamstrings, but often don’t focus on strengthening said hamstrings; this imbalance is what can lead to damage over time.

    To help prevent Yoga butt, it’s essential to balance stretching with strengthening. You can look into incorporating hamstring-strengthening exercises like Romanian deadlifts, hamstring curls, and modified yoga poses into your routine.

    (If you’re new to strengthening exercises, we recommend reading Women’s Strength Training Anatomy Workouts or Strength Training for Seniors).

    Watch the full video to learn more and hopefully protect yourself from long-term injuries:

    Let us know your thoughts, and whether you have any other topics you’d like us to cover.

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    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Is there anything special that might help someone with Tourette’s syndrome?❞

    There are of course a lot of different manifestations of Tourette’s syndrome, and some people’s tics may be far more problematic to themselves and/or others, while some may be quite mild and just something to work around.

    It’s an interesting topic for sure, so we’ll perhaps do a main feature (probably also covering the related-and-sometimes-overlapping OCD umbrella rather than making it hyperspecific to Tourette’s), but meanwhile, you might consider some of these options:

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  • Jamaican Coconut Rice

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    This is a great dish that can be enjoyed hot or cold, as a main or as a side. It has carbs, proteins, healthy fats, fiber, as well as an array of healthy phytochemicals. Not to mention, a great taste!

    You will need

    • 1 cup wholegrain basmati rice (it may also be called “brown basmati rice“; this is the same) (traditional recipe calls for pudding rice, but we’re going with the healthier option here)
    • 2 cans (each 12 z / 400g) coconut milk
    • 2 cups (or 2 cans, of which the drained weight is comparable to a cup each) cooked black beans. If you cook them yourself, this is better, as you will be able to cook them more al dente than you can get from a can, and this firmness is desirable. But canned is fine if that’s what’s available.
    • 1 large red onion, finely chopped
    • ½ cup low-sodium vegetable stock (ideally you made this yourself from vegetable offcuts you saved in the freezer for this purpose, but failing that, low-sodium stock cubes can be bought at any large supermarket)
    • 2 serrano chilis, finely chopped
    • 1 Scotch bonnet chili, without doing anything to it
    • 1 tbsp black pepper, coarse ground
    • 1 tbsp chia seeds
    • 1 tbsp coconut oil
    • Garnish: parsley, chopped

    Note: we have erred on the side of low-heat when it comes to the chilis. If you know that you and (if applicable) everyone else eating would enjoy more heat, add more heat. If not, let extra heat be added at the table via your hot sauce of choice. Sounds heretical, but it ensures everyone gets the right amount! It’s easy to add heat than to take it out, after all.

    However: if you do end up with too much heat in this or any other dish, adding acid will usually help to neutralize that. In the case of this dish, we’d recommend lime juice as a complementary flavor.

    Method

    (we suggest you read everything at least once before doing anything)

    1) In a big sauté pan, add the coconut oil, melt it if not already melted, and add the chopped onion and the chopped chilis, at a temperature sufficient to sizzle. Keep them all moving. Once the coconut oil is absorbed into the onion (this will happen before the onion is fully cooked), add the vegetable stock, followed by the coconut milk; mix it all gently to create a smooth consistency.

    2) Add the rice, chia seeds, and black pepper; mix it all gently but thoroughly; turn the temperature to a simmer, and add the Scotch bonnet chili, without cutting it at all.

    3) Cover and keep on low for about 20–30 minutes until the rice is looking done. Check on it periodically to make sure it’s not running out of liquid, but resist the urge to stir it; it shouldn’t be burning but paradoxically, once you start stirring you can’t stop or it will definitely burn.

    4) Take out the Scotch bonnet chili, and discard*. Add the black beans.

    *its job was to add flavor without adding the high-level heat of that particular chili. If you’re a regular heat-fiend, feel free to experiment with using sliced Scotch bonnet chilis instead of serrano chilis; just be aware that there’s a big difference in heat. Only do this if you really like heat. Using it the way we described in the main recipe is what’s traditional in the Caribbean, by the way.

