The World's First Black Patient Face Transplant Posed Unique Challenges

 Robert Chelsea, before his face transplant Lightchaser Photography

 (HealthDay News) — WEDNESDAY, March 17, 2021 (HealthDay News) — After losing most of his face in a devastating Los Angeles traffic accident years ago, Robert Chelsea needed a new one.

According to a new study, Chelsea is Black, and the process of giving him the first-ever face transplant presented unique complications for his doctors.

Due to a shortage of donors and the greater variety in skin tone among Black Americans, doctors said it took four times as long to find Chelsea a qualified donor as it does for white patients.

In an interview with the BBC, Chelsea added, "It's very uncommon to find a Black face [for transplant]." "We had no idea how uncommon it was."

Due to Chelsea's darker skin tone, doctors were less able to see the redness that serves as an early warning sign for rejection, which made tracking his post-surgery progress more difficult, according to lead surgeon Dr. Bohdan Pomahac, director of plastic surgery transplantation at Brigham and Women's Hospital in Boston.

"Redness might be seen on a white patient as a sign of infection or rejection. You can't really detect with African-American patients "Pomahac explained. "If it's possible to perceive the redness, it's quite subtle."

Chelsea's crippled car was hit by a drunk driver on an L.A. freeway in August 2013 with such power that the vehicle exploded.

Chelsea was burned on more than 60% of his torso and face. He lost his lips, a portion of his nose, and a portion of an ear, and he needed more than 40 surgeries to get back on his feet.

Chelsea was put on the transplant list after doctors recommended a face transplant.

Chelsea told the BBC before his surgery, "To be able to address a person without intimidating them would be a great comfort."

Finding a qualified donor, on the other hand, was not straightforward.

Chelsea was on the waiting list for nine months before receiving the first offer of a donor, and he was on it for a total of 17 months before his operation, according to researchers who published their findings in the New England Journal of Medicine on March 18. For a white patient on the waiting list, the average duration to find a donor is four months.

Finding a qualified donor, on the other hand, was not straightforward.

 Robert Chelsea with Dr. Bohdan Pomahac Lightchaser Photography

Chelsea was on the waiting list for nine months before receiving the first offer of a donor, and he was on it for a total of 17 months before his operation, according to researchers who published their findings in the New England Journal of Medicine on March 18. For a white patient on the waiting list, the average duration to find a donor is four months.

One issue was a scarcity of donors. "The amount of African-American donors is quite low," Pomahac remarked.

A good match for your skin tone

Another issue was finding an appropriate match for skin tone, which can range from almost dark black-blue to light cappuccino in a Black patient, according to Pomahac.

"There are so many various ranges of different colors," Pomahac noted, "that a transplant with a mismatched tone would seem really unsettling."

Chelsea turned down two potential donors before finding one he liked. Other donors, according to Pomahac, were not even brought to Chelsea as a possibility since they were so mismatched from the start.

The eventual amount of the procedure was also influenced by skin tone. Chelsea only required a half face transplant, but "we eventually chose to do full-face because I was scared the face would look strange" with two distinct skin tones, according to Pomahac.

Chelsea, aged 68, became the oldest person and the first Black American to have a face transplant at Brigham and Women's Hospital in a 16-hour surgical surgery involving a team of nearly 45 medical specialists.

In July, Robert Chelsea became the first African-­American face-­transplant recipient

 

John Francis Peters for TIME

In 2005, France performed the world's first partial face transplant, and Spain conducted the first full-face transplant in 2010. Prior to Chelsea, only roughly 40 similar procedures had been performed, all on Caucasian people.

The procedure went well, but Pomahac and his team ran into another issue as they tried to figure out if Chelsea's body would accept or reject the transplant.

Lightchaser Photography with Robert Chelsea and Dr. Bohdan Pomahac

Skin redness is such a strong marker of rejection in white patients that "we feel like we can monitor rejection in real time, very much," according to Pomahac.

Doctors added regular inspection and biopsies of Chelsea's mucous membranes — the inside of his cheek, the lining of his lips — as a technique of tracking rejection because such redness is harder to discern in the skin of a Black patient.

Organ donation is in high demand.

Chelsea's transplant was successful, but his ordeal has highlighted the importance of encouraging Blacks and other ethnic groups to donate organs, according to specialists.

