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What's All the Fuss About the Human Genome Project?
In February of 2001, virtually every media outlet, whether TV news, newspapers, radio, Internet news services, or news magazines, was all worked up about the announcement of the completion of the Human Genome Project. In this article we will explore this monumental achievement and what it means for the future of medicine and our understanding of ourselves.
To appreciate this important accomplishment, we need to review a little basic genetics. It may actually astonish most adults just how much genetics the National Institutes of Health assumes we know about our genetic heritage. The educational video from the HGP includes a three-minute review of basic genetic processes like DNA packaging, transcription of DNA into message RNA, and the translation of message RNA into protein. It's no exaggeration to say that when I played this short piece during a lecture for high school students and their parents, mom and dad were left in the dust.
Honestly, I did that intentionally; because we are only in the beginning stages of a genetic revolution that will transform the way we diagnose and treat disease and how we may even alter our genetic structure. These new technologies bring with them numerous ethical and moral dilemmas we have only begun to address and for which there may not be simple answers. If we don't take the time to familiarize ourselves with genetic research and its implications, we risk responding out of fear and ignorance and potentially throwing away crucial medical advances.
I have contended for a long time that we can no longer afford to remain ignorant of genetic technologies. They simply harbor far too great a power for both tremendous good and tremendous evil. We must work hard to take every thought captive to Christ and see what there is of benefit and what avenues of research and application we need to avoid to preserve human freedom and dignity.
Well let's talk about our genome, the sum total of all our genes. In most of the 100 trillion cells of our body are 46 chromosomes. These chromosomes are tightly coiled and packed strings of a remarkable molecule called DNA (Deoxyribonucleic Acid). DNA is a polymer, a repetitive sequence of four molecules, which I will only refer to by their one-letter abbreviations, A, G, C, and T. The human genome sequence is simply the sequence of these four molecules in DNA from all our chromosomes. If you laid out the DNA from all our chromosomes in each of our cells end to end, it would stretch six feet long.
A gene is a segment of DNA that contains the precise coding sequence for a protein. And proteins do all the real work in our cells. By looking at our completed sequence, it is predicted that our genome consists of 30,000 to 45,000 genes in each of our cells. So, now that we have the sequence, what does it mean? We'll begin answering that question in the next section.
What Does the Human Genome Project Hope to Accomplish?
The National Institutes of Health in cooperation with several international research organizations began the HGP in 1990 in the U.S. There were four primary objectives among the many goals of the HGP{1}.
The first and primary goal of the HGP was to map and sequence the entire human genome. There is a critical and significant difference between a map and the sequence. There are over three billion letters, or base pairs, in the human genome, spread out over 23 pairs of chromosomes. Trying to locate a sequence of say 1,000 letters, the code for a large protein, is a one in a million task. Therefore, researchers needed a refined roadmap to the genome. The map entails particular sequences that can be used like signs on a road map. If the trait a scientist is studying always seems to be present with this marker, the gene involved is probably nearby. In 1995, a detailed map was published with over 15,000 markers, one for every 200,000 base pairs. This will aid greatly in associating genes with particular diseases. And now with the sequence nearly complete, with over 99% accuracy, determining the precise effect of this gene on disease will be even easier.
A second critical goal was to map and sequence the genomes of several important model organisms: specifically, the bacterium E. coli, yeast, the roundworm, fruit fly, and mouse. This information is helpful, because each of these organisms have been used for laboratory studies for decades. Being able to coordinate knowledge of their genomes with cellular and biological processes will certainly inform our study of the human genome and its various functions.
The third important objective of the HGP was to systemize and distribute the information it gathered. Any sequence over 2,000 base pairs is released within 24 hours. The sequence and map data is contained in publicly accessible databases on the Internet. The HGP has also been creating software and other tools for large-scale DNA analysis.
The fourth and final primary goal of the HGP was to study the ethical, legal, and social implications of genetic research. A full 5% of all funds appropriated for the HGP have been earmarked for these kinds of considerations. There are many concerns revolving around the use of genetic sequence data. Not the least of which are worries about ownership, patenting, access to personal sequence data by insurance companies, potential for job discrimination based on personal sequence data, and the prospects for genetic screening, therapy, and engineering. In the next section we'll begin investigating how the HGP thinks this information can be used.
What are the Long Term Hopes for the HGP?
The completion of the sequence was announced jointly in February 2001 in the journals Nature{2} and Science{3}. Both Science and Nature have made these landmark issues available, without subscription, on their websites.
The importance of recognizing the sequence of a particular gene has three important ramifications.{4} The first is diagnosis. Over the last few years, single genes have been found leading to deafness and epilepsy. Numerous genes, however, will influence most diseases in complex ways. Recently, genetic influences have been found in many forms of hypertension, diabetes, obesity, heart disease, and arteriosclerosis{5}. Genetic analysis of cancer tumors may someday help determine the most effective drug therapy with the fewest side effects. Genetic diagnosis has the potential to more precisely prescribe treatments for many medical conditions.
Second, diagnosing ailments with more precision with genetics will also lead to more reliable predictions about the course of a disease. Genetic information about an individual's cholesterol chemistry will aid in predicting the course of potential heart disease. Obtaining a genetic fingerprint of a cancerous tumor will provide information concerning its degree of malignancy. Third, more precise genetic information will also lead to the development of better strategies for prevention of disease.
Many more ailments in newborns can eventually be screened more specifically to avoid disorders later in life. Currently, babies in the U.S. and other countries are routinely screened for PKU, a metabolic disorder that prevents the breakdown of a specific amino acid found in proteins. This condition becomes toxic to the nervous system, but can be prevented and managed with appropriate diet. Without dietary changes, affected babies face extreme mental retardation. Hopefully, the number of conditions this type of screening applies to can be expanded.
Screening can also be done for adults, to see if they may be carriers of potential genetic conditions. Certain Jewish and Canadian populations regularly obtain voluntary screening for Tay-Sachs disease, a known child-killer. This information has been used to help make decisions about future marriage partners.
Perhaps the greatest benefit will come from what is called gene-based therapy. Understanding the molecular workings of genes and the proteins they encode will lead to more precise drug treatments. The more precise the drug treatment, the fewer and milder will be the side effects.
Actual gene therapy, replacing a defective gene with its normal counterpart, is still very experimental. There are still many hurdles to overcome involving how to deliver the gene to the proper cells, controlling where that gene is inserted into a chromosome, and how it is activated.
Not surprisingly, some have seen the human genome sequence as a vindication of Darwin. We'll examine that contention next.
Did the Human Genome Sequence Vindicate Darwin?
Amid the controversy and exultation over the release of the near complete human genome sequence has been a not so quiet triumphal howling from evolutionary biologists. The similarity of many genes across boundaries of species, the seemingly messy patchwork nature of the genome, and the presence of numerous apparently useless repetitive and copied sequences all have been laid out for us as clear validations of evolution. Really!
If Darwin were alive today, he would be astounded and humbled by what we now understand about the human genome and the genomes of other organisms.
Let's take a closer look at the claims of one bioethicist, Arthur Caplan{6}, who thought the major news story was missed. So let's just pick a few of the more glaring statements to help us understand that little in his comments should be trusted.
First, Caplan says, "Eric Lander of the Whitehead Institute in Cambridge, Mass., said that if you look at our genome it is clear that evolution must make new genes from old parts."
While it may be true that we can see some examples of shared sequences between genes, it is by no means true that we see wholesale evidence of gene duplication throughout the genome. According to one group of researchers,{7} less than 4,000 genes share even 30% of their sequences with other genes.
Over 25,000 genes, as much as 62% of the human genes mapped by the Human Genome Project, were unique, i.e., not likely the result of copying.
Second, Caplan says, "The core recipe of humanity carries clumps of genes that show we are descended from bacteria. There is no other way to explain the jerry-rigged nature of the genes that control key aspects of our development."
Not everyone agrees. The complexity of the genome does not mean, necessarily, that it has been jerry-rigged by evolution. There is still so much we do not know. Caplan is speaking more out of ignorance and assumption than data. Listen to this comment from Gene Meyers, one of the principal geneticists from Celera Genomics, from a story in the San Francisco Chronicle:
'What really astounds me is the architecture of life,' he said. 'The system is extremely complex. It's like it was designed.'
My ears perked up. 'Designed? Doesn't that imply a designer, an intelligence, something more than the fortuitous bumping together of chemicals in the primordial slime?'
Myers thought before he replied. 'There's a huge intelligence there. I don't see that as being unscientific. Others may, but not me.'{8}
Jerry-rigged? Hardly! Confusing at the moment? Certainly! But more likely to reveal hidden levels of complexity, rather than messy jerry-rigging.
It will take more than bluster to convince me that our genome is solely the result of evolution. The earmarks of design are clear, that is, if you have eyes to see.
What are the Challenges of the Human Genome Project?
In closing, I would like to address what are many people's concerns about the potential for abuse of this information. While there is great potential for numerous positive uses of the human genome, many fear unintended consequences for human freedom and dignity.
Some are justifiably worried about the rush to patent human genes. The public consortium, through the National Institutes of Health, has made all its information freely available and intends to patent nothing. However, there are several patent requests pending on human genes from the time before the HGP was completed.
It is important to realize that these patents are not necessarily for the genes themselves. What the patent does protect is the holder's right to priority to any products derived from using the sequence in research. With the full sequence fully published, this difficult question becomes even more muddled. No one is anxious for the courts to try its hand at settling the issue. Somehow companies will need some level of protection to provide new therapies based on genetic information without hindering the public confidence and health.
