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Image source, Getty ImagesA third child in Scotland has died with Strep A infection, Public Health Scotland has said.The agency said it was aware of 17 deaths among invasive group A streptococcal infections (iGAS) cases between 3 October and 15 January, an increase of four since its last report.Those figures now include three under age 10 - one more than last week.Strep A cases are usually mild, causing illness ranging from a sore throat to scarlet fever.But on rare occasions can develop into an iGAS infection. Early symptoms of an iGAS infection include a high temperature, severe muscle aches and localised muscle tenderness, as well as possible redness at the site of a wound. Last month Scotland's national clinical director told BBC Scotland the deaths of children from the infection was "not unusual".Prof Jason Leitch said the country was experiencing the highest number of Strep A infections since 2017.But he added it was a very mild disease in the "extreme majority" of children and the elderly. The health body's latest report, published on Wednesday, stated: "PHS is aware of 17 deaths amongst iGAS cases that appear to meet the case definition between 3 October and 15 January 2023, an increase of four deaths since the previous report. "Three of these deaths were in children under ten years of age, an increase of one since the previous report." According to the new data, 13 of the country's 14 NHS boards had reported iGAS cases between October last year and 15 January this year.The report also reveals 22 iGAS cases were reported across all age groups, the same number as the previous week.Of the new cases, 13 involved children under the age of 10 - meaning that since the start of October there have been 41 cases in this age group.Last week the UK Health Security Agency (UKHSA) data showed 190 people - including 30 children under 18 - have died in England from the invasive form of the bacterial infection.It said a rise in Strep A cases this year is most likely due to high amounts of the bacteria circulating and increased social mixing.Meanwhile, PHS said in the week ending 15 January there were 532 cases of Group A Streptococcus (GAS).This is down from 600 in the previous week, but compares with 300 and 480 reports a week that were observed at infection peaks since 2016.But PHS said the rise could be due to increased testing.When to seek medical adviceParents are being urged to look out for symptoms and to promptly contact their GP or NHS24 if they have any concerns.The UKHSA advises people to call 999 or go to A&E if:your child is having difficulty breathing - you may notice grunting noises or their tummy sucking under their ribsthere are pauses when your child breathesyour child's skin, tongue or lips are blueyour child is floppy and will not wake up or stay awakeWhat is Strep A?Image source, BSIP/Getty ImagesGroup A streptococcal (GAS) infection is caused by strains of the streptococcus pyogenes bacteriumThe bacteria can live on hands or the throat for long enough to allow easy spread between people through sneezing, kissing and skin contactMost infections cause mild illnesses such as "strep throat" or skin infectionsIt can also cause scarlet fever and in the majority of cases this clears up with antibioticsOn rare occasions the bacteria can get deeper into the body - including infecting the lungs and bloodstream. It is known as invasive GAS (iGAS) and needs urgent treatment as this can be serious and life-threateningRelated Internet LinksThe BBC is not responsible for the content of external sites. | Epidemics & Outbreaks |
Canada is facing an exodus of our emergency room doctors. Smaller ERs increasingly lock their doors to the public as there are no doctors or nurses to staff them, leaving people to travel to the next closest ER in their greatest time of need. Sometimes, if that ER is too far away, they die preventable deaths.
In my Victoria, B.C. group of 50 ER doctors, nearly all of my colleagues have either considered an alternative occupation or a reduction in shifts. One freshly minted attending physician, after 13 years of gruelling education and training, is thinking about “other options.” How have we come to this? Why are so many leaving?
Moral injury pertains to the effects of perpetuating, observing or failing to prevent acts that transgress deeply held moral standards. ER doctors are leaving because we can no longer do what we trained to do; we can no longer help people — our raison d’être — to the standard they deserve. In short, continual moral injury is breaking your ER doctors.
Our beloved universal health-care system can be seen as on par with a developing country’s. (The Commonwealth Fund, a health-care advocacy group, ranked Canada’s performance 10th among 11 high-income countries — with the U.S. last.) Heart attacks and perforated guts can languish for hours in the ER wait room, directly leading to morbidity and mortality for the unfortunate patients. Only a small portion of these stories make it to the media. And universal access to our broader system is a joke when getting a GP is increasingly about who you know, faster care is awarded to those who shout the loudest, and those who can afford it pay for private imaging or fly to the U.S. to get more timely care.
Tragically, I regularly diagnose more patients with late-stage cancers than ever. These are people who should have been screened earlier, but either did not have a family doctor or had insufficient access to one, and are now sentenced to die. Perhaps worse are the cases when someone’s cancer has been caught at an early stage, but they come to our ERs seeking help as they are still waiting two months later for their first appointment with an oncologist. All I can do is offer my sympathy and send them home with the knowledge that their treatable cancer is spreading.
This is an unconscionable systemic failure. As ER doctors, we lack the tools to fix this problem, but we bear the brunt of the emotional toll because patients have nowhere else to turn. And we, rightly, never turn our patients away from at least seeing an ER physician.
In our very busy city hospitals, I would estimate that 15 per cent of ER patients have actual medical emergencies. The vast majority of ER patients are presenting with family medicine problems. My non-medical partner is no longer surprised to see me arrive home, invigorated, after having treated a patient that was stabbed or shot, after resuscitating a patient with septic shock, or even after giving a patient a dignified death surrounded by family when their time comes. These are true medical emergencies and it is what I’m trained to do, something that only a very few of us in society are capable of doing. And it feels so good to be of use.
But these shifts are the rarity, maybe once or twice a month. I work whole shifts without having a patient sick enough to be admitted to hospital and after those, I feel emotionally exhausted. For the vast majority of my shifts, I am plugging holes in the dam, responding to social, and often serious, chronic problems that I am not equipped to deal with. Patients are not to blame; they really have nowhere else to go.
When we do see acutely unwell patients, we are forced to compromise on our standards due to our stretched health-care system. Examination in hallways for lack of space is all too common, depriving patients of respect and dignity. Patients with alcohol or drug abuse who finally get the courage to come in for help are sent away because we lack detox beds. Or the family of an 85-year-old must be convinced that taking oral antibiotics at home for their UTI sepsis really may be the better option than languishing in an ER bed for 36 hours and developing delirium because there are no admission beds — the latter being what the patient actually needs. I walk away from these discussions feeling a deep burden of guilt for something completely out of my control. This is moral injury.
When I walk into a patient room in my ER, I usually apologize for the long wait. If I can address the anger that almost all patients experience after waiting eight hours to see me, I know that the assessment will go better. As eight-, 10-, 12-hour waits become the standard, I find myself apologizing 20 times per shift, 15 shifts a month, likely thousands of times per year, for something that is not my fault. While I’m just the face of a system that has failed, my nursing colleagues and I bear the brunt of patients’ frustration and anger.
ER doctors, leaders of highly skilled teams, are generally big-hearted people who want to help those in need. It can literally be a thankless job, with our sickest patients never remembering the team who saved their lives because of the severity of their illness. The off-hour and shift-work nature of the job has been proven to reduce our life expectancy by around five years. Instead of reading to my two young kids at bedtime, I am instead, on many nights, seeing those in need at the hospital. Suicide and burnout rates for ER doctors are among the highest of any profession.
So why do we do it? Because, underneath the superficial visage of being the “adrenalin junkies” and “surfer dudes” of the medical world, we want to make a difference for our patients. It’s a principled choice. The people who come to see us in the ER often have nowhere else to go and we are uniquely placed to help them. We could have trained to be radiologists or dermatologists, work regular office hours, make on average twice as much and live five years longer. But we wanted to help people in their most vulnerable and sickest hour.
Long gone are the days of the early pandemic, when our neighbours banged their pots and pans in appreciation every evening. Now we are yelled at every single shift about the long wait times. We are verbally and physically assaulted so regularly that the B.C. provincial health authority recently mandated violence-prevention training. All these things, it’s just too much.
We are just at the beginning of this crisis — more doctors will leave, fewer will sign up to train in emergency medicine and governments will try to fill in the holes via physician assistants and other stopgap measures. Or they’ll try to squeeze more out of the antiquated fee-based pay system designed in the 1970s that rewards ER doctors who spend less time with each patient. Further ERs will close and wait times will increase. How many people will have to die before our governments are shamed into real action, real change?
I’m not sure I’ll still be there to find out.
Dr. Brian Wall is an emergency physician and clinical assistant professor of medicine at the University of British Columbia. | Health Policy |
Satellite images show reality of China's funeral homes 04:19 - Source: CNN Coronavirus 16 videos Satellite images show reality of China's funeral homes 04:19 Now playing - Source: CNN Will approaching winter mean new Covid-19 surge? 04:20 Now playing - Source: CNN Artist wears 27 hazmat suits to protest China's policies 03:08 Now playing - Source: CNN See how Hong Kong is trying to revitalize itself after Covid-19 02:23 Now playing - Source: CNN See late night reactions to President Biden claiming pandemic over 01:45 Now playing - Source: CNN Business Dr. Gupta: This treatment for 'brain fog' from long-Covid just might surprise you 04:05 Now playing - Source: CNN Aaron Rodgers tells Joe Rogan why he didn't get vaccinated for Covid 02:16 Now playing - Source: CNN How Covid upended children's lives 10:16 Now playing - Source: CNN 'Wasn't too surprising': Doctor reacts to Biden's positive Covid test 02:50 Now playing - Source: CNN New studies suggest Covid-19 likely originated from Wuhan wet market 01:39 Now playing - Source: CNN Dr. Fauci gives update on Biden's Covid-19 infection 05:50 Now playing - Source: CNN 'This was entirely predictable': Doctor on Biden testing positive for Covid-19 01:22 Now playing - Source: CNN Jill Biden speaks out after President Biden contracts Covid-19 00:45 Now playing - Source: CNN 'I'm losing my mind': Chinese depositor loses life savings in bank 03:58 Now playing - Source: CNN Doctor: Covid-19 BA.5 variant is highly transmissible 02:31 Now playing - Source: CNN Dr. Fauci explains why new BA.5 subvariant is concerning 04:58 Now playing - Source: CNN CNN — The US Centers for Disease Control and Prevention is ironing out the “logistical and legal” aspects of testing wastewater from airplanes for coronavirus variants as it continues to explore such a Covid-19 monitoring program. The agency is still “figuring out how to operationalize this program,” a person close to CDC discussions said, adding that there are “logistical and legal” hurdles that need to be sorted out before the program “would be operational.” Some of the agency’s partners tell CNN that they are poised to help roll out this potential next frontier in the nation’s Covid-19 surveillance effort. Monitoring sewage for traces of coronavirus variants is a “validated” scientific process – no longer in its pilot phase – and airplanes are a logical next step, said Matt McKnight, general manager at Boston-based synthetic biology company Ginkgo Bioworks. Its Concentric by Ginkgo biosecurity and public health unit has been chosen to partner in the CDC’s traveler-based genomic surveillance program to detect Covid-19 and flu variants among international travelers. For now, the use of testing services to collect and analyze airplane wastewater for variants “is an active conversation between CDC, the White House and the airlines,” McKnight said. But the process of testing airplane wastewater itself is “validated methodology, and it is a program that can be run actively,” he added. “The system is ready to go.” Testing aircraft wastewater involves collecting sewage from individual passenger-carrying commercial airplanes. “You can pull it off the airplane in under two minutes, quickly put it into a lab network, which we manage all of that,” McKnight said. Once those wastewater samples arrive at a diagnostic lab for testing, scientists scan them for traces of known or unknown viruses, such as emerging variants of SARS-CoV-2, the coronavirus that causes Covid-19. When samples test positive for the virus, scientists conduct genome sequencing to identify exactly which variant that virus is. “Usually, sequencing takes about five to seven days,” said Casandra Philipson, a researcher and program lead for Ginkgo Bioworks. Then, scientists may analyze their results and submit their findings to the CDC. “We can do analysis really quickly,” Philipson said, such as in a few days. “And then return results immediately.” Both McKnight and Philipson said that airplane wastewater surveillance not only can help with detecting emerging coronavirus and influenza variants – serving as a “radar system” – it can alert vaccine makers to which variants our Covid-19 shots might need to target each year. Advisers to the US Food and Drug Administration are scheduled to meet this week to discuss Covid-19 vaccines becoming annual immunizations, similar to the seasonal flu vaccine. That process could include streamlining the vaccine composition, immunization schedules and periodic updates of vaccines, according to meeting documents posted Monday. The FDA has said it expects to assess circulating strains of the coronavirus at least annually and decide in June which strains to select for the fall season, similar to the process of updating annual flu vaccines. “If you give Moderna or Pfizer information early enough, they can make a vaccine really quickly, which we couldn’t do at the beginning of the pandemic,” McKnight said. “The big lesson learned is that you can think about all of these variants of viruses circulating around the world, and it’s kind of like anything else we would have a radar system for, to detect what is out there so you can get an early warning.” A report released last week by the National Academies of Sciences, Engineering and Medicine describes wastewater surveillance as a “valuable component” of infectious disease management and notes that wastewater surveillance at major US airports and ports of entry could help identify initial cases for pathogens from other regions among international travelers. The report was produced at the request of the CDC. A separate study conducted in the United Kingdom, published last week in the journal Plos One, found that the majority of wastewater samples collected from 150 terminals and 32 aircraft at three major international airports in the UK in March 2022 tested positive for SARS-CoV-2. All samples taken from sewers at the arrival terminals of Heathrow and Bristol airports, and 85% of samples taken from sites at Edinburgh airport, were positive for the virus, according to the study. “I was not surprised that we found SARS-CoV-2 RNA in those wastewater samples. This was a proof-of-concept study: being able to detect the viral RNA in the samples proved that our methodology works, which was a positive outcome,” Kata Farkas, an author of the study and researcher at Bangor University in the UK, said in an email Tuesday. “In our study, we used PCR-based detection, but other studies have utilised sequencing successfully for these types of samples. Therefore, variants can also be identified in aircraft/airport wastewater, supporting other types of surveillance programmes to better understand which variants are circulating globally,” she wrote. “It is worth noting that the methodology we described can be used for the identification of other viruses that may threaten global public health.” | Epidemics & Outbreaks |
Image: Scanning electron micrograph of a single prostate cancer cell. Credit: Anne Weston, Francis Crick Institute
Prostate cancer’s resistance to treatment can be reversed in some patients by stopping hijacked white blood cells from being ‘pulled into’ tumours, according to new research published in Nature.
In an early clinical trial, researchers showed that blocking the messages cancer uses to hijack white blood cells can resensitise a subset of advanced prostate cancers to treatment – shrinking tumours or halting their growth.
Reverse drug resistance
The research provides the first proof in a human trial that targeting 'feeder' myeloid white blood cells – which are co-opted by tumours to help fuel cancer growth, progression, and resistance to treatment – can reverse drug resistance and slow tumour progression.
Researchers tested a combination of AZD5069, an experimental drug which prevents myeloid cell recruitment to tumours, and enzalutamide, a hormone therapy commonly used to treat prostate cancer, in patients with advanced disease.
Five of 21 (24 per cent) evaluable patients responded to the treatment, meaning their tumours shrunk by over 30 per cent, they saw dramatic decreases in circulating levels of prostate specific antigen (PSA), a marker secreted by the prostate which is often elevated by cancer, or their blood levels of circulating tumour cells dropped, in response to the combination.
Blood levels of myeloid cells also dropped in patients who received treatment, and biopsies following treatment also revealed fewer myeloid cells within their tumours.
Building on a decade of research
The research builds on over a decade of work by teams at the ICR, The Royal Marsden and IOR working to understand how myeloid cells fuel prostate cancers.
This began with a surprising observation that patients with aggressive and resistant prostate cancer had much higher levels of myeloid RNA in their blood.
Research by this international team has since shown that myeloid cells within tumours enter a sleep state called 'senescence', and become "hormone factories," manufacturing signals which support tumour growth, division and survival. They then send further signals to the bone marrow to recruit more 'conspirator' myeloid cells to enter the tumour and the cycle continues.
The new study is the first to prove that blocking this pathway has anti-tumour activity in humans with prostate cancer. It is an example of a treatment that works by disrupting the cancer ecosystem - a pioneering approach to cancer treatment which is a key focus of the ICR's latest strategy, Defeating Cancer.
The treatment AZD5069 prevents myeloid cells being recruited to tumours by blocking a receptor on myeloid cells called CXCR2, which acts as a mailbox for recruitment messages sent by myeloid cells already residing in tumours.
These messages encourage myeloid cells to travel towards places of inflammation, such as tumours, and infiltrate them.
'Tremendously exciting'
"This research proves for the first time that targeting myeloid cells rather than the cancer cells themselves can shrink tumours and benefit patients. This is tremendously exciting, and it suggests we have an entirely new way to treat prostate cancer on the horizon.
"We've been studying these myeloid cells at the ICR for many years. More than a decade ago we first noticed that they were elevated in patients with much more aggressive tumours, and showed these tumours were more treatment resistant. Professor Andrea Alimonti at the Institute of Oncology Research (IOR) then demonstrated in laboratory studies that these cells could promote prostate cancer growth, with their inhibition blocking tumour progression.
“It's hugely rewarding to see our theory proven in a trial of patients with this disease. Myeloid cells may be implicated in treatment resistance in a range of cancers, so the impact of this research could be very broad, across multiple cancer types."
"It's a major achievement to plan and run a clinical trial on predominantly charity funding. We're incredibly grateful to the charities like Prostate Cancer UK, Cancer Research UK, the Prostate Cancer Foundation and Swiss Card Onco grant organisation, who made this research possible."
"It’s fantastic to see such an innovative approach to treatment showing benefits in a clinical trial. It helps to act as a proof of principle for disrupting cancer’s supportive ecosystem, as a smart new way of targeting tumours.
"I look forward to seeing how this work progresses and hope it will pave the way to a new treatment that is beneficial to people with prostate cancer, and potentially also many other cancer types."
'Revolutionary research'
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, which part-funded the research commented:
“A man living with advanced prostate cancer needs treatments that will control his disease to give him years more life, feeling as well as possible. Sadly, for many men, their cancer resists treatments, ending too many lives far too soon.
“Six years ago, Prostate Cancer UK brought together some of the world’s top experts in the field to work out how prostate cancer is using the immune system to evade treatments, and how we can disrupt this. Since then, we’ve moved from initial ideas to laboratory research, and now to a clinical trial that shows us a completely new, safe, effective way treat advanced prostate cancer without resistance.
“I’m extremely excited by these results, and proud that we’re funding such revolutionary research. Now we want to see pharmaceutical companies working with researchers to develop new drugs based on what we’ve learnt, and to test them in larger trials — turning research into reality for men.”
Help us continue to find new ways to defeat prostate cancer – and improve the chance of survival for men with this disease. Please make a donation today.
Donate now | Drug Discoveries |
CNN — Since the summer launch of the 988 Suicide and Crisis Lifeline, the new three-digit number has seen a significant rise in call volume – routing more than 2 million calls, texts and chat messages to call centers, with the majority being answered in under a minute. “The average speed to answer year-over-year was about three minutes in 2021. It’s now 44 seconds in December of 2022,” said Dr. John Palmieri, a senior medical advisor at the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, who serves as 988’s deputy director. The 988 Suicide and Crisis Lifeline, formerly known as the National Suicide Prevention Lifeline, launched last July, transitioning the former 1-800-273-TALK phone number to the three digits of 988. The new number is intended to be easy to remember, similar to how people can dial 911 for medical emergencies. Since that transition, in the past six months, about 2.1 million calls, texts and chats to the new 988 number have been routed to a response center and, of those, around 89% were answered by a counselor, according to a CNN analysis of data from SAMHSA, which oversees 988. Many of the calls that went unanswered were due to callers hanging up before reaching a counselor. “We know that there are many individuals in this country who are struggling with suicidal concerns, with mental health or substance use concerns, who aren’t able to access the care that they need. And in many respects, historically, because of funding limitations or other limitations, the system has let them down,” Palmieri said. “So, this is truly an opportunity with 988 – as a catalytic moment – to be able to transform the crisis care system to better meet those needs in a less restrictive, more person-centered, more treatment- and recovery-oriented way.” Since the summer launch of 988, more than 300,000 calls, texts and chats have come in each month. SAMHSA data on the new lifeline show that in December 2022 versus December 2021, calls answered increased by 48%, chats answered increased by 263% and texts answered increased by 1,445%. “We see the uptick in volume as an indicator that more people are aware of the service and able to access it,” Kimberly Williams, CEO and president of Vibrant Emotional Health, the nonprofit administrator and operator of the 988 lifeline, said in an email Thursday. She added that Vibrant was “not surprised” by the increase in volume and has been “working strategically” with the more than 200 call centers in the 988 network to respond. “In December of 2022 compared to December of 2021, over 172,000 more contacts were answered as part of the lifeline system,” Palmieri said. The average amount of time counselors spent talking, chatting or texting with contacts was about 21 minutes and 55 seconds. “It’s really eye-opening to see the increase in the texts, chats and calls that are coming in. But to see that more states have a more than 90% answer rate for contacts coming from their state – and that average speed of answering is down, so people are getting help more quickly,” said Hannah Wesolowski, the chief advocacy officer for the National Alliance on Mental Illness. She added that before the launch of 988, there were likely many people seeking mental health support but didn’t feel like there was a call service available for them. “With the National Suicide Prevention Lifeline, even though they did answer a range of crises, it was billed as the ‘National Suicide Prevention Lifeline.’ So a lot of people who are not feeling suicidal but were in distress didn’t feel like that was a resource for them,” Wesolowski said. “I think awareness of 988 continues to grow each month,” she said. “This country is in a mental health crisis at large. I believe that many more people are feeling that they’re approaching a crisis situation or are in crisis.” The 988 lifeline also has been testing a pilot program specifically for the LGBTQ+ community, in partnership with the Trevor Project, in which calls, texts or chats from LGBTQ+ youth have the option of being connected with counselors specially trained in LGBTQ-inclusive crisis care services. The pilot program began around the end of September, and “there has been a lot of demand and a lot of utilization of that service,” Palmieri said. He added that LGBTQ+ youth are at a higher risk of suicide. “With that pilot program, it is so important that particularly a young person who’s feeling alone, who’s feeling isolated, is able to connect to somebody that they feel can share their experience and that comes from a similar place of understanding,” Wesolowski said. “I’m very anxious to see what the data shows when the pilot ends in March, but I feel very encouraged by my conversations with the Trevor Project and others involved in this.” Since its launch, the 988 lifeline also has increased the number of call centers taking Spanish calls from a total of three to seven. Spanish language options will increase for text and chat messaging as well, Palmieri said. “We are also implementing video phone capabilities for people who are deaf and hard of hearing,” he said.”In addition to that, in Washington state, there’s a pilot currently providing specialized care access for individuals who are American Indian/Alaskan Natives to be able to be connected to an organization that’s focused more specifically on their needs.” HHS announced in December that through SAMHSA, more than $130 million has been awarded in grants to support the 988 Suicide and Crisis Lifeline. The funding comes from the Bipartisan Safer Communities Act. The federal spending omnibus bill includes about $500 million for the 988 Suicide & Crisis Lifeline, according to SAMHSA. In total, the Biden administration has invested nearly $1 billion in the 988 lifeline. “Our country is facing unprecedented mental health and substance use crises among people of all ages and backgrounds,” HHS Secretary Xavier Becerra said in the announcement last month. “Although rates of depression and anxiety were rising before the pandemic, the grief, trauma, and physical and social isolation that many people experienced during the pandemic exacerbated these issues. Drug overdose deaths have also reached a historic high, devastating individuals, families, and communities,” he said. “The significant additional funding provided by the Bipartisan Safer Communities Act will have a direct positive impact on strengthening the behavioral health of individuals and communities across the country.” The 988 lifeline is just one tool in the ongoing effort to improve our nation’s mental health, which Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, calls “a key concern of public health” right now. “It is also one of the root causes of substance abuse and misuse, which is fueling the national epidemic that we have. We’re also concerned about, of course, rates of suicide and what we can do to alleviate and lower those rates,” Freeman said. “This is very much also a primary public health crisis of concern and leads to many other public health issues that need to be addressed: homelessness, food insecurity, substance misuse, and poor health outcomes,” she said. “We need to get people healthy and well, and connected to the right resources and professionals that can help them overcome their mental health crises.” | Mental Health Treatments |
Even after mask mandates were dropped across the country amid dwindling COVID-19 cases and deaths, face coverings have still been required in many doctors’ offices, hospitals and other health care settings.
Now, a group of esteemed medical experts is calling for a change.
In an April 18 journal entry in the Annals of Internal Medicine, an academic medical journal, several physicians — including infectious disease specialists — wrote that it’s time to remove masking requirements in health care facilities.
"While critically important in the earlier phases of the pandemic, we’ve entered a more stable phase, with substantial population-level immunity, durable protection against severe disease, a series of less virulent variants, and other important and favorable changes," said corresponding author Erica S. Shenoy, M.D., PhD, in a press release.
She is the medical director of infection control for Mass General Brigham and an infectious diseases physician at Massachusetts General Hospital in Boston.
"As conditions change, we need to re-evaluate our infection prevention policies, including masking requirements in health care settings, and adapt," she added.
Other contributing physicians came from Harvard Medical School, Washington University School of Medicine, University of Iowa College of Medicine, Dartmouth Hitchcock Medical Center, Tufts University School of Medicine and Trinity Health Michigan.
"Masking requirements in health care have continued longer than in the community because these settings have a higher proportion of individuals at high risk for complications of infection," the authors wrote in the journal entry.
"However, the context and conditions of the pandemic have changed dramatically and favorably since masking requirements in health care were initially adopted, and evidence-based public health policy should also adapt in response."
‘Makes complete sense’
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical and a Fox News contributor, agreed with the decision.
"It makes complete sense to remove the universal mask requirements for medical centers — and NYU did it weeks ago," he told Fox News Digital. "It hasn't made sense for a while."
"We should adapt mask policies to reflect this new reality."
Dr. Shana Johnson, a physical medicine and rehabilitation physician in Scottsdale, Arizona, reviewed the doctors’ recommendations.
"As we transition to the place where SARS-CoV-2 is a constant and stable presence in our community, we should adapt mask policies to reflect this new reality," she told Fox News Digital.
Weighing costs, benefits
In the journal entry, the authors pointed out that masking in health care settings was appropriate early in the pandemic as a means of limiting spread among medical personnel, patients and visitors.
But as the population has achieved greater immunity and COVID has entered a "more stable phase" — and as public health agencies and the U.S. government have declared that the public health emergency is over — the physicians stated in the findings that the small benefits of continuing to require masks don’t justify the costs.
"Masks do have downsides, such as impaired communication and disrupted human connection."
"After three years of universal masking in health care, the risk-benefit calculation has shifted," said Shira Doron, M.D., chief infection control officer for Tufts Medicine health system and hospital epidemiologist at Tufts Medical Center, in the press release announcing the paper.
"Masks do have downsides, such as impaired communication and disrupted human connection. We are at a stage of the pandemic where it now makes sense to end mandatory masking," she added.
Among the drawbacks of masks, the study authors cited an "increased cognitive load" for doctors who are trying to listen to patients wearing face coverings.
This is particularly difficult for patients who do not speak fluent English or who are hard of hearing, they added.
"Masks obscure facial expression; contribute to feelings of isolation; and negatively impact human connection, trust and perception of empathy," the authors wrote.
"Masking is not without its downsides," Dr. Johnson said. "Masks make it more difficult to hear, understand and communicate with your provider. Some choice makes sense."
‘Standard precautions’ should be used
In lieu of universal masking, the study authors suggested that health care settings should follow "Standard Precautions and Transmission-Based Precautions," as outlined by the Centers for Disease Control and Prevention (CDC).
Health care personnel should wear masks to prevent exposure as needed, according to those guidelines.
Also, any people with respiratory symptoms (namely, coughing or sneezing) should use a face covering.
Additionally, if a medical worker is "caring for patients with suspected or confirmed respiratory infection, they should use personal protective equipment and other interventions."
Rather than having universal masking requirements, Dr. Siegel believes the decision should be "based on individual risk."
"Universal masking in health care is a policy whose time has come and gone ... for now."
"It should be reserved for patients who are immunocompromised or severely or chronically ill or the doctors that care for them," he told Fox News Digital. "Patients who are acutely ill and those with chronic lung problems should continue to wear masks."
The doctor said he continues to wear a KN95 or N95 mask in the room with most patients, especially those with respiratory symptoms.
"Certain health care settings with high-risk patients could still choose to use universal masking, but it would not be required in other areas of normal risk," added Dr. Johnson.
Reconsidering other early-pandemic precautions
Along with dropping mask requirements in health care settings, the physicians wrote that other protocols should be reconsidered.
"Moving away from universal masking policies should be accompanied by reconsideration of other pandemic-era strategies (for example, asymptomatic testing, resource-intensive contact tracing), which similarly have experienced a shift in their risk-benefit balance over the course of the pandemic," they stated in the discussion.
Potential for masking to return
The latest commentary doesn’t mean that masking policies won’t return sometime in the future, the physicians noted.
"Future pandemics or significant localized outbreaks may justify more widespread or targeted masking policies, respectively, as part of a bundled response," they wrote, noting that it’s important to educate health care personnel and patients as policies change.
"Change and adaptation are expected," said senior author Dr. Westyn Branch-Elliman, an infectious diseases specialist and clinical investigator at VA Boston Healthcare System.
"That does not mean 'the science has changed,' but almost everything around it has."
The doctors called for "focused research" to "ensure requirements are not maintained longer than necessary and are reinstated when needed."
Additionally, the authors noted that the Healthcare Infection Control Practices Advisory Committee (HICPAC) at the Centers for Disease Control and Prevention (CDC) "is currently reevaluating existing approaches to Transmission-Based Precautions, which is likely to inform future considerations for health care transmission mitigation strategies."
"The time has come to de-implement policies that are not appropriate for an endemic pathogen when the expected benefits of such policies are low," they concluded.
"Universal masking in health care is a policy whose time has come and gone ... for now."
COVID cases and deaths continue to decline.
As of April 19, the CDC reported 94,142 weekly deaths in the U.S., down from a peak of 5.5 million in January 2022.
Weekly deaths from COVID were down to 1,160; the highest count was 23,629 in January 2021.
The World Health Organization released updated masking guidelines in January 2023.
Despite the decreasing COVID numbers, the agency stated that "masks are recommended following a recent exposure to COVID-19, when someone has or suspects they have COVID-19, when someone is at high risk of severe COVID-19, and for anyone in a crowded, enclosed or poorly ventilated space." | Epidemics & Outbreaks |
Fears of a potentially devastating bird flu pandemic were heightened today after a 'worrisome' outbreak among mink.Top virologists from across the world have sounded the alarm after tests confirmed the H5N1 strain was spreading between mammals.It raises the prospect that the pathogen could acquire troublesome mutations that allow it to spread much easier between humans, helping it clear the biggest hurdle that has stopped it from sweeping the world.One virus-tracking scientist described the H5N1 strain, detected in Spain, as being similar to one purposely engineered to better infect humans in controversial 'gain of function' lab experiments. Top virologists from across the world have sounded the alarm after tests confirmed the H5N1 strain was spreading between mink (pictured). The outbreak occurred in a farm in Galicia, north west Spain, in October which housed 52,000 of the animals Alan Gosling (pictured), a retired engineer in Devon, caught the virus after his ducks, some of which lived inside his home, became infected. No one else caught the virus Bird flu outbreak: Everything you need to know What is it? Avian flu is an infectious type of influenza that spreads among birds.In rare cases, it can be transmitted to humans through close contact with a dead or alive infected bird.This includes touching infected birds, their droppings or bedding. People can also catch bird flu if they kill or prepare infected poultry for eating. Wild birds are carriers, especially through migration.As they cluster together to breed, the virus spreads rapidly and is then carried to other parts of the globe.New strains tend to appear first in Asia, from where more than 60 species of shore birds, waders and waterfowl head off to Alaska to breed and mix with migratory birds from the US. Others go west and infect European species.What strain is currently spreading? H5N1.So far the new virus has been detected in some 80million birds and poultry globally since September 2021 — double the previous record the year before.Not only is the virus spreading at speed, it is also killing at an unprecedented level, leading some experts to say this is the deadliest variant so far.Millions of chickens and turkeys in the UK have been culled or put into lockdown, affecting the availability of Christmas turkey and free-range eggs.Can it infect people? Yes, but only 860 human cases have been reported to the World Health Organization since 2003.The risk to people has been deemed 'low'.But people are strongly urged not to touch sick or dead birds because the virus is lethal, killing 56 per cent of people it does manage to infect. Professor Rupert Beale, an immunology expert at the world-renowned Francis Crick Institute in London, said: 'We should have vaccine contingency plans already.' And Professor Isabella Eckerle, a virologist at the University of Geneva's Centre for Emerging Viral Diseases, called the findings 'really worrisome'.Other experts warned that outbreaks among mink could lead to a recombination event — when two viruses switch genetic material to make a new hybrid.A similar process is thought to have caused the global 2009 swine flu crisis that infected millions across the planet.The same biological phenomenon was also seen during the Covid pandemic, such as so-called Deltacron — a recombination of Delta and Omicron, first detected in France last February.For decades, scientists have warned that bird flu is the most likely contender for triggering the next pandemic.Experts say this is because of the threat of recombination — with high levels of human flu strains raising the risk of a human becoming co-infected with avian flu as well.This could see a deadly strain of bird flu merge with a transmissible seasonal flu.The mink outbreak occurred in a farm in Galicia, north west Spain, in October which housed 52,000 of the animals. It was only spotted after a sudden surge in the animals dying. Up to four per cent died in one week during the course of the outbreak, which was declared over by mid-November.Farm vets swabbed the minks and the samples were analysed at a Government lab, where they tested positive for H5N1.It led to all of the animals being culled, farm workers isolating for 10 days and heightened security measures in farms across the country. These included wearing face masks and disposable overalls and showering before leaving the premises. Analysis of samples taken, which were published yesterday in the infectious disease journal Eurosurveillance, show the virus had gained nearly a dozen mutations — most of which had never or rarely been seen before in bird flu strains.One was previously seen on the virus behind the 2009 global swine flu pandemic. Scientists probing the samples believe it was triggered by a H5N1 outbreak among seabirds in a nearby province. The UK has logged a record number of bird flu cases last winter. Levels usually fall in the spring and summer, but the outbreak rumbled on past its usual end point. Nearly 300 confirmed cases of H5N1 have been detected among birds in England since the current outbreak began in October 2021. However, the true toll is thought to be much higherThe report, from experts at Spain's Ministry of Agriculture, Fisheries and Food, along with some from the Counsel of Rural Affairs, states that this is the first time H5N1 has spread among mink in Europe. They warned minks could act as a 'potential mixing vessel' for H5N1 transmission among birds, mammals and humans — such as by recombining the strain with human flu viruses, which can infect people.Increased biosecurity measures at mink farms and increased surveillance are needed to limit any risk of transmission to people, the report warned.Professor Francois Balloux, an infectious disease expert based at University College London, said: 'The sequenced genomes carry several rare or previously unreported mutations, likely acquired after mink-to-mink transmission.'Avian flu AH5N1 can infect a range of carnivores and also sometimes humans. Small clusters in humans have been reported but human-to-human transmission remains ineffective.'Such outbreaks of avian flu in mink farms are highly suboptimal as they create natural "passaging experiments" in a mammalian host, which could lead the virus to evolve higher transmissibility in mammals.'Dr Jeremy Ratcliff, a senior scientist at Johns Hopkins University Applied Physics Laboratory in Maryland, said there is no need to panic over the outbreak because it ended two months ago.'However, that H5N1 can successfully adapt to mammal-mammal transmission is worrisome in general,' he added.Other virologists online warned that the mutated version of H5N1 was similar to one made in a lab to better infect mammals. They pointed to one controversial experiment, by Dutch scientist Ron Fouchier, which involved tweaking H5N1 so it could better infect ferrets. The results sparked controversy among the scientific community and security agencies over concerns they could be used to create a bioweapon.Findings showed a version that could infect mammals can be achieved with just a few tweaks to the virus. The US National Science Advisory Board for Biosecurity asked for some parts of the findings not to be published — but eventually permitted the findings to be published in the journals Nature and Science. Advocates of these so-called 'gain of function' tests claim they can help pandemic preparedness by revealing how viruses can mutate, allowing scientists to develop drugs and vaccines that work against them. But critics argue the experiments could trigger an outbreak if the virus accidentally leaked from a lab, which is how some scientists believe the Covid pandemic started.The UK has logged a record number of bird flu cases last winter. Levels usually fall in the spring and summer, but the outbreak rumbled on past its usual end point.Nearly 300 confirmed cases of H5N1 have been detected among birds in England since the current outbreak began in October 2021. However, the true toll is thought to be much higher.One year ago, the UK's logged its first case of H5N1 in a person. Alan Gosling, a retired engineer in Devon, caught the virus after his ducks, some of which lived inside his home, became infected. No one else caught the virus.The virus struggles to latch onto human cells, unlike seasonal flu, scientists say. As a result, it is usually unable to penetrate them and cause and infection. | Epidemics & Outbreaks |
Pediatrician explains when children with RSV need to be taken to the hospital 01:48 - Source: CNN CNN — When Covid-19 patients younger than 5 also test positive for another respiratory virus, they tend to become sicker and develop more severe disease, a new study suggests. Among hospitalized children younger than 5, testing positive for both Covid-19 and another respiratory virus at the same time is associated with about twice the odds of severe respiratory illness than those who tested negative for other viruses, according to the study published Wednesday in the journal Pediatrics. The study comes amid a harsh season of respiratory viruses, including RSV, flu, Covid-19 and other viruses that overwhelmed children’s hospitals. The findings demonstrate the impact respiratory viruses have on pediatric hospitals and how “continued surveillance” of circulating Covid-19 and other illnesses can help predict future surges in hospitalizations, wrote the researchers, from the US Centers for Disease Control and Prevention and various universities and health departments across the United States. Caring for young children with overlapping respiratory illnesses was something Jenevieve Silva has experienced firsthand throughout the Covid-19 pandemic. “The height of the illnesses was from September through mid-November, when our household just could not catch a break,” she said. The mother of eight, based in San Jose, California, said that her toddler-age twin boys “have been battered by viruses” since they started preschool in May 2021. Last October, Silva’s twins tested positive for Covid-19 and then developed what their pediatrician suspected was another respiratory viral infection, possibly respiratory syncytial virus or RSV, around the same time. “Based on what the pediatrician told us, she said ‘I highly believe that they had these overlapping viruses,’” Silva said, adding that the boys’ symptoms included shortness of breath, cough, fatigue, and fever, with one twin having a 105-degree fever for four days straight. Warm baths and massaging Vicks VapoRub onto their backs and chest helped ease their pain, but watching her boys battle these respiratory illnesses was “brutal,” Silva said. “They had just looked so frail – they looked sick, like something deeper than just back-to-back viruses,” she said. “It was hell. I mean, it was really bad.” The boys have recovered and are currently “doing great” and have gained healthy weight, Silva said, but she worries that they developed asthma following their illnesses. Ever since October, when they had the overlapping viruses, “the doctor has now said it seems like that might have triggered asthma in them. And so now, ever since then, when they get a cold, they have asthma symptoms – violent episodes of coughing, sometimes throwing up,” Silva said. “I can’t be the only mom dealing with virus after virus,” she said, adding that for other parents out there, she has a message of hope: “Be patient. Listen to your doctor.” The new study included data on 4,372 children who were hospitalized with Covid-19. Among those who were tested for other respiratory viruses, 21% had a codetection, meaning another respiratory virus was also detected in their test results. The data came from the US Centers for Disease Control and Prevention’s Covid-19 hospitalization surveillance network called COVID-NET, with data from across 14 states. The researchers noted that they focused on codetection, not coinfection, since testing wouldn’t necessarily show that a child was actively infected with both viruses just because they test positive. Overall, “this study found that respiratory virus codetections were rare in the first year of the pandemic, RSV and rhinovirus or enterovirus codetections increased during the Delta-predominant period and influenza codetections were infrequent throughout the first 2 years of the pandemic,” the researchers wrote in their study. The data also showed that children with codetections were more likely to be younger than 5, receive increased oxygen support, and be admitted to the intensive care unit. No significant associations were seen among children 5 and older. Specifically for children younger than 2, testing positive for respiratory syncytial virus or RSV while having Covid-19 was significantly associated with severe illness. More research is needed on the precise impact that two respiratory viruses can simultaneously have on the body, said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases, who was not involved in the new study. “But we do think that being attacked by two viruses, particularly if you are less than five years of age, it’s been clearly demonstrated by this study, it does tend to make your illness more severe, more likely to be prolonged in the hospital, more likely to be in the pediatric intensive care unit,” Schaffner said. “And so clearly, having your lungs and your throat and your body – generally your immune system – attacked by two viruses simultaneously, understandably might make some young children more severely ill.” Dr. Asuncion Mejias, associate professor of pediatric infectious diseases at Nationwide Children’s Hospital, said hospitalized children she has treated for Covid-19 and codetections of other respiratory viruses often require increased oxygen support and treatment in the intensive care unit. “Covid is a very proinflammatory virus, so it really weakens your immune response,” said Mejias. “And when you haven’t recovered yet, and you get a second hit, in this case, RSV or rhinovirus, you develop a more severe disease.” Overall, Schaffner said that these new study findings are more reason why it remains important to make sure children are up to date on their Covid-19 vaccinations as well as vaccinated against the flu. Mejias agreed, emphasizing the importance of safe practices to prevent the spread of viruses to children too young to be vaccinated. “The pandemic taught us how contagious these viruses are,” Mejias said about respiratory pathogens. “If somebody is sick, try to avoid contact,” she said. “These viruses are not only transmitted by saliva and secretions but by hands. It can survive in your hands for more than 30 minutes. So if you touch your mouth and then touch a little baby, the baby can self inoculate the virus and become infected. So washing hands and all these measures are very important.” | Epidemics & Outbreaks |
We've had three years of an unprecedented pandemic, stagnated wages and the highest inflation we’ve seen in four decades, leading to a catastrophic cost of living crisis.
