Day: November 9, 2023

Surgeons have performed the world’s first transplant of an entire human eye, an extraordinary addition to a face transplant — although it’s far too soon to know if the man will ever see through his new left eye. 

An accident with high-voltage power lines destroyed most of Aaron James’ face and one eye. His right eye still works. But surgeons at NYU Langone Health hoped replacing the missing one would yield better cosmetic results for his new face, because it would support the transplanted eye socket and lid. 

The NYU team announced Thursday that so far, it’s doing just that. James is recovering well from the dual transplant last May, and the donated eye looks remarkably healthy. 

“It feels good. I still don’t have any movement in it yet. My eyelid, I can’t blink yet. But I’m getting sensation now,” James told The Associated Press as doctors examined his progress recently. 

“You got to start somewhere, there’s got to be a first person somewhere,” said James, 46, of Hot Springs, Arkansas. “Maybe you’ll learn something from it that will help the next person.” 

Today, transplants of the cornea — the clear tissue in front of the eye — are common to treat certain types of vision loss. But transplanting the whole eye — the eyeball, its blood supply and the critical optic nerve that must connect it to the brain — is considered a moonshot in the quest to cure blindness. 

Whatever happens next, James’ surgery offers scientists an unprecedented window into how the human eye tries to heal. 

“We’re not claiming that we are going to restore sight,” said Dr. Eduardo Rodriguez, NYU’s plastic surgery chief, who led the transplant. “But there’s no doubt in my mind we are one step closer.” 

Some specialists had feared the eye would quickly shrivel like a raisin. Instead, when Rodriguez propped open James’ left eyelid last month, the donated hazel-colored eye was as plump and full of fluid as his own blue eye. Doctors see good blood flow and no sign of rejection. 

Now researchers have begun analyzing scans of James’ brain that detected some puzzling signals from that all-important but injured optic nerve. 

One scientist who has long studied how to make eye transplants a reality called the surgery exciting. 

“It’s an amazing validation” of animal experiments that have kept transplanted eyes alive, said Dr. Jeffrey Goldberg, chair of ophthalmology at Stanford University. 

The hurdle is how to regrow the optic nerve, although animal studies are making strides, Goldberg said. He praised the NYU team’s “audacity” in even aiming for optic nerve repair and said he hopes the transplant will spur more research. 

“We’re really on the precipice of being able to do this,” Goldberg said. 

James was working for a power line company in June 2021 when he was shocked by a live wire. He nearly died. Ultimately, he lost his left arm, requiring a prosthetic. His damaged left eye was so painful it had to be removed. Multiple reconstructive surgeries couldn’t repair extensive facial injuries including his missing nose and lips. 

James pushed through physical therapy until he was strong enough to escort his daughter Allie to a high school homecoming ceremony, wearing a face mask and eye patch. Still, he required breathing and feeding tubes, and he longed to smell, taste and eat solid food again. 

“In his mind and his heart, it’s him — so I didn’t care that, you know, he didn’t have a nose. But I did care that it bothered him,” said his wife, Meagan James. 

Face transplants remain rare and risky. James’ is only the 19th in the United States, the fifth Rodriguez has performed. The eye experiment added even more complexity. But James figured he’d be no worse off if the donated eye failed. 

Three months after James was placed on the national transplant waiting list, a matching donor was found. Kidneys, a liver and pancreas from the donor, a man in his 30s, saved three other people. 

During James’ 21-hour operation, surgeons added another experimental twist: When they spliced together the donated optic nerve to what remained of James’ original, they injected special stem cells from the donor in hopes of spurring its repair. 

Last month, tingles heralded healing facial nerves. James can’t yet open the eyelid and wears a patch to protect it. But as Rodriguez pushed on the closed eye, James felt a sensation — although on his nose rather than his eyelid, presumably until slow-growing nerves get reoriented. The surgeon also detected subtle movements beginning in muscles around the eye. 

Then came a closer look. NYU ophthalmologist Dr. Vaidehi Dedania ran a battery of tests. She found expected damage in the light-sensing retina in the back of the eye. But she said it appears to have enough special cells called photoreceptors to do the job of converting light to electrical signals, one step in creating vision. 

