Health Meaning

A psychiatrist whose failure to disclose the drug's corporate income contributed to a furor over conflicts of interest in research biomedical has just received its first national Institutes of Health grant (NIH) in 3 years.

lax reporting of Charles Nemeroff of $ 1.2 million less in payments from pharmaceutical companies to his employer, Emory University, and similar payments to other academic psychiatrists prompted a Senate inquiry 07. Nemeroff resigned as chairman of psychiatry at Emory, and the NIH suspended a grant of $ 9 million he held for a study of depression. In December 08, Emory was forbidden to apply for NIH funding for 2 years.

A year later, Nemeroff moved to the University of Miami Miller School of Medicine in Florida. This has prompted concerns because the ban on Emory NIH grants did not move with him. (Fueling the flames was a telephone call in which the National Institutes of Mental Health (NIMH) Director Thomas Insel apparently assured the University of Miami medical school dean that Nemeroff could seek NIH funding if it has moved.)

NIH requested input on how to handle this situation in a revision of its rules of conflict of interest, but in the final rules issued last summer, he has not addressed specifically.

Now Nemeroff is back in the lap of researchers funded by the NIH. According to the NIH grants database, it received a $ 401.675 per year, 5-year R01 grant from NIMH to study "psychobiological risk factors for PTSD [post-traumatic stress disorder]." The study examines the genetic risk factors and does not appear to involve testing drugs.

The prohibition of 2 years by Emory would have expired anyway. But Paul Thacker, a former staff member for Senator Chuck Grassley (R-IA) who led the Senate inquiry, said NIH itself had the power to impose a ban more. "It shows they are not really serious about the problem," said Thacker.

YOKOHAMA, JAPAN -For more than a decade, stem cell therapies have been touted as offering hope for those who suffer from genetic and degenerative diseases. The promise took a step towards reality last week with announcements here at the annual meeting of the International Society for Research on stem cells (ISSCR) that both groups progressing to human clinical research, one putting the focus on a rare genetic neurological disease and the other for vision loss in the elderly.

StemCells Inc. of Newark, California, reported encouraging results from an initial human trial using human neural stem cells to treat Pelizaeus-Merzbacher disease (PMD). PMD is a progressive and fatal disease in which a genetic mutation inhibits the normal growth of myelin, a protective material that surrounds nerve fibers in the brain. Without myelin, nerve signals are lost and the patient, usually an infant suffers degenerating motor coordination and other neurological symptoms. In his presentation, Ann Tsukamoto, StemCells Vice President for Research, said the company chose to test its approach to neural stem cells on PMD because there is currently no cure for the condition and a diagnosis can be confirmed by genetic testing and MRI. "This creates an opportunity for early intervention when it can best help."

The company has created highly purified neural stem cell banks that are isolated from adult neural tissue. Injected into rodents, the cells do not form tumors; instead, they migrate through the animal brain, where they differentiate into different types of neuronal cells, including cells that create the myelin that protects nerves. When neural stem stems were injected into mice, they showed "robust registry and migration, new myelin formation," said Tsukamoto.

The company now sponsored an initial safety test the strategy in four infants with PMD. in each patient, researchers at the University of California, San Francisco, 75 million transplanted neural stem cells in each of the four sites in the brain and followed this with immunosuppressive therapy so that the recipient would not reject foreign cells. no safety concerns were raised during the trial, Tsukamoto reported. in addition, the MRI taken 18 months later showed the formation of new myelin around axons and clinical observations of patients reported that their motor functions remained stable or enjoyed modest gains. The company is now planning larger trials. Tsukamoto said that if the treatment is effective, it could lead to treatments of neural stem cells for multiple sclerosis, cerebral palsy and Alzheimer's disease.

In a second speech at the meeting, cell researcher stem Masayo Takahashi Biology of RIKEN Centre for Development in Kobe report on progress in the preclinical work her wet targeting group degeneration age-related macular (AMD). In AMD, the cells of the retinal pigment epithelium (RPE) of the retina that supports the eye cells that detect light wear, and there is also the growth of abnormal, leaky blood vessels under the retina . These conditions lead to an impairment of vision in the central part of the eye. The strategy proposed by the group is to surgically remove the problematic blood vessels and replace the damaged RPE cells with new RPE cells derived from a patient own cells. Using a known cellular reprogramming process, researchers take skin cells of a patient, be converted into the so-called induced pluripotent stem (iPS) cells, which can differentiate into all cells in the human body. They then transform these iPS cells into RPE cells and form them into sheets in the laboratory. Since iPS approach uses the patient's own cells, they avoid the need for immunosuppressive drugs.

