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00:00:01experiments with human embryos, however, remain strictly
00:00:04regulated. What we call the 14-day rule
00:00:08is a period of time where scientists
00:00:11around the world have agreed that we can
00:00:14actually culture human embryos up to that day. And
00:00:17so that's the day basically allow
00:00:20scientists to grow human embryos until day 14 of
00:00:23development.
00:00:26Those first few days are exactly where success or failure is decided.
00:01:30He wants everything to be just perfect.
00:01:33Researchers in Germany are developing new testing methods to
00:01:37detect rare metabolic disorders and vitamin deficiencies in
00:01:40newborns.
00:01:48For Neo, this is the final checkup. After today's
00:01:51blood test, he won't need to return to Heidelberg University Hospital in
00:01:55Southwest Germany. Shortly after he was born, doctors
00:01:59discovered he had a vitamin B12 deficiency, a condition
00:02:02that can seriously affect brain development if left
00:02:05untreated.
00:02:09When infants have a vitamin B12 deficiency, it usually becomes
00:02:12noticeable from around 4 to six months of age. They
00:02:16may show significant developmental delays and muscular
00:02:19hypotonia, meaning they're a bit floppy and not learning to move
00:02:22properly. It can cause brain damage, and in some cases those
00:02:26effects may not be fully reversible, even if the deficiency is identified. Few
00:02:37days after birth, a small blood sample is
00:02:40taken from the baby and analyzed for signs of metabolic and other serious
00:02:44disorders. Until now, screening for vitamin B12
00:02:47deficiency, as in Neo's case, was part of a research
00:02:50study. The results showed that the test
00:02:53reliably identifies affected
00:02:55children.
00:03:00screening is carried out, far fewer children go to develop the
00:03:03severe infantile vitamin B12 deficiency, so screening
00:03:07and early treatment really do make a difference.
00:03:11As a result, vitamin B12 deficiency has now been added to
00:03:14Germany's routine newborn screening program.
00:03:18Vitamin B12 is found primarily in animal
00:03:20products. A deficiency can develop when mothers are unable to take
00:03:24in enough of the vitamin during pregnancy. A vegan
00:03:27diet can be one reason, although there are many. Others
00:03:31once detected, the deficiency is usually easy to
00:03:34treat. The infants receive vitamin supplements and are
00:03:37monitored regularly. In most cases, the problem resolves
00:03:41once they begin eating animal-based foods themselves.
00:03:45Every day, between 500 and a thousand blood samples from newborns
00:03:49arrive at the metabolic laboratory at Heidelberg University
00:03:52Hospital. Over the past decades, newborn screening has
00:03:56expanded dramatically. When it was first introduced in 19
00:04:00'69 it looked for just one rare disorder, today it screens for
00:04:0433. Originally, there weren't
00:04:07machines. Testing was based on microbiological inhibition
00:04:11assays. Today, as you see, we have large analytical
00:04:14machines that can measure metabolites and amino acids very
00:04:17precisely. That means we can test for far more and with much greater
00:04:21accuracy.
00:04:24On average, one blood sample each day in Heidelberg produces an abnormal
00:04:27result, but screening for
00:04:30B12 deficiency has only become reliable in recent
00:04:33years. That was made possible by advances in laboratory
00:04:37analysis. Developments that researchers in Heidelberg also helped
00:04:40towards.
00:04:43Vitamin B12 deficiency is far more common than many of the disorders
00:04:47that were already included in newborn screening. And in most
00:04:50cases, this test also identifies deficiency in the
00:04:53mother that's been passed on during pregnancy. George
00:04:57Hoffman's team also investigated.
00:05:00it would be possible to detect the deficiency even earlier during
00:05:03pregnancy, but clear indicators are not always easy to
00:05:06find. Erstaunlicherweise
00:05:09zeigt
00:05:11Anemia. Around 10% of all pregnant women are anemic
00:05:14anyway, and the more specific signs of vitamin
00:05:18B12 deficiency that are described in textbooks simply
00:05:22aren't very often
00:05:22seen.
00:05:26So for now, the focus remains on screening newborns.
00:05:30Neo's mother's vitamin B12 deficiency has since been
00:05:33treated. She's simply grateful that she agreed to the additional
00:05:37screening test when Neo was born a year and a half
00:05:39ago.