But on International Women’s Day, which highlights the achievements and value of women all over the world, we speak to just a handful of brilliant women who help keep Britain running in largely female-led industries.
Carmel O'Boyle
Carmel O’Boyle, 42, is a nurse practitioner living in Merseyside.
“It’s been a really, really busy winter. We open the clinic at 8am and there’s usually a queue at the door before you get your coat off.
"Throughout the day we’re triaging people to make sure they’re safe. But we’re always trying to catch up.
"This is one of the worst winters I’ve ever seen, certainly in my 20-odd years of working in the NHS, and my colleagues across all the different sectors of the NHS have really struggled.
"There’s more patients and not enough staff to deal with them. We’ve got an ageing, diverse population and we just don’t have the healthcare professionals to keep up with that demand.
"I’ve been a nurse for the last six years and before that I was working as a healthcare assistant.
"I was adamant I wouldn’t do my nurse training - the pay to responsibility ratio was too great - but a very wise lady said to me, ‘If your house was on fire, you wouldn’t stand in the garden with an empty bucket. So put your big girl pants on and go and get involved.’
"I still have quite vivid nightmares about things at the beginning of the pandemic, which I’m not sure will ever go away. I think there’s a certain amount of PTSD for everybody who has done this kind of work, and I don’t think any of us will ever be the same again.
"When I see queues of people outside my clinic, I feel panic.
"Some people are coming to get their dressings changed, but others might be really unwell, but they can’t be seen in other places because of overwhelming demand.
"I had a patient the other day who needed an ambulance and then you have to explain to everyone else waiting that someone else needs to be seen as a priority.
"It is difficult at the moment, and I can understand why younger people might be put off going into nursing. But I will say it’s an honour and a privilege doing this job.
"There’s a nurse there for you every moment in your life, from birth until the very end, and all those bits in between where you need somebody, there will always be a nurse."
Louise Atkinson
Louise Atkinson, 42, a primary school teacher in Carlisle, is taking a year’s secondment to work as president of the National Education Union (NEU), which has been taking industrial action.
“I always knew I wanted to be a teacher, but I took a different route. I had quite a disruptive home life and ended up leaving school at 16 with a handful of GCSEs, and went into various jobs to make ends meet.
"I had my children in my early twenties, and that’s when I decided to take a course as a teaching assistant through the Workers’ Educational Association, which provided a creche for the kids.
"After working as a TA I studied part-time with the Open University, got my degree then did a PGCE so I could work as a teacher, and qualified in 2014.
"In recent years the workload intensity has increased, there’s more expected from you and that’s all down to the lack of funding across the board.
"Crucially, the support networks like special advisory teachers, educational psychologists, adolescent mental health services, social services - all of those are really stretched, which impacts what we’re doing in the classroom.
"Now with the cost of living, many, many more children are living in poverty, and the impact of all that makes it very difficult within schools. I know of teachers who are providing food and extra supplies from their own pocket to children in need.
"It’s heartbreaking when you’re going to work every single day, giving it your all to make the difference for those children in front of you.
"But as one person, there’s only so far you can stretch yourself. And it is very, very emotionally difficult knowing that there’s children missing out, no matter how hard you work and what you do.
"One of my proudest moments was as a TA, giving intervention for one child over six to eight months, and seeing what a huge positive difference it made to that child’s future.
"But I look at other children who no longer receive that support, it’s such a false economy, because their issues only become more profound as they progress through school.”
Maariyah Razaq
Maariyah Razaq, 32, is a Patient Assessor for Sobell House Hospice, which provides at-home end-of-life care for patients in Oxfordshire
“My job is very rewarding, but it can be morbid. I work with a team providing palliative and end-of-life care for patients who want to die at home, so death is always on my mind.
"The greatest reward is being there for family members, so they can take a step back from being an unpaid carer and be there instead as a daughter, as a husband, as a family member.
"It takes the pressure off them and allows the patient to be in control in their own environment, because hospital isn’t always the best place for somebody in their final days.
"Predominantly I work with the elderly, but in the last six months the demographic has changed - we’ve recently had a 27-year-old and a 33-year-old, we’re getting more people in their forties and fifties now who have kids, and I find that’s the hardest to get to grips with.
"Sometimes my patients have only just received a terminal diagnosis and they’re trying to process that, and already they’re at the end-of-life stage.
"It means it can literally happen to any of us at any time, so that means you do take the job home with you.
"My mum is only 52 but I nag her about power of attorney, wills and whether she wants a Do Not Resuscitate order.
"We have to be prepared about these things! Unfortunately - or fortunately, however you look at it - I experienced grief when I was 11, when I lost someone very close to me, so I can completely empathise with the families of my patients.
"Everybody wants a good death. We want to feel in control of our environment, we want the ones we love around us. Being able to do this job means patients can choose their favourite duvet to snuggle in, they can have music in the background and they can choose who they see in their final minutes.
"One patient sticks in my mind as she had an ornament near her bed, and I asked her family why. They said it had always brought her joy, so they’d put it next to her to look at and it made her smile. It means a lot that I can help provide that level of comfort to someone at the end of their life."
Karina Warner
Karina Warner, 55, works as a team leader with Upward Care, which provides care for people in their homes in Wolverhampton.
"I left school at 16 to work in care, and I’ve been doing this for 39 years now. I started out as a carer and worked my way up to manager level in various places.
"When the pandemic hit in 2020 I was working in supported living accommodation, and that was really difficult.
"I got away lightly - I only caught Covid once - but talking to my staff, a lot of us worked horrendously long hours to enable our service users and residents to have the care that they needed.
"For quite some time, our accommodation was locked down and the residents weren’t allowed to see their families. It was horrendous.
"We could rarely get a doctor out, unless they were there to give out vaccines. We had to keep a lid on our own fears and keep it light for the residents.
"You couldn’t cry about it, you just had to get on with it. And because they couldn’t see their loved ones, we used to take them out of their rooms to the corridor for socially distanced painting and quizzes to keep their brains stimulated.
"Now I work for Upward Care in people’s own homes, and the highlight of my day is going in in the morning and seeing a smiley face. It brings me joy to tell them what we’re going to be doing today, to take them on holiday.
"The government doesn’t recognise what we carers do. They seem to be in denial that many of us will need carers ourselves when we get older.
"Being there at the end of someone’s life is a privilege. Them knowing you’re there, you telling them, ‘don’t worry, you’re not going to die alone, we’re going to be with you.’
"And even though it’s tough, there’s a reason I’ve been doing this for 39 years - I’m passionate about my work."
Pertunia Griffith
Pertunia Griffith, 47, has been a Health Care Assistant at Marie Curie’s West Midlands Hospice in Solihull since 2010.
"If you haven’t been to a hospice, you might not know the vital difference we make to people’s lives. I see it every day.
"We make sure no one dies alone, even if they have no family or relatives live far away and can’t be there.
"Ensuring a patient is not in pain, holding their hands and talking kindly to them in their last moments is the very least we can do.
"When a patient’s loved ones are close, they can be very distressed after their last goodbyes. We look after them too. It’s amazing the difference a cup of tea or a comforting chat makes.
"Having time for people is essential but far too often overlooked. We want to take all their worries away.
"When a new life enters this world new mums and their babies naturally get lots of support. We believe exactly the same should happen when a life nears its end. Final moments are always remembered.
"My job is emotionally tough sometimes, especially when someone is young and leaves small children. Marie Curie nursing teams are experts in their field and we look after patients as well as each other.
"We have special attributes of kindness, empathy and understanding and know when a patient is close to death. We know when a family needs extra support.
"That’s why, even though there are easier roles out there, we know we’re in the right job.
"Perhaps no one likes to think about dying too much. But working in your community, in hospices and people’s homes up across Britain, nursing teams like ours are quietly working hard to make sure people have the best end of life care possible.
"I feel glad and privileged to do my job." | Global Health |
Nov. 28, 2023 -- The "sunscreen paradox" has confounded doctors of late: As more and more people use sunscreen, rates of melanoma and other skin cancers are going up.Â
The statistics on all types of skin cancer are sobering:
- Invasive melanoma cases diagnosed annually increased 27% over the past 10 years.Â
- The rate of basal cell carcinoma (BCC) has risen in all age groups in the country at a rate of nearly 10% each year, according to the National Library of Medicine.
- Yale Medicine reports that squamous cell carcinoma (SCC)Â has risen to nearly 1 million diagnosed cases in the U.S. per year.Â
- Even cases of Merkel cell carcinoma, the rare, aggressive skin cancer that cause the recent death of singer Jimmy Buffet, is projected to jump to over 3,200 cases per year over the next 2 years.Â
Why is this happening? A new study from McGill University in Montreal might have solved some of the mystery: Many people may think sunscreen gives them free rein to tan or stay out in the sun as long as they want to.Â
"Patients have told me that they think it is safe to tan if they are wearing sunscreen,â said James Ralston, MD,  president of the Dermatology Center of McKinney in McKinney, TX. âThe reality is that there is no safe way to tan. Every time you tan, you damage your skin. As this damage builds, you speed up the aging of your skin and increase your risk for all types of skin cancer.â
Whatâs more, you may unknowingly increase your skin cancer risk by doing other things. The reality is that knowledge can prevent many cases of the disease. âSkin cancer is one of the most common and also one of the most preventable cancers in the United States,â said Shanthi Sivendran MD,  senior vice president of cancer care support at the American Cancer Society.Â
What Are the Symptoms of Skin Cancer?Â
According to MD Anderson Cancer Center, signs of the disease include:Â
- A spot that newly appears on your skinÂ
- A preexisting spot that changes color, shape, or size
- An itchy or painful spot
- A sore that doesnât heal or gets crusty
- A shiny bump that looks red or is the color of your skin
- A rough, scaly section of skinÂ
- A lesion that has a raised border, is crusty in the center, or bleeds
- A growth that looks like a wartÂ
- A growth that looks like a scar and has an undefined borderÂ
Who Is at Risk for Skin Cancer?
âMelanoma can strike anyone,â Ralston said.Â
A person with more than 50 moles, large moles, or atypical moles has an increased risk, he said. Also, youâre at higher risk if you have a blood relative who has had melanoma, have a tendency to sunburn easily, have red or blond hair, or blue or green eyes, or have a history of excessive sun exposure or indoor tanning. Youâre also at higher risk if you have a previous skin cancer diagnosis or a history of other cancers such as breast or thyroid cancer, Ralston said.
When it comes to other types of skin cancer, "people who have been diagnosed with either basal cell carcinoma or squamous cell carcinoma have an increased risk of developing future skin cancers, including melanoma,â he said.Â
Letâs examine five other ways you may be increasing your skin cancer risk without realizing it â and how to take the right steps to prevent it.Â
Youâre Not Using Enough SunscreenÂ
âPeople rarely use as much sunscreen as they should,â says Vivian Bucay, MD, a dermatologist practicing in San Antonio, TX, and a spokesperson for the Skin Cancer Foundation. âTo achieve the SPF value, you should apply 2 tablespoons -- equivalent to about a shot glass full -- of sunscreen to your entire body, and a nickel-sized dollop to your face,â she said.Â
Cover often-missed spots like your eye area, the tops of and behind your ears, your hands, and the back of your neck. Donât forget about your lips, either.Â
âI tell patients to carry a lip product with SPF so they can reapply after eating,â Bucay said. âReapply every 2 hours, or immediately after swimming, sweating, or toweling off.â
Youâre Not Using Sunscreen Year-RoundÂ
Many people only wear sunscreen during warm weather. âIâve heard patients say they didnât put on sunscreen because it was a cloudy or snowy day,â says Ralston. âSome ultraviolet light passes through clouds, and clouds reduce warmth. Without that warning sensation of warmth, people are at increased risk of overexposure to UV light, especially UVA, which is relatively unaffected by cloud cover.âÂ
If you enjoy winter sports, youâre also at risk. âSnow reflects 80% of the sunâs rays, so it makes it easy to get a sunburn,â Ralston explains.
You Donât Wear Sunscreen IndoorsÂ
âThere are unexpected ways in which one may get sun exposure without realizing it,â Sivendran said. âFor example, the sunâs rays penetrate through windows, so sitting near a window for a prolonged period can increase skin cancer risk. It is important to wear sunscreen indoors to reduce this.âÂ
If you're inside a car or traveling in a window seat by plane, bus, or train, this rule also applies.
"Standard window glass blocks the transmission of UVB but not UVA," Ralston said. "Car windows block some UVA, especially if the windows are tinted. However, even short trips in the car add up over years and cause significant sun damage."
You're a ManÂ
A second new McGill University study found that men are more likely to doubt the usefulness of sunscreen and less likely to have new moles checked than women.Â
Men are also more likely to be exposed to UV rays through outdoor recreation and work. Outdoor employment is a significant factor:Â New research from the World Health Organization found that people who work in the sun represented 1 in 3 deaths from nonmelanoma skin cancers. The bottom line is men need to be just as diligent when it comes to sun protection on a daily basis.
You Don't Know Your Family History
It's important to ask about your relatives' medical history of skin cancer, as this information can help protect you and other members of your family. The National Cancer Institute reports that 5% to 10% of all melanomas occur in families with multiple members who have had a skin cancer diagnosis. This means a melanoma risk can be inherited, and the the Melanoma Research Alliance has identified specific inherited gene mutations that can increase your risk.Â
The American Academy of Dermatology says you may benefit from genetic testing for melanoma if:Â
- You've had three or more melanomas that spread or grew deep into your skin, especially before you turned 45. Â
- If three or more blood relatives on one side of your family have had melanoma or cancer of the pancreas.Â
- If you've had two or more atypical moles called Spitz nevi.Â
- If you've had one or more Spitz nevi and one of your close blood relatives has had mesothelioma, meningioma, or an eye melanoma.
How Can You Best Prevent Skin Cancer Every Day?Â
"Avoiding the sun's harmful rays at peak strength hours â between 10 a.m. and 2 p.m. â and seeking shade can reduce your risk," Sivendran said. "Use a broad-spectrum, water-resistant sunscreen with an SPF of at least 30. There is also stylish, lightweight, sun-protective clothing you can wear year-round."Â Â
Make these moves a habit, and you'll easily stay sun-safe. | Disease Research |
Bacteria that feast on mucus in the human gut may prove useful in controlling cholesterol levels, a new study conducted in mice and lab dishes suggests.
Akkermansia muciniphila is a bacterium that lives in humans, and primarily in mouse studies, the microbe has been linked to protection from metabolic diseases, neurological disorders and certain infections. As its name suggests, A. muciniphila mostly consumes mucins — large, sugar-rich proteins that form the bulk of the mucus that covers the lining of the intestines.
Because mucins are typically hard for microbes to digest, scientists were interested in investigating what enables A. muciniphila to colonize the human gut and thrive on the proteins.
In their new study, published June 19 in the journal Nature Microbiology, the team first cultured A. muciniphila on mucin collected from pigs and observed the bacteria growing under a microscope. They saw that the bacteria were hoarding mucins in compartments within their cells, which the scientists named mucinosomes. Interestingly, these compartments seem to be specific to Akkermansia species, as they aren't observed in Bacteroides thetaiotaomicron, another mucin-loving microbe.
The scientists then created mutant A. muciniphila strains using "transposon mutagenesis," a process that introduced genetic mutations in the microbes' DNA, and grew these mutants in mucin. Some mutants weren't able to produce amino acids, the building blocks of proteins, and these strains failed to multiply on the mucin, indicating that the production of amino acids is critical to the microbes' ability to benefit from mucins.
Next, the team fed mutant A. muciniphila to different genetically modified lab mice. The mutants' growth patterns in the cecum, a part of the large intestine, revealed that the bacteria that lacked the genes to produce amino acids had a really hard time proliferating, especially in the presence of other bacterial species. Genes for four specific amino acids — alanine, asparagine, glutamine and arginine — seemed especially important for A. muciniphila to successfully colonize the gastrointestinal tract.
In further mouse experiments, the researchers uncovered two groups of genes that are key for the transportation of mucin into the bacterial cells' special compartments. Dubbed mucin utilization locus (MUL) genes, they are critical for the bacteria's growth and their colonization of the gut.
The so-called MUL1 group of genes codes for proteins that transport mucin into the bacterial cells. The MUL2 gene group produces proteins that form pili — thin, hair-like appendages that protrude from the cell surface and likely also help transport mucin into the bacteria.
In "germ-free" mice bred to carry no gut bacteria, normal strains of A. muciniphila outgrew mutants with dysfunctional MUL1 or MUL2 genes when all the strains were made to commingle in the mouse gut. In addition, when grown in isolation, normal A. muciniphila suppressed the expression of mouse genes involved in cholesterol production, while the same cholesterol-making genes were jacked up in mice that carried A. muciniphila mutants with dysfunctional MUL1.
This showed that the mucin-gobbling bacteria could directly influence cholesterol production in the gut and could therefore serve as an important tool to curb high cholesterol levels, the authors concluded.
"This is an important and elegant study" that establishes a method for genetically tweaking A. muciniphila and shows how critical mucin is for the mucus-gobbling microbe's interactions with its host and with other bacteria, Willem Meindert de Vos, a professor emeritus at Wageningen University and Helsinki University who was not involved in the research, told Live Science in an email.
In a recent proof-of-concept study, de Vos and colleagues tried giving A. muciniphila as a supplement to human volunteers with insulin resistance and found that the volunteers' sensitivity to insulin improved and their cholesterol levels fell over time. However, that trial was very small, and more data on A. muciniphila supplementation in humans is still needed.
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Soumya Sagar holds a degree in medicine and used to do research in neurosurgery at the University of California, San Francisco. His work has appeared in New Scientist, Science, Discover, and Mental Floss. He is a passionate science writer and a voracious consumer of knowledge, especially trivia. He enjoys writing about medicine, animals, archaeology, climate change, and history. Animals have a special place in his heart. He also loves quizzing, visiting historical sites, reading Victorian literature and watching noir movies. | Disease Research |
World June 15, 2022 / 1:45 PM / CBS News WHO studying monkeypox transmission WHO studying monkeypox transmission 01:36 London — The World Health Organization has scheduled an emergency meeting for next week on the monkeypox outbreak to determine if the virus should be classed as a threat to international health. The agency is also investigating exactly how the disease is spreading.CBS News' Tina Kraus reports the United Nations health agency is now exploring the possibility that monkeypox could be sexually transmitted, after the virus was found in body fluids of patients in Italy and Germany. Catherine Smallwood, the WHO incident manager for monkeypox in Europe, said that among the identified cases on the continent, some "had semen tested for [the] virus and came back positive, so that's something that we're looking at." The agency has already said the disease — which has infected more than 1,600 people in 35 countries, including the U.S. — is transmitted through close physical contact. Officials urge public to remain calm as more monkeypox cases are investigated in the U.S. 02:15 In the U.K., a survey of 152 monkeypox patients found that 99% identified as men who have sex with men, according to Britain's Health Security Agency. Across Europe, most infections have been among gay and bisexual men, but James McFadzean, who contracted monkeypox, said it was important not to stigmatize certain communities. "I think we need to be careful how we label it. It's not, you know, a 'gay disease,'" he said. "It's a tropical, strange disease."The WHO is already working with experts to come up with a new name for the virus and the disease it causes after more than 30 international scientists complained that its current moniker is discriminatory."In the context of the current global outbreak, continued reference to, and nomenclature of this virus being African is not only inaccurate but is also discriminatory and stigmatizing," they wrote. WHO Director General Tedros Adhanom Ghebreyesus said the agency would "make announcements about the new names as soon as possible." He added that the current "global outbreak of monkeypox is clearly unusual and concerning." The global outbreak of #monkeypox is clearly unusual and concerning. I have decided to convene the Emergency Committee under the International Health Regulations on Thursday next week, to assess whether this outbreak represents a public health emergency of international concern.— Tedros Adhanom Ghebreyesus (@DrTedros) June 14, 2022 Europe remains the epicenter of the current outbreak, with around 85% of the world's infections.The disease, which was first discovered in African macaques, causes a rash that can look like chickenpox. The virus originates in wild animals like rodents, but occasionally jumps into human populations. Most people recover from the virus within weeks, but in rare cases the disease can be deadly.The U.S. Centers for Disease Control and Prevention recommends that travelers protect themselves from monkeypox by wearing masks, and the WHO has urged people who contract the virus to use condoms during sex for 12 weeks as a precaution after their recovery. U.S. officials have said the country has plenty of effective vaccines and treatments to respond to any further spread of the virus. In: Monkeypox World Health Organization European Union United Kingdom Thanks for reading CBS NEWS. Create your free account or log in for more features. Please enter email address to continue Please enter valid email address to continue | Epidemics & Outbreaks |
A 15-year-old girl whose family spent years trying to work out why she was suffering from severe pains says she now lives a normal life after doctors linked the issue to her mental health.
Jasmine was aged seven when she was injured while on a trampoline.
Initial pain in her knee spread to her legs and she started to eat less, but doctors could not determine the cause.
She was eventually diagnosed with a condition where physical symptoms occur in response to psychological distress.
Jasmine, who lives in Peterborough, had undergone various tests for three years before she was seen at a mental health centre in Cambridge, and diagnosed with somatoform disorder, or conversion disorder.
"The anxiety over not eating was linked to my pain," Jasmine says.
Jasmine had to wear a leg brace following the trampoline accident, and the pain in her leg escalated to a point where she was no longer able to attend school.
She used a wheelchair and crutches to get around.
"I was really scared," she said. "I wasn't able to go to school, play with my friends.
"I couldn't do all the typical things a young person could do. I was in and out of a wheelchair."
After years of seeing doctors, Jasmine's family said she was not getting any answers to the cause of her severe pain.
"I didn't know how long it would last and if it would affect my whole life," Jasmine said. "I just wanted to know why it was happening."
Jasmine said she was seen by "loads of doctors" at two different hospitals, "where I had CT scans, but they couldn't find what was wrong, which made me really angry".
'Convinced someone had poisoned my grapes'
The not knowing, slowly led to Jasmine refusing to eat any food.
"I was convinced someone had poisoned my grapes and then it moved to breakfast cereals like cornflakes," she said.
"I would only be eating bread and then it got to the extent where I wasn't eating bread, so I wasn't eating anything."
Shortly after, Jasmine went to The Croft Child and Family Unit, an in-patient centre for children with mental health conditions and their families.
It was there through play therapy and traditional therapy sessions that they found Jasmine's symptoms and food anxiety were linked to her physical pain, and she was diagnosed with conversion disorder.
Nancy Bostock, consultant paediatrician at The Croft, said: "We know about 75% of all mental health disorders start in childhood and adolescence, so it's super important that we understand the importance of the lifelong impact that mental health difficulties have on children.
"You can't have physical health without mental health, and you can't have mental health without physical health, they are absolutely interlinked."
Jasmine left The Croft on her 11th birthday and says she now has a normal life.
"I've been so active. I dance, I do gymnastics, I do theatre," she said.
"I love acting. It's just been really good."
It is hoped a new children's hospital in Cambridge will provide a joined up approach to mental and physical health.
She said the hospital would aim to bring together the mental and physical treatment of children.
"That hasn't been done in a complete way before," she said.
"We've reached a stage in medicine where we shouldn't be separating mind and body, we need to be working on both together." | Mental Health Treatments |
There was a time in the early 2000s when Paolo Macchiarini was a world-renowned thoracic surgeon with an enviable roster of celebrity patients. He’d pioneered a groundbreaking transplant operation involving the world’s first plastic organs, which not only made him fabulously wealthy but also brought him plaudits from top scientists and doctors. Macchiarini’s VIP patients reportedly included Pope Francis, President Obama, and Hillary Clinton, and he also worked for a time at the Karolinska Institute in Stockholm, which awards the Nobel Prize in medicine.
Macchiarini’s seemingly perfect veneer, however, obscured a chilling truth: He’d carved a path to riches and notoriety, while also leaving a trail of dead patients in his wake. Bad Surgeon: Love Under the Knife is a new three-part Netflix docuseries from director Ben Steele that probes the story of the now-disgraced doctor — and, specifically, the fight to hold him accountable for nearly all of his transplant patients dying.
Thanks to its collision of science, crime, ethics, and even love, Bad Surgeon unfolds like a riveting thriller, which has also helped make it the #1 Netflix series in the US at the moment.
According to the streamer, Macchiarini’s transplant operation involved plastic windpipes infused with stem cells. When his patients kept dying after their transplants, the doctor brushed it off as something to be expected from an experimental surgery. Skeptics eventually began taking a closer look at him, but they faced an uphill battle. Journalists, for example, at one point brought evidence against the surgeon to the Karolinska Institute, which pushed back and stuck up for the doctor.
According to a 2018 essay from Benita Alexander, Macchiarini’s former fiancee, Swedish prosecutors would later find that Paolo never performed the animal experiments required before doing experimental surgeries on human beings. “In addition,” she continues, “he not only lied about having the scientific evidence he needed to operate, he didn’t stop, even when his patients started dying. He literally used people as guinea pigs.
“I spoke to doctors and scientists who call him a “murderer,” I had heartbreaking meetings with the anguished families of his patients. No one I spoke to could fathom what drove him to lie to so many people.”
Bad Surgeon is a Netflix series about the right to bring the doctor to justice, and it includes interviews with families of his victims, as well as Alexander plus colleagues-turned-whistleblowers. Check out a trailer for the series below. | Medical Innovations |
A dermatologist in New York City has reported the country's first known cases of highly contagious ringworm infections that are resistant to common anti-fungal treatments—and caused by a newly emerging fungus that is rapidly outstripping other infectious fungi around the world.
In February, the dermatologist reported two cases to health officials in the state, which are described in a brief case study published Thursday in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
The two cases occurred a year apart and had no connection to each other. The first, from the summer of 2021, was in a 28-year-old pregnant woman who had no recent international travel history, no underlying medical conditions, and no known contact with anyone who had a similar rash. The case suggests that the fungus is quietly spreading in the community.
Ringworm—aka tineas, dermatophytosis, jock itch, and athlete's foot—is a superficial fungal infection of the skin that causes red, itchy, sometimes scaly circular rashes. There are more than 40 different species of fungi that can cause the infection, which spreads from infected people and animals and also lurks in environments and on common household items, like towels. Ringworm is extremely common and can strike anyone. Usually, it's treatable with over-the-counter creams.
But, in the 28-year-old's case, her 2021 infection was only finally cured in early 2022, after the birth of her baby, after first-line treatment failed and she underwent a four-week course of an oral anti-fungal medicine, itraconazole.
The second case occurred in the summer of 2022 in a 47-year-old woman during a trip to Bangladesh. There, she received a common topical antifungal and steroid combination, but it didn't help. Back in the US, she went to the emergency department three times during the fall of 2022 for her infection, each time getting common anti-fungal treatments that didn't work. In December 2022, she saw a dermatologist who prescribed a four-week oral course of terbinafine, a common first-line anti-fungal. But it didn't work. She next tried a four-week course of griseofulvin, which is sometimes used to treat tinea on the scalp. It only resulted in about 80 percent improvement. At the time the case study was written, the woman was being considered for another round of treatment, possibly itraconazole. The woman's husband and son were also reported to have similar skin infections and were being evaluated.
Global scourge
While alarming, the identification of cases in the US is not surprising. The fungus behind the infections is Trichophyton indotineae (previously described as Trichophyton mentagrophytes type VIII), which is a newly emerging fungus globally. Though genetic studies date isolates back to at least 2008 in Australia, a multidrug-resistant lineage seemed to erupt in India between 2017 and 2018. Since then, it has reached epidemic proportions in the subcontinent, replacing other common causes of ringworm, and the pathogen has rapidly emerged in many countries throughout Asia and Europe, and Canada.
In the US cases, common lab tests don’t distinguish T. indotineae from other species, and both cases were first identified as being caused by T. mentagrophytes. It wasn't until sufficient suspicion was raised in March 2023 that isolates from both cases were genetically sequenced, conclusively identifying T. indotineae.
Although ringworm infections are not considered life-threatening, drug-resistant forms can spread over large swaths of the body, potentially establishing chronic or recurring intensely itchy infections. In the young pregnant woman's case, the rash covered her neck, abdomen, pubic region, and buttocks. In the older woman's case, the uncomfortable plaques covered her thighs and buttocks. Such rashes can cause extreme discomfort, social stigma, and lower quality of life. Complications of ringworm infections can include secondary bacterial infections and, in rare cases, infections that reach deeper into the skin that can be serious.
The rise of T. indotineae is linked to the abuse of topical treatments that contain egregiously large combinations of steroids and antifungal/antibacterial agents, spurring the development of resistance. This is particularly a problem in India.
As New York and CDC health officials note in the MMWR case study, "Antimicrobial stewardship efforts are essential to minimize the misuse and overuse of prescribed and over-the-counter antifungal drugs and corticosteroids." The authors called for clinicians to look for resistant ringworm cases, as clinical testing can misidentify the fungus.
Tips to try to avoid the infection include basic hygiene like daily baths and changing your socks and underwear daily, plus avoiding tight shoes that make your feet sweat, showering after contact sports, and washing your hands after playing with pets. | Disease Research |
I spend £4,300 a year buying bottled water to drink and BATHE in - and it's helped with my anxiety, migraines and eczemaJohn Junior, 34, from Cheshire, spends around £4,300 a year on bottled waterThe IT consultant said the move has helped his anxiety, migraines and eczemaHe cut down on extra spending including takeout coffee to afford the extra costRead: We gave up city life to live in a van and only spend £450 a month on bills Published: 09:00 EST, 17 January 2023 | Updated: 09:00 EST, 17 January 2023 A man who will only wash with bottled water has claimed cutting out tap water stopped his anxiety and is worth the £4,300 a year price tag.John Junior, 34, from Wilmslow, Cheshire, switched from tap water to bottled water five months ago and believes the move improved his health and wellbeing.After experimenting cutting out different parts of his diet, he concluded that switching out tap water 'changed my life', including helping with his anxiety, constant migraines and eczema. The IT consultant splashes £12 a day in Co-op buying supermarket water to wash with and Fiji water to drink, working out at roughly £360 a month or £4,300 a year. John Junior, 34, from Cheshire, will only drink, wash his clothes, and bathe in bottled waterHis daily soak requires 30 litres of water which he bathes in cold - adding just a single kettle of hot water to feel comfortable.He has cut down on buying takeout coffee and other luxuries in order to afford the water amid the cost of living crisis.John said: 'I'm not a scientist - but it's genuinely changed my life. I don't know why it works for me. Maybe I'm allergic to the chlorine that they use to disinfect the water. But there must be something in it to make me feel so bad.'Despite being unable to drive, John says he manages to ferry water in from his local store by delivery or with the help of friends. His daily soak requires 30 litres of water which he bathes in cold - adding a single kettle of hot water The IT consultant (pictured) said switching to bottled water helped with his anxiety, migraines and eczemaHe claims he sometimes has to travel into Manchester to purchase it in bulk when it is unavailable nearby and John has even visited the source of Co-op's water.He said: 'I always call [tap water] the devil's drink - even though my friends always laugh at me for it. I don't use it at all. I don't drink it, wash with it, I wash my clothes in bottled water.'I used to struggle with extremely bad anxiety constantly and migraines, and after a while I did loads of experiments on myself to try and stop it.'I cut loads of different things out of my diet and eventually I just thought that it just had to be the water - so I tried cutting that out and I just feel so much better now. John spends £12 a day in Co-op buying supermarket water to wash with and Fiji water to drink, working out at roughly £4,300 a year After experimenting with cutting out different parts of his diet, John said cutting out tap water 'changed my life' He has bottles of water delivered or sometimes buys it in bulk and has even visited the source of Co-op's water'I used to have migraines that would leave me feeling sick and unable to move, but now I get them way less.' John added: 'I have PTSD as well after seeing my father die in front of me in 2018, which has become much better since I cut out the tap water.'I'd been offered medication to help fight the PTSD but it didn't work for me, along with loads of other holistic ways like going to the gym, swimming and stuff - none of it seemed to help.'From then I'd struggled with my anxiety and even my eczema, but now I've cut out the water it feels better. I actually feel healthier - I genuinely think it's the devil's drink. John said showering in the local gym felt like 'bathing in rain water' and had a bad smell Although the cost is expensive, John cuts down on extra spending so he can afford bottled water'I think it's a multitude of things, like PH balance - there's more magnesium in bottled water for example, which helps with anxiety.' He continued: 'Sometimes I have to shower in my local gym and I find the water there almost feels like bathing in rain water or something. It smelled as well - it's horrible. If I have a drink of water, or a brew, I feel vile.' John said he accepts that the cost might seem steep but insists it is manageable because he makes sacrifices.He said: 'It does cost £12 a day, which seems like a lot. But if you go to Starbucks with your mates and get a coffee and a cake - you're already spending nearly that much anyway.'So I just cut down on my extra spending, and now it doesn't seem like it costs so much. I don't mind paying the extra money to feel better.' Advertisement | Mental Health Treatments |
One year after undergoing a heart procedure, the model shared how she's doing today.
"This time last year I had a procedure done to close a hole I had in my heart known as a PFO (Patent Foramen Ovale) following having a transient stroke," she wrote on Instagram Stories April 24 alongside a throwback photo of her in a hospital bed. "So grateful to have found this and have it closed, and so grateful for my amazing doctors. A year later I'm feeling strong and healthy."
Hailey—who is married to Justin Bieber—was rushed to the hospital in March 2022 after experiencing "one of the scariest moments" of her life.
"On Thursday morning, I was sitting at breakfast with my husband when I started having stroke like symptoms and was taken to the hospital," she wrote on Instagram Stories at the time. "They found I had suffered a very small blood clot to my brain, which caused a small lack of oxygen, but my body had passed it on its own and I recovered completely within a few hours."
As the Rhode founder explained in an April 2022 YouTube video, the hospital doctors concluded that she suffered a transient ischemic attack (TIA) but weren't certain how the blood clot traveled to her brain, leading her to pursue further testing at UCLA where it was determined she had a PFO.
"I did this test, and they actually found that I had a grade five PFO, which is the highest grade that you can have. So, mine was fairly large," she noted in the video. "But at this point too, I was just grateful that they found it and that they knew that it was there. And also the conclusion was that I had a blood clot that traveled into my heart."
Hailey shared the blood clot had escaped through the hole in her heart and traveled to her brain, resulting in the TIA. She later had a PFO closure procedure.
"I feel great," she continued. "The biggest thing I feel honestly is I just feel really relieved that we were able to figure everything out, that we were able to get it closed, that I will be able to just move on from this really scary situation and just live my life."
In June of that year, Justin experienced his own health scare and shared he was diagnosed with Ramsay Hunt syndrome, which caused temporary paralysis in parts of his face and led him to postpone his Justice World Tour shows before eventually canceling the concert series.
Throughout both experiences, the couple leaned on each other.
"I think the silver lining of it, honestly, is that it brings us a lot closer 'cause you're going through this together," Hailey told Good Morning America later that month. "You're being there for each other, you're supporting each other and there's just something that really bonds you through these times." | Medical Innovations |
A woman’s newly adopted cat may have brought her an unwelcome gift: a bacterial germ that caused her months of diarrhea. In a new case report this month, doctors say that the woman’s bout of recurrent Clostridioides difficile could have been fueled by her cat, who also tested positive for the bacteria. Thankfully, both the cat and the owner were eventually treated successfully, but the case might represent the first known instance of cat-to-human transmission of the infection.
Clostridioides difficile, also called C. diff, is a ubiquitous source of gastrointestinal misery, typically causing diarrhea and colitis (inflammation of the colon). It’s estimated that nearly half a million C. diff infections occur in the U.S. every year, according to the Centers for Disease Control and Prevention. But what makes the germ more pernicious is that it commonly reappears after the initial illness fades away, even with antibiotic treatment. About one in six people sickened by C. diff will become sick again within the following two to eight weeks, either from the original infection or catching a new one.
Recurrent C. diff is a painful experience for anyone, but it’s more common and outright life-threatening for already vulnerable people, such as the elderly and hospitalized. In 2017, there were an estimated 223,900 such cases in hospitalized patients and 12,800 related deaths in the United States.
One of the most important risk factors for C. diff is a preceding disruption of the gut microbiota, the community of normally harmless or beneficial bacteria that live along our digestive tract. This can happen after people take broad-spectrum antibiotics to treat other infections, which is one reason why C. diff is common in hospitals. However, the authors of this case report believe there was an added furry element to their patient’s infection.
According to their paper, published last week in the American Journal of Case Reports, the previously healthy 31-year-old patient first developed severe diarrhea soon after she finished a week’s course of antibiotics to treat a urinary tract infection. She was briefly monitored in the hospital, diagnosed with C. diff, and given a new two-week course of antibiotics.
The treatment seemed to work at first, but two months later, she returned to a primary care clinic with the same symptoms and once again tested positive for the infection. Continued antibiotic therapy was even less effective this time, and at a follow-up visit a month later she reported still having bouts of diarrhea, now about every four hours. During that visit, she asked if it was possible that her newly adopted cat—found as a stray a month before her illness began—could have contributed to her infection.
The woman was given different antibiotics, and she decided to have the cat examined by her vet and tested for C. diff. The cat did indeed test positive for the bacteria, though appeared to have no symptoms, and was given treatment. Right around that same time, the woman had been referred to a gastroenterologist, who prescribed her a new antibody-based treatment for her C. diff. The woman reported that her illness only began to clear up after both she and the cat were treated for their infection. And at a follow-up visit two months later, doctors confirmed that she was finally symptom-free.
“In conclusion, given the temporal relationship between the patient’s symptom onset and the adoption of the cat, and given the resolution of the patient’s symptoms following treatment of the cat, it is possible that the patient acquired C. difficile from the cat,” the authors wrote.
The authors’ hypothesis of the C. diff cat, it should be noted, is based on circumstantial evidence. There is other research suggesting that people can pass on the infection to their pets, but this would be the first known case of a pet transmitting C. diff to a human. It’s also possible that the transmission chain is even more complicated than it seems. The woman may have caught C. diff from somewhere else, which she then transmitted to her cat. At some point in between her multiple antibiotic treatments, the cat might have given it back to her, restarting the diarrhea carousel all over again. And of course, the cat could be entirely blameless here, their infection being a red herring that had nothing to do with their owner’s misery.
At the very least, the authors say, this case should provoke other doctors and researchers to further investigate whether pets and other animals that interact with people can be a reservoir for recurrent C. diff, which could be a more common public health threat even outside of hospitals.
“This case highlights the importance of comprehensive history taking and considers the zoonotic transmission of C. difficile as a novel” cause of community-acquired C. diff, the authors wrote. | Disease Research |
Parents of a two-day-old girl who died in hospital after an emergency C-section are calling for a national inquiry into maternity services.
Abigail Fowler Miller died at Brighton's Royal Sussex County Hospital (RSCH), in January last year.
An inquest last week found her life would have been prolonged if her mother had been admitted to hospital sooner.
University Hospitals Sussex NHS Foundation Trust said it had made "several improvements" since her death.
In October, families whose babies have died or been harmed in the care of the NHS called for a statutory public inquiry into England's maternity services.
Robert Miller, Abigail's father, told BBC Newsnight: "A national inquiry is the only way forward - we cannot continue to treat every incident as a separate tragedy."
Distressed call
On 21 January 2022, Mr Miller and Katie Fowler contacted the hospital's maternity assessment unit four times during the day.
Their first phone call was to inform the maternity assessment unit Ms Fowler was in labour, then to report bleeding, and finally to tell them she had become faint and short of breath.
According to the Health Safety Investigation Branch's (HSIB) report, staff recorded that Ms Fowler sounded "distressed" in the fourth phone call to the unit, and she thought she was having a panic attack.
Staff said she could not answer questions in the fourth phone call because of her "distressed state" and she was asked to come into the hospital. Ms Fowler went into cardiac arrest on the journey in a taxi due to a uterine rupture.
The couple's daughter, Abigail, was born via caesarean in a hospital reception.
Both Abigail and her mother needed resuscitating, and Ms Fowler was placed into an induced coma.
Abigail had no heartbeat and was not breathing, according to the HSIB's report.
Ms Fowler was brought out of her coma to meet her daughter for the first time and to say goodbye to her, before Abigail died on 23 January.
'Destroyed us'
Last week, an inquest found Abigail had severe hypoxic ischaemic encephalopathy, which resulted in multiple organ failure.
Concluding, Coroner Joanne Andrews said the policy of University Hospitals Sussex NHS Foundation Trust, which runs RSCH, required people to have an invitation to attend an assessment.
She concluded that if Ms Fowler had been offered an assessment, she would have been an in-patient and treated for the rupture - treatment she said could have "significantly prolonged Abigail's life".
Speaking to Newsnight, Ms Fowler said: "To lose our daughter has destroyed us and to know things should have been different is impossible to come to terms with.
"Abigail should still be with us. We miss her every single day, but it isn't just about our loss. It's also about hers, of the life she should have had."
The HSIB report said Ms Fowler should have been invited into the hospital for an assessment following her third phone call to the maternity assessment unit.
It found the call document was "not completed fully" to allow staff to do a "dynamic risk assessment" of Ms Fowler when the couple called.
This resulted in staff not being alerted to the "changing clinical picture", the investigation found.
The HSIB recommended guidance be put in place to support staff with making decisions on maternity telephone triage services.
