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Cesarean section or C-section is a surgical procedure that delivers a baby through an abdominal incision. It is commonly used when the physicians believe it is a safer route for the parent, baby, or both. Cesarean section has appeared throughout history including Ancient Greece, India, Egypt, and Rome. There are even passages on cesarean section in different religious texts. It is believed that the name was attributed to the way Juluis Caesar was born. However, in Ancient Rome a cesarean section was only performed if at the time of birth, the mother was fatally ill and could not deliver naturally. It has been recorded that Julius Caesar’s mother was present during his life, therefore, historians believe he was not delivered through a cesarean section. Medical historians now believe the term originated from a decree in which Julius Caesar ordered women fated by birth to have a cesarean section which in Latin is “Caesones”. To this day, it is still incompletely understood where the name originated.

Cesarean sections are now routinely performed, and the procedure is well established. Interestingly, long-term effects of cesarean sections are not well known. Previously physicians noted no difference in health outcomes between children born through vaginal birth or cesarean section. Recently, however, a research group at the University of Cambridge found that a single dose of the measles vaccine is 2.6 times more likely to not be effective in children born through cesarean section. Unfortunately, a lack of vaccine efficacy leads to weakened immunity due to an inadequate number of antibodies produced to fight infection. While the first vaccination produced little efficacy, researchers demonstrated that a second measles vaccine was comparable to vaginally born children. More specifically, the vaccine was effective and produced the necessary antibodies to fight infection.

The recent paper published in Nature Microbiology by Dr. Henrik Salje, concluded the long-term effects of cesarean section delivery. Researchers suggest an increased risk of measles outbreak among children that were born through cesarean section and had only one measles vaccination. Salje and others explain that lack of vaccine efficacy is linked to the infants’ gut microbiome. It is well established that children receive great exposure to healthy microbes through vaginal birth, which boosts their immune systems. By avoiding microbe exposure through cesarean section, the infant loses critical immune protection.

Maj. Gen. Dr. Paul Friedrichs, MD is the Inaugural Director of the Office of Pandemic Preparedness and Response Policy, at the White House (OPPR — https://www.whitehouse.gov/oppr/), a permanent executive office aimed at leading, coordinating, and implementing actions to prepare for and respond to pathogens that could lead to a pandemic or significant public health-related disruptions in the U.S., and principal advisor on pandemic preparedness and response, appointed by President Biden.

Dr. Friedrichs was previously the Joint Staff Surgeon at the Pentagon where he provided medical advice to the Chairman of the Joint Chiefs of Staff, the Joint Staff and the Combatant Commanders, coordinating all issues related to health services, including operational medicine, force health protection and readiness among the combatant commands, the Office of the Secretary of Defense and the services. He also led the development and publication of the initial Joint Medical Estimate and served as medical advisor to the Department of Defense COVID-19 Task Force.

Dr. Friedrichs received his commission through the Reserve Officer Training Corps and his Doctor of Medicine (M.D.) from the Uniformed Services University. He has commanded at the squadron and group level, served as an Assistant Professor of Surgery and led joint and interagency teams which earned numerous awards, including “Best Air Force Hospital.” As Chair of the Military Health System’s Joint Task Force on High Reliability Organizations, he oversaw developing a roadmap to continuously improve military health care. As the Command Surgeon for Pacific Air Forces, U.S. Transportation Command and Air Combat Command, the general and his teams identified gaps, developed mitigation plans and enhanced readiness for future conflicts and contingencies.

“The ORFAN study is an expanding global registry which will include long-term clinical and outcome data for 250,000 patients from around the world, and we are very pleased to publish these initial results,” said Keith Channon, MD, Professor of Cardiovascular Medicine at University of Oxford, Caristo Chief Medical Officer, and co-author of The Lancet publication.

“Coronary inflammation is a crucial piece of the puzzle in predicting heart attack risk. We are excited to discover that CaRi-Heart results performed exceptionally well in predicting patient cardiac events. This tool is well positioned to help clinicians identify high-risk patients with seemingly ‘normal’ CCTA scans.”

Ron Blankstein, MD, Professor of Medicine and Radiology at Harvard Medical School, Director of Cardiac Computed Tomography at Brigham and Women’s Hospital, and co-author of the publication, applauded The Lancet for publishing results from one of the largest studies in the field of CCTA.

Duarte et al. report that common genetic variants linked to psychiatric disorders influence the regulation of ancient retroviruses integrated into the genome. This suggests ancient viruses acquired millions of years ago may have shaped modern human brain function.

Immunotherapy is a form of cancer treatment that harnesses the immune system to recognize and target the tumor. In most cancers, the immune system fails to detect the rapid proliferation of tumor cells. Lack of immune cell detection is due to the tumor polarizing or reprogramming immune cells to promote cancer progression and suppress the immune system. This is done through variety of ways including the release of proteins or cytokines that direct immune cell development and function. Current immunotherapies target these polarized immune cells to switch them back toward an anti-tumor function. Although there are many ways to redirect immune cells to attack cancer, immunotherapies maintain limited efficacy due to the immunosuppressive mechanisms within the tumor microenvironment (TME). In addition, heightened toxicity associated with immunotherapy also pose challenges when prescribing treatments to patients.

One immunotherapy that has demonstrated significant promise in cancer patients is chimeric antigen receptor (CAR) T cells are immune cells within the body that are responsible for killing or lysing invading pathogens, including cancer. The immune system orchestrates a response by employing T cells to recognize an infection, in healthy individuals. In the context of cancer, T cells cannot recognize that the tumor is deleterious to the body. Therefore, CAR T cells are generated to reprogram the cell’s ability to recognize and lyse the tumor. CAR T cell therapy takes the patient’s T cells and engineers them to target specific surface markers on the tumor. They are then grown in a dish and expanded before being intravenously reinfused in the patient. CAR T cell therapy is commonly associated with lymphoma, but unfortunately neurotoxicity can be an adverse side effect which limits efficacy.