Blood, urine and other bodily fluids: how your leftover pathology samples can be used for medical research
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A doctor’s visit often ends with you leaving with a pathology request form in hand. The request form soon has you filling a sample pot, having blood drawn, or perhaps even a tissue biopsy taken.
After that, your sample goes to a clinical pathology lab to be analysed, in whichever manner the doctor requested. All this is done with the goal of getting to the bottom of the health issue you’re experiencing.
But after all the tests are done, what happens with the leftover sample? In most cases, leftover samples go in the waste bin, destined for incineration. Sometimes though, they may be used again for other purposes, including research.
Who can use my leftover samples?
The samples we’re talking about here cover the range of samples clinical labs receive in the normal course of their testing work. These include blood and its various components (including plasma and serum), urine, faeces, joint and spinal fluids, swabs (such as from the nose or a wound), and tissue samples from biopsies, among others.
Clinical pathology labs often use leftover samples to practise or check their testing methods and help ensure test accuracy. This type of use is a vital part of the quality assurance processes labs need to perform, and is not considered research.
Leftover samples can also be used by researchers from a range of agencies such as universities, research institutes or private companies.
They may use leftover samples for research activities such as trying out new ideas or conducting small-scale studies (more on this later). Companies that develop new or improved medical diagnostic tests can also use leftover samples to assess the efficacy of their test, generating data needed for regulatory approval.
What about informed consent?
If you’ve ever participated in a medical research project such as a clinical trial, you may be familiar with the concept of informed consent. In this process, you have the opportunity to learn about the study and what your participation involves, before you decide whether or not to participate.
So you may be surprised to learn using leftover samples for research purposes without your consent is permitted in most parts of Australia, and elsewhere. However, it’s only allowed under certain conditions.
In Australia, the National Health and Medical Research Council (NHMRC) offers guidance around the use of leftover pathology samples.
One of the conditions for using leftover samples without consent for research is that they were received and retained by an accredited pathology service. This helps ensure the samples were collected safely and properly, for a legitimate clinical reason, and that no additional burdens or risk of harm to the person who provided the sample will be created with their further use.
Another condition is anonymity: the leftover samples must be deidentified, and not easily able to be reidentified. This means they can only be used in research if the identity of the donor is not needed.
The decision to allow a particular research project to use leftover pathology samples is made by an independent human research ethics committee which includes consumers and independent experts. The committee evaluates the project and weighs up the risks and potential benefits before permitting an exemption to the need for informed consent.
Similar frameworks exist in the United States, the United Kingdom, India and elsewhere.
What research might be done on my leftover samples?
You might wonder how useful leftover samples are, particularly when they’re not linked to a person and their medical history. But these samples can still be a valuable resource, particularly for early-stage “discovery” research.
Research using leftover samples has helped our understanding of antibiotic resistance in a bacterium that causes stomach ulcers, Helicobacter pylori. It has helped us understand how malaria parasites, Plasmodium falciparum, damage red blood cells.
Leftover samples are also helping researchers identify better, less invasive ways to detect chronic diseases such as pulmonary fibrosis. And they’re allowing scientists to assess the prevalence of a variant in haemoglobin that can interfere with widely used diagnostic blood tests.
All of this can be done without your permission. The kinds of tests researchers do on leftover samples will not harm the person they were taken from in any way. However, using what would otherwise be discarded allows researchers to test a new method or treatment and avoid burdening people with providing fresh samples specifically for the research.
When considering questions of ethics, it could be argued not using these samples to derive maximum benefit is in fact unethical, because their potential is wasted. Using leftover samples also minimises the cost of preliminary studies, which are often funded by taxpayers.
Inconsistencies in policy
Despite NHMRC guidance, certain states and territories have their own legislation and guidelines which differ in important ways. For instance, in New South Wales, only pathology services may use leftover specimens for certain types of internal work. In all other cases consent must be obtained.
Ethical standards and their application in research are not static, and they evolve over time. As medical research continues to advance, so too will the frameworks that govern the use of leftover samples. Nonetheless, developing a nationally consistent approach on this issue would be ideal.
Striking a balance between ensuring ethical integrity and fostering scientific discovery is essential. With ongoing dialogue and oversight, leftover pathology samples will continue to play a crucial role in driving innovation and advances in health care, while respecting the privacy and rights of individuals.
Christine Carson, Senior Research Fellow, School of Medicine, The University of Western Australia and Nikolajs Zeps, Professor, School of Public Health and Preventive Medicine, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Somatic Exercises For Nervous System Regulation – by Rose Kilian
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We’ve written before about the vagus nerve, its importance, and how to make use of it, but it’s easy to let it slip from one’s mind when it comes to exercises. This book fixes that!