A risk assessment tool should be available for the telephone triage service to identify mothers who immediately need an ambulance to get to hospital, the investigation also recommended.
'Pattern of consistent failures'
Earlier this month, England's healthcare regulator told BBC News that maternity units currently have the poorest safety ratings of any hospital service it inspects.
BBC analysis of Care Quality Commission (CQC) records showed it deemed two-thirds (67%) of them not to be safe enough, up from 55% last autumn.
The Brighton couple are now calling for a national inquiry into NHS maternity services. "
The need for change is urgent and long overdue, and our own traumatic experience has shown the results of ignoring these issues," Mr Miller said.
"A national inquiry is the only way forward - we cannot continue to treat every incident as a separate tragedy.
"The government needs to look at the pattern of consistent failures across the UK and make real changes to maternity care to reverse the decline of this vital service."
The couple said they have had to battle to get the answers for their daughter and called on NHS trusts to be willing to have open and honest conversations.
Emma Chambers, director of midwifery at University Hospitals Sussex NHS Foundation Trust, said it had made "several improvements" to how they triage mothers.
The maternity team "works incredibly hard" to provide the "best care" to all those using its services, she said.
"We want to do everything possible to keep them, and their babies safe, and to respond quickly to any early signs that may require a response," she said.
"We have implemented a nationally-recommended triage process and monitor our performance constantly."
The BBC has contacted NHS England and the Department of Health and Social Care for comment.
If you have been affected by any of the issues raised in this story you can visit BBC Action Line. | Women’s Health |
A panel that advises the Food and Drug Administration agreed that a new drug to treat Alzheimer’s disease was beneficial for slowing cognitive decline, paving the way for full regulatory approval next month.
Earlier this year, the drug, known as lecanemab, was granted partial, or accelerated, approval, but that restricted it to people who could pay $26,500 a year or were enrolled in a clinical trial. Under its current status, it is not available under the public health programs Medicare and Medicaid.
According to the Alzheimer’s Association, 6.5 million Americans are living with the disease, the most common cause of dementia, that shows up initially as problems with memory, language and thinking.
Alzheimer’s and other dementias will cost the US $345bn this year, according to the organization. By 2050, when the number of Alzheimer’s patients is projected to reach 11 million, and the cost of care is projected to rise to $1tn annually.
According to studies, people with mild cognitive impairment or mild Alzheimer’s dementia showed a 27% slower decline in cognitive abilities using lecanemab, which can remove sticky amyloid plaques from the brain, compared with those receiving a placebo.
Full FDA approval would make lecanemab, under the brand name Leqembi, the first drug to modify the course of the disease, not simply treat its symptoms.
The studies have also revealed some serious side-effects for some patients, including brain swelling and bleeding or microhemorrhages.
The Centers for Medicare & Medicaid Services said earlier this month it will cover the drug for patients who agreed to enroll in a national registry that collects “evidence about how these drugs work in the real world”.
But that registry has yet to be created, and the Alzheimer’s Association argues that the step will make it harder for patients to access treatment. “We continue to believe that registry as a condition of coverage is an unnecessary barrier,” the group said in a statement.
Analysts anticipate that with full FDA approval, Leqembi could exceed $1bn in sales in 2026 and reaching $5.7bn by 2030.
The Alzheimer’s Association CEO, Joanne Pike, urged approval and expanded patient access “without barriers”. “We are in full agreement with the FDA Advisory Committee that Leqembi provides clinical benefit and that this benefit outweighs the risks,” she told Reuters. | Drug Discoveries |
It’s been 13 years in the making, but Dr. David Sinclair and his colleagues have finally answered the question of what drives aging. In a study published Jan. 12 in Cell, Sinclair, a professor of genetics and co-director of the Paul F. Glenn Center for Biology of Aging Research at Harvard Medical School, describes a groundbreaking aging clock that can speed up or reverse the aging of cells.
Scientists studying aging have debated what drives the process of senescence in cells—and primarily focused on mutations in DNA that can, over time, mess up a cell’s normal operations and trigger the process of cell death. But that theory wasn’t supported by the fact that older people’s cells often were not riddled with mutations, and that animals or people harboring a higher burden of mutated cells don’t seem to age prematurely.
Sinclair therefore focused on another part of the genome, called the epigenome. Since all cells have the same DNA blueprint, the epigenome is what makes skin cells turn into skin cells and brain cells into brain cells. It does this by providing different instructions to different cells for which genes to turn on, and which to keep silent. Epigenetics is similar to the instructions dressmakers rely on from patterns to create shirts, pants, or jackets. The starting fabric is the same, but the pattern determines what shape and function the final article of clothing takes. With cells, the epigenetic instructions lead to cells with different physical structures and functions in a process called differentiation.
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In the Cell paper, Sinclair and his team report that not only can they age mice on an accelerated timeline, but they can also reverse the effects of that aging and restore some of the biological signs of youthfulness to the animals. That reversibility makes a strong case for the fact that the main drivers of aging aren’t mutations to the DNA, but miscues in the epigenetic instructions that somehow go awry. Sinclair has long proposed that aging is the result of losing critical instructions that cells need to continue functioning, in what he calls the Information Theory of Aging. “Underlying aging is information that is lost in cells, not just the accumulation of damage,” he says. “That’s a paradigm shift in how to think about aging. “
His latest results seem to support that theory. It’s similar to the way software programs operate off hardware, but sometimes become corrupt and need a reboot, says Sinclair. “If the cause of aging was because a cell became full of mutations, then age reversal would not be possible,” he says. “But by showing that we can reverse the aging process, that shows that the system is intact, that there is a backup copy and the software needs to be rebooted.”
In the mice, he and his team developed a way to reboot cells to restart the backup copy of epigenetic instructions, essentially erasing the corrupted signals that put the cells on the path toward aging. They mimicked the effects of aging on the epigenome by introducing breaks in the DNA of young mice. (Outside of the lab, epigenetic changes can be driven by a number of things, including smoking, exposure to pollution and chemicals.) Once “aged” in this way, within a matter of weeks Sinclair saw that the mice began to show signs of older age—including grey fur, lower body weight despite unaltered diet, reduced activity, and increased frailty.
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The rebooting came in the form of a gene therapy involving three genes that instruct cells to reprogram themselves—in the case of the mice, the instructions guided the cells to restart the epigenetic changes that defined their identity as, for example, kidney and skin cells, two cell types that are prone to the effects of aging. These genes came from the suite of so-called Yamanaka stem cells factors—a set of four genes that Nobel scientist Shinya Yamanaka in 2006 discovered can turn back the clock on adult cells to their embryonic, stem cell state so they can start their development, or differentiation process, all over again. Sinclair didn’t want to completely erase the cells’ epigenetic history, just reboot it enough to reset the epigenetic instructions. Using three of the four factors turned back the clock about 57%, enough to make the mice youthful again.
“We’re not making stem cells, but turning back the clock so they can regain their identity,” says Sinclair. “I’ve been really surprised by how universally it works. We haven’t found a cell type yet that we can’t age forward and backward.”
Rejuvenating cells in mice is one thing, but will the process work in humans? That’s Sinclair’s next step, and his team is already testing the system in non-human primates. The researchers are attaching a biological switch that would allow them to turn the clock on and off by tying the activation of the reprogramming genes to an antibiotic, doxycycline. Giving the animals doxycycline would start reversing the clock, and stopping the drug would halt the process. Sinclair is currently lab-testing the system with human neurons, skin, and fibroblast cells, which contribute to connective tissue.
In 2020, Sinclair reported that in mice, the process restored vision in older animals; the current results show that the system can apply to not just one tissue or organ, but the entire animal. He anticipates eye diseases will be the first condition used to test this aging reversal in people, since the gene therapy can be injected directly into the eye area.
“We think of the processes behind aging, and diseases related to aging, as irreversible,” says Sinclair. “In the case of the eye, there is the misconception that you need to regrow new nerves. But in some cases the existing cells are just not functioning, so if you reboot them, they are fine. It’s a new way to think about medicine.”
That could mean that a host of diseases—including chronic conditions such as heart disease and even neurodegenerative disorders like Alzheimer’s—could be treated in large part by reversing the aging process that leads to them. Even before that happens, the process could be an important new tool for researchers studying these diseases. In most cases, scientists rely on young animals or tissues to model diseases of aging, which doesn’t always faithfully reproduce the condition of aging. The new system “makes the mice very old rapidly, so we can, for example, make human brain tissue the equivalent of what you would find in a 70 year old and use those in the mouse model to study Alzheimer’s disease that way,” Sinclair says.
Beyond that, the implications of being able to age and rejuvenate tissues, organs, or even entire animals or people are mind-bending. Sinclair has rejuvenated the eye nerves multiple times, which raises the more existential question for bioethicists and society of considering what it would mean to continually rewind the clock on aging.
This study is just the first step in redefining what it means to age, and Sinclair is the first to acknowledge that it raises more questions than answers. “We don’t understand how rejuvenation really works, but we know it works,” he says. “We can use it to rejuvenate parts of the body and hopefully make medicines that will be revolutionary. Now, when I see an older person, I don’t look at them as old, I just look at them as someone whose system needs to be rebooted. It’s no longer a question of if rejuvenation is possible, but a question of when.”
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By Patsy Wheeler, as told to Keri WigintonÂ
In 2019, an MRI showed lesions in my brain. I had relapsing-remitting multiple sclerosis (RRMS), the doctor told me. This wasnât welcome news, but at least it explained my facial numbness, double vision, and that constant room-spinning sensation.Â
I knew people with MS at the time, and they were fine. But I was really down and sad about my illness for a good 6 months after my diagnosis. My adult son would sometimes come home to find me sitting on the floor, crying. Itâs not that I wanted to be on the ground. Iâd been trying to get up, but I didnât have enough energy to move.Â
RRMS almost brought me to my breaking point in those early days. But that simply wouldnât happen now. Why? Because Iâve learned how to live properly with this disease.Â
My new life comes with certain limits. For example, now I know that eating poorly will leave me fatigued for days. And I can no longer focus on multiple tasks at once. But thatâs OK. And being OK with not being OK has made everything in my world better.Â
What I Do When I Hit the Wall
Most of the time I feel pretty good. But RRMS symptoms like fatigue and vertigo seem to come when they want.Â
Some days I may wake up already feeling like Iâm going on zero hours of sleep. Others, Iâll set out with a full to-do list only to have my energy fizzle out later on. I can also get this feeling like Iâm suddenly on a ship or nonstop merry-go-round. And when that wall of dizziness hits, Iâm down for the day.Â
These symptoms make it hard to move around or think straight. And, sure, I feel sad when that happens. But Iâve learned how to take more control in those moments.Â
When I feel awful, sometimes Iâll ask my husband to bring me some celery juice. I donât know if itâs actually lowering inflammation, but it makes me feel good. And I always seem to have more energy and less brain fog after I drink it.Â
My dad passed away in December 2018, which was the worst year of my life and may have triggered my RRMS. But I have pictures of him all over the place. And I talk to him all the time, which helps me feel better.
And I write with music playing in the background. But I donât bother with full sentences. I jot down words or phrases that Iâm feeling: Strong. Irritated. Upset. How come? Trips. Vacation. Where to?Â
If I get that hit-the-wall feeling at work, I may take a break and walk around the building. If necessary, Iâll let one of my co-workers know I need some help. And I donât feel bad about it. Iâve learned that itâs perfectly fine to say, "I canât handle this right now."
For instance, I work at a call center for a light company. Some people will need to start services at multiple buildings, and Iâll have to tell the client to wait and give me a second. And Iâll ask someone else to take the call because itâs too much for me at that moment.Â
Living Well With RRMS
It took me several months to come around to the idea of taking a strong medication for my disease. But a disease-modifying treatment (DMT) is the best way to keep RRMS from progressing. Now I get a DMT once every 5 months.Â
But medical treatment is only one way Iâve empowered myself. Â
My no. 1 healer is music and dancing. I use dance to exercise. But I love everything about the way my body feels to the rhythm of the beat. When I feel down, sometimes Iâll put on a song that my mom used to sing to me or that my son played in his elementary school talent show.
And I canât say enough good things about my MS community. I vent to one particular friend when Iâm experiencing something nobody in my household understands. Sheâll respond right away even if I text her in the middle of the night.Â
Iâll ask something like, "Do you ever have one of those days where all you want to do is get up and clean everything around you and get your whole house together, but you literally canât move?" And sheâll say, "Do I ever?" And weâll have a good conversation about that.Â
Diet Changes Are KeyÂ
Iâve kept a food journal for a while, and thatâs helped me pinpoint problem foods. Now I limit dairy products and avoid bread or anything with gluten.
Donât get me wrong. I enjoy eating a good bowl of macaroni and cheese or a Philly cheesesteak sandwich in the moment. But about an hour later, Iâm more sluggish and exhausted than I need to be. And my head feels overwhelmingly heavy.Â
My go-to meals are usually salads. Iâll eat one with chicken, steak, or taco fixings. Sometimes I go meatless and throw in a bunch of nuts instead. Or maybe Iâll have a fruit smoothie with some protein to make sure I stay full.Â
And when I eat those healthy foods, I feel vibrant. I can work a full 8 hours and come home and still cook a meal for my family if thatâs what I want to do. And if my son and husband want to go to the movies, I know that Iâll have the energy to join them.Â
But letâs talk about what happens when I donât follow my eating plan.Â
My birthday and Thanksgiving both happen in November. And last year, I told my husband that I wanted to eat whatever I wanted on those two days.
On my birthday, we had a charcuterie board party. There was a movie board with popcorn, M&Ms, and different snacks. Then there was a chicken and waffle board. You could even build your own baked potato.Â
And I told all my guests not to worry about any of my gluten-free or other dietary issues. Not on that day.Â
Two days after my party, I hit a wall. I had to take a day off from work because I couldnât function very well. The exact same thing happened after we hosted a big Thanksgiving meal. I was too tired to do much of anything for days.Â
Iâd eaten everything I wanted to, and it was just awful. When I went back to eating gluten-free and having my good fruits, vegetables, and peanuts for snacks, I felt fine in a week.Â
Moving Forward With RRMS
Some people take things day by day. For me, itâs second by second or hour by hour. But I have an amazing support system. My son and husband have my back. Not to mention my sister, who lives in Houston, and my mom, who is here in Minnesota with me.Â
I also joined the MS Society and other support groups on Facebook. I often say that MS turned friends into strangers but strangers into friends.Â
And I work with an amazing group of colleagues who get it. My boss even did her own research about my condition so she could help me out at work. Itâs wonderful.Â
I hope I can one day help others the way my community has helped me. And if you have MS, I want you to know this: There is help out there for you and your family. Donât give up. Do not allow this disease or any other disease to take over you. You have it. It does not have you.Â
Patsy Wheeler, 42, was diagnosed with relapsing-remitting multiple sclerosis (RRMS) in September 2019. She lives in Inver Grove Heights, MN, with her husband and son.
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Photo Credit: SeventyFour / Getty Images
SOURCE:Â
Patsy Wheeler, multiple sclerosis advocate, Inver Grove Heights, MN. | Disease Research |
A lack of support with his autism and problems at home led to Matthew being sectioned at the age of 17.
He spent the next 16 years locked in hospital settings, away from family and deprived of his liberty, a charity said.
Matthew is one of about 2,000 people who have experienced injustices as they remain trapped in the hospital system, Changing Our Lives said.
'Why are we stuck in hospital?' is a new exhibition in Birmingham.
It is hoped the project will "shine a light on this national scandal," said Jayne Leeson, chief executive of the rights-based organisation.
Part of the exhibition is a display based on Matthew's story.
It describes how he found himself moving from hospital to hospital, including a locked ward where he tried to take his own life.
He was then moved to a medium secure unit, but was "traumatised" to find himself sharing a ward with people who had killed.
"This shouldn't happen," he said.
"There was one guy who used to beat me up and I was really scared. I had my own room but you couldn't have a lock on it, so you couldn't keep yourself safe from other people," he added.
He remained at the unit for a year, and described his wait for treatment as "frustrating".
"Why should we be detained longer than we need to be? Why don't they hire more staff? I felt powerless in this situation," he said.
This "inadequate" support resulted in Matthew losing all freedoms for 16 years of his life, said Ms Leeson.
"Had Matthew been appropriately supported earlier, by a team who understood him, his thought processes, and communication style, there is no doubt in my mind that he would have been spared many of those years in hospital."
He is now living happily in his own home, which is a "testament to what can be achieved when the right support is put in place", she added.
There are about 2,000 autistic people or people who have learning disabilities currently detained in specialist hospitals across England, with hundreds there for more than a decade, research for the project found.
According to the National Autistic Society, the majority of detentions are made under the Mental Health Act 1983, despite autism itself not being a mental health disorder.
The project was carried out in a partnership between the University of Birmingham's School of Social Police, and street artist Foka Wolf.
It coincides with the publication of policy guidelines based on the experiences of people with learning disabilities their families and front-line staff.
"Some people might need a short spell in hospital in an absolute emergency - but no one should live in a hospital," said Professor Jon Glasby of the university.
"We closed our previous asylums, but it's a national scandal that so many people are still stuck in modern-day equivalents."
Why Are We Stuck in Hospital? runs at the Ikon Gallery in Brindley Place, Birmingham, from 7 to 19 March with a free event at The Exchange in Centenary Square on 7 March. | Mental Health Treatments |
Microautophagy is essential for preventing aging, finds lysosomes study
To age or not to age? How does aging affect organisms on a cellular level? What mechanisms help cells survive self-inflicted or external harm? It is known that lysosomes—critically important cellular structures—are crucial for digesting damaged cellular components and pathogens, and to maintain stability within cells and tissues. But can they also be repaired, and if so, how?
In a study published this month in EMBO Reports, researchers from Osaka University and Nara Medical University have shown that damaged lysosomes are repaired by a mechanism called microautophagy, and have identified two key regulators of this process.
Microautophagy is one of the three main types of autophagy in most higher organisms. It is a regulated process by which cellular components that have become dysfunctional or are no longer required are broken down. Although it is assumed to be involved in defense mechanisms collectively called lysosomal damage responses, the details remain unknown.
Lysosomes frequently become damaged, and lysosomal dysfunction has been linked to accelerated aging and a shortened lifespan. In this study, the researchers tried to understand the repair mechanisms. To identify a novel regulator of lysosomal damage response, they focused on a signaling pathway called Hippo pathway, which controls multiple processes such as cellular growth.
They knocked down individual components of the Hippo pathway in the human cells, and then observed whether the cells could respond to induced lysosomal damage. This screening revealed that a protein called serine-threonine kinase 38 (STK38) is essential for the lysosomal damage response.
They then found that STK38 works with a protein complex called the endosomal sorting complex required for transport (ESCRT) machinery, which was already known to be linked to lysosomal repair.
"STK38 recruits the protein vacuolar protein sorting 4 (VPS4) to damaged lysosomes and is crucial for disassembling the ESCRT machinery at the end of the repair process," explains lead author of the study Monami Ogura. The team further found that lysosomal membrane repair by ESCRT machinery is mediated by microautophagy.
Additionally, they identified that non-canonical lipidation of a subfamily of autophagy-related protein 8 (ATG8s) molecules—the key autophagy proteins—known as gamma-aminobutyric acid receptor-associated proteins (GABARAPs) is required for this process. Lipidation, the process of modifying ATG8s with lipid extensions, is the main process involved in autophagy. In non-canonical lipidation, ATG8s are lipidated into single-membrane endolysosomes, instead of double-membrane phagophores seen in canonical lipidation.
The researchers showed that the GABARAPs are essential for the first step of the process of lysosomal repair.
"We showed that non-canonical lipidation of ATG8s is crucial for the initial recruitment of the ESCRT machinery to damaged lysosomes and their subsequent repair," explains senior author Shuhei Nakamura.
The team also showed that depletion of the regulators of microautophagy increased the rate of senescent cells and shortened lifespan in C. elegans. Both STK38 and GABARAPs also have evolutionarily conserved roles, indicating the significance of this pathway in maintaining lysosomal integrity, healthy cellular function, and the prevention of cellular senescence and organismal aging. The detailed understanding provided by this study paves the way for increasing healthy aging and has great therapeutic value for the treatment of age-related diseases.
More information: Microautophagy regulated by STK38 and GABARAPs is essential to repair lysosomes and prevent aging, EMBO Reports (2023). DOI: 10.15252/embr.202357300
Provided by Osaka University | Longevity |
People are becoming more concerned about COVID-19 amid the recent uptick in cases and new variants, according to Gallup’s latest quarterly poll.
Gallup polled more than 5,000 U.S. adults between Aug. 29 and Sept. 5.
Thirty percent of respondents said they believe the pandemic is getting worse — up from 5% in late May/early June and 8% in February, according to a news release on Gallup’s website.
Although Gallup noted that this is the "highest rate of pessimism" since July 2022, it is far more positive than in 2020, when up to 73% of Americans said the pandemic was getting worse.
Despite the increase of worried Americans, the largest share (41%) said they believe the COVID situation is improving.
Another 30% said it is remaining the same, Gallup noted.
About 25% of people in the U.S. said they are at least "somewhat" worried about getting infected with COVID, up from 18% in May/June.
Thirty-six percent are "not too worried," and 37% are "not worried at all," the poll found.
Thirty percent of respondents said they believe the pandemic is getting worse, up from 5% in late May/early June and 8% in February.
Despite the uptick, that is still less than half the share of people who were worried in 2020, when 59% were concerned.
Overall, the majority of Americans (53%) still believe the pandemic is over, although this is a decrease from 64% in May/June.
Outlooks vary by political party
Among political parties, all are more likely to say the COVID situation is worsening — but "Democrats have grown particularly negative about the trajectory," stated the Gallup news release.
The share of Democrats who feel the situation has worsened has risen from 6% in May/June to 44% in September.
Among Republicans, only 16% believe the situation has gotten worse.
"Meanwhile, the smaller changes seen this quarter in Americans’ concern about getting the coronavirus and belief the pandemic is over can be attributed mainly to Democrats," the Gallup release stated.
Democrats’ concern about getting COVID rose from 26% to 41%; yet this fear did not rise for Republicans or independents compared to the last poll.
While 51% of Democrats thought the pandemic was over last quarter, only 35% feel that way now.
Meanwhile, 77% of Republicans and 57% of independents believe it’s over.
Most people are still not wearing masks, poll finds
The poll also asked U.S. adults about their stance on masking.
A little over half of respondents, or 55%, said they never wear a mask, while 45% still wear one at least some of the time.
Of the 45%, only 6% wear one always or very often, 11% said they do so sometimes and 28% said they wear one only rarely.
Democrats are much more likely to wear a mask currently — 25% of the Democrats who answered the survey wear one at least sometimes, compared to 15% of independents and only 6% of Republicans.
Those who said they still do wear masks provided the following reasons for doing so, according to Gallup:
- 13% say they are immunocompromised and protecting themselves from COVID-19
- 35% say they are not immunocompromised but wear masks for protection anyway
- 11% say they are following CDC guidelines to wear one for other people’s protection
- 19% say they are protecting themselves from poor air quality
- 22% mentioned other reasons not related to COVID-19
COVID is ‘back on the radar,’ says Dr. Siegel
COVID is "back on the radar," according to Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor — but the responses are mixed, from fear to denial to fatigue, he said.
"The most important thing, and this is what I tell my patients, is that we have tools now that we didn't have before — rapid tests, Paxlovid, vaccines, even masks, which you can get some benefit from if a proper-fitting, high-grade mask is worn in a high-risk setting for a high-risk patient," noted Siegel.
"I have the tools to help my patients, so for the most part, the worry is much less."
While the doctor does not believe that COVID is over, he said that because there is "significant remaining immunity in the community," the current version appears to be much more of an upper respiratory virus than the original.
"I have the tools to help my patients, so for the most part, the worry is much less," Siegel said.
"The time for COVID hysteria — both among those who are petrified and among those who would deny it — is over."
Cold and flu season plays a part, says Dr. Laura Purdy
Dr. Laura Purdy, a board-certified family medicine physician in Miami, said she believes the revival of the COVID conversation stems from entering cold and flu season.
"This time of year, patients in general have concerns about getting sick and what they can personally do to protect themselves," she told Fox News Digital.
"We’re going to see COVID cases because this is the time of year when people catch and transmit viruses more easily, and it seems most of the population is aware of that," Purdy continued.
"So these concerns are valid, since we will most likely see a rise in numbers."
"The time for COVID hysteria — both among those who are petrified and among those who would deny it — is over."
For those who are concerned about the health risks of getting COVID, Purdy suggested taking protective measures.
"If that is getting a COVID vaccine, washing hands frequently or wearing a mask, they should do that," she said.
Practicing good hygiene and handwashing practices is always a good rule of thumb during flu season, the doctor noted.
"Each person is going to pick and choose how they would like to protect themselves and others during this season," Purdy said.
"If you have any questions or concerns about how you can best protect yourself and what to do if you get sick, consult your doctor," she also said.
Context is key, says Dr. Brett Osborn
Dr. Brett Osborn, a neurologist and longevity expert in Florida, said there's a need for context when considering the rise in COVID-related hospital admissions.
"There has been a spike in COVID-19 hospitalizations during September — and the poll makes reference to the first week of September only — but the curve is already flattening," he told Fox News Digital.
This is shown in the updated CDC data from Sept. 25, Osborn noted. "There has been a 4.3% decrease in COVID-related hospitalizations as of the most recent week."
As time goes by, Osborn predicts that COVID-19 and its subvariants will closely mirror the flu.
"This is how I counsel my patients," he said. "In that regard, there has not been a single patient in my practice who has voiced concerns about COVID."
"COVID is here to stay. There is nothing we can do about this very basic epidemiologic fact."
As far as the people who believe the pandemic is getting worse, Osborn described that as "a misrepresentation of reality."
"This is simply a virus being a virus, nothing more," he said.
"We can expect more of these sporadic peaks in the future, but they will likely be of low amplitude, as is the case here, and of far less clinical relevance than during the 2020 pandemic."
The doctor added, "COVID is here to stay. There is nothing we can do about this very basic epidemiologic fact." | Epidemics & Outbreaks |
Seeing the unseen: How butterflies can help scientists detect cancer
There are many creatures on our planet with more advanced senses than humans. Turtles can sense Earth's magnetic field. Mantis shrimp can detect polarized light. Elephants can hear much lower frequencies than humans can. Butterflies can perceive a broader range of colors, including ultraviolet (UV) light.
Inspired by the enhanced visual system of the Papilio xuthus butterfly, a team of researchers have developed an imaging sensor capable of "seeing" into the UV range inaccessible to human eyes. The design of the sensor uses stacked photodiodes and perovskite nanocrystals (PNCs) capable of imaging different wavelengths in the UV range. Using the spectral signatures of biomedical markers, such as amino acids, this new imaging technology is even capable of differentiating between cancer cells and normal cells with 99% confidence.
This new research, led by University of Illinois Urbana-Champaign electrical and computer engineering professor Viktor Gruev and bioengineering professor Shuming Nie, was recently published in the journal Science Advances.
Small Variations
"We've taken inspiration from the visual system of butterflies, who are able to perceive multiple regions in the UV spectrum, and designed a camera that replicates that functionality," Gruev says. "We did this by using novel perovskite nanocrystals, combined with silicon imaging technology, and this new camera technology can detect multiple UV regions."
UV light is electromagnetic radiation with wavelengths shorter than that of visible light (but longer than X-rays). We are most familiar with UV radiation from the sun and the dangers it poses to human health. UV light is categorized into three different regions—UVA, UVB and UVC— based on different wavelength ranges. Because humans cannot see UV light, it is challenging to capture UV information, especially discerning the small differences between each region.
Butterflies, however, can see these small variations in the UV spectrum, like humans can see shades of blue and green. Gruev notes, "It is intriguing to me how they are able to see those small variations. UV light is incredibly difficult to capture, it just gets absorbed by everything, and butterflies have managed to do it extremely well."
The Imitation Game
Humans have trichromatic vision with three photoreceptors, where every color perceived can be made from a combination of red, green and blue. Butterflies, however, have compound eyes, with six (or more) photoreceptor classes with distinct spectral sensitivities. In particular, the Papilio xuthus, a yellow, Asian swallowtail butterfly, has not only blue, green and red, but also violet, ultraviolet and broadband receptors. Further, butterflies have fluorescent pigments that allow them to convert UV light into visible light which can then be easily sensed by their photoreceptors. This allows them to perceive a broader range of colors and details in their environment.
Beyond the increased number of photoreceptors, butterflies also exhibit a unique tiered structure in their photoreceptors. To replicate the UV sensing mechanism of the Papilio xuthus butterfly, the UIUC team has emulated the process by combining a thin layer of PNCs with a tiered array of silicon photodiodes.
PNCs are a class of semiconductor nanocrystals that display unique properties similar to that of quantum dots—changing the size and composition of the particle changes the absorption and emission properties of the material. In the last few years, PNCs have emerged as an interesting material for different sensing applications, such as solar cells and LEDs. PNCs are extremely good at detecting UV (and even lower) wavelengths that traditional silicon detectors are not. In the new imaging sensor, the PNC layer is able to absorb UV photons and re-emit light in the visible (green) spectrum which is then detected by the tiered silicon photodiodes. Processing of these signals allows for mapping and identification of UV signatures.
Health care and beyond
There are various biomedical markers present in cancerous tissues at higher concentrations than in healthy tissues—amino acids (building blocks of proteins), proteins, and enzymes. When excited with UV light, these markers light up and fluoresce in the UV and part of the visible spectrum, in a process called autofluorescence. "Imaging in the UV region has been limited and I would say that has been the biggest roadblock for making scientific progress," explains Nie. "Now we have come up with this technology where we can image UV light with high sensitivity and can also distinguish small wavelength differences."
Because cancer and healthy cells have different concentrations of markers and therefore different spectral signatures, the two classes of cells can be differentiated based on their fluorescence in the UV spectrum. The team evaluated their imaging device on its ability to discriminate cancer-related markers and found that is capable of differentiating between cancer and healthy cells with 99% confidence.
Gruev, Nie and their collaborative research team envision being able to use this sensor during surgery. One of the biggest challenges is knowing how much tissue to remove to ensure clear margins and such a sensor can help facilitate the decision-making process when a surgeon is removing a cancerous tumor.
"This new imaging technology is enabling us to differentiate cancerous versus healthy cells and is opening up new and exciting applications beyond just health," Nie says. There are many other species besides butterflies capable of seeing in the UV, and having a way to detect that light will provide interesting opportunities for biologists to learn more about these species, such as their hunting and mating habits. Bringing the sensor underwater can help bring a greater understanding of that environment as well. While a lot of UV is absorbed by water, there is still enough that makes it through to have an impact and there are many animals underwater that also see and use UV light.
More information: Cheng Chen et al, Bioinspired, vertically stacked, and perovskite nanocrystal–enhanced CMOS imaging sensors for resolving UV spectral signatures, Science Advances (2023). DOI: 10.1126/sciadv.adk3860. www.science.org/doi/10.1126/sciadv.adk3860
Journal information: Science Advances | Medical Innovations |
The unnecessary revival of price controls should worry us all
Government price caps are again in the news again. The U.S. government is in the process of imposing them on key drugs as authorized by the Inflation Reduction Act. Across the Atlantic, the British government suggests their use not just for energy but now also for food retail.
These are not new reactions to inflation and escalating costs. They are in line with the natural knee-jerk reaction of politicians to impose price controls as a mistaken cure for rising prices. For example, in the 1970s both British Prime Minister Edward Heath and U.S. President Richard Nixon experimented with price caps of one sort or another. These experiments sparked shortages and sparked inflation after the caps were lifted, severely harming the British and American economies.
Price caps have a long and sordid history, dating back to at least 301 A.D. when the Roman Emperor Diocletian imposed maximum prices on key products and services. Diocletian’s “Decree on Maximum Prices” failed miserably. It generated a massive shortage of all goods and was quickly lifted.
In short, price controls have never actually succeeded in combatting inflation. Instead, they have sown the seeds of dangerously anti-competitive markets and structural impediments to economic growth in the medium and long term. As economist Pierre Lemieux explains, price caps cause shortages, increasing the quantity demanded of a good while reducing its supply. As a result, sellers invest less in the production of the good, leading to an inefficient undersupply of the product in the future, to the detriment of consumers.
In the case of energy, where the United Kingdom regrettably still operates a price cap — one which has often acted as a price floor rather than a ceiling — maintaining price regulation will cause energy producers to exit markets and thereby lessen competition. This will drive up inefficiency, increasing the ultimate costs of energy production which the taxpayer eventually has to pay.
An energy price cap invariably harms the economy, yielding higher prices and lower production. The fact that a U.K. price cap is now being openly talked about in the context of food and supermarkets is very troubling.
As for U.S. drug price controls, these can be expected to deter innovation and the future supply of new drugs, denying innovative new life-saving medicines to patients. Specifically, the U.S. Chamber of Commerce recently reported that in light of the Department of Health and Human Services Department price control plans, research and development into important blood cancer and eye disease treatments is being dropped. Furthermore, important R&D in the fields of RNA and radioligands may also be discouraged.
More generally, the Congressional Budget Office points out that “proposed regulation of some drug prices would affect the sales volumes of existing drugs and, as a result, expected returns on R&D on future drugs; in turn, lower expected returns would result in fewer new drugs.”
In a similar vein, an Americans for Prosperity analysis finds that “drug price controls result in drug shortages, lower research and development spending by pharmaceutical companies, fewer drugs reaching the market, and longer wait times for drugs that do.”
Government price cap regimes are a textbook case of what we have called “anti-competitive market distortions.” These distortions lead to increased costs and more inefficiency and ultimately must be paid for by taxpayers. There is a reason that reliance on free markets — which enable human beings to meet each other’s needs in voluntary exchange — has been the most efficient and cost-effective way of uniting consumer demand with supply.
The cost of food is not high because of any type of market failure in the sector. It is especially high in the U.K. because of massive energy cost increases caused by a price cap for consumers in that sector and through a lack of sufficient generation of power.
High drug prices are a function of the very risky and massive R&D needed to produce new drugs. Only a small proportion of drug R&D projects actually result in new drugs being marketed.
The lesson is clear: Government price controls that ignore the diverse market factors that affect the pricing of different goods and services are a recipe for harmful market failure, not economic betterment.
Governments need to start addressing the real reasons for inflationary pressures. They could start by curbing the massive deficit spending and excessive money supply increases that lie at the heart of inflation. They should not apply infected band-aids in the form of price cap regulations that make the patient worse, not better. Let us hope that politicians and government officials pay heed to this economic reality and act accordingly.
Shanker Singham is an academic fellow with the Institute of Economic Affairs, CEO of Competere Ltd, and a former advisor to the United States Trade Representative and U.K. Trade Secretary. Alden Abbott is a senior research fellow with the Mercatus Center at George Mason University and a former general counsel with the Federal Trade Commission. They are co-authors of a new book, “Trade, Competition and Domestic Regulatory Policy.”
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
July 2023 was the hottest month ever recorded. It could even be the hottest month in human history.
And it’s just one in a chain of broken heat records (SN: 7/13/23). A record-breaking heat wave is still lingering in the U.S. Southwest. In 2020, temperatures jumped to 38° Celsius in Siberia, marking the highest ever recorded in the Arctic Circle (SN: 7/01/20). Nine of the 10 hottest years on record have taken place in the last decade.
That heat has tested the limits of our very bodies to tragic effect: In 2003, an estimated 70,000 people died from a European heat wave. In 2022, another heat wave there caused some 62,000 deaths. Thousands more have died in other extreme heat events, and even more have suffered heat illness or injury.
The human body can adapt to heat, but only to a certain point, research has shown (SN: 7/27/22).
“The body works quite hard to keep the core body temperature within a pretty narrow range,” says Kristie Ebi, who researches climate change and health at the University of Washington in Seattle. “If you can’t cool down that core body temperature, then your cells and your organs start being affected.”
Sustained heat waves place our bodies under strain, which can set off a cascade of effects that can lead to permanent injury or death, Ebi and colleagues wrote in a 2021 review in the Lancet. Heat waves are also getting more humid, limiting our ability to cool down, and nights are growing hotter, cutting into the time we might rest and recover. Both these trends undercut our ability to adapt to rising heat.
While people have ways to keep themselves and their communities safe, heat risks will only increase with rising temperatures, researchers say. Here’s what extreme heat and high humidity do to the body — and how you can protect yourself.
Humid heat waves, hot nights
The body has two main pathways to keep cool. First is sweating. As body temperature rises, sweat glands in the skin release salty water out of pores. That water absorbs heat as it evaporates, cooling you off.
At the same time, the body redirects blood toward the skin surface by dilating blood vessels just under the skin and pumping the heart harder, which is why many people look flush when they’re hot. This allows the blood to better disperse the heat to the surrounding air.
Within a certain range, these systems work in concert to keep your internal body temperature within a safe window, usually around 37° Celsius. Unfortunately, Earth isn’t just getting hotter; it’s getting hotter in ways that are harder for our bodies to handle.
Climate change is spurring heat waves that are not only hotter and longer but, crucially, more humid (SN: 7/19/23). “It’s becoming more dangerous because the humidity is acting as a barrier to how we cool ourselves,” says Rachel Cottle, who researches thermoregulation at Penn State. Since humid air is full of water, sweat doesn’t evaporate like it would in drier climates. So instead of cooling us off, the sweat sticks to the skin, and the heart must work even harder to compensate by pushing blood away from our core.
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Even nights aren’t offering much of a break. Usually, nighttime is much cooler than daytime, which allows the body to shed heat at night. But global nighttime temperatures are rising faster than daytime ones. And as nights get warmer, the heart must work harder.
Hotter nights also cut into our sleep, says Kelton Minor, a data scientist at Columbia University who studies climate risks. “Across seasons, demographics and different climate contexts, warmer outside temperatures consistently erode sleep.”
In a preliminary study of sleep behaviors across the world posted April 5 at medRxiv.org, Minor and his colleagues found that on random, hot nights “individuals slept less, took longer to fall asleep and woke up earlier” compared with cooler nights, he says. Other research has linked poor sleep to decreased cardiovascular health and increases in the risk of injury, anxiety, depression or even gun violence and suicide, Minor says.
The dangers of high heat
The combined forces of increased heat, higher humidity and hotter nights tax the systems that cool our bodies. And when it stays too hot for too long, things can start to go haywire.
Pushing that blood toward the skin forces the heart to work harder while simultaneously reducing the supply of oxygen-rich blood to the heart. Over several hours, this can lead to oxygen shortages in the heart and, eventually, heart failure.
This intense strain helps explain why cardiovascular failure is responsible for around half of the deaths among older people during heat waves, Ebi says. The other half happens when other organs, especially the lungs, fail under the stress of handling the heat, in part from lack of oxygen. Usually, these risks pop up in people with preexisting conditions such as diabetes or chronic obstructive pulmonary disease.
These risks are especially high if the body can’t keep its temperature stable. In that case, the body’s core temperature begins to crawl upward to dangerous levels. When a person’s internal temperature reaches around 38° C, they can experience heat exhaustion, which can lead to faintness, headache, dizziness and heavy sweating.
Left unchecked, heat exhaustion can progress to heat stroke. Here, body temperature pushes past 40° C. The heat can kill cells and interfere with organ function. Symptoms include skin that is hot and dry, delirium and even seizures. Without immediate intervention, heat stroke can lead to organ failure, permanent injury and death.
Even sweating can have its risks. If you don’t drink enough water while sweating, your body begins to get dehydrated. Dehydration can thicken the blood, putting even more strain on the heart. It also puts pressure on the kidneys, which need water to filter out toxins and waste from the body. In cases of chronic dehydration, as with some outdoor workers, it can lead to kidney disease.
Even in cases that aren’t fatal, some research suggests heat-related injury can lead to years of increased risk of heat injury or death.
While these symptoms and their outcomes may seem dire, “these mechanisms play out over hours,” Ebi says. “It’s not instantaneous.” People often begin to feel symptoms well before they end up in an emergency, she says. Mortality doesn’t start peaking until around 24 hours after a heat wave starts.
This means that, often, there’s time to act and help prevent the worst outcomes.
How to stay safe
“Almost every heat-related death is preventable,” Ebi says. “People shouldn’t be dying from heat waves.” Preventing those deaths takes a mix of personal and societal actions to keep those who are most vulnerable safe.
Individuals should stay well hydrated in high heat. They should also turn on air conditioning if it’s available or, if possible, find a cooling center or public location with air conditioning. Cottle also recommends staying inside and avoiding vigorous activity during the hottest hours of the day. Putting a cool towel on your neck, using fans in humid heat or dipping your hands or feet in a cold-water bath can also help you keep cool, she says.
These tips may have particular relevance to those most at risk, either because they are less able to cool down or more susceptible to injury if they overheat. This includes adults over 65, newborns, pregnant people, individuals on certain medications and people with heart and lung conditions.
Some may also be put at increased risk due to their location or occupation. People who are unhoused and outdoor laborers may not have the option to go inside during the hottest part of the day. Poor urban neighborhoods, which tend to have many dark surfaces and relatively few trees, tend to be hotter, including at night, putting the people who live there at increased risk (SN: 4/3/18). And globally, people living in warmer, humid climates, such as Southeast Asia, are at higher risk than those living elsewhere.
To help alleviate these risks, there are a few steps that local governments can take, such as implementing early warning systems that notify residents of upcoming heat waves, Ebi says. Or officials can require roofs that naturally cool buildings. White or light-colored paint, for example, reflects heat, while “green roofs” with plants on top can cool off buildings as they evaporate water into the air. Cooling infrastructure like trees throughout a city and air conditioning run by clean power to avoid contributing to greenhouse gas emissions would also help, Minor adds.