Another concern is the availability of information about individual genetic conditions. There are legitimate worries about employers using genetic information to discriminate over whom they will hire or when current employees will be laid off or forced into retirement. Upwards of 80-90% of Americans believe their genetic information should be private and obtained or accessed only with their permission. The same fears arise as to the legality of insurance companies using private genetic information to assess coverage and rates. A recent bill (June 29,2000) before Congress to address these very concerns was amended to the Health and Human Services appropriations bill, but was removed in committee. The bill will be reintroduced this session.{9} I would be very surprised if some level of privacy protection is not firmly in place by 2002.
Moreover, many are apprehensive about the general speed of discovery and the very real possibilities of genetic engineering creating a new class, the genetically enhanced. Certainly, there is cause for vigilance and a watchful eye. I have said many times that we can no longer afford to be ignorant of genetic technologies. And while I agree that the pace of progress could afford to slow down a little, let's be careful not to throw the baby out with the bathwater.
After a series of lectures on genetic engineering and human cloning at a Christian high school, one student wrote me to say:
I am a senior, in an AP Biology class, and I find genetics absolutely fascinating. It's both fascinating and scary at the same time. . . . [You have inspired me] to not be afraid of the world and science in particular, but to take on its challenge and trust God.
Amen to that!
1. "Genetics: The Future of Medicine," NIH, Publication No. 00-4873, 2.
2. Nature, 409 (15 February, 2001), www.nature.com.
3. Science, 291 (16 February, 2001), www.sciencemag.org.
4. Genetics: The Future of Medicine, 9-11.
5. Kevin Davies, "After the genome: DNA and human disease," Cell, 104 (Feb. 23, 2001), 465-467.
6. www.probe.org/did-the-human-genome-project-prove-that-darwin-was-right/.
7. Wen-Siung Li, Zhenglong Gu, Haidong Waing, and Anton Nekrutenko, "Evolutionary analyses of the human genome," Nature, 409 (15 Feb 2001):847-849.
8. Tom Abate, "Human Genome Map Has Scientists Talking About the Divine – Surprisingly low number of genes raises big questions," Monday, February 19, 2001, San Francisco Chronicle.
9. James M. Jeffords and Tom Daschle, "Political issues in the genomic era," Science, 291 (16 February, 2001), 1249-1251.
© 2001 Probe Ministries International
Human Genetic Engineering
Although much has occurred in this field since this article was written in 2000, the questions addressed by Dr. Bohlin are still timely and relevant. Is manipulating our genetic code simply a tool or does it deal with deeper issues? Dealing with genetic engineering must be done within the context of the broader ethical and theological issues involved. In the article, Dr. Bohlin provides an excellent summary driven from his biblical worldview perspective.
What forms of genetic engineering can be done in human beings?
Genetic technology harbors the potential to change the human species forever. The soon to be completed Human Genome Project will empower genetic scientists with a human biological instruction book. The genes in all our cells contain the code for proteins that provide the structure and function to all our tissues and organs. Knowing this complete code will open new horizons for treating and perhaps curing diseases that have remained mysteries for millennia. But along with the commendable and compassionate use of genetic technology comes the specter of both shadowy purposes and malevolent aims.
For some, the potential for misuse is reason enough for closing the door completely–the benefits just aren't worth the risks. In this article, I'd like to explore the application of genetic technology to human beings and apply biblical wisdom to the eventual ethical quagmires that are not very far away. In this section we'll investigate the various ways humans can be engineered.
Since we have introduced foreign genes into the embryos of mice, cows, sheep, and pigs for years, there's no technological reason to suggest that it can't be done in humans too. Currently, there are two ways of pursuing gene transfer. One is simply to attempt to alleviate the symptoms of a genetic disease. This entails gene therapy, attempting to transfer the normal gene into only those tissues most affected by the disease. For instance, bronchial infections are the major cause of early death for patients with cystic fibrosis (CF). The lungs of CF patients produce thick mucus that provides a great growth medium for bacteria and viruses. If the normal gene can be inserted in to the cells of the lungs, perhaps both the quality and quantity of their life can be enhanced. But this is not a complete cure and they will still pass the CF gene on to their children.
In order to cure a genetic illness, the defective gene must be replaced throughout the body. If the genetic defect is detected in an early embryo, it's possible to add the gene at this stage, allowing the normal gene to be present in all tissues including reproductive tissues. This technique has been used to add foreign genes to mice, sheep, pigs, and cows.
However, at present, no laboratory is known to be attempting this well-developed technology in humans. Princeton molecular biologist Lee Silver offers two reasons.{1} First, even in animals, it only works 50% of the time. Second, even when successful, about 5% of the time, the new gene gets placed in the middle of an existing gene, creating a new mutation. Currently these odds are not acceptable to scientists and especially potential clients hoping for genetic engineering of their offspring. But these are only problems of technique. It's reasonable to assume that these difficulties can be overcome with further research.
Should genetic engineering be used for curing genetic diseases?
The primary use for human genetic engineering concerns the curing of genetic disease. But even this should be approached cautiously. Certainly within a Christian worldview, relieving suffering wherever possible is to walk in Jesus' footsteps. But what diseases? How far should our ability to interfere in life be allowed to go? So far gene therapy is primarily tested for debilitating and ultimately fatal diseases such as cystic fibrosis.
The first gene therapy trial in humans corrected a life-threatening immune disorder in a two-year-old girl who, now ten years later, is doing well. The gene therapy required dozens of applications but has saved the family from a $60,000 per year bill for necessary drug treatment without the gene therapy.{2} Recently, sixteen heart disease patients, who were literally waiting for death, received a solution containing copies of a gene that triggers blood vessel growth by injection straight into the heart. By growing new blood vessels around clogged arteries, all sixteen showed improvement and six were completely relieved of pain.
In each of these cases, gene therapy was performed as a last resort for a fatal condition. This seems to easily fall within the medical boundaries of seeking to cure while at the same time causing no harm. The problem will arise when gene therapy will be sought to alleviate a condition that is less than life-threatening and perhaps considered by some to simply be one of life's inconveniences, such as a gene that may offer resistance to AIDS or may enhance memory. Such genes are known now and many are suggesting that these goals will and should be available for gene therapy.
The most troublesome aspect of gene therapy has been determining the best method of delivering the gene to the right cells and enticing them to incorporate the gene into the cell's chromosomes. Most researchers have used crippled forms of viruses that naturally incorporate their genes into cells. The entire field of gene therapy was dealt a severe setback in September 1999 upon the death of Jesse Gelsinger who had undergone gene therapy for an inherited enzyme deficiency at the University of Pennsylvania.{3} Jesse apparently suffered a severe immune reaction and died four days after being injected with the engineered virus.
The same virus vector had been used safely in thousands of other trials, but in this case, after releasing stacks of clinical data and answering questions for two days, the researchers didn't fully understand what had gone wrong.{4} Other institutions were also found to have failed to file immediate reports as required of serious adverse events in their trials, prompting a congressional review.{5} All this should indicate that the answers to the technical problems of gene therapy have not been answered and progress will be slowed as guidelines and reporting procedures are studied and reevaluated.
Will correcting my genetic problem, prevent it in my descendants?
The simple answer is no, at least for the foreseeable future. Gene therapy currently targets existing tissue in a existing child or adult. This may alleviate or eliminate symptoms in that individual, but will not affect future children. To accomplish a correction for future generations, gene therapy would need to target the germ cells, the sperm and egg. This poses numerous technical problems at the present time. There is also a very real concern about making genetic decisions for future generations without their consent.
Some would seek to get around these difficulties by performing gene therapy in early embryos before tissue differentiation has taken place. This would allow the new gene to be incorporated into all tissues, including reproductive organs. However, this process does nothing to alleviate the condition of those already suffering from genetic disease. Also, as mentioned earlier this week, this procedure would put embryos at unacceptable risk due to the inherent rate of failure and potential damage to the embryo.
Another way to affect germ line gene therapy would involve a combination of gene therapy and cloning.{6} An embryo, fertilized in vitro, from the sperm and egg of a couple at risk for sickle-cell anemia, for example, could be tested for the sickle-cell gene. If the embryo tests positive, cells could be removed from this early embryo and grown in culture. Then the normal hemoglobin gene would be added to these cultured cells.
If the technique for human cloning could be perfected, then one of these cells could be cloned to create a new individual. If the cloning were successful, the resulting baby would be an identical twin of the original embryo, only with the sickle-cell gene replaced with the normal hemoglobin gene. This would result in a normal healthy baby. Unfortunately, the initial embryo was sacrificed to allow the engineering of its identical twin, an ethically unacceptable trade-off.
So what we have seen, is that even human gene therapy is not a long-term solution, but a temporary and individual one. But even in condoning the use of gene therapy for therapeutic ends, we need to be careful that those for whom gene therapy is unavailable either for ethical or monetary reasons, don't get pushed aside. It would be easy to shun those with uncorrected defects as less than desirable or even less than human. There is, indeed, much to think about.
Should genetic engineering be used to produce super-humans?
The possibility of someone or some government utilizing the new tools of genetic engineering to create a superior race of humans must at least be considered. We need to emphasize, however, that we simply do not know what genetic factors determine popularly desired traits such as athletic ability, intelligence, appearance and personality. For sure, each of these has a significant component that may be available for genetic manipulation, but it's safe to say that our knowledge of each of these traits is in its infancy.
Even as knowledge of these areas grows, other genetic qualities may prevent their engineering. So far, few genes have only a single application in the body. Most genes are found to have multiple effects, sometimes in different tissues. Therefore, to engineer a gene for enhancement of a particular trait–say memory–may inadvertently cause increased susceptibility to drug addiction.