The promised 35 exercises are quite a range, and are organized into sections:
- Revitalizing through breath
- Stress and tension release
- Spinal and postural health
- Mindfulness and grounding
- Movements for flexibility
- Graceful balance and focus
While it’s not necessary to do all 35 exercises, it’s recommended to do at least some from each section, to “cover one’s bases”, and enjoy the best of all worlds.
The exercises are drawn from many sources, but tai chi and yoga are certainly the most well-represented. Others, meanwhile, are straight from physiotherapy or are things one might expect to be advised at a neurology consultation.
Bottom line: if you’d like to take better care of your vagus nerve, the better for it to take care of you, this book can certainly help with that.
Click here to check out Somatic Exercises For Nervous System Regulation, and take care of yourself!
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Dr. Greger’s Daily Dozen
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Give Us This Day Our Daily Dozen
This is Dr. Michael Greger. He’s a physician-turned-author-educator, and we’ve featured him and his work occasionally over the past year or so:
- Brain Food? The Eyes Have It! ← this is about dark leafy greens, lutein, & avoiding Alzheimer’s
- Twenty-One, No Wait, Twenty Tweaks For Better Health ← he says 21, but we say one of them is very skippable. Check it out and decide what you think!
- Dr. Greger’s Anti-Aging Eight ← his top well-evidenced interventions specifically for slowing aging
But what we’ve not covered, astonishingly, is one of the things for which he’s most famous, which is…
Dr. Greger’s Daily Dozen
Based on the research in the very information-dense tome that his his magnum opus How Not To Die (while it doesn’t confer immortality, it does help avoid the most common causes of death), Dr. Greger recommends that we take care to enjoy each of the following things per day:
Beans
- Servings: 3 per day
- Examples: ½ cup cooked beans, ¼ cup hummus
Greens
- Servings: 2 per day
- Examples: 1 cup raw, ½ cup cooked
Cruciferous vegetables
- Servings: 1 per day
- Examples: ½ cup chopped, 1 tablespoon horseradish
Other vegetables
- Servings: 2 per day
- Examples: ½ cup non-leafy vegetables
Whole grains
- Servings: 3 per day
- Examples: ½ cup hot cereal, 1 slice of bread
Berries
- Servings: 1 per day
- Examples: ½ cup fresh or frozen, ¼ cup dried
Other fruits
- Servings: 3 per day
- Examples: 1 medium fruit, ¼ cup dried fruit
Flaxseed
- Servings: 1 per day
- Examples: 1 tablespoon ground
Nuts & (other) seeds
- Servings: 1 per day
- Examples: ¼ cup nuts, 2 tablespoons nut butter
Herbs & spices
- Servings: 1 per day
- Examples: ¼ teaspoon turmeric
Hydrating drinks
- Servings: 60 oz per day
- Examples: Water, green tea, hibiscus tea
Exercise
- Servings: Once per day
- Examples: 90 minutes moderate or 40 minutes vigorous
Superficially it seems an interesting choice to, after listing 11 foods and drinks, have the 12th item as exercise but not add a 13th one of sleep—but perhaps he quite reasonably expects that people get a dose of sleep with more consistency than people get a dose of exercise. After all, exercise is mostly optional, whereas if we try to skip sleep for too long, our body will force the matter for us.
Further 10almonds notes:
- We’d consider chia superior to flax, but you do you. Flax is a fine choice also.
- We recommend trying to get each of these top 5 most health-giving spices in daily if you can.
Enjoy!
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The FDA Just Redefined “Healthy”—But How?
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In the ongoing war of labelling regulations (usually with advertisers on one side and regulators on the other), the FDA has updated what’s required in order to label a food as “healthy”.
Here’s what they’re now* requiring:
To bear the “healthy” claim, a food product needs to:
- Contain a certain amount of food (food group equivalent) from at least one of the food groups or subgroups (such as fruits, vegetables, fat-free and low-fat dairy etc.) recommended by the Dietary Guidelines.
- Adhere to specified limits for the following nutrients: saturated fat, sodium, and added sugars.
Source: FDA | Press Releases | FDA Finalizes Updated “Healthy” Nutrient Content Claim
*however, manufacturers have 3 years to conform, which if we’re being cynical about it, looks suspiciously like just short of a US presidential election cycle so that actual enforcement will be someone else’s problem.
Will it help?
Maybe! It’s not too dissimilar to the “traffic light system” already in use in Europe, although that currently emphasizes the absence/presence of “bad things” e.g. saturated fat, sodium, and added sugars.