Some of these suggestions are starting to become reality. In the United States, cities such as Los Angeles, Denver and Washington, D.C., now require some new buildings to have light-colored or green roofs.
Additionally, Ebi says, the world must reduce greenhouse gas emissions to help limit the climate extremes that can be most fatal. “Heat is an all-of-society issue,” she says, “and needs an all-of-society approach to protect the most vulnerable to make sure that people have access to the services they need.” | Global Health |
Nursery worker, 26, who was desperate to become a mother dies suddenly after suffering three miscarriagesJemma Zoezee, 26, tragically died just days before Christmas on December 16Her grieving brother Asa said that her first of three miscarriages 'destroyed' herThe family have since launched a GoFundMe to pay for the costs of her funeralCall the Samaritans to talk to someone anonymously for free on 116 123 Published: 14:27 EST, 8 January 2023 | Updated: 14:28 EST, 8 January 2023 A heartbroken family have paid their tributes to a young nursery worker who died suddenly just days before Christmas after the heartache of suffering three miscarriages became 'too much to bear.' Jemma Zoezee, 26, had always wanted to become a mother but was 'destroyed' after losing her first child while three months pregnant, her family said, before experiencing two further miscarriages which caused her mental health to deteriorate. Following her death on December 16, Jemma's devastated family has now launched a GoFundMe page to raise funds for her funeral and the charity Tommy's, which conducts research into miscarriages, stillbirths and premature births.Her brother Asa told Wales Online: 'The first miscarriage destroyed Jemma. There was very little support for her. When you are down, and then have to dive even deeper into your emotions it can be difficult. Jemma Zoezee, 26, (pictured) had always wanted to become a mother but was 'destroyed' after losing her first child while three months pregnant, her family said, before experiencing two further miscarriages which caused her mental health to deteriorate'We just really wish she felt she could navigate through how she was was feeling, but there is very little professional support there.'There was no proactive support for her after the miscarriages. No-one explained to her why she kept losing her babies, and the effect mentally put her under an immense amount of pressure.'He said he would speak to her on the phone for hours, but that 'after the first miscarriage we had lost a part of Jemma.' The grieving sibling said he was 'so proud of Jem' for 'how hard she fought to be happy' but that 'in the end, her sadness was too much to bear.' Asa said that children had 'brought so much happiness' to her life, but the 'pain of losing her babies was too much for her.' Jemma had begun nannying while still at school and 'adored' working with kids, and ended up being employed as a young care co-ordinate in nurseries. She became besotted with her niece after she was born, telling her brother that she was 'one of the only things keeping me going'. Following her death on December 16, Jemma's devastated family has now launched a GoFundMe page to raise funds for her funeral and the charity Tommy's, which conducts research into miscarriages, stillbirths and premature births (Pictured: Jemma with her husband Tony) Asa added: 'I would say to her that it was amazing that she had that power, but that we were there to help and support her too. But Jemma just seemed unable to get herself out of that hole.'Jemma's husband previously ran 100 miles in a week for the Tommy's charity following the loss of their first baby. Asa said: 'It's especially difficult as many couples who go through the loss of a baby, suffer in silence.'This can result in feelings of loneliness and isolation, when you really just need someone to say, 'it's okay not to be okay'.'Which is why we think it is so important to bring awareness to a subject many don't talk about and encourage those who are struggling to talk to a charity like Tommy's.' Asa said the family is still coming to terms with her death and miss Jemma 'every day', adding that his daughter, Jemma's niece, still asks him to ring 'jemjem'. Asa added: 'We love her so much. We will never be the same without her.'We wake up every morning hoping this was just a horrible dream. But Jem is not hurting anymore, we just wish we could have done more.'Call the Samaritans to talk to someone anonymously for free on 116 123. Advertisement Read more: Nursery worker who adored children died suddenly after 'sadness of three miscarriages became too much to bear' - Wales Online Fundraiser by Asa Roberts : Fundraiser for Jemma Zoezee (was Roberts) | Mental Health Treatments |
When Orion Lyonesse is getting depressed, she turns into a hermit. She doesn't want to leave the house (not even to pick up the mail), and she cuts off contact with her friends and family.
"The more I'm alone, the deeper the depression gets," Lyonesse, an artist and writer in Lake Stevens, Wash., tells WebMD in an email. "I don't even want to cuddle my cats!"
Avoiding social contact is a common pattern you might notice when falling into depression. Some people skip activities they normally enjoy and isolate themselves from the world. Others turn to alcohol or junk food to mask their pain and unhappiness.
Depression traps vary from person to person, but what they have in common is that they can serve to worsen your mood, perpetuating a vicious cycle. Here are six behavioral pitfalls that often accompany depression -- and how you can steer clear of them as you and your doctor and therapist work on getting back on track.
Trap #1: Social Withdrawal
Social withdrawal is the most common telltale sign of depression.
"When we're clinically depressed, there's a very strong urge to pull away from others and to shut down," says Stephen Ilardi, PhD, author of books including The Depression Cure and associate professor of psychology at the University of Kansas. "It turns out to be the exact opposite of what we need."
"In depression, social isolation typically serves to worsen the illness and how we feel," Ilardi says. "Social withdrawal amplifies the brain's stress response. Social contact helps put the brakes on it."
The Fix: Gradually counteract social withdrawal by reaching out to your friends and family. Make a list of the people in your life you want to reconnect with and start by scheduling an activity.
Trap #2: Rumination
A major component of depression is rumination, which involves dwelling and brooding about themes like loss and failure that cause you to feel worse about yourself.
Rumination is a toxic process that leads to negative self-talk such as, "It's my own fault. Who would ever want me a friend?"
"There's a saying, 'When you're in your own mind, you're in enemy territory,'" says Mark Goulston, MD, psychiatrist and author of Get Out of Your Own Way. "You leave yourself open to those thoughts and the danger is believing them."
Rumination can also cause you to interpret neutral events in a negative fashion. For example, when you're buying groceries, you may notice that the checkout person smiles at the person in front of you but doesn't smile at you, so you perceive it as a slight.
"When people are clinically depressed, they will typically spend a lot of time and energy rehearsing negative thoughts, often for long stretches of time," Ilardi says.
The Fix: Redirect your attention to a more absorbing activity, like a social engagement or reading a book.
Trap #3: Self-Medicating With Alcohol
Turning to alcohol or drugs to escape your woes is a pattern that can accompany depression, and it usually causes your depression to get worse.
Alcohol can sometimes relieve a little anxiety, especially social anxiety, but it has a depressing effect on the central nervous system, Goulston says. Plus, it can screw up your sleep.
"It's like a lot of things that we do to cope with feeling bad," he says. "They often make us feel better momentary, but in the long run, they hurt us."
Trap #4: Skipping Exercise
If you're the type of person who likes to go the gym regularly, dropping a series of workouts could signal that something's amiss in your life. The same goes for passing on activities -- such as swimming, yoga, or ballroom dancing -- that you once enjoyed.
When you're depressed, it's unlikely that you'll keep up with a regular exercise program, even though that may be just what the doctor ordered.
Exercise can be enormously therapeutic and beneficial, Ilardi says. Exercise has a powerful antidepressant effect because it boosts levels of serotonin and dopamine, two brain chemicals that often ebb when you're depressed.
"It's a paradoxical situation," Ilardi says. "Your body is capable of physical activity. The problem is your brain is not capable of initiating and getting you to do it."
The Fix: Ilardi recommends finding someone you can trust to help you initiate exercise -- a personal trainer, coach, or even a loved one. "It has to be someone who gets it, who is not going to nag you, but actually give you that prompting and encouragement and accountability," Ilardi says.
Trap #5: Seeking Sugar Highs
When you're feeling down, you may find yourself craving sweets or junk food high in carbs and sugar.
Sugar does have mild mood-elevating properties, says Ilardi, but it's only temporary. Within two hours, blood glucose levels crash, which has a mood-depressing effect.
The Fix: Avoid sugar highs and the inevitable post-sugar crash. It's always wise to eat healthfully, but now more than ever, your mood can't afford to take the hit.
Trap #6: Negative Thinking
When you're depressed, you're prone to negative thinking and talking yourself out of trying new things.
You might say to yourself, "Well, even if I did A, B, and C, it probably wouldn't make me feel any better and it would be a real hassle, so why bother trying at all?"
"That's a huge trap," says Goulston. "If you race ahead and anticipate a negative result, which then causes you to stop trying at all, that is something that will rapidly accelerate your depression and deepen it."
The Fix: Don't get too attached to grim expectations. "You have more control over doing and not doing, than you have over what the result of actions will be," Goulston says. "But there is a much greater chance that if you do, then those results will be positive."
 | Mental Health Treatments |
In the wake of the Golden Globes last week, several celebrities said they have tested positive for COVID-19.At least four stars, including Jamie Lee Curtis and Michelle Pfeiffer, revealed they contracted the virus following the awards show.In response, the Critics Choice Awards, which was held on Sunday, announced that all attendees would be required to submit a negative COVID-19 test before entering the venue, according to Deadline.Public health experts said the news of actors and actresses falling ill is not surprising due to the relaxed regulations and people gathering indoors.Jamie Lee Curtis and Tracy Morgan speak onstage at the 80th Annual Golden Globe Awards held at the Beverly Hilton Hotel, Jan. 10, 2023, in Los Angeles.Rich Polk/NBC via Getty Images"This is sort of a window into what our future holds," said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor. "I mean, this is not unexpected. You have indoor gatherings during a time when a lot of virus is circulating, whether it's cold or flu, and proximity without masking and especially if there was also no testing requirements."He continued, "It's not surprising that you're going to have active transmission of viruses, one of the many respiratory viruses that are circulating now."According to data from the Centers for Disease Control and Prevention, weekly COVID-19 cases have topped 400,000 for the last six weeks, which are figures not seen since late September although the overall number has declined from last week.Meanwhile, weekly COVID-19 deaths are trending upward with 3,907 reported as of Jan. 11, CDC data shows, although some of this may be due to reporting lags over the holidays.Additionally, CDC data shows that while flu cases are declining the cumulative hospitalization rate of 54.4 per 100,000 is 1.8 times higher than the highest figure recorded at this point in the year dating back to the 2010-11 season.It is well known that infected individuals can expel droplets that move throughout an entire indoor space and even linger after a person leaves the area.What's more, with lack of ventilation -- be it high-efficiency particle arresting filters or open windows -- and people gathered closely together with no masks, Brownstein said it's no wonder people contracted COVID."We sort of have to decide collectively, as a society, what we want to do to keep transmission down," he said. "Obviously, we know mitigation strategies help and then we recognize that we still have a lot of vulnerable people that are succumbing to COVID."Brownstein added, "But I think the idea of testing pre-gathering is still a very good idea, so it makes sense that the Critics Choice Awards used that as a tool to help limit the amount of risk of transmission at the event."Honoree Ryan Murphy accepts the Carol Burnett Award onstage at the 80th Annual Golden Globe Awards held at the Beverly Hilton Hotel, Jan. 10, 2023, in Los Angeles.Christopher Polk/NBC via Getty ImagesBrownstein said this doesn't mean that every event will turn into a super-spreader or that it signals trouble for the U.S. Rather, Americans shouldn't let their guard down."As much as people want to assume that we've moved on from the pandemic, the pandemic hasn't yet moved on from us," he said. "We're still dealing with events where that super-spreading can occur and there's a bivalent vaccine out there that can lower your risk of severe illness and help reduce your risk of severe consequences and deaths from this virus." | Epidemics & Outbreaks |
By Tessa Wong and BBC ChineseBBC News Image source, Getty ImagesImage caption, In many Chinese cities, residents have to scan QR codes and show their health status on their phonesAuthorities in the Chinese province of Henan are suspected to be restricting some residents' movements using a Covid app, following rare protests.Multiple people say they are being forced to quarantine, blocked from public transport or entering buildings.Most appear to be customers of four rural banks which had run into issues providing cash withdrawals, report Chinese media outlets.The banks froze deposits, prompting angry demonstrations last month.China's banking and insurance regulator has since ordered an investigation into the banks. More than 39 billion yuan (£5bn; $6bn) is believed to have been frozen, affecting hundreds of thousands of customers.Turning redIn many Chinese cities, residents use a "health code" app to enter buildings and shops, use public transport, or leave the city. Users must scan a QR code and show a colour-coded "health status" on their phone before entering. If this status turns red, it indicates the person has tested positive for Covid recently or is suspected to have Covid, and must be quarantined for 14 days.On Tuesday, some residents found their status had turned red when they tried to enter train stations, buildings, or hotels. It is not known how many have been affected, but Chinese reports indicate that the issue has occurred in several towns and villages in Henan. Customers of the four banks who travelled from other provinces to Henan's capital city Zhengzhou have also encountered the same issue.One bank customer in Zhengzhou told BBC Chinese her status was red even though she had never been in contact with a confirmed case, and her most recent tests showed she was negative.She added that she was visited by health officials who asked her to stay at home and refused to explain why her status had suddenly turned red. Some of those affected appear to be relatives of customers. One woman who lives in Zhumadian, a town 200km (124 miles) from Zhengzhou, said she was taken to a hotel for mandatory quarantine once her status turned red. "I am not a customer, it's my dad who deposited money in one of the banks and now he can't get it out," she told BBC Chinese."He recently went to Zhengzhou to understand the situation. Once he came back, his health status turned red. My whole family is now in quarantine after our statuses turned red."A staff member at the Zhengzhou health commission confirmed with BBC Chinese that many of the banks' customers had run into the same problem."There is such a situation. At the moment, they can only contact their community managers to apply (to change their status). After they do two Covid tests within three days, their status can be changed back," the staff member said.Image source, WeiboImage caption, In recent weeks, customers of the four banks have been holding rare protests in Henan'Breach of laws'The move has raised questions on Chinese social media where many have pointed out that this was a possible abuse of power by officials.Popular Chinese commentator and former newspaper editor Hu Xijin said that "health codes" should "only be used purely for pandemic prevention purposes"."If any area uses health codes to restrict people's movements for other purposes, this is clearly a breach of pandemic prevention laws... and damages the support of the people for our fight against the virus," he said.In April, the New Oriental Country Bank of Kaifeng, Zhecheng Huanghuai Community Bank, Shangcai Huimin County Bank, and Yuzhou Xin Min Sheng Village Bank froze their customers' deposits.Since then, thousands of customers have been travelling to Zhengzhou to attempt to withdraw their money. Small protests have erupted, culminating in a large demonstration on 23 May where thousands took to the streets, before police shut it down.The China Banking and Insurance Regulatory Commission said last month that the major shareholder of the village banks, a company called Henan New Fortune, used third-party platforms or a money broker to take public funds. The company is suspected of financial crimes and authorities are currently investigating. | Epidemics & Outbreaks |
The safety of people with learning disabilities in England is being compromised when they are admitted to hospital, a watchdog says.
The Health Services Safety Investigations Body (HSSIB) reviewed the care people receive and said there were "persistent and widespread" risks.
It warned staff are not equipped with the skills or support to meet the needs of patients with learning disabilities.
Nearly one million adults in England are living with a learning disability.
The watchdog launched its review after receiving a report about a 79-year-old who died following a cardiac arrest two weeks after being admitted to hospital.
The man, who had a mild learning disability and struggled with speaking and hearing, was originally admitted with chest and skin infections.
He became anxious while in hospital and staff struggled to communicate with him, partly because of problems with his hearing aids.
But the difficulties were also compounded by the fact the sole specialist learning disability nurse employed by the hospital was on leave.
During his two weeks in hospital, the man refused care as well as blood tests. When a successful blood test was taken it was discovered he was suffering with kidney failure, but he died following a cardiac arrest before those results were known.
The watchdog said the hospital had failed to meet his needs sufficiently.
As part of its investigation, HSSIB also looked at the care provided in other places to people with learning disabilities.
It warned systems in place to share information about them were unreliable, and that there was an inconsistency in the availability of specialist teams - known as learning disability liaison services - that were in place in hospitals to support general staff.
It also said general staff had insufficient training - although it did note a national mandatory training programme is currently being rolled out.
Senior investigator Clare Crowley said: "If needs are not met, it can cause distress and confusion for the patient and their families and carers, and raises the risk of poor health outcomes and, in the worst cases, harm."
Saffron Cordery, of NHS Providers, which represents hospitals, said services were committed to "stamping out" the inequalities this group of patients faced.
But she said there needed to be investment in training programmes and a more consistent approach to specialist support. | Health Policy |
Rational design of mRNA nanovaccine for cancer immunotherapy
Messenger RNA (mRNA) vaccines are revolutionizing the therapy of cancer. They can be flexibly developed in a short period of time, allowing transient expression of multiple antigens for safe and efficient immunization. A diversity of mRNA vaccines is being explored in clinic to benefit patients with cancer.
However, the translation of mRNA vaccines is still hampered by multistage delivery barriers before initiating strong immunity, including rapid clearance, poor targeting to lymphoid organs and dendritic cells, catalytic hydrolysis and weak capability to pass through phospholipid bilayers. Additionally, vaccination with mRNA alone can barely induce strong immune responses in the absence of adjuvants. It remains challenging to improve cytosolic delivery of mRNA and promote its in vivo vaccination efficacy in combination with adjuvants.
In past decades, a huge number of nanocarriers have been reported to promote transfection efficacy of nucleic acid drugs or deliver drugs to lymph nodes. These studies provide valuable features including size, surface charge, modification, responsiveness, components and cytotoxicity to achieve the goal for lymph nodes drainage or cytosolic access.
Machine learning techniques provide powerful tools for exploring the physicochemical characteristics and biological features of these nanoparticles, and facilitate the design of nanocarriers with high efficiency. Commonly, machine learning models were trained, selected and optimized with high quality and massive datasets from computations and high-throughput experimental data, and in turn guide the rational design, screening and optimization of nanocarriers.
By leveraging existing nanocarriers' databases, machine learning may provide insights into rational design of nanovaccines with high efficiency.
In a new research article published in the National Science Review, scientists from the Chinese Academy of Sciences and Shanghai Jiao Tong University used machine learning to guide the rationalized design of mRNA nanovaccines. This study identified the key parameters of nanovaccines for efficient delivery of mRNA and cGAMP based on a machine learning model from the Nanocarrier Database.
The mRNA/cGAMP nanocomplexes based on phenylboronic acid grafted polyethyleneimine were prepared and further encapsulated with anionic lipids to obtain the nanovaccine.
(1) The negative surface charge of the nanovaccine reduces the interaction with negatively charged glycosaminoglycans in matrix and improves accumulation in the lymph nodes.
(2) The nanovaccine, after being internalized by the antigen-presenting cells (APCs) in the lymph nodes, promotes the release of mRNA and cGAMP from the endosomes to the cytoplasm, which activates the STING pathway and induces the presentation of tumor antigens.
(3) The activation of STING pathway promotes the release of IFN-I, which activates T cell immune response to kill tumor cells and inhibit tumor growth and metastasis. Compared with the mRNA alone, the therapeutic strategy based on this nanovaccine demonstrated stronger anti-tumor effects in melanoma and colorectal cancer models.
The paper is published in the journal National Science Review.
More information: Lei Zhou et al, STING agonist-boosted mRNA immunization via intelligent design of nanovaccines for enhancing cancer immunotherapy, National Science Review (2023). DOI: 10.1093/nsr/nwad214
Provided by Science China Press | Vaccine Development |
Illustration: Shutterstock (Shutterstock)Research from a team in Israel appears to offer encouraging news: The majority of symptoms tied to long covid might fade away over time for those who initially had a mild case of covid-19. The study found that mild cases had a higher risk of more than a dozen health conditions compared to uninfected controls in the months following infection, but this increased risk largely disappeared within a year.OffEnglishThe study was led by scientists from the KI Research Institute in Israel, in collaboration with Maccabi Healthcare Services, one of the country’s four health maintenance organizations (HMOs). In Israel, practically all health care is provided and covered through these HMOs—a universal system that makes it relatively easy for researchers to study the population’s health through deidentified electronic medical records. Relative to many other peer countries during the pandemic, Israel has also been more vigilant in providing residents easily accessible testing for acute cases of covid-19. The sheer amount of data available to these researchers meant that they could track people’s health following a bout of covid-19 to an extent that few others have been able to.The study included around 300,000 people who tested positive for covid-19 infection but weren’t hospitalized as a result between March 2020 and October 2021. The team tracked how often these people went on to later be diagnosed with 70 different health conditions possibly linked to long covid up to a year later, and compared them to controls matched in age and other factors who never tested positive for covid-19 during the same period of time. They intentionally focused on those with milder covid-19, since these represent the majority of covid-19 cases and, likewise, the majority of people who develop long covid.“The specific emphasis on patients experiencing mild disease, which are the majority of the infected population, is what adds and gives this [research] its unique point of view,” study author Maytal Bivas-Benita, a researcher at KI, told Gizmodo in an email.Bivas-Benita's team found that mild covid-19 cases had a higher risk on average of being diagnosed with several different conditions compared to uninfected people within one to six months after infection. These conditions, 13 in total, included hair loss, chest pain, shortness of breath, and problems with memory or concentration, commonly referred to as “brain fog.” However, this increased risk declined over the next six months, with the risk of nearly all outcomes reaching or coming close to the baseline risk seen in uninfected controls. The risk of anosmia and dysgeusia (the loss or impairment of smell and taste), brain fog, shortness of breath, and general weakness did remain elevated a year later, but these conditions became less common over time, too.G/O Media may get a commissionUp to $100 creditSamsung ReserveReserve the next gen Samsung deviceAll you need to do is sign up with your email and boom: credit for your preorder on a new Samsung device.“Patients with mild covid-19 had an increased risk for a small number of health outcomes, with only a few symptoms persisting a year from SARS-CoV-2 infection and their risk decreased with time from infection,” Bivas-Benita said. The team’s findings were published Wednesday in The BMJ.Other studies have indicated that some people do recover from long covid, at least partially. But the authors say theirs is one of the most detailed and lengthy follow-ups of patients with initially mild covid-19.The extensive dataset also meant that Bivas-Benital’s team could make lots of different comparisons between groups of people. Children, for instance, seem to have a lower risk of any long covid symptoms than adults, while the highest risk may be in people between the ages of 41 and 60. The risk of shortness of breath was lower in vaccinated people who developed a breakthrough infection compared to unvaccinated people, though the risk of other conditions appeared to be similar. And interestingly enough, they found no difference in long covid risk from catching either the Alpha or Delta variant, compared to the original strain, though they only had a few months of data on Delta specifically.No study comes without caveats, though. The reliance on electronic health records and official diagnostic codes means that some cases of long covid may have gone unnoticed. And it’s possible that some people stopped reporting lingering symptoms to their doctors as time went on, even if they still felt sick. On the other hand, health care in Israel is free and considered high-quality, limiting some of the reasons why sick people would avoid or stop seeking care. And Bivas-Benita notes that people who got covid-19 may actually see the doctor more compared to uninfected people, simply because they’re paying more attention to their health following infection, “resulting in higher reporting and increased screening for potential covid-related outcomes in these patients.”Conversely, a key strength of the study is the ability to compare these cases to a large group of uninfected controls, which is important since many symptoms often associated with long covid can be caused by other things. As a result, these findings might also indicate that only a small proportion of mild covid-19 cases go on to experience any illness that’s possibly linked to the infection. At the same time, the findings do not mean that people haven’t and will continue to experience chronic, sometimes debilitating symptoms caused by covid-19.“It seems that as long as SARS-CoV-2 will be with us, there will be a small proportion of patients that will experience lingering symptoms of this infection,” Bivas-Benita said.The authors say that more study is needed to understand the specific risks of long covid posed by the Omicron variant, which has become the dominant variant worldwide since late 2021. Another critical and still underexplored area is the impact of reinfections on long covid risk. | Disease Research |
What type of brain tumor does this patient have? AI technology helps to determine this as early as during surgery, within 1.5 hours. This process normally takes a week. The new technology allows neurosurgeons to adjust their surgical strategies on the spot. Today, researchers from UMC Utrecht and researchers, pathologists and neurosurgeons from the Princess Máxima Center for pediatric oncology and Amsterdam UMC have published about this study in Nature.
Every year, 1,400 adults and 150 children are diagnosed with a tumor in the brain or spinal cord in the Netherlands. Surgery is often the first step taken in treatment. Currently, during surgery, neurosurgeons do not precisely know what type of brain tumor and what degree of aggressiveness they are dealing with. The exact diagnosis will usually only be available one week after surgery, after the tumor tissue has been visually and molecularly analyzed by the pathologist.
Deep-learning algorithm
Researchers from UMC Utrecht have developed a new 'deep-learning algorithm', a form of artificial intelligence, which significantly speeds up diagnosis.
Jeroen de Ridder, research group leader within UMC Utrecht and Oncode Institute: "Recently, Nanopore sequencing became available: a technology that helps to read DNA in real time. For this, we developed an algorithm that is equipped to learn from millions of simulated realistic 'DNA snapshots'. With this algorithm, we can identify the tumor type within 20 to 40 minutes. And that is fast enough to directly adjust the surgical strategy, if necessary."
Tested and trained with biobank
Bastiaan Tops is in charge of the Pediatric Oncology Laboratory at the Princess Máxima Center. He brought together the new technology and the needs from the operating room. This was made possible by funding from the KiKa foundation and, more specifically, to the extensive biobank that the Máxima Center has maintained for years. Among other things, this biobank stores tissue from children with brain tumors. The algorithm was trained and tested using the biobank.
"That we can now determine the type of brain tumor as soon as during surgery shows how technology can speed up diagnostics. And how we can use an existing biobank to develop new technology," Tops says.
Used during surgery
Consequently, the whole procedure was also carried out several times during actual brain surgeries, from taking the tissue in the operating room to determining the tumor type. In Utrecht, this happened with children, and in Amsterdam with adults. Total length of the procedure: 60 to 90 minutes.
The Princess Máxima Center has decided that the results of the technique are sufficiently reliable and is already using it with children for whom the outcome may determine the surgical strategy. Amsterdam UMC will also use the technique in daily practice, to help them speed up diagnosis.
Eelco Hoving, pediatric neurosurgeon and clinical director of neuro-oncology at the Máxima Center, is excited about the possibilities of DNA analysis during surgery: "During surgery, a small remnant of tumor tissue is sometimes deliberately left behind to prevent neurological damage. But if it will later turn out, for example, that the tumor is very aggressive, a second surgery may still be necessary to remove that last remnant. This will again create risks and stress for patients and their families. This can be avoided now because we will already know during the first surgery what type of tumor we are dealing with."
Jeroen de Ridder: "It is wonderful that we have been able to actually make the step into clinical practice by combining all areas of expertise, from basic researchers to pathologists and surgeons. By doing so, we can help surgeons to optimize the outcome of brain tumor surgery."
Comparative research
To use the new technique even more widely and structurally, more research is needed. For instance, more tumor types should be added to the algorithm. In this way, international standards will be met, allowing comparison of data. Also, the outcomes of the new and current (lengthier) method will be further compared, in collaboration with other (inter)national centers. This should make clear whether the new method will also contribute to patients' quality of life in the long term.
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Scientists are to begin piloting simple blood tests for dementia that could revolutionise detection of the disease and within five years lead to people being diagnosed in seconds by the NHS.
Currently, getting a formal diagnosis in the UK relies on mental ability tests, brain scans or invasive and painful lumbar punctures, where a sample of cerebrospinal fluid is drawn from the lower back.
Patients and their families wait for up to four years to get an appointment and the results, charities say. More than one in three people living with dementia in England are yet to receive a formal diagnosis.
A team of researchers backed by Alzheimer’s Research UK and the Alzheimer’s Society have launched a £5m project to trial simple blood tests in the NHS, with the hope of speeding up diagnosis and reaching more people. They aim to be able to determine whether someone has the disease using a single drop of blood.
Blood tests are already offered in private clinics in the US and in Hong Kong, where patients can pay the equivalent of £693 to see if they have dementia up to a decade before symptoms first emerge.
Researchers behind the initiative in the UK say more work is needed to ensure tests measure the right combination of biomarkers and do not wrongly confirm or rule out the disease.
Dementia affects about 900,000 people in the UK. Experts predict that this will rise to 1.4 million by 2040.
With funding from the People’s Postcode Lottery, the team is working with the National Institute for Health and Care Research to make reliable blood tests for dementia on the NHS a reality.
A range of tests are in the research stages, including tests looking for specific proteins that occur before dementia symptoms appear. The pharmaceutical firms Roche and Eli Lilly have announced that they have joined forces to develop a blood test for dementia.
The need for blood tests to diagnose Alzheimer’s has become more pressing since the medicines donanemab and lecanemab were found to slow cognitive decline.
Fiona Carragher, the director of research and influencing at the Alzheimer’s Society, told a briefing in London that some people faced “heartbreaking” waits of up to four years for a diagnosis, and hundreds of thousands remained undiagnosed.
“Nearly four in 10 people in the UK who have dementia have not received a diagnosis,” she said. “We also know that those who do have a diagnosis have often waited many months, sometimes years, to receive it. This means thousands of families are stuck in limbo, trying to manage symptoms and plan for the future without access to the vital care and support that a diagnosis can bring.
“New drugs targeting early-stage Alzheimer’s disease are just around the corner, but without a diagnosis, people simply won’t be able to access them if they are approved.”
She said developing a blood test for use on the NHS within five years was pivotal to enable as many people as possible to access the groundbreaking treatments on the horizon.
“This could absolutely revolutionise the way dementia is diagnosed and accelerate progress towards a blood test for dementia into UK healthcare systems – a truly gamechanging win in the fight against this devastating disease,” Carragher said.
Dr Susan Kohlhaas, the executive director of research and partnerships at Alzheimer’s Research UK, told the briefing: “We expect more people to be coming forward for diagnosis, we expect them to be coming forward at a younger age and we expect them to be coming forward with less obvious symptoms. We need better, more scalable tests that are also accurate and compare to current gold-standard methods.
“Significant investment is needed to ensure the NHS has the right tools to identify people with dementia much earlier than it is currently able to. Low-cost tools like blood tests that are non-invasive and simpler to administer than current gold-standard methods are the answer to this. But we need to move these tests out of the lab and assess their effectiveness in real-world settings like the NHS.” | Disease Research |
Before I received my first Alexa-enabled smart display as a Christmas gift in 2019, I was not a big fan. I just didn’t feel like I could trust an Amazon device with a camera inside of it. I’d heard about all the privacy concerns, and I was determined to avoid it like the plague.
But then a plague really did happen — and right when my mom got sick. And then, suddenly, this device I was once suspicious of became a vital part of our support system. Those people Amazon always claim love Alexa? I somehow suddenly found myself becoming one of them.
To be clear, Mom had been sick for years. Mom has Parkinson’s disease, an incurable neurological disorder that affects everything from mobility to memory. At first, she suffered from a few tremors every now and then, but she was still able to go for a run at the gym. Then the pandemic happened. I don’t know why — maybe it was the stress and isolation of the time — her condition suddenly took a drastic turn for the worse.
The woman who impressed even the diehard gym buffs with her ability to quickly run a mile was suddenly unable to walk longer than ten minutes.
Thankfully, there are medications the doctors prescribed to help her manage the condition, which allows her to walk for a little longer. Side effects — like high blood pressure — were the tradeoff. Shortly after the stay-at-home order went into effect in March 2020, she was hospitalized for a hypertensive crisis and nearly had a stroke.
It was the first hospitalization of many more to come during the pandemic. The list of medications began growing at as rapid of a pace as her Parkinson’s symptoms — and the side effects of those meds — intensified.
Each day was getting more overwhelming. I thought it would be years before she would reach this stage in her disease, but it had arrived and during a global pandemic to boot. Suddenly, I was forced into becoming a carer during the most isolated time in modern history.
I didn’t know what I was doing, and I sure as hell had no idea how to cope. It was so hard to see my mom — this strong force of nature, who single-handedly raised three children as a widow with little money — suddenly become so helpless. I was terrified I was going to mess everything up and, as a result, lose her — my best friend and the only parent I have had since my dad died at 7 — too.
We — I — needed support more than ever, but quarantine meant there was nobody who could physically come and help us. And so I turned to Alexa.
I was floored — and, truthfully, secretly thrilled — the first time I realized that Alexa could be helpful for something. A few weeks after Mom’s first hypertensive crisis, she was on the verge of having another one. The pandemic was raging, and I wanted to avoid the hospital as much as I could for fear of exposing her to covid.
She was incredibly weak, and her breathing started to shorten. I tried everything to calm her, but the number on the blood pressure monitor kept shooting up. Desperate to find something to lower her blood pressure and honestly totally lost for what to do, I wildly looked around at anything that could help. My eyes fell on Alexa, and I asked what anybody would do when the world is ending because of a virus and your mom is dangerously sick.
“ALEXA, PLAY FART SOUNDS!!”
And Alexa did. Loud ones, juicy ones, and even “long and crispy” ones (yeah, Alexa names farts). As Alexa exploded into a firework of flatulence, my mom burst out into hysterical laughter, and our worries disappeared. Thirty minutes later, Mom’s blood pressure had dropped to a healthy level.
Ironically, all of Alexa’s farts earned my respect — and gave me a sense of hope. I began to research how else Alexa could help me and slowly began relying on this weird device more and more.
It turns out Alexa offers all kinds of features that are really helpful for the sick and elderly. I started using Alexa to remind my mom when to take her medications. Given the list just kept growing during that time while Mom’s memory started to decline, this helped lighten the load considerably. When I wasn’t around and Mom couldn’t move, I taught Mom how to ask Alexa to turn the lights on.
Over time, we grew comfortable with this thing in our home, and Mom actually started treating it like a beloved pet. Many times, I’d walk in to find my mom laughing at Alexa’s antics or talking to Alexa when she was lonely or down about her disease. To this day, it doesn’t matter how bad of a day I’m having — the sight alone warms my heart and makes me smile.
I’ve now developed a bizarre affection for my Echo Show and Alexa. I’ll never fully trust it — I avoid getting dressed in front of it, for example — but whereas once I treated it with disdain, now it’s easily my favorite gadget in the world. Alexa helped carry me through when I first started really becoming a carer and the reality of what Parkinson’s disease truly is sunk in. During a once-in-a-lifetime pandemic when nobody could be there, Alexa also gave my mom and me companionship and a helping hand.
And, of course, most importantly, an encyclopedic knowledge about farts. | Disease Research |
The number of fentanyl overdose deaths that also include— an animal tranquilizer increasingly mixed into the illicit drug supply — have surged around the country in recent years, new data released by the Centers for Disease Control and Prevention confirm, with xylazine now showing up in more than a quarter of fentanyl deaths from some states.
Xylazine, also known as "tranq," is a powerful sedative that is not approved for any use in humans. Itto overdose-reversing medications like Narcan, and it is gruesome skin wounds in users.
The new figures, published Thursday in the CDC's Morbidity and Mortality Weekly Report, offer the biggest window to date into the growing toll from xylazine's rapid ascent in the illegal U.S. drug supply through last year.
Across 31 states and the District of Columbia which had enough data reported to the CDC on toxicology reports from overdose deaths, the agency says xylazine was detected in 9% of fatal overdoses involving illicit fentanyl from January 2021 through June 2022.
Of these states, Maryland has the worst statewide rate: 27.7% of fentanyl deaths in the state also involved xylazine. Connecticut is next highest at 26.4% of these deaths, followed by Pennsylvania at 23.3%.
That increase came as drug overdose deaths overall were accelerating nationwide. Overdose deaths have since plateaued at more than 100,000 per month.
"These data show that fentanyl combined with xylazine is increasingly dangerous and deadly. This is why the Biden-Harris Administration recently," Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said in a statement.
Experts have pointed to communities in the mid-Atlantic, from Maryland to Philadelphia, as early hotspots for the drug. in January that according to medical toxicologists from Temple Health, xylazine could be found in 90% of that city's dope supply.
A study published in April by the CDC from syringe services programs around Maryland found more than 8 in 10 survey participants had unknowingly taken xylazine, when intending to buy other opioids like fentanyl.
However, the agency cautions that even some states with incomplete data still reported hundreds of fatalities linked to xylazine.
For example, 735 death certificates in New York and 261 in Florida during this time listed positive xylazine results, though there were too many more deaths missing toxicology results for them to be formally included in this new analysis.
A 276% increase from 2019 to 2022
The CDC data also marks a near tripling in fentanyl deaths involving xylazine, across a smaller subset of health departments that have enough data on testing dating back to 2019 reported to the federal State Unintentional Drug Overdose Reporting System.
In these 20 states and the District of Columbia, less than 3% of fentanyl deaths in January 2019 were also testing positive for the animal tranquilizer. By mid-2022, xylazine's prevalence had climbed 276% to 10.9% of fentanyl deaths.
Some of that increase might be from increased efforts to test for xylazine, the agency's authors said, though inconsistent approaches to check for it in overdose deaths mean these figures are likely still an underestimate.
Many routine toxicology tests still do not test for xylazine, a finding the Substance Abuse and Mental Health Services Administration described as "alarming" earlier this year.
A separate CDC arm that analyzes death certificate data, the National Center for Health Statistics, also plans to soon release its first nationwide estimates tracking xylazine overdose deaths from 2018 through 2021.
A cause of death
Not all overdose deaths that spotted xylazine in toxicology reports actually blamed the animal tranquilizer as a cause of death, with a wide range – from 0% to more than 90% – between states blaming xylazine as a cause when detected in fentanyl deaths.
"Medical examiners and coroners might differ regarding whether they consider xylazine to increase fatal overdose risk, or they might be unfamiliar with xylazine and therefore not list it on death certificates," the agency's authors wrote.
Xylazine's increase has been especially worrying since drugs deployed to combat the opioid crisis, likeand medications to treat withdrawal like methadone, are not designed to work for the animal tranquilizer.
However, the CDC authors said more needs to be researched about xylazine's effects.
For example, they did not find an association between naloxone use and xylazine deaths, suggesting the animal tranquilizer so far might not be driving a feared increase in naloxone failures. And compared to fentanyl deaths without xylazine, fewer fatalities with xylazine had no pulse when first responders arrived.
"Naloxone will not reverse the effects of xylazine. However, because xylazine is often used with opioids like fentanyl, naloxone should still be given," the CDC says.
Kerry Breen contributed reporting.
for more features. | Epidemics & Outbreaks |
VIENNA, June 25 (Reuters) - Cocaine demand and supply are booming worldwide and methamphetamine trafficking is expanding beyond established markets, including in Afghanistan where the drug is now being produced, a United Nations report said on Sunday.
Coca bush cultivation and total cocaine production were at record highs in 2021, the most recent year for which data is available, and the global number of cocaine users, estimated at 22 million that same year, is growing steadily, the U.N. Office on Drugs and Crime said in its annual World Drug Report.
Cocaine seizures have, however, grown faster than production, containing the total supply to some extent, the report said. The upper band of the estimated total supply was higher in the mid-2000s than now.
"The world is currently experiencing a prolonged surge in both supply and demand of cocaine, which is now being felt across the globe and is likely to spur the development of new markets beyond the traditional confines," the UNODC report said.
"Although the global cocaine market continues to be concentrated in the Americas and in Western and Central Europe (with very high prevalence also in Australia), in relative terms it appears that the fastest growth, albeit building on very low initial levels, is occurring in developing markets found in Africa, Asia and South-Eastern Europe," it said.
While almost 90% of methamphetamine seized worldwide was in two regions - East and Southeast Asia and North America - seizure data suggests those markets have stabilised at a high level yet trafficking has increased elsewhere, such as the Middle East and West Africa, the report said.
It added that reports and seizures involving methamphetamine produced in Afghanistan suggested the drug economy was changing in that country, where 80% of the world's illicit opium poppy, which is used to make heroin, is produced.
"Questions remain regarding the linkages between illegal manufacture of heroin and of methamphetamine (in Afghanistan) and whether the two markets will develop in parallel or whether one will substitute the other," it added.
Our Standards: The Thomson Reuters Trust Principles. | Drug Discoveries |
As he prepares for prostate cancer surgery, Paul Burrell is haunted by the memory of private moments he shared with Princess Diana when she confided in him some of her deepest secrets.
And now the man Diana referred to as her “rock” is terrified that he may take those secrets to his grave, never getting the chance to tell the late princess’s sons William and Harry what he knows about their mother.
He said: “I know some of it isn’t pretty, but if I leave this place and go somewhere else they’ll never know.
“I think they should know.”
In an interview with the Mirror at his home in Cheshire, the former royal servant said: “My illness has focused my attention on telling the boys things before it’s too late – telling them what they really should know.
“I think Diana would say to me, ‘Paul, you must make this a priority. You must go and see my boys’.”
He revealed last month that he had prostate cancer and said his diagnosis had left him fearing he will run out of time to “tell them the truth”.
Paul, 64, who was Diana’s butler for 10 years up until her death in 1997, said: “I spent many hours with Diana, during her happiest times as well as her darkest times.
“She confided in me and there are many things I have never spoken about, but now I feel the time is right.
“I think what I have to say could bring the boys back together, which Diana would have desperately wanted. I will only tell them the truth, that is all. I am not looking for anything in return.”
The princes have become increasingly estranged since Harry moved to the US with wife Meghan in 2020.
Paul said he would like to “try and do my bit” to see them reconciled. He said: “Wouldn’t it be wonderful to see the boys repair their relationship and to be back where they should be back. The public would love that. I’d applaud that.
“I’d love to see William put his arm around his brother, but I don’t think we’re going to see that because there are too many obstacles in the way.”
But he said his dearest wish was to have the chance to sit down with William and “fill in the gaps of those years that are missing in his mind”.
Paul said: “While he was away at school, he could ask me any question, and I will be able to answer. I want just to say the truth. Some of the truth may be difficult, but if he doesn’t know, he’s not informed.
