Richard horton, barcelona 2014

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Vall d'Hebron Institute of Research (VHIR)

The document discusses the future of human health and argues that the survival of modern civilization over the next century is uncertain. It notes that humanity has escaped death and deprivation over the last 250 years but preconditions like corruption, poverty, and economic decline could lead to instability, social chaos, and eventual collapse without resilience, transformation and reconstitution to stabilize and reconstruct society. The document calls for global health, science, society, solidarity and sustainability to foster a shared global identity.

Science and charity: the
purpose of medicine and
the meaning of health
Richard Horton
The Lancet
December 12, 2014

“I think I have
found out the
simple way by
which species
become exquisitely
adapted to various
ends.”

“Man in the distant future will be a
far more perfect creature then he
now is.”

“And fast by hanging in a golden chain
This pendent world.”
Book ll, Paradise Lost

“I think the odds are
no better than 50/50
that our present
civilisation will
survive to the end of
the present century.”
Our Final Century (2003)

The Great Divergence
“Humanity’s escape
from death and
deprivation began
around 250 years
ago.”

PRECONDITIONS
Corruption
Incompetence
Insecurity
Degradation
Poverty
Invasion
ECONOMIC
DECLINE
Economic
Crisis
INITIAL
BREAKDOWN
Conflict
Privatisation
Disease
Decline
Depopulation
INSTABILITY
ADVANCED
BREAKDOWN
Fracture
Civil war
Social chaos
Famine
Fragmentation
COLLAPSE
RESILIENCE/
ADAPTATION
Vision
Solidarity
Transformation
STABILISATION
RECONSTITUTION
Recovery
Cultural memory
New Beliefs
RECONSTRUCTION

SUSTAINABILITY
RESILIENCE
Food
Security
Civilisations
Economic
Systems
Disease
Political
systems
Extreme
Events
Water
Population
Social
stability
Peace
Physical
Systems
Human
Systems

“See with what heat these dogs of hell
advance
To waste and havoc yonder world, which I
So fair and good created, and had still
Kept in that state, had not the folly of man
Let in these wasteful furies…”
John Milton, Paradise Lost (Book 10)

GLOBAL HEALTH
GLOBAL SCIENCE
GLOBAL SOCIETY
GLOBAL SOLIDARITY
GLOBAL SUSTAINABILITY
GLOBAL IDENTITY

This revised edition of Human Nature begins a new phase in the most important intellectual controversy of this generation Is human behavior controlled by the species' biological heritage Does this heritage limit human destiny With characteristic pungency and simplicity of style the author of Sociobiology challenges old prejudices and current misconceptions about the naturenurture debate. He shows how evolution has left its traces on the most distinctively human activities how patterns of generosity selfsacrifice and worship as well as sexuality and aggression reveal their deep roots in the life histories of primate bands that hunted big game in the last Ice Age. His goal is nothing less than the completion of the Darwinian revolution by bringing biological thought into the center of the social sciences and the humanities. Wilson presents a philosophy that cuts across the usual categories of conservative liberal or radical thought. In systematically applying the modern theory of natural selection to human society he arrives at conclusions far removed from the social Darwinist legacy of the last century. Sociobiological theory he explains is compatible with a broadly humane and egalitarian outlook. Human diversity is to be treasured not merely tolerated he argues. Discrimination against ethnic groups homosexuals and women is based on a complete misunderstanding of biological fact. But biological facts can never take the place of ethical choices. Once we understand our human na

MASS CREATIVITY

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The discovery of the nuclear factor TDP-43 involvement in neurodegenerative disease has increased significantly the general interest on the characteristics of this protein. The aberrant localization and aggregation of TDP-43 in affected tissues coupled with the tight auto regulation of TDP 43 cellular levels has suggested novel pathways for neurodegeneration. TDP 43 is predominantly a nuclear protein that shuttles between nucleus and cytoplasm. In disease neurons TDP 43 mislocalize to cytoplasmic inclusions with devastating consequences on neuronal survival. These cytoplasmic aggregation disrupts the TDP-43 control of its own cellular level. In fact autoregulation is mediated byan unusual splicing event in the 3’UTR of its pre mRNA for which is essentiial the presence of TDP 43 in the nucleus. In addition animal models and highthroughput assays have recently highlighted the role played by this protein in the regulation of hundreds of nuclear and cytoplasmic RNA transcripts, many of them belonging to key genes for neuronal metabolism. A model has been developed to study the determinants of the aggregation process and the impact of the latter on neuronal function. Animal models of the disease have been developed in different species mainly mice and flies.