The RPE cells generated by the team Takahashi shows the pattern of the structure and expression of genes characteristic of human RPE cells authentic. Injections of the cells into mice triggered no tumors, it was also reported, and the cells survived for more than 6 months when transplanted into monkeys. The research team has not tested directly whether the transplanted RPE cells improved the vision of the animal. But Takahashi noted that some people with AMD had transplanted RPE cells from the periphery to the center of them, improving their central vision. She hopes to have all necessary authorizations for research involving humans within a year.

Earlier this year, scientists from the University of California, Los Angeles, and Advanced Cell Technology of Marlborough, Massachusetts, reported in The Lancet on safe and successful use RPE cells derived from human embryonic stem cells rather than iPS cells to treat a different type of AMD in a limited number of human patients. Takahashi predicted that in the future, choosing from different stem cell therapies will "depend on the target disease and the status of the host."

The positive results reported in The Lancet paper presented at ISSCR will help the field "to grow," said Fiona Watt, stem cell researcher UK Cambridge Research Institute Cancer Research. And George Daley, a scientist on stem cells at Harvard Medical School in Boston, is even more optimistic. Noting the progress reported at the conference this year, he said, "Wait until next year in Boston, "the site of the 2013 meeting ISSCR.

* This article was corrected on June 21 original caption refers only to insert the image. the legend has been corrected to describe the bigger picture.

A US federal court has found that stem cell therapy offered by a Colorado clinic meets the definition of a regulated drug. The decision could stimulate repression US Food and Drug Administration on other clinics offering treatments of adult stem cells are not tested in the United States.

The company, Regenerative Sciences Inc. in Broomfield, Colorado, uses stem cells extracted from bone marrow of a patient to treat bone and joint injuries. The company says that its treatment is a medical procedure and not subject to federal oversight. But in a suit in 2010 seeking to block the company to sell the treatment, the US government argued that because science regenerative stem cells are more than "minimal manipulation" and reagents for use that cross state lines, the cells are a biological medicinal FDA regulated.

On July 1 decision 23 (the first time by New Scientist ), the US District Court for the District of Columbia in Washington, DC, agreed that "the product of cultured cells is a drug "under federal law.

The decision could have implications for stem cell clinics in Texas. In April, the Texas Medical Board approved the first policy of the State to supervise the treatment of experimental stem cells. Critics said the policy would allow doctors to avoid scrutiny. But an official of the board, showing the current suit against Regenerative Sciences, said state rules were necessary because of the uncertainty of the FDA authority to regulate stem cells.

CellTex, a stem cell bank in Sugar Land, Texas, involved in the treatment of Gov. Rick Perry (R-TX) with his own stem cells last summer, also said its cells that it provides are not an experimental drug. In June, however, the FDA found problems with the CellTex manufacturing process and describes its product as a biological drug.

University of Minnesota bioethicist Leigh Turner said the court decision this week "is particularly important given that we are seeing in the United States the proliferation of clinical stem cell procedures of marketing," many of which "appear to be push the quackery of stem cells, "he said.

Science regenerative CEO Christopher Centeno said New Scientist that the company plans to appeal.

NEW DELHI -On Monday India opened a laboratory of $ 12 million government-backed, whose mission is to create a new vaccine against HIV. The Translational Research Laboratory vaccine against HIV, which aims to recruit about 30 scientists, is integrated within the Institute of Science and Technology of translational health facility of $ 0 million in development on the outskirts of New Delhi. It will work with the New York-based International AIDS Vaccine Initiative (IAVI); operating costs will be shared equally.

India has the third largest global burden of AIDS, despite the fact that "HIV infections have decreased by 56% during the last decade, from 270,000 in 00 to 0,000 in 09 "said Health Minister Ghulam Nabi Azad of India. He says there is a desperate need for a vaccine against HIV.