“I’d like to tell them the truth.
“There are things that happened in their mother’s world, which they may not have knowledge of. And I think it just might fill in some blanks.”
In the past, Paul has described himself as Diana’s “best friend” and claimed she said he was “the only man she ever trusted”. The trust she placed in him led him to protect her secrets, but now he wants to share what he knows with her sons, hoping it will bring them closer together.
He said: “If we ever sat down, I would say to William, ‘This is within these walls and will never come out’.”
In his biography Spare, Harry dismisses Paul as “mummy’s butler”.
Paul said: “He has discarded me, but he hasn’t thought about all of those years that I spent with his mother, in private, loving her, caring for her, watching out for her. I’ve been dismissed and I’m sad about that.”
As we discussed the brothers’ bitter rift, Paul said: “You look at Harry and William as an 11-year-old and 14-year-old walking behind their mother’s coffin, the nation saw that, the nation witnessed that, and our hearts broke for those two boys.
“That path should have been the same path from then on. That’s what Diana would have wanted. For the two boys to be stuck side by side for the rest of their lives.
“Her death should have glued them together forever, but it didn’t.”
Paul had two sons Alexander and Nicholas with his wife Maria Cosgrove before he came out as gay and they divorced. In 2017, he married Graham Cooper, who he now lives with in the village of Tarporley in Cheshire.
Sitting beside a painting showing the Queen on a Zoom call during the first Covid lockdown, Paul flicks through scrapbooks from his 21 years serving the royals, first as a footman for Her Majesty at Buckingham Palace and then as Diana’s butler at Highgrove and Kensington Palace.
Pausing at photos of his sons and Harry and William as children playing in the gardens of Highgrove and another showing then seven-year-old Alexander with Prince Charles at Christmas, Paul broke down.
Weeping, he said: “I love Christmas, and wrapping Christmas presents and giving is part of who I am. Wrapping them last year, I was in floods of tears, thinking, ‘Will I do this again?’
“And I hope I will be. But none of us know, do we? We don’t know.” A routine medical last summer showed an unusual prostate-specific antigen (PSA) reading in his blood.
An MRI showed he had prostate cancer. His treatment has included HRT and he will have surgery this month before radiation known as brachytherapy. While looking forward to celebrating his fifth wedding anniversary in April with husband “Coop”, Paul admits his illness and heartache over the Queen’s death has taken a “tremendous toll”.
He said: “The Queen’s death did affect me. I went to Buckingham Palace when I was 18 years old and the Queen became my surrogate mother.
“The Queen was the beating heart of our country.
“She’d been there for all of us all her life and it was inconceivable to think that she wouldn’t be there. A chapter closed when she died and a new era began. Charles will take pages from his mother’s book, but it can never be the same.”
As he prepares for the next stage of his cancer treatment, Paul said he wanted to warn men over 50 to go for a check-up, which could save their life.
He said: “I must be one of millions of men who have never heard of PSA. So, now that you do, listen to what I say – your loved ones would want you to take a blood test. You owe it to them to live longer and be there for them.”
- Paul Burrell did not receive payment for this interview.
Get checked for prostate cancer
Men over 50, those with a family history of prostate cancer, or of Afro-Caribbean heritage should get the PSA test.
See a GP if you urinate often; take a long time to pee; have weak flow; feel your bladder has not emptied fully; see blood in urine/semen. Early detection leads to less aggressive treatment. Go to prost8.org.uk | Men's Health |
Leanne Hainsby said she got a second opinion that "saved my life."A Peloton instructor is opening up for the first time about her battle with breast cancer, revealing she got a lifesaving second opinion after discovering a lump on her breast.Leanne Hainsby, a 35-year-old cycling instructor for the fitness company, revealed on Instagram that she was diagnosed with breast cancer last August.She wrote that she self-discovered a lump on her breast and was told "everything was OK" at a doctor's appointment that same day."I trusted my gut and got a second opinion. That saved my life," Hainsby wrote, adding to her followers, "Check, and check again."Hainsby, who is based in London, said that in the past six months since her diagnosis, she has undergone surgery as well as 12 weeks of chemotherapy.Leanne Hainbsy is a London-based cycling instructor for Peloton.Courtesy of PelotonShe said she will next undergo two weeks of radiation."Treatment will continue for a long time for me, hospital visits are the norm, and I focus on one step at a time," wrote Hainsby, who did not share what stage of cancer she is battling.Hainsby also shared that prior to chemotherapy, she underwent in-vitro fertilization, or IVF, which can be done if there is concern that the chemotherapy medicine may cause infertility."I was lucky enough to be given time ahead of chemotherapy to do a round of IVF," Hainsby wrote, adding of her and her partner, Ben Alldis, a fellow Peloton instructor, "We weren't mentally prepared, but we got it done and we're so grateful."Leanne Hainsby at the World Premiere of "NO TIME TO DIE" at the Royal Albert Hall on Sept. 28, 2021 in London.John Phillips/Getty Images, FILEA Peloton spokesperson told ABC News in a statement, "Our love and support is with Leanne and Ben at this time but, as a policy and to respect their privacy, we don't comment on the personal lives of our team members."Hainsby's confirmation of her diagnosis at age 35 underscores the warning that breast cancer can impact women of all ages, though most breast cancers are diagnosed in women ages 50 and older, according to the CDC.In the United States, breast cancer is the second-most common cancer among women, with over 260,000 new cases reported in 2019, the latest data available, according to the Centers for Disease Control and Prevention.Although the risk for breast cancer in young women remains low, breast cancer found in young women can be more aggressive and more difficult to treat, Dr. Margaret Thompson, a doctor in breast services at Cleveland Clinic Florida, told ABC News in October.Breast cancer can also be more difficult to spot in young women.Younger breast tissue tends to be more dense so spotting tumors, even on mammograms, can be more challenging and may be misdiagnosed, according to the Cleveland Clinic.Mammogram screenings are recommended once every two years for women age 50 to 74 years who have an average risk of breast cancer, according to U.S. Preventive Services Task Force guidelines.Women ages 40 to 49 may choose to begin screening once every two years if they "place a higher value on the potential benefit than the potential harms" of the mammogram, according to the guidelines.For women of all ages, when an ultrasound shows a concerning finding, a follow-up visit should be scheduled to discuss next steps with your healthcare provider. | Women’s Health |
Findings Show Inflammation Stops Some Neurons from Maturing in the Developing Brain, Which Could Open the Door to New Treatments
Severeinflammation inearlychildhood is a clinically known risk factor for developing autism and schizophrenia. Now, for the first time, scientists from the University of Maryland School of Medicine (UMSOM) have discovered that inflammation alters the development ofvulnerable brain cells, and this could have mechanistic links to neurodevelopmental disorders. This finding could lead to treatments for many different childhood-onset neurodevelopmental disorders.
Using single-cell genomics to study the brains of children who died from inflammatory conditions—such as a bacterial or viral infections or asthma—along with those who died from a sudden accident, researchers from the University of Maryland School of Medicine (UMSOM) led a study that found inflammation in early childhood prevents specific neurons in the cerebellum from maturing completely. The cerebellum is a brain region responsible for motor control and higher cognitive functions used in language, social skills, and emotional regulation.
Faculty from UMSOM’s Institute for Genome Sciences (IGS), Department of Pharmacology, and the University of Maryland-Medicine Institute of Neuroscience Discovery (UM-MIND) conducted the research. The study appears in the October issue of Science Translational Medicine. It is part of a collection of nearly 30 papers describing the development and diversity of cell types in the human brain. All of these studies were coordinated by the Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative Cell Census Network, a multisite consortium funded by the National Institutes of Health.
Previous research has shown that babies born with abnormalities of the cerebellum frequently go on to experience neurodevelopmental disorders, and animal models exposed to inflammation before birth also develop these conditions.
“We looked at the cerebellum because it is one of the first brain regions to begin developing and one of the last to reach its maturity, but it remains understudied,” said Seth Ament, PhD, IGS scientist and Associate Professor in the Department of Psychiatry at UMSOM who co-led the research with Margaret McCarthy, PhD, the James and Carolyn Frenkil Dean’s Professor and Chair in Pharmacology and Director of UM-MIND. “With the fairly new technology of single nucleus RNA sequencing we could look at the cell level to see changes in the brains.”
Added Dr. McCarthy: “This has never been done before in this age group and in the context of inflammation. The gene expression in the cerebella of children with inflammation were remarkably consistent.”
The researchers examined donated post-mortem brain tissues of 17 children who died when they were one to five years old, eight from conditions that involved inflammation and nine from accidents. None of the donors had been diagnosed with a neurological disorder prior to death. The two groups were similar in age, gender, race/ethnicity, and time since death. These unique brain tissue specimens had been collected over many years by UMSOM researchers at theUniversity of Maryland Brain and Tissue Bank, a tissue repository of the NIH NeuroBioBank, as well as the Maryland Brain Collection of the Maryland Psychiatric Research Center.
The study found that two specific, yet rare types of cerebellar neurons were most vulnerable to brain inflammation—the Golgi and Purkinje neurons. At the single-cell level, these two types of neurons showed premature disruption of their maturation.
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“Although rare, Purkinje and Golgi neurons have critical functions,” Dr Ament said. “During development, Purkinje neurons form synapses connecting the cerebellum to other brain regions involved in cognition or emotional control, while Golgi neurons coordinate communication between cells within the cerebellum. Disruption of either of these developmental processes could explain how inflammation contributes to conditions like autism spectrum disorders and schizophrenia.”
As with many diseases, both genetics and the environment—in this case, inflammation—likely contribute to the risk of developing these disorders. That’s why it is crucial to understand the roles of specific cells within the brain regions—as well as how they interact with genes to influence brain function—to find treatments for brain disorders, like ASD and schizophrenia, as well as others including dementia,Parkinson’s disease, or substance use disorders.
“This study is one of the first to show that gene expression changes during inflammation may set the stage for later cellular dysfunction, such as reducing synaptic connectivity or altering energy metabolism,” said UMSOM Dean Mark Gladwin, MD, who is also Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor at UMSOM. “It’s critical to understand these mechanisms and changes at the cellular level during brain development in the hope that someday we can develop treatments for neurodevelopmental disorders.”
The data from this study—along with all of the BRAIN Initiative papers—has been deposited in the Neuroscience Multi-Omic Archive (NeMO Archive)— a curated genomic data repository—housed at the Institute for Genome Sciences at UMSOM. Neuroscience researchers can access the archive’s data through a user-friendly portal to transform their understanding of the complex workings of the brain.
About the Institute for Genome Sciences: The Institute for Genome Sciences (IGS) at the University of Maryland School of Medicine has revolutionized genomic discoveries in medicine, agriculture, environmental science, and biodefense since its founding in 2007. IGS investigators research areas of genomics and the microbiome to better understand health and disease, including treatments, cures, and prevention. IGS investigators also lead the development of the new field of microbial forensics. IGS is a leading center for major biological initiatives currently underway including the NIH-funded Human Microbiome Project (HMP) and the NIAID-sponsored Genomic Sequencing Center for Infectious Diseases (GSCID). Follow us on X @GenomeScience and @MDGenomics.
About UM-MIND: The newly founded University of Maryland – Medicine Institute for Neuroscience Discovery (UM-MIND) focuses on foundational and translational research in the areas of brain development, neuropsychiatric disorders, traumatic brain injury, brain cancers, aging and neurodegenerative disorders. State-of-the-art facilities in microscopy and CRISPR-Cas9 technology provide researchers with the tools they need to unravel the many remaining mysteries of brain function in both health and disease. Follow us on X @um_mind.
About the University of Maryland School of Medicine
Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 46 academic departments, centers, institutes, and programs, and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.2 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic, and clinically based care for nearly 2 million patients each year. The School of Medicine has more than $500 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 students, trainees, residents, and fellows. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity (according to the Association of American Medical Colleges profile) is an innovator in translational medicine, with 606 active patents and 52 start-up companies. In the latest U.S. News & World Report ranking of the Best Medical Schools, published in 2023, the UM School of Medicine is ranked #10 among the 92 public medical schools in the U.S., and in the top 16 percent (#32) of all 192 public and private U.S. medical schools. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu
The National Academy of Sciences (NAS) has announced that Claire M. Fraser, PhD, the Dean E. Albert Reece Endowed Professor in the Department of Medicine at the University of Maryland School of Medicine (UMSOM), and the Founding Director of the Institute for Genome Sciences (IGS), has been elected as a new member of the prestigious academy. Dr. Fraser is one of 120 U.S. and 23 international new members elected on May 2, 2023 to the NAS, bringing its total U.S. membership to 2,565 members.
Claire Fraser, PhD, a pioneer and global leader in genomic research, has announced that she will step down from her position as Director of the Institute for Genome Sciences (IGS) in the University of Maryland School of Medicine (UMSOM). She will now continue as the Dean E. Albert Reece Endowed Professor and Professor of Medicine and Microbiology and Immunology at UMSOM and scientist at IGS until she retires in 2024.
Neuroscience researchers now have access to 50 million brain cells to better understand how the brain develops and functions or changes with disease or trauma. Last month, scientists at the University of Maryland School of Medicine’s (UMSOM) Institute for Genome Sciences (IGS) unveiled a “one-stop shop” for brain cell data called the Neuroscience Multi-Omic Archive (NeMO Archive). This archive is now available to neuroscience researchers to transform their understanding of the complex workings of the brain.
Researchers at the University of Maryland School of Medicine (UMSOM) and their colleagues published a new analysis today in the journal Nature from genetic sequencing data of more than 53,000 individuals, primarily from minority populations. The early analysis, part of a large-scale program funded by the National Heart, Lung, and Blood Institute, examines one of the largest and most diverse data sets of high-quality whole genome sequencing, which makes up a person’s DNA. It provides new genetic insights into heart, lung, blood, and sleep disorders and how these conditions impact people with diverse racial and ethnic backgrounds, who are often underrepresented in genetic studies.
The Institute for Genome Sciences (IGS) at the University of Maryland School of Medicine (UMSOM) was awarded $17.5 million from the National Institute of Allergy and Infectious Diseases (NIAID) to fund the IGS Genome Center for Infectious Diseases (GCID) for another five years.
Owen White, PhD, professor of epidemiology and public health, and Associate Director for Informatics at the Institute for Genome Sciences (IGS) at the University of Maryland School of Medicine (UMSOM), has received the 2018 Microbiome Pioneer Award. The prestigious honor is part of the Bioinformatics for the Microbiome Symposium organized by Stanford University. The microbiome is the name given collectively to the community of trillions of microbial organisms that live on and within our bodies. | Disease Research |
Who COULD she be talking about? Kate raises eyebrows as she tells teens ‘talking therapies don’t work for everyone’ during hospital visit after psychoanalysis fan Prince Harry’s book was launchedKate Middleton said that 'talking therapies don't work for some' during outing The Prince and Princess of Wales avoided question about Prince Harry's bookIn his memoir Spare, the Duke of Sussex mentions therapy multiple times Published: 20:43 EST, 12 January 2023 | Updated: 20:44 EST, 12 January 2023 Kate Middleton raised eyebrows during her first public outing since Prince Harry's memoir was released by commenting that therapy does not work for everyoneThe Prince and Princess of Wales were in Merseyside yesterday visiting mental health charity Open Door, when Kate said: 'Talking therapies don't work for some.'In Prince Harry's shocking autobiography Spare he references therapy multiple times and even thanks collection of therapists in the acknowledgements.In the book he claims that his older brother William believed he was being 'brainwashed' by the therapist he was seeing.The Duke of Sussex says his sibling was so worried about what he was being exposed to at his confidential sessions that he even asked to come along to one. The Prince and Princess of Wales visited the new Royal Liverpool University Hospital, where Kate told several teenagers that talking therapies 'don't work for everyone' The Princess of Wales chats to medics and visited Open Door Charity - who use arts and dance to help with well-being Prince Harry, pictured here doing exercises in a therapy session, claims he called his therapist after a physical bust-up with his brother WilliamWill and Kate met several teenagers at the Open Door Charity, who use arts and dance to help with mental health.The Sun reported that Kate asked: 'Has producing music and taking part in those workshops helped? Has it helped with your personal lives?'One boy replied that using music as a tool helps him express his emotions through something he enjoys.He said: 'Producing music and letting out what you're feeling is better than saying it in a clinical atmosphere. I can put it into words. That was tough to explain!'Kate said: 'Talking therapies don't work for some people, they're not for everybody. It's so important to have a range of therapies.'She added: 'Everyone is talking a lot more about mental health.'There have often been negative connotations around it. But if we get across that there are these more positive spaces and experiences out there, then we are changing how we talk about it.' A smiling Kate smiles for the cameras during the visit this afternoon Prince Harry wrote in his book that he called his therapist after being physically attacked by his brother William following a heated argument.The Duke of Sussex claims that his older sibling left him with visible injuries after a furious row over his wife Meghan Markle.In one section of the book, Harry claims immediately following the argument he called his therapist instead of his wife.The Prince and Princess of Wales have so far avoided commenting on any of the outlandish claims levied against them in the book.While at the Liverpool Royal Hospital a journalist queried: 'Have you had a chance to read your brother's book?'William, who has been at the centre of attacks by his younger sibling, ignored the question, prompting Mr Rashid to ask again: 'Have you had a chance to read your brother's again your Royal Highness?'A smiling William and Kate continued on, walking past the reporter without acknowledging his question.Harry has previously spoken of going to therapy to process the trauma of his childhood, which included the death of his mother, Princess Diana.The Duke praised EMDR - which stands for Eye Movement Desensitisation and Reprocessing - for helping him deal with his past.It is based on the principle that the mind can heal from trauma by using external stimuli to help the brain process traumatic experiences and facilitate healing.Prince Harry, 36, previously shared a video of him closing his eyes and tapping his chest during a therapy session via videolink with Sanja Oakley, a UK-based psychotherapist, which aired on his Apple TV+ show. Appearing on The Me You Can't See, Harry 'processed his negative thoughts' by crossing his arms and taking in a deep breath, before closing his eyes and slowly tapping each side of his chest. The Duke of Sussex closes his eyes during a therapy session shown in an Apple TV documentary seriesHe told Oprah: 'EMDR is always something that I've wanted to try and that was one of the varieties of different forms of healing or curing that I was willing to experiment with.'And I never would have been open to that had I not put in the work and the therapy that I've done over the years.'Devotees say simply moving your eyes from left to right between 25 and 30 times can diminish negative memories and, therefore, their impact on your wellbeing.This, done repeatedly with a trained psychologist - up to 40 times in an hour session - can change your life immeasurably for the better, so experts claim.While critics have dismissed it as pseudoscience, EMDR has a body of scientific research behind it that proves it to be effective for the treatment of severe trauma.Not only is it available on the NHS, but training is compulsory for Ministry of Defence mental health personnel on the front line. Advertisement Read more: Kate shares thoughts on 'talking therapy' during hospital visit with Wills... so was she referring to Prince Harry? | The Sun | Mental Health Treatments |
Gaetz suggests eliminating marijuana testing of service members
Rep. Matt Gaetz (R-FL) has proposed an amendment to the National Defense Authorization Act that would eliminate marijuana testing of service members both when they are enlisted and when they receive a commission.
“Our military is facing a recruitment and retainment crisis unlike any other time in American history. I do not believe that prior use of cannabis should exclude Americans from enlisting in the armed forces. We should embrace them for stepping up to serve our country,” Gaetz said in a statement.
An increasing number of recruits have tested positive for cannabis, including in states where marijuana is legal. Almost 33 percent more recruits tested positive in 2022 compared to 2020, according to The New York Times.
As more states legalize marijuana for recreational use, the U.S. government has relaxed guidelines around drug testing, including in the military.
More than 3,400 new military recruits who failed a drug test on their first day were given a grace period to test again in the last five years, according to the Times.
More House coverage from The Hill
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- Ocasio-Cortez knocks Biden plan for student loan interest to kick in during ‘on-ramp’ period
- Ro Khanna argues ‘regressive’ Supreme Court rulings show court must be overhauled
Medical marijuana is legal in 38 states and Washington, D.C., and recreational marijuana in 22 states and D.C., according to the National Conference of State Legislatures, but the drug is still illegal under federal law.
Gaetz’s amendment is one of a handful that have been proposed around cannabis and the military.
Reps. Brian Mast (R-Fla.), Barbara Lee (D-Calif.), Earl Blumenauer (D-Ore.) and David Joyce (R-Ohio) of the Congressional Cannabis Caucus proposed allowing the Department of Veterans Affairs to give medical opinions on cannabis as a treatment for patients in states where the drug is legal.
In addition, Rep. Tony Gonzalez (R-Texas) proposed an amendment that would allow service members to consume legal CBD products.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Health Policy |
By Bob Averack, as told to Hope Cristol
I became an advocate for myasthenia gravis (MG) the hard way. I was diagnosed in 2006, a time before technology connected people like it does today. So, I went through a lot of trial and error when it came to managing MG.
For a while, every time I came up against a trigger, it felt like getting hit on the head with a 2x4. Iâm a strong dude who didnât want MG to dictate how Iâd live my life. But MG said to me, âOh yeah? Well, Iâm stronger than you.â
The moment when the light bulb finally went on for good was when I went through a whopper of a myasthenic crisis and ended up in the Cleveland Clinic while on a trip to Florida. After 6 days in the ICU, I finally realized I needed to work with MG instead of fight it.
Iâm a co-administrator of a Facebook group focused on healthy eating for MG. For a while I was the moderator of a hospital-based support group under the auspices of the Myasthenia Gravis Foundation of America (MGFA). Iâm still one of MGFAâs âgo-toâ people for talking to people about the disease. Some of the things I talk about, besides the basic medical stuff, are common MG triggers and how to manage them. These are five of the big ones.
1) Extreme temperatures. Down here in Florida, that means heat and humidity. Standing for a few hours in this weather can really knock the stuffing out of you. You might need to lie down to sleep or end up on the couch to rest, and you might even need a pretty significant recovery time after that.
This will have a much smaller impact on your life if you plan for it, because you may not always want to avoid triggering events that are outside, like a beachside retirement party, nature-based volunteer work, or in my case in recent years, political and community activism. Hereâs how you can minimize the impact of these occasions:
- Stay well hydrated.
- Find ways to get cool during and after the event.
- Get plenty of rest the night before. If you canât do that, make naps a priority.
- Manage othersâ expectations after the event. You may need time off of work or you may need to cancel other plans.
2) Lack of sleep. Lack of sleep is a major trigger for extreme bodywide fatigue. I think thereâs a more profound impact when Iâm not getting enough sleep versus if I was just doing physical labor, like helping a family member or friend lift or move things.
I know that if I have a couple of days of too-little sleep, Iâm going to be one with my club chair. Lack of adequate sleep makes it pretty hard to muster the energy to do much of anything. Â My balance is affected, so Iâll be less steady on my feet. My vision is affected, so things look very blurry, very cloudy, like being in a fog. I might even experience shortness of breath, a residual symptom from my myasthenic crisis of 2013.
I canât stress enough the critical importance of sleep. Itâs not just about the rest you need to feel refreshed. The cellular regeneration that occurs during sleep is a critical part of how well youâll feel and function the next day.
3) Excess weight. I know firsthand how important it is to improve symptoms, especially fatigue.
For decades, I had a pretty significant weight management challenge. It got to a dangerous point after my myasthenic crisis, when I was put on very high doses of prednisone. Over a 9-month period I gained 75 pounds, on top of already being overweight. It had a multiplicative effect -- not just fatigue but other symptoms got worse as well.
I lost all the weight following sensible strategies and eating within an 8-hour window every day. I cut out highly processed foods and red meat, like burgers. Basically, I became 90%-95% vegetarian.
For the first time since my diagnosis, I really started to feel some sense of well-being and improvement in my life with MG. I felt stronger. I felt more stable on my feet. I felt like I could do more without it knocking me out. A big part of that is the weight loss: removing the physical weight from my body. But itâs not the only thing.
4) A lousy diet. Â Excess weight itself triggers inflammation. So do the foods that contribute to excess weight, like red meat and fried food. Inflammatory foods can bring on fatigue. You can feel very, very tired without having exerted yourself in any way. With dietary inflammation, I usually can feel the effects of that within an hour or two of eating or drinking the wrong thing.
If someone Iâm talking to resists the idea of dietary change, I try an approach that may make them reconsider. Instead of telling them about their health risks, I might say, âHave you ever had the Impossible Burger? Youâd be amazed how much the taste and texture are just like the real thing.â
5) Stress. Stress is a well-known trigger for MG, but people with MG may not realize how serious an impact it can have. There was a time in my life when one extremely high-stress conversation led to challenges with enunciation and even swallowing.
Stress also has indirect consequences for MG. In a healthy person, it can wear down your immune system enough so that bacteria and viruses, like the common cold, can get a foothold. Someone with MG doesnât just end up with a cold, though; they get a cold plus worsening of MG symptoms, because colds tend to do that with this disease.
No one can eliminate stress, but there are ways to limit its impact on MG. If you can meditate, great. If you can do yoga, great. If you can go for a calm walk, great. And if you canât do anything physical, listen to the voice of children playing, music, or audio books.
Your goal is to move your mind away from the ruminations. You canât eliminate the fact that you have MG, but a lot of people have more control over their symptoms than they may realize.
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Photo Credit:Â AJPhoto / Science Source
SOURCE:
Bob Averack, myasthenia gravis advocate, Delray Beach, FL. | Disease Research |
The UK's first official consumption room for illegal drugs including heroin and cocaine has been approved by authorities in Glasgow.
The facility is backed by the Scottish government as a way to tackle the country's drugs deaths crisis.
The pilot scheme will be based at a health centre in the east end of Glasgow.
It will see users take their own drugs under the supervision of trained health professionals.
Glasgow's Integration Joint Board, which brings together NHS and council officials, ratified the plans at an online meeting on Wednesday morning.
Dr Saket Priyadarshi, associate medical director of Glasgow alcohol and drug recovery services, told the gathering the project would "reduce drug-related harms" for individuals as well as providing them with "opportunities for treatment, care and recovery".
A report on the facility prepared by officials from the NHS and Glasgow City Council said it aimed to tackle the problem of "approximately 400 to 500 people injecting drugs in public places in Glasgow city centre on a regular basis".
The idea has been discussed for years but it is able to go ahead now after Scotland's senior law officer said users would not be prosecuted for possessing illegal drugs while at the facility.
The guidance issued to prosecutors by Lord Advocate Dorothy Bain KC earlier this month stated that it would "not be in the public interest" to bring proceedings in such cases.
The Glasgow consumption room would be based at Hunter Street in the east end of the city alongside a clinic where 23 long-term drug users are currently prescribed pharmaceutical heroin.
Jade, 33, a drug user in the east end described it as a "brilliant idea" which would "make a massive, massive difference".
She told BBC News that she had used heroin and cocaine to block out trauma from her past and had witnessed many loved ones dying as a result of drug addiction.
"My ex-partner died of drugs. My dad died. He was an addict. My sister passed away. A lot of my friends have passed away," she said.
Users will be able to inject drugs at the Glasgow facility but a proposal for a room where they can smoke illegal substances has been removed from the original plans.
Dr Priyadarshi said that was because of the legal issues posed by Scottish anti-smoking legislation as well as technical challenges with ventilation and filtration.
"Maybe it's something we can add to in due course as we move forward," he said.
Cecilia O'Lone, Labour councillor for the Calton ward where the facility is located, told the board meeting that there was "some concern" in the community about the plans.
"If we don't take the community with us, it's leaving it open to fail because it can be stigmatised," she told the meeting.
Susanne Millar, chief officer of Glasgow's Heath and Social Care Partnership, said engagement would begin immediately, with an initial community meeting scheduled for Thursday.
She promised "clear mechanisms for quickly sorting any issues that might arise".
'No single answer'
The consumption room is part of a wider move by the Scottish government to tackle a crisis which is claiming more lives per head than anywhere else in Europe.
Drugs deaths peaked at 1,339 in 2020 before falling slightly in 2021 and then dropping by about a fifth in 2022 to 1,051.
Since then preliminary figures suggest they have begun to creep up again.
The consumption room plan is supported by Scottish National Party, Labour and Liberal Democrat politicians but the UK Home Office insists "there is no safe way to take illegal drugs".
That position is shared by Annemarie Ward, chief executive of the charity Faces and Voices of Recovery UK, which helped draft the Right to Recovery Bill tabled at Holyrood last year by the Scottish Conservatives.
Ms Ward said the SNP was playing politics by calling for Westminster to amend the 1971 Misuse of Drugs Act to decriminalise possession of drugs, a move rejected by the UK government.
Instead, she said, the Scottish government should be focusing not just on harm reduction but also on treatment, prevention, dissuasion and reintegration of users into society.
"They are stoking a constitutional debate about independence, unfortunately, and that's at the cost of people's lives," she said.
SNP ministers deny that is the case.
Last week Elena Whitham, minister for drugs and alcohol policy, told the Scottish Parliament "the war on drugs is over. No-one won and the main casualties were not organised criminals but the poorest and most vulnerable."
"We know that Scotland as a nation needs to do something different and, within the confines of the law, Police Scotland is going to be a part of that, working in partnership," said Dep Ch Con Malcolm Graham, head of local policing at Police Scotland.
He insisted the force would continue to crack down on drug dealers but added that supply was only part of the problem.
"We need to tackle the demand and we also need to tackle the harm," said Mr Graham, adding: "There is no single answer to this problem that our nation faces." | Drug Discoveries |
Scientists are developing "bionic breasts" that could restore sensation to breast cancer survivors who have undergone mastectomies and reconstructive surgeries.
Every year, more than 100,000 women in the U.S. have one or both of their breasts surgically removed to treat breast cancer and to help stop the disease from returning, or as a preventative treatment for those with a high genetic risk of breast cancer.
After a mastectomy, many patients opt to have reconstructive surgery to rebuild the breasts with implants or tissues from elsewhere in the body. However, there's only recently been an option to potentially restore the nerves of the chest and nipples as part of this procedure. Thus, many patients experience a loss of sensation in their breasts and a decline in sexual satisfaction that can negatively impact their mental health.
The new bionic breast, which would be implanted in the skin of the chest, is still being developed. However, the team has just received $4 million from the National Institutes of Health (NIH) to start testing parts of the device in patients as early as next year.
"We're working hand in hand with our patients to take the best of science from across disciplines, as you can see, and solve a very fundamental but massively important problem that causes great human suffering," Dr. Stacey Lindau, a gynecologist and professor of obstetrics and gynecology at the University of Chicago who is leading the research, told Live Science.
Lindau got the idea for the new project after hearing patients describe their experiences of recovering from reconstructive surgery following a mastectomy. Not only were their sex lives impeded afterward but also their everyday social interactions — for example, they could no longer feel the warmth and pressure of a hug from a friend, she said.
"My patients who know that I am also a researcher have asked me, can you please find a solution for this problem?" Lindau said. "The breasts are an important sexual organ for many women and their partners, and loss of sensation in the breast for some women is as distressing as it would be for a man to lose sensation in his penis, for example," she said.
When designing the new bionic breast device — which the researchers first described in a 2020 article in the journal Frontiers in Neurorobotics — the team drew inspiration from technology that had already been developed to restore sensation in patients with prosthetic hands.
The idea is to insert artificial pressure sensors under the skin of the reconstructed breast. When stimulated by pressure, these sensors send signals to implanted electrodes under the arm that, in turn, stimulate "intercostal" nerves that run between the ribs. These nerves then relay the signals to the brain, where they are interpreted as sensation.
Over the next four-and-a-half years, Lindau and her team plan to use the NIH funds to conduct a proof-of-concept study in eight patients undergoing mastectomy and reconstructive surgery to confirm they can deliver electricity to the intercostal nerves via electrodes.
At the same time, bioengineers are developing the artificial pressure sensors from soft, flexible polymer materials that would feel similar to breast tissue, Sihong Wang, an assistant professor of molecular engineering and member of the team at the University of Chicago, told Live Science. They're also working on ways to ensure that the sensors wouldn't trigger a harmful immune response once they're implanted in the body.
If these efforts are successful, the team plans to combine the flexible sensors and the electrodes in a device that could be tested in patients, Lindau said.
Broadly, the effort may have potential applications beyond breast cancer survivors.
"We have every reason to believe that the work we're doing here could apply to many other health conditions where people suffer loss of sensory functions," Lindau said.
This article is for informational purposes only and is not meant to offer medical advice.
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Emily is a health news writer based in London, United Kingdom. She holds a bachelor's degree in biology from Durham University and a master's degree in clinical and therapeutic neuroscience from Oxford University. She has worked in science communication, medical writing and as a local news reporter while undertaking journalism training. In 2018, she was named one of MHP Communications' 30 journalists to watch under 30. ([email protected]) | Medical Innovations |
WASHINGTON -- The Biden administration said Tuesday it is planning to conduct a yearly audit to verify the prices drug makers charge on a handful of the costliest prescriptions covered by Medicaid.
Under the proposal, the Centers for Medicare and Medicaid Services would require as many as 10 drug makers every year to furnish the government with proprietary and non-proprietary information as evidence to support the price it charges states, which administer Medicaid.
Drugs that cost Medicaid the most money — some as much as $2 million per treatment — will be selected for the survey.
The proposal was prompted by rising drug prices and complaints from states leaders who say they are having trouble negotiating those costs with manufacturers, said Dan Tsai, director of Center for Medicaid and Children's Health Insurance Program Services.
“We’ve got very high cost drugs, who have no competition,” Tsai said Tuesday.
More than 90 million people are enrolled in Medicaid and CHIP, which provides the poorest Americans with health insurance.
Simply surveying the cost of the drugs won't change the price, and CMS doesn't have the power to force drug companies to change how much they charge. But the administration hopes making more information about how drug companies arrive at their pricing publicly available will put political pressure on the drug companies.
Drug makers that refuse to provide information to CMS will be referred to the U.S. Health and Human Services' Office of Inspector General, which can launch criminal and civil investigations, he said.
The proposal hasn't been finalized yet, and the public will have 60 days to weigh in on it.
The move is likely to be met with stiff resistance from drug manufacturers, who are already gearing up for a showdown later this year with the federal health agency over a new program that will allow the government to negotiate the price on the drugs Medicare spends the most money on. The agency has not yet announced which drugs will be selected for that program, but they are likely to include some of the most popular drugs, such as the blood thinner Eliquis, used by older and disabled Americans who are on Medicare.
Medicare spends about $10 billion filling Eliquis prescriptions every year. | Drug Discoveries |
NEWYou can now listen to Fox News articles! FIRST ON FOX: U.S. Department of Education on Tuesday launched the National Parents and Families Engagement Council in move to ensure parents can "constructively participate in their children’s education" and to facilitate "strong and effective relationships" between schools and families.The council will consist of parent, family, or caregiver representatives from national organizations that will work with the Education Department to identify "constructive ways" to help families engage at the local level.HOW PARENTS TOOK DOWN THE ‘TOXIC MACHINE’ OF THE NATIONAL SCHOOL BOARD ASSOCIATION"Parents are a child’s first teachers, and there’s no one better equipped to work with schools and educators to identify what students need to recover," Education Secretary Miguel Cardona said. "The National Parents and Families Engagement Council will serve as an important link between families, caregivers, education advocates and their school communities." Education Secretary Miguel Cardona speaks during the National and State Teachers of the Year event at the White House, April 27, 2022. (AP Photo/Susan Walsh, File)Cardona said the council will also help to "foster a collaborative environment where we can work together to serve the best interest if students and ensure they have the academic and mental health support they need to recover from the pandemic and thrive in the future."ILLINOIS SCHOOL DISTRICT UNVEILS CURRICULUM TEACHING PRESCHOOLERS ABOUT SEXUAL ORIENTATION, GENDER IDENTITYThe Department of Education said the council will be a "channel for parents and families to constructively participate in their children’s education by helping them understand the rights they have," as well as to create a "feedback loop" with schools to discuss how COVID-19 relief and American Rescue Plan funds are deployed to meet students’ needs and identify summer learning and enrichment opportunities for children in their communities. Girl wears a face mask in classroom while working on school work at her desk. MISSOURI TEACHERS CAN HIDE PRIVATE CONVERSATIONS WITH STUDENTS FROM PARENTS, SAYS POLICY IN DOZENS OF SCHOOLSEducation Department officials said that organization representatives will "reflect the diversity of the education system, including, but not limited to, families of students in public schools, charters, private schools, and homeschool."NJ BOARD OF EDUCATION REFUSES TO REVIEW CONTROVERSIAL SEX EDUCATION CURRICULUM FOR YOUNG STUDENTSFor months, parents across the nation have been sounding the alarm about a lack of respect for parental rights in the classroom, amid decisions made by school boards surrounding the COVID-19 pandemic. Parents have taken to school board meetings in their communities, protesting mask and vaccine mandates for children in schools. Parents have also protested and demanded more input with regard to in-person vs. remote learning for their children during spikes of COVID-19. And they have protested school boards' decisions on certain curricula in the classroom, like critical race theory and controversial sex curriculum for young students. Virginia school board meeting over mask policies gets heated. (WTKR)"Parents provide critical perspective, and they should always have a seat at the table whenever decisions are made that impact their children. And this is more important than ever in the effort to help students recover from the COVID-19 pandemic," Anna King, president of the National Parent Teacher Association (PTA) said. "National PTA applauds the Department of Education for launching the National Parents and Families Engagement Council and providing a channel for parents’ voices to be heard and considered."MOM SUING SCHOOL DISTRICT FOR IGNORING FOIA OF GENDER, ETHNIC CURRICULUM CALLS ON SCHOOLS TO WORK WITH PARENTSKing added: "This is essential to help make sure the needs of students are met coming out of the pandemic and ensure every child has everything they need to make their potential a reality." Classroom with empty desks. (iStock)Vito Borrello, the executive director of the National Association for Family, School and Community Engagement, applauded the creation of the council, saying it "provides the opportunity to bring diverse parent voices together to inform the Department’s policies and programs, while also serving as a dissemination vehicle for engaging families across the country in equitable education policy."OPINION: FIGHTING CRITICAL RACE THEORY: THE LAW IS A PARENT'S BEST WEAPONThe council at this point includes The Council of Parent Attorneys and Advocates, Fathers Incorporated; Generations United; Girls, Inc.; League of United Latin American Citizens; Mocha Moms; National Association for Family, School, and Community Engagement; National Action Network; National Military Family Association; National Parent Teacher Association, National Parents Union; The National Center for Parent Leadership, Advocacy, and Community Empowerment, United Parent Leaders Action Network; and UnidosUS.The co-founder and president of the National Parents Union Keri Rodrigues told Fox News that the council is "an opportunity for parents and families who have been struggling even before the pandemic to have their voices heard because this is now a tab;e that's being built together with our input." "The education system in this country needs bold changes that put children first, not special interests," Rodrigues said. "The boldest, baddest and most beautiful families are ready to get to work and have their struggle and solutions heard in the halls of Washington D.C." Officials said the council will meet in the coming weeks to discuss ways to best "constructively" engage with schools."The Department and the Council will hold local listening sessions with parents, families, principals, educators, and school community members to better understand the needs of students as they start the 2022-23 school year," the Education Department said. Brooke Singman is a Fox News Digital politics reporter. You can reach her at [email protected] or @BrookeSingman on Twitter. | Health Policy |
A team of University of Toronto Engineering researchers, led by Professor Timothy Chan, is leveraging machine learning to optimize the macronutrient content of pooled human donor milk recipes.
The researchers introduce their data-driven optimization model in a new paper published in Manufacturing and Systems Operations Management.
Chan and his team worked with Mount Sinai Hospital’s Rogers Hixon Ontario Human Milk Bank — which provides donor milk to preterm and sick babies who are hospitalized across Ontario — as well as Dr. Debbie O’Connor, a professor at the Temerty Faculty of Medicine.
“For a variety of reasons, many hospitalized infants do not have a full supply of mother’s milk. In this instance human donor milk can be lifesaving particularly as it helps to protect preterm infants from necrotizing enterocolitis, a life-threatening bowel disease,” says Dr. Sharon Unger, a neonatologist and the medical director of the Rogers Hixon Ontario Human Milk Bank.
“The new program developed by Dr. Chan helps to ensure that each batch of human donor milk meets the protein and calorie needs of preterm infants.”
Currently, many milk banks, including Mount Sinai’s, rely on individual decision making when pooling donor milk. This presents a significant challenge in producing a consistent donor milk product that contains sufficient macronutrients for premature and sick babies in neonatal intensive care units.
“It takes a lot of time to create these recipes without a defined method,” says Chan.
“While there are studies that show that milk that comes from donors who are early in their postpartum period tends to be more protein rich, our approach provides a good prediction of the actual macronutrient content that will allow milk bank employees to make better pooling decisions.”
Given that milk banks are often non-profit entities operating on lean budgets, a low-cost alternative to obtaining a consistent, nutrient-balanced product could be useful across the entire sector.
Devices known as human milk analyzers can be used to measure the exact macronutrient content of each milk sample at a milk bank. However, these devices are costly and require extensive regulatory approval for use, with the result that only half of all milk banks in North America use one. On top of that, analyzing every donation is a costly endeavour that is labour and resource intensive.
“Our data-driven framework bypasses the need for a device to analyze the donor milk by using an artificial intelligence model to predict the macronutrient content of each donation,” says Rachel Wong, a lead researcher of the study.
“In addition, by using an optimization model to choose which donations to pool together, we can increase the consistency of macronutrient content in the donor milk product.”
The multi-phased study included a one-year implementation trial at the Rogers Hixon milk bank that was designed to test whether AI-informed models could help to fill the gap.
