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Table of Contents

Disclaimer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

I. Medicinal Treatments

The current state of stem cell treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

On painless stem cell treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Re-examining prior treatments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Pastoral integration #1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

II. Physiological/Neurological Treatments

Building microscopic bridges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Hope through the light. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Solidifying broken spinal cords by breaking solid barriers. . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Pastoral integration #2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

III. Biomechanical Treatments

Stimulating growth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Pastoral integration #3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Appendices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

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Disclaimer

Many of the articles summarized herein involve scientific research conducted through the use of

animal testing. My personal beliefs include those stating that all life, regardless of species, is

sacred.

However, once the purpose and goal of an experiment is clear; once the treatment methods are as

painless as possible; and only once the researchers have concluded that animal testing is an

absolute necessity does there allow for the prevalent gray area of bioethics to emerge.

While I do believe in the cause of this research, I may not automatically condone or disapprove

of the methods of experimentation on animal subjects.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

“Whoever is righteous has regard for the life of his beast”

- Proverbs 12:10

“Who teaches us more than the beasts of the earth…?”

- Job 35:11

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The current state of stem cell treatment.

Spinal cord injury results in a disruption of “communication” between the brain and

muscles that move, or perceive sensation from, extremities. Voluntary movement is either

impaired or completely suppressed, which also involves the control of bladder and bowel

movements. Spinal cord injuries result from different types of event trauma (See Figure A.1, p.

24). Depending on the severity of the accident, the level of impairment is also affected (See

Figure A.3, p. -). Although the number of people affected in the United States alone is increasing

at an approximate rate of 11,000 per year (retrieved from:

http://www.sci-info-pages.com/facts.html), that figure also represents those alive, which could

indicate a positive correlation with the prevalence of modern treatments and improved acute care

in the hours following the injury (Kraft, 2005, para. 3).

Since the discovery of the potential human stem cells have in fighting disease, much of

the research concerning a possible cure for paralysis have involved stem cell experimentation.

Along with spinal cord injury induced paralysis, stem cell research has a capability to provide

life changing treatment to those suffering from Parkinson’s disease, Alzheimer’s disease, and

Amyotrophic lateral sclerosis (aka Lou Gehrig’s disease) to name only a few.

In order to write as exhaustive a literature review as possible concerning the major trends

and breakthroughs in spinal cord therapy, there needs to be a great deal of focus on stem cell

research. Although this modality, as will be discussed, is at the forefront of the discovery of a

cure for spinal cord injury, it also stands as the most controversial.

Embryonic stem cells are considered to be the “Swiss Army knife” of regenerative

science. Their unique pluripotency allows the cells to grow into any type of over 200 tissue types

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(Svoboda, 2009, para. 2). However, the cells are harvested during the early fetal stage. This is

most commonly protested by those who believe that human life begins at the moment of

conception, therefore, the extraction process technically constitutes murder.

Induced pluripotent stem cells are, on the other hand, not received from a human embryo.

They do, however, possess similar regenerative powers, and can metamorphose into lung,

stomach, and heart cells, to name a few. When injected into skin cells, they reset their

developmental process, thus earning them the name “the fountain of youth” (Svoboda, 2009,

para. 3).

Regardless of how stem cells are extracted, and regardless of how much spiritual and

legal supervision is provided, “as stem cell research intensifies, so to will the ethical objections”

(Svoboda, 2009, para. 26). These ethical objections, if left unresolved for long enough, will coax

the government to intervene and enforce a decision one way or another. In an interview, actor

and activist Christopher Reeve stated: “I used to think that hope was the product of science

funding, but actually, to a large extent, it’s going to be determined by politics. This makes it very

difficult to project time lines” (New Scientist, 2003, para. 24).

In 2005, President George W. Bush vetoed the first bill that would have provided federal

funding to stem cell research. He vetoed the second in 2007. In November of 2009, however,

President Obama signed into law the Stem Cell Research Enhancement Act. Since then, many

individual states have lifted, or loosened, their restrictions of funding or use.