In a news release, Alexandra Glazier, president and CEO of New England Donor Services, said, "It is very important for persons of all races and ethnicities to explore organ donation, especially the donation of external grafts, such as the face and hands." "Unlike internal organs, the donor's skin tone may play a role in identifying a match."

Following his surgery, Chelsea said, "May God bless the donor and his family who chose to donate this beautiful gift and offer me a second shot." "Words are inadequate to express how I feel. I'm overwhelmed with appreciation and consider myself extremely fortunate to have received such a wonderful gift."

Patients of color should take heart from Chelsea's story and seek medical help if they require comparable procedures, according to Pomahac.

"It's critical for African Americans and individuals of all skin colors to know that we are here for them, regardless of their history, and that we can assist them," Pomahac added.

Additional information

More information regarding Robert Chelsea's face transplant can be found at Brigham and Women's Hospital.

SOURCES: Bohdan Pomahac, MD, plastic surgery transplantation director, Brigham and Women's Hospital, Boston; New England Journal of Medicine, March 18, 2021; BBC.

I tested 03 of Trader Joe's award-winning foods and would repurchase at least 02 of them.

 

I went to my local Trader Joe's and grabbed 18 award-winning goods.

Every year, I look forward to the Trader Joe's Customer Choice Awards, which showcase customers' top goods and introduce me to new chain favorites.
Some foods, such as Mandarin orange chicken, have ruled for years, while others, such as plantain chips, have only lately risen to the top. So I went to Trader Joe's and bought as many award-winning items as I could to determine which ones were truly deserving of their fame.
Read on to find out which of these 18 Trader Joe's fan favorites I'd buy again and which I'd pass on.

This burrito with black beans and Monterey Jack cheese was wonderful and substantial.

Burrito with black beans and Monterey Jack cheese from Trader Joe's

When I first saw this grab-and-go burrito on Trader Joe's bestsellers list, I thought to myself, 

"How good could a basic bean-and-cheese burrito possibly be?"It turned out to be excellent. This burrito was stuffed full of beans and cheese.
After I microwaved it, it flattened out and lost its cylindrical shape, but the chunks of cheese and beans flowing out the side more than made up for this tiny fault.

When I heated it up, the cheese and beans spilled out.

The burrito was straightforward, but it was far from boring. It's a flour tortilla loaded with well-seasoned black beans and Monterey Jack cheese, according to the label.
That was all it needed to be, to be honest. Other ingredients or a strong cheddar might have been a distraction, but the gentle bite of the Monterey Jack worked nicely with the earthy character of the beans.I liked how parts of the black beans were partially whole and others were mashed, resulting in an exceptionally tasty mixture into which the cheese melded effortlessly.

According to Airbnb, these are the five most cheap private islands.

Stann Creek District is in Belize, which is also home to the Blue Hole (pictured). 

Getty Images / Matteo Colombo

Despite the fact that the Covid-19 pandemic has spread to every corner of the earth, there are still a few lovely places where you can get away from it all for a bit.

You may rent an entire island to yourself if you've ever fantasized about long lengths of pristine beaches, coral reefs, and tropical vistas, regardless of how flush (or bare) your bank account is.

Hundreds of private island rentals on Airbnb check all the boxes.

For under $350, here are the five most cheap private islands on Airbnb.

A rural island just outside Venice, Italy

The island isn't too far — or too close — to Venice (pictured). 

Getty Images / Ian.CuiYiCavallino, Italy is home to this private island.
It has seven bedrooms that can sleep up to 16 people.
This island, located in the Venetian lagoon, is home to a salmon-colored villa with an Italian flair.
The hotel is surrounded by natural beauty and does not draw the throngs that you would encounter in the heart of Venice.
You can still move between the island and the coast with ease.

• $80 per night.

An Irish cottage on an island near Galway

Derryclare Lough is just one of the areas you could visit if you choose to stay in Galway. 

Getty Images / levers2007This lovely hideaway may be found in Ireland's County Galway.It has room for six more people.It's not your average Caribbean island, but it captures the island's rustic appeal and has a stone fireplace.The exquisite accommodation is supplied by the hosts from Kenny Bay, near Lough Corrib, and is only five minutes by boat on the lake.

• $248 per night.

16-hectare private island in Honduras

Cayo Fort Morgan is in Honduras, also home to Tabyana Beach (pictured). 