In the first phase, researchers collected the necessary data to create a machine learning model to predict the macronutrient content of the pooled recipes, and then designed an optimization model to create the recipes based on macronutrient requirements, that is, the necessary levels of protein and fat.
The team then created a simulation model to test the method before embarking on an experiment in the milk bank, which took place over 16 months in 2021 and 2022.
“Since our study was performed in the milk bank during regular operating hours, rather than in a controlled environment, there were a number of unexpected challenges that we had to adapt to,” says Wong.
“During the COVID-19 pandemic, the volume of donations fluctuated based on the provincial restrictions — during the lockdown periods there was an unprecedented increase in the number and volume of donations.
“We also needed to adapt the AI decisions that had already been proposed to ensure that we abided with the milk bank’s operating protocols.”
The last phase of the study began by observing the milk bank’s operation for six months and measuring the fat, protein and bacteria levels in the pooled recipes.
For the following six months, the milk bank used the data-driven optimization framework to create the pooled milk recipes. At the end of the year, the researchers compared the optimized recipes to the previous ones to assess which recipes met the macronutrient targets.
“We found that our pooled recipes met the bar for protein and fat simultaneously up to 75% more often, without compromising other factors like an increase in bacteria,” says Chan. “And it took us 60% less time to make the recipes.”
The team’s optimized recipes also have an added benefit for pre-term and sick babies, who have underdeveloped digestive systems that make it especially crucial to ensure that the milk they are consuming isn’t overly rich in protein or fat.
Chan’s team is currently working towards expanding this research to measure other nutrients in human donor milk to see if their models can optimize them. The research has won INFORMS’s 2023 Pierskalla Best Paper Award and an Excellence in Quality and Safety award from Sinai Health.
“Our ultimate goal is to show that our tool is applicable to other milk banks,” says Chan. “We would like to design a system that can plug into hospital systems to optimize recipes in a way that is sustainable for milk bank staff.”
Wong says that the entire team is grateful to all those who have made the project possible.
“We couldn’t have done this without all of the mothers who donate to the milk bank and the staff who work incredibly hard to provide donor milk to infants across Ontario and beyond,” she says.
“I hope that this research will provide a framework to help milk banks across North America increase the consistency of macronutrient content in their donor milk product. The eventual end goal would be to see a downstream impact of improved growth and developmental outcomes for the infants that receive this donor milk.”
Journal
Manufacturing & Service Operations Management
Article Publication Date
17-Nov-2023 | Nutrition Research |
CVS is revamping the way it reimburses its pharmacies for prescription medications, a move that could make prescription drug pricing simpler and change how much consumers pay for their medicines.
The company said in an announcement Tuesday that its new pharmacy reimbursement model will bring more transparency to its drug pricing system. It’s a similar model to the one entrepreneur Mark Cuban is pushing with his Cost Plus Drugs company.
Currently, the prices customers pay for drugs and the payments pharmacies receive are largely determined by middlemen known as pharmacy benefit managers, which negotiate rebates from drug manufacturers to insurers. These complex reimbursement formulas aren’t directly based on what pharmacies spent to purchase specific drugs.
The new approach, named CVS CostVantage, will use a simpler formula that includes the cost of the drug, a set markup and a fee to determine the drug’s price and reimbursement with pharmacy benefit managers. It is expected to launch for commercial payors in 2025. The Wall Street Journal was first to report the news.
This shift in payment models could change the cost of prescription drugs for some patients, although it will not necessarily make all medicine cost less. Some drugs may cost less, while others might rise in price, CVS executives said. More prescription costs should fall than rise for consumers, employers and health insurers, they said.
“We are leading with an approach that will shift how our retail pharmacy is compensated by implementing a more transparent and sustainable model that fairly aligns pharmacy reimbursement to the quality services we provide,” said Prem Shah, president of CVS Pharmacy and chief pharmacy officer at CVS Health, in a statement. “It provides our [pharmacy benefit managers] and payor clients a foundational step towards more pricing clarity for consumers.”
The health care industry as a whole provides less price transparency for consumers than other businesses.
“At a minimum, the goal for CVS and others should be to shine a light on the way drugs are priced, any discounts that are negotiated and overhead that comes from a variety of sources,” said Nick Fabrizio, senior lecturer in health policy at Cornell University. “Americans would be surprised at the hidden costs that are passed on to them by a variety of third parties. These extra or hidden costs make prescriptions more expensive.”
Cuban’s Cost Plus Drug Company provides price transparency throughout the prescription drug supply chain, Fabrizio said, noting that it is “forcing pharmacies to change their model to remain competitive.”
The announcement is the latest in series of changes that are roiling the prescription drug pricing model.
The high cost of medications is one of Americans’ biggest health care headaches, and the lack of transparency surrounding how prices are set have been a focus of a multitude of players, including Congress, which is considering several bills to force more light into the process.
Americans spend around $1,200 a year on average for prescription drugs — more than any other country — according to the Organization for Economic Co-operation and Development. One out of every three US adults taking prescription drugs say that they’ve been unable to take their medication as prescribed due to cost, according to the Kaiser Family Foundation.
CVS Caremark’s business suffered a significant blow over the summer when a major California health insurer, Blue Shield of California, announced it will no longer use the company as its pharmacy benefit manager and instead will partner with several companies, including Amazon Pharmacy and Mark Cuban Cost Plus Drug Company.
Blue Shield said earlier this year that Cuban’s pricing model will be “simple, transparent and more affordable.” The move could shake up the prescription drug pricing system beyond Blue Shield’s 4.8 million members.
This story has been updated with additional context. | Health Policy |
Of all the cataclysmic events I have ever experienced, October 7 affected me like no other. The videos of hateful protests and bloody or charred bodies unearthed memories I’d long kept buried. In one, I am a girl standing in the doorway of our home in Tehran, staring at graffiti that appeared overnight on a neighbor’s wall. Punctuated by a Swastika—something I had never seen before—were three words, scrawled in black paint on red brick: Kikes get lost.
This was in January 1979, just a few weeks before Iran’s Islamic Revolution, and nothing was as it had been. The rest of the world saw the revolution embodied in the figure of the ascetic cleric Ayatollah Ruhollah Khomeini, seated cross-legged on a cot in a spartan room in the suburbs of Paris. But for those of us in Iran, its signs were uncomfortably close, ubiquitous, and inescapable. “Allahu akbar!” was its soundtrack—an all-purpose call that was at times a plea, at other times a call to arms. The streets were ablaze with bonfires that winter, tires and much else set aflame. Whatever harm the Great Satan, America, and the Little Satan, Israel, had allegedly inflicted on the nation before, at least in those few weeks of a nationwide oil shortage, those countries’ burning flags kept the protesters warm.
Finally came the revolution’s most indelible sign of all: the Islamic dress code forced on women, who could wear only black, gray, brown, or navy blue. The mandatory hijab drained a once-colorful capital of its vibrant hues, casting half of the population into shadow. Women demonstrated in opposition to the order, but they had few allies. Even the secular intelligentsia banded with the ayatollah, dismissing the protests and the blatant anti-Semitic and anti-feminist character of the new leadership as a few minor quirks upon which the great revolution could not afford to dwell.
What brought these memories back on October 7 was a single video on social media. In it, a Hamas terrorist dragged a battered Israeli woman, the 19-year-old peace activist Naama Levi, by the hair out of a pickup truck, chanting “Allahu akbar!”—that ominous, familiar call, as yet another woman suffered at the hands of men who bore an uncanny resemblance to their Iranian precursors. Levi’s blood-soaked pants suggested that she had been assaulted—a tragedy that would bond her to women prisoners in Iran, where, in the aftermath of the 2022 “Woman, Life, Freedom” protests, many women who had been arrested for violating the Islamic morality code were raped by their captors.
Experts have pontificated over whether Iran had a hand in planning the October 7 attack. But perhaps more significant is the common ideology that Tehran’s rulers and Hamas share, composed of equal parts misogyny, anti-Semitism, and Islamism. Death, to them, is an aspiration rather than a destiny to forestall. And so their subjects become expendable pawns whose demise is never a loss. Sadegh Khalkhali, the Islamic Republic’s Sharia judge from the early revolutionary era, was once asked how he had so swiftly issued orders to execute so many political prisoners. He breezily replied that either the prisoners were guilty, in which case they’d received their due punishment, or they were innocent, in which case he had simply hastened their ascent to paradise.
Both Hamas and the Iranian regime are at war with the West and, as such, with all the laws devised in the West, including the laws of war. The most brutal of the Islamic Republic’s anti-riot thugs do not come to the scene of demonstrations dressed in the uniforms of the police or the Revolutionary Guard Corps. They come as what the protesters call “civilian dressers,” just as Hamas terrorists have done throughout this war to blend in with the public. Both use ambulances to penetrate the ranks of their opponents, to snatch prisoners, or to get away from hostile crowds. They share not a secret manual but a playbook of the lawless, in which nothing is forbidden if it advances the cause of the “righteous,” among whom Tehran and Hamas count themselves.
And yet, what Iran’s regime has done for more than four decades to create a new crop of zealots in its own image has backfired. Iran’s younger generations show a moral clarity that other nations in the region, and even the throngs on the streets of London and New York, do not demonstrate with regard to Hamas’s malevolent program. If Iranians have always been distinct from their predominantly Arab neighbors by virtue of race, religion, and language, now they are distinct in a new way: They are the only people in the region among whom such a large number reject the call for Israel’s destruction. Even a host on one of Iran’s official television broadcasts had to make this admission last week: “The people of Iran have been the greatest supporters of the Zionist regime in the world and by a large margin.”
Diasporic Iranians have been marching alongside supporters of Israel throughout Europe, the United States, and Canada, and a few have been physically attacked while doing so. In Iran, students refuse to stomp on the flags of the United States and Israel that have been painted on the ground at the entrances of their schools. When a Palestinian flag was raised at a soccer stadium in Tehran last month, the spectators began chanting profanities to express their indignation.
Iranians began distancing themselves from the regime’s propaganda nearly two decades ago, when the revolution’s fever had cooled and its promises remained undelivered. The distance only grew as the regime invested more and more in proxy groups throughout the region. The crowds at the annual Qods Day rallies began to thin, and protesters at various demonstrations chanted: “Neither Gaza nor Lebanon. I sacrifice my life for Iran.”
The significance of this shift in attitude among Iranians transcends Iran. If Ukrainians’ fight against Russia is about the future of democracy in Europe, then the struggle of Iranians against their regime is about the future of the Middle East without radicalism. For 44 years, Iran has been the region’s political laboratory for Islamist governance. The country gave theocracy a try, and it failed: A country with immense promise only 50 years ago is now a menace to people within its borders and beyond them. The narrative that the regime has peddled about itself—a religious utopia fighting for the well-being of downtrodden Muslims—has no currency among its own subjects. What Iranians have learned the hard way is what others around the world who dream of living under an Islamic state have yet to discover.
One of the most poignant moments of Iran’s 2022 protests came when a Palestinian woman named Rasha, moved by the uprising, recorded a statement saying that the demonstrations had made her see through the lies she had been told since childhood about Iran’s regime: “I now see that a government that kills its own people, oppresses its own people, cannot help liberate my people, cannot help liberate me.”
In 1978, Iranians euphorically followed a Shiite cleric in pursuit of what they thought was a noble cause and staged a popular resistance that was to deliver greater freedom and democracy to them. But he quickly led them into war, chaos, global isolation, and economic ruin. This is the dark legacy of Hamas’s chief patron. Those who have embraced Hamas have yet to know this truth—that their heroes are not liberators but brutal tyrants detested by their people. | Women’s Health |
The Chan Zuckerberg Initiative is opening a research center in New York City dedicated to developing new techniques for early disease detection and treatment. CZ Biohub NY, as it’s being called, will work with Columbia, Rockefeller and Yale universities to learn how immune cells detect and attack specific diseases, and eventually use this insight to engineer cells that could do the job more precisely.
The charitable organization headed by Priscilla Chan and Meta CEO Mark Zuckerberg has committed $250 million to the effort, according to STAT, alongside investments of $10 million each from the State of New York and New York City. In a blog post announcing CZ Biohub NY, the Chan Zuckerberg Initiative said it will start by focusing on cancers and other diseases that often go undetected until they’ve advanced to the point of being difficult or impossible to treat. That includes “ovarian and pancreatic cancers; neurodegenerative diseases, including Parkinson’s and Alzheimer’s; as well as aging and autoimmunity,” CZI says.
CZ BioHub NY aims to get to the bottom of how immune cells work, down to their ability to spot tissue-specific changes that can be among the earliest indications of a disease’s onset. Then, its researchers hope to be able to create cells that can sniff out these abnormalities even earlier than they’re currently able, and be sent to the disease sites directly for more effective treatment. These bioengineered immune cells would “scout, report, and repair damage to our cells before it leads to serious illnesses,” said Chan.
The New York hub is the latest in CZI’s growing network of research institutions, and joins three others that have been established in San Francisco, Chicago, and Redwood City. All have pledged to break ground on their respective scientific goals within a time frame of 10-15 years. Now, according to STAT, the New York biohub just needs to secure a site to work out of. | Disease Research |
Press ReleaseNovember 30, 2023
Loss of Auditory Nerve Fibers Uncovered in Individuals with Tinnitus
Media Contact
Ryan Jaslow
Program Director, External Communications - Research, Mass General Brigham
617-573-4385 | [email protected]
Mass Eye and Ear researchers link tinnitus to auditory nerve degeneration in individuals with a normal hearing test.
A new study from Mass Eye and Ear investigators shows that individuals who report tinnitus, which present as a ringing in the ears in more than one out of ten adults worldwide, are experiencing auditory nerve loss that is not picked up by conventional hearing tests. This work is part of a P50 grant awarded by the National Institutes of Health (NIH) to Mass Eye and Ear researchers within the Eaton-Peabody Laboratories (EPL) for their work on cochlear synaptopathy, which is commonly referred to as “hidden hearing loss.” The results from this study provide a better understanding on the origins of tinnitus and are published November 30th in Scientific Reports.
“Beyond the nuisance of having persistent ringing or other sounds in the ears, tinnitus symptoms are debilitating in many patients, causing sleep deprivation, social isolation, anxiety and depression, adversely affecting work performance, and reducing significantly their quality of life,” said senior author Stéphane F. Maison, PhD, CCC-A, a principal investigator at Mass Eye and Ear, a member of Mass General Brigham, and director of the Mass Eye and Ear Tinnitus Clinic. “We won’t be able to cure tinnitus until we fully understand the mechanisms underlying its genesis. This work is a first step toward our ultimate goal of silencing tinnitus.”
Many individuals with hearing loss report a buzzing, humming, ringing or even roaring sound in their ears. It’s been a longstanding idea that these symptoms, known as tinnitus, arise as a result of a maladaptive plasticity of the brain. In other words, the brain tries to compensate for the loss of hearing by increasing its activity, resulting in the perception of a phantom sound, tinnitus. Until recently though, this idea was disputed as some tinnitus sufferers have normal hearing tests.
However, the discovery of cochlear synaptopathy back in 2009 by Mass Eye and Ear investigators brought back to life this hypothesis as it was evidenced that patients with a normal hearing test can have a significant loss to the auditory nerve. In view of this paradigm shift in the way researchers and clinicians think about hearing loss, Maison and his team sought to determine if such hidden damage could be associated with the tinnitus symptoms experienced by a cohort of normal hearing participants. By measuring the response of their auditory nerve and brainstem, the researchers found that chronic tinnitus was not only associated with a loss of auditory nerve but that participants showed hyperactivity in the brainstem.
“Our work reconciles the idea that tinnitus may be triggered by a loss of auditory nerve, including in people with normal hearing,” said Maison.
In terms of future directions, the investigators aim to capitalize on recent work geared toward the regeneration of auditory nerve via the use of drugs called neurotrophins.
“The idea that, one day, researchers might be able to bring back the missing sound to the brain and, perhaps, reduce its hyperactivity in conjunction with retraining, definitely brings the hope of a cure closer to reality”, Maison added.
Disclosures: The authors declare no competing interests.
Funding: This work was supported by a grant from the NIDCD (P50 DC015857) and the Lauer Tinnitus Research Center at the Mass Eye and Ear.
Paper cited: Vasilkov, V et al. “Evidence of cochlear neural degeneration in normal-hearing subjects with tinnitus” Scientific Reports DOI: 10.1038/s41598-023-46741-5
About Mass Eye and Ear
Massachusetts Eye and Ear, founded in 1824, is an international center for treatment and research and a teaching hospital of Harvard Medical School. A member of Mass General Brigham, Mass Eye and Ear specializes in ophthalmology (eye care) and otolaryngology–head and neck surgery (ear, nose and throat care). Mass Eye and Ear clinicians provide care ranging from the routine to the very complex. Also home to the world's largest community of hearing and vision researchers, Mass Eye and Ear scientists are driven by a mission to discover the basic biology underlying conditions affecting the eyes, ears, nose, throat, head and neck and to develop new treatments and cures. In the 2023–2024 “Best Hospitals Survey,” U.S. News & World Report ranked Mass Eye and Ear #4 in the nation for eye care and #7 for ear, nose and throat care. For more information about life-changing care and research at Mass Eye and Ear, visit our blog, Focus, and follow us on Instagram, Twitter and Facebook. | Disease Research |
Image source, Hudgell SolicitorsImage caption, Laura Winham, of Woking, suffered from schizophreniaA severely mentally ill woman was discovered in a "skeletal state" after lying dead for more than three years in her flat, her family say.Laura Winham, 38, was "abandoned and left to die" by the NHS and social services before her body was found by her brother in May 2021, they claimed.She is thought to have died in November 2017 after being referred to social care twice in the previous years.The NHS and Surrey Police have been contacted for comment. Surrey County Council said it was a "truly tragic case" and that it would provide information for an upcoming inquest into the death.Ms Winham, who had schizophrenia, lived in social housing in Woking, Surrey, and had become estranged from her family.In 2014, a referral was made to Woking Community Mental Health Recovery and her GP, flagging that she appeared to have "untreated mental health issues", her family said. This was not followed up. After visiting Ms Winham in October 2017, in what was probably the last time anyone saw her alive, Surrey Police officers reported to Surrey County Council that she had been "self-neglecting, had little food, and appeared unaware of how to access local services for help".Shortly after this visit, the markings on Ms Winham's calendar stopped. One of the last entries read: "I need help".Image source, Hudgell SolicitorsImage caption, Laura's body was discovered by her brother on the first floor flat of this buildingHer sister Nicky said despite the "warning signs" about her deteriorating mental health, "everyone seems to have turned a blind eye".She added: "Everybody who was in contact with Laura and had a duty to her at some stage simply wiped their hands of her and forgot her. "She was abandoned and left to die."It's just heart-breaking to think of how she lived in her last few years, unable to ask for help, without anyone there for her."Iftikhar Manzoor, of Hudgell Solicitors, who are acting for the family, said: "Laura was referred to adult social care teams twice, firstly in 2014 and then by the police in October 2017. "Assessments of her needs were not carried out. Without doubt these were clear missed opportunities to intervene and carry out a welfare check."A spokesperson for Surrey County Council said it was a "truly tragic case"."It's important that every aspect of this complex case is reviewed and we're committed to participating fully in the inquest process" they added.They confirmed they would provide any information needed to support the coroner's enquiries.Follow BBC South East on Facebook, on Twitter, and on Instagram. Send your story ideas to [email protected]. | Mental Health Treatments |
Graceland, the legendary mansion which once belonged to Elvis Presley, will go to Lisa Marie Presley's three daughters following her sudden death at age 54.A representative for the Memphis, Tennessee estate confirmed to People the property, which is in a trust and was passed down to Elvis' daughter following his death in 1977, will benefit Lisa Marie's daughters - Riley, 33, and 14-year-old twins Harper and Finley.This comes as details of Lisa Marie's public memorial have emerged. A public memorial service for Lisa Marie is set to occur on Graceland's front lawn on Sunday, January 22 at 9AM, a statement revealed, according to ABC News. It had previously been revealed that Lisa Marie would be laid to rest at Graceland next to her late son, Benjamin Keough, in addition to her father and other family members buried at the estate. Graceland, the legendary mansion which once belonged to Elvis Presley, will go to Lisa Marie Presley's three daughters following her sudden death at age 54Lisa Marie died last week at age 54 after suffering two cardiac arrests. Lisa Marie's finances remain contentious: her fourth husband, Michael Lockwood, lost his 2016 bid in their divorce to undo their prenup, but he reopened the case in 2021, demanding she pay the $4,600-a-month child support that a court ordered.The case is yet to be settled, and the state of her finances is unclear.She inherited $100million in 1993, on her 25th birthday, but said that it had almost entirely disappeared thanks to mismanagement and bad investments.Graceland, however, remained.Lisa Marie had four children - her three daughters and son Benjamin Keough, who took his own life in July 2020 following a lengthy battle with drug addiction and depression. Lisa Marie is pictured in 2021 with her 33-year-old daughter Riley and 14-year-old twin daughters Harper Vivienne Ann and Finley Aaron Love Riley Keough is pictured with her mother in October 2017 Riley Keough and Lisa Marie Presley with twins Finley and Harper Vivienne Harper and Finley Vivienne pictured together at the handprint ceremony to honor their grandmother Priscilla in June 2022Riley, whose latest role is in Amazon Prime series Daisy Jones and the Six, charting the story of a 1970s rock band, said last year while promoting Zola that her brother's death had hit her hard.She told The New York Times she endured 'a year of feeling like I was thrown into the ocean and couldn't swim'.She added: 'The first four or five months, I couldn't get out of bed. I was totally debilitated. I couldn't talk for two weeks.'Even now, Riley finds the tragedy hard to accept.'It's very complicated for our minds to put that somewhere because it's so outrageous,' she said. Lockwood and his daughters Harper Vivienne and Finley at his Santa Barbara wedding to Beauty Beach Lounge hairstylist Stephanie Hobgood in October Elvis Presley bought Graceland in 1957, and on his death in 1977 it passed to his only child, Lisa Marie. She owned 100 per cent of the property Elvis and Priscilla Presley are pictured at Graceland with a baby Lisa Marie Lisa Marie Presley, 54, died on Thursday after suffering a cardiac arrestIn latest developments Lisa Marie Presley told fans at Graceland she had become a recluse in a poignant speech just days before her sudden death aged 54;Her heartbroken mother Priscilla confirms the news saying 'my beautiful daughter Lisa Marie has left us' after she rushed to her hospital bedside in LA;Elvis's late daughter confessed to being 'destroyed' by her son's suicide, saying she 'blames herself every single day';Days before her death she was unsteady while being interviewed on the red carpet at the 2023 Golden Globes, where she attended to support the film Elvis'If I'm going through a breakup, I know what to do with that and where to file it in my mind, but suicide of your brother? Where do you put that? How does that integrate? It just doesn't.'While struggling to come to terms with Benjamin's death, she became interested in death doulas, and trained as a practicioner - guiding people through the final stages of their lives.'That's really what's helped me, being able to put myself in a position of service,' she said. 'If I can help other people, maybe I can find some way to help myself.'She said she was supported by her husband, Australian stuntman Ben Smith-Petersen, who she met on the set of Mad Max: Fury Road.The pair married in February 2015, after traveling to Nepal to spend time building houses in the Himalayas. The look of love: Riley and and Ben Smith-Petersen met in 2012 on the desert set of Mad Max: Fury Road, for which he won a SAG Award for best stunt ensemble Riley and her husband Ben (left) are seen together with Benjamin and his girlfriend Diana in 2018 on a holiday to Tulum, Mexico Benjamin, 27, died after he shot himself in July 2020She said her brother's death increased her sense of spirituality, and made her wish death was not such a taboo.'There's nothing that can prepare you for loss and tragedy and I wish there was,' she told Vogue.'When I lost my brother, I felt so angry that no one talks about death. It's hidden away and then it happens to you and you're thrown into an ocean and you can't swim.'So for me, what's been helpful is trying to help other people who are experiencing similar things. I trained to be a death doula and got my certificate to be a death midwife.'I read a lot, meditate and I'm very spiritual. I think it's rewired my entire existence and also made me thankful for every moment. I have so much more love in my heart than I could ever have imagined.'But, it is painful and a lot of work. It's been a tragic year for so many people. There's been so much suffering. It makes you realize how connected we all are.'In addition to Riley, Lisa Marie also had two other daughters. Harper Vivienne and Finley, daughters of musician Michael Lockwood and Presley, frequently appeared with their parents on the red carpet.At the time of their mother's death the 14-year-olds were living with her in Calabasas, although they had at times lived with their grandmother Priscilla, throughout their parents' acrimonious divorce.In October their father remarried, to celebrity hairdresser Stephanie Hobgood.The twins were 'grooms women'.Lockwood said, following Lisa Marie death, that the girls were with him. ''Michael had been hoping for a speedy and complete recovery because her children needed her. It is very sad it didn't turn out that way,' said Joe Yanny, Lockwood's spokesman. 'Michael's world has been turned on its ear. He is with both of his daughters now.' Lisa Marie has previously spoken of her son's, left, similarity to her dad Elvis, right, calling their resemblance 'uncanny' Lisa Marie (right) and her mother Priscilla (left) were at the Golden Globe Awards on Tuesday night to see Austin Butler (center) who played her father in the movie 'Elvis'In July 2020 Benjamin took his own life. At the time, sources revealed he'd been 'struggling' and that his death, while devastating, was not a 'huge surprise' to his mother or other relatives.It's unclear how much alcohol or cocaine he had in his system but there were traces of both, according to Los Angeles County Coroner's office.The report also describes Benjamin's history with mental illness.He had tried to take his life six months earlier, then spent three weeks in rehab four months before he died.Benjamin had attempted rehab three times before. The autopsy makes reference to his drug abuse and says he also had a history of depression.On what would have been his 28th birthday in 2020, Lisa Marie posted a poignant tribute. 'My beautiful beautiful angel,' the singer-songwriter wrote on Instagram next to a picture of Benjamin as he is about to blow out birthday candles on a cake.'I worshipped the ground you walked on, on this earth and now in Heaven. My heart and soul went with you. The depth of the pain is suffocating and bottomless without you every moment of every day.'I will never be the same. Please wait for me my love, and hold my hand while I stay to continue to protect and raise your little sisters and to be here for Riley.'I know you would want that. Happy Birthday my sweet sweet Boy. You were much too good for this world.' Lisa Marie Presley paid tribute to her late son, Benjamin Keough (pictured above), on what would have been his 28th birthday 'I worshipped the ground you walked on, on this earth and now in Heaven,' Lisa Marie wrote on what would have been her son's 28th birthday. 'My heart and soul went with you.' Benjamin Keough with his mother Lisa Marie Presley in 2012. He took his own life in July 2020Graceland, the Memphis, Tennessee estate, was bought by her Mississippi-born father Elvis in the spring of 1957, when he was 22 and had just hit fame.The 1939 house and its grounds were sold to the young rocker for $100,000, and on his death in 1977 they passed to his only child, Lisa Marie.Lisa Marie's mother Priscilla - who divorced Elvis in 1973 - transformed the faltering estate into a tourist attraction on his death, opening it to visitors in 1982.The grounds now see 600,000 visitors a year - making it second only to the White House and the Biltmore Estate for tourist numbers.And while the house sees a stream of people to gawk at the jaw-dropping excess of the jungle room, and gaze at the fabulously kitsch white and blue 1970s living room, the building remains in use as a family home - where the Presleys gather for dinners and reunions. Lisa Marie is pictured with twins Harper Vivienne and Finley, daughter Riley, and son Benjamin Benjamin was the son of musician Danny Keough, who married Lisa Marie in 1988 and divorced her in 1994. Pictured, Lisa Marie and Danny His suicide led to fears for a devastated Lisa Marie's own health, with her ex-husband Michael Lockwood saying in court documents he feared she would relapse into drug addiction.Riley and Benjamin were born during their mother's first marriage, to actor Danny Keough.Despite Lisa Marie leaving him in 1994 and marrying Michael Jackson 20 days later, Danny and Lisa Marie remained on friendly terms.She was living with him at the time of her death, and he found her collapsed at their home after returning from taking the twins to school: he performed CPR until the paramedics arrived.How much money Lisa Marie's three daughters will inherit remains unclear.Despite their grandfather being one of the biggest-selling musicians of all time, the finances were frequently precarious - thanks to The King's lavish lifestyle and generosity.When he died in 1977, he had only $5million in the bank - thanks, in part, to a deal made by his manager, Colonel Tom Parker, five years before his death.In 1973 Parker sold all of Presley's master recordings to RCA Records for $5.4million, which means the label pays no royalties to the estate for tracks released before 1973.Of his 23 studio albums, only five were released after 1973.Elvis's catalogue has been shopped around over the years: in 2013 the rights to his music and image were bought by Authentic Brands, which owns Marilyn Monroe and Muhammad Ali's rights.Last year, Authentic announced a deal with Universal Music to share the rights.The royalties are not the only issue.Elvis's trust, which was once valued at $100million, was all but gone by 2015.Lisa Marie appointed Barry Siegel in 2003 to manage the money - the same year she launched a musical career of her own.Siegel, senior managing director of Provident Financial Management and a prominent entertainment business manager, counted Al Pacino, Elijah Wood, Pulitzer Prize-winning playwright David Mamet, and Frankie Valli and the Four Seasons as his clients. But in 2005 Siegel sold off 85 per cent of Lisa Marie's share in Elvis Presley Enterprises, which saw her lose control of her father's name and image rights.Siegel said the deal 'cleared up over $20million in debts that Lisa had incurred and netted her over $40million cash and a multi-million dollar income stream'.Lisa Marie said it lost her millions thanks to a subsequent investment in Core Entertainment, the company behind American Idol that went bankrupt in 2016.Siegel then allegedly began liquidating Lisa Marie's assets in order to supplement her trust income. She claimed his business decisions left her with a $500,000 credit card debt. Barry Siegel began managing Lisa Marie's finances in 2003, and in 2005 sold off 85 per cent of her share in Elvis Presley Enterprises, which saw her lose control of her father's name and image rights. He insisted it was necessary to pay off her debtsLisa Marie divorced her fourth husband, Michael Lockwood, in 2016, and in their divorce proceedings claimed she was $16million in debt - which Lockwood said was not true. According to the documents, Lisa Marie at the time owed more than $10million in taxes from 2012 to 2017 and had defaulted on her debt of more than $6million from her United Kingdom home. She also owed $263,050 in professional frees, $47,844 in credit card debt and an estimate of $250,000 in miscellaneous unpaid bills.Presley revealed her financial struggles in response to a request from Lockwood that she help pay part of his $450,000 in attorney fees.In 2018, she sued Siegel, accusing him of mismanaging her finances. Siegel and his company, Providence Financial Management, countersued, alleging Presley's 'out-of-control spending' led to her financial predicament.Leon Gladstone, a lawyer representing Barry Siegel, said at the time: 'It's clear that Lisa Marie is going through a difficult time in her life and is looking to blame others instead of taking responsibility for her actions.' Yet Lisa Marie was adamant that the financial collapse was his fault. Lisa Marie and Michael Lockwood signed a pre nuptial agreement, but when they divorced in 2016 he challenged it. The case was still pending at the time of her death'Between 2005 and the time of the American Idol bankruptcy, Siegel billed $4.9million to 'manage' the trust, an average annual salary of $701,000 per year,' the court documents state.'Had Siegel disclosed the the trust's true financial condition to Presley and restricted spending to the trust's 'income' rather than its principal assets, Presley would have lived comfortably on an annual budget of between $1.5 and $2million per year, after taxes.'On this budget, Siegel's lucrative compensation package would have amounted to between 40 to 50 per cent of Presley's post-tax annual budget - an amount she undoubtedly would not have agreed to had she been aware of her true financial condition.'Instead of telling Lisa Marie the truth, Siegel covered up the dire straits of her finances, say her lawyers.'Siegel repeatedly led Lisa to believe she was in "good shape" with her finances,' the documents state.Her attorneys cited several emails from Siegel responding to inquiries from Lisa Marie about how her trust fund was faring.Lisa Marie drug treatment over the years also ate into her bank balances.She said she was in rehab at least five times - with stints at one site she attended, Hills Treatment Center in Los Angeles, costing $40-50,000 a month. | Mental Health Treatments |
Chemotherapy shortages push cancer centers toward crisis
Cancer centers are contending with shortages of key chemotherapy drugs, with potentially dire consequences once the scarcity starts hitting patients.
A new survey released this week by the National Comprehensive Cancer Network (NCCN) found that 93 percent of cancer centers are reporting shortages of carboplatin and 70 percent are reporting shortages of cisplatin. These two drugs are commonly used together to treat a wide variety of cancers — including breast, lung, prostate and many types of leukemias — often with the aim of curing them.
The survey conducted in May found that cancer centers were still able to treat patients with cisplatin without delays or claim denials, but only 64 percent of centers were able to keep patients on a regime of carboplatin. A fifth of cancer centers said they were able to continue prescribing carboplatin for some but not all of their patients.
According to Mike Ganio, director of pharmacy practice and quality for the American Society of Health-System Pharmacists (ASHP), the U.S. is seeing “a near-10 year high in active ongoing shortages”
Much of the current shortages stem from a major interruption in manufacturing that occurred when a facility in India, run by Intas Pharmaceuticals, halted production in March after the Food and Drug Administration (FDA) discovered a “cascade of failures” in the plant’s quality control.
The FDA issued an import alert to the facility last week, stating all future shipments originating from the facility would be denied admission into the U.S. except for 24 drugs that are in short supply, including carboplatin and cisplatin.
“These are critical oncology medicines,” Alyssa Schatz, senior director of policy and advocacy for NCCN, said.
“I think the good news is that there are safe alternatives in many cases, but NCCN is concerned that a lack of guidance and clarification from payers on how those drugs will be covered with or without prior authorization can cause harmful delays in care,” she said.
Schatz noted that when cancer care was disrupted during the pandemic, insurance companies responded by providing flexibilities with telehealth and releasing guidance on coverage when it came to oral equivalents of chemotherapy that could be sent through the mail.
To help with the current chemotherapy shortages, she said insurance providers must provide this same type of response, providing clear guidance on waiving prior authorization for chemotherapy alternatives.
The shortages of these critical medications has caught the attention of Congress with Democratic Sens. Dick Durbin (Ill.), Debbie Stabenow (Mich.), Gary Peters (Mich.) and Rep. Elissa Slotkin (D-Mich.) recently calling on the FDA to take immediate action, such as importing chemotherapy drugs and alternative treatments from other countries.
FDA Commissioner Robert Califf appeared to heed these calls when he announced last week that his agency would to allow the “temporary importation of certain foreign-approved versions of cisplatin products from FDA-registered facilities.”
The FDA is working with Qilu Pharmaceuticals in China to increase the availability of cisplatin and Canadian pharmaceutical company Apotex to distribute it.
These short term fixes may improve the situation for the time being, but stakeholders warn that drug shortages are an ever-increasing problem that needs to be addressed at the systemic level.
Schatz cited lower-priced generics as one factor behind drug shortages, albeit in a roundabout way.
“Paradoxically, low drug prices are a key driver of this shortage. We often hear about how the US overpays for drugs, but that conversation is primarily related to brand-name drugs,” said Schatz. “Generics manufacturers operate on a razor thin margin and that can lead to quality and supply issues.”
These margins pressure manufacturers to operate at near-capacity and reduce the number of makers in the market, leaving it vulnerable to shortage when crises occur.
“We’re talking about things that have low profit margins. Therefore there’s little incentive to invest in facilities, there’s little incentive for manufacturers to get into manufacturing those products,” Ganio from ASHP said.
Healthcare organizations continue to urge Congress to advance policies that incentivize manufacturers to invest in critical drug production, for cancer and other diseases, and improve how the Strategic National Stockpile functions and encourage stronger manufacturing quality.
To that end, Reps. Buddy Carter (R-Ga.) and Lisa Blunt Rochester (D-Del.) reintroduced the Essential Medicines Strategic Stockpile Act earlier this year. The bill would direct federal agencies to develop a stockpile of 50 generic drugs at risk of shortage that could supply U.S. patients with their medicines for six months.
While this bill would not address the root cause of shortages, it would provide the market with a supply of drugs while a disruption to the supply chain was addressed, experts told The Hill.
In a letter to Califf and Health and Human Services Secretary Xavier Becerra on Thursday, a bipartisan group of 70 House lawmakers asked the officials how the federal government can improve its oversight and enforcement of pharmaceutical supply chains in light of the chemotherapy shortage.
“Patients, physicians, and pharmacists are often the last to know when an essential drug will no longer be available, yet, are affected by these shortages the most,” they wrote.
“We strive to ensure patients, physicians, and pharmacists never have to experience shortages of essential medications, but when shortages do occur it is vital that these individuals are made aware as quickly as possible so that they can better prepare.”
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
Seventy five years ago today, Aneurin Bevan inaugurated the National Health Service with a symbolic handing over of keys to Park Hospital in Trafford, Manchester. The aims of the new service had been spelt out with stirring clarity in a White Paper a year-and-a half before. Everybody “irrespective of means, age, sex or occupation shall have equal opportunity to benefit from the best and most up-to-date medical and allied services available”.
Furthermore, the NHS would be “comprehensive and free of charge”. Bevan said that costs were unpredictable – and he was right. He reckoned it would take a year of experience to find out what those costs were – and he was wrong. He also thought that the high early costs would fall as the backlog was treated – oh, dear, very wrong indeed. The infectious diseases that had afflicted Britons for centuries were certainly cleared up, but others were coughing politely in the wings.
“We shall never have all we need,” the minister predicted. “Expectation will always exceed capacity.” But even Bevan – a man of large and compassionate imagination – could not look into the future and see all the clamorous demands that would one day cripple the NHS and threaten to finish it off for good.
In 1948, only babies of over 28 weeks’ gestation were considered viable (under 3lb and perhaps 10 to 20 per cent would live; today it’s closer to 90 per cent). Premmies the size of a shoe are coaxed towards a life that Mother Nature may not have intended, in neo-natal intensive care, the incubator and personal care costing more than a Mayfair hotel. It’s vastly expensive and the long-term outcome is uncertain, but parents of a 23-week-old prefer anything to the alternative – which is death. Who would dare say no?
The miracles of 75 years ago are regarded now as standard issue. Heart attack patients who, back then, would have been left in a corner under a blanket, now have complex surgeries. A cancer specialist tells me about a pill that banishes a certain kind of tumour; £30,000 a pop. A course of treatment can be £1.5 million, but no one wants to hear that magic costs or rationing may be necessary.
At a special service in Westminster Abbey earlier today, the Duke and Duchess of Edinburgh and 1,500 members of staff, including NHS chief executive Amanda Pritchard, paid tribute to the NHS. It was a heartfelt and touching occasion, no doubt, but mainly it was a lie, a great big suppurating lie. For the sad and painful truth is, there is very little to celebrate on this landmark birthday for the NHS. And holding a religious ceremony in its honour is a big part of what’s gone wrong, if we’re honest.
Other countries don’t sanctify their health systems (invariably far superior to our own). As a mystified German woman said to me the other day, “Nobody would sing Happy Birthday or put posters up saying ‘Danke GKV’ in their windows. It’s just a health insurance scheme for which we pay.”
Instead of an efficient health insurance scheme, which delivers excellent outcomes or goes bust, we have a quasi-religion which delivers terrible outcomes and can never be allowed to go bust because, well, it’s “our NHS”.
A deep sentimental attachment to a wonderful idea has meant a reluctance to admit just how bad the reality is. But faith is finally waning fast. I find that encouraging. Most people have either had a bad NHS experience or know someone who has. A young producer at GB News told me that his father, an amputee, spent two hours sitting in his own faeces and crying in hospital last week. Horrifying, but not unusual. The spotless wards, and the spit-spot nurses of the early years of the NHS, are long gone. Matron would have a nervous breakdown if she saw their successors.
A staggering 7.4 million people are on a hospital waiting list (with hundreds of thousands more desperate to get on a list and apparently subject to delaying tactics so it looks like the numbers are coming down). Doctors’ strikes add 100,000 to that impossible number every day they down stethoscopes.
The data are universally dire. A survey published last week by the King’s Fund thinktank found that our health service was the second worst out of 19 comparable countries on that rather key metric “Saving lives”. The NHS significantly underperforms on cancer and heart disease and came bottom of the class for stroke victims. Not only is our health service appalling at dealing with the major life-threatening illnesses, a report by Civitas estimated that 50,000 British people every year are dying from treatable diseases. Basically, if those 50,000 men and women lived in Germany, France, Australia or, indeed, any country with properly functioning healthcare, they would still be alive.
Ah, say the defenders of the NHS, the service has been starved of funds by those nasty Tories. Not really. In the year 2021/22, total healthcare expenditure in the UK was £280.7 billion. That works out at about £4,188 per person. You might think that kind of sum would at least buy you a face-to-face appointment with a GP. Nope. “Due to the coronavirus pandemic we are experiencing a high volume of calls and will never get back to you, but please try later.” Increasingly, it’s hard to see what we get for our money, and it’s a lot of money to get nothing in return.
The “entire British state is on the verge of becoming a subsidiary of the NHS”, Sajid Javid, former Health Secretary, warned yesterday. Javid pointed out that the percentage of all public spending on the NHS has risen from 27 per cent in the year 2000 to 44 per cent today, and yet health outcomes are the worst among major nations. British people consistently die younger as a result of inferior healthcare.
Why should we have to put up with that? Maybe we won’t; not for much longer. Patient satisfaction levels have slumped to the lowest level ever according to the British Social Attitudes survey – just 20 per cent said they were happy with the NHS in 2022. Major reform is desperately needed, but political parties have tended to treat the NHS like a roadside bomb. They are scared stiff the electorate will punish them if they harm this national treasure. But who really thinks the NHS is a treasure any more? A real leader, a man of vision like Aneurin Bevan, could sell the need to change to a new system.