Even when the hurdles are removed, and stem cell research can make subsequent

breakthroughs, a lot more time will be needed in order to help eliminate the possibility of

unexpected side-effects and reactions. Although stem cells could be considered universal, there

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does remain the issue of adapting to each individual’s unique biochemistry (as will be discussed

later with the issue of cybernetics). Although the federal restriction on research funding was

lifted, and even if money was no object, there must be no rush in this matter. It is only once work

is sped up does it run the risk of being done sloppily. In order for any new treatments, and even

cures, to be released to the general public, all aspects and potential outcomes need to have their

benefits greatly outweigh negative risks.

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On painless stem cell treatment.

Research conducted at the Karolinska Institute in Stockholm, Sweden was able to make

lab rats, whose hind limbs were paralyzed by spinal cord injuries, show improved mobility in

their hind legs (Hofstetter et al., 2005). Adult neural stem cells had been injected into the rats’

injury sites. Five weeks after the initial treatment, though, the rats displayed signs of increased

tactile sensitivity in their forelegs and upper body half. Slight touches or slight changes in room

temperature caused the rats to become agitated.

Once the spinal cords of the rats were examined afterward was the mystery surrounding

the bizarre reactions revealed. The injected stem cells were able to bridge the gap in the spinal

cord; however, the cells did not know when to “stop” growing. This resulted in abnormally large

amounts of astrocytes, which coaxed even further growth among the newly mended spinal cord.

Nerves along the spinal cord which sense pain (involving both pressure and temperature) had

multiplied, thus resulting in a much lower threshold of sensitivity.

In order to prevent a reoccurrence, subsequent tests had to include an artificial gene along

with stem cell treatment which would cause the astrocyte to stop growing upon reaching a

certain level of development. Another hope of which would be that there would then be a higher

number of oligodendrocytes, which also work to repair damaged nerve fibers.

The results of the follow-up experiment were a success. This research was a critical move

in general stem cell research. It specifically shed light on the issue of combining maturing neural

fibers with a previously developed individual. The injected cells need to also possess the

information of when and where to stop growing. It’s possible that, along with tactile

hypersensitivity, other side effects could include bodily convulsions, psychological hysteria, and

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reactions resembling those of a grand mal seizure. This was a reminder that, although no amount

of experimentation can accurately predict and counteract negative consequences, research must

do what it can in order to exhaust all possibilities direct and indirect.

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Re-examining prior treatments.

While examining articles to select for a literature review, one must assess the importance

of the research. Basically, what could set this particular article apart from others in what it has to

offer the scientific community? Of course, this is a difficult question to address, primarily

because by the time a research article has reached its publication stage, the seeming importance

of the research itself may be inflated. It is, therefore, effective to try to see past any type of

potentially vague promise, e.g. “this could mean amazing things to the world!...”. One of the

most important aspects in any type of research involving the curing of disease is how practical

would it be to have it available for the masses. A sign of practicality would be if a treatment is

not an invention of a new wheel, but the formation of a new wheel using smaller ones.

Even an optimist would claim that the cure for spinal cord injury will likely never be a

matter of “one and done”. In 2003, three separate experiments were being conducted in the hopes

of forming a single three-pronged form of treatment. The conglomerate form of therapy would

involve a series of injections, given at different times, to chemically coax the reformation and

growth of neurons surrounding the site of injury. The therapy would also seek to suppress the

inhibitory factors that had been preventing neuronal regrowth.

A recent discovery found that spinal neurons could not regrow because of the Reticulon-4

isoform called “NOGO-A”, a genetic protein that permanently halts neuron growth once the

appropriate stage of development is reached (Oertle et al., 2003).

The development of an antibody, IN-1, was not effective. It was then discovered that the

inhibition of neuronal growth is also affected by two additional factors: myelin-associated

glycoprotein and oligodendrocyte myelin glycoprotein.

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All three proteins, though, bind to the same neural receptor. Therefore, if the receptor site

itself is blocked, the inhibitory factors of the proteins would be blocked simultaneously. Filbin et

al. (2003) found that raised levels of cyclic adenosine monophosphate (cAMP) overcomes the

inhibitory factors of NOGO-A. Thankfully, there had already existed a relatively inexpensive

prescription medication which did exactly that.

Rolipram, (aka brand name Calbiochem), was prescribed as an anti-depressant. Although

it was eventually withdrawn due to its side effects of nausea and vomiting, there are no side

effects present if taken intravenously (which is what this treatment would require).

