Probably 90 % of ceramide gathers at the very top or apical end of these early stem cells, helping cells have direction literally. ‘We have cell polarity, an and down up, a member of family head and foot of the cell, and that’s what ceramide probably regulates,’ says Dr. Bieberich. ‘Cell polarity is completely essential for differentiation; otherwise you have a ball of cells, not organized tissue.’ Actually, we begin as a wad of cells, but within a day, some cells die and others become portion of the hollow sphere with an internal layer – – the primitive ectoderm – – that may further differentiate into an embryo, and an outer coating – – the primitive endoderm – – that sustains the embryo during development.This outpatient psychiatric consultation service is an attempt to explore a model that might begin to handle these needs, says Michael Fiori, MD, one of the consulting doctors. The wish is that this will enable patients who might not normally seek help for his or her emotional and psychiatric problems to be more comfortable getting treatment. The planned program within CNE contains the solutions of Butler psychiatrists Dr. Fiori, and Dawn Picotte, MD. Dr. Fiori provides mental wellness consultations to females seeking advanced treatment for cancers, urogynecologic disorders and obstetrical issues at Women & Infants. That is going to be a tremendous help for all of us as we observe women exceptional fear and anxiety associated with a cancer medical diagnosis and various other psychiatric reactions to their treatment and any required surgery, adds Robert D.