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Category Archives: Mind Building
‘Miracle baby’ born after womb transplant
Benjamin is only the second child in the US to be born through the procedure.
A single gene for scent reception separates two species of orchid bees
A male orchid bee zips around the rainforest, a flash of iridescent green against an equally emerald background. The bee stops at various flowers, fungi and dead trees, collecting fragrant particles and storing them in pockets in its hind legs. Then, it perches on a tree trunk. But the bee doesn’t rest. Instead, it flitters about, using its wings to disperse a bouquet of perfumes into the air.
The aromatic efforts are all for the sake of attracting a mate.
“We know that many animals produce pheromones and they usually produce them through some metabolic pathway,” said Associate Professor Santiago Ramirez, UC Davis Department of Evolution and Ecology. “But orchid bees are unique in that the majority of their pheromones are actually collected from plants and other sources like fungi.”
Orchid bees are master perfumers, and research suggests that the perfumes males concoct are unique to their specific species. For years, Ramirez, a member of the UC Davis Center for Population Biology, and recent Ph.D. graduate student Philipp Brand, Population Biology Graduate Group, have studied orchid bee mating behaviors, unraveling the complex chemicals responsible for successful procreation. The research has given them an unprecedented view into the formation of new species. And the driver of divergence: environmental perfumes.
In a study appearing in Nature Communications, Brand, Ramirez and their colleagues link the evolution of sexual signaling in orchid bees to a gene that’s been shaped by each species’ perfume preferences.
“Our study supports the hypothesis that in the orchid bee perfume communication system, the male perfume chemistry and the female preference for the perfume chemistry can simultaneously evolve via changes in a single receptor gene,” said Brand, whose thesis was the basis for the study.
“Imagine you have an ancestral species that uses certain compounds to communicate with each other,” said Ramirez. “If you have a chemical communication channel and then that chemical communication channel splits into two separate channels, then you have the opportunity for the formation of two separate species.”
A fragrant, front row seat to evolution
Of the 250 orchid bee species, Brand’s and Ramirez’s research focused on Euglossa viridissima and Euglossa dilemma, two separate species previously classified under a single scientific name. They diverged roughly 150,000 years ago. Physically and genetically, these two species are almost indistinguishable, but luckily, they primarily live in non-overlapping ranges in Central America and South America, with some overlap in Mexico’s Yucatán Peninsula.
“This is a neat distribution for the study of species formation because it reveals that the variation we observed is not just the product of geographic variation, and when the two species coexist, they still remain as separate species, even though they experienced hybridization in the recent past,” said Ramirez. “Each species is occupying a unique niche in chemical space.”
E. viridissima and E. dilemma are actually easier to tell apart by the chemical differences of their perfumes. Using gas chromatography and mass spectrometry, the researchers separated and analyzed each chemical compound in a male orchid bee’s enticing perfume. Between the perfumes of E. viridissima and E. dilemma, the difference came down to two molecules. E. viridissima‘s perfume contains a molecule called 2-hydroxy-6-nona-1,3-dienylbenzaldehyde (HNDB), and E. dilemma‘s contains a lactone called L97.
“We found the bees grouped into two clouds based on the presence of these major compounds, which strongly suggest that each of these corresponds to a separate species of orchid bee,” said Ramirez.
According to Ramirez, this means that these pheromone-like perfumes aren’t just different between the species but that they likely influenced their original divergence.
“It makes sense, right?” said Ramirez. “If you have a chemical signal that is different and therefore you’re not going to mate with those who have a different signal, then that will help maintain species separate from each other.”
Scent signals — follow your antennae
After analyzing the genomes of E. viridissima and E. dilemma, Ramirez and his colleagues highlighted differences in a cluster of olfaction-related genes. In orchid bees, these genes are expressed in their antennae, allowing them to detect airborne molecules. The researchers identified olfactory receptor gene 41 (OR41) as being different between the two species.
“That gene has accumulated a lot of changes between these two species, suggesting that those changes are responsible for the collection of different perfume compounds,” said Ramirez. “The idea here is that as these olfactory genes evolve and accumulate new mutations, they’re more sensitive to different molecules and therefore enable the bees to collect or not collect certain compounds.”
According to Brand, such differences in a single gene is extremely rare. “Usually divergent genetic regions — also called ‘genomic islands of divergence’ — include tens to hundreds of genes and it is very hard to pinpoint the gene under selection,” he said.