Normally, the optic nerve then would send those signals to the brain to be interpreted. James’ optic nerve clearly hasn’t healed. Yet when light was flashed into the donated eye during an MRI, the scan recorded some sort of brain signaling. 

That both excited and baffled researchers, although it wasn’t the right type for vision and may simply be a fluke, cautioned Dr. Steven Galetta, NYU’s neurology chair. Only time and more study may tell. 

As for James, “we’re just taking it one day at a time,” he said. 
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Recent heavy rain and flooding killed 15 people in Kenya and displaced thousands of others, the Kenya Red Cross Society says.

The heavy rainfall also killed livestock and destroyed businesses and farmland, said Peter Murgor, a disaster risk reduction and climate change adaptation manager with the Kenya Red Cross Society.

“Schools [are] being affected … and even hospital facilities in some of the places that have been marooned are also affected,” Murgor told VOA.

The situation could get worse, Murgor said.

In its forecast for this year’s last quarter, the Kenya Meteorological Department had warned the country will experience above-average rainfall, driven by warmer sea surface temperatures over the central and eastern equatorial Pacific Ocean.

“We are informed by the [weather forecaster] that November normally is the peak,” Murgor told VOA. “If November is the peak and we are just at the beginning of November, chances are … the situation is likely to worsen in the month towards the end, probably seeing a bit more people being displaced, probably seeing a bit more loss of livelihoods.”

Nearly half of the 47 counties in Kenya are at risk, he said, with the northeastern part of the country being the most affected.

Heavy rains also have affected neighboring Uganda, Ethiopia and Somalia, where the government declared a state of emergency after 29 people died and hundreds of thousands were displaced as a result of the extreme weather.

Meanwhile, in Kenya, Murgor said flash floods would likely cause more problems.

“We are likely to see a rise in disease outbreak as a secondary impact of the flooding,” he said. “But from the Kenya Red Cross prospect, we are working together with the ministry of health, with the government, with stakeholders, trying to see how to mitigate against the effect, how to anticipate and then try to act early [and] work with farmers to do post-harvest loss management.”

He also said that in cases in which early warnings are possible, communities would be alerted about possible floods so people can move to safer ground. 
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An industrial robot grabbed and crushed a worker to death at a vegetable packaging plant in South Korea, police said Thursday, as they investigated whether the machine was defective or improperly designed.

Police said early evidence suggests that human error was more likely to blame rather than problems with the machine itself. But the incident still triggered public concern about the safety of industrial robots and the false sense of security they may give to humans working nearby in a country that increasingly relies on such machines to automate its industries.

Police in the southern county of Goseong said the man died of head and chest injuries Tuesday evening after he was snatched and pressed against a conveyor belt by the machine’s robotic arms.

Police did not identify the man but said he was an employee of a company that installs industrial robots and was sent to the plant to examine whether the machine was working properly.

South Korea has had other accidents involving industrial robots in recent years. In March, a manufacturing robot crushed and seriously injured a worker who was examining it at an auto parts factory in Gunsan. Last year, a robot installed near a conveyor belt fatally crushed a worker at a milk factory in Pyeongtaek.

The machine that caused the death on Tuesday was one of two pick-and-place robots used at the facility, which packages bell peppers and other vegetables exported to other Asian countries, police said. Such machines are common in South Korea’s agricultural communities, which are struggling with a declining and aging workforce.

“It wasn’t an advanced, artificial intelligence-powered robot, but a machine that simply picks up boxes and puts them on pallets,” said Kang Jin-gi, who heads the investigations department at Gosong Police Station. He said police were working with related agencies to determine whether the machine had technical defects or safety issues.

Another police official, who did not want to be identified because he wasn’t authorized to talk to reporters, said police were also looking into the possibility of human error. The robot’s sensors are designed to identify boxes, and security video indicated the man had moved near the robot with a box in his hands which likely triggered the machine’s reaction, the official said.

“It’s clearly not a case where a robot confused a human with a box -– this wasn’t a very sophisticated machine,” he said.