It has its faults, because for example…
- not all saturated fat is bad, and a jar of coconut oil is now definitely going to get labelled as very unhealthy
- low-sodium salt is, ironically, going to to get flagged as being very high in sodium and therefore unhealthy
This latter is because on a g/100g basis, a product that’s ⅓ sodium chloride is going to have a lot of sodium, even if it’s approaching ⅔ less sodium than the product it’s (healthily!) replacing.
However, on a large scale, these kinds of problems are surely going to be small next to (hopefully) manufacturers scrambling to find ways to cut down on the saturated fats, sodium, and added sugars.
You may be wondering…
What will they replace them with?
Sometimes, companies trying to make something healthier will mess up, like when the health risks of smoking hit public consciousness, one cigarette company had the bright idea of putting asbestos in their filter tips, to market them as healthier. So, could something similar happen here?
- Saturated fat: definitely could; because the health benefits/risks of different kinds of fats and their constituent fatty acids are a lot more nuanced than just “saturated” vs “mono-/polyunsaturated”, it is definitely possible that companies may replace healthier saturated-heavy fats with less healthy unsaturated fats, depending on what is cheaper.
- See also: Can Saturated Fats Be Healthy?
- Sodium: probably not; likely go-to replacements for sodium chloride will be potassium chloride (healthier than sodium chloride) and MSG (has an unearned bad reputation in the US, but is healthier than sodium chloride).
- Added sugars: probably—things get very complicated very quickly when it comes to artificial sweeteners, and also the crux will definitely lie in what gets defined as an “added sugar”; watch out for a rise in the use of things that slide by the definition of added sugar while still being chemically (and, which is important, metabolically) the same thing.
Well that doesn’t sound great
It doesn’t, but on the flipside, the positive inclusions will probably be mostly good.
For example, the only way to get a “healthy” labelling in including fiber is to include more fiber, same with vitamins and minerals.
The low-fat dairy thing could possibly get abused (much like with the general “low-fat” trend of the 80s).
The “portion of fruit” thing will need to be carefully defined to avoid running straight back into the “this is just added sugar by another name” problem; mostly that it’ll need to still include the same amount of fiber as was in the whole fruit, gram for gram.
See also: What Matters Most For Your Heart? ← it’s about fiber, not salt or saturated fats!
Take care!
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The Vitamin Solution – by Dr. Romy Block & Dr. Arielle Levitan
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A quick note: it would be remiss of us not to mention that the authors of this book are also the founders of a vitamin company, thus presenting a potential conflict of interest.
That said… In this reviewer’s opinion, the book does seem balanced and objective, regardless.
We talk a lot about supplements here at 10almonds, especially in our Monday Research Review editions. And yesterday, we featured a book by a doctor who hates supplements. Today, we feature a book by two doctors who have made them their business.
The authors cover all the most common vitamins and minerals popularly enjoyed as supplements, and examine:
- why people take them
- factors affecting whether they help
- problems that can arise
- complicating factors
The “complicating factors” include, for example, the way many vitamins and/or minerals interplay with each other, either by requiring the presence of another, or else competing for resources for absorption, or needing to be delicately balanced on pain of diverse woes.
This is the greatest value of the book, perhaps; it’s where most people go wrong with supplementation, if they go wrong.
While both authors are medical doctors, Dr. Romy Block is an endocrinologist specifically, and she clearly brought a lot of extra attention to relevant metabolic/thyroid issues, and how vitamins and minerals (such as thiamin and iron) can improve or sabotage such, depending on various factors that she explains. Informative, and so far as this reviewer could see, objective and well-balanced.
Bottom line: supplementation is a vast and complex topic, but this book does a fine job of demystifying and simplifying it in a clear and objective fashion, without resorting to either scaremongering or hype.
Click here to check out The Vitamin Solution, and upgrade your knowledge!
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Morning Routines That Just FLOW
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Morning Routines That Just FLOW
“If the hardest thing you have to do in your day is eat a frog, eat that frog first!”, they say.
And, broadly speaking, it is indeed good to get anything stressful out of the way early, so that we can relax afterwards. But…
- Are we truly best at frog-eating when blurry-eyed and sleepy?
- Is there a spoonful of sugar that could make the medicine go down better?
- What do we need to turn eating the frog into an enjoyable activity?
Flow
“Flow” is a concept brought to public consciousness by psychologist Mihaly Csikszentmihalyi, and it refers to a state in which we feel good about what we’re doing, and just keep doing, at a peak performance level.