Allogeneicity and Immunogenicity of Stem Cell Therapy : a cardiovascular focus

Vall d'Hebron Institute of Research (VHIR)

On March 12th 2013 took place at Vall d’Hebron Institut de Recerca (VHIR) the seminar ‘Allogeneicity and Immunogenicity of Stem Cell Therapy: a cardiovascular focus’, conducted by Pr. Dominique Charron, MD, PhD, Professor of Medicine, Immunology at the University of Paris and Chairman of the Department of Immunology and Histocompatibility at Hospital Saint Louis in Paris. Research on stem cell therapies for regenerative medicine is progressing rapidly. Although the use of autologous stem cells is a tempting choice, there are several instances in which they are either defective or not available in due time. Allogenic stem cells derived from healthy donors presents a promising alternative. Whether autologous or allogenic, recent advances have proven that stem cells are not as immune privileged as they were thought. Therefore understanding the interactions of these cells with the recipient immune system is paramount to their clinical application. Transplantation of stem cells induces humoral as well as cellular immune response. The research group of Pr. Dominique Charron investigated the immune characteristics of human cardiac stem/progenitor cells lines in term of major histocompatibility complex (MHC) expression, allogenicity and immuno modulatory properties. By using an experimental model of allogeneic stimulation, they demonstrate that, whether under inflammatory conditions or not, human cardiac progenitor cells (hCPC) do not trigger conventional allogeneic T helper cells type responses but instead induce proliferation and selective expansion of suppressive of regulatory T cells (Treg). Thus, hCPC in allogeneic settings acquire the capacity to down-regulate an ongoing immune response. For stem cell therapy to move to the clinics, immunological barriers should be pragmatically managed. It could be recommended to minimize immunogenetic differences between stem cell and recipient, assay the immunization status of the recipient prior to stem cell injection, and monitor both allogenic and autoimmunity post stem cell transplantation. Integrating the unique immunobiology of stem cell with the patient immune status is key to successful translation to the clinics.

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The New Society [student’s name] Coastline Community College English 100 Professor Davis August 6, 2015 THE NEW SOCIETY 1 Abstract Human civilization has hit a critical point and has finally woken up: life on Earth is in grave danger. Thus, a collective human consciousness arises and sweeps across the world, forming a New Society. People have concluded that for things to continue major changes have to come, and they have to come now. After eliminating money, borders, and religion, people then begin focusing on maintaining life on earth and achieving happiness through the unification of our species. Switching to a plant-based diet, adopting alternative sources of energy worldwide, and teaching diversity and art, humans become happy and content with life. The basic human necessities are available to all, and money is eradicated. Humans are humbled, united in harmony with each other and all other life on earth. Keywords: Utopia, Solar Energy, Religion, Veganism, Meditation, Space, Happiness THE NEW SOCIETY 2 The New Society How will the end of the world come? Will it be a meteor crash? Will it be an ice age brought on by climate change? A runaway greenhouse effect like Venus’s? Will it be a nuclear arms exchange? Or will it just come from the expansion of our sun once the hydrogen is depleted in its core? For the final scenario we have roughly five billion more years to figure out what to do before the supernova naturally occurs. For most of the other possibilities, it seems that we humans have at least some control over whether they become a reality or not. This essay will use an imaginary scenario (perhaps not too unlike our own current one) where humans have realized that they've been doing many things wrong for a long time and that huge changes are now a necessity. These necessities will describe my utopian country. But how would one utopian country exist? What good is it to live in a utopian country when another country bordering the utopian country decides it wants to take it over? If happiness is defined as the emotion of joy that a person experiences in life, then initially this must be based on the premise that that person must be alive in the first place. So in order to achieve the greatest happiness for the most humans, there needs to be a single focused and collective consciousness. This would not be a country, then, but will be referred to as the world's New Society, where happiness stems from just being alive, experiencing the gift of life, and understanding the role of maintaining our ecology. So what's the first major change? A good place to start is money, and those who don't believe the phrase “money is the root of all evil” are duped. Money is what operates most of the world, so to rid of it would be a huge improvement in almost everything that humans know. But it's a must for many reasons. ...

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Durante los últimos años se han redoblado los esfuerzos de las agencias de investigación para financiar la creación, desarrollo y sostenibilidad de plataformas e infraestructuras de investigación. En Europa, el programa de infraestructuras europeas (EuropeanStrategyForumon Research Infrastructures -ESFRI) es un ejemplo de este tipo de acciones, que es apoyado desde los Estados Miembros. Los registros de enfermedades raras constituyen sistemas de información estandarizada, que han sido tradicionalmente asociados a las administraciones sanitarias. Su uso, ha sido por tanto, restringido a la toma de decisiones de índole general sin aparente repercusión para las personas afectadas por una enfermedad. Más recientemente, los registros han ido tomando cada vez más importancia por su utilidad para la promoción de la investigación, ya que permiten tomar decisiones sobre la puesta en marcha de nuevas áreas de investigación, obtener datos válidos para la creación de buenas prácticas de utilidad directa para las personas enfermas y desarrollar estudios observacionales y experimentales a partir de la contribución de los sujetos que consientan la participación. Los registros de enfermedades raras son particularmente necesarios tanto para la promoción de la investigación en este campo como para la toma de decisiones socio-sanitarias, debido a la baja prevalencia de estas enfermedades y a las dificultades que supone el encontrar casos suficientes de una misma enfermedad. El proyecto SpainRDR, del ISCIII, constituye un modelo cooperativo de registros de enfermedades raras en red para la investigación. También otros países europeos, los NIH, USA y la pro pia Comisión Europea están desarrollando modelos de registros basados en amplias colaboraciones y creación de plataformas.