It’s the bee’s knees (or genes)
To figure out what molecules the two species of orchid bees detect using OR41, Brand and Ramirez used another airborne insect, the fruit fly (Drosophila melanogaster).
“We created these transgenic flies expressing orchid bee genes and it’s an ideal setup for dissecting exactly what the function of this gene is,” said Ramirez.
The team tested each species’ variant OR41 against single odors and blends of odors commonly found in the orchid bees’ environment.
When the team tested odors against E. viridissima‘s OR41 variant, they found it responded to perfume mixtures found in waxes used for brood cell construction by females and to “several medium to long-chain fatty-acids” common in waxes. The variant didn’t respond to single compound odors.
E. dilemma‘s OR41 variant responded consistently to the species-specific HNDB compound and E. dilemma perfume mixtures containing HNDB.
“The OR41 variant in E. dilemma evolved to become a highly specific receptor responding exclusively to its major species-specific perfume compound,” said Brand. “It is plausible that E. dilemma gained the ability to discriminate HNDB from other chemicals because of this.”
Brand has continued exploring insect chemosensory systems as a postdoctoral researcher in the lab of Associate Professor Vanessa Ruta, of The Rockefeller University. He’s working “to identify key genetic and neural mechanisms underlying the evolution of behavior.”
“I am focusing on reproductive behaviors such as courtship and mating and how these evolve and contribute to the origin and maintenance of novel species,” said Brand
“To me, fully integrating the traditionally separated fields of neurobiology and evolutionary biology is the next big step to learn how behaviors diverge and give rise to novel species,” he added.
Ramirez has also established the first-ever breeding population of orchid bees at a research facility at the University of Florida’s Ft. Lauderdale campus. Ramirez hopes to use the facility to continue studying bee behaviors and see if orchid bees are a viable option for in-depth research in chemical communication, animal behavior and pollination biology.
Nanosatellites improve detection of early-season corn nitrogen stress
For corn growers, the decision of when and how much nitrogen fertilizer to apply is a perennial challenge. Scientists at the University of Illinois have shown that nanosatellites known as CubeSats can detect nitrogen stress early in the season, potentially giving farmers a chance to plan in-season nitrogen fertilizer applications and alleviate nutrient stress for crops.
“Using this technology, we can possibly see the nitrogen stress early on, before tasseling. That means farmers won’t need to wait until the end of the season to see the impact of their nitrogen application decisions,” says Kaiyu Guan, assistant professor in the Department of Natural Resources and Environmental Sciences at the University of Illinois, and Blue Waters professor at the National Center for Supercomputing Applications. He is also principal investigator on a new study published in IEEE Journal of Selected Topics in Applied Earth Observations and Remote Sensing.
Being able to detect and address changes in crop nutrient status in real time is vitally important to avoid damage at critical periods and optimize yield. In general, existing satellite technology cannot achieve both high spatial resolution and high revisiting frequency (how often a given satellite comes back to the same spot above the Earth). Alternatively, drones can detect nutrient status in real time, but they usually can only cover local areas; thus, their utility is limited in scale.
CubeSats bridge the gap between existing satellite technology and drones. With more than 100 of the relatively tiny satellites currently in orbit, Guan says, “CubeSats from Planet get down to a 3-meter resolution and revisit the same location every few days. So, right now we can monitor crop nitrogen status in real time for a much broader area than drones.”
Guan and his collaborators tested the capabilities of both drones and CubeSats to detect changes in corn chlorophyll content, a proxy for the plant’s nitrogen status. The researchers focused on an experimental field in Central Illinois during the 2017 field season. Corn in the field was nitrogen-stressed to varying degrees due to multiple nitrogen application rates and timings, including all nitrogen applied at planting, and split applications at several developmental stages.
The analyzed field was one of several in a larger study looking at nitrogen rates and timing, set up by Emerson Nafziger, professor emeritus in the Department of Crop Sciences at Illinois and co-author on the study.
“The idea was to see how much effect timing and form of nitrogen fertilizer would have on yield. This study allows an evaluation of how well the imaging could capture yield responses to nitrogen applied at different rates and times,” Nafziger says.
The scientists compared images from drones and CubeSats, and their signals matched well with tissue nitrogen measurements taken from leaves in the field on a weekly basis. Both technologies were able to detect changes in chlorophyll contents with a similar degree of accuracy and at the same point in the season.