    5) Now you can (and in fact must) stir, to mix in the black beans and bring them back to temperature within the dish. Be aware that once you start stirring, you need to keep stirring until you’re ready to take it off the heat.

    6) Serve, adding the parsley garnish.

    (this example went light on the beans; our recipe includes more for a heartier dish)

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • The Best Foods For Collagen Production

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    Dr. Andrea Suarez gives us the low-down on collagen synthesis and maintenance. Collagen is the most abundant protein in our body, and it can be fairly described as “the stuff that holds us together”. It’s particularly important for joints and bones too, though many people’s focus on it is for the skin. Whatever your priorities, collagen levels are something it pays to be mindful of, as they usually drop quite sharply after a certain age. What certain age? Well, that depends a lot on you, and your diet and lifestyle. But it can start to decline from the age of 30 with often noticeable drop-offs in one’s mid-40s and again in one’s mid-60s.

    Showing us what we’re made of

    There’s a lot more to having good collagen levels than just how much collagen we consume (which for vegetarians/vegans, will be “none”, unless using the “except if for medical reasons” exemption, which is probably a little tenuous in the case of collagen but nevertheless it’s a possibility; this exemption is usually one that people use for, say, a nasal spray vaccine that contains gelatine, or a medicinal tablet that contains lactose, etc).

    Rather, having good collagen levels is also a matter of what we eat that allows us to synthesize our own collagen (which includes: its ingredients, and various “helper” nutrients), as well as what dietary adjustments we make to avoid our extant collagen getting broken down, degraded, and generally lost.

    Here’s what Dr. Suarez recommends:

    Protein-rich foods (but watch out)

    • Protein is essential for collagen production.
    • Sources: fish, soy, lean meats (but not red meats, which—counterintuitively—degrade collagen), eggs, lentils.
    • Egg whites are high in lysine, vital for collagen synthesis.
    • Bone broth is a natural source of collagen.

    Omega-3 fatty acids

    • Omega-3s are anti-inflammatory and protect skin collagen.
    • Sources: walnuts, chia seeds, flax seeds, fatty fish (e.g. mackerel, sardines).

    Leafy greens

    • Leafy dark green vegetables (e.g. kale, spinach) are rich in vitamins C and B9.
    • Vitamin C is crucial for collagen synthesis and acts as an antioxidant.
    • Vitamin B9 supports skin cell division and DNA repair.

    Red fruits & vegetables

    • Red fruits/vegetables (e.g. tomatoes, red bell peppers) contain lycopene, an antioxidant that protects collagen from UV damage (so, that aspect is mostly relevant for skin, but antioxidants are good things to have in all of the body in any case).

    Orange-colored vegetables

    • Carrots and sweet potatoes are rich in vitamin A, which helps in collagen repair and synthesis.
    • Vitamin A is best from food, not supplements, to avoid potential toxicity.

    Fruits rich in vitamin C

    • Citrus fruits, kiwi, and berries are loaded with vitamin C and antioxidants, essential for collagen synthesis and skin health.

    Soy

    • Soy products (e.g. tofu, soybeans) contain isoflavones, which reduce inflammation and inhibit enzymes that degrade collagen.
    • Soy is associated with lower risks of chronic diseases.

    Garlic

    • Garlic contains sulfur, taurine, and lipoic acid, important for collagen production and repair.

    What to avoid:

    • Reduce foods high in advanced glycation end products (AGEs), which damage collagen and promote inflammation.
    • AGEs are found in fried, roasted, or grilled fatty proteinous foods (e.g. meat, including synthetic meat, and yes, including grass-fed nicely marketed meat—although processed meat such as bacon and sausages are even worse than steaks etc).
    • Switch to cooking methods like boiling or steaming to reduce AGE levels.
    • Processed foods, sugary pastries, and red meats contribute to collagen degradation.

    General diet tips:

    • Incorporate more plant-based, antioxidant-rich foods.
    • Opt for slow cooking to reduce AGEs.
    • Since sustainability is key, choose foods you enjoy for a collagen-boosting diet that you won’t seem like a chore a month later.

    For more on all of this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    We Are Such Stuff As Fish Are Made Of ← our main feature research review about collagen

    Take care!

    Don’t Forget…

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