But what if in the next 50 to 100 years, many of these unknowns can be anticipated and engineering for advantageous traits becomes possible. What can we expect? Our concern is that without a redirection of the worldview of the culture, there will be a growing propensity to want to take over the evolution of the human species. The many people see it, we are simply upright, large-brained apes. There is no such thing as an independent mind. Our mind becomes simply a physical construct of the brain. While the brain is certainly complicated and our level of understanding of its intricate machinery grows daily, some hope that in the future we may comprehend enough to change who and what we are as a species in order to meet the future demands of survival.
Edward O. Wilson, a Harvard entomologist, believes that we will soon be faced with difficult genetic dilemmas. Because of expected advances in gene therapy, we will not only be able to eliminate or at least alleviate genetic disease, we may be able to enhance certain human abilities such as mathematics or verbal ability. He says, "Soon we must look deep within ourselves and decide what we wish to become."{7} As early as 1978, Wilson reflected on our eventual need to "decide how human we wish to remain."{8}
Surprisingly, Wilson predicts that future generations will opt only for repair of disabling disease and stop short of genetic enhancements. His only rationale however, is a question. "Why should a species give up the defining core of its existence, built by millions of years of biological trial and error?"{9} Wilson is naively optimistic. There are loud voices already claiming that man can intentionally engineer our "evolutionary" future better than chance mutations and natural selection. The time to change the course of this slow train to destruction is now, not later.
Should I be able to determine the sex of my child?
Many of the questions surrounding the ethical use of genetic engineering practices are difficult to answer with a simple yes or no. This is one of them. The answer revolves around the method used to determine the sex selection and the timing of the selection itself.
For instance, if the sex of a fetus is determined and deemed undesirable, it can only be rectified by termination of the embryo or fetus, either in the lab or in the womb by abortion. There is every reason to prohibit this process. First, an innocent life has been sacrificed. The principle of the sanctity of human life demands that a new innocent life not be killed for any reason apart from saving the life of the mother. Second, even in this country where abortion is legal, one would hope that restrictions would be put in place to prevent the taking of a life simply because it's the wrong sex.
However, procedures do exist that can separate sperm that carry the Y chromosome from those that carry the X chromosome. Eggs fertilized by sperm carrying the Y will be male, and eggs fertilized by sperm carrying the X will be female. If the sperm sample used to fertilize an egg has been selected for the Y chromosome, you simply increase the odds of having a boy (~90%) over a girl. So long as the couple is willing to accept either a boy or girl and will not discard the embryo or abort the baby if it's the wrong sex, it's difficult to say that such a procedure should be prohibited.
One reason to utilize this procedure is to reduce the risk of a sex-linked genetic disease. Color-blindness, hemophilia, and fragile X syndrome can be due to mutations on the X chromosome. Therefore, males (with only one X chromosome) are much more likely to suffer from these traits when either the mother is a carrier or the father is affected. (In females, the second X chromosome will usually carry the normal gene, masking the mutated gene on the other X chromosome.) Selecting for a girl by sperm selection greatly reduces the possibility of having a child with either of these genetic diseases. Again, it's difficult to argue against the desire to reduce suffering when a life has not been forfeited.
But we must ask, is sex determination by sperm selection wise? A couple that already has a boy and simply wants a girl to balance their family, seems innocent enough. But why is this important? What fuels this desire? It's dangerous to take more and more control over our lives and leave the sovereignty of God far behind. This isn't a situation of life and death or even reducing suffering.
But while it may be difficult to find anything seriously wrong with sex selection, it's also difficult to find anything good about it. Even when the purpose may be to avoid a sex-linked disease, we run the risk of communicating to others affected by these diseases that because they could have been avoided, their life is somehow less valuable. So while it may not be prudent to prohibit such practices, it certainly should not be approached casually either.
1. Lee Silver, Remaking Eden: Cloning and Beyond in a Brave New World, New York, NY: Avon Books, p. 230-231.
2. Leon Jaroff, Success stories, Time, 11 January 1999, p. 72-73.
3. Sally Lehrman, Virus treatment questioned after gene therapy death, Nature Vol. 401 (7 October 1999): 517-518.
4. Eliot Marshall, Gene therapy death prompts review of adenovirus vector, Science Vol. 286 (17 December 1999): 2244-2245.
5. Meredith Wadman, NIH under fire over gene-therapy trials, Nature Vol. 403 (20 January 1999): 237.
6. Steve Mirsky and John Rennie, What cloning means for gene therapy, Scientific American, June 1997, p. 122-123.
7. Ibid., p. 277.
8. Edward Wilson, On Human Nature, Cambridge, Mass.: Harvard University Press, p. 6.
9. E. Wilson, Consilience, p. 277.
©2000 Probe Ministries
Genetic Engineering – A Christian Scientist's Perspective
Dr. Ray Bohlin examines the rapidly moving world of genetic engineering from a Christian worldview perspective. He explains that most genetic engineering attempts to make more efficient changes similar to those previously done through selective breeding and other conventional techniques. However, those working in the field need to be aware of the ethical and religious issues that arise in this area of science.
What Is Genetic Engineering?
Our culture teeters on the edge of a steep and dangerous precipice. New technologies will soon allow us to change, radically and permanently, the world in which we live. Indeed, we will hold in our hands the capability of directly and purposefully changing who we are as human beings. The technology I am speaking of is genetic engineering.{1} Ethical and technical questions swirl around discussions of genetic engineering like the wall clouds of the eye of a hurricane. Many in society seem to be bracing themselves for the disappearance of the calm of the eye and the coming of the full force of a powerful and destructive combination of new plants and animals unleashed on an unsuspecting environment, with new and improved humans designed to succeed.
Before your alarm buttons go on overload, let me say that I hope to lend a reassuring voice with a dose of sober realism. Genetic technology will undoubtedly unleash great power to change our world forever, but should it, and will it? In this article I want to explore just a few of the technical and ethical questions we face as a society. The time to discuss these issues is now, while we still have time to think without simply reacting.
The phrase genetic engineering, unfortunately, often conjures up images of macabre experiments resulting in Frankenstein-like monsters and the cold-hearted use of genetic information to create new social classes depending on our genes, as in the 1997 film Gattaca.{2} However, genetic engineering can simply be defined as the manipulation or alteration of the genetic structure of a single cell or organism.
Sometimes the manipulation of an organism's genome, the totality of all its genes, can simply refer to the project of identifying its complete DNA sequence in order to gain information for future study and potential alteration. The Human Genome Project is therefore, in a sense, a form of genetic engineering because the human genome must be broken up and manipulated in order to gain the desired information.
Ordinarily, genetic engineering refers to the direct addition, deletion, or intentional mutation of an organism's DNA sequence to produce a desired effect. Knockout experiments in mice seek to determine the effects of eliminating a particular gene from the mouse genome. Recombinant DNA experiments usually take a gene found in one organism and place the gene into another organism. These animals can be of the same or different species.
Sometimes researchers will simply change the DNA sequence in a gene to study what effect the specific change has on the gene or its protein product. All of these alterations fall under the umbrella of genetic engineering. In this broad definition, genetic engineering is neither good nor evil. The nature of the experiments themselves will determine if they are moral or immoral.
Why Are There Genetic Illnesses?
The initial thrust of genetic research is the treatment and potential cure of genetic illnesses. Therefore, we must explore why genetic illnesses occur at all. "Why questions" within science usually occur on two levels and are notoriously difficult. The first level and usually the easier of the two are the scientific. The "why" is best changed to "how." For our purposes this means, How do genetic illnesses arise? The second, more difficult question asks on a moral basis, Why do genetic illnesses occur?
The answer to the first question, How do genetic illnesses arise?, is simply, mutations. Mutations are mistakes in the DNA sequence. Sometimes a mutation is simply the substitution of one nucleotide for another.
Mutations can also result from a piece of DNA being deleted. This may cause one or more codons to disappear. In cystic fibrosis (CF), codon 508 out of 1,480 is missing, causing one amino acid to be removed from the resulting protein. This causes the severe respiratory and digestive problems of CF patients that are usually lethal before their 30th birthday.
So far, genes for more than 1,200 human disorders have been identified, which are found over all twenty-three pairs of human chromosomes. Some estimate that there may be as many as 3,000 to 4,000 human genetic disorders that are due to defects in a single gene. Most disorders, however, will be due to mutations in a host of genes.
The moral question is perhaps not so difficult in its answer, but in our acceptance of the answer. Mutations exist as a result of the Fall. We know the serpent was cursed, Eve was cursed, and Adam was cursed (Gen. 3:14-19). But Romans 8:18-22 also tells us that all creation was subjected to futility, groans and suffers, and eagerly awaits the revealing of the sons of God so it may be set free from its slavery to corruption. This world is not as God intended.
Asking why someone suffers from a genetic disease is no different than asking why someone was killed in a traffic accident when others walked away. We know our suffering is temporary. We know that God will somehow work it all out for good (Rom. 8:28). But in 2 Corinthians Paul tells us we suffer so we can comfort those who suffer after us (1:4), so other sufferers will know they are not alone (1:6), and, principally, we suffer so we will trust in God and not ourselves (1:9).
Part of the Christian mission has always been to alleviate suffering where possible. While Jesus' miracles clearly were part of fulfilled prophecy, they were also about relief from suffering. Genetic engineering, while possessing a power that can be used for evil, which we will discuss, also at least has the potential to relieve the suffering from, if not even cure, genetic disease.
Could Changing Genetic Material Produce a Dangerous Superbug?