“This information generates timely and actionable insights related to nitrogen stress, and so could provide guidance for additional nitrogen application where it’s needed,” Guan says.
The implications go beyond optimizing yield.
“The low cost of nitrogen fertilizer and high corn yield potential motivates farmers to apply extra nitrogen as ‘insurance’ against nitrogen deficiency that lowers yield. But applying more nitrogen than the crop requires is both a financial and environmental risk,” says Yaping Cai, graduate student in Guan’s research group and lead student author on the paper.
Guan adds, “A better tool for fertilizer use, enabled through new satellite technology and ecosystem modeling, could ultimately help farmers to reduce cost, increase yield, and meanwhile reduce environmental footprint for a sustainable agricultural landscape.”
Biological clock is key to reducing heart damage from radiation therapy
Treatment for breast cancer commonly includes radiation therapy, which offers good chances of success but comes with a serious long-term side effect: toxicity due to radiation that reaches the heart, causing DNA damage in healthy heart cells. Over time, this can lead to heart disease and eventually heart failure.
A new study conducted by researchers in the Washington State University College of Pharmacy and Pharmaceutical Sciences suggests that a preventive solution may lie in the biological clock, the built-in time-keeping mechanism that keeps us on a 24-hour cycle of rest and activity and regulates a wide variety of processes in our bodies.
Published in the FASEB Journal, their study used a rodent model to determine whether the biological clock is involved in heart toxicity from radiation therapy and could be used as part of a strategy to reduce this toxicity. Their findings showed that after receiving a dose of radiation to the heart, mice with disrupted biological clocks had significantly worse heart function than control mice.
In addition, the researchers demonstrated that a protein known as Bmal1 — which drives 24-hour rhythms in the expression of many genes — plays an important role in protecting the heart from radiation-related damage.
“Our findings suggest that Bmal1 serves as a biomarker for the susceptibility to radiation-induced DNA damage to the heart,” said Shobhan Gaddameedhi, an assistant professor in the Department of Pharmaceutical Sciences and the study’s senior author.
Though more research is needed, the researchers are hopeful that their discovery could someday be used to improve treatment outcomes for breast cancer patients. Panshak Dakup — the study’s first author and a PhD in pharmaceutical sciences student — said their finding holds promise for personalized medicine. “For example, in breast cancer patients who have a long history of working night shifts, the expression of biological clock proteins such as Bmal1 may be compromised, and it could be that radiation therapy is not the best option for them.”
Gaddameedhi added that it could also be used to optimize the timing of radiation therapy so it is provided when a patient’s Bmal1 level offers the greatest level of protection from heart damage. That timing may vary depending on a person’s chronotype — whether they are early birds or night owls — as well as on other factors that influence the status of the master biological clock, such as shiftwork or frequent travel across time zones.
Dakup conducted the experiments for the study as part of a predoctoral fellowship supported by the American Heart Association. Additional major support for the study came from the National Institutes of Health.
In the study’s main experiment, Dakup looked at the heart function of two groups of mice with disrupted clocks, as compared to that of control mice. One group had a genetic mutation that eliminated Per1 and Per2 — two genes that control the body’s master biological clock. The second group were wild-type mice that were put on a simulated rotating shift schedule in which light-dark cycles were reversed weekly, throwing off their clocks. The control group consisted of wild-type mice with healthy biological clocks that were on a simulated day shift schedule. All mice received radiation treatment to the chest that included all of the heart.
Collaborating with assistant professor of pharmaceutical sciences and cardiovascular biology expert Zhaokang Cheng, Dakup used ultrasound echocardiography technology to compare heart function among the three groups, both prior to and up to six weeks after radiation treatment. In clock-disrupted mice, the heart’s ability to pump blood out and into circulation was compromised due to a loss of elasticity in the heart ventricle. Those mice also had more heart scar tissue than control mice.
Additional analyses focused on determining a potential relationship with the biological clock protein Bmal1. The researchers showed that Bmal1 levels across 24 hours were significantly lower in clock-disrupted mice versus control mice and peaked at a later time. They also found that higher levels of Bmal1 were associated with lower DNA damage levels, and vice versa.
Finally, the researchers found that Bmal1 interacts with the BRCA1, BRCA2, and ATM genes, three DNA damage response genes they said are important in fighting against radiation-induced DNA damage and cell death.
“When Bmal1 binds to these genes, it is potentially trying to elevate or activate their function against the collateral damage caused by radiation therapy,” Gaddameedhi said.