"The design of a new vaccine against HIV broad spectrum will be the mandate of this new laboratory," said Margaret G. McGlynn, CEO of IAVI. It can be done, she said: "Researchers have long known that, after several years of infection, a minority of people with HIV produce antibodies that can neutralize a broad range of HIV variants" The goal is to find. an antibody broad spectrum suitable for this purpose. McGlynn said the plan is to make and test a vaccine in India, she says is "properly placed with its scientific talented workforce, the well-established pharmaceutical industry and a huge commitment from the government. "

Health officials worldwide are on alert after the discovery of a new virus in two patients with pneumonia. The agent belongs to the coronavirus group, which includes several cold virus, but the virus that causes SARS, a serious disease that has killed more than 700 people in a global epidemic moving fast in 02 and 03 before be contained.

the first known patient in the new incident was a 60-year-old from Jeddah, Saudi Arabia, who died of pneumonia in July; her case was reported by Ali Mohamed Zaki Soliman Fakeeh Hospital in Jeddah on ProMED, a list of e-mail on emerging infections, September 15. Yesterday, Health Protection Agency UK (HPA) reported that a man 49 years old Qatari, who had traveled to Saudi Arabia and is being treated in an intensive care unit in London, is infected with the same virus. Several other cases are reportedly under investigation; it is not known if the virus can be transmitted between humans or the size of a threat he may pose to public health.

Science Insider spoke to Ron Fouchier, a virologist at Erasmus MC in Rotterdam, the Netherlands, who have sequenced the genome of the virus and found that the Saudi and Qatari patients most likely are infected by the same virus. Questions and answers were written for brevity and clarity

Q:.? What do you think we're dealing with

RF: For now, all we know is that one patient died and another is terribly ill. Other cases are under investigation, but as far as I know they have not been confirmed. So for now, we're just assuming that there were two individual infections, probably some animal reservoir. They were 3 months apart, which is too long for one another infected. I can not speculate on that

There are now six known human coronaviruses. one of them is SARS, but four cause colds and are quite harmless. So we will keep both feet on the floor and do not blow this out of proportion

Q:.? How your laboratory will be involved in this case

RF: We participated in the discovery of several viruses, including other coronaviruses, and recently, we published an article in PLoS oNE describing a test for the whole family of paramyxoviruses. So when Dr. Zaki had cultivated an unidentifiable virus from one of his patients, he emailed me, mainly because he wanted us to test for paramyxoviruses, and then he sent us the virus. I asked him if he had tested for coronaviruses, it has not yet done. There is a test developed by [the U.S. Centers for Disease Control and Prevention] which tests for all known coronaviruses. So while the virus was on its way to our laboratory, Dr. Zaki discovered it was a coronavirus. But it does not have the facilities to the sequence of the virus, so that what we have done here.

When he posted the conclusion on ProMED, there was a patient in intensive care in London, so the HPA immediately began looking for a coronavirus as well, and that is positive income . They sent us the sequence of a very small PCR [polymerase chain reaction] fragment, only 0 nucleotides, and except for one nucleotide, it was identical to our virus. Of course, you need to sequence the entire genome, but on the basis of this we can assume that we are dealing with the same virus. Meanwhile, we have sent the complete genome and the virus itself to the UK, so they can determine if it is really

Q:.? Why did you think it might be a coronavirus

RF: We always think coronavirus. ... Flu, paramyxovirus and coronavirus are the most obvious candidates when you have a serious respiratory infection

Q:.? Will you study this new virus

RF: Yes, we do. We wrote a case report with Dr. Zaki on this first case and are working on the annotation of the complete genome, we will write such a paper as well. But of course, we need to start doing animal experiments. At first, we thought it was an isolated case in Saudi Arabia; Now that the virus has resurfaced in London also, I think we need to become a little more aggressive.

First, we'll see if the animals sick of this virus. You can isolate a patient of a virus, but it does not mean that they died of it; to show that causes the disease you need to fulfill Koch's postulates. That's what we did for SARS, and it is what we hope to do here; we have applied for emergency ethical approval. The most obvious animal species to this virus are mice, ferrets, and perhaps monkeys. We must see what we can get approval for.

The University of Tokyo today rejected the researcher who claimed to have achieved what would have been the first world trial the treatment of human patients with cells created from their own induced pluripotent stem (iPS). The researcher Hisashi Moriguchi, later admitted at a press conference that the initial application of the injection of cardiac muscle cells derived from iPS cells into the hearts of five patients was false, but maintained the procedure was performed on one patient at a Boston hospital in mid-2011.