Laboratory studies showed that 70% of a group of rats, whose spinal cords were partially

severed in the neck region, had regained voluntary mobility in the affected bodily area. Only

20% of the placebo group had regained theirs’. The treatment of rolipram had lasted

approximately two weeks (Filbin et al., 2003).

While this study in itself cannot be considered conclusive, (only 20 rats were used in the

experiment, and a 20% success rate can be high for a placebo group), it does suggest that raised

levels of cAMP help play a role in spinal cord regeneration.

Experiments conducted around this time were guided by the recent finding that neurons

could actually regrow, and that the factors deterring them from such were external. Similarly, the

concept of neurogenesis is only about 20 years old. Before then, it was commonly believed and

accepted that neurons were simply unable to regrow and that a person was born with all the

neurons and brain cells he or she will ever have (retrieved from: http://www.sfn.org/index.aspx?

pagename=brainBriefings_adult_neurogenesis).

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The promise that this experiment offers, unfortunately, is matched by so many other

experiments seeking to accomplish the same thing. Research experimentation is, for lack of a

better term, a gamble. Despite the potential each group of scientists see in a possible new lead in

the curing if spinal cord injury, “[this field has seen many false dawns…not all findings live up

to their initial promise” (Wilson, 2003, para. 11).

Pastoral Integration #1

The role of the therapist in general is to serve as a guide. In the case of medicinal

treatments, a likely source of dissonance, or basic reason of why the client is seeking counseling

from a pastoral counselor, would be pain as a medicinal side effect. If any of the above

mentioned treatments were eventually used on humans, it is not unreasonable to believe that

moderate to severe pain would be an eventuality. A pastoral counseling may be able, for

instance, to aid the client with meditative and mind-centering techniques that would help to

alleviate pain.

Also, in the case of, let’s say, a Vatican I Roman Catholic, he or she might believe that

the pain felt could have meaning or purpose. After all, Christ suffered; and pain could be easily

viewed as a reminder of our human frailty, thus rightful humility. A pastoral counselor may work

with this particular client to either remove personal responsibility from the pain, (e.g. “this is not

your fault”), because the client’s initial mindset could bring the potential of honing in to more

insidious mentalities, (e.g. “I deserve this”).

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Building microscopic bridges.

Italian scientists, inspired by hollow tube-like pasta called bucatini, created and

developed a form of implantable, biodegradable scaffolding that serves two purposes in helping

neurons regrow and possibly reconnect. The first purpose is as a guide so that the neurons do not

deviate from their intended pathways, and secondly, as a preservation barrier through fluid-filled

cysts and scar tissue. “The tubes provide the reference point for the cells, and the tissue starts to

build up” (Coghlan, 2011, para. 3).

These “nano-conduits”, only between two and three millimeters long and 0.5 millimeters

in diameter, are made of two substances called polycaprolactone and poly(lactic-co-glycolic)

acid, or PGLA. In order to ensure that the tubes, once implanted, would remain in place, they

were coated with self-assembling peptides (aka chemical “hooks”) that would anchor into cells

along the outside surface of the tube. The inside of the tubes were filled with a gel containing

natural growth factors that would serve to aid the growth and development of the neurons.

Once the tubes were ready for the experimental stage, they were implanted into the

damaged spinal cords of rats. After a period of only six months, Vescovi et al. (2011) found that

the necessary neurons had regrown through the majority of the implanted tubes. Along with the

newly formed neuronal cells, new blood vessels had grown as well.

Physical tests showed that the rats had, also in six months, recovered a degree of mobility

in their hind legs. Although a great deal of progress was made during that short period, chemical

markers indicated that tissue repair was still in progress. The breakthrough this research provided

was demonstrated in the striking result of proper alignment of axonal growth (Coghlan, 2011,

para. 7).

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Previous attempts to build biological scaffolding had only managed to support axonal

growth going into the tube. This was, however, the first successful instance of neurons thriving

after having passed all the way through the tube. During the time of research, the recent

measurement had been approximately one centimeter, although special dye tracers were

subsequently required in order to set the newly grown nerve fibers apart from the native ones. In

other words, since neuron fibers do not have arrows on them indicating the direction of their

growth, future research would be required to compare the ratio of the spinal circuits growing in

and those growing out of each end of the tube.

