Although studies in young children are limited in number, they all underline the high rate of amputation in this population, with conflicting results being recently reported regarding their prognosis.

Methods: To enhance knowledge on the clinical characteristics and prognosis of osteosarcoma in young children, we reviewed the medical records and histology of all children diagnosed with osteosarcoma before the age of five years and treated in SFCE (Societe Francaise des Cancers et leucemies de l’Enfant) centers between 1980 and 2007.

Results: Fifteen patients from 7 centers were studied. Long bones were involved in 14 cases.

Metastases were present at diagnosis in 40% of cases. The histologic type was osteoblastic in 74% of cases.

Two patients had a relevant history. One child developed a second malignancy 13 years after osteosarcoma diagnosis.Thirteen children received preoperative chemotherapy including high-dose methotrexate, but only 36% had a good histologic response.

Chemotherapy was well tolerated, apart from a case of severe late convulsive encephalopathy in a one-year-old infant. Limb salvage surgery was performed in six cases, with frequent mechanical and infectious complications and variable functional outcomes.Complete remission was obtained in 12 children, six of whom relapsed.

With a median follow-up of 5 years, six patients were alive in remission, seven died of their disease (45%), in a broad range of 2 months to 8 years after diagnosis, two were lost to follow-up.

Conclusions: Osteosarcoma seems to be more aggressive in children under five years of age, and surgical management remains a challange.

Author: Maud GuillonPierre MaryLaurence BrugierePerrine Marec-BerardHelene PacquementClaudine SchmittJean-Marc GuinebretiereMarie-Dominique Tabone
Credits/Source: BMC Cancer 2011, 11:407

Lukas Burch / THE EASTERN ECHO

“I was ten years old when I found out I had cancer,” Samuels said. “I was diagnosed at Mott Children’s Hospital by doctors from the University of Michigan.”

Samuels, a warm, outgoing and physically-active ten-year-old, was overwhelmed most by the desolate reality of being condemned to a hospital bed for the last remaining years of his childhood.

“I didn’t really understand what cancer was at first, but I understood that I was going to have to stay in the hospital for a very long time,” Samuels said.

“It wasn’t so much the fact that I realized that I could actually die at some point in my life. It was more that this was going to completely transform my life to the extent that I couldn’t be the kid that I wanted to be. I just wanted to be a normal kid. I was at school, I had all kinds of friends, I wanted to run around, I wanted to play sports, but I had to grow up. Week after week in a hospital bed, a large part of my childhood was gone.”

Samuels’ grueling struggle with cancer continued for four years. At first, doctors didn’t think amputation would be necessary.

“They tried what’s called ‘limb salvage,’” Samuels said. “They took out the femur and replaced it with a metal one. I had that for a while, and I was still on two legs. But the cancer came back two years later. Not only it had spread upward, but it was in my lungs as well.”

Samuels was 12 when the doctors informed him the cancer had returned, had spread and that amputating his leg was now the best way to combat the cancer. Yet somehow, at an age when most adolescents are playing video games, obsessing over acne and nursing quiet infatuation, he received the news without flinching.

“I was cool with it,” Samuels said. “That was about two years into my cancer battle, so I was pretty battle-hardened by then. At that point I had the perspective, ‘Let’s just do what it takes to get this done. Bring it on.’ I was talking with my doctors and I told them, ‘If this is what you guys think is the best route to go and the best way to end this right now, then let’s do it.’“

Amputating his leg proved to be a prudent decision. Samuels ultimately won the war and has been cancer-free for a decade. His last surgery was Sept. 11, 2001.

“We were walking through the hospital and everybody was standing around looking at the TV,” Samuels said. “Obviously, the planes had hit the towers. My doctor was watching as well in the lobby. It was really impressive. He said, ‘Andrew, we’re not going to worry about what’s going on right now. We’re going to focus on you.’ So he turned off the television and he said, ‘This is our day. We’re going to get you fixed up.’ I was really impressed by that, and I’ll always have respect for UM doctors.”

Victory over cancer has had a profound effect on Samuels’ outlook on life.

“Through my experience, I developed the perspective that I don’t believe in giving up on anything,” Samuels said. “No matter what adversity you’re facing, why would you ever give up? The moment you give up, the chance of your succeeding is zero. Even if the chance of succeeding is so very small, there’s still that chance. So you take the shot. No matter what.”