Writer’s note: as a writer, for example…
Sometimes I do not want to write, I pace to and fro near my computer, going on side-quests like getting a coffee or gazing out of the window into my garden. But once I get going, suddenly, something magical happens and before I know it, I have to trim my writing down because I’ve written too much. That magical window of effortless productivity was a state of flow.
Good morning!
What is a good morning, to you? Build that into your morning! Set parameters around it so you don’t get carried away timewise and find yourself in the afternoon (unless that would work for you!), but first thing in the morning is the time to light up each part of your brain with appropriate neurotransmitters.
Getting the brain juices flowing
Cortisol
When we wake up, we (unless we have some neurochemical imbalance, such as untreated depression) get a spike of cortisol. Cortisol is much-maligned and feared, and indeed it can be very much deleterious to the health in cases of chronic stress. But a little spike now and again is actually beneficial for us.
Quick Tip: if you want to artificially stimulate (or enhance) a morning cortisol spike, a cold shower is the way to go. Or even just a face-plunge into a bowl of ice-water (put ice in it, give it a couple of minutes to chill the water, then put your face in for a count of 30 seconds, or less if you can’t hold your breath that long).
Serotonin
Serotonin is generally thought of as “the happy chemical”, and it’s stimulated by blue/white light, and also by seeing greenery.
Quick tip: to artificially stimulate (or enhance) a morning serotonin boost, your best friend is sunlight. Even sun through a partly-clouded sky will tend to outperform artificial lighting, including artificial sunlight lighting. Try to get sun between 08:30 and 09:00, if you can. Best of all, do it in your garden or nearby park, as the greenery will be an extra boost!
Dopamine
Generally thought of as “the reward chemical”, but it’s also critical for a lot of kinds of brainwork, including language processing and problem-solving.
Quick Tip: to artificially stimulate* a dopamine surge to get you going, do something that you and/or your body finds rewarding. Examples include:
- Exercise, especially in a vigorous burst
- A good breakfast, a nice coffee, whatever feels right to you
- An app that has motivational bells and whistles, a streak for you to complete, etc
Note: another very enjoyable activity might come to mind that doesn’t even require you getting out of bed. Be aware, however, gentleman-readers specifically, that if you complete that activity, you’ll get a prolactin spike that will wipe out the dopamine you just worked up (because prolactin is antagonistic to dopamine). So that one’s probably better for a lazy morning when you can go back to sleep, than a day when you want to get up and go! Ladies, this is less of a worry for us as the physiology an orgasm driven by estrogen+progesterone rather than testosterone is different; there will not usually be a prolactin spike following the spike of dopamine; our orgasm-related dopamine spike is followed by a wave of oxytocin instead (“the cuddle chemical”), which is much more pleasant than prolactin.
*there’s no “(or enhance)” for this one; you won’t get dopamine from doing nothing, that’s just not how “the reward chemical” works
Flow-building in a stack
When you’ve just woken up and are in a blurry morning haze, that’s not the time to be figuring out “what should I be doing next?”, so instead:
- Work out the things you want to incorporate into your morning routine
- Put them in the order that will be easiest to perform—some things will go a lot better after others!
- Remember to also include things that are simply necessary—morning bathroom ablutions, for example
The goal here is to have a this-and-this-and-this-and-this list of items that you can go through without any deviations, and get in the habit of “after item 1 I automatically do item 2, after which I automatically do item 3, after which…”
Implement this, and your mornings will become practically automated, but in a joyous, life-enhancing way that sets you up in good order for whatever you want/need to do!
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How to Eat to Change How You Drink – by Dr. Brooke Scheller
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Whether you want to stop drinking or just cut down, this book can help. But what makes it different from the other reduce/stop drinking books we’ve reviewed?
Mostly, it’s about nutrition. This book focuses on the way that alcohol changes our relationship to food, our gut, our blood sugars, and more. The author also explains how reducing/stopping drinking, without bearing these things in mind, can be unnecessarily extra hard.
The remedy? To bear them in mind, of course, but that requires knowing them. So what she does is explain the physiology of what’s going on in terms of each of the above things (and more), and how to adjust your diet to make up for what alcohol has been doing to you, so that you can reduce/quit without feeling constantly terrible.
The style is very pop-science, light in tone, readable. She makes reference to a lot of hard science, but doesn’t discuss it in more depth than is necessary to convey the useful information. So, this is a practical book, aimed at all people who want to reduce/quit drinking.
Bottom line: if you feel like it’s hard to drink less because it feels like something is missing, it’s probably because indeed something is missing, and this book can help you bridge that gap!
Click here to check out How To Eat To Change How You Drink, and do just that!
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