The researchers’ next step is to test their hypothesis in a cancer model. This will help them pin down the exact mechanism by which the biological clock protects the heart from radiation damage. They could then use this knowledge to develop new treatment strategies to minimize heart damage while maximizing the ability to kill tumor cells. Any such strategies would first need to be tested in clinical trials before they could be adopted.
High-Trust Pricing
Many entrepreneurs find pricing decisions for their products and services really challenging. You’ll often hear such people asking each other, “What should I charge?”
I’ve read a number of books about pricing with complex ideas on how to do it correctly. Most involved some form of testing and optimization. They all shared the same underlying assumption though: that the optimal prices are those which extract the most long-term profit. Since that’s extremely difficult to predict, testing is essential.
Testing of that nature can be dreadfully boring though, and you still won’t know if your tests are accurate. Since economies fluctuate anyway, a test done one month could yield different results than if you run it a month later.
I dislike that approach mainly because I find the framing too limiting. It’s a very objective model, and I have a long history of getting better results when I use subjective framing. If my reality is some kind of simulation, it seems unlikely that my simulation is programmed to train me to care about pricing optimizing by doing split tests. That seems like a rather useless skill to develop, akin to improving my telephone sanitizing skills (which admittedly aren’t very polished). I have no desire to sculpt my character into a split testing mogul.
Pricing as Communication
A model I like much better is to think of pricing as a form of communication. The pricing is part of the offer and inseparable from it. The price isn’t something to be tacked on later.
Pricing can communicate whether you’re trying to provide something cheaply or luxuriously, for instance. If I tell you that I bought a car for $8000, that would communicate something different than if I say I bought one for $80,000, even if I told you nothing else about the car.
In this sense pricing also serves as a filter. Your price will affect the types of customers and clients you attract. For instance, I could price Conscious Growth Club at $10K per year instead of $2K a year, and the group would still work, but we’d have different types of members and fewer of them. Otherwise the program’s structure and design could be entirely the same. The price would communicate what types of members we’re looking for. Similarly I know someone who charges $80K per year for his coaching program and $5K for his seminars. Are they objectively any better than our $2K coaching program and $500 workshops? Nope, but the pricing difference will attract different people.
So when I think about pricing from this perspective, I think about the kinds of people I’d like to attract and work with. If I want to offer a coaching program for the kinds of people who like $10K programs, I’ll price it at $10K. I’m personally one of those people, currently enrolled in a friend’s $12K coaching program for the year.
Pricing From the Customer’s Perspective
Another frame I like is to think about what price is best for the customer to pay. This is a good model if you know your customer base really well, and you know how different prices will make them feel.
You could price something low to communicate that it’s easy and accessible if that’s what you think is best for the customer.
Or you could price something higher if you want to communicate that a product or service is a bigger investment or a bigger value. People often appreciate higher priced products more. Pricing too low can reduce a person’s appreciation.
I use this on myself too. I know that if I join a coaching program that costs $10K per year, I’ll appreciate it more and gain more value from it than if I pay $1K per year. When making purchasing decisions, I think about pricing and features in terms of what will help me appreciate a purchase.
Pricing can be a bit funny that way. It’s hard to admit that sometimes it’s better to pay more because you’ll appreciate the ownership experience more. If you pay too little, you may communicate to yourself that you don’t value the purchase as much. Trying to get something for less isn’t always wise.
Setting prices based on what’s likely to be best for my core customer base has been super helpful. I could continue to maintain a healthy business just with this pricing model alone. It seems to work very well in practice, as I get more compliments than complaints about my pricing. People pay enough that they value and appreciate the investment, but it’s still low enough that they can extract lots of value from their purchase to make it very worthwhile. This generates a lot of repeat business too. Most of the sign-ups for our new Stature course are from repeat customers.
The best price for the customer to pay is the price that helps them extract the most value, satisfaction, and appreciation from their purchase. One key factor for the courses I offer is that people need to do the lessons to extract the value. When someone completes the course, I know from experience that they’re very likely to get really good value from it and feel that the deal was more than fair, generous even. But they also have to invest time and energy to extract the full value. If they pay too little, there’s less buy-in and less motivation to do the work and finish the lessons, even if it will benefit them immensely. Paying too little sends a message to their minds that maybe they shouldn’t value this investment as much.