Upon examination of this article, like others detailed in this literature review, an

annoyance resurfaced: that being occasional ambiguity. Those instances include the use of the

word “damaged” when describing the rats’ spinal cords without clarifying what type of damage

and its severity. Nerve fibers had regrown through “many” of the scaffoldings, however, no

percentage from total tubes implanting was offered. The experimental group of rats had

recovered “some” mobility in their hind quarters, yet their definition of “some” is absent from

the article as is the number or percentage of rats who did recover mobility. Were some rats in the

experimental group unable to regain mobility? This question is left unanswered.

The article concludes in the style of serial cliffhanger. The ambiguity of whether or not

the nerve fibers protruding from the other end of the tube were growing in or out was met with

the assurance that a subsequent experiment was forthcoming. However, no brainstorm is offered

in terms of how the researchers would go about solving the mystery, other than with the use of

tracing dye. It is almost as though so much time and care was put in to the research,

experimentation, and reporting of the finding, only for the article to truncated in mid-thought.

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An examination of the ethical issues surrounding this research would give rise to the

safety of human participants. While it was never argued that the scaffolding used was safe in the

bodies of rats, how closely would that translate into the safety for people? How long would the

tubes need to be in humans for there to be a high success rate? Would this treatment, if approved

for use in people, be a “one and done deal”, or would people require a more longitudinal

treatment? Could there be any adverse side effects once the tubes dissolve and are mixed with

the biochemistry of humans? The success rate of the treated rats were reportedly (or allegedly)

high, however, there remains the issue of quadrupedal recovery versus bipedal recovery. The

treated rats showed such progress during the six month period. However, how does that compare

to a person whose two legs need to withstand more pressure of weight than rats whose weights

are proportionately distributed along down their bodies?

In summation, the treatment administered showed tremendous potential and promise, all

that seemed to be missing was how this method could be translated across species.

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Hope through the light.

It is rudimentary biology that any creature possessing a central nervous system requires a

combination of chemistry and electricity in order to achieve movement. In humans, the degree of

bioelectricity produced results in the speed, force, and reflexive movement of limbs and organs.

Up until recently, it was thought that only electricity could accurately produce or reproduce the

fluidity needed to achieve mobility. Deisseroth et al. (2010) of Stanford University in California

tested anaesthetized mice with light stimulating the sciatic nerve to artificially manipulate the

Achilles tendon. The field is called optogenetics.

Light activated proteins from photosynthetic algae are removed and attached to nerve

cells in the peripheral nervous system (or PNS). The proteins are allowed to bind through an

added genetic adhesive protein called Channelrhodopsin (or ChR2).

Despite the relatively short time line required for the experimentation, the results were

rather astounding. The simple action of creating a sequence of light impulses allowed the mice to

move with more fluidity than one would normally consider. By using only electricity from an

external source, larger signals were caused before smaller ones. This would result in a person

displaying jerky and robotic movements which would also be quick to exhaust him.

Optogenetics, on the other hand, is a hear perfect recreation of the natural bioelectrical firing

order, which could potentially allow a person to move as naturally as though no treatment was

ever administered. Not only could this possibly help people recovering from spinal cord injury,

but also those afflicted with cerebral palsy, Parkinson’s disease, or other conditions with affect

gross and fine motor coordination, and voluntary movement (Marchant, 2010, para. 6).

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Of the articles included in the literature review, this is one that shows a higher amount of

promise. Mainly for the relatively noninvasive technique, short time frame necessary, and high

success rate. That does, though, come with the price of relative drawbacks. The article does not

mention how many mice were tested. The use of the word “mice” obviously indicates more than

one, but beyond that, the number of mice is anyone’s guess.

The light was emitted through a cuff lined with diodes. It was described as running all the

way down the back. This does pose another issue for people. How intrusive would this device be

for someone on a daily basis? Could it be possible to flatten the cuff so that it remains

undetectable under the back of a shirt? What about a power source? Could the individual be able

to switch batteries with enough power remaining during the time it takes to make the switch?

What about even being able to reach it fast enough?

This article displays a large amount of optimism, albeit with a multitude of ambiguous

statements concerning its practicality and use in people, e.g. “…this could one day help

people…” (Marchant, para. 1), “Light pulses might restore…” (para. 2), “…the hope of this

is…” (para. 2).