"On October 19, the University of Tokyo has initiated a disciplinary dismissal Hisashi Moriguchi, a project scientist at the university hospital," reads a press release sent by e-mail reporters and posted this afternoon Japan time. He explained that the school's use of work rules call termination "in the case of severe damage to the honor or credibility of the university."

"It was conduct unbecoming a member of the faculty of this university, and he was treated strictly" wrote Fumio Isoda, executive vice president, in a statement accompanying. He added that the incident was regrettable and said an ongoing investigation would "clarify the facts as soon as possible."

Although investigations are ongoing, the scale and nature of the problem is becoming clearer. Moriguchi was the corresponding author of two papers online Exchange Protocol Nature Group website, ovarian tissue cryopreservation and cover another direct reprogramming describing human liver cancer cells using chemicals. Both contributions initially made several co-authors, but notes on the Exchange Protocol website indicate that as of Wednesday, all co-authors had requested that their names be removed. One of those, Taro Okitsu school Keio University of Medicine in Tokyo, said exchange protocol that has not participated in the study, according to the online edition of the English language The Yomiuri daily .

Another co-author on the Exchange protocol contributions Chifumi Sato, who studies liver diseases and health promotion at Tokyo Medical and Dental University (TMDU) could also face disciplinary action . The Commission of Inquiry concluded that TMDU Sato knew that his name was used on Moriguchi papers even though he did not check the data, according to comments made to the press by Ikuo Morita, a university trustee oversees research. "This behavior is inappropriate for a researcher," the Asahi Shimbun Article online quoted Morita as saying after a Thursday night committee meeting.

for more than a century, Egyptologists have puzzled over the mysterious disappearance of Ramses III in 1155 BCE According to the records of tests kept on the judicial Papyrus of Turin, an assassin murdered the Pharaoh during a bloody palace coup. But was it really the case, and if so, who led the plot? A new study published today in BMJ shows that Ramses III died violently after conspirators slashed his throat and reveals that one of the alleged ringleaders, son of Ramses Pentawere, may have later been strangled . The research team came to these conclusions after analyzing the two samples of DNA and CT scans of two mummies: Ramses III (with linen bandage, top right) and a young unidentified man previously found with him in a Cache at Deir el Bahari. The unidentified 20 (arrows pointing to the tablet unusual skin folds) have proven to be a son of Ramses: He seems to have been strangled (also highlighted in the analysis by the overinflated chest) and buried with goatskin, a PELT that the ancient Egyptians deemed ritually unclean and thus dishonor brand befitting a murderer. Sitting on a throne has long been a perilous undertaking, it seems.

See Science Shots

biomedical research community will lose one of its long-time champions with the upcoming retirement of Senator Tom Harkin (D-IA). Saturday, Harkin announced he would not seek a sixth term in November 2014, ending a 40-year career in Congress.

Harkin, 73, is currently chairman of the Senate committee that sets funding levels for the National Institutes of Health (NIH). He also chairs the committee that oversees federal policies on health, education and labor. Harkin has teamed up with his then counterpart Republican, Arlen Specter of Pennsylvania, to earn a doubling of the 1998 NIH budget in 03. He also led an effort to Specter and include $ 10.4 billion for NIH in the packet 09 stimulus.

"Harkin obviously has been a consistent and very good champion for NIH and for medical research. So his decision not to run again is a huge loss," said Ann Bonham, Scientific Director Association of American Medical colleges in Washington, DC "for years, he and Specter essentially traded the championship to and fro. They both looked after very deeply about NIH and made it a priority regardless of the funding picture, "says Jennifer Zeitzer, legislative analyst with the Federation of American Societies for Experimental Biology.

With Specter, Harkin also sponsored legislation in the 00s that have expanded federal funding for research on human embryonic stem cells. In 1992, he helped create a research program for breast cancer at the Ministry of Defence, doubling the funding for research for the disease.

Harkin was elected to the House of Representatives in 1974 and won a Senate seat in 1984. Everything Harkin has satisfied the scientists, however. In the 190s, Harkin has pushed Congress to create an NIH office for alternative medicine, citing its own success in taking bee pollen for allergies. The office attracted controversy scientists who said it funded non-scientific studies of marginal medical treatments. In 1998, Congress raised the office center and appointed a new NIH director under which the center was less vague. But the $ 128 million National Center for Complementary Medicine and alternative continues to annoy some observers of the NIH.

