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<p>In an extremely rare case, conjoined twins were born in Indonesia with four arms, three legs, and shared genitalia. These twins, scientifically termed as <em>ischiopagus tripus</em>, are born only once in two million births. Known colloquially as 'spider twins', only a few instances of such conjoined twins have been documented. The case of Indonesian boys was recently published in the American Journal of Case Reports, although they were born in 2018.</p>

<p>"The rarity of ischiopagus tripus conjoined twins complicates the surgical separation, owing to the lack of cases and high complexity," the authors wrote in the <a href="https://amjcaserep.com/abstract/index/idArt/942126"><em>American Journal of Case Reports</em></a>.</p>

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<p>They are described as those who are joined at the lower half of their bodies rather than at the upper torso.</p>

<p><a href="https://www.wionews.com/trending/texas-couple-welcomes-rare-identical-quadruplets-girls-i-was-crying-in-the-delivery-room-718872">Also read | Texas couple welcomes rare identical quadruplets girls: ‘I was crying in the delivery room’</a></p>

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<p>In over 60 per cent of such cases, one of the twins typically dies post birth or is stillborn. Nevertheless, these infants defied the odds. However, due to their unique body structure, the brothers had to remain in a flat position for their initial three years, unable to sit up.</p>

<p>According to the case report, surgeons conducted an amputation of their third leg, which usually consists of two fused legs, and stabilised their hips and legs to enable the brothers to sit upright independently. A follow-up appointment three months after the surgery showed no complications.</p>

<p>The twins remain conjoined, and it remains uncertain whether doctors will attempt such a complex separation surgery.</p>

<p>Births like these occur when the embryo incompletely separates to develop into two individuals due to a congenital birth defect, according to Mayo Clinic. As the babies develop from this embryo, they remain physically connected, most frequently at the chest, abdomen, or pelvis.</p>

<h2><strong>World’s oldest conjoined twins, Lori and George Schappell die</strong></h2>

<p>Just last month, the world’s oldest conjoined twins&nbsp;ever, Lori and George Schappell, passed away at a hospital in Pennsylvania, United States, the Guinness World Records confirmed.</p>

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<p>At the time of their passing, the twins were 62 years and 202 days old, marking them as nine years senior to the second-oldest recorded female conjoined twins, as per the Guinness World Records. The reason for their death was not disclosed.</p>

<p><strong>Also watch | Metabolic changes mapped by scientists to regulate pregnancy health</strong></p>

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<p>Their heads were partly joined together, they shared important blood vessels, and around 30 per cent of their brains were shared.</p>

<p>In 2007, they were the first conjoined twins of the same sex to identify as different genders when George decided to live as a man.</p>

<p><em>(With inputs from agencies)</em></p>
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In an extremely rare case, conjoined twins were born in Indonesia with four arms, three legs, and shared genitalia. These twins, scientifically termed as ischiopagus tripus, are born only once in two million births.

In an extremely rare case, conjoined twins were born in Indonesia with four arms, three legs, and shared genitalia. These twins, scientifically termed as ischiopagus tripus, are born only once in two million births. Known colloquially as 'spider twins', only a few instances of such conjoined twins have been documented. The case of Indonesian boys was recently published in the American Journal of Case Reports, although they were born in 2018. "The rarity of ischiopagus tripus conjoined twins complicates the surgical separation, owing to the lack of cases and high complexity," the authors wrote in the American Journal of Case Reports. They are described as those who are joined at the lower half of their bodies rather than at the upper torso. Also read | Texas couple welcomes rare identical quadruplets girls: ‘I was crying in the delivery room’ In over 60 per cent of such cases, one of the twins typically dies post birth or is stillborn. Nevertheless, these infants defied the odds. However, due to their unique body structure, the brothers had to remain in a flat position for their initial three years, unable to sit up. According to the case report, surgeons conducted an amputation of their third leg, which usually consists of two fused legs, and stabilised their hips and legs to enable the brothers to sit upright independently. A follow-up appointment three months after the surgery showed no complications. The twins remain conjoined, and it remains uncertain whether doctors will attempt such a complex separation surgery. Births like these occur when the embryo incompletely separates to develop into two individuals due to a congenital birth defect, according to Mayo Clinic. As the babies develop from this embryo, they remain physically connected, most frequently at the chest, abdomen, or pelvis. World’s oldest conjoined twins, Lori and George Schappell die Just last month, the world’s oldest conjoined twins ever, Lori and George Schappell, passed away at a hospital in Pennsylvania, United States, the Guinness World Records confirmed. At the time of their passing, the twins were 62 years and 202 days old, marking them as nine years senior to the second-oldest recorded female conjoined twins, as per the Guinness World Records. The reason for their death was not disclosed. Also watch | Metabolic changes mapped by scientists to regulate pregnancy health Their heads were partly joined together, they shared important blood vessels, and around 30 per cent of their brains were shared. In 2007, they were the first conjoined twins of the same sex to identify as different genders when George decided to live as a man. (With inputs from agencies)