One concern that many people have about genetic engineering is the possibility of unintentionally creating a superbug or a damaging plant or animal whose destructive nature is only discovered after the fact. After all, our knowledge of the workings of genes and proteins is still growing. We hear constantly how complex everything is. What makes us think we can tinker with this incredible biological reservoir of information without making some incredible blunder from which there is no turning back?
When genetic engineering in bacteria was first discovered and introduced (Recombinant DNA technology), many scientists had this very fear. This was partially the reason for the self-imposed moratorium and four levels of containment in the early 1970s. But geneticists and molecular biologists found that dangerous, unintentional consequences were virtually nonexistent. Enforcement of the guidelines eventually relaxed and soon became outdated and ignored. What this means is that researchers were quite convinced that transferring DNA of known sequence and function into bacterial chromosomes and plasmids did not result in unforeseen consequences. The procedure became routine and straightforward.
This does not mean that someone, somewhere, won't use biotechnology to produce a superbug intentionally. Certainly this technology can be used to produce even more powerful and resistant agents of biological warfare. Some even speculated that HIV (human immunodeficiency virus), the virus that causes AIDS, was intentionally produced. Though this hypothesis has been successfully refuted, the prospect remains that DNA recombinant technology has opened up a new field that can be used for evil.
However, we must be clear that this is not the fault of the technology itself. It is entirely human to shrink with fear away from things that we don't understand. The first predictable reaction of tribal societies when faced with modern technology was to cower in fear. Something dreadful was about to descend upon them. Usually this didn't happen and, with some education and familiarity, fear dissipated. But only human agents alone can make evil choices. Fire will heat our homes and cook our food, but it can also kill indiscriminately in the hands of an arsonist. But fire itself is not evil.
What should concern us more than the advent of biotechnology is the growing popularity of a totally secular and naturalistic worldview. Naturalism contends that humans are just complicated animals. The end result of this assumption is that ethics becomes an exercise in simply determining what works, not what is right.
Biotechnology is powerful, indeed, but we cannot put the genie back in the bottle. Therefore we must engage the discussion as to how this technology can be used to cure disease and not become another snare to degrade and dehumanize people's lives.
Are We Playing God by Creating Organisms That Never Existed Before?
Unfortunately, the concept of playing God means different things to different people.{3} For some it may have nothing to do with God at all. They are simply expressing awe and wonder at the power that humans can wield over nature.
For some Christians, however, the notion of playing God carries a pietistic view of God's realm of activity versus that of the human race. In this context, playing God means performing tasks that are reserved for God and God alone. If this is what genetic technology does, then the concerns about playing God are justified. But what is often being reflected in this perspective is that God acts where we are ignorant and it should stay that way.
What is really at stake is fear, fear of what we may learn, fear of what new responsibility this new knowledge will put on our shoulders, and fear that this new knowledge will be used to harm us and not for the common good. The point was made that technology itself is not evil. Any technology can be used to further God's purposes or hinder them. People make those decisions, not technology.
By the very fact that we are called to be stewards of God's creation (Gen. 1:26-28), we need to expand our knowledge of what God has made in order to better rule over His creation. Part of being made in God's image is our creativity. In this sense we "play God" by imitating Him. Our works of art, buildings, management of natural parks, and care for the poor, sick, and disadvantaged all imitate God for the good of His creation.
But we are still creating new creatures that did not exist before. Isn't God the only Creator in that sense? We seldom realize that we are hard-pressed to find in nature today the ancestors of nearly all the plants and animals we use for food or service. Our current varieties of corn, wheat, flowers, cattle, dogs, horses, etc., bear little resemblance to the original stock in nature. That is because we have selected and manipulated them over the millennia for our own purposes. We have already created animals and plants that never existed before. Genetic technology has greatly increased the specificity and power of our abilities, but the nature of what we can do is the same as before.
If we are to play God in the sense of imitating Him as we apply the truth of being created in His image and in exercising our appointment as stewards over all He has made, then we need to do so with humility and compassion. Our creative abilities should be used to enhance the condition of men and women as we struggle in a fallen world. Genetic technologies can and should be used to help alleviate or even cure the effects of genetic disease.
Is It Wrong to Combine Genes from Different Species?
Have you ever wondered if we should be transferring genes from one species to another at all? Does this in itself violate some ethical principle? One gene does not define a species. Bacteria are composed of thousands of genes and it is estimated that humans possess as many as 100,000 genes. Therefore, transferring one gene from one organism to another does not create a hybrid in the traditional sense. Genes, remember, are composed of DNA. DNA is a molecule; it is not living in and of itself.
If the idea of adding something foreign to an organism is troublesome, just realize that we do this all the time when we take antibiotics, over the counter pain medications, and other synthetic medications. Our bodies would never come across most of these substances in nature.
What is different is that with genetic engineering, we have added something to a cell or organism that will change the composition of that cell or organism, possibly for as long as it lives, and is potentially passed on to future generations. It is reasonable to ask if we have the wisdom even to try to make these kinds of changes. No doubt, genetic technology provides a power never before possessed by human beings: to design intentionally or create a new variety of organism by altering its genetic structure.
Once again, the issues are, Which genes are actually being transferred? and, For what purpose? These questions, asked case by case, should rule our choices, not the inherent legitimacy of genetic engineering itself. Creating crops internally resistant to disease, particularly to help developing countries better feed their people, is a goal worthy of God's image-bearers.
However, intentionally manipulating the gene of a known pathogenic and deadly bacterium with the expressed intent of creating a biological weapon that is untreatable and incurable is a hideous evil. Kerby Anderson also warns that we need to consider the extent that genetic manipulation may cross over barriers God instituted in the created kinds.{4} If God felt it important to create boundaries of reproduction that his creatures were to stay within, we ought not cross over them ourselves (Gen. 1:11, 12, 21, 24, 25).
It is certainly possible for genetically modified organisms created for agricultural and medical purposes to develop in ways not planned or foreseen. Therefore, it is necessary that proper and extensive tests be performed to assure, as much as possible, that no unnecessary harm will come to the environment or to humans. As vague as this prescription is, it only serves to reinforce the necessity of further education on the part of everyone to ensure that this powerful technology is used responsibly. We simply cannot afford to be ignorant of genetic issues and technologies and expect to contribute to the necessary discussion that lies ahead.
1. An excellent resource for Christians on this topic is Genetic Engineering: A Christian Response, Timothy J. Demy and Gary P. Stewart, eds. (Grand Rapids, MI: Kregel Publications, 1999)
2. Gattaca, a film by Andrew Niccol, A Jersey Films production, distributed by Columbia Pictures, 1997.
3. Allen D. Verhey, "Playing God," in Genetic Ethics: Do the Ends Justify the Genes? (Grand Rapids, MI: Eerdmans Publ. Co., 1997), 60-74.
4. J. Kerby Anderson, "The Ethics of Genetic Engineering and Artificial Reproduction," in Genetic Engineering: A Christian Response, Timothy J. Demy and Gary P. Stewart.


It has been more than two weeks since Apple released iOS 9, which includes number of new features such as the ability to switch back to the previous app, Proactive Assistant, transit directions in Maps, enhanced multitasking features for the iPad, all-new News app, revamped Notes app and Low Power mode.
It goes without saying that like many of you we are eagerly waiting for the iOS 9 jailbreak, but the big question is, are there still enough reasons to jailbreak iOS 9 since it kills a number of jailbreak apps and tweaks. ?
Jailbreaking will allow you customize your iOS device in every way possible. You can install themes to change the look and feel of your iPhone or you can use Winterboard that allows you to transform your iPhone into an Android phone or transform your iPad into a Mac. Jailbreak tweaks also let you add a 5-icon dock, additional row of keys to iOS' virtual keyboard, change the carrier logo and lots more.
You can change app icons that annoy you to better versions, designed by people from the community. You can check our post on the perfect jailbroken iPhone to get an idea of how you can customize your device.
In addition to theming, tweaks like Springtomize 3 allow you to customize every aspect of the iOS such as increase the number of apps in the dock to 10, give the dock a cool coverflow effect, change the duration of the system-wide animations, remove the page limits, customize the default animations, the lock screen, hide icons of stock apps, resize icons and lots more.
Apple revamped the Messages app and added some cool features like audio messages, self-destructing attachments and interactive notifications in iOS 8.
However, jailbreak tweaks like MessageCustomiser allow you to completely change the look and feel of the Messages app. It's a pity that biteSMS hasn't been updated for iOS 8 and most likely won't be updated for iOS 9, but tweaks like Columba have attempted to bring some biteSMS features like Quick Compose, message forwarding and scheduling and message templates make the Messages app even better.
Tweaks like IntelliScreenX add a ton of useful information to the Notification Center and Lock Screen. The tweak adds Mail, RSS, Facebook and Twitter to the Notification Center, extends the Calendar view to 2 weeks, and adds a new way to quick reply and compose messages without having to go to the Messages app. It also adds a neat way to quickly access all these types of information from the Lock screen.
With Control Center, we can only turn on or off 5 system toggles and have quick launch icons for 4 apps/features. CCSettings fixes this by allowing you to customize Control Center by allowing you to add extra toggles in the top row, and also extra quick launch app icons in the bottom row.
Power users are going to love iPhone 6s' 3D Touch feature, which allows you to peek and pop into emails and messages, switch easily to the previous app, and even turn iPhone keyboard into a trackpad.
But it does not replace Activator. It is still a must-have jailbreak tweak for power users. It allows you to invoke actions using shortcuts from anywhere in the iOS. You would be surprised by the number of shortcuts you can use such as double tap on the status bar, triple tap the Home button, double press the sleep button to trigger stock actions or launch an app or go to the Settings toggle. It offers almost limitless shortcuts to make it easier to use your iOS device.
