Direct cellular reprogramming techniques for cardiovascular regenerative therapeutics.

Cardiovascular diseases remain a leading cause of hospitalization affecting approximately 38 million people worldwide. While pharmacological and revascularization techniques can improve the patient's survival and quality of life, they cannot help reversing myocardial infarction injury and heart failure. Direct reprogramming of somatic cells to cardiomyocyte and cardiac progenitor cells offers a new approach to cellular reprogramming and paves the way for translational regenerative medicine. Direct reprogramming can bypass the pluripotent stage with the potential advantage of non-immunogenic cell products, reduced carcinogenic risk, and no requirement for embryonic tissue. The process of directly reprogramming cardiac cells was first achieved through the overexpression of transcription factors such as GATA4, MEF2C, and TBX5. However, over the past decade, significant work has been focused on enhancing direct reprogramming using a mixture of transcription factors, microRNAs, and small molecules to achieve cardiac cell fate. This review discusses the evolution of direct reprogramming, recent progress in achieving efficient cardiac cell fate conversion, and describes the reprogramming mechanisms at a molecular level. We also explore various viral and non-viral delivery methods currently being used to aid in the delivery of reprogramming factors to improve efficiency. However, further studies will be needed to overcome molecular and epigenetic barriers to successfully achieve translational cardiac regenerative therapeutics.

The human dimension of good economic policymaking.

Good economic policymaking requires the best possible economic advice. To be an effective adviser, a policy economist needs to remain credible, even under pressure. There is a gap between theory and reality; minding the gap can help policy economists determine which theories are more likely to work as a matter of practical policymaking. Adding the human dimension makes for better decisions by casting light on how people might respond to otherwise rational policy proposals. It is not sufficient for good policy outcomes that economists confer only with their professional peers. Citizens must be persuaded that the proposed policy reform is in the best interests of the community as a whole. Good economic policymaking should not underestimate the power of incentives to override moral and ethical restraint. Regulation is a poor substitute for culturally-embedded moral restraint. While it is possible to divorce the mechanical side of economics from its moral foundations, this is not the route to good economic policymaking.