Very, very rare conjoined twins born in Indonesia have 4 arms, 3 legs, shared genitalia

<p>Doctors believe that a group of 10 to 12 babies in the United States born with multiple congenital malformations could be suffering from a new syndrome related to exposure to fentanyl in the womb.&nbsp;</p>

<p>Healthcare professionals from across the country, in a recent report, found the group of babies whose mothers had used fentanyl while pregnant were born with an abnormally small head, short body, and physical birth defects like a cleft palate or fused toes.</p>

<p><img alt="1" data-entity-type="file" data-entity-uuid="69a7e148-6f11-46f6-b6cd-804a6376009b" src="//cdn.wionews.com/sites/default/files/inline-images/WION%20IMAGES%21%20-%202023-12-06T132744.908.png" /></p>

<h4><em><strong>The image shows six babies identified and enrolled as a part of the study in a photo published in an article in Genetics in Medicine Open.&nbsp;</strong></em></h4>

<p>The doctors could not find any common genetic cause for the babies’ condition. However, their mothers admitted that they used street drugs, particularly fentanyl, while they were pregnant, leading the researchers to believe that exposure to the synthetic opioid was the root cause of these abnormalities. &nbsp;</p>

<h2><strong>What did the study find?</strong></h2>

<p>The study was published by a group of healthcare professionals in Genetics in Medicine Open. “In light of the ongoing fentanyl use epidemic, public health impact of the novel syndrome associated with prenatal fentanyl exposure is likely to be significant,” the authors wrote in the report.&nbsp;</p>

<p><strong>ALSO READ |&nbsp;<a href="https://www.wionews.com/world/top-us-senator-chuck-schumer-accuses-chinese-firms-of-fuelling-fentanyl-crisis-during-visit-to-shanghai-643836">Top US Senator Chuck Schumer accuses Chinese firms of ‘fuelling’ fentanyl crisis</a></strong></p>

<p>The research began with the identification and enrollment of six babies who were identified with the potential syndrome at Nemours Children’s Health in Delaware. Additionally, four babies with similar features were found in the US states of California, Massachusetts and Rhode Island, but they were not enrolled.</p>

<p>All the babies were initially believed to have Smith-Lemli-Opitz Syndrome which is a genetic developmental disorder that affects many parts of the body and is caused by a cholesterol metabolism issue which is necessary for normal cell function and brain development.</p>

<p>However, researchers found that the 10 children did not exhibit any features of SLOS or any other syndrome.&nbsp;</p>

<p>Erin Wadman, a genetic counsellor at Nemours, in an interview with NBC News said that the cases were linked in 2022 when she was asked to consult in the case of a baby who had been born with birth defects.</p>

<p>It was during the appointment that she was able to link all the aspects, including the features of the child and the story of her past patients. “I was sitting there in the appointment, and I was just like this face looks so familiar. This story sounds so familiar. And I was just thinking about how this patient reminded me so much of a patient I'd seen earlier in the year,” Wadmen said, as quoted by NBC News.&nbsp;</p>

<p>She added, “That’s when we were like we think we might have stumbled on something really big here.”</p>