On the other hand, if the price is too high, then people feel stressed out and worried. Or they talk themselves out of making that kind of commitment. Some people, however, will feel even more excited when they commit to a price that’s a stretch for them. I’ve experienced this myself when I’ve stepped up to pay for high-end coaching programs. It can be exciting and fun to spend enough money such that it feels edgy and risky, and so far I’ve always gotten more than my money’s worth when I’ve stretched myself to pay more. That’s mainly because when I take a bigger financial risk, I’m very committed to doing my part to extract the value; otherwise I’d feel really stupid for paying that much for something and not leveraging the heck out of it.
Another factor could be that I join a group with other people who’ve stretched themselves to join as well, and such groups are just awesome to participate in because people really put in the effort to make it work, which benefits everyone in the group. We’re all committed, so we all pitch it and make it work for each other. When everyone has to stretch a bit to get in, it’s even better inside. Higher pricing can serve as a good filter for attracting ambitious, growth-oriented people – not perfectly but pretty well.
One reason I price Conscious Growth Club at $2K is that for much of my audience, that pricing feels pretty edgy already while $10K would feel out of reach for them. Based on the great community I’m seeing inside, I think it’s the right pricing for most members. For some I can tell it’s not edgy enough though. If you’re looking for a community of only entrepreneurs, for instance, a $10K program would be better. In our community people work on all different types of goals: health, relationships, finances, life purpose, meaningful work, creative skills, and more.
Pricing for Trust
Another frame I like using today is what you might call trust-based pricing. I didn’t learn about this somewhere else, at least not to my knowledge. It just gradually evolved from trying to find better frames for this aspect of business.
In doing workshops, creating courses, and running Conscious Growth Club, I experience just how wonderful it is to work closely with people who trust me. High-trust relationships are so win-win all around. Trust reduces friction and makes it easier for people to get results, which in turn leads to more appreciation. Appreciation is good all around, both for business and personal reasons.
When people ask me questions about our products and services, and I can tell they’re not really aligned with what we provide or the kind of relationship I’d like to have with them, I gently recommend that they don’t buy anything. Sometimes I’ll suggest free articles to read instead, and sometimes I’ll suggest other resources in this field that might be a better fit for them. I don’t try to invite everyone to become a customer. To me that’s a special relationship, and the alignment matters.
I’m not suggesting that people need to trust my advice blindly. That’s not the type of trust we’re talking about here.
In this case I’m referring to trust in my intentions, experience, and honesty. I want people to trust that I’m on their side and that I genuinely want to help them grow and improve. If they can at least buy into that, it makes a world of difference for us. These days I only want to work only with people who can feel aligned with having this kind of relationship. I feel very fortunate that I can maintain this standard and still attract plenty of business. Not everyone is right for this kind of relationship, but for the right people who are aligned with it, they tend to love and want nothing less. Having such a high-trust relationship is just beautiful.
I love these kinds of relationships with other businesses too. For instance, I really like the dental practice that I’ve been going to for the past several years. I’ve worked with multiple dentists there, and they’re all great. The people at the front desk are super friendly, and I sometimes joke around with them. The hygienist is awesome too. She and I chat about all sorts of things like travel and even ayahuasca. I’ve never been to another dental practice like this; previous ones felt somber, cold, and heartless. But in this place, it’s obvious that the people like working with each other, and they like their patients too. In the past, I’ve gone at least a decade between dental appointments because I disliked the experience so much. With these people I’m currently going 3x per year, which I’ve never done before. Most importantly, I trust them. They aren’t just friendly. They’re also good at what they do. I hope they stay in business for as long as possible.
I’m a good customer for them too. I show up on time. I follow their advice. I pay every bill on the spot, so they never have to bill me. I never complain about prices or try to negotiate them down.
With high trust in a coaching situation, people are willing to share deeper truths about themselves. If you only get the surface truth, coaching can only go so deep. With more trust people will share the more vulnerable parts of themselves, and that leads to even deeper trust.
When someone trusts me in this way, such as by sharing something that’s really difficult for them to share, I feel honored. It’s a privilege to be trusted with that level of intimacy. It makes me feel more invested in helping the person. Handling such situations can be delicate. Delicate is a word that in my distant past, I’d never have applied to myself. But today I like sculpting my character in that direction. I love the realm of high-trust relationships because it leads into a world of subtlety and delicacy, yet there’s still room for playfulness and fun.
In terms of pricing models, I think about pricing for trust. If I want to attract more high-trust customers (if only because they’re delightful to serve), then I think about what price will best align with attracting and developing high-trust relationships.