Wolfgang Kaehler/LightRocket via Getty ImagesAnother of Airbnb's best-kept secrets is this private island in Cayo Fort Morgan, Honduras.This 16-hectare private island off the coast of Roatan, which is part of the country's Bay Islands, can accommodate up to 16 people.You can spend the day on a white-sand beach or in the hammocks on the water's edge on the terrace.If that wasn't enough, food and water activities are also included in the ticket.

• $250 per night.

An all-inclusive tropical island in Belize

Stann Creek District is in Belize, which is also home to the Blue Hole (pictured). 

Getty Images / Matteo ColomboIf you're looking for a romantic and quiet getaway, this private island in Stann Creek District, Belize, is accessible on Airbnb.However, if you're looking for luxury, this isn't the place for you.Because the island is a tropical hideaway, be prepared for a wilderness adventure if you stay in this cabin.Meals are included in the stay, so there is a bar and restaurant on the island that serves dinner and lunch every day.

• $365 per night.

Island paradise with a white-sand beach in the Philippines

You might like to try a typical Filipino Balangay Boat while you're in the Philippines. 

Getty Images / MlennyWith 15 companions, you may enjoy a white-sand beach backed by a lush canopy of vegetation and tropical flora on this private island in El Nido, Philippines.The vivid hues of the majestic mansion stand out among the surrounding foliage.Every day, the opulent resort serves a Filipino breakfast, lunch, and supper.

• $399 per night

Initial postmortem ‘shows euthanized animal did not have tuberculosis,' according to Geronimo the alpaca.

According to his owner, preliminary findings of a post-mortem examination on Geronimo the alpaca suggest he did not have bovine tuberculosis.

Helen Macdonald has demanded that Environment Secretary George Eustice resign, prompting screams of "murderer" from supporters outside Mr Eustice's offices.

Ms Macdonald said that government officials kept her in the dark about how the animal was murdered and how they "tortured" him on his final journey.

Officials from the Department for Environment, Food and Rural Affairs (Defra) disagree with Ms Macdonald's interpretation, claiming that the post-mortem examination revealed lesions that will be evaluated in the coming months.

Before being imported from New Zealand in 2017, the alpaca was tested negative for bovine tuberculosis. He had had no symptoms since then, but Defra claimed he should be culled because he had tested positive.

After a long battle by Ms Macdonald and her veterinary adviser to prove the tests were defective, officials, aided by police, finally led him to his death on August 31.

To cheers from supporters of "shame on Defra," campaigner Dominic Dyer called Geronimo's capture "one of the most terrible cases of animal crime in this nation I have ever witnessed."

After her own expert was denied permission to attend, Ms Macdonald, a veterinary nurse, demanded the full post-mortem reports.

Officials allegedly threatened and intimidated her, as well as “wheeling out experts” who had no knowledge of camelids.

“There is a long list of people who contributed to the barbaric treatment of Geronimo,” Ms Macdonald told the crowd. She claimed they were punishing her for daring to “stand up to their dogma”.

“Geronimo was the innocent victim of arrogance, ignorance and greed,” she said.

“Geronimo was a blessing in the world,” Ms Macdonald said to more cheers, pledging to fight for him and ensure his legacy lived on for all animals.

"No PhD, Master's Degree Valuable," According to the Taliban's new Education Minister

Despite the Taliban's assurances of transformation in an attempt to gain international legitimacy, such promises have been questioned and discarded amid considerable criticism.

A new cabinet was introduced Tuesday, less than a month after the Taliban reclaimed power in Afghanistan, leaving foreign leaders to ponder the country's future relations. In his first public statement following the fall of Kabul on August 15, Taliban supreme leader Haibatullah Akhundzada stated, "In the future, all subjects of governance and life in Afghanistan would be ruled by the laws of the Holy Sharia."

Despite the Taliban's claims to be a new, improved version of the hardline organisation in an attempt to gain international recognition, the claims have been questioned due to reality on the ground and the leaders' statements.

Sheikh Molvi Noorullah Munir, the Taliban's Minister of Education, is shown in a video widely circulated on social media criticizing the value of academic education.

"Today, a master's degree is more useful than a Ph.D. You can see that the Mullahs and Taliban in control have no Ph.D., MA, or even a high school diploma, but they are the most powerful of them "In the video, Sheikh Molvi Noorullah Munir is heard saying. The remarks received a lot of backlash, as one might imagine.

Sheikh Molvi Noorullah Munir's remarks on higher education drew criticism.