Gut microbiota for health: lessons of a metagenomic scan (by Joel Doré)

Vall d'Hebron Institute of Research (VHIR)

VHIR Seminar led by Joel Doré. Research Director. Institut National de la Recherche Agronomique (INRA). Jouy-en-Josas, France. Abstract: The human intestinal tract harbours a complex microbial ecosystem which plays a key role in nutrition and health. Interactions between food constituents, microbes and the host organism derive from a long co-evolution that resulted in a mutualistic association. Current investigations into the human faecal metagenome are delivering an extensive gene repertoire representative of functional potentials of the human intestinal microbiota. The most redundant genomic traits of the human intestinal microbiota are identified and thereby its functional balance. These observation point towards the existence of enterotypes, i.e. microbiota sharing specific traits but yet independent of geographic origin, age, sex etc.. It also shows a unique segregation of the human population into individuals with low versus high gene-counts. In the end, it not only gives an unprecedented view of the intestinal microbiota, but it also significantly expands our ability to look for specificities of the microbiota associated with human diseases and to ultimately validate microbial signatures of prognostic and diagnostic value in immune mediated diseases. Metagenomics of the human intestinal tract was applied to specifically compare obese versus lean individuals as well as to explore the dynamic changes associated with a severe calory-restricted diet. Microbiota structure differs with body-mass index and a limited set of marker species may be used as diagnostic model with a >85% predictive value. Among obese subjects; the overall phenotypic characteristics are worse in individuals with low gene counts microbiota, including a worse evolution of morphometric parameters over a period of 10 years, a low grade inflammatory context also associated with insulin-resistance, and the worst response to dietary constraints in terms of weight loss or improvement of biological and inflammatory characteristics. Low gene count microbiota is also associated with less favourable conditions in inflammatory bowel disease, such as higher relapse rate in ulcerative colitis patients. Finally, microbiota transplantation has seen a regain of interest with applications expanding from Clostridium difficile infections to immune mediated and metabolic diseases. The human intestinal microbiota should hence be regarded as a true organ, amenable to rationally designed modulation for human health.

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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol that is rapidly distributed in the body and brain. Ethanol alters many neurochemical systems and has rewarding and addictive properties. It is the oldest recreational drug and likely contributes to more morbidity, mortality, and public health costs than all illicit drugs combined. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) integrates alcohol abuse and alcohol dependence into a single disorder called alcohol use disorder (AUD), with mild, moderate, and severe subclassifications (American Psychiatric Association, 2013). In the DSM-5, all types of substance abuse and dependence have been combined into a single substance use disorder (SUD) on a continuum from mild to severe. A diagnosis of AUD requires that at least two of the 11 DSM-5 behaviors be present within a 12-month period (mild AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria). The four main behavioral effects of AUD are impaired control over drinking, negative social consequences, risky use, and altered physiological effects (tolerance, withdrawal). This chapter presents an overview of the prevalence and harmful consequences of AUD in the U.S., the systemic nature of the disease, neurocircuitry and stages of AUD, comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and pharmacotherapies for AUD.

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1. Science and charity: the purpose of medicine and the meaning of health Richard Horton The Lancet December 12, 2014

7. “I think I have found out the simple way by which species become exquisitely adapted to various ends.”

8. “Man in the distant future will be a far more perfect creature then he now is.”

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12. “And fast by hanging in a golden chain This pendent world.” Book ll, Paradise Lost

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28. “I think the odds are no better than 50/50 that our present civilisation will survive to the end of the present century.” Our Final Century (2003)

29. DOES HUMAN HEALTH HAVE A FUTURE?

30. The Great Divergence “Humanity’s escape from death and deprivation began around 250 years ago.”

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46. PRECONDITIONS Corruption Incompetence Insecurity Degradation Poverty Invasion ECONOMIC DECLINE Economic Crisis INITIAL BREAKDOWN Conflict Privatisation Disease Decline Depopulation INSTABILITY ADVANCED BREAKDOWN Fracture Civil war Social chaos Famine Fragmentation COLLAPSE RESILIENCE/ ADAPTATION Vision Solidarity Transformation STABILISATION RECONSTITUTION Recovery Cultural memory New Beliefs RECONSTRUCTION

47. SUSTAINABILITY RESILIENCE Food Security Civilisations Economic Systems Disease Political systems Extreme Events Water Population Social stability Peace Physical Systems Human Systems

48. “See with what heat these dogs of hell advance To waste and havoc yonder world, which I So fair and good created, and had still Kept in that state, had not the folly of man Let in these wasteful furies…” John Milton, Paradise Lost (Book 10)

49. GLOBAL HEALTH GLOBAL SCIENCE GLOBAL SOCIETY GLOBAL SOLIDARITY GLOBAL SUSTAINABILITY GLOBAL IDENTITY

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