Harkin's departure at the end of 2014 will leave a vacancy for the unofficial title of chief booster NIH, Zeitzer said. A candidate is Senator Barbara Mikulski (D-MD), who chairs the full appropriations committee. Although this position will keep him busy, Zeitzer predicted that the NIH, located in the state of Mikulski, "will be a priority for her."

the prospect of surgery while not fully "in" may seem like the stuff of horror movies. But a thousand patient remembers moments of awareness under general anesthesia, the doctor evaluate. Memories are sometimes neutral images or sounds of the operating room, but sometimes patients report being fully aware of the pain, terror and immobility. Although surgeons carefully monitor vital signs such as pulse and blood pressure, anesthesiologists have no clear signal as to whether the patient is conscious. But a new study finds that the brain can produce an early warning signal that consciousness returns-that is detectable by an electroencephalography (EEG), the recording of neuronal activity via electrodes on the skull.

"We have known since the 1930s that brain activity changes significantly with increasing doses of anesthetic," says corresponding author of the study, Patrick Purdon anesthesiologist at Massachusetts General Hospital in Boston. "But the monitoring of a patient's brain with EEG has never become common practice."

in the early 190s, some anesthesiologists began using an approach called (BIS) bispectral index, where the readings from a single electrode connected to a device that calculates and displays a unique number indicating where the patient's brain activity falls on a scale of 100 (fully conscious) to zero (a "flatline" GET ). While between 40 and 60 is considered the target range for unconsciousness. But this index and similar are only indirect measures, Purdon says. in 2011, a team led by Michael Avidan anesthesiologist at Washington University School of Medicine in St. Louis, Missouri, found that monitoring the BIS index was slightly less successful in preventing awareness during surgery of the measurement method exhaled anesthetic base nonbrain- in the patient's breath. Among the 2861 patients treated with BIS index, seven had memories of the surgery, while only two of 2852 patients were analyzed everything souvenir breath.

Despite this, Purdon and colleagues expressed hope that "unconsciousness signature" in the brain could be found. Last year, the team worked with three epilepsy patients who had electrodes implanted in their brains to surgery to reduce their seizures. Recording from single neurons in the cortex, where consciousness is thought to reside, the researchers gave patients an injection of propofol, an anesthetic. They asked volunteers to press a button every time they heard a voice, recording the activity of neurons. Loss of consciousness, defined as the time when patients stopped pressing, immediate was 40 seconds after injection. As immediately, neurons groups began to issue a slow oscillation characteristic, a kind of undulation in the electric field of the cells. Neurons are not completely inactive, but bursts of activity took place only at specific points in this oscillation, resulting in activity incompatible brain cells.

The next step was to see if the same signature can be detected on the outside, with an EEG. Purdon and his team recruited 10 healthy volunteers "go under" very slowly with propofol: Anesthesia was delivered gradually as the drop-off process was not 40 seconds, but nearly an hour. Every 4 seconds, the volunteers pressed a button in response to clicks or words, including their names, until they reached unconsciousness.

At that time, the researchers report today in Proceedings of the National Academy of Sciences , EEG readings showed a similar activity to that seen in study of patients with epilepsy. Alpha waves, associated with relaxation and drowsiness, increased loss of consciousness, as did the even slower, "low frequency waves." Both business models began to decline with the return of consciousness.

The researchers also found a unique pattern of the transition period. During the transition in and out of unconsciousness, waves almost canceling: The highest point or "peak" of alpha waves are produced at "trough" of low frequency waves. This combination, called the model "trough-max" can be read on an EEG and can be the early warning signal that the patient returns to consciousness. When the patient is deeply unconscious, motive "peak-max" in which the strengths of the two types of waves occur together, can prove to be a reliable sign that the patient is out.

" There is a rigorous, elegant study, "says Avidan." the trough max model may well prove to be an early warning signal. "he cautions, however, that the volunteers were healthy and did not undergo actual surgery, so further research in surgical patients are needed to confirm the results.

March 26, a 73 year-old from Abu Dhabi, the capital of the UAE, has died at the Klinikum Schwabing, a Munich hospital. It was the 11th known death related to infection by the novel coronavirus (Sxy), a pathogen that was first reported in September 2012 and aroused significant interest to researchers. Overall, officials have reported 17 cases of infection Ncov.