Those who bemoan the state of hospitals today should cast their minds back to 1948. Paddington General, where the maternity cots stood in tins of oil to discourage the cockroaches from visiting the newborn, was not untypical. There were few drugs, cancer treatment was primitive. Illness was far too expensive for the man in the street. A patient with TB for whom an operation was required, might pay more than £1,000 from time of admission to discharge months later. My paternal grandfather, a sweet, gentle man who probably didn’t earn that much in a year, died of TB in his mid-thirties. TB killed 23,175 other people in England and Wales that year, the same year that Bevan pledged to “lift the shadow from millions of homes”.
How amazing the National Health Service was, a wonder-drug for a war-wounded nation. But Bevan’s promise that everybody “irrespective of means, age, sex or occupation shall have equal opportunity to benefit from the best and most up-to-date medical and allied services available” is being broken every day now.
You can’t have a “comprehensive and free of charge” health service in 2023, not with all the advances in medicine, not with patients consulting Dr Google. The NHS is a steam train in the digital age; nostalgia must not keep us stuck in the past. Sajid Javid is right to suggest a Royal Commission, a non-partisan look at health services around the world that actually work. Ours did once, but not any more. There is too much suffering, too many avoidable deaths. Aged 75, the NHS is on life support. Time to switch the machine off and begin afresh for all our sakes. | Health Policy |
Rishi Sunak is planning the biggest expansion of private sector involvement in the NHS since the Blair era in an effort to clear record backlogs.
On Friday, ministers will announce measures to “use every tool at our disposal” to cut waiting lists ahead of the next election.
Private sector firms will be asked to operate community diagnostic centres for NHS patients, starting with eight units carrying out more than 400,000 scans, checks and tests a year.
Across the country, such companies will be asked to identify all spare capacity, enabling the NHS to send patients facing long waits to private hospitals that can treat them more quickly.
Latest figures show 7.47 million – more than one in eight people – are on waiting lists, the highest figure since records began in 2007.
The plans echo the drive set in motion by Sir Tony Blair to expand the use of the private sector in the health service. The Labour government funded a network of 30 private clinics carrying out operations and tests for NHS patients between 2003 and 2010.
Writing for The Telegraph, Will Quince, the health minister, said record waiting lists meant it was “vital that we go further” than previous attempts to use the independent sector to bolster NHS capacity.
“The NHS has used the independent sector to bolster NHS capacity and ease pressure at critical times for nearly two decades,” he said.
“But at a time of record waiting lists it is vital that we go further to improve care for patients while remaining true to the NHS’ founding principles, free at the point of use.”
But Labour has accused the Tories of acting too slowly – saying that if spare independent sector capacity had been used sooner, 330,000 more patients would already have been treated since January 2022.
Wes Streeting, the shadow health secretary, has previously said that Labour would have gone further than the Tories in using private hospital beds for NHS patients.
The drive follows orders from the Prime Minister to “turbocharge” use of the private sector, and give patients a choice of hospital, in order to bring down waits.
Mr Sunak set up the Elective Recovery Taskforce, chaired by Mr Quince, which will publish its recommendations on Friday.
Under the drive, dashboards will be used to capture real-time information about spare capacity in the NHS and the private sector, in an attempt to make use of all resources.
David Hare, chief executive of the Independent Healthcare Provider Network, who sat on the taskforce, said the announcement was “a real, significant step forward to unlocking more of the capital, capacity and capability of the independent sector”.
GPs are already being asked to ensure that all patients being referred for hospital care get a choice of five providers, which could include the private sector.
From October, anyone who has waited more than nine months without being given an appointment will be told they can switch to a provider with a shorter wait.
Independent-run sites in the South West – located in Redruth, Bristol, Torbay, Yeovil and Weston-super-Mare – will be operated by diagnostics company InHealth.
Other private facilities will be set up in Southend, Northampton and south Birmingham, with providers yet to be decided. They will join four already operating in Brighton, north Solihull, Oxford and Salford.
Five new NHS-run sites will also be created in Hornchurch, Skegness, Lincoln, Nottingham and Stoke-on-Trent, carrying out more than 340,000 extra checks.
Ministers have pledged to open 160 centres in total by 2030, as part of efforts to speed up diagnosis of cancer and other deadly conditions.
The latest plans aim to make maximum use of all diagnostic and surgical capacity, regardless of where it comes from.
During the pandemic, the NHS agreed to block contracts with the private sector, but failed to ensure much of the capacity was actually used.
One source close to the plans said: “This isn’t just about setting up private clinics which operate purely for NHS patients.
“That is the start of it, but the intention is something far more ambitious, to squeeze much more out of the independent sector so that supply and demand can be matched in real time.”
Steve Barclay, the Health Secretary, said: “We must use every available resource to deliver lifesaving checks to ease pressure on the NHS.
“By making use of the available capacity in the independent sector, and enabling patients to access this diagnostic capacity free at the point of need, we can offer patients a wider choice of venues to receive treatment and in doing so diagnose major illnesses quicker and start treatments sooner.”
Mr Sunak vowed to bring waiting lists down earlier this year, but last month said industrial action across the NHS was making the task “more challenging”, with around 700,000 appointments cancelled.
Junior doctors are currently preparing for another four-day strike on Aug 11 in their ongoing row with the Government over pay, with consultants set to walk out for 48 hours on Aug 24.
We must use every tool at our disposal to cut NHS waiting lists
By Will Quince
We have a duty to patients to use every tool at our disposal to tackle the backlogs that built up during the pandemic.
That’s why we set up the Elective Recovery Taskforce, which I chaired, to bring together expertise from academics and experts within and outside the health service to explore ways to maximise spare independent sector capacity.
This will help to cut waiting times and give patients more choice over their care – which is what matters to Telegraph readers.
The NHS has used the independent sector to bolster capacity and ease pressure at critical times for nearly two decades. But at a time of record waiting lists, it is vital that we go further to improve care for patients while remaining true to the NHS’s founding principles, free at the point of use.
As part of this, we’re announcing eight new community diagnostic centres (CDCs) that will be run by the independent sector, with a network of five across the South West and others in Birmingham, Northampton and Southend. These one-stop shops offer checks for conditions such as cancer or heart disease, closer to people’s homes.
When up and running, these will deliver nearly 401,900 checks, tests and scans a year, and will add to the four independent sector-led centres that are already open.
I visited one of these this week in Oxford, which is run in partnership with the private sector and has already delivered thousands of checks to local patients – from ultrasounds to lung tests.
Through the CDC model, patients can even get their blood and lung scans and tests carried out in one appointment, often the day after their initial hospital appointment.
The Telegraph has backed calls for greater use of the independent sector to tackle NHS waiting lists and, by using independent sector funding to set these centres up, as well as its workforce, the NHS can ramp up capacity for diagnostic tests more quickly.
Alongside our investment in NHS diagnostics, this will help patients receive earlier and faster diagnoses that could help save more lives.
In addition, we are announcing five new NHS-run centres. We’re on track to open up to 160 in total across the country by 2025, backed by £2.3 billion, with 114 currently operational and more than 4.6 million checks, tests and scans delivered since July 2021.
The taskforce also set out a number of actions which we are taking forward, including publishing more data on NHS use of the independent sector and developing a mechanism to better track, evaluate and monitor the impact of the sector on NHS capacity.
We will also review training opportunities for staff and cut red tape for doctors moving across providers.
And earlier this year, we announced plans to give people greater options over where they are treated, which could help cut their waiting time.
After speaking with their GP, patients should be able to view information for a minimum of five providers where possible – including in the independent sector – with information about waiting times, distance to travel and quality to help them make their choice.
These plans will build on the progress hard-working staff have already made to cut waiting lists, one of our top five priorities. This includes virtually eliminating waits of over 18 months, which have now been reduced by 94 per cent since the September 2021 peak.
I don’t want anyone to wait longer than necessary for care, and I know these measures are the right ones for patients to help address pressures and improve care.
Will Quince is minister for health and chairman of the Elective Recovery Taskforce | Health Policy |
A research team, led by Professor Ja Hyoung Ryu from the Department of Chemistry at UNIST, in collaboration with Professor Hyewon Chung from Konkuk University, has achieved a significant breakthrough in the treatment of age-related diseases. Their cutting-edge technology offers a promising new approach by selectively removing aging cells, without harming normal healthy cells. This groundbreaking development is poised to redefine the future of healthcare and usher in a new era of targeted therapeutic interventions.
Aging cells, known as senescent cells, contribute to various inflammatory conditions and age-related ailments as humans age. To address this issue, the research team focused on developing a technology that could precisely target and eliminate aging cells, while sparing normal healthy cells.
In their study, the team designed organic molecules that selectively target receptors overexpressed in the membranes of aging cells. By leveraging the higher levels of reactive oxygen species (ROS) found in aging cells, these molecules promote the formation of disulfide bonds and create oligomers that bind together.
Through self-assembly of these oligomers, the researchers successfully created artificial proteins with a stable α-helix secondary structure. These protein-like nanoassemblies exhibited strong binding affinity to the mitochondrial membranes of aging cells, leading to membrane disruption and subsequent cell self-destruction.
"The selective removal of aging cells by targeting the mitochondria and inducing dysfunction has been successfully demonstrated in our experiments," stated Professor Ryu. "This approach represents a new paradigm for treating age-related diseases."
This innovative technology offers several advantages, including minimal toxicity concerns and a wide therapeutic window by specifically targeting organelles within cells. It opens up exciting possibilities for designing preclinical and clinical trials in the future.
Supported by the National Research Foundation of Korea (NRF) and the Ministry of Science and ICT (MSIT), this groundbreaking research has been published in the online version of the Journal of the American Chemical Society (JACS) on September 4, 2023.
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Materials provided by Ulsan National Institute of Science and Technology(UNIST). Note: Content may be edited for style and length.
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The mother of a four-year-old boy with complex needs said she fears he could die waiting for life-changing surgery.
Collette Mullan made the claim to BBC Spotlight as it examined the scale of hospital waiting lists.
Northern Ireland has the worst waiting times in the UK, with more than half a million cases queued for an outpatient or inpatient appointment.
The Department of Health has described current waiting lists as "entirely unacceptable".
ÃisÃn, from County Londonderry, has a number of health conditions including cerebral palsy, and is currently waiting for two procedures.
He is fed with a tube that carries his food through his nose into his stomach, but since it was inserted six months ago, his mum Collette said he has struggled to breathe.
"His breathing has been horrendous, choking all the time."
"He would choke until he vomits. It's very scary" she said.
ÃisÃn is now waiting to have the nasogastric tube removed and replaced by a different feeding system which goes directly to his stomach.
Collette said she was told it could be a three-year wait for the procedure.
She is concerned that ÃisÃn's cerebral palsy puts him at a greater risk of complications, saying she had been warned there was a danger he could aspirate.
"He could die. Anything going into his lung really, it could be very dangerous," she said.
The Belfast Health and Social Care Trust, where the specialist surgery is to be carried out, told Spotlight the wait should be no more than two years.
It apologised for the time ÃisÃn has had to wait, adding that there was a limited number of paediatric surgeons who fit the tubes.
It said 75 children were currently waiting for the surgery.
"It is extremely difficult to prioritise these children based on clinical need due to the complex nature of their care plans" the trust said.
Collette told Spotlight ÃisÃn is also waiting for surgery on his hip.
"His right hip is completely out of socket; it is just completely out," she said.
"Because this is out, then we have to match the two up together. It's not going to make him walk but it's to prevent pain.
"Pain will eventually come at some stage. Thank goodness it hasn't come yet."
ÃisÃn was placed on the list for this procedure last year but Collette said she had no idea when it was likely to be carried out.
The Belfast Trust said demand for such surgery was outstripping capacity, and that it was exploring options to alleviate waiting lists across paediatric orthopaedic services.
BBC Spotlight also spoke to Taylor Clark, a 30-year-old former coffee-shop manager who has had to give up work due to poor mobility and severe pain.
The Bangor woman has Ehlers Danlos syndrome, which affects the tissues supporting her joints and muscles.
"The ligaments and tendons and muscle are all affected by that because they're not being held like a structure - they're sort of swimming around," she told the programme.
"I'm just in pain constantly - everything hurts."
Taylor said she was referred for an outpatient rheumatology appointment two years ago.
When she phoned in January this year to check her progress on the waiting list, she said she was told it could be approximately another six years.
The South Eastern Trust said it could not comment on individual cases.
In a statement the trust said it was "very conscious that patients have to wait for a significant time to receive a first outpatient rheumatology appointment" and that it understood the "distress" this could cause for patients.
As part of the programme, Spotlight brought together a panel of health experts to come up with ways to try and tackle Northern Ireland's waiting list crisis.
They included the former director of public health, Professor Gabriel Scally, health economist Professor Dame Carol Propper and former chief executive of the Northern Ireland Health and Social Care Board John Compton.
The panel agreed that more accountability within the health service was needed, along with the introduction of a performance management regime.
It also recommended greater involvement with the public and strong political leadership, which the experts said were all required to try to fix the current waiting list crisis.
The Department of Health told Spotlight that Northern Ireland's hospital waiting times were "entirely unacceptable" and had been "made significantly worse by the pandemic".
"Far too many people in our community [are] waiting far too long for assessment and treatment" the department said.
It said a key component in tackling waiting times was a greater separation of elective care from urgent and emergency care.
"This ringfences staffing, bed capacity and theatre capacity for elective treatments, helping to increase the number of patients treated and reducing cancellations due to emergency cases," the department said in a statement.
It added: "Reconfiguration of our hospital services is under way with the establishment of day procedure centres and elective overnight stay centres."
Spotlight How Do We Fix Our Waiting Lists? Watch now on the BBC iPlayer, or on BBC One Northern Ireland Tuesday 03 October 22.40 BST. | Health Policy |
An anonymous reader quotes a report from Scientific American: This week doctors announced they had completed the first successful transplant of a partial face and an entire eye. In May at NYU Langone Health in New York City, the surgery was performed on a 46-year-old man who had suffered severe electrical burns to his face, left eye and left arm. He does not yet have vision in the transplanted eye and may never regain it there, but early evidence suggests the eye itself is healthy and may be capable of transmitting neurological signals to the brain. The feat opens up the possibility of restoring the appearance -- and maybe even sight -- of people who have been disfigured or blinded by injuries. Researchers caution there are many technical hurdles before such a procedure can effectively treat vision loss, however.
"I think it's an important proof of principle," says Jeffrey Goldberg, a professor and chair of ophthalmology at the Byers Eye Institute at Stanford University, who was not involved in the surgery but has been part of a team working toward whole-eye transplants in humans. "I think it points to the opportunity and importance that we really stand on the verge of being able to [achieve] eye transplants and vision restoration for blind patients more broadly."But he cautions that the main obstacle is achieving regeneration of the optic nerve, which carries visual signals from the retina to the brain; this step has not yet been successfully demonstrated in humans.
Scientists have been working toward whole-eye transplantation for many years. "This has been, I would say, science fiction for a long time," says Jose-Alain Sahel, a professor and chair of the department of ophthalmology at the University of Pittsburgh School of Medicine, who has been working toward such transplants with Goldberg and others. Progress in surgical techniques and nerve regeneration have made this goal seem more attainable. [...] "The fact that this surgery was successful is wonderful news," Sahel says. He cautions that surgery is only a small part of the issues that need to be addressed in order to restore eye function, however. These include making sure the immune system doesn't reject the donor eye, which is a challenge with any type of transplant. Then the corneal nerve -- which carries sensory signals from the transparent part of the eye -- must be reconnected. Yet the most complex part is regenerating the optic nerve. In order to do so, surgeons have to coax the nerve fibers to grow to the right place, which Sahel says could take months or even years. And complete optic nerve regeneration has not yet been successfully achieved in humans or other mammals.
"I think it's an important proof of principle," says Jeffrey Goldberg, a professor and chair of ophthalmology at the Byers Eye Institute at Stanford University, who was not involved in the surgery but has been part of a team working toward whole-eye transplants in humans. "I think it points to the opportunity and importance that we really stand on the verge of being able to [achieve] eye transplants and vision restoration for blind patients more broadly."But he cautions that the main obstacle is achieving regeneration of the optic nerve, which carries visual signals from the retina to the brain; this step has not yet been successfully demonstrated in humans.
Scientists have been working toward whole-eye transplantation for many years. "This has been, I would say, science fiction for a long time," says Jose-Alain Sahel, a professor and chair of the department of ophthalmology at the University of Pittsburgh School of Medicine, who has been working toward such transplants with Goldberg and others. Progress in surgical techniques and nerve regeneration have made this goal seem more attainable. [...] "The fact that this surgery was successful is wonderful news," Sahel says. He cautions that surgery is only a small part of the issues that need to be addressed in order to restore eye function, however. These include making sure the immune system doesn't reject the donor eye, which is a challenge with any type of transplant. Then the corneal nerve -- which carries sensory signals from the transparent part of the eye -- must be reconnected. Yet the most complex part is regenerating the optic nerve. In order to do so, surgeons have to coax the nerve fibers to grow to the right place, which Sahel says could take months or even years. And complete optic nerve regeneration has not yet been successfully achieved in humans or other mammals. | Medical Innovations |
Published January 25, 2023 5:27PM Conjoined twins separated at Cook Children's Medical Center The twins, Jamie Lynn and Amie Lynn, were joined from the lower chest to their belly button. FORT WORTH, Texas - A team of doctors successfully performed Cook Children's Medical Center's first-ever conjoined twin separation surgery. "It was a scary journey because we didn't know what was going to happen," said father James Finley. Three months into their pregnancy Finley and Amanda Arciniega learned their twin girls were conjoined. The twins, Jamie Lynn and Amie Lynn, were joined from the lower chest to their belly button and shared a liver. (Courtesy: Cook Children's) "One of the questions they asked when I saw them at three months pregnancy is ‘Do we need to go somewhere else?’ And that to me was a very important question," said Dr. Ben Gbulie, a plastic surgeon at Cook Children's. The hospital's answer to that question: no. The family's emotional journey to separate their babies was detailed in a large scale news conference at the hospital complete with a video. FULL VIDEO: Conjoined twins separated at Cook Children's Medical Center Watch the story of Jamie Lynn and Amie Lynn and the amazing surgery to separate them. (Video courtesy: Cook Children's Medical Center) "On the ride home we were just quiet. We were like thank you, but out of everybody we were like, why us?" said Arciniega through tears. The work to assemble a world-class team began. The complexity of what they faced was all documented, from months of planning to the day and minutes before surgery. "We had to work to find the ideal time timing for when to do this. They were born at 34 weeks, they were a little early ,so we had to grow them and get them a little bit bigger. We got to a point where their positioning was a real challenge," said pediatric surgeon Jose Iglesias. In the operating room there were two full medical teams, one for each baby girl. It took five hours in the OR just to prep before the procedure began, it lasted hours and ended successfully. The parents broke down in tears upon hearing the surgery was a success. READ MORE: 'Get certified': Stranger saves 10-day-old baby with CPR at restaurant Bishop T.D. Jakes, pastor of the twins' grandmother, was a spiritual counselor for the family. "I asked everybody from all over the country to pray. We're just so happy to see the good outcome that came out of this. The doctors did such an amazing job. I'm so inspired," said Jakes. "Like a lot of doctors told us the truth, the survival rate after birth. A lot of conjoined twins don’t live that long, and so we’ve learned how to be strong," said Finley. "I want to thank Anita and James for the trust you put in us. I hope you can see there not just another patients to us. We really love your girls," said neonatologist Mary Frances. During Wednesday's announcement one of the surgeons said the girls can now sleep in their own beds, and grow and develop on their own. | Medical Innovations |
A Texas mother-daughter duo was honored by three former presidents this month, becoming 2023 Points of Light Award honorees for their fierce dedication and advocacy for children with pediatric pancreatitis.
The little-known disease struck Rebecca Taylor when she was just 7-years-old, causing excruciating pain. Now 21, Rebecca was chosen for the award because of the work with her mom, Christyn, on their nonprofit Rebecca’s Wish.
When Rebecca was 12, the Make A Wish Foundation granted her selfless wish to form a group to help other children dealing with pediatric pancreatitis.
Their national organization has raised over $3 million to support families whose children have the disease, to advance cutting-edge medical research, and to fund fellowships that train doctors to treat such patients.
“I wanted to start a pancreatic charity for other children so they don’t suffer like I did,” Rebecca said. “Rebecca’s Wish not only gives me a way to help others; it also helps me focus on something greater than myself and that—surprisingly—has helped my own pain.”
And the young woman has defied all the odds since doctors told the family that she wasn’t expected to live past the age of 12. She’s been hospitalized throughout 150 surgeries, including a life-saving experimental pancreas transplant—and nearly died multiple times.
Today, Rebecca is a biomedical engineering student at Texas A&M University working on medical research and treatment options for the disease, which is estimated to affect 3-13 children in every 100,000 kids.
“Great purpose can evolve from great adversity,” said Rebecca’s mom Christyn Taylor, President of Rebecca’s Wish. “As a mom, I would never have chosen this for my daughter but we now get the privilege to help thousands, if not tens of thousands, of children so they don’t have to walk the difficult journey we did.”
“We can do so much good, and help so many because we’ve lived this,” she told GNN.
Christyn also leads Rebecca’s Wish programs that provide medical grants and supportive care to thousands of patients and their families through travel reimbursements to and from hospitals, developing medical equipment that better fits children, and sending kids to a summer camp called Camp Hope.
“We had very little hope for this disease path when Rebecca was diagnosed,” said Christyn. “We went from hospital to hospital and nobody knew how to help a child with long-term pancreatitis. We do not want another child or family to have to go through what we went through in our long journey.”
“I’m really proud of what my mom and I have created—and I’ll work on this until the day I die,” said Rebecca, who invites you to learn more on their website, RebeccasWish.org.
MULTIPLY THE GOOD By Sharing the Inspiration on Social Media… | Disease Research |
Christine McGuinness has spoken about her marriage split from Top Gear host Paddy and admitted she was unhappy and stayed with him for too long because her autism made it difficult to walk away.
In a new BBC documentary, she explained why she needs a new chapter in her life and how petrified she initially felt about the breakup.
Christine cries as she also tells about being raped as a youngster and says it caused suicidal thoughts.
Reflecting on what she discovered in her documentary about autism, the model said: “I felt like I said in the film I didn’t want my family to ever fall apart. And that’s why I stayed married.
“As an autistic woman, I like to stay where I am comfortable. I like things to stay the same. And so that’s something I suppose I chose to do... But sometimes change has to happen.”
The reality TV star, 34, is seen on the programme throwing clothes away shortly after splitting from Paddy, 49.
She discusses having worn some of the outfits as part of a “masking” technique used by some autistic people to fit in.
Christine says: “I was only 19 when I met [Paddy]. And for the last 15 years my role has been wife and mum.
“I think when I got diagnosed, I kind of set out on a mission to figure out who I was, because I’ve played that many different roles and not really knowing which part of it was actually me or which one was mostly me.”
She adds: “So I’m clearing out, because I had a wardrobe full of clothes to wear how I thought I was supposed to look. I have also separated with my husband in the process, and I’m just I suppose shedding my old identity, trying to figure out what my new one is...
“I think the changes for me, although they’re massive, I am doing everything very slowly. I’m trying to not pretend, I’m trying to not always fit in.
“And then with things like my marriage, that’s massive. I’ve only had this one man in my life for 15 years. I can’t imagine living with anybody else.
“I don’t know what it’s like to date. I can’t remember being single.
“I am just going into a new chapter... on my own, which is petrifying for someone who doesn’t like change.”
Christine and Paddy married in 2011 and are parents to Felicity and twins Leo and Penelope. All the children are autistic. The couple announced last June that they had split up. It was six months after their moving BBC documentary Our Family and Autism.
Christine was diagnosed as autistic during the making of that programme.
In the new documentary, she speaks to three specialists about autism going undiagnosed in girls and women, and problems that can occur as a result.
One of the doctors explains that the issue of consent is very difficult for some women with autism and that in wanting to be liked they can fail to get out of a dangerous situation.
Christine tells them: “I experienced that. It was a long time ago and I didn’t speak up and I wonder if I never said it because I was autistic.
“Was it me? Would a typical woman have said something? Is it my fault? It’s something I experienced when I was a teenager. And then when I met my husband, that was a time I felt very safe. And I wonder if that’s why I stayed in that relationship for 15 years.
“Being a single woman, being a single parent, is an extremely vulnerable place to be and it petrifies me.”
She is then asked if she felt more able to leave the marriage after her autism diagnosis.
Christine replies in tears: “Yeah, because I know that I’ve stayed in a place where I was probably unhappy because it was safe and I don’t like change. And ultimately, I wanted to keep my family together.”
At a later time, she says while crying: “I don’t know how to say it. Before [Paddy], I had been sexually abused. I was raped... I would pray every night that I wouldn’t wake up in the morning, just cos it was so awful. The abuse I suffered started when I was only nine years old.
“I wonder how many things in life could have been avoided if I had an earlier [autism] diagnosis and more support at school.”
She uncovers links between autism and sexual abuse and having an eating disorder as a girl.
Christine speaks to young people with autism whose lives are improving because they have been diagnosed.
There are 122,000 people in England waiting for an autism assessment, according to NHS figures.
Christine hopes the TV programme will lead to more help being offered to girls with autism.
Ending the film on a bright note, she says: “I’m excited for life. I want to live as much as possible. I need to live for ever because I’ve got three children, but I need to live for myself too.
“I’ve always wanted to travel [and] to try all different things, and I know now I am fully able to.”
In an interview with the Mirror about the documentary, Christine said her priority is her children and she is in no rush to get into a long term relationship.
She said: “I’m excited about this documentary.
“I hope people understand more about how I feel about relationships after watching [it].
“Dating was never on my mind when I was filming the documentary. But I think watching it, hopefully, people will understand why. I think most people will expect somebody who’s just come out of a long relationship to be really excited about dating. But it’s not something I am thinking about.
“I have been in one place for a long time and I don’t like change, so I’m certainly not going to be speed dating anytime soon.”
On speaking about the marriage in the documentary, she said: “I wanted to be honest.
“I’m not from one of these drama schools, I’m not a TV presenter, I am a mum.”
She added: “I wanted to be the perfect wife and the perfect mum. I insisted on doing absolutely everything. I’m trying to not people-please as much, which is hard.
“I’m trying to say yes to more opportunities that scare me because I want to experience more. But also say no to things that I don’t want to do. I’m a lot less apologetic about myself now.
“I don’t know if I can ever fully love myself but I’m proud of myself and I’m happy with where I am right now.”
When they announced their split, Christine and Paddy said in a statement: “Our main focus is to continue loving and supporting our children.
“We’ll always be a loving family, we still have a great relationship and still live happily in our home together.”
*Christine McGuinness: Unmasking My Autism is due to air on March 15 at 9pm on BBC1 and iPlayer. | Mental Health Treatments |
There is no denying the importance of sleep. Everyone feels better after a good night of sleep, and lack of sleep can have profoundly negative effects on both the body and the brain. So what can be done to substitute for a lack of sleep? Put another way, how can you get less sleep and still perform at your peak?
As a psychologist who studies the ways in which sleep benefits memory, I’m also interested in how sleep deprivation harms memory and cognition. After some initial research on sleep deprivation and false confessions, my students at Michigan State University’s Sleep and Learning Lab and I wanted to see what interventions could reverse the negative effects of sleep deprivation.
We found a simple answer: There is no substitute for sleep.
Sleep deprivation impairs cognition
For many years, scientists have known that sleep deprivation reduces the ability to maintain attention. When asked to monitor a computer screen and press a button whenever a red dot appears—a pretty simple task—participants who are sleep deprived are much more likely to have lapses in attention. They don’t notice a bright red dot and fail to respond within a half-second. These lapses in attention are due to a buildup in pressure to sleep and are more common at points in the 24-hour circadian cycle when the body expects to be sleeping.
Research investigating the effect of sleep deprivation on more complex types of thinking has shown somewhat mixed results. So my team and I sought to determine how keeping people awake for one night affected different types of thinking. We had participants perform various cognitive tasks in the evening before we randomly assigned them to either go home and sleep or stay awake all night in the laboratory. The participants who were permitted to sleep returned in the morning, and everyone completed the cognitive tasks again.
Along with impairments in attention, we also found that sleep deprivation led to more placekeeping errors. Placekeeping is a complex ability that involves following a series of steps in order without skipping or repeating any of them. This would be similar to following a recipe to bake a cake from memory. You wouldn’t want to forget to add eggs or accidentally add the salt twice.
Can caffeine replace sleep?
Next, we set out to test different ways to potentially make up for a lack of sleep. What would you do if you did not sleep enough last night? Many people would reach for a cup of coffee or an energy drink. One 2022 survey found that over 90 percent of the American adults sampled consume some form of caffeine daily. We wanted to see whether caffeine would help maintain attention and avoid placekeeping errors after sleep deprivation.
Interestingly, we found that caffeine improved the ability to pay attention in sleep-deprived participants so well that their performance was similar to people who slept all night. Giving caffeine to people who had a full night of sleep also boosted their performance. So caffeine helped everyone maintain attention, not just those who did not sleep. This result was not surprising, as other studies have had similar findings.
However, we found that caffeine did not reduce placekeeping errors in either the sleep-deprived group or the group that slept. This means that if you are sleep deprived, caffeine may help you stay awake and play Candy Crush, but it likely will not help you ace your algebra exam.
Can naps make up for lost sleep?
Of course, caffeine is an artificial way to replace sleep. We also reasoned that perhaps the best way to replace sleep would be with sleep. You have likely heard that naps during the day can boost energy and performance, so it is logical to think that a nap during the night should have a similar effect.
We gave some of our participants the opportunity to nap for either 30 or 60 minutes during an overnight deprivation period between 4 am and 6 am. This time period roughly coincides with the lowest point of alertness in the circadian cycle. Importantly, we found that participants who napped did no better on either the simple attention task or the more complex placekeeping task than those who stayed up all night.
Thus, a nap in the middle of the night had no discernible benefits to cognitive performance during the morning after a night of overall sleep deprivation.
Get your Zs
While caffeine may help you stay awake and feel more alert, it likely won’t help you with tasks that require complex thought. And while a short nap may make you feel better on nights that you need to stay awake, it probably won’t help your performance. In short, sufficient sleep is essential to your mind and brain, and there is simply no substitute for sleep. | Stress and Wellness |
Oona Tempest/KFF Health News
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There are 80 different autoimmune diseases, affecting up to 50 million Americans.
Oona Tempest/KFF Health News
There are 80 different autoimmune diseases, affecting up to 50 million Americans.
Oona Tempest/KFF Health News
After years of debilitating bouts of fatigue, Beth VanOrden finally thought she had an answer to her problems in 2016 when she was diagnosed with Hashimoto's disease, an autoimmune disorder.
For her and millions of other Americans, that's the most common cause of hypothyroidism, a condition in which the thyroid, a butterfly-shaped gland in the neck, doesn't produce enough of the hormones needed for the body to regulate metabolism.
There's no cure for Hashimoto's or hypothyroidism. But VanOrden, who lives in Athens, Texas, started taking levothyroxine, a much-prescribed synthetic thyroid hormone used to treat common symptoms, like fatigue, weight gain, hair loss, and sensitivity to cold.
Most patients do well on levothyroxine and their symptoms resolve. Yet for others, like VanOrden, the drug is not as effective.
For her, that meant floating from doctor to doctor, test to test, and treatment to treatment, spending about $5,000 a year.
Beth VanOrden
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Beth VanOrden has Hashimoto's disease, but the most common drug for it was not effective for her. Her quest for other treatments has proven costly.
Beth VanOrden
Beth VanOrden has Hashimoto's disease, but the most common drug for it was not effective for her. Her quest for other treatments has proven costly.
Beth VanOrden
"I look and act like a pretty energetic person," says VanOrden, 38, explaining that her symptoms are not visible. "But there is a hole in my gas tank," she says. And "stress makes the hole bigger."
Autoimmune diseases occur when the immune system mistakenly attacks and damages healthy cells and tissues. Other common examples include rheumatoid arthritis, lupus, celiac disease, and inflammatory bowel disease. There are more than 80 such diseases, affecting up to an estimated 50 million Americans, disproportionately women. Overall, the cost of treating autoimmune diseases is estimated at more than $100 billion annually in the U.S.
Despite their frequency, finding help for many autoimmune diseases can prove frustrating and expensive. Getting diagnosed can be a major hurdle because the range of symptoms looks a lot like those of other medical conditions, and there are often no definitive identifying tests, says Dr. Sam Lim, clinical director of the Division of Rheumatology at Emory University School of Medicine in Atlanta. In addition, some patients feel they have to fight to be believed, even by a clinician. And after a diagnosis, many autoimmune patients rack up big bills as they explore treatment options.
"They're often upset. Patients feel dismissed," Dr. Elizabeth McAninch, an endocrinologist and thyroid expert at Stanford University, says of some patients who come to her for help.
Insufficient medical education and lack of investment in new research are two factors that hinder overall understanding of hypothyroidism, according to Antonio Bianco, a University of Chicago endocrinologist and leading expert on the condition.
Some patients become angry when their symptoms don't respond to standard treatments, either levothyroxine or that drug in combination with another hormone, says Douglas Ross, an endocrinologist at Massachusetts General Hospital in Boston. "We will have to remain open to the possibility that we're missing something here," he says.
Jennifer Ryan, 42, says she has spent "thousands of dollars out-of-pocket" looking for answers. Doctors did not recommend thyroid hormone medication for the Huntsville, Alabama, resident — diagnosed with Hashimoto's after years of fatigue and weight gain — because her levels appeared normal. She recently switched doctors and hopes for the best.
"You don't walk around hurting all day long and have nothing wrong," Ryan says.
And health insurers typically deny coverage of novel hypothyroidism treatments, says Brittany Henderson, an endocrinologist and founder of the Charleston Thyroid Center in South Carolina, which sees patients from all 50 states. "Insurance companies want you to use the generics even though many patients don't do well with these treatments," she says.
Meanwhile, the extent of Americans' thyroid problems can be seen in drug sales. Levothyroxine is among the five most prescribed medications in the U.S. every year. Yet research points to some overprescribing of the drug for those with mild hypothyroidism.
A recent study, paid for by AbbVie — maker of Synthroid, a brand-name version of levothyroxine — said a medical and pharmacy claims database showed that the prevalence of hypothyroidism, including milder forms, rose from 9.5% of Americans in 2012 to 11.7% in 2019.
The number of people diagnosed will rise as the population ages, says McAninch. Endocrine disruptors — natural or synthetic chemicals that can affect hormones — could account for some of that increase, she says.
In their search for answers, patients sometimes connect on social media, where they ask questions and describe their thyroid hormone levels, drug regimens, and symptoms. Some online platforms offer information that's dubious at best, but overall, social media outlets have increased patients' understanding of hard-to-resolve symptoms, Bianco says.
They also offer one another encouragement.
VanOrden, who has been active on Reddit, has this advice for other patients: "Don't give up. Continue to advocate for yourself. Somewhere out there is a doctor who will listen to you." She has started an alternative treatment — desiccated thyroid medication, an option not approved by the FDA — plus a low dose of the addiction drug naltrexone, though the data is limited. She's feeling better now.
Research of autoimmune thyroid disease gets little funding, so the underlying causes of immune dysfunction are not well studied, Henderson said. The medical establishment hasn't fully recognized hard-to-treat hypothyroid patients, but increased acknowledgment of them and their symptoms would help fund research, Bianco says.
"I would like a very clear, solid acknowledgment that these patients exist," he says. "These people are real."
KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism. | Disease Research |
"My perception was this was no big deal," Terry exclusively told E! News, "give me a second."
After initially refusing to go to the hospital, The Real Housewives of Orange County star convinced her husband to get checked out—and it ended up saving his life. During testing, doctors discovered that a blood clot had passed through a hole in his heart (known as a patent foramen ovale or PFO) and traveled to his brain, causing a transient ischemic attack (or TIA), which causes stroke-like symptoms.
"Had I gone home, gone to sleep, continued to have little teeny blood clots come from my lower extremities from all the recent flying we'd been doing, I would have had many more clots," Terry noted. "If she wasn't insistent and persistent and I got on a plane or I went home that night—dead. Heather Dubrow saved my life, no question about it."
Now, Terry is speaking out to spread awareness in the hopes others won't ignore warning signs.
"It's important to understand that if you're having a stroke, you have only five hours to dissolve that clot," the 64-year-old explained. "You need to be in an emergency room and have a clot-dissolver, otherwise your brain is gonna die and you're gonna die. The mortality rate of a real stroke is 60 percent."
"The difference between me and Hailey Bieber is the right side of her face was paralyzed and she had numbness and tingling, so she had more physical symptoms," Terry noted. "It was so obvious. Justin Bieber—who's not a neuroscientist, let's be honest—knew she was having a stroke."
But aside from the obvious symptoms like speech-slurring or facial paralysis, the reality star doesn't want everyone to worry if they have PFO.
"We don't want to freak people out and tell them they all need to have an echocardiogram to see if they have PFO," Terry stated, "but they need to understand the number one cause of death in this country and in most industrialized countries is cardiovascular disease and the number one cause of death in that group is stroke."
As for what you can do to prevent a similar health scare? "If you have a heart murmur, figure out if you have PFO," he added. "If you're going to go on a long trip, wear compression socks. Get up on the plane every hour and walk around in the cabin. We are constantly being showered by little blood clots, but if you have PFO and a little blood clot gets to your brain, it is no joke."
Watch a brand-new episode of Botched tonight at 10 p.m. | Disease Research |
Do people who enjoy making puns derive a form of sadistic pleasure from the act? New research suggests that although people might use puns to elicit groans in their audiences, puns themselves are not indicative of everyday sadism. The findings, published in Personality and Individual Differences, shed light on the complexity of humor preferences and reactions in different contexts.
A pun is a form of wordplay that exploits the multiple meanings of a word or words that sound similar but have different meanings (e.g., you have to be sharp to work in a tack factory). They rely on the ambiguity of language and the double meanings of words to create a humorous or thought-provoking effect. But why research puns?
“The more refined response is, the research unites two of my research interests, humor and pain. The simpler — and perhaps more honest — response is, I find it to be such a fun idea, that something as lighthearted as puns could be told for nefarious, self-serving purposes,” explained study author Cody Gibson, a Ph.D. student at Northern Illinois University.
The researchers noted that a common reaction to puns is groaning, an expression of distaste. They wanted to understand if punsters derive enjoyment from causing a mild form of discomfort (groans) to others, and whether this enjoyment aligns with the concept of everyday sadism — a term used to describe a personality trait characterized by the enjoyment or satisfaction derived from causing discomfort, pain, or suffering to others in day-to-day, non-criminal situations. To investigate this hypothesis, they conducted two studies.
The researchers first conducted an online survey with 155 undergraduate students from a Midwestern university. The participants’ average age was 20.80 and they were from various racial and ethnic backgrounds.
Participants were asked to rate their enjoyment of different types of jokes, including puns, physical comedy, self-deprecating humor, topical humor, observational humor, toilet/scatological humor, dark/black comedy, and insult comedy. They were also asked about their tendency to make multiple jokes of the same type in succession for reactions.
The participants’ everyday sadism levels were measured using the Comprehensive Assessment of Sadistic Tendencies (CAST) questionnaire. Additionally, personality traits were assessed using the Ten-Item Personality Inventory (TIPI) and the Dirty Dozen Dark Triad Measure.
The results of Study 1 suggested that puns are not inherently sadistic in nature. Punning did not correlate with everyday sadism, and there were no strong links between punning and the Dark Triad traits (psychopathy, narcissism, and Machiavellianism). However, participants who enjoyed punning did express a desire for groans as reactions.
The study also found that puns were the most enjoyed type of joke, even though they often elicited groans. The researchers noted that punning seems to be associated with enjoyment regardless of the groan reactions it receives.
“Puns don’t appear to be sadistic; in fact, they seem beloved,” Gibson told PsyPost. “The groans might just be an act, a way to express approval through what is usually a sign of disgust. It’s somewhat funny that even our theatrical reactions to puns may be considered a play on words.”
The researchers conducted a second iteration of the survey with 122 undergraduate students to replicate their findings. The survey was similar to the first study, with some modifications. The Joke Reactions section was updated to include questions about desired reactions to physical comedy and insult jokes, and the Humor Styles Questionnaire (HSQ) was included to assess affiliative, self-enhancing, self-defeating, and aggressive humor styles.
The findings of Study 2 largely replicated those of Study 1. In addition, exploratory analyses showed that puns were associated with affiliative and self-defeating humor styles. Affiliative humor involves using humor to enhance social bonds, create positive relationships, and bring people closer together, while self-defeating humor involves making oneself the target of humor in order to gain approval or deflect criticism.
Contrary to expectations, puns were actually rated as more enjoyable compared to most other types of jokes. For instance, while over 40% of participants indicated that they did not make scatological jokes, the percentage was consistently under 10% for puns, suggesting that puns are more widely embraced. Moreover, puns were significantly more enjoyable to audiences compared to scatological jokes.
“I am not entirely surprised by the lack of link between everyday sadism and punning, but I certainly didn’t expect to find such a love for puns,” Gibson said. “A significant portion of the process was spent reading about how disliked puns are, how they are the bastards of language and derail conversations. Instead, puns were tied with observational humor for the most enjoyed type of joke.”
Interestingly, jokes categorized as negative humor, such as self-deprecating humor, insult comedy, dark comedy, and scatological jokes, were often associated with negative personality traits like everyday sadism, psychopathy, and disagreeableness. This finding, which is in line with previous research, indicates that humor preferences might serve as heuristic indicators of personality traits.