Returning to the issue of the myriad of the false dawns of discovery, it is an unfortunate

fact of life that we must all be prepared for an equal chance of a negative outcome along with a

positive. Optimism must be met with realism. Although the promise of what this discovery could

mean for humanity is truly admirable, words denoting uncertainty, e.g. might, maybe, could,

perhaps, probably, etc., do not deserve as much space or utterance in a research than was

afforded in this article.

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Solidifying broken spinal cords by breaking solid barriers.

New pathways in the treatment of spinal cord injury were able to be seen only once

scientists were able to ignore the previous philosophy that it was biologically and physically

impossible for brain and spinal neurons to regrow, reconnect, and be rebuilt.

Now it is just as commonplace to consider human nerve tissue fundamentally repairable.

Along with a newly discovered humility in the awe of the resiliency of the human body, modern

technology is enabling scientists to see closer up into the gaps that paralysis creates. Axonal

“fingers” are trying to reach farther across the gaps. One major preventative force (or inhibitory

factor) is, as previously discussed, is Nogo-A. Despite its antagonistic connotation within this

literature review, Nogo-A does serve a necessary biological purpose: by acting as a “molecular

brake system” (Kraft, para. 7), our extremely intricate central and peripheral nervous systems are

stabilized.

Schwab et al. (1995) of the University of Zurich surgically implanted pumps that would,

over time, dispense antibodies of Nogo-A in the general region of spinal cord injury sites in lab

rats. Microscopic imaging allowed them to see that spindle-like nerve tissue was, in fact,

growing in the gap. Subsequent behavioural examinations showed that rats in both the control

and experimental groups were nearly indistinguishable in terms of gross mobility.

Independent research conducted in 2000 discovered the human gene responsible for the

production of Nogo-A. Through the use of cloning, a biological antibody was able to be

produced. The major pharmaceutical company GlaxoSmithKline was quick to notice and took

part in progressive testing. In 2001, Novartis secured the rights to Schwab’s antibody

formulation (Kraft, para. 9).

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Although it seemed for a time that disabling Nogo-A was the only way to allow the spinal

cord to heal, other scientists have tried alternatives. One way was to temporarily block its

receptor sites. Artificial peptide molecules, injected by catheter, were docked into the receptor

sites of rats, and within only four weeks, rats were able to move significantly better than those

who the same treatment but without the peptides (Strittmetter, S., 2001).

Along with the evolutionary brake system, the body’s natural immune system also serves

as a hindrance in the spinal cord’s reparation process. Fluid buildup from inflammation cuts off

the necessary blood supply, thus crushing most nerves and killing the survivors through

immunity messenger molecules. The resulting scar tissue that surrounds the site of injury builds

a dense, impenetrable barrier that neurite genesis cannot compete with.

Elizabeth Bradbury (2005) in London developed chondroitinase ABC, or what was

referred to as a “molecular machete”, (Kraft, para. 15), which removed the sugars from the scar

tissue’s from its proteoglycans, thus dissolving them. After two weeks of treatment involving

rats with injured spinal cords, the mobility was fairly similar to the rats that were never injured.

Back in 1985, Geoffrey Raisman discovered that olfactory neurons regenerate

spontaneously. This explains why we were able to retain the sense of smell even after nasally

inhaling a noxious odour, strong solvent, or even when we have a cold. His discovery was that

olfactory neurons were surrounded by olfactory ensheathing cells (OECs). By transplanting these

cells onto injured spinal cord cells, he observed that the OECs formed organized patterns that

served as a bridge between the two severed ends. Over time, a layer of insulating myelin sheaths

formed around these young neurons, and the rats were able to walk and move as normally as

before.

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Pastoral Integration #2

The concept of a person becoming part robotic, or a cyborg, does sound exciting like a

fun adventure story. However, the reality of it would be more than somewhat different. If a

person now has to define his body now in terms of part machine, it is likely that he would then

feel obligated to forfeit a part of his soul or humanity. The merging of the artificial with the

biological may lead one to, for example, question the nature of his own existence if it needs to be

considered now in terms of metal, wires, and kilowatts.

A pastoral counselor may aid someone, let’s say a Buddhist, along the path of realization

that although his body may be radically different than how he thought it was intended, electricity

is still part of the world. It represents the energy which provided his impetus before the

cybernetic implant. Meditation also has little to do with the body. Quite the contrary, once the

mind can be free from physical obstacles could enlightenment be reached.