Clemens Wendtner, Professor of Medicine and Associate Medical Director at the University of Cologne, is a doctor at the Munich hospital. Science Insider Wendtner asked how the case was handled and why he thinks the patient may have been infected with one of his racing camels. Questions and answers were written for brevity and clarity

Q:.? Why does the patient get treatment in Germany and why did he come to the Klinikum Schwabing

CW: We are one of the seven reference centers for infectious diseases in Germany; Klinikum Schwabing has a unit for highly infectious patients, and one of the first SARS patient was treated here in 03. This particular patient was treated in Munich for multiple myeloma, who had been diagnosed in 09. he flew to Germany on a frequent basis for chemotherapy and even stem cell transplantation in a private center

While in Abu Dhabi, his condition deteriorated and his hematologist deal here in Munich asked steal for a closer look. the family also wanted to be transferred to him. At this point, we knew he had lung problems, but we were not aware of any coronavirus test; this has not been done in the United Arab Emirates

Q:.? When did you suspect it might have the virus

CW: When we examined his condition and had his medication list; he had even begun to [the influenza drug] Tamiflu, but her condition did not improve. So we said: "Maybe it's a good idea to check for the coronavirus." So we made a bronchoalveolar lavage [a procedure to sample fluid from the lungs,] and sent the material to the laboratory of Christian Drosten at the University of Bonn; This is the German reference laboratory for the new coronavirus. The results came back March 23. At this point, the patient's condition was very bad

Q:.? Did you take special care when you knew he was infected to prevent further infections

CW: This was done from the beginning. We are trained in infectious diseases of difficult situations, so what we do when we do not know what happens. He was in an intensive care unit and placed in special isolation; staff use special precautions, such as 3M masks. We also tested the staff for the virus, but no one was positive

Q:.? How many people did you test

CW: We had a group of about 60 people, not just staff. ... The patient flew in a private jet, and we planned the crew members and four parents who came with him. But we did PCR testing only for people who had symptoms like cough and flulike symptoms. There was less than 10 thereof, and all were negative. The others have been on screening for surveillance, but if they develop symptoms, they are not tested

Q:.? Ask these precautions have now finished

CW: Yes

Q :. Is it worrying that some patients altogether with the new coronavirus have sought medical treatment in Germany and the UK? With SARS, you saw people who infect others on plans or seeding new homes in countries where they arrived.

C.W :. This virus is not in the same category as SARS in terms of risk of spread. But a point is very valid: Screening tests, especially in the [Arabian Peninsula], are underdeveloped. Therefore, there may be a greater number of undetected cases. I was approached by U.A.E officials. they were worried about this first case, because most of the cases were in Saudi Arabia, and they are very interested in getting tests implemented in their countries. We will help them, in collaboration with the Drosten professor at Bonn

Q :. . "Ruling family" The German tabloid Bild said the patient was a "sheikh" from a

CW: Well, to Bild , the truth is not their biggest concern. ... He is a wealthy Abu Dhabi, fail. He has the money to hire a Learjet and get treatment in Germany. But it is not a member of the royal family

Q :. You have said in interviews that he has been infected by contact with a camel. What is the evidence for that

C.W:. So far, there is only circumstantial evidence. The patients in camel races. One of them fell ill and was very weak; the patient was in close contact with the camel, the camel and the evening was very ill, the patient developed flu symptoms. Three days later, he was in a medical unit in Abu Dhabi. There is another family member who was also in close contact with the camel, he also got sick, but we could not keep up with this gentleman.

We are really interested to find the missing link, for perhaps a material -some blood, some stools of this camel. Professor Drosten may send one of his fellow scientists in Abu Dhabi. We will also help the U.A.E. . Consulate in Munich

Q: So the UAE is ready to cooperate in this ?

CW: Yes, they understood that it is in their interest to get a better understanding of how the disease could spread from animals to humans

Q: is this still the camel alive

CW:. Yes, at least he was alive a few days ago

Q: When this investigation start?

CW :. As you can imagine, we are very interested in solving this problem, so it would probably happen in the next two days

Q: Have you heard of other camels Abu Dhabi or UAE get sick

CW: no, I do not have information about it. Even the consulate could not tell me. But maybe they did not pay attention to before. This just emerged as a problem, so they can have a look at more closely in the future

Q:.? Have you made a patient's autopsy

CW: We would have liked to get some hardware, but as you can imagine, it is very difficult in [the patient's] Culture to get any kind of autopsy. Thus, the family refused and we did not insist.