Check our post on how you can supercharge your jailbroken iPhone or iPad with Activator.
Apple has made Find My iPhone more fool proof by adding Activation Lock, however it still does not offer features offered by jailbreak tweaks such as iCaughtU Pro that take a photograph of the person who enters the wrong passcode using the front camera and prevent someone from turning off your device, makes it a lot more fool proof. There have been several instances it has helped catch a thief who is oblivious of such hacks.
One of the major limitations of iOS is the lack of an option to set your favorite third-party app as the default app. Thankfully jailbreak tweaks like MapsOpener, allow you to set Google Maps as the default app instead of Apple's Maps app and BrowserChooser allow you to change the default browser.
You can lock apps with Touch ID using apps like Asphelia, BioLockdown, BioProtect, or AppLocker.
We've all been there – a notification arrives on your iPhone late at night, and the screen brightness nearly blinds you for the first few seconds after unlocking. F.lux aims to solve this problem by adjusting the color of your iPhone's display to better adapt to the time of the day.
You'd be amazed to realize how relaxed your eyes feel after installing this tweak, especially if you`tend to use your iPhone just before sleeping. In addition to this, it also helps you get rid of that eerie glow on your face when using your iPhone at night.
iOS 9 includes an app for iCloud Drive. But it is still very limited. iFile offers a complete file manager and viewer for the iPhone. It gives full access to the file system including system files. It also allows you to edit text files and property lists, which can be quite useful occasionally.
Barrel adds cool animations while swiping through Home screen pages.
BytaFont 2 allows you change the system font on your jailbroken iPhone. It allows you to change the font in apps, Lock screen, and more.
iPhone 6s and iPhone 6s Plus finally come with always-on "Hey Siri" functionality which allows you to use Siri without connecting your device to a power source. But with a jailbroken device, you can enable the always-on "Hey Siri" feature on older devices with the UntetheredHeySiri tweak.
We can't wait to see how Cydia developers will use features like iPhone 6s' 3D Touch to unlock its potential. It also remains to be seen if the jailbreak community will be able to bring iOS 9 features like Split Screen multitasking to older devices which is available only on the iPad Air 2.
There hasn't been any major development since our last iOS 9 jailbreak update. The good news is that iOS 9 has already been jailbroken. Few days back, iH8sn0w, developer of popular jailbreak tools such as Sn0wbreeze, P0sixspwn published a video to demonstrate that iOS 9 can be jailbroken. He doesn't plan to release the iOS 9 jailbreak, so we will have to wait for Pangu or TaiG team to discover the vulnerabilities to jailbreak iOS 9. But the fact that it can be jailbroken gives us some hope that a jailbreak for iOS 9 could be released a lot sooner than the jailbreak for iOS 8 was released. Jailbreak for iOS 8 was released more than a month after it was released.
With iOS 9.1 already seeded to developers, it is very likely that the jailbreak will be released directly for iOS 9.1 rather than iOS 9.
As always, we'll let you know as soon as we get any further details about the iOS 9 jailbreak. don't forget to join our Facebook Fan page, follow us on Twitter, add us to your circles on Google+, subscribe to our RSS feed, our Daily Newsletter or subscribe to our all-new push notifications on your Mac in Safari for the latest updates on the iOS 9 jailbreak.
We're eagerly waiting to jailbreak iPhone 6s. What about you? Do you plan to jailbreak your iOS device when a jailbreak for iOS 9 is released? Let us know your top reasons to jailbreak in the comments below.


Sometime ago I was listening to US Supreme Court Justice Antonin Scalia. He made an interesting remark. He said that if we want absolute liberty in a society then we should get rid of the constitution. Because a constitution sets limit to the actions and behaviors of individuals.
(i) Due process or legal code: This means that a procedure or code is laid down to deal with all situations governed by the law. For instance to select a committee what will be the procedure. Or to punish a thief which procedure should be pursued by both prosecution and defense to enable a judge to announce a verdict. Even a judge has to award verdict based on a code rather than his personal desire. Failure to comply with due process impinges on the final outcome and can render the final outcome to lose legitimacy.
(ii) Final outcome: Final outcome can be the establishment of a committee or boundaries of a punishment. It can also be vesting of an authority on a position.
Each organization has to be governed by a constitution that is approved and adopted by its members. A person or persons assuming office in the organization become custodians of the constitution of that organization. All actions taken by these office bearers have to conform to the articles laid out in the constitution. If any one of the two components are not observed then the actions can be deemed as outside the constitution and lose power of legitimacy or authority. For instance, if a committee is formed without going through the due process then that committee is unconstitutional and the decisions taken by that committee are not binding on the organization.


slideextract is a program to extract slides from videos.
to account for video encoding artifacts.
final state of the entire slide (animated bullet points, etc...).
when the video jumps back and forth between slides.
BSD 2-Clause license, see the COPYING file for more details.


The Unispeed Mass Surveillance program is designed to perform intensive communication "surveillance, monitoring and evidence gathering" in situations where regulatory data retention and Lawful Interception does not provide for sufficient pro activeness, accuracy or trending to counter the challenges.
Unispeed Mass Surveillance provides real-time targeting and capture of mail correspondence, web visits, chat discussions and social network communication.
Our equipment offers unmatched flexibility in terms of tracking criminal activity on the network. Filters and thresholds can be applied at any protocol level including searching for strings in attachments, instant messages, file transfers etc. The generic trigger functionalities adds intelligence to Unispeed products as it allows the user to expand or redefine search patterns automatically.
Capture and real-time process visits to web sites, mail accounts, chat rooms and social networking sites like Facebook, Twitter, Arabchat etc.
Capture of traffic targeted and identified by patterns and strings in the full communication content (key words, credit card numbers, user credentials etc.
law enforcement from timely intervention.


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GoHealth's Second Quarter 2020 Earnings Release and Conference Call Scheduled for August 19, 2020
Aug 05, 2020 at 7:10 PM EDT
CHICAGO, Aug. 05, 2020 (GLOBE NEWSWIRE) -- GoHealth, Inc. (GoHealth) (NASDAQ: GOCO), a leading health insurance marketplace, announced that the company will release its financial results for the second quarter of fiscal 2020 on August 19, 2020 after 4:00 p.m. (ET), followed by a conference call/live audio webcast to discuss the results at 5:00 p.m. (ET).
A live audio webcast of the conference call will be available via GoHealth's website, www.gohealth.com, through the Investor Relations link. A digital audio recording of the conference call will be made available following the conference call. Interested parties are also invited to join the conference call by dialing 833-519-1310 and conference ID 9537505. The company suggests that participants dial-in approximately ten minutes in advance of the 5:00 p.m. (ET) start time.
About GoHealth:
As a leading health insurance marketplace, GoHealth's mission is to improve access to healthcare in America. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science and deep industry expertise to match customers with the healthcare policy and carrier that is best for them. Since its inception, GoHealth has enrolled millions of people in Medicare and individual and family plans. For more information, visit https://www.gohealth.com.
Jason Koval, Vice President
Melanie Funderburk, Director
pressinquiries@gohealth.com
Deloitte Technology Fast 500
Crain's Fast 50
Techweek100
Chicago's Best and Brightest Companies to Work For
Ernst & Young Entrepreneur Of The Year
Built In Chicago's list of Best Places to Work in 2020
Copyright © 2021 GoHealth. All Rights Reserved
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The intracellular environment is a challenging place for all molecules. Nonetheless, it has been shown that macromolecules such as proteins can be extremely long-lived in vivo. In our paper, we now demonstrate that such longevity, and in turn stability, can even be achieved on the scale of small molecules - coenzymes.
We all know that nothing lasts forever. In living, metabolically active cells, things can get particularly tricky. Molecules are packed in a crowded, highly reactive environment. As "nothing of chemistry disappears in biology" (A. Golubev, ref. 1), biochemists have long been wondering how this potent, chemically reactive surrounding affects the stability of intracellular components. While we owe our very existence to the longevity and stability of DNA (enabled by a set of dedicated repair mechanisms), findings of very long-lived proteins came to a larger surprise. In tissues where cells barely divide, some proteins may stick around for months or even years (see e.g. ref. 2), facing an increased probability of damage accumulation and perhaps acting as a molecular mechanism behind the aging process.
Attending a talk on the stability of such long-lived protein complexes, but working mainly with small molecules (metabolites), we wondered if this could also be possible at an even smaller scale. A promising set of candidate molecules immediately came to mind: coenzymes! Like their much larger counterparts — enzymes — they mainly act catalytically and do not dissipate during a catalytic cycle. However, when browsing the literature, we learned that a lot can go wrong in the challenging life of a coenzyme. Most notably, they are intrinsically reactive and face a plethora of damage reactions that can corrupt them. Although specific coenzyme repair mechanisms (reviewed in ref. 3) have been discovered, little was known about the actual half-life and factors driving the exchange of coenzymes in the cell. Asking colleagues what they would expect, all would start with a rather long pause, a smile, followed by "I don't know". After additional pondering, some would finally conclude: "they might be quite stable". That was our assumption, too; they could be … but are they? We set out to actually determine the half-life of coenzymes in metabolically active cells and were surprised by the answer: Some coenzymes, mostly derived from B vitamins, are not turned over at all; they are essentially only made to compensate for growth. After all, when one cell becomes two, the amount of available coenzyme must also double.