This fierce practical optimism ultimately played a large role in Samuels’ decision to resume his education by enrolling at Eastern Michigan University.

“I used to think I could never ever do math and physics,” Samuels said. “I was terrible at it in high school, but it was because I didn’t think I could do it.

“After I graduated, I started my own Internet marketing company. I did that for two years, made a little money, and I thought, ‘If I can run a business and be somewhat successful at it, what else can I do? What can’t I do?’ So I came back to school. Again, I was just challenging all of my previous roadblocks that I thought were roadblocks but really weren’t, and realizing that even if they were, I could jump over them.”

One can’t help but feel impressed by Samuels. For someone who never considered himself to be proficient at math or physics, he’s made tremendous accomplishments.

He’s currently researching space weather in Earth’s upper atmosphere for Dr. David Pawloski. As if that isn’t impressive enough, Samuels hopes to use his degree to further the technology to provide people with comfortable and affordable robotic prosthetics.

“I have a prosthetic,” Samuels said. “However, the technology right now for people who are amputated at the hip is not good. It’s really uncomfortable and they’re really heavy and cumbersome. The computerized ones are starting to take off, but they’re very expensive and most insurance companies won’t even pay for them. Part of the reason I’m in engineering physics is that, if I have that sort of background, maybe I can build my own.”

Samuels’ ability to persevere through life’s most daunting tribulations with a smile and his head held high is something to revere. Perhaps most admirable of all is his eagerness to give back to the hospital that saved his life.

“I volunteer there now on Thursday nights,” Samuels said.

“The UM athletes come up for a program called Michigan From the Heart. Along with the Thursday night visits to Mott Children’s Hospital, the program also organizes trips to take the kids to the games and setup meetings between them and the players afterwards, so they can get autographs and photos. It’s a really cool thing to be a part of and I get to share my experience with kids who have the same type of cancer I had.

“It took me awhile to be convinced to ever go back to the hospital. After my treatment, spending four or five years there, why would I want to go back? But I realized I had a lot to share and I thought I could make someone else’s experience a little better by sharing mine with them.”

Samuels is truly an inspiration, like a prize-fighting boxer swinging until he collapses.

“I feel like if there’s that chance, you should take it,” he said. “I mean it’s life and death. Quite literally in my experience.”

By Plain Dealer staff

FOSTORIA, Ohio — A rare and radical surgery is helping a 13-year-old Fostoria boy survive bone cancer and keep up an active life with the healthy parts of his right leg, doctors told his hometown paper.

In 2008, when he was 10, Dugan Smith was diagnosed with osteosarcoma, the most common bone cancer in children. His knee and part of his thigh had to be amputated. But rather than have his movements limited, Dugan opted for “rotationplasty,” which turned his lower leg around, attached it to the remainder of his thigh and allowed his ankle to take over in place of his knee.

The Tiffin Advertiser-Tribune began the story in 2008.

In April, the Columbus Dispatch picked up the tale:

Less than three years after doctors from Ohio State University Medical Center amputated much of his right leg to remove a softball-size tumor from above his right femur (thighbone), Dugan plays baseball and basketball, went skiing last week, and plans to go out for freshman football in the fall.

The Fostoria Review-Times explained more last week:

“The foot fits into a prosthetic and allows him to expend much less energy walking than if he had opted to simply amputate the diseased portion of his leg.”

But the leg does look strange.

“Initially, they were just like any one would be when you describe the surgery, they were taken aback,” Dr. Joel Mayerson, an orthopedic oncologist at the Arthur G. James Cancer Hospital told the R-T. “But, they understood it would bring Dugan back to the most functional state.”

“… For Dugan, it was a no-brainer.”

Now an unusually determined seventh-grader, Dugan pitches and plays first base for the Fostoria Junior Redmen, and continues to work to strengthen his hip and leg.