If I price too cheaply, it means people can buy without having to trust as much, which can flood the business with too many jaded and skeptical people that I’d rather not deal with. If they want something too cheaply, they probably don’t want something really good, which means they won’t have the right attitude for supporting me in doing my best work. That isn’t going to create a win-win relationship.
If I price too high though, it can damage trust because then people might assume I’m just doing it for personal greed. So if there’s a valid reason for pricing higher than usual, it’s important to communicate that clearly.
It’s also wise to consider the existing trust relationship. I like to offer launch discounts for new courses, such as for the new Stature course that’s launching now. Most of the people who will join during the launch already have a trusting relationship with me, like repeat customers and long-term blog readers or newsletter subscribers, so from my view they don’t have to prove themselves to me. I want to make it easier for them to join, so we’ll have a nice, high-trust group inside. And I also want to make the price lower for them as a way of saying that I trust them too and that I appreciate our relationship. I trust that even at the lower price, they’ll still take it seriously enough and do the work of the course, so they can get the benefits.
After the launch, the course can continue selling for many years, but the new people who discover it probably aren’t part of my core, high-trust audience yet. They may be new to my work. They’re not sure if they can trust me, and I’m not sure if I can trust them. So it may be better if they start with reading free articles for a while. Then they can think about taking a course when they trust me enough to do so. The higher price is a bigger hurdle for them, so it takes more trust for them to say yes.
Some people are really into growing their businesses. For me alignment is way more important than growth. If I can do both, that’s great, but between the two, I see alignment as far more important. I’d be a lot less happy if I 10X’d my business but messed up the alignment in the process. I just don’t want to work closely with people unless we can develop and maintain high-trust relationships.
I really, truly don’t want to do business with people who don’t trust me enough to make it win-win. Even if I made a lot more money trying to capture those extra sales, I wouldn’t want it. Even if I could delegate way more, including all of the customer service, I wouldn’t feel good about a customer service rep having to deal with misaligned customers either. It wouldn’t be right.
Alignment Pricing
I think the ultimate pricing model is to price for alignment. What would an aligned business look like for you, and what pricing decisions would help you create that?
Incidentally, you can use this mindset even if you’re an employee. What’s the right salary for you to request and for your employer to pay such that the alignment is there, and you’re able to invest in a high-trust relationship?
We can also see why split-testing and traditional optimization strategies look good on paper but often fall short in reality. Trying to optimize for profit is short-sighted and risks attracting many misaligned customers. That can increase support costs, negative reviews, product returns, staff turnover, etc. Many people I know who use this model would consider a refund rate of 5-10% to be pretty good. My business’ current refund rate is 0.0%. And the reason is simple, we don’t offer refunds. Instead we have an honor code. If you’d like to see my explanation of the honor code and why we have it, watch the Stature video from 27:33 onward. But the main reason is that I tested offering a money-back guarantee, and while it brought in more sales, it messed up the alignment and created more problems and friction inside the business. It really sucks to feel hesitant about investing fully in someone because I suspect they might request a refund. It’s so nice not to have to deal with that anymore.
Having an honor code instead of money-back guarantee really does turn away some business. I would almost certainly make more money in the short-term by offering unconditional refunds. But the reason I don’t is simple. The headaches aren’t worth it to me.
People have to meet a higher standard of trust to buy with our honor code – trust in me and trust in themselves to follow through. That’s the standard I want. It means fewer people getting through but way more alignment inside. And it makes the business so much nicer and more fulfilling to run. People who are jaded or suspicious just aren’t going to accept such an offer, and I’m glad for that. I’m delighted to refer their business to other people who’d welcome it.
I also think that in the long run, this approach will make the business better for staff members too. It means that staff also get to work with aligned customers who will trust and appreciate them. No staff member should have to deal with customers from hell. We’ll fire such customers from hell and keep the aligned staff. Our staff won’t be treated poorly.
Creating win-win relationships is a high standard, but it elevates so many other parts of the business. It removes so much friction and makes it easier to just do the real work of serving people. Financially it works well too. This will be a six-figure January for us, which is a nice way to start the year.
Health24.com | 5 secret healing powers of pineapple
13 January 2020
5 secret healing powers of pineapple
It’s not just delicious, it’s good for you too.
Stringr
Pineapples are packed with nutrients, antioxidants and enzymes that can fight inflammation and disease.
