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Abstract Patients with rare and complex diseases such as congenital adrenal hyperplasia (CAH) often receive fragmented and inadequate care unless efforts are coordinated among providers. Translating the concepts of the medical home and comprehensive health care for individuals with CAH offers many benefits for the affected individuals and their families. This manuscript represents the recommendations of a 1.5 day meeting held in September 2009 to discuss the ideal goals for comprehensive care centers for newborns, infants, children, adolescents, and adults with CAH. Participants included pediatric endocrinologists, internal medicine and reproductive endocrinologists, pediatric urologists, pediatric surgeons, psychologists, and pediatric endocrine nurse educators. One unique aspect of this meeting was the active participation of individuals personally affected by CAH as patients or parents of patients. Representatives of Health Research and Services Administration (HRSA), New York-Mid-Atlantic Consortium for Genetics and Newborn Screening Services (NYMAC), and National Newborn Screening and Genetics Resource Center (NNSGRC) also participated. Thus, this document should serve as a "roadmap" for the development phases of comprehensive care centers (CCC) for individuals and families affected by CAH.

Purpose: This study examines the readability of online medical information regarding cloacal exstrophy (CE). We hypothesize that inappropriate levels of comprehension are required in these resources, leading to poor understanding and confusion amongst caregivers. Methods: The Google and Bing search engines were used to search the terms "cloacal exstrophy" and "cloacal exstrophy treatment". The first 100 results for each were collected. Each webpage was analyzed for readability using four independent validated scoring systems: the Gunning-Fog index (GFI), SMOG grade (Simple Measure of Gobbledygook), Dale-Chall index (DCI), and the Flesch-Kincaid grade (FKG). Results: Forty-seven unique webpages fit the inclusion criteria. Mean readability scores across all websites were GFI, 14.6; SMOG score, 10.8; DCI, 9.3; and FKG, 11.8, correlating to adjusted grade levels of college sophomore, 11th grade, college, and 11th grade, respectively. There were significant differences across all readability formulas. Non-profit websites were significantly less readable than institutional and commercial webpages (GFI p = 0.012, SMOG p = 0.018, DCI p = 0.021, FKG p = 0.0093). Conclusion: Caregiver-directed health information regarding CE and its treatment available online is written at the 11th grade reading level or above. Online resources pertaining to CE must be simplified to be effective. Plain Language Summary: Cloacal exstrophy is a rare severe birth defect that does not always show up in prenatal screening. Parents are often unfamiliar with this disease and must learn about the disease, procedures, and outcomes their child may have in a short amount of time. Online medical information has been recommended to be written at a 6th grade reading level so that the general public may understand. The authors of this study wanted to investigate if average websites that parents might find using common search engines would be easily understood. The authors used different search phrases on Google and Bing search engines, and used them to look at the top 100 search results for each. The text from each page was graded based on 4 different readability scoring systems. The authors found 47 unique webpages that matched the criteria and found that most pages had reading levels of about 11th grade-college level. Due to its rarity, the information available about cloacal exstrophy are similar and would likely be poorly understood by most parents. Hospital institutions and non-profit exstrophy programs need to make a concerted effort to work together to develop simple yet helpful information regarding this disease. [ABSTRACT FROM AUTHOR]

Although the differentiation of ES cells to cardiomyocytes has been firmly established, the extent to which corresponding cardiac precursor cells can contribute to other cardiac populations remains unclear. To determine the molecular and cellular characteristics of cardiac-fated populations derived from mouse ES (mES) cells, we isolated cardiac progenitor cells (CPCs) from differentiating mES cell cultures by using a reporter cell line that expresses GFP under the control of a cardiac-specific enhancer element of Nkx2-5, a transcription factor expressed early in cardiac development. This ES cell--derived CPC population initially expressed genetic markers of both stem cells and mesoderm, while differentiated CPCs displayed markers of 3 distinct cell lineages (cardiomyocytes, vascular smooth muscle cells, and endothelial cells)--Flk1 (also known as Kdr), c-Kit, and Nkx2-5, but not Brachyury--and subsequently expressed Isl1. Clonally derived CPCs also demonstrated this multipotent phenotype. By transcription profiling of CPCs, we found that mES cell--derived CPCs displayed a transcriptional signature that paralleled in vivo cardiac development. Additionally, these studies suggested the involvement of genes that we believe were previously unknown to play a role in cardiac development. Taken together, our data demonstrate that ES cell--derived CPCs comprise a multipotent precursor population capable of populating multiple cardiac lineages and suggest that ES cell differentiation is a valid model for studying development of multiple cardiac-fated tissues., Introduction The heart is the first organ to function in the vertebrate embryo. In mice, the cardiac mesoderm forms a structure called the cardiac crescent at approximately 7.5 dpc; at [...]

The forthcoming transition in the focus of stem cell research from basic science in the development of therapies raises important questions of justice. This transition is marked by increasing interest [...]

Author(s): Peter J. Donovan [1]; John Gearhart [2] The new millennium promised to usher in the era of the human genome. So far, a different area of biology -- stem [...]

Hypoxia-inducible factor 1 (HIF-1) is a major regulator of developmental and cellular O2 homeostasis. The factor is induced as a response to physiologically relevant levels of hypoxia, which is an important physiological and developmental stimulus. mRNAs encoding glucose transporters and glycolytic enzymes were found reduced in embryonic cells with HIF-1x deficiency.

If human neural stem cells were implanted into the brains of other primates what might this do to the mind of the recipient? Could such grafting teach us anything of [...]