An Ohio State Medical Center oncologist talks about the case:

What is being hailed as the first of its kind surgery here in the United States, a multi-disciplinary team of oncologists, urologists, neurosurgeons, plastic surgeons and general surgeons from The Ohio State University Comprehensive Cancer Center have successfully rebuilt the pelvis of a cancer patient out of bones from his own amputated leg. Even more remarkable than the sheer engineering complexity of the pelvic device is the fact that the patient, now considered a cancer survivor, is almost able to walk without any assistance.
Mike Prindle was an Ohio mail carrier who developed a chondrosarcoma tumor on his pelvis and sacrum that necessitated the removal of the malignant part of his pelvis, and the amputation of his left leg. However, instead of discarding the amputated limb, doctors kept the femur, fibula, and their surrounding blood vessels, muscles, and skin, which were unaffected by the cancer. They then engineered a custom device consisting of the salvaged leg bones, two large rods and a couple of smaller rods fixed to the pelvis and spine with 14 screws to help provide support.
Most patients who receive a similar device made of cadaver bones or artificial materials are confined to wheelchairs for the rest of their lives because the reconstructed pelvis does not heal strongly enough to support a person’s body weight. However, Prindle’s own bones fused together to create a pelvic ring strong enough to allow him to walk again using a prosthetic leg. The prosthetic leg, a C-Leg ^[1] from Germany based Otto Block, contains mini-computers at the hip joint, knee joint and foot to analyze his gait, reducing the amount of strain on the prosthetic and allowing him to walk with greater ease.

Article from OSUCCC: Ohio State Surgeons Rebuild Pelvis Of Cancer Patient… ^[2]
Medgadget’s Otto Bock archives… ^[3]

Tuesday, December 28, 2010 11:37 AM

Anolis lizards first entered Arizona State University biologist Kenro Kusumi’s life in 1980 when, as a member of a junior curator program, he recorded in his field notebook that he had found an Anolis egg on a field trip. Kusumi still has those notes, along with other memorabilia that document the influence that both his early life and more recent experiences have had on his current pursuits in developmental biology. One such souvenir is a small Pueblo lizard sculpture that sits on a table in his office. With one missing leg and a tail, broken and repaired in two places, it is not particularly eye-catching, but it does symbolize Kusumi’s current research model: a lizard which can “fix” or more accurately, regenerate, its broken tail.

Human regeneration is mainly limited to small portions of liver tissue, bone, or muscle, yet understanding how regeneration occurs in other taxonomic groups may enable scientists to improve human regenerative abilities in the future. Kusumi is working to understand the molecular processes that enable some lizards to regenerate their tissues with fellow ASU School of Life Sciences faculty members Jeanne Wilson-Rawls, Allan Rawls, Rebecca Fisher and Dale DeNardo (collectively referred to as “JARKD” by their students). Lizards can regenerate facial bones, certain areas of the spinal cord, and, as is most commonly known, most lizards can regenerate their tail – including muscles, cartilage, and spinal cord. The regenerated tail does not contain bone, but instead is supported by a tube of hyaline cartilage – the same cartilage humans have lining many of their joints. With widespread medical problems such as arthritis and spinal cord injuries, the application of these regenerative abilities is of extreme interest to medical institutions.

“Members of my family have terrible osteoarthritis,” Kusumi explains. “That means the cartilage at the joints has degenerated. These lizards can regenerate that kind of cartilage, and they have no problem doing so. How is it that we can’t do this, but they can?” With the help of the Anolis model, Kusumi and the rest of the JARKD team are delving into this mystery, recently funded by a $412,606 grant from the National Institutes of Health and a $225,000 grant from the Arizona Biomedical Research Commission.

Many vertebrate and invertebrate species can regenerate tissues, but there are several kinds of regeneration. Lizards most likely use stem-cell mediated regeneration, where new cells involved in regrowth arise from tissue-specific progenitor cells. This type of regeneration is the best bet for a regenerative process compatible with the human system, Kusumi says. Now that the Anolis carolinensis genome is sequenced, rather than trying to solve the puzzle blind, the research team has a view of the bigger picture as a guide to work from.

Molecular methods have improved to the point that the JARKD team is focusing on this question at the perfect time. Kusumi mused, “the beauty is that now we know enough about development that we can actually have candidates for what cells are making this new tail – we can have guesses as to what might be right.” Using this candidate approach, Wilson-Rawls and graduate student Rajani George have successfully identified and isolated lizard cells that can make new muscle. Meanwhile, the Kusumi lab is working to uncover what developmental control genes are being expressed in regenerating tails. Here, with collaborators from the Translational Genomics Research Institute (TGen), JARKD is using RNA-Seq, a next-generation technology that allows researchers to take a more unbiased approach, finding all the genes being expressed in a tissue at one point in time. When compared with embryonic development of the tail, which is being investigated by graduate student Walter Eckalbar, differences between initial tissue generation and regenerative processes can be identified. The genes involved in regeneration are likely conserved across various taxonomic classes, but the genetic switches for those genes may be turned off or down. “Once we understand the nuts and bolts of how this is happening, we can use available technologies to manipulate and change that,” Kusumi explains, “then we will try to translate that to the mouse model.”