How did we determine coenzyme turnover? We used microorganisms that are able to derive their coenzymes from simple sugar molecules, and changed their menu to a "heavy" sugar where all carbon atoms are replaced by a heavier isotopic form. We then followed the incorporation of "heavy" carbon into coenzymes over time using a state of the art mass spectrometer which allows us to distinguish the associated mass shifts. Next, we measured the fraction of "old" coenzymes with no label, and "new" coenzymes that had obtained at least one labelled carbon. We observed a close match between the rate of renewal of coenzymes and the expected synthesis rate that only compensates for growth. Most notably, this finding then allowed us to infer that these coenzymes must be maximally long-lived in vivo, that is, "within the cell", but potentially also "enabled by the cell", as some coenzymes might well owe their stability to repair systems.
Thus, not only macromolecules such as proteins, but also molecules as small (and reactive!) as coenzymes can achieve exceptional longevity within a cell. In other words - some coenzymes might very well outlive their macromolecular counterparts - enzymes - and are passed on to their grand-grand-… children.
Read the paper in Nature Microbiology: Longevity of major coenzymes allows minimal de novo synthesis in microorganisms.
Golubev A (2009) How could the Gompertz-Makeham law evolve. J. Theor. Biol. 258:1-17.
Toyama BH, et al. (2013) Identification of long-lived proteins reveals exceptional stability of essential cellular structures. Cell 154:971-982.
Linster CL, Van Schaftingen E, & Hanson AD (2013) Metabolite damage and its repair or pre-emption. Nat. Chem. Biol. 9:72-80.
Very neat paper. It would be very interesting to measure turnover rates for B1, B7 and B12 as these are commonly thought to be exchanged in natural environments, implying production does exceed cellular requirements.


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Hospital Infection Control & Prevention
Despite increased infection prevention efforts in many hospitals, Clostridium difficile infection (CDI) remains a persistent threat to patient safety, according to a new survey of infection preventionists by the Association for Professionals in Infection Control and Epidemiology (APIC).
Hospitals increase efforts, but C. diff persists
IPs reaching point of being 'maxed out'
Though 70% of responding IPs reported increasing C. diff interventions, 43% of the IPs surveyed said CDI rates have not declined.
"This is very concerning to me because it implies prevention activities are up, but we are not seeing an impact," said Jennie Mayfield, BSN, MPH, CIC, APIC president-elect and a clinical epidemiologist at Barnes-Jewish Hospital in St Louis. "That makes me wonder if we need to know more about the basic science and epidemiology. Are we individually spinning our wheels and not really able to focus on the things that might be working? This [finding] is a concern because it tells me we still aren't sure what to do and what really works."
Released recently at a C. diff conference in Baltimore, the APIC survey also cited staffing woes in infection control departments. While CDI rates have climbed to all-time highs in recent years, 77% of IPs surveyed said they have not been able to add staff to address the problem, Mayfield said.
"Twenty-one percent were able to add staff and that's encouraging, but we still have a ways to go," she told conference attendees. "I know at my facility we are starting to reach the point where we are maxed out, and we are not going to be able to take on a lot more without giving something else up."
APIC conducted the 2013 CDI Pace of Progress survey in January 2013 to assess activities that have been implemented in U.S. healthcare facilities in the last three years to prevent and control CDI. A total of 1,087 APIC members completed the survey, which is intended to provide a general overview of trends and indicate areas where more in-depth research might be beneficial. The majority of survey respondents work in acute care settings (78%). Respondents also work in long term care (9%), ambulatory care (4%), and other settings (9%) such as long-term acute care, rehabilitation, behavioral health, and hospice.
"Over half of the respondents that knew whether or not C. diff was declining in their institutions, said 'No, it's not," said Stephen Parodi, MD, chief of infectious diseases for the Kaiser Permante Napa Solano Service Area in northern California. "Of those who don't know [whether CDI is declining] I have to wonder whether they don't know because they don't have the ability to surveil it in an accurate fashion or they just don't know at all."
Approaches to CDI prevention appear to vary widely, both in diagnostic testing and duration of contact isolation for infected patients. Concerning the latter, 42% of respondents keep CDI patients in isolation for the duration of their stay. A quarter keep CDI patients in isolation until treatment has started and there has been no diarrhea for 48 hours. There is no national practice recommendation for discontinuation of contact precautions for CDI, APIC noted.
"We don't have answers to some of the critical questions — testing methodologies are varied across institutions, duration of isolation is all over the map," Parodi said.
IPs are battling back
While C. diff has clearly won the early rounds, infection preventionists are making some progress in the fight to prevent CDIs. Perhaps most importantly, antimicrobial stewardship programs are slowly increasing. Sixty percent of survey respondents are using antimicrobial stewardship programs at their facilities, compared with 52% in 2010. Because antimicrobial use is one of the most important risk factors for CDI, stewardship programs that promote judicious use of antimicrobials should be encouraged, APIC urged.
Other APIC survey findings include:
Health care facilities are making CDI a tracking and monitoring priority. Three-quarters of respondents were actually performing surveillance for CDI before the Centers for Medicare & Medicaid Services reporting requirements went into effect in January 2013.
A known killer of C. diff, bleach is widely used over many less effective cleaners. Two-thirds of respondents (67%) use bleach for all daily and discharge cleaning of rooms with CDI patients. Moreover, new tech weapons are being brought to bear on the persistent spores, as 9% of respondents report using at least one of the emerging disinfection technologies such as ultraviolet light or vaporized hydrogen peroxide.
More than three-quarters of facility policies (77%) promote soap and water hand wash for CDI patients, but also have alcohol-based hand rubs (ABHR) available on the units. Fifteen percent of facilities surveyed also promote soap and water hand washing for CDI patients but do not provide ABHR in patient care areas. Ten percent of respondents indicate that their policy requires the use of soap and water hand washing for CDI patients in outbreak situations, and 8% said their hand hygiene policy is the same for CDI and non-CDI patients. Current opinions regarding the use of hand washing with soap and water instead of ABHR are conflicting. Recommendations on the use of soap and water in outbreak settings are based on the theoretical benefit of physical removal and dilution of spores by friction and rinsing rather than definitive evidence, APIC noted.
Environmental cleaning programs have been enhanced, but monitoring the effectiveness of cleaning has not kept pace. More than nine in 10 respondents (92%) have increased the emphasis on environmental cleaning and equipment decontamination practices since March 2010, but 64% said they rely on observation, versus more accurate and reliable monitoring technologies to assess cleaning effectiveness. Fourteen percent said that nothing was being done to monitor room cleaning. Because C. diff spores can survive in the environment for many months and are highly resistant to cleaning and disinfection, environmental cleaning and disinfection are critical to prevent the transmission of CDI, APIC reminded.
Those who have not adopted more aggressive CDI prevention measures already have strong programs in place. Among those who have not adopted more aggressive measures to combat CDI in the last three years, the most common reasons cited were best practices were already in place (65%); CDI was not identified as a high-priority problem for their facility (37%); there is an infection control plan to increase interventions in the event of an outbreak (34%); and CDI rates are declining with current practices (18%).
Patient education lags behind provider education. Eighty-five percent of survey respondents say they or others at their facility have participated in educational offerings about CDI. Only 50% have initiated patient education programs about CDI.
Nearly a third of respondents (30% percent) have participated in CDI learning collaboratives. Learning collaboratives bring together hospitals and health facilities in a specific region to share best practices, provide training, and implement successful prevention approaches, APIC noted.
Hospital Infection Control & Prevention: Online - $449
Issue Date: April 1, 2013
Dramatic reduction of C. diff infections in the UK an 'indictment' of U.S. struggles
Hand washing ineffective, gloves must be used
Guest Column: Fecal transplants a promising cure for CDI


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Do you see Jesus as He truly is? The Transfiguration? The Shekinah Glory?
How often are we disgruntled, challenged, shaken, while still we are meant to have faith in Christ?
Having faith in The Savior does not always mean we are as bold, and confident as we should be.
As much as we believe in God, have had an encounter with Jesus and have been born again, the reality is that in a world that is visible and physical, not being able to see God, but by the ways He chooses to reveal Himself is a walk of faith.
One of the ways He did chose to reveal Himself, both for His disciples encouragement and also for us to consider today was on the mount of "Transfiguration".
Jesus had just shared with His followers of His upcoming death, calling them to carry their cross, die to self, lose their lives and not be ashamed of Him.
Once sharing with them such a harsh reality, of possible death, giving of life, and the likes, what was the focus He gave them as an encouragement?
As He took three of His disciples upon the mountain, in one of the most significant events of His life, He chose to reveal to them His Glory.
The Glory that would reveal Who He truly is, and how He is not just a child, a carpenter, or even just One Who would end up on The Cross. No, His focus here is upon Who He is actually is in eternity past, present and future.
Today, Who do you see Jesus as? And what would it mean if we pictured Him today as He truly is, in His Glory?
Full sermon on YouTube channel.
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An Open Letter to ISRO on the Eve of Mangalyaan's Tryst with Mars
Leave a Comment on An Open Letter to ISRO on the Eve of Mangalyaan's Tryst with Mars
By Krishna Jagannathan (Assistant Professor, Department of Electrical Engineering)
This letter was originally published here.
Dear ISRO,
I realize that your engineers and technicians must be working around the clock, as we approach the historic day of the Mars Orbiter Mission (Mangalyaan) entering the Mars orbit. I wish your team the very best, and fervently hope for the success of this mission.