00:05:44"I took part in the newborn screening program and also volunteered to have some
00:05:48additional tests done because I just thought, well it can't
00:05:51hurt," but I hadn't really read all the information in
00:05:54detail, and I didn't give it much thought. It was only when our
00:05:58pediatrician called to say something wasn't right that I went back and looked through the
00:06:01paperwork from the hospital. That's when I
00:06:04realized what the consequences could have been, erst dann wurde mir überhaupt
00:06:07bewusst, was das überhaupt für Folgen haben kann.
00:06:10Fortunately, never became a
00:06:13reality.
00:06:18Now let's go back to the beginning. After
00:06:21fertilization, the human egg cell divides again and
00:06:24again. This process forms embryonic stem
00:06:27cells, cells that can develop into every tissue in the
00:06:30human body. We still have stem cells as
00:06:34adults. They're vital for the body's repair processes, but
00:06:37they're already specialized for particular tasks.
00:06:41Around 20 years ago. Research has discovered how to reprogram
00:06:44adult cells, returning them to a state much like an embryonic
00:06:48stem cell. Now scientists hope tiny
00:06:51nanorobots can persuade these artificial stem cells to
00:06:55become bone cells. Sounds crazy, take a
00:06:58look.
00:07:01In these dishes are human stem cells and tiny microscopic
00:07:05robots.
00:07:07It's only under the microscope that their remarkable ability becomes
00:07:11visible. The robots can trigger stem
00:07:15cells to transform into bone cells, a breakthrough that could
00:07:18one day help damaged bone tissue
00:07:20regenerate.
00:07:23Artificially grown bone tissue like this could help shorten recovery times
00:07:27for diseases such as bone cancer or after
00:07:30serious accidents and may even prevent the need for
00:07:33amputations in some cases.
00:07:36And this is how it works: inside the dishes are tiny
00:07:40gel-filled cushions packed inside.
00:07:45They're made up of chemical molecules that can
00:07:47contract. A laser activates the tiny
00:07:50robots. As they contract, they press against the stem
00:07:54cells. This constant gentle pressure, almost like
00:07:57massage, switches on the stem cells genetic
00:08:00program. That causes them to transform into bone
00:08:04cells. Here we can see the cells after
00:08:07activation and the resulting fully differentiated bone
00:08:10cells.
00:08:12is to use this process to repair damaged tissue, and
00:08:16potentially not just bone, depending on how
00:08:19long and how intensely they're massaged by the robots, the same stem
00:08:23cells can also become heart muscle cells or cartilage
00:08:26cells.
00:08:29Our gel cushions can do two things:
00:08:32first, they can train a patient's stem cells,
00:08:36and second, they can transport the important cargo, for example,
00:08:39heart muscle cells, into the patient.
00:08:46At the bottom of this tube are 400 thousand of these gel
00:08:49cushions, each containing molecular nano robots
00:08:53and stem cells, but it could still be several years before the
00:08:56technology is ready for use in patients.
00:09:00Research on insulin-producing cells is already much further
00:09:03advanced. In people with diabetes, these cells are
00:09:06damaged or destroyed. The team led by stem cell
00:09:09researcher is developing
00:09:13into insulin-producing cells, known as islet
00:09:16cells.
00:09:19Since the discovery of these stem cells, we've now reached the point
00:09:22where we can produce islet cells that look almost identical to those found
00:09:26naturally in the human body. These cells are
00:09:29already being transplanted into patients as part of clinical trials
00:09:32and those patients no longer need insulin
00:09:35injections.
00:09:39can also now grow living organ components from stem cells?
00:10:25molecules we use today will very likely continue to be necessary as
00:10:28well.
00:10:31The hope is that combining both approaches could make it faster and
00:10:35more precise to regenerate damaged tissue using stem
00:10:38cells.
00:10:42A small cut usually heals all by itself within a few
00:10:45days. Put a band-aid on it and the body does the
00:10:48rest. But it's a very different story when internal organs such
00:10:52as the heart are damaged. Heart muscle cells only
00:10:55regenerate to a limited extent, and when the heart
00:10:58becomes weak, the consequences can quickly become
00:11:01life-threatening.
00:11:04Open heart surgery in Göttingen in Central Germany. The
00:11:08patient is suffering from advanced heart failure. Part of his
00:11:11heart muscle has died and can no longer help to pump blood around the
00:11:15body. As a result, the heart grows progressively
00:11:18weaker, until eventually it can no longer keep
00:11:21going.