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Stimulating growth.

Since it is, for now at least, accepted that electrical stimulation of the muscles themselves

would result in sloppy, jerky movements, scientists then went on to have electricity stimulate the

growth of the neurons themselves rather than the muscles they would connect to. This form of

pseudo-“electroshock therapy” served a dual purpose of also preventing atrophy in the muscles

from chronic periods of inactivity.

A 2006 trial known as the flat interface nerve electrode (FINE) applies necessary

pressure to the nerve in order to evenly distribute the electrical stimulation. The pressure also

molds the nerve into a shape and position that allows for easier neurite growth. The pulses of

electricity administered through the FINE were almost too fast for a person to notice, (250

milliseconds, approximately half the time needed to blink).

Experiments in 2006 led by Case Western included seven human participants who had

been undergoing thigh surgery. The results held that although the electricity was not enough to

cause the legs to bend and move independently, the muscles flexed to the point of significance in

the experiment. As a result, FINE would likely be used primarily in paraplegics.

Upon the relative success of the research, there then arose the issue of biofeedback and

proprioception. After all, the ability to experience tactile sensation was one of life’s primary

evolutionary traits as it alerts us to potential tissue damage. It is not unreasonable for one to

consider that the sense of touch was the first sense to develop and evolve.

There is also the biofeedback matter that a patient cannot judge or determine the efficacy

of the entire therapy unless he or she is able to regain sensation as well as voluntary movement.

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Andy Hoffer (2006) of Simon Fraser University in Vancouver, Canada, designed

NeuroStep (Neurostream Technologies of Saint-Augustin-de-Desmaures). It is a device which,

when worn as a cuff around the ankle with four electrodes inplanted, interprets human sensation

signals and transmits it to the patient’s brain in a form the brain can understand and perceive as a

bodily sensation. This form of cybernetics is, unfortunately, relatively obstinate.

Greg Clark (2010) developed what he dubbed the “Utah slanted array”, which contains

approximately 100 wires so small and compacted, they can fit comfortably inside an actual

nerve, “getting up close and personal with the nerve fibers themselves” (Campbell, 2010, para.

12). The Utah slanted array remains the most precise in any electrical-limb-activating devices. It

has shown significant results in cats who regained gross motor coordination, and in monkeys

who were able to perform fine motor tasks with their fingers.

A relative drawback to this invention lies in the numbers…human nerves contains tens of

thousands of axons, and each has the capability of being controlled by the brain itself. It is a

simple matter of a marionette with a million strings, but so far only being able to tug at a few.

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Pastoral integration #3

Not all forms of integration need to involve how to directly treat clients with specific

religions and specific conditions.

Concerning the growing prevalence of cyber therapies, it would be relevant for a pastoral

counselor to be aware of the location of the facilities in case he knows someone or knows of

someone who he feels would greatly benefit from the treatment, or a combination of treatments.

Quadriplegics, in some cases, may benefit from simultaneous treatment of electrodes in the

lower extremities, and computer controlled equipment for the upper extremities.

Pastoral counselors are at the mercy of, among many things, the issues of the world, and

how do translate beliefs into supportive realities for many. Even if an issue does not relate to

spirituality directly, there are therapeutic techniques that could benefit from spiritual awareness.

And as the issues of the world change, so must our ways of translating the lessons, and the

awareness of God to help bring us closer to the awareness of our placement in the universe.

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2 0 7 ( 2 7 8 0 ) .

M i l l e r , G . ( 2 0 0 5 ) . S t e m c e l l s i d e e f f e c t . S c i e n c e N o w ,   2 .

S v o b o d a , E . ( 2 0 0 9 ) . T h e e s s e n t i a l g u i d e t o s t e m c e l l s .   P o p u l a r S c i e n c e ,

2 7 4 ( 6 ) .

T h e g o o d f i g h t . ( 2 0 0 3 ) . I n N e w S c i e n t i s t , 1 7 7 ( 2 3 8 6 ) .

W i l s o n , C . ( 2 0 0 3 ) . O l d d r u g o f f e r s h o p e o f n e w g r o w t h i n s p i n a l c o r d . N e w

S c i e n t i s t . 1 8 0 ( 2 4 2 5 ) .