Less than a month after the Taliban returned to rule Afghanistan, a new cabinet was unveiled Tuesday with world leaders left to wonder about future ties with the nation. "In the future, all matters of governance and life in Afghanistan will be regulated by the laws of the Holy Sharia," Taliban supreme leader Haibatullah Akhundzada made it clear it in his first public statement since the August 15 fall of Kabul.

Even though the Taliban have promised a new, improved version of the hardline group, in an attempt to seek global recognition, the claims have been questioned because of the reality on the ground and the pronouncements of its leaders.

A video widely shared on social media shows the Taliban's Minister of Education, Sheikh Molvi Noorullah Munir, questioning the relevance of higher education.

"No Phd degree, master's degree is valuable today. You see that the Mullahs and Taliban that are in the power, have no Phd, MA or even a high school degree, but are the greatest of all," Sheikh Molvi Noorullah Munir is heard saying in the video. The remarks, as expected, drew huge criticism.

"Why is this man talking about education," said one Twitter user.

"Minister of Higher education saying higher education is not worth it," another user said.

"They have such reprehensible ideas about education; having them in power is disastrous, especially for young and children!" read one of the Twitter posts

Mullah Mohammad Hassan, the little-known head of the Taliban's leadership council, has been named acting Prime Minister in the Taliban's new "interim government."

Sirajuddin Haqqani, a UN-designated terrorist, is the new acting Interior Minister in the 33-member cabinet, which includes no women.

Sheikh Molvi Noorullah Munir's remarks on higher education drew criticism.

Less than a month after the Taliban returned to rule Afghanistan, a new cabinet was unveiled Tuesday with world leaders left to wonder about future ties with the nation. "In the future, all matters of governance and life in Afghanistan will be regulated by the laws of the Holy Sharia," Taliban supreme leader Haibatullah Akhundzada made it clear it in his first public statement since the August 15 fall of Kabul.

Even though the Taliban have promised a new, improved version of the hardline group, in an attempt to seek global recognition, the claims have been questioned because of the reality on the ground and the pronouncements of its leaders.

A video widely shared on social media shows the Taliban's Minister of Education, Sheikh Molvi Noorullah Munir, questioning the relevance of higher education.

"No Phd degree, master's degree is valuable today. You see that the Mullahs and Taliban that are in the power, have no Phd, MA or even a high school degree, but are the greatest of all," Sheikh Molvi Noorullah Munir is heard saying in the video. The remarks, as expected, drew huge criticism.

"Why is this man talking about education," said one Twitter user.

"Minister of Higher education saying higher education is not worth it," another user said.

"Such shameful thoughts about education, having them in power is catastrophic especially for the youth & children!" read one of the posts on Twitter.

In the Taliban's new "interim government", Mullah Mohammad Hassan, the little-known head of the Taliban's leadership council, has been named as acting Prime Minister.

UN-designated terrorist Sirajuddin Haqqani is the new acting Interior Minister in the 33-member cabinet that has no woman member.

"As I speak and today, the Taliban announced their government. It is anything but inclusive," Afghanistan's Ambassador and Permanent Representative to the UN Ghulam Isaczai said on Tuesday.

(With inputs from PTI, AFP) 

Semifinal opening odds for Euro 2021 knockout stage

Semifinal opening odds for Euro 2021 knockout stage

Italy and Spain kick off the semifinal stage at the European Championship.

Nicolo Barella of Italy celebrates with Marco Verratti and Federico Chiesa after scoring their side’s first goal during the UEFA Euro 2020 Championship Quarter-final match between Belgium and Italy at Football Arena Munich on July 02, 2021 in Munich, Germany.

 Photo by Christof Stache - Pool/Getty Images

The semifinals of Euro 2020 have begun, and tournament favorite Italy continues to look the part. In the first semifinal, the Azzurri will face Spain, while TEAM and TEAM will face off.

The first lines for the semifinal round are listed below.

Opening odds, Semifinals

Italy vs. Spain

Italy: +160
Tie: +215
Spain: +195

Italy and Spain meet in a rematch of the 2012 Euro final. Spain won that match to complete a historic trifecta (2008 European Championship, 2010 World Cup, 2012 European Championship), although Italy is the favorite tonight. Spain has been shaky at the back at times during the knockout stage and Italy is scoring goals in bunches.