00:11:24These unassuming... hexagonal patches could offer a
00:11:26lifeline.
00:11:29They're a kind of band-aid for the heart, made up of millions of
00:11:33heart muscle and connective tissue cells grown in the
00:11:35lab.
00:11:43Further north at Schleihof Holstein University
00:11:45Hospital, Frank Tieger is also a heart failure
00:11:48patient. After a total of nine heart attacks,
00:11:52large numbers of his heart muscle cells have died.
00:12:36If the heart's pumping capacity remains above 40%, the
00:12:40condition can usually be kept stable, allowing patients to lead
00:12:43a largely normal life, but when that
00:12:46figure sinks further, the risks increase
00:12:49dramatically.
00:13:05Both are serious, high-risk procedures. The heart patch
00:13:09could offer a life-saving alternative. As
00:13:12part of an ongoing clinical trial, Stephan
00:13:15Ensminger has already implanted 10 of these
00:13:17patches. Some of his patients are on the waiting list for a
00:13:21donor heart. Across Germany, nearly 700 people are
00:13:24currently waiting, but only around 350 donor hearts
00:13:27become available each year. If the heart patch proves successful, it
00:13:31could save many more lives.
00:13:34There are around 25,000 patients in Germany living with advanced
00:13:38heart failure, all of whom could potentially benefit. But there
00:13:41are still many unanswered questions. We're running a clinical
00:13:44study with strict inclusion criteria, and there are
00:13:47limitations. Some patients respond very well, others
00:13:50less so, but so far we haven't had a single patient who showed no
00:13:54improvement.
00:13:58If these early results continue to hold up, one man in particular will be
00:14:01delighted.
00:14:03The heart patch is in many ways the culmination of Volfram Hubertus
00:14:07Zimmermann's life's work.
00:14:10For 30 years he's been researching artificial heart
00:14:14tissue.
00:14:17Now that research is finally helping patients who are fighting for their
00:14:20lives.
00:14:23Wir sehen ja Patienten.
00:14:55currently takes around 3 months. The process
00:14:58begins with stem cells from a donor cell bank. Researchers
00:15:01induce these cells to develop into beating heart muscle
00:15:04cells. By the time the patch is finished, no stem cells
00:15:08remain.
00:15:13Once manufactured, the patches must be implanted within 14
00:15:17days. To meet what could become enormous demand,
00:15:20researchers are now focusing on making production faster and more
00:15:23efficient.
00:15:37That means patients would no longer have to wait 3 months. Instead, we
00:15:41would have them readily available for immediate clinical
00:15:44use. Back in the operating theater in
00:15:47Göttingen, the surgeons stitched together 10 individual heart
00:15:50patches to create a larger graft. The yellow sponge
00:15:54acts as a supporting base and later breaks down naturally inside the
00:15:58body. Researchers estimate that around
00:16:01half of the 800 million implanted cells will survive.
00:16:05Eventually they contract in sync with the patient's heartbeat. If
00:16:09the heart's pumping function simply stops getting worse, that alone would be
00:16:13considered a success. If it improves, the patient may no longer
00:16:17need a donor heart at all.
00:16:20The patches stitched directly onto the beating heart, where it gradually
00:16:23integrates with the surrounding tissue over the following
00:16:26weeks.
00:16:29It will be significantly less
00:16:31expensive.
00:17:37that would allow them to treat more hospital patients with these potentially
00:17:40life-saving heart
00:17:42patches.
00:17:48What if instead of simply swallowing medicines and allowing
00:17:51them to circulate throughout the entire body, we could deliver them
00:17:55directly to the precise location where they're
00:17:58needed, perhaps with the help of an
00:18:01implant produced a 3D
00:18:04printer.
00:18:07Research is underway in a lab in Würzburg in southern Germany,
00:18:10a technology that could one day transform the way medicines are
00:18:14delivered. Anna Flyher is leading the project and first had the
00:18:17idea in 2019.
00:18:21Heutzutage werden Medikamente medications are usually administered as
00:18:25tablets or through infusion. They enter the
00:18:28bloodstream through a vein or in some cases through a
00:18:30port, but that means the drugs are distributed throughout the entire
00:18:34body, reaching organs where they're not actually needed.