<h2><strong>'Critical importance'</strong></h2>

<p>Eventually, Wadman and her colleague at Nemours, Dr Karen Gripp, a geneticist and paediatrician suspected that fentanyl may be causing similar disruptions to cholesterol metabolism during pregnancy.</p>

<p>“Although fentanyl’s effect on cholesterol metabolism has not been directly tested, based on indirect evidence it is biologically plausible that it affects cholesterol metabolism in the developing fetus,” the authors wrote.&nbsp;</p>

<p><strong>ALSO READ |&nbsp;<a href="https://www.wionews.com/world/explained-fentanyl-seized-in-2022-enough-to-kill-every-american-says-us-federal-drug-agency-545087">Explained: Fentanyl seized in 2022 enough to kill every American, says US federal drug agency</a></strong></p>

<p>The researchers also acknowledged the gaps in their report including “lack of quantifiable prenatal drug exposure and lack of laboratory evidence directly showing fentanyl’s effect on cholesterol metabolism and embryological development”.&nbsp;</p>

<p>However, they said that the recognition of the novel syndrome linked with prenatal fentanyl exposure is of “critical importance”.&nbsp;</p>

<p>Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. In 2022, US officials seized enough fentanyl to kill every American as the country continues to struggle with an epidemic of drug overdose deaths.&nbsp;</p>

<p><em>(With inputs from agencies)</em><br />
&nbsp;</p>


Doctors believe that a group of 10 to 12 babies in the United States born with multiple congenital malformations could be suffering from a new syndrome related to exposure to fentanyl in the womb.

Doctors believe that a group of 10 to 12 babies in the United States born with multiple congenital malformations could be suffering from a new syndrome related to exposure to fentanyl in the womb. Healthcare professionals from across the country, in a recent report, found the group of babies whose mothers had used fentanyl while pregnant were born with an abnormally small head, short body, and physical birth defects like a cleft palate or fused toes. The image shows six babies identified and enrolled as a part of the study in a photo published in an article in Genetics in Medicine Open. The doctors could not find any common genetic cause for the babies’ condition. However, their mothers admitted that they used street drugs, particularly fentanyl, while they were pregnant, leading the researchers to believe that exposure to the synthetic opioid was the root cause of these abnormalities. What did the study find? The study was published by a group of healthcare professionals in Genetics in Medicine Open. “In light of the ongoing fentanyl use epidemic, public health impact of the novel syndrome associated with prenatal fentanyl exposure is likely to be significant,” the authors wrote in the report. ALSO READ | Top US Senator Chuck Schumer accuses Chinese firms of ‘fuelling’ fentanyl crisis The research began with the identification and enrollment of six babies who were identified with the potential syndrome at Nemours Children’s Health in Delaware. Additionally, four babies with similar features were found in the US states of California, Massachusetts and Rhode Island, but they were not enrolled. All the babies were initially believed to have Smith-Lemli-Opitz Syndrome which is a genetic developmental disorder that affects many parts of the body and is caused by a cholesterol metabolism issue which is necessary for normal cell function and brain development. However, researchers found that the 10 children did not exhibit any features of SLOS or any other syndrome. Erin Wadman, a genetic counsellor at Nemours, in an interview with NBC News said that the cases were linked in 2022 when she was asked to consult in the case of a baby who had been born with birth defects. It was during the appointment that she was able to link all the aspects, including the features of the child and the story of her past patients. “I was sitting there in the appointment, and I was just like this face looks so familiar. This story sounds so familiar. And I was just thinking about how this patient reminded me so much of a patient I'd seen earlier in the year,” Wadmen said, as quoted by NBC News. She added, “That’s when we were like we think we might have stumbled on something really big here.” 'Critical importance' Eventually, Wadman and her colleague at Nemours, Dr Karen Gripp, a geneticist and paediatrician suspected that fentanyl may be causing similar disruptions to cholesterol metabolism during pregnancy. “Although fentanyl’s effect on cholesterol metabolism has not been directly tested, based on indirect evidence it is biologically plausible that it affects cholesterol metabolism in the developing fetus,” the authors wrote. ALSO READ | Explained: Fentanyl seized in 2022 enough to kill every American, says US federal drug agency The researchers also acknowledged the gaps in their report including “lack of quantifiable prenatal drug exposure and lack of laboratory evidence directly showing fentanyl’s effect on cholesterol metabolism and embryological development”. However, they said that the recognition of the novel syndrome linked with prenatal fentanyl exposure is of “critical importance”. Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. In 2022, US officials seized enough fentanyl to kill every American as the country continues to struggle with an epidemic of drug overdose deaths. (With inputs from agencies)