A regenerating mouse tail is only one of the many images inspired by Kusumi’s Anolis studies. In concert with colleagues at the Smithsonian Tropical Research Institute (STRI) in Panama and Elizabeth Hutchins, one of Kusumi’s graduate students, the JARKD team is adopting an evolutionary perspective of various Anolis processes or adaptations. “Occasionally you have a very unique opportunity to look at a natural experiment where one species arrived on one island or was isolated in a region, which then led to the adaptive radiation of many species to fill a variety of niches,” Kusumi says. Anolis has in fact been described by some scientists as the “Darwin’s finch” of reptiles. This reference points to the number and range of ecomorphs in the Anolis genus, as species have arisen in different regions bearing highly similar behaviors and morphology (also known as convergent evolution). While anoles have been the focus of many evolutionary studies, the JARKD-STRI team is focusing on the intersection of evolution and development, where “you can look for the regulatory changes that drove a limb to be longer or muscles to be more robust.”

With such a bright road ahead for both the regenerative and evolutionary undertakings, Kusumi hopes ASU will lead internationally, as a center for the Anolis work. The opportunity to create such an interdisciplinary research program attracted him in part to School of Life Sciences in ASU’s College of Liberal Arts and Sciences, which Kusumi describes as a place that “breaks down the walls between disciplines. Of course, the realization of this vision depends on complex collaborations, which Kusumi jokes are growing so large that listing those not involved may be easier. Kusumi’s Anolis collaborations go well beyond JARKD, STRI, TGen and ASU, and also include some of Kusumi’s undergraduate mentees. Glenn Markov, a Barrett’s Honors College undergraduate and member of the School of Life Sciences Undergraduate Research (SOLUR) program, has spent two years contributing to the ground work of the regeneration project. Much like the tissue-specific process of human progenitor cells, each member of the collaborative team – whether undergraduate, graduate student, or faculty – makes unique contributions to ensure the creation of a functional end product.

Mark Twain once stated “a man who carries a cat by the tail learns something he can learn in no other way.” In a similar vein, Kusumi, with lizard tail in hand, may hold the most likely key to unlock the secrets of medically applicable regeneration.

Source:
Margaret Coulombe
Arizona State University

Main News Category: Biology / Biochemistry

Also Appears In:  Arthritis / Rheumatology,  Neurology / Neuroscience,  Genetics,

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Bone implants with the ability to carry chemotherapeutical drugs in conception in CICECO

Chemotherapy, followed by the surgical removal of the affected tissue is the treatment usually adapted to bone tumors. An implant which can fill the areas of subtraction, while releasing chemotherapeutical agents locally, in a controlled manner, during the treatment period, is the aim of a research led by the Research Centre in Ceramic Material and Composites (CICECO/UA). In these experiences, specialists are using potential “anti-tumor” drugs coated by nanocapsules.

The osteosarcoma is the most common malignant primary bone tumor. Its major incidence is in children and youngsters and usually involves the amputation of arms and legs. The treatment for this type of tumor implies chemotherapy, followed by the surgical removal of the affected tissue with a safety area, in order to avoid the tumor’s reappearance. This area is then filled with a bone or synthetic biomaterial implant.

Considering how important it is to avoid repeating new chemo or radiotherapy treatments in these cases when neutralizing possible residual focus, 11 researchers from the Universities of Aveiro and Coimbra intend to develop an implant which can contain chemotherapeutical agents of specific ranges of action, and also release these components in a controlled manner for a specific and adequate period of time.

“The bone implants we are studying will serve as a support and releasing agent of capsulated drugs in a ciclodextrin nanocapsule. We are currently experimenting with an active molecule with anti-cancer properties specifically directed to osteosarcomas. Nevertheless, it is intended to broaden its application to other types of cancer”.