I am writing this to express my gratitude for doing what you do, and for instilling a sense of heroism among millions of young people across the country. As an eighteen year old, when I was an electrical engineering undergraduate at IIT Madras, I was lucky enough to witness the first ever launch of the GSLV rocket from Sriharikota on 18 April 2001. No, I will not tell you how I managed to get into Sriharikota on that day! The sight of the rocket belching yellow flames and soaring gloriously into the gray sky is permanently etched in my mind. As the shattering rumble of the liquid strap-on boosters eventually reached to shake the earth and the trees around me, the rocket was a yellow speck, already miles high in the sky. Thirteen years hence, I want to thank you for providing that moment of inspiration for that eighteen year old.
Last year, when you launched Mangalyaan, millions of kids across the country would have watched, at least on television, the sight of your reliable workhorse, the PSLV, soaring majestically towards Mars. I can imagine the rush of blood that kids like these would have felt, as they looked up at the rocket. If one in ten of these kids grows up with a passion for science and technology, the cost of the Mars mission would be more than justified.
ISRO, your ability to launch complex missions on shoestring budgets is indeed remarkable. I read that the Mangalyaan mission, at USD 73 million, is cheaper than the unit cost of the cheapest Boeing civilian aircraft!
ISRO, have you noticed that some highly reputed sections of the international media have expressed thinly-veiled outrage over launching the Mars mission, amidst the "overwhelming poverty in India"? Did you wonder why these high-profile media houses seem all of a sudden so sympathetic and concerned about poor people in India, after you sent the PSLV soaring? If you haven't seen these pieces, please read this,this, and this for starters.
"How can poor countries afford space programmes?" thunders The Economist in this article. ISRO, it is mainly because of our indigenous capabilities in remote sensing that we managed to save tens of thousands of lives in Orissa, during cyclone Phailin. Indeed, I recall that our predictions were spot on, and more accurate than the wind speed readings predicted by leading western countries. In 1999, in the same state of Orissa, we lost some 15,000 of our people due to a cyclone, because we did not have good capabilities in remote sensing, and we had to depend on data from foreign satellites. The entire nation was thankful to ISRO and other agencies for preventing such a tragedy during Phailin. But they ask how a poor country like India can afford to build indigenous capacity, and launch its own remote sensing satellites.
As a further provocation, The Economist cannot resist mentioning "space development" and poor sanitation in the same sentence: "What if the 16,000 scientists and engineers now working on space development were deployed instead to fix rotten sanitation?"
Why didn't you think of something as simple as that, ISRO? Your best scientific minds and most hard-nosed engineers deployed in building toilets! They must be able to build such sublime toilets, that the whole world will marvel at the outcome! Instead, you're wasting your time proving our frugal technological mettle, and inspiring our children.
The Economist seems fine with our space program, but only as long as it brings direct benefits to the people. Britain, on the other hand, cannot countenance our Mars mission, and wants to cut down on its massive $300 million aid. This aid, which we have apparently declined in 2012, is smaller than India's aid to some south Asian countries. The Economist blackmails thus: "Why should donors bother to help tackle poverty where governments have enough spare resources to think about space." Take that ISRO. They will not help us tackle poverty, because you had the audacity to think about space!
While the cost of Mangalyaan is lesser than that of a single Boeing 737, why don't we hear the same sanctimonious sermons when we place orders for hundreds of aircraft for our civil aviation sector? After all, how can we poor Indians afford to fly planes? Let us take this argument further. India has the dubious distinction of being the largest arms importer in the world. The great powers of the day have no problem pocketing hundreds of billions of dollars of "poor India's" money, and continue to lobby (sometimes even illegally) for huge defense deals. But how dare we launch a space probe using a bit of our own money and our own technology, they ask.
What explains this angst among these elite media houses? Could it be that these learned people cannot stomach the fact that the Mars mission was executed largely indigenously, and that we did it without genuflecting to other countries?
ISRO, your achievements present a ray of hope that we have the ability to build our own sophisticated technology, and one day perhaps be self-sufficient in defense. Could it be that the western powers and arms manufacturers are wary of our slowly increasing capabilities, and worry at the prospect of reduced arms sales to India?
Or, as this article argues, could it simply be plain old racism, masquerading as analysis and opinion pieces?
Or could it be that these reputed media houses feel genuinely for our poor countrymen, and are simply voicing their heartfelt sympathy and concern — concern we don't have for our own countrymen?
You know ISRO, I went to a school which mainly had students from middle-class and upper-middle class backgrounds. But there was the odd kid in the class who came from a not-well-to-do family, who had to think twice about buying an expensive textbook or a calculator. The more affluent kids would show off their fancy graphing calculators, and mock him for still using logarithmic tables. However, I feel that the striving and aspirations of the poorer kid was in everyway heroic, and his achievements perhaps even greater than that of the others, because of the initial conditions of his circumstances.
In the elite club of space faring nations, ISRO, you remind me a lot of the poorer school kid. The richer nations do have a lot of resources and capabilities at their disposal, and to be sure, some remarkable achievements as well. Sometimes they may be helpful to you, sometimes just polite, and sometimes plain condescending to you regarding your achievements. Regardless of what the great space powers think about you, please remember that you will be cheered by millions of people in India every time you launch a mission.
As we wait with bated breath for the main motor on Mangalyaan to come back to life on September 24, I hope fervently that the mission is successful. If the mission fails, some of the above media houses will have a field day, and remind you that India had no business to attempt this in the first place. If it succeeds, they may point out how NASA's MAVEN reached Mars ahead of Mangalyaan, in spite of leaving earth much later (NASA, incidentally knows there's a genuine reason for this!), or ask why we are space-racing with China.
In any case ISRO, I know that your spirit will not be dented even if the mission were to fail. After all, true greatness lies in learning from one's own errors. I know that ISRO will get it right the next time. Or the time after that!
Just remember that every time you send a rocket soaring, there will be thousands of kids (and millions on television) who will crane their necks to watch it go, their own spirit and inspiration soaring to the sky.
Krishna Jagannathan obtained his B. Tech. in Electrical Engineering from IIT Madras in 2004, and the S.M. and Ph.D. degrees in Electrical Engineering and Computer Science from the Massachusetts Institute of Technology (MIT) in 2006 and 2010 respectively. During 2010-2011, he was a visiting post-doctoral scholar in Computing and Mathematical Sciences at Caltech, and an off-campus post-doctoral fellow at MIT. Since November 2011, he has been an assistant professor in the Department of Electrical Engineering, IIT Madras.
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The Apartment at 60: is this Billy Wilder's finest film?
Jack Lemmon and Shirley MacLaine in The Apartment – it's so obvious they belong together. Photograph: Allstar/United Artists
The writer-director's humane and often surprisingly dark romantic comedy shows him at his finest with two charming leads in Jack Lemmon and Shirley MacLaine
Scott Tobias
Mon 15 Jun 2020 02.20 EDT
Last modified on Wed 11 Nov 2020 07.58 EST
Jack Lemmon often gets referred to as the great everyman of American actors – down-to-earth, identifiable, a little put-upon but fundamentally decent. And that's the image that gets projected when his character in The Apartment, a lowly insurance accountant named CC "Bud" Baxter, is first shown at desk #861 on the 19th floor of the Consolidated Life building in New York – a city whose population, he tells us, would stretch from "Times Square to the outskirts of Karachi" if they were laid end-to-end. What man could be more average than the one sitting among a sea of office drones so expansive that they work from 8.50am to 5.20pm, every day, just to stagger the elevator times?
The Shining at 40: will we ever fully understand what it all means?
Still an indefinable marvel after 60 years, The Apartment is not merely about an everyman type, but a profound reflection on what life is like for the everyman in America – and for the everywoman, too, as embodied by Shirley MacLaine, playing Fran Kubelik, a lowly elevator operator. Director Billy Wilder, operating at the peak of his powers – he and his screenwriting partner IAL Diamond had made the screwball classic Some Like It Hot with Lemmon one year earlier – has made a comedy about two people who are utterly compromised and in no control over their own lives and happiness. He has also made a heartrending drama about the same thing. And then, finally, as a small and precious mercy to Bud, Fran, and the audience that's come to love them, he's made a little bit of romance, too.
The premise for The Apartment, inspired in part by Noël Coward's Brief Encounter, sounds like the type of broad bedroom farce that Wilder handled so deftly in Some Like It Hot and The Seven Year Itch. Bud is a hard-working bachelor whose combination of career ambition, deference, and low self-esteem has led him to loan out his Manhattan apartment to company executives who need a place to take their mistresses. With four bosses already on the schedule – and the biggest boss of all, Mr Sheldrake (Fred MacMurray), bidding to be the fifth – Bud spends most nights shut out of his own place. A typical evening finds him cooking a sad TV dinner for himself at 9pm, and an atypical evening sends him out to Central Park after midnight to accommodate a spontaneous one-night stand.
Jack Lemmon, the great American everyman. Photograph: Cinetext/Sportsphoto/Allstar
For Bud, the carrot dangling at the end of this stick is the promotion his betters have promised him, which finally arrives in the form of a second administrative assistant job that could not sound more deflating, but comes with an office door with stenciled letters. He flirts with Fran in the elevator – she appreciates that he takes off his hat, like a gentleman – but the notion that he could ever take a woman back to his own apartment, like his bosses do, seems utterly fanciful, as if only top-level executives deserve to get lucky. As it turns out, Fran is having an affair with Mr Sheldrake, the latest in a long line of pretty office ladies who accept the fiction that Sheldrake will leave his wife and family in White Plains when the time is right. The relationship will end, as the others did, when the lie becomes too embarrassingly obvious.