Cleft palate, fused toes: Fentanyl likely causing certain birth defects in newborns

<p>Scientists have generated early-stage human&nbsp;embryo&nbsp;models that could help shed light on the "black box" of initial human development stages and improve research on pregnancy loss and birth defects.</p>

<p>Two separate teams found different ways to produce versions of a blastocyst,&nbsp;the pre-embryonic mass of cells at the stage of development around five days after a sperm fertilises an egg, potentially opening the door for a huge expansion of research.</p>

<p>The scientists make clear that the models differ from human blastocysts and are not capable of developing into embryos. But their work comes as new ethical guidelines on such research are being drafted and could spark fresh debate.</p>

<p>The teams, whose research was published Thursday in the journal Nature, believe the models dubbed "blastoids" will aid research on everything from miscarriages to the effects of toxins and drugs on early-stage embryos.</p>

<p>"We're very excited," said Jun Wu of the University of Texas Southwestern Medical Centre, who led one of the teams.</p>

<p>"Studying human development is really difficult, especially at this stage of development, it's essentially a black box," he told a press briefing ahead of the research's publication.</p>

<p>At the moment, research on the earliest days of embryonic development relies on donated blastocysts from IVF treatment.</p>

<p>But supply is limited, subject to restrictions, and available only to certain research facilities.</p>

<p>So being able to generate unlimited models could be a game-changer, said Jose Polo, a professor at Australia's Monash University, who led the second research team.</p>

<p>"This capacity to work at scale, we think, will revolutionise our understanding of early stages of human development," he told reporters.</p>

<p>Generating models of blastocysts has so far only been done in animals, with researchers in 2018 successfully generating them in mice using stem cells.</p>

<p>The two teams approached the development of a human model in slightly different ways.</p>

<p>Wu's team used two different types of stem cells, some derived from human embryos, and other so-called induced pluripotent stem cells, which have the potential to become any cell and are produced from adult tissue.</p>

<p>Polo's team instead started with adult skin cells, but both teams ended up with effectively the same result: the cells began to organise themselves into blastoids, featuring the three key components seen in a human blastocyst.</p>

<p>"For us what was completely surprising was that when you put them together, they self-organise, they seem to talk to each other in some way... and they consolidate," Polo said.</p>

<p>But while the models are similar to human blastocysts in many ways, there are also significant differences.</p>

<p>Both teams' blastoids ended up containing cells of unknown types, and they lack some elements that come specifically from the interaction between a sperm and an egg.</p>

<p>The blastoids only worked about 20 per cent of the time on average, though the teams say that still represents a pathway to a significant research supply.</p>

<p><strong>Ethical debate</strong></p>

<p>The scientists are at pains to make clear that the models should not be seen as pseudo-embryos, and are not capable of developing into foetuses.</p>

<p>Still, they proceeded cautiously, opting to end research with the blastoids four days after cultivation, equivalent to about 10 days after fertilisation in normal egg-sperm interaction.</p>

<p>Research rules involving human blastocysts set that deadline at 14 days.</p>

<p>Peter Rugg-Gunn, group leader at the life sciences research Babraham Institute in the UK, said the processes represented "an exciting advance" but work was needed to generate the blastoids more reliably.</p>

<p>"To capitalise on the discovery, the process will need to be more controlled and less variable," he said.</p>

<p>And given the differences between the blastoids and human blastocysts, any hypotheses they help generate "will need to be validated in human embryos", said Teresa Rayon of the Francis Crick Institute, a biomedical research centre.</p>