Source: http://www.news-medical.net/news/20100315/Bone-implants-that-support-and-release-chemotherapeutical-agents-in-ciclodextrin-nanocapsule.aspx

On March 29, 2010, Morgan lost a portion of the bone in her upper leg to osteosarcoma (bone cancer) and was facing the potential of numerous surgeries in order to keep her left leg even with her right, as she grows into adulthood. In her initial surgery two weeks ago, Dr. Rex Marco, an oncologic orthopedic surgeon at Texas Children’s Hospital and the University of Texas Health Science Center at Houston, implanted a prosthetic device that saved Morgan from a lower limb amputation and allowed her cancerous bone to be replaced with a metal implant. The device, a Stanmore Implants Extendable Distal Femoral Replacement, can be extended as Morgan grows, saving her from ongoing invasive procedures.

This week at Texas Children’s Cancer Center, Morgan underwent her first outpatient procedure to magnetically extend her leg. By placing her leg into a magnetized “donut” in the outpatient clinic, doctors were able to extend the implanted prosthesis without having to do any surgery. The magnet extender, manufactured by Stanmore Implants, is a reversible extender that is the first and only device of its kind to be used in Texas.

“The difference this device makes for Morgan is incredible,” said Dr. Marco. “Her quality of life is so much higher than it would be if she were constantly undergoing surgery.”

While the device has been approved and is regularly being used in Europe, it is still pending U. S. Food and Drug Administration approval and has only been used for approximately 15 patients in this country. Dr. Wang, pediatric oncologist at Texas Children’s Cancer Center and Assistant Professor, Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, and Dr. Marco, advocated for and received a “compassionate use” exception for the young girl, in order to implant the groundbreaking device. “Morgan has already been through a lot of treatment for her cancer,” said Dr. Wang, Morgan’s oncologist, “and this will prevent her from future uncomfortable surgeries.”

Source: Texas Children’s Hospital

Source: http://www.news-medical.net/news/20100416/Nine-year-old-cancer-patient-benefits-from-procedure-to-magnetically-extend-her-leg.aspx

Advisor: Christian Puttlitz

Committee: Susan James, Brandon Santoni, Paul Heyliger

Title: “Development of a Novel Enoprosthesis for Canine Limb-Sparing Using a Finite Element Approach”

Abstract

Osteosarcoma is the most prevalent bone tumor in the canine population and the distal radius is the most commonly affected site. To date, amputation has been the preferred treatment option among veterinarians for distal radius osteosarcoma. However, with the advent of better chemotherapy protocols and the subsequent increasing survival rates, interest has now turned towards saving the legs of dogs with osteosarcoma.

The current endoprosthesis used for limb-sparing is associated with a high failure rate, and hence, the design of a novel endoprosthesis is warranted. To aid in the development of a new endoprosthesis for canine limb-sparing a finite element model of the canine forelimb was generated. Accurate mechanical properties of soft tissues are essential to build a reliable finite element model.

Since no data exists regarding the mechanical properties of canine carpal ligaments, six primary stabilizing ligaments of the canine carpus were identified and their tensile mechanical properties were investigated by uniaxial testing in a materials testing machine.

Convergence and validation are two crucial steps in the development of a finite element model. Convergence was investigated by generating three models with increasing mesh resolution. For the purposes of validation, eight intact canine forelimbs were tested in a materials testing machine. The limbs were instrumented to record bone strains, relative displacements and interosseous rotations.

The acquired data were used to validate the canine forelimb model. The current endoprosthesis was evaluated to determine the mechanical underpinnings of clinical failures associated with these implants using the canine forelimb finite element model. The implant failure locations predicted by the model were similar to those observed clinically. The use of a locking plate in place of the current non-locking plate was also investigated. Several stress redistribution strategies were also examined.

A novel modular design was developed in collaboration with the Colorado State University’s Veterinary Teaching Hospital oncology surgeons. The design was extensively evaluated with the use of the validated and converged finite element of the canine antebrachium. The design was modified and improved based on the results.

Significant stress reduction was achieved within the proximal radial screws and the distal metacarpal screws. Off-axis loading of the construct was also eliminated. The final design was approved for prototype development, biomechanical testing and cadaveric evaluation.

——————————

Event Contact: Denise Morgan can be reached at (970) 491-0924

Sponsored by the Department of Mechanical Engineering.