Wilder and Diamond wring all the laughs they can out of this idea, particularly in a masterly sequence where Bud catches a cold and works frantically at his desk to rearrange schedules so he can recuperate at home. (Sheldrake proves not to be flexible.) But what's surprising about The Apartment is how far it steers into outright despair – though even that, in the true Wilder spirit, isn't unleavened despair. When Fran finally comes to the inevitable realization about Sheldrake, on a night he's taken her to Bud's apartment for a casual romp, she takes enough sleeping pills to kill herself. After he and a neighboring doctor revive her, Bud tells his own story about a botched suicide attempt – an anecdote he's spun generously for laughs.
Wilder is understood as a cynic about human nature, based on the greed and moral corruption on display in films like Double Indemnity and Ace in the Hole, but he always had a strong affinity for the little guy – and, in Bud and Fran, he's found the littlest. The Apartment is a romantic comedy where the two leads are kept apart partially by circumstance and partially by the mutual understanding that they don't deserve love. It's inconceivable to Bud that a man of his station could attract a woman like Fran; it's inconceivable to Fran that a woman of her station is worthy of kindness and decency. These are not typical romcom obstacles. These are two psychologically bruised individuals, conditioned to believe the key to happiness is as exclusive as the key to the executive washroom.
The tonal wizardry of The Apartment is often miraculous, like the Christmas party where Fran's heartbreak over hearing of Sheldrake's past dalliances contrasts directly with Bud goofing around in a new bowler hat like Charlie Chaplin. Most films define themselves as one genre or another, but this one can be several of them at once. But that sort of high-level plate-spinning is true of the screenplay in general, which is immensely satisfying in the way it keeps planting and paying off turns of the plot. When Bud discovers a broken compact mirror left in his apartment and returns it to Sheldrake, we know that it belongs to Fran but he doesn't; when Fran allows Bud to use it during the party, it's a reveal that crushes his spirit. Other seeds sprout later, too, like the keys that circulate the office or sleeping pills that take on different meanings in different contexts. A Wilder and Diamond screenplay can make the whole field seem like a lost art.
And finally, there's Jack Lemmon and Shirley MacLaine. Fran may be more glamorous than the lowly Bud, but Lemmon and MacLaine keep them on the same wavelength – courteous and deferential to a fault, yet high-spirited and silly by nature, trading the sort of elevated banter that tends to separate the couples in old screwball comedies from mere mortals. It's so obvious to the audience that they belong together, and so elating when it finally happens – as it should be in any good romcom. But The Apartment understands the forces that keep them apart so clearly, and they're as ordinary as clocking into work.


The uni-verse is a continuum, the flow of infinite energy. Within the human energy field the heart is the center of centers, the place of integration, remembrance and awakening. Join us for a non-competitive, holistic practice integrating root teachings of yoga, tantra and Bhakti into a mandala for body, mind and heart. Deep flow of healing heart centered yoga asana practice with breathwork, meditation, chanting, music and essential teachings of Dharma Chakra ( the wheel of Universal truth with the Heart). All levels are welcome.


This dish is the Greek experience and can be referred to as the Greek "fast food." Although, it's far from being as unhealthy or unsavory as American fast food tends to be. These juicy bits of meat loaded on a skewer provide for the ultimate meat lovers snack. In the US/abroad, souvlaki is usually wrapped inside a piping hot pita bread and topped with fresh vegetables, however in Greece, it's traditionally served on skewers (pictured) with a side of fries.
Souvlaki is an amazingly delicious meal. We prefer it with pita, crisp onions, tomatoes, cucumbers, and a dollop of tzatziki sauce finish this dish off to perfection.
It's been said before when referring to Greek cooking, "the holy trinity" of flavors. These refer to lemon, garlic, and oregano combined to form a perfect confection of flavors in your mouth. Yum! The "holy trinity" of flavors should be used, without a doubt, when making Souvlaki. The marinade is really up to you however and truly creates the direction in which you want your meal to flow. For example, using a red wine marinade or one full of only spices and olive oil can make this more robust rather than zesty. You get where I'm going with this. Pair it with pits, fries, rice pilaf, or even eat it alone for a brilliant meal.
PS. Don't forget to serve these with tzatziki and homemade pita bread!
Souvlaki is skewers of meat grilled. The choice of meat can vary so make it to your specifications.
Clean meat (remove extra fat) and cut into small cubes.
Putting the meat aside, in bowl combine all other ingredients and mix.
Taste mixture and when happy add in raw meat - coating well.
Cover and let marinate for 30mins in the refrigerator.
Take skewers and add meat (start at bottom and work your way to the top of the skewer).
Place souvlaki on BBQ and cook for about 5-6mins on each side (this will vary depending on what meat you are using, so cook to preference (e.g. med, well, etc.,).
Once done, remove, and serve the souvlaki some fresh tzatziki!
Feel free to add more olive oil if you feel it's not coating all the meat. Also, have a favorite herb? Make it your own. Go Crazy!
Holy hot damn! I'm eating this right now and it's sooooo good! And sooo easy! And sooooo healthy! THANK YOU!
My favorite! Of course, I'll say the same when I comment on your next post! I have never seen thyme added, but you can bet I will next thyme 🙂 I have enjoyed many hours exploring your site, keep up the good work. Thank you!
I used this method for chicken gyro meat and it was delish! I had lemon thyme on hand and used it since I thought it would pair well. It went awesome with the gyros but I cooked the chicken right from the grill.
That's great to hear Jessica. We're glad you liked it!!
Are the measurements for dry herbs or fresh?
Good question Jen! These are for dry herbs. We try to specify when they are fresh.
Really?! That's so cool 🙂 If you do, let us know how you like it.
I ended up making your Greek yogurt chicken souvlaki…and it was fantastic. Everyone in the family loved it which was amazing since I have a demanding and picky crowd to feed:) Even Kenton cleaned his plate (usually he leaves half of his food uneaten). Thanks again for the great recipes.
Yay, so glad to hear!!
Can you prepare the skewers in advance? Say the morning, when planning to cook that evening?
Hi Kate, yes, I think that will be ok. What we have done is add the chicken to the marinade, cover, place in the fridge, and cooked them when we got home.
Thanks! I will be cooking them this week for friends. Can't wait!
Can you replace oregano with thyme? Personally love oregano but other half likes but less so.
Also, is it better to marinade longer, if so how much longer?
Yes, that would be perfect. Thyme goes great with chicken, too. Personally, I wouldn't do anything more than an hour. We've tried it for longer, but couldn't taste a different.


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Possibility of O'Sullivan's retirement 'flagged' to Taoiseach last week
Updated / Wednesday, 13 Sep 2017 23:31
Nóirín O'Sullivan announced her sudden retirement as garda commissioner last Sunday
A spokesperson for the Taoiseach has said the possibility of former garda commissioner Nóirín O'Sullivan retiring was flagged with him in the middle of last week.
Leo Varadkar was formally told about the retirement last Sunday, the day Ms O'Sullivan's retirement was announced.
The Cabinet was today briefed about the process of recruiting the new commissioner which will be handled largely by the Policing Authority.
It was the first Cabinet meeting since the retirement.
The recruitment process is expected to take several months to complete.
However, Acting Garda Commissioner Dónall O'Cualáin has confirmed that he will not be applying for the position of Commissioner.
He said: "I am honoured to have been appointed Acting Commissioner. My focus as Acting Commissioner is to ensure that An Garda Síochána continues to protect and support communities, while progressing the significant changes to the organisation under the Modernisation and Renewal Programme."
Measures to deal with the housing crisis were also discussed by the Taoiseach and his ministers.
Charlie Flanagan
Garda Commissioner
Nóirín OSullivan
Policing Authority


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ViewRay to get nearly $60M in equity financing
February 27, 2018, 7:45 a.m. EST
ViewRay is raising nearly $60 million through an agreement to sell nearly 9 percent of its stock and warrants to a Chinese-based conglomerate and investment company.
The investment will raise Fosun International's ownership stake in ViewRay to 18.4 percent, up from the current 9.9 percent. Cleveland-based ViewRay offers a clinical MRI-guided radiation therapy system.
The company says its MRIdian radiation therapy system is built on a proprietary high-definition MR imaging system designed to address the challenges and clinical workflow for advanced radiation oncology. Unlike MR systems used in diagnostic radiology, MRIdian's high-definition MR was designed to deliver highly precise radiation that limits skin toxicity and other safety concerns.
ViewRay expects to complete the deal with Fosun by March 2. Under the terms, ViewRay will sell its common stock and warrants to an affiliate of Fosun International Limited in a direct registered offering for gross proceeds of about $59.1 million.
ViewRay agreed to sell approximately 7.1 million shares of common stock and warrants to purchase about 1.4 million shares of common stock with a per share exercise price of $8.31 per share. The warrants will expire seven years from the date of issuance.
ViewRay executives say proceeds from the offering will be used primarily to support the ongoing commercialization of the MRIdian Linear Accelerator Technology, for research and development related to continued product development activities, and for general corporate purposes, including working capital.
"We are excited to complete this financing, which will enable us to scale up production and to continue investing in sales and marketing to meet the growing demand for the MRIdian Linac," said Chris A. Raanes, president and chief executive officer of ViewRay.
RadiologyMedical imagingDiagnosis and treatmentM&A


In the season premier of the Banyan Online Supervision Meetings, Cal opens the floor for Kristin, the supervising hypnotist at the Hypnosis Center. During the meeting, Kristin explains the steps that she took in great detail to give you an incredibly in-depth look at how 5-PATH® progresses step-by-step. The second part of this multi-part series focuses on Florence, a 63 year-old woman with neck tremors. Nothing is left out in the explanation of how Kristin has progressed with the client.
Building raport with the client.
Full title: Case Study of Using Hypnosis for Tremors and Anxiety.