<p>The research may also spark ethical debates, said Yi Zheng and Jianping Fu of the University of Michigan's department of mechanical engineering.</p>

<p>"As protocols are optimised, these blastoids will more closely mimic human blastocysts," they wrote in an opinion piece published in Nature.</p>

<p>Some "might view human blastoid research as a path towards engineering human embryos", they warned.</p>

<p>The research "calls for public conversations on the scientific significance of such research, as well as on the societal and ethical issues it raises".</p>


Scientists have generated early-stage human embryo models that could help shed light on the "black box" of initial human development stages and improve research on pregnancy loss and birth defects.

Scientists have generated early-stage human embryo models that could help shed light on the "black box" of initial human development stages and improve research on pregnancy loss and birth defects. Two separate teams found different ways to produce versions of a blastocyst, the pre-embryonic mass of cells at the stage of development around five days after a sperm fertilises an egg, potentially opening the door for a huge expansion of research. The scientists make clear that the models differ from human blastocysts and are not capable of developing into embryos. But their work comes as new ethical guidelines on such research are being drafted and could spark fresh debate. The teams, whose research was published Thursday in the journal Nature, believe the models dubbed "blastoids" will aid research on everything from miscarriages to the effects of toxins and drugs on early-stage embryos. "We're very excited," said Jun Wu of the University of Texas Southwestern Medical Centre, who led one of the teams. "Studying human development is really difficult, especially at this stage of development, it's essentially a black box," he told a press briefing ahead of the research's publication. At the moment, research on the earliest days of embryonic development relies on donated blastocysts from IVF treatment. But supply is limited, subject to restrictions, and available only to certain research facilities. So being able to generate unlimited models could be a game-changer, said Jose Polo, a professor at Australia's Monash University, who led the second research team. "This capacity to work at scale, we think, will revolutionise our understanding of early stages of human development," he told reporters. Generating models of blastocysts has so far only been done in animals, with researchers in 2018 successfully generating them in mice using stem cells. The two teams approached the development of a human model in slightly different ways. Wu's team used two different types of stem cells, some derived from human embryos, and other so-called induced pluripotent stem cells, which have the potential to become any cell and are produced from adult tissue. Polo's team instead started with adult skin cells, but both teams ended up with effectively the same result: the cells began to organise themselves into blastoids, featuring the three key components seen in a human blastocyst. "For us what was completely surprising was that when you put them together, they self-organise, they seem to talk to each other in some way... and they consolidate," Polo said. But while the models are similar to human blastocysts in many ways, there are also significant differences. Both teams' blastoids ended up containing cells of unknown types, and they lack some elements that come specifically from the interaction between a sperm and an egg. The blastoids only worked about 20 per cent of the time on average, though the teams say that still represents a pathway to a significant research supply. Ethical debate The scientists are at pains to make clear that the models should not be seen as pseudo-embryos, and are not capable of developing into foetuses. Still, they proceeded cautiously, opting to end research with the blastoids four days after cultivation, equivalent to about 10 days after fertilisation in normal egg-sperm interaction. Research rules involving human blastocysts set that deadline at 14 days. Peter Rugg-Gunn, group leader at the life sciences research Babraham Institute in the UK, said the processes represented "an exciting advance" but work was needed to generate the blastoids more reliably. "To capitalise on the discovery, the process will need to be more controlled and less variable," he said. And given the differences between the blastoids and human blastocysts, any hypotheses they help generate "will need to be validated in human embryos", said Teresa Rayon of the Francis Crick Institute, a biomedical research centre. The research may also spark ethical debates, said Yi Zheng and Jianping Fu of the University of Michigan's department of mechanical engineering. "As protocols are optimised, these blastoids will more closely mimic human blastocysts," they wrote in an opinion piece published in Nature. Some "might view human blastoid research as a path towards engineering human embryos", they warned. The research "calls for public conversations on the scientific significance of such research, as well as on the societal and ethical issues it raises".

New embryo models coaxed from skin cells offer a divisive new way to study human life

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