Czech Republic/Denmark vs Ukraine/England

TEAM:
Tie:
TEAM:

Why Bill Cosby's conviction was overturned

 

Bill Cosby arrives for his sexual assault trial, Thursday, April 26, 2018, at the Montgomery County Courthouse in Norristown, Pa. (AP Photo/Matt Slocum)

By MARYCLAIRE DALE and ALANNA DURKIN RICHER Associated Press

PHILADELPHIA (AP) – Bill Cosby's sexual assault conviction was thrown out Wednesday by Pennsylvania's highest court in a ruling that swiftly freed the actor from prison more than three years after he was found guilty of drugging and molesting Temple University employee Andrea Constand at his suburban Philadelphia mansion.

Cosby, 83, was the first celebrity tried and convicted in the #MeToo era, and his conviction was considered as a turning point in the movement to hold powerful men accountable for sexual misbehavior.

Here's a look at the case against Cosby and the court's decision:

WHY DID THE COURT TOSS HIS CONVICTION?

The split court found that Cosby was unfairly punished because the former district attorney had assured the comedian once known as "America's Dad" that he wouldn't be charged over Constand's charges. Cosby was charged by another prosecutor who claimed he wasn't bound by that arrangement.

The court said that's not the case. The court decided that Cosby relied on that assurance when he consented to testify without using his Fifth Amendment privilege against self-incrimination in a lawsuit brought against him by Constand.

The court found the prosecutor who later presented the charges was bound to stick to the nonprosecution agreement, hence the conviction cannot stand. The judges said that "denying the defendant the benefit of that decision is an affront to fundamental fairness, particularly when it results in a criminal prosecution that was foregone for more than a decade."

WHAT'S THE DEAL WITH THE NONPROSECUTION AGREEMENT?

The promise not to charge Cosby was made in 2005 by Bruce Castor, who was then the senior prosecutor for Montgomery County. Castor was also on the legal team that defended former President Donald Trump during his historic second impeachment trial following the Jan. 6 rebellion at the U.S. Capitol by his supporters.

During a court hearing weeks after Cosby's 2015 arrest, Castor said that he promised Cosby he wouldn't be charged in the hopes that it would induce the actor to testify in a civil action brought by Constand and allow her to collect damages. Castor recognized the only place the subject was stated in writing was in the 2005 press statement announcing his decision not to prosecute but said his decision was meant to insulate Cosby from prosecution "for all time."

His successor highlighted, during the appeal arguments, that Castor went on to indicate in the news release that he could rethink the decision in the future.

Castor had argued that Constand's case would be tough to prove in court because she waited a year to come forward and stayed in contact with Cosby.

The initial jurors who heard the case may have agreed with him, as they could not reach a decision in 2017. But a second jury empaneled after the #MeToo movement burst found him guilty during his 2018 retrial. Constand resolved her civil case against Cosby for more than $3 million.

Castor's successor, District Attorney Kevin Steele, charged Cosby in 2015 after a federal judge, acting on a request from The Associated Press, released documents from her 2005 lawsuit against Cosby, disclosing his damaging testimony about sexual encounters with Constand and others. Castor has stated Cosby "would've had to have been nuts to say those things if there was any chance he could've been prosecuted."

HOW RARE IS THIS?

Extremely rare.

Wesley Oliver, a Pennsylvania law professor who has watched Cosby's case closely over the years, said he has never heard of a high court in Pennsylvania or anyplace else contending with a prosecutor's informal commitment not to prosecute.

"It creates new ground totally," said Oliver, who teaches at Duquesne University School of Law in Pittsburgh. "It establishes precedence not just for Pennsylvania but potentially other states."

He said the ruling should bring home to prosecutors the risks of implying at news conferences, in press releases, or even in private that they will not prosecute.

"They should at least add three words — 'at this moment,'" he remarked. "If you add that qualifier, which wasn't done in Cosby's instance, you should be fine to go," Oliver added.

CAN COSBY BE TRIED AGAIN?

It's quite unlikely. The judgment on Wednesday prohibits Cosby from being tried again over Constand's complaint, finding it to be the "sole remedy that comports with society's legitimate expectations of its elected prosecutors and our criminal justice system."

And the charges leveled by dozens of other women, like the five who testified at his 2018 trial, sometimes go back decades and are most likely too remote to prosecute.

Cosby turns 84 next month. However, his lawyer stated he remained in good health, save for vision impairments that leave him legally blind.

The trial judge found him a sexually violent predator who could still represent a danger to women given his wealth, power and renown, and ordered that he be on a lifetime sex offender registry and check-in monthly with authorities. However, the decision negates that finding.