Link to Abstract

Lightning-fast connections between robotic limbs and the human brain may be within reach for injured soldiers and other amputees with the establishment of a multimillion-dollar research center led by SMU engineers.

Funded by a Department of Defense initiative dedicated to audacious challenges and intense time schedules, the Neurophotonics Research Center will develop two-way fiber optic communication between prosthetic limbs and peripheral nerves.

This connection will be key to operating realistic robotic arms, legs and hands that not only move like the real thing, but also “feel” sensations like pressure and heat.

Successful completion of the fiber optic link will allow for sending signals seamlessly back and forth between the brain and artificial limbs, allowing amputees revolutionary freedom of movement and agility.

Potential to patch injured spinal cord

Partners in the Neurophotonics Research Center also envision man-to-machine applications that extend far beyond prosthetics, leading to medical breakthroughs like brain implants for the control of tremors, neuro-modulators for chronic pain management and implants for patients with spinal cord injuries.

The researchers believe their new technologies can ultimately provide the solution to the kind of injury that left actor Christopher Reeve paralyzed after a horse riding accident. “This technology has the potential to patch the spinal cord above and below a spinal injury,” said Marc Christensen, center director and electrical engineering chair in SMU’s Lyle School of Engineering. “Someday, we will get there.”

The Defense Advanced Research Projects Agency (DARPA) is funding the $5.6 million center with industry partners as part of its Centers in Integrated Photonics Engineering Research (CIPhER) project, which aims to dramatically improve the lives of the large numbers of military amputees returning from war in Iraq and Afghanistan.

Currently available prosthetic devices commonly rely on cables to connect them to other parts of the body for operation – for example, requiring an amputee to clench a healthy muscle in the chest to manipulate a prosthetic hand. The movement is typically deliberate, cumbersome, and far from lifelike.

A link compatible with living tissue

The goal of the Neurophotonics Research Center is to develop a link compatible with living tissue that will connect powerful computer technologies to the human nervous system through hundreds or even thousands of sensors embedded in a single fiber.

Unlike experimental electronic nerve interfaces made of metal, fiber optic technology would not be rejected or destroyed by the body’s immune system.

“Enhancing human performance with modern digital technologies is one of the great frontiers in engineering,” said Christensen. “Providing this kind of port to the nervous system will enable not only realistic prosthetic limbs, but also can be applied to treat spinal cord injuries and an array of neurological disorders.”

The center brings together researchers from SMU, Vanderbilt University, Case Western Reserve University, the University of Texas at Dallas and the University of North Texas.

The Neurophotonics Research Center’s industrial partners include Lockheed Martin (Aculight), Plexon, Texas Instruments, National Instruments and MRRA.

Integrated system at cellular level

Together, this group of university and industry researchers will develop and demonstrate new increasingly sophisticated two-way communication connections to the nervous system.

Every movement or sensation a human being is capable of has a nerve signal at its root. “The reason we feel heat is because a nerve is stimulated, telling the brain there’s heat there,” Christensen said.

The center formed around a challenge from the industrial partners to build a fiber optic sensor scaled for individual nerve signals: “Team members have been developing the individual pieces of the solution over the past few years, but with this new federal funding we are able to push the technology forward into an integrated system that works at the cellular level,” Christensen said.

The research builds on partner universities’ recent advances in light stimulation of individual nerve cells and new, extraordinarily sensitive optical sensors being developed at SMU. Volkan Otugen, SMU site director for the center and Lyle School mechanical engineering chair, has pioneered research on tiny spherical devices that sense the smallest of signals utilizing a concept known as “whispering gallery modes.” A whispering gallery is an enclosed circular or elliptical area, like that found beneath an architectural dome, in which whispers can be heard clearly on the other side of the space.

Ultimate combination for two-way interface

The ultimate combination of advanced optical nerve stimulation and nerve-sensing technologies will create a complete, two-way interface that does not currently exist. “It will revolutionize the field of brain interfaces,” Christensen said.

“Science fiction writers have long imagined the day when the understanding and intuition of the human brain could be enhanced by the lightning speed of computing technologies,” said Geoffrey Orsak, dean of the SMU Lyle School of Engineering. “With this remarkable research initiative, we are truly beginning a journey into the future that will provide immeasurable benefits to humanity.”

Source: Southern Methodist University

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Main News Category: Medical Devices / Diagnostics

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