According to data from the International Federation of Robotics, South Korea had 1,000 industrial robots per 10,000 employees in 2021, the highest density in the world and more than three times the number in China that year. Many of South Korea’s industrial robots are used in major manufacturing plants such as electronics and auto-making.
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Crying in a hospital bed with a nebulizer mask on his tiny face, 1-month-old Ayansh Tiwari has a thick, hacking cough. His doctors blame the acrid air that blights New Delhi every year.

The spartan emergency room of the government-run Chacha Nehru Bal Chikitsalaya hospital in the Indian capital is crowded with children struggling to breathe — many with asthma and pneumonia, which spike as air pollution peaks each winter in the megacity of 30 million people.

Delhi regularly ranks among the most polluted major cities on the planet, with a melange of factory and vehicle emissions exacerbated by seasonal agricultural fires.

“Wherever you see there is poisonous smog,” said Ayansh’s mother Julie Tiwari, 26, as she rocked the baby on her lap, attempting to calm him.

“I try to keep the doors and windows closed as much as possible. But it’s like breathing poison all the time. I feel so helpless,” she told AFP, fighting back tears.

On Thursday, the level of PM2.5 particles — the smallest and most harmful, which can enter the bloodstream — topped 390 micrograms per cubic meter, according to monitoring firm IQAir, more than 25 times the daily maximum recommended by the World Health Organization.

Government efforts have so far failed to solve the country’s air quality problem, and a study in the Lancet medical journal attributed 1.67 million premature deaths to air pollution in the world’s most populous country in 2019.

‘Maddening rush’

“It’s a maddening rush in our emergency room during this time,” said Dhulika Dhingra, a pediatric pulmonologist at the hospital, which serves poor neighborhoods in one of Delhi’s most polluted areas.

The foul air severely impacts children, with devastating effects on their health and development.

Scientific evidence shows children who breathe polluted air are at higher risk of developing acute respiratory infections, a UNICEF report said last year.

A study published in the Lung India journal in 2021 found nearly one out of every three schoolchildren in Delhi had asthma and airflow obstruction.

Children are more vulnerable to air pollution than adults because they breathe more quickly and their brains, lungs and other organs are not fully developed.

“They can’t sit in one place, they keep running and with that, the respiratory rate increases even more. That is why they are more prone to the effects of pollution,” said Dhingra.

“This season is very difficult for them because they can hardly breathe.”

Vegetable vendor Imtiaz Qureshi’s 11-month-old son, Mohammad Arsalan, was admitted to the hospital overnight with breathing issues.

“We have to live day in and day out in this air,” said the distraught 40-year-old, who pulls his cart through the streets every day.

“If I go out, the air will kill me. If I don’t, poverty will kill me.”

‘Toxic environment’

The hospital provides treatment and medicine free of cost — none of its patients can afford private health care, and many cannot buy even a single air purifier for their one-room homes in the city’s sprawling slums.

Pediatrician Seema Kapoor, the hospital’s director, said patient inflows had risen steadily since the weather cooled, trapping pollutants closer to the ground.

“About 30-40% of the total attendance is primarily because of respiratory illnesses,” she said.

Pulmonologist Dhingra said the only advice they can offer parents is to restrict their children’s outdoor activities as much as possible.

“Imagine telling a parent not to let the child go out and play in this toxic environment.”

The Delhi government has announced emergency school closures, stopped construction and banned diesel vehicles from entering the city in a bid to bring down pollution levels.

But stubble burning by farmers in the neighboring agrarian states, which contributes significantly to Delhi’s pollution, continues unabated, drawing a rebuke from the Supreme Court on Tuesday.

Delhi’s choked air is resulting in the “complete murder of our young people,” said the court.

Housewife Arshi Wasim, 28, brought her 18-month-old younger daughter Nida Wasim to the hospital with pneumonia.

“She coughs non-stop,” she said. “She doesn’t take milk or even water because her lungs are choked. Sometimes we have to give her oxygen and rush her to the doctor two or three times a day.

“Every year it’s the same story.”
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