Image credit: Fiona Smallwood, Unsplash
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Health24.com | ‘Less is more’ when it comes to testicular cancer chemo
Treatment with half the typical amount of chemotherapy can still prevent the return of one type of testicular cancer, a new study suggests.
Giving patients with the “non-seminoma” form of testicular tumour just one cycle of chemotherapy was just as effective at preventing the cancer from coming back as the standard two cycles, the study found.
Fewer hospital visits
Cutting the amount of chemotherapy in half also reduced serious side effects that can have a lifelong impact on a patient’s health, said the team of British researchers.
The findings might prove a boon for patients, most of whom are young.
“Reducing the overall dose of chemotherapy could spare young men who have their whole lives ahead of them from long-term side effects, and also means they will need fewer hospital visits for their treatment,” said lead researcher Robert Huddart.
He spoke in a news release from The Institute of Cancer Research in London, where he’s a professor of urological cancer.
One patient who’s been treated using the lower-dose strategy said he’s already benefiting.
“I was playing [soccer] semi-professionally at the time I was diagnosed,” noted 35-year-old Kris Taylor, from Britain’s West Midlands. “Even though my prognosis was good, knowing that you have cancer is really scary, and the key thing for me was to get back to normality as soon as possible.”
Removal of testicle
Speaking in the institute news release, Taylor said he’d “already had to have time off for surgery. So when I was offered the chance to have less chemo but with no greater risk the cancer would return, I jumped at it.”
Currently, testicular cancer patients first undergo surgical removal of the affected testicle. They then choose between two cycles of chemotherapy – to destroy any cancer that may have spread to other areas – or a watch-and-wait “surveillance” approach.
If the latter route is chosen, the patient receives no chemotherapy unless their cancer comes back, at which point they receive three cycles of chemo.
Survival rates for testicular cancer are very high, but many patients are diagnosed in their 20s and 30s, so having chemotherapy means they may have to live with long-term side effects, the researchers noted.
In the new study, Huddart’s group tracked outcomes for nearly 250 men with early-stage testicular cancer that was at high risk of returning after surgery. The men received one three-week cycle of a chemotherapy known as BEP – a combination of the drugs bleomycin, etoposide and the platinum agent cisplatin.
After two years, testicular cancer returned in just 1.3% of the patients. That was nearly identical to the rate found in prior studies of patients who had received two cycles of the chemotherapy, the researchers said.
Still ‘fighting fit’
About 41% of patients who received one cycle of chemotherapy had one or more serious side effects during treatment – such as an increased risk of infection, sepsis or vomiting – but only 2.6% had long-term side effects such as damage to their hearing.
For his part, Taylor acknowledged that “the side effects of the treatment were really difficult”.
But he said that he was still able to return to soccer quickly, and “five years on, and I’m still fighting fit”.
“It’s great to know that others may now be able to benefit from the trial’s findings,” he added. “Being able to reduce the amount of chemotherapy a person receives can make such a big difference to their quality of life in both the short-term and the long-term.”
Two US experts in treating testicular cancer agreed that the study might change practice. But they also cautioned that treatment decisions are always made on a case-by-case basis.
“This is an important study emphasising how ‘less is more’ in patients,” said Dr Nikolaos Karanikolas, who directs urologic surgical oncology at Staten Island University Hospital in New York City.
Results look promising
But overall, “the need to provide effective care while preserving quality of life and reproductive success is paramount,” he said.
Dr Michael Schwartz directs robotic and laparoscopic surgery at Northwell Health’s Arthur Smith Institute for Urology in Lake Success, New York. He said the results of the British study do look promising, but more research is needed.
“This study measured short-term toxicity, which appeared similar between the two groups,” Schwartz noted. “Long-term toxicities, and the effects of the different chemotherapy doses on fertility, were not reported in this study, but are expected with longer follow-up of the patients.”
Also, not every man with non-seminoma testicular cancer will benefit equally from a reduced dose of chemo, he said.
“The results here have the potential to influence the treatment paradigm for testicular cancer, but it is important to remember that the results only apply to a highly selected patient population,” Schwartz said. “All patients with non-seminoma testicular cancer will not necessarily be candidates for this reduced chemotherapy regimen.”
The study was published in the journal European Urology.
Image credit: iStock
NHS campaign for male blood sparks controversy
Many gay and bisexual men have hit out at an NHS campaign asking for more male blood donations.