00:18:38So we thought, wouldn't it make more sense to release medications exactly where
00:18:42they're required, without putting unnecessary strain on the rest of the
00:18:45body, restlichen Körper unnötig
00:18:47belasten. The project is called Endorelease, short for
00:18:51endovascular release. The idea is
00:18:54to use an implant placed inside a blood vessel to deliver
00:18:57medication directly where it's
00:18:58needed.
00:19:01The system works by implanting a drug- filled device into the body using a
00:19:05minimally invasive procedure.
00:19:08A catheter is then used to guide it through an artery to the target
00:19:11location.
00:19:14We're making use of the body's natural infrastructure. Over the
00:19:17course of evolution, arteries have become the ideal highways that we can
00:19:21use to transport our implant and capillaries
00:19:24the ideal sites for exchange where medications can pass into the target
00:19:28tissue.
00:19:30Experts from a wide range of disciplines are working together to make that vision a
00:19:34reality. The team is currently developing and testing.
00:19:45systems will make treatments both safer and more effective by delivering
00:19:49highly concentrated doses directly to the target
00:19:52site while avoiding systemic side effects in the rest of the
00:19:55body.
00:19:58Another potential advantage is that the technology could help reduce
00:20:01healthcare costs.
00:20:07come from using less medication, although we would
00:20:10be releasing much smaller amounts locally. The bigger
00:20:14benefit is that we may be able to treat diseases earlier and more
00:20:17effectively, potentially avoiding a huge amount of follow-up
00:20:20costs.
00:20:23The system has now been filed for patent protection in several
00:20:26countries, but there's still a long road ahead before it reaches clinical
00:20:30use. How quickly that happens will depend on future
00:20:33funding and on how successfully the technology performs
00:20:36in further testing?
00:27:14Young people in Albania, what does the daily life of a
00:27:18high school student in the capital of Tirana look like?
00:27:21French parenting, what do parents in France do
00:27:24differently?
00:27:27Walking in the Wadden Sea, what can you
00:27:30experience along the German North Sea coast? All this and much
00:27:33more in today's Euromax.
00:27:53Tirana, the Albanian capital, is very popular among
00:27:56tourists, but what is it like to grow up in this city? A young Albanian
00:28:00shows us his daily
00:28:06life. Hello, I'm Drin, I'm 16 years old and I live in Tirana.
00:28:10This is the city where I grew up and where I experienced many things for the first
00:28:14time. Come with me, I'll show you what a day of
00:28:18mine looks like.
00:28:21Hello, welcome to my
00:28:23home. I live with
00:28:27my parents. My grandparents live in an apartment that
00:28:31is connected to ours. This is my mother who always
00:28:35helps me get ready for breakfast, or for
00:28:38school. Drin's older brother works
00:28:41abroad. In Albania, it is normal for several generations of the same
00:28:45family to live under the same roof.
00:28:48This is my room, I love it, it reflects my character,
00:28:52it is also very practical because I spend most of my
00:28:55time here studying or
00:28:58playing music.
00:29:05Drin's day starts at 6 AM. He has to walk quite a bit to the
00:29:09bus that takes him to school.
00:29:13He attends a private Catholic high school. Classes start at 8
00:29:17AM. Today his class has an Albanian
00:29:20language test. Classes end after the sixth
00:29:23period.
00:29:27After school, Drin goes back to his grandmother's, his father's mother. Since
00:29:31his grandfather passed
00:29:34away, she lives
00:29:36alone. On the ground floor there is a room
00:29:40that has a special meaning for Drin.
00:29:47These are the ships that my grandfather and I built for years. These are
00:29:51models of real
00:29:53ships.
00:29:57My grandfather was very dedicated to it and he passed that love on to
00:30:00me.
00:30:03This is my grandfather, as a young man, he attended a naval
00:30:07academy, and later worked on a
00:30:09ship for years. And here's my
00:30:13grandmother.
00:30:16Hello.
00:30:22My grandmother and I are very close, so I try to visit her as
00:30:25often as possible. Three to four times a week, and even on
00:30:28weekends.
00:30:32In Albania, the most important
00:30:33thing.
00:30:36In the afternoon, Drin goes with his friend Boran to the city
00:30:40center. Both are part of the same group of school
00:30:43friends.
00:30:46We hang out outside of school too.
00:30:49We play sports, play video games and do similar
00:30:53things. Or, like today, they go
00:30:56to the bakery for Burek.