“Even though the research spotlights puns and everyday sadism, other personality traits and joke types were included in the study,” Gibson told PsyPost. “For example, we found people who enjoyed toilet humor tended to be more sadistic and less agreeable.”
But the study, like all research, includes some caveats.
“I think there are two things to keep in mind when reading the results,” Gibson said. “One, the participants were college students. It may be that some types of jokes are more appealing to them and some less appealing. Two, this research was correlational. We asked whether they enjoyed a particular type of joke instead of trying to create a representative example.”
The study, “Pun-intentionally sadistic: Is punning a manifestation of everyday sadism?“, was authored by Cody Gibson and Brad J. Sagarin. | Mental Health Treatments |
EUGENE, Ore. -- PeaceHealth announced this week it is closing the only hospital in Eugene, Oregon, and moving services 6 miles (9.6 kilometers) to its Springfield location.
PeaceHealth said Tuesday the hospital serving the city of about 178,000 people is underutilized, the Register-Guard reported.
The PeaceHealth Sacred Heart Medical Center University District in Eugene, which first opened in 1936, employs hundreds of nurses, health care professionals and staff.
PeaceHealth officials said patient volume has been declining, causing the hospital to lose an average of $2 million per month. The facility has about 95 patient visits daily, with about 15.5 patients per month admitted as inpatients and 7.5 patients per month admitted for observation, according to hospital officials.
“As the needs of the Lane County community evolve, PeaceHealth services and sites of care also need to evolve to ensure compassionate, high-quality care now and in the future,” Alicia Beymer, chief administrative officer of the University District hospital, said. “We believe consolidating some services at RiverBend will provide an enhanced care experience.”
PeaceHealth plans to move inpatient rehabilitation, emergency department and related medical services to the PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield.
Emergency services will phase out of the Eugene hospital in November. Inpatient rehab will temporarily relocate in early 2024, with plans to open a larger rehab facility in 2026.
At the Eugene location, ambulatory services, including PeaceHealth Medical Group clinics and Home & Community services, will remain open. The Eugene location will also continue providing behavioral health services at University District “until there is a sustainable alternative in the community.”
In addition to PeaceHealth in Springfield, three other hospitals serve patients in Lane County.
PeaceHealth said it is “committed to retaining its valued caregivers as it evolves its care services in Lane County, finding equivalent positions within PeaceHealth’s Oregon network.”
Scott Palmer, chief of staff for the Oregon Nurses Association, called the decision a “disaster.”
“It’s a horribly short-sighted decision on the part of PeaceHealth, and they should reverse that decision immediately,” Palmer said, adding that the nurses association and University District staff were blindsided by the email sent Tuesday about the impending closure.
The nurses union just settled a long-negotiated four-year contract with the hospital, which was ratified by the union last week.
“At no point during those negotiations were we or any of the nurses given even the slightest hint that a closure of university district hospital was on the table,” Palmer said. “This is a huge, huge disastrous decision that is going to impact not only the hundreds and hundreds of staff at the hospital, but the tens of thousands of people in Eugene."
“We’re concerned that this is going to have immediate, dramatic and dangerous impacts on the health of the people of this region," he said.
Palmer said the Oregon Nurses Association is working with other local union groups and organizations to keep the hospital open.
Alan Dubinsky, communications director of the Service Employees International Union Local 49, said the union is still assessing the potential impact on its members at the Eugene hospital.
Dubinsky said SEIU Local 49 represents about 1,800 healthcare workers and staff among three PeaceHealth hospitals in the Northwest: University District, Riverbend and St. John Medical Center in Longview, Washington.
During the Board of County Commissioners meeting Tuesday, Lane County commissioner Laurie Trieger said she disagreed with the closure.
“The closure will have far-reaching negative impacts,” she said. “It is alarming to think that the third largest city in this state will have no emergency room. This closure will decrease access and degrade health care in our community, and we should all be very concerned.”
Trieger also said she was concerned about how the closure could affect how long it could take to get emergency care, especially during peak traffic times. | Health Policy |
Editor’s note: If you or anyone you know is struggling with mental health there are a number of ways to get help, including by calling Talk Suicide Canada at 1-833-456-4566. A list of local crisis centres is also available here. The arrest of a Mississauga man has sent shockwaves through some of the darkest corners of the internet.
Kenneth Law, 57, is accused of selling over 1,200 kits to vulnerable people contemplating suicide around the world. Law’s alleged offerings, displayed on now-defunct websites with names like “Imtime Cuisine” and “Escape Mode,” ranged from sodium nitrite, a lethal substance which can kill humans in small doses, to flow regulators and gas masks.
An April investigation by the Times of London shoved Law into the international spotlight, leading to his eventual arrest by Peel police. The Times investigation caught Law on tape advising how to use his products, as well as assuring the reporter that “many, many people” had died taking sodium nitrite. Law later confirmed those details in-person when the Times spoke with him outside a post office in Mississauga.
Law was arrested by Peel police on May 2 and charged with two counts of counselling or aiding suicide. It’s possible more charges could follow from additional police jurisdictions – a Dutch man by the name of “Alex S.” was sentenced to three-and-a-half years in prison last week for similar charges in the Netherlands.
Over 40 countries and 11 Ontario police forces are now involved in the investigation against Law, who briefly appeared in court on Friday.
The prosecution of Kenneth Law is proving to be a flashpoint in two major online movements: the “pro-choice” suicide advocates, who run forums with detailed guides on how to take one’s own life, and the parents of children who lost their lives in part due to information gleaned from those sites, often with the help of people selling suicide devices online. CP24.com has studied these sites extensively, and Law’s alleged businesses were frequently recommended to at-risk users before his arrest in May.
It is still not clear when Law’s trial will begin, though whenever it does the proceedings are sure to garner interest well outside of the GTA’s borders. Here is why the world will be watching:
‘ONE OF THE WORST THINGS YOU COULD POSSIBLY DO’: ADVOCATES IN U.S., U.K.
Kelli Wilson and Catherine Adenekan, located in the U.S. and U.K. respectively, are both mothers of children who lost their lives after accessing pro-suicide forums.
They will be watching Law’s trial with a hope for justice – for their own sons and for the other children who have died due in no small part to businesses like the one Law is alleged to have operated.
“This trial is monumental in so many ways,” said Wilson. “These sites sell to vulnerable people. It’s aiding and abetting suicide, which is akin to murder.Law weaponized mentally ill people against themselves, and that can’t be allowed to continue. It’s a no-brainer. He needs to be held accountable for what he’s (allegedly) done. And the lawmakers, as well – they’ve facilitated these havens for crime.”
“What he’s (allegedly) done is one of the worst things you could possibly do,” added Adenekan. “The root cause of the problem, though, is [pro-suicide forums], which is how sellers like Law get their customers.
“We’re hoping that each and every person he has (allegedly) assisted will get justice for what he’s done,” she continued.
The charges against Law have not yet been tested in court. His lawyer did not return calls for comment about the case.
‘WE ARE TRYING EVERY DAY’: SODIUM NITRITE VICTIMS IN ITALY, NETHERLANDS, U.S.
Families of sodium nitrite victims around the world are looking to Law’s trial in the hopes it will mean justice for their own children. While others are believed to be selling the substance, the scope of Law’s alleged operation has poised the verdict in his trial to be significant for similar cases internationally.
“We are trying every day,” said a father in Italy. “The pain is so strong. It’s hard to forget about your son or daughter.”
The man, who asked not to be named, lost his son to sodium nitrite, and says an acquaintance lost their child to the same substance, allegedly purchased from Law, in May.
“Law’s case could be a legal precedent in the United States, and Europe,” he said. “That could help us continue to battle against the pro-suicide sites, and the free sale of poison.”
A bereaved mother in the Netherlands shared similar hopes for Law’s trial, saying “there are very bad things on the internet,” and that the verdict in the legal proceedings against Law could lead to the erasure of pro-suicide forums and chat rooms.
A mother in Illinois also lost her daughter to sodium nitrite late last year, and says she will be watching the trial with interest.
“This is a serious battle,” she said. “(Selling sodium nitrite to at-risk individuals) is one of the worst things you could do. This is disgusting, these sites where they tell people to take their own lives.”
‘THE ELON MUSK OF ASSISTED SUICIDE’
Philip Nitschke is an Australian advocate for assisted suicide, as well as a former physician. Dubbed by Newsweek “the Elon Musk of assisted suicide,” he is also the founder of a pro-euthanasia group for seniors, as well as the author of a lengthy guide on how to take one’s own life.
“It’s a fundamental human right,” he told CP24.
Nitschke says he first published details about sodium nitrite as a means of suicide in 2018, when the substance was freely available on sites like Amazon. American lawsuits against the retail giant briefly resulted in the substance being taken off the site, but a U.S. judge dismissed those suits late last month, rejecting the claim that Amazon had acted negligently in offering sodium nitrite on their site.
“In that context, [members of Nitschke’s pro-euthanasia group] became aware of this new source, Kenneth Law,” he alleged. “And many, many of our members bought from him.”
Nitschke added that many of his group’s members do not necessarily intend to take their own lives immediately, but instead prefer to keep substances like sodium nitrite on hand “just in case.”
“Our members are watching with great apprehension,” he said. “And our members are finding themselves the hapless subjects of wellness checks in the middle of the night by local police…which is very intimidating.”
While Nitschke advocates for seniors hoping to end their own lives, he says Law acted short-sightedly by allegedly selling sodium nitrite to younger individuals.
“Kenneth was being a little unrestrictive,” he said. “Elderly people have this idea that they should have a right to access the substances, but they’re not terribly sympathetic to the idea of teenagers going out there and buying a substance.”
Several of Law’s alleged customers were teenagers, and died after taking the sodium nitrite sent to them.
Despite that misgiving, Nitschke concedes the “real help” Law has done for members of his group.
“He’s helped them achieve their goals. We’re watching this trial with great interest.”
Law will next appear in court on Aug. 25. | Mental Health Treatments |
Wearable heart monitor ticks all the boxes for better health care, says study
A new compact, lightweight, gel-free and waterproof electrocardiogram (ECG) sensor offers more comfort and less skin irritation, compared to similar heart monitoring devices on the market.
ECGs help manage cardiovascular disease—which affects around 4 million Australians and kills more than 100 people every day—by alerting users to seek medical care.
The team led by RMIT University in Australia has made the wearable ECG device that could be used to prevent heart attacks for people with cardiovascular disease, including in remote health care and ambulatory care settings. While most wearable ECG monitors typically weigh a few hundred grams, the RMIT device weighs only 10 grams.
The research is published in the journal Applied Physics Reviews.
Lead author Ph.D. scholar Peter Elango from RMIT said that heart attacks often occurred with little or no warning, as signals were difficult to spot without continuous monitoring.
"Nearly half of the people who have heart attacks do not realize what's happening until it's too late," Elango said. "My dream is a world with zero preventable heart attacks."
Elango was one of the top 10 competitors at the recent Falling Walls Lab Australia 2023 Final at the Australian Shine Dome in Canberra, where he gave a pitch about the ECG device.
RMIT has filed an international patent (PCT) application to protect the ECG device that the team developed.
"RMIT is exploring ways to translate the work into a commercial product, and we are in discussions with partners regarding potential licensing opportunities," Elango said.
Optimizing design and comfort
Professor Madhu Bhaskaran, Deputy Director (Research) of the ARC Hub for Connected Sensors for Health at RMIT, said the team's focus was on improving the electrode design and materials for increased performance as well as comfort.
"Commercially available wearable ECG devices are usually bulky, heavy and have 12 'wet' electrodes connecting the patient to the device, whereas the RMIT invention can fit in the palm of your hand," Bhaskaran said. "The device has just three 'dry' electrodes that are almost invisibly thin, can sense even the slightest signals of a heart in distress, and can also be recycled."
Wet electrodes contain a conductive gel to increase cardiac signals, while dry electrodes do not need this gel to operate effectively.
"Wet electrodes are uncomfortable, dry out over time, and have been known to cause skin irritation," Bhaskaran said.
The team's experiments tested the RMIT miniaturized three-electrode ECG device's sensing performance against a 12-electrode wearable monitor on the market, demonstrating a comparable level of precision in capturing the heart's electrical activity.
"The RMIT device efficiently captures the heart's activity, whether the user is at rest or experiencing stress," Bhaskaran said.
Enabling continuous monitoring
ECG data recorded over time helps obtain important diagnostic information concerning the activity of the patient's heart.
To conduct continuous monitoring, Elango said dry electrodes offered some significant advantages.
"Dry electrodes prioritize user comfort, remain durable over time and reduce the likelihood of skin irritation," Elango explained. "The electrodes are also hydrophobic, meaning they don't get wet, and so a user can wear the device while they do activities in the water such as swimming and showering—unlike other ECG monitors. These attributes make them ideal for continuous monitoring—a crucial feature for wearable ECG devices."
After extensive experimentation, the team discovered that a hexagonal design was the "winning formula," as it suits the curvy nature of skin and active lifestyles and more accurately captures ECG signals, compared with other wearable devices on the market.
"The device can capture ECG signals even when it is fitted behind a person's neck—ideal for patients in the aged care sector, including for someone with dementia who may remove it from their chest," Elango noted, adding that it wasn't all about design aesthetics.
"We also dived into the nitty gritty of how different body areas influence ECG measurements. This yielded valuable insights to enhance sensor performance," he said. "The dry electrodes, which are less than one-tenth the width of a human hair, are highly sensitive to the cardiac signals of the user."
RMIT led this research in collaboration with Dr. Sherly Elango from Annamalai University in India.
More information: Peter Francis Mathew Elango et al, Dry electrode geometry optimization for wearable ECG devices, Applied Physics Reviews (2023). DOI: 10.1063/5.0152554 | Medical Innovations |
The World Health Organization's cancer agency has deemed the sweetener aspartame — found in diet soda and countless other foods — as a “possible” cause of cancer, while a separate expert group looking at the same evidence said it still considers the sugar substitute safe in limited quantities.
The differing results of the coordinated reviews were released early Friday. One came from the International Agency for Research on Cancer, a special branch of the WHO. The other report was from an expert panel selected by WHO and another U.N. group, the Food and Agriculture Organization.
The Lyon, France-based cancer agency periodically reviews potential cancer hazards, but doesn't determine how likely they are to cause cancer in their evaluations which range from “possibly” carcinogenic to “probably” to cancer-causing.
Aspartame joins a category with more than 300 other possible cancer-causing agents, including things like aloe vera extract, Asian-style pickled vegetables and carpentry work.
The guidance on use of the sweetener, though, isn’t changing.
“We’re not advising consumers to stop consuming (aspartame) altogether,” said WHO’s nutrition director Dr. Francesco Branca. “We’re just advising a bit of moderation.”
Here's a look at the announcement:
WHAT IS ASPARTAME?
Aspartame is a low-calorie artificial sweetener that is about 200 times sweeter than sugar. It is a white, odorless powder and the world’s most widely used artificial sweetener.
Aspartame is authorized as a food additive in Europe and the U.S. and is used in numerous foods, drinks such as Diet Coke, desserts, chewing gum, medications including cough drops and foods intended to help with weight loss. It's in tabletop sweeteners sold as Equal, Sugar Twin and NutraSweet.
Aspartame was approved in 1974 by the U.S. Food and Drug Administration with an acceptable daily intake of 50 milligrams per kilogram of body weight. According to the FDA, a person weighing 132 pounds (60 kilograms) would need to consume about 75 aspartame packets to reach that level.
U.N. experts evaluated the safety of aspartame in 1981 and set the safe daily limit slightly lower, at 40 milligrams of aspartame per kilogram.
David Spiegelhalter, an emeritus statistics professor at Cambridge University, said the guidance means that “average people are safe to drink up to 14 cans of diet drink a day … and even this ‘acceptable daily limit’ has a large built-in safety factor.”
WHAT DID THE TWO GROUPS SAY?
WHO's cancer agency, IARC, convened its expert group in June to assess the potential of aspartame to cause cancer. It based its conclusion that aspartame is “possibly carcinogenic” on studies in humans and animals that found “limited” evidence that the compound may be linked to liver cancer.
In a separate evaluation, experts assembled by WHO and the food agency updated their risk assessment, including reviewing the acceptable daily intake. They concluded there was “no convincing evidence” at the currently consumed levels that aspartame is dangerous; their guidelines regarding acceptable levels of consumption were unchanged.
The move comes weeks after the WHO said that non-sugar sweeteners don't help with weight loss and could lead to increased risk of diabetes, heart disease and early death in adults.
SHOULD I BE CONCERNED ABOUT GETTING TOO MUCH?
Not as long as you don’t exceed the guidelines. The FDA said scientific evidence continues to support the agency's conclusion that aspartame is “safe for the general population,” when used within limits.
Almost any substance can be dangerous in excessive amounts, said David Klurfeld, a nutrition expert at the Indiana University School of Public Health-Bloomington.
“The dose makes the poison,” said Klurfeld, who previously served on an IARC panel. “Even essential nutrients like vitamin A, iron and water will kill you within hours if too much is consumed.”
SO WHAT SHOULD CONSUMERS DO?
WHO’s Branca said it was acceptable for people to consume a “pretty large” amount of aspartame without suffering any ill effects. “High consumers" might want to cut back, he said.
Dr. Peter Lurie, executive director of the Center for Science in the Public Interest, which previously nominated aspartame for IARC review, said there’s an easy choice for consumers.
“At least when it comes to beverages, our message is your best choice is to drink water or an unsweetened beverage,” he said.
Most people, though, probably don’t pay much attention to IARC evaluations. The agency has previously classified processed meat like hot dogs and bacon as cancer-causing, noting in particular its link to colon cancer. That move surprised even others in the scientific community — the U.K.’s biggest cancer charity reassured Britons that eating a bacon sandwich every so often wouldn’t do them much harm.
WHAT DOES THIS MEAN FOR THE FOOD AND BEVERAGE INDUSTRY?
Food and beverage producers say there’s no reason to avoid products with aspartame.
“There is a broad consensus in the scientific and regulatory community that aspartame is safe," the American Beverage Association said in a statement.
WHO's Branca said the agency advises food manufacturers in general to “use ingredients that do not require the addition of too much sugar.” After the latest assessments of aspartame, Branca said that using sweeteners “is probably not the way forward.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content. | Nutrition Research |
Low-flavanol diet linked to age-related memory loss
30 May 2023
A diet low in flavanols – compounds found in many foods such as tea, apples and berries – is linked to age-related memory loss, according to a large randomised controlled trial in older adults.
The research published in today's issue of PNAS explores the impact of flavanols on cognitive ageing in 3562 older individuals over three years. The study's findings show that individuals with high habitual flavanol consumption have a better hippocampal memory function, which is responsible for one aspect of cognitive ageing, than those with lower flavanol consumption. However, an intervention of 500mg of flavanols daily can reverse the negative effects of low flavanol intake and improve memory function in these individuals.
Lead investigator Scott Small MD, Professor of Neurology at Columbia University said: “The identification of nutrients critical for the proper development of an infant’s nervous system was a crowning achievement of 20th century nutrition science.
“As we are living longer, research is starting to reveal that different nutrients are needed to fortify our ageing minds.”
Co-lead, Adam Brickman, Professor of Neuropsychology at Columbia University added: “The improvement among study participants with low-flavanol diets was substantial and raises the possibility of using flavanol-rich diets to improve cognitive function in older adults.”
Gunter Kuhnle, Professor of Nutrition and Food Science at the University of Reading and co-investigator of the study, said: "These are exciting results because they suggest that there is an optimum amount of flavanols in the diet.
“We used nutritional biomarkers in urine to measure the baseline diet of around one-third of the participants. This method is more accurate than relying on self-reported diet and provided us with a better estimate of flavanol intake and its association with memory function.”
This research was part of the COSMOS study (Cocoa Supplement and Multivitamin Outcomes Study), a double-blind, placebo controlled randomised study of more than 21,000 participants over three years. In contrast to many other studies, which rely on foods as source of flavanols, the COSMOS study used a standardised flavanol extract. This allowed a better control of the intervention and made it possible to attribute any effects to flavanols and not specific foods. This study already showed that flavanols reduce the risk of cardio-vascular diseases.
Professor Kuhnle said: “The results show the importance of considering bioactive compounds when developing official dietary guidelines. While these compounds are not essential like vitamins, some of them, like flavanols, are important for health. This is very similar to fibre, which is not an essential nutrient but important to lower the risk of heart disease and cancer. Results from this study - and data from the main COSMOS trial and other studies - clearly show that a low flavanol intake has a detrimental effect on health.
JoAnn Manson MD leads the COSMOS parent trial, along with Dr Howard Sesso at Brigham and Women’s Hospital. She said: “COSMOS-Web is a model for the synergy possible between observational research and gold-standard randomized trials; here, baseline low flavanol intake tracked with relatively lower memory and randomized supplementation with cocoa flavanols was shown to reverse the lower memory.”
The flavanol-based intervention in the study used flavanols extracted from cocoa, but the study authors point out that eating chocolate is unlikely to provide sufficient levels of flavanols to affect cognitive function, as most flavanols are destroyed during traditional processing of cocoa when making chocolate.
The good news for the UK is that on average, most older adults consume high amounts of flavanols that are comparable with the group that received the 500mg per day supplement. The main sources of flavanols in the British diet are tea, apples and berries. Making some small dietary changes can boost intake to the recommended amounts and protect cognitive health into older age. | Nutrition Research |
- The Health and Human Services Department has recommended easing restrictions on marijuana, a spokesperson for the Drug Enforcement Agency told CNBC on Wednesday.
- That move could potentially expand the market for cannabis, sending shares of Canopy Growth, Tilray Brands and Cronos Group higher.
- Marijuana is currently classified as a Schedule I drug, a designation reserved for drugs with no currently accepted medical use and a high potential for abuse, such as heroin.
The U.S. Health and Human Services Department has recommended reclassifying marijuana as a lower-risk drug, which would in turn ease restrictions on the budding business, a spokesperson for the Drug Enforcement Agency told CNBC on Wednesday.
Marijuana is currently a Schedule I drug under the Controlled Substances Act, meaning it's deemed to have no currently accepted medical use and a high potential for abuse. Despite being legalized for recreational use in nearly half of states, marijuana's federal classification alongside drugs like heroin and LSD has hindered the industry's growth.
After enjoying a sales surge during the pandemic, the industry is in free-fall as investors turn away and capital dries up. The industry has also been barred from accessing most banking services, or from being traded across state lines, resulting in a glut of cannabis in many states and a drop in prices.
A federal reclassification could potentially expand the market for marijuana, which is a multibillion-dollar industry in the U.S. and a cash crop in many newly legalized states.
In a letter addressed to DEA officials, HHS called for marijuana to be reclassified as a Schedule III drug under the Controlled Substances Act, a DEA spokesperson told CNBC. Schedule III is defined as drugs with a moderate to low potential for physical and psychological dependence.
The DEA, which regulates controlled substances, has the final authority to reschedule marijuana. The agency will now initiate a review of the drug, the spokesperson said.
A lack of federal regulation has meant cannabis businesses in states where recreational sales are legal still can't access traditional banking services or institutional capital. A congressional bill called the Secure and Fair Enforcement Banking Act, or SAFE, would lift such restrictions but hasn't made it through the Senate, despite passing in the House several times.
Patrick Rea, managing director at cannabis investment firm Poseidon Garden Ventures, said his fund is "cautiously optimistic" for the changes a reclassification could bring to the industry.
"Certainly moving cannabis off of Schedule 1 is the right decision and long overdue," Rea said in a statement. "Though a full descheduling would be preferred and likely most appropriate for cannabis, we welcome smart decisions and progress towards full legalization and regulation in the legal cannabis industry." | Drug Discoveries |
More than 1,000 people have died from dengue in Bangladesh’s worst outbreak on record, official data shows, with rising temperatures due to the climate crisis driving the ongoing spread as more cases are reported away from dense urban centers for the first time.
Since January, 1,017 people have died from the mosquito-borne disease, including more than 100 children, with infections rising over 208,000, according to figures from the Bangladesh Directorate General of Health Services released Monday.
While dengue fever is endemic in the South Asian country, with infections typically peaking during the monsoon season between July and September, this year the uptick in cases started much earlier – toward the end of April.
A prolonged monsoon season that saw warmer temperatures combined with irregular, heavy rainfall created ideal breeding conditions for the Aedes mosquito, which carries the dengue disease, scientists say.
The influx of patients has strained the country’s health care system and hospitals have faced a shortage of beds and staff to care for them, local media have reported.
Fatalities from the outbreak are almost four times higher than last year, when 281 people died. In September alone, there were more than 79,600 reported cases and 396 deaths, according to Bangladesh health authorities.
There is also growing concern about the outbreak spilling into the cooler months. Last year, dengue cases only peaked in October with most deaths recorded in November.
A viral infection, dengue causes flu-like symptoms, including piercing headaches, muscle and joint pains, fever and, in some cases, internal bleeding and death. It is transmitted to humans through the bite of an infected Aedes mosquito and there is no specific treatment for the disease.
Dengue, also known as breakbone fever, is endemic in more than 100 countries and every year, 100 million to 400 million people become infected, according to the World Health Organization (WHO).
In the past, outbreaks had generally been confined to densely-populated urban centers like the capital Dhaka – home to more than 20 million people – but this year infections rapidly spread to every district across the country, including rural areas, WHO said.
WHO director-general Tedros Adhanom Ghebreyesus said in a news briefing last month that the UN agency is supporting the Bangladeshi government and authorities “to strengthen surveillance, lab capacity, clinical management, vector control, risk communication and community engagement,” during the outbreak.
But there are calls from public health experts in the country to make dengue more of a priority and focus on prevention measures, including early detection and access to adequate health services – repeat infections of dengue can be more serious and even deadly.
Those calls to action are not limited to Bangladesh. As the planet rapidly heats due to the burning of fossil fuels, outbreaks will become more common in new regions of the world.
The global number of dengue cases has already increased eight-fold in the past two decades, according to WHO.
As the climate crisis worsens, mosquito-borne diseases like dengue, Zika, chikungunya and yellow fever will likely spread further and have an ever greater impact on human health.
This year, dengue has hit South America severely with Peru battling its worst outbreak on record. Cases in Florida prompted authorities to put several counties on alert. In Asia, a spike in cases has hit Sri Lanka, Thailand and Malaysia, among other nations. And countries in sub-Sarahan Africa, like Chad, have also reported outbreaks.
WHO’s alert and response director Abdi Mahamud called the outbreaks a “canary in the coalmine of the climate crisis” and said “more and more countries” are experiencing “the heavy burden of these diseases.” | Epidemics & Outbreaks |
A common ingredient in over-the-counter cold and cough medicines might not be long for this world. The Food and Drug Administration is about to decide whether oral phenylephrine should remain in OTC nasal decongestant drugs. Outside experts will deliberate the topic and offer their recommendations this week, but FDA scientists have already argued that oral phenylephrine is practically worthless.
This week, the FDA is hosting an advisory committee meeting on nonprescription drugs, with one of the topics being whether oral phenylephrine should be pulled from the market as a nasal decongestant. The ingredient is found in many cold and allergy medicine brands, such as Sudafed PE and certain formulations of Nyquil. The specific change being debated is whether phenylephrine should lose its current designation of being “Generally Recognized as Safe and Effective,” or GRASE. In advance of this meeting, the agency’s own researchers detailed their conclusions in a report released last Thursday.
This same question was debated in 2007. Though there was some evidence back then that oral phenylephrine might be ineffective, the advisory committee and FDA were ultimately convinced otherwise by the overall data as well as the arguments made by cold medicine makers, so the drug stayed put. However, the agency did state that it might reassess the decision in the future once more research was concluded. In 2015, the FDA was petitioned by researchers from the University of Florida to do just that, which has led to this new meeting.
Since 2007, there have been several studies on the topic, including three large clinical trials. And it appears that the data nowadays is much more definitive. These large placebo-controlled trials have shown no evidence that standard and even higher doses of oral phenylephrine relieve nasal decongestion. While the drug might have a decongestant effect when taken intranasally, other data cited by the FDA has found that our bodies barely absorb it when taken orally. In other words, it’s likely that no amount of oral phenylephrine will help your stuffy nose, at least not at a dosage that would be practical or safe to take over-the-counter. The FDA scientists also determined that some of the past positive studies on the drug had glaring methodological flaws and/or biases.
“We believe that these new clinical pharmacology and clinical data are consistent, substantial, and believable, and they confirm that orally administered [phenylephrine] is not effective at any dose that can be developed and still provide a reasonable margin of safety,” the agency’s reviewers wrote in their report.
The FDA’s review is not the final word on the subject. It’s possible that the advisory committee will recommend once again that oral phenylephrine remains on shelves. But even if the panel does recommend that, the FDA can still choose to ignore their advice and pull the drug anyway. | Drug Discoveries |
The number of COVID-19 hospitalizations is rising this summer in the U.S., according to the Centers for Disease Control and Prevention (CDC).
Hospitalizations of people with the virus are up 10%, per CDC data — the sharpest increase since December 2022.
More than 7,100 patients with COVID were hospitalized in the week of July 15, up from 6,444 the prior week.
COVID-related emergency room visits are also on the rise, comprising 0.73% of visits as of July 21, compared to 0.49% a month prior.
"After roughly six, seven months of steady declines, things are starting to tick back up again," Dr. Brendan Jackson, the CDC's COVID-19 incident manager in Atlanta, Georgia, told NPR this week.
"We've seen the early indicators go up for the past several weeks," he continued.
"And just this week, for the first time in a long time, we've seen hospitalizations tick up as well."
He added, "This could be the start of a late summer wave."
The spikes have been most prominent in the Southeast, Jackson said.
"Early indicators of COVID-19 activity (emergency department visits, test positivity and wastewater levels) preceded an increase in hospitalizations seen this past week," CDC spokesperson Kathleen Conley said in a statement.
Despite the uptick, she confirmed that COVID rates are still at "near-historic lows" in the U.S.
Overall, COVID deaths continue to decline.
They're now at the lowest rate since the CDC started keeping track, according to Jackson.
The surge in summer cases doesn’t mean the CDC plans to recommend a return to masking, he said.
More concerning are the "mutagenic" subvariants emerging in Asia, the doctor said.
"For most people, these early signs don't need to mean much," Jackson said.
Dr. Marc Siegel, professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, is skeptical that a summer surge is underway.
"Ordinarily, I would pay careful attention to wastewater analysis, but given the amount of immunity still around from prior infection and vaccination — coupled with the fact that we are still within the Omicron family with most infections remaining mild and hospitalizations showing only a slight uptick — I don't see this as a harbinger of another surge," he told Fox News Digital.
"These are just embers of a fire not completely out."
More concerning to Siegel are the "mutagenic" subvariants emerging in Asia, the doctor said.
As a result, said Siegel, "I am likely going to recommend the new XBB subvariant booster in the fall, especially for those in high-risk groups who haven't had a recent infection or vaccine." | Epidemics & Outbreaks |
- Only one-third of the 1 million adults in the U.S. who tested positive for hepatitis C between 2013 and 2022 have been cured, according to a CDC report published Thursday.
- Hepatitis C is often referred to as the silent killer because the initial infection has few to no symptoms.
- Health insurance restrictions and the high cost of oral antiviral treatments, at up to $24,000 per patient, are preventing people from getting cured, health officials said.
The overwhelming majority of people in the U.S. who have tested positive for hepatitis C have not been cured due to the high cost of oral antiviral treatments and obstacles imposed by insurance plans, federal health officials said on Thursday.
Hepatitis C is often referred to as the silent killer because the initial infection has few to no symptoms. Overtime, however, the virus can cause liver damage, liver cancer, liver failure and ultimately death.
The virus is spread through contact with an infected person's blood, primarily through sharing needles and other equipment used to inject drugs.
Breakthrough oral antiviral treatments made by Gilead Sciences and Abbvie have been on the U.S. market for nearly a decade now. These pills, taken once a day for eight to 12 weeks, cure more than 95% of hepatitis C cases.
Despite the availability of these medications, only one-third of the 1 million adults in the U.S. who tested positive for hepatitis C between 2013 and 2022 have been cured, according to a report from the Centers for Disease Control and Prevention published Thursday. Health officials estimate up to another million people in the U.S. are infected but don't know they have the virus.
Hepatitis C contributed to the deaths of nearly 15,000 people in 2020, according to the CDC.
"Thousands of people are dying every year in our country, and many more are suffering from an infection that has been curable for more than 10 years," Dr. Jonathan Mermin, director of the CDC division that specializes in HIV and viral hepatitis, told reporters on a call Thursday.
The Biden administration has asked Congress to approve $11 billion in funding for a national program to eliminate hepatitis C by 2030. Dr. Francis Collins, who is leading the initiative at the White House, said the program will save thousands of lives and pay for itself by reducing health care costs.
Health officials said the primary obstacles to treatment are requirements imposed by health insurance plans and the high cost of treatment. The course of pills can cost up to $24,000 per patient.
Dr. Carolyn Wester, who heads the CDC's viral hepatitis division, said some health insurers require burdensome preauthorization before patients can receive the pills and also limit which health-care providers can prescribe the medications.
Collins, who previously served as director of the National Institutes of Health, said community health centers that treat the uninsured cannot afford the pills for everyone. Only 1 in 4 uninsured adults diagnosed with hepatitis C have been cured, according to the CDC.
Even state Medicaid plans impose burdensome requirements such as evidence of liver disease, sobriety and the involvement of specialists, Collins told reporters on Thursday. The high cost of the drugs has made it difficult for Medicaid to treat everyone who is infected, according to the U.S. Health and Human Services Department.
Under Biden's proposal, the federal government would pay pharmaceutical companies like Gilead and Abbvie a lump sum for the drugs. The companies would then make the medications available for free to the uninsured, state Medicaid programs, prison systems and people living on Native American reservations.
The proposal is based on a model launched by Louisiana in 2019, in which the state paid Gilead subsidiary Asegua Therapeutics a lump sum for enough drugs over five years to cure nearly all Medicaid patients and people who are incarcerated.
Collins said NIH and the Food and Drug Administration are also working on the approval of a rapid hepatitis C test that would provide a diagnosis in an hour or less. The test would be used to diagnose and treat patients in a single visit, he said. | Disease Research |
SACRAMENTO, Calif. — Nearly two years into Gov. Gavin Newsom’s $12 billion experiment to transform California’s Medicaid program into a social services provider for the state’s most vulnerable residents, the institutions tasked with providing the new services aren’t effectively doing so, according to a survey released Tuesday.
As part of the ambitious five-year initiative, called CalAIM, the state is supposed to offer the sickest and costliest patients a personal care manager and new services ranging from home-delivered healthy meals to help paying rental security deposits.
But a quarter of the health care insurers, nonprofit organizations, and others responsible for implementing the program don’t know enough about it to serve those in need, and many are not equipped to refer and enroll vulnerable patients, according to research by the California Health Care Foundation. (KFF Health News publishes California Healthline, an editorially independent service of the California Health Care Foundation.)
The survey found that only about half of primary care providers and hospital discharge planners are very or somewhat familiar with the initiative, even though they are essential to identifying patients and referring them for services.
“These workers are on the front lines and if they don’t know about it, that’s a pretty easy win to educate them so they can help more people,” said Melora Simon, an associate director at the foundation, which conducted the survey between July 21 and Sept. 12. The initiative debuted in January 2022.
“These workers are most likely to see people in the hospital, in crisis,” she added, and “have the opportunity to do something about it.”
The roughly two dozen managed care insurance companies serving patients in Medi-Cal, California’s Medicaid program for low-income people, are responsible for identifying and enrolling patients into the program, and providing the new services. To make this happen, they contract with local government agencies, community nonprofit groups, social service organizations, hospitals, community clinics, and more. Those organizations can also make referrals and link patients to new services. The foundation surveyed 1,196 of these so-called implementers.
Most of the respondents said state payment rates do not cover the cost of providing expensive social services, and half say the workforce they need to deliver them is “tapped out and overwhelmed.”
About 44% also cited inconsistencies and different rules imposed by managed care plans, making participation very or somewhat challenging. For example, some insurers provide on-the-spot Uber rides for doctor appointments while others offer only a bus pass. Plus, not all plans offer the same services.
The survey did pinpoint some early successes. For instance, about half of respondents said the initiative has enabled them to serve more people, and that their ability to manage the comprehensive needs of patients has gotten better.
Tony Cava, a spokesperson for the state Department of Health Care Services, which administers Medi-Cal, acknowledged that the survey findings “resonate” and said the state is working to streamline and standardize patient referrals and authorizations.
“Implementers are on board with the core goals, and we are seeing improvements. But there is room to increase familiarity with CalAIM and broaden and deepen networks,” Cava said.
He said CalAIM represents a major shift in how Medi-Cal delivers care, and that the “kind of seismic system change that we are undergoing takes time.”
“Rather than reactive, we are moving toward a system that is proactive and considers all factors affecting health — the social drivers of health — and not simply what may happen inside of a medical facility,” he added.
The department provides financial and technical assistance to implementers, though only about one-third of survey respondents have found the training, technical guidance, and other resources adequate.
Van Do-Reynoso, chief healthy equity officer for CenCal Health, the Medi-Cal health insurer serving Santa Barbara and San Luis Obispo counties, acknowledged that it has been difficult to provide a full complement of CalAIM services. She cited a variety of obstacles such as inadequate reimbursement, lack of housing, and working with social services agencies unfamiliar with the health care system.
Nearly 3,000 CenCal enrollees are receiving CalAIM services, she said, many of them housing- and homelessness-related.
“We are working hard to better engage with hospital CEOs, community providers, and medical providers,” Do-Reynoso said. “People are getting housed. They’re practicing sobriety. It has only whetted our appetite to continue doing this work.”
When Newsom launched CalAIM, the Democratic governor promised it would transform Medi-Cal. The goal, his administration said, is to improve health and prevent people from winding up in costly institutions like the emergency room and jail, and to help move homeless people into housing.
It’s unclear how many of the 15.2 million Californians enrolled in Medi-Cal are eligible for new services and benefits, but several large populations qualify, including homeless Californians, people leaving jail or prison, foster children, people with severe mental illness or addiction, and older nursing home residents who want to transition home.
So far, about 141,000 Medi-Cal patients have a personal care manager through CalAIM, according to Cava, though hundreds of thousands more likely qualify. About 76,000 patients are receiving other social services, which are optional for plans to offer, he said.
In some cases, qualified Medi-Cal enrollees are turning down new services because they are being offered at the wrong time or by the wrong person, Simon said. For instance, a homeless person might not accept services from a police or code enforcement officer.
Insurers say they want to do more but need more help from the state.
“I am very hopeful that a year from now, we are going to be able to demonstrate even greater strides,” Do-Reynoso said. “What we hear often is what is reflected in the survey. We need higher rates, more communication, a more streamlined approval process.” | Health Policy |
After she returned to the Senate recently, Sen. Dianne Feinstein’s office confirmed that the California senator was hospitalized for severe neurological complications of shingles that affected her brain and face.
"While the encephalitis resolved itself shortly after she was released from the hospital in March, she continues to have complications from Ramsay Hunt syndrome," a spokesperson for Feinstein, 89, confirmed on Thursday in a statement.
Feinstein, California’s senior Democratic senator, previously said that she did not have encephalitis, noting, "It really has never been diagnosed properly."
The senator was diagnosed with shingles on February 26 by her physician in San Francisco, then was "briefly" hospitalized until March 6.
She returned to her home in California to recover, her office said in a statement.
But when she returned to the Capitol, she appeared frail and at times confused as she navigated its halls in a wheelchair, according to multiple reports.
"It is important not to speculate on anyone’s medical diagnosis without an in-person medical evaluation," Dr. Michael S. Okun, executive director of the Norman Fixel Institute for Neurological Diseases at University of Florida Health in Gainesville, Florida, told Fox News Digital late this week.
"I’m still experiencing some side effects from the shingles virus," Feinstein said.
"However," he added, "the reports on Senator Feinstein offer us an opportunity to educate the public on the importance of recognizing and treating meningoencephalitis."
What is Ramsay Hunt syndrome?
The syndrome is a rare neurological complication of shingles that classically occurs in adults over 60 years old, according to the National Organization for Rare Disorders (NORD).
It sometimes can occur in younger people — as pop singer Justin Bieber was diagnosed with the condition last year.
The virus that causes chicken pox, known as varicella zoster virus (VZV), stays "dormant" in the body after someone gets chickenpox; but later in life, it can reactivate in a nerve that controls the facial muscles, known as the facial nerve.
This leads to a constellation of symptoms because of the location of the nerve in the face. Symptoms can include paralysis of one side of the face, painful blisters near the ear and ear pain, according to the National Institutes of Health (NIH).
"Even though I’ve made significant progress and was able to return to Washington, I’m still experiencing some side effects from the shingles virus," Feinstein said in a statement on May 10.
"My doctors have advised me to work a lighter schedule as I return to the Senate."
These "temporary" side effects are affecting her vision and ability to balance.
"My doctors have advised me to work a lighter schedule as I return to the Senate," she added.
Some patients have permanent facial paralysis and hearing loss from the syndrome, NORD added.
What is encephalitis?
Three protective layers of membranes known as the meninges cover the brain and spinal cord — which make up the central nervous system — to prevent them from moving, according to Cleveland Clinic.
In meningitis, these outer protective layers surrounding the brain become inflamed — but encephalitis is when the brain gets inflamed, per Johns Hopkins Medicine’s website.
Patients with meningitis often present themselves to health care professionals within hours with the classic triad of symptoms of fever, headache and neck stiffness.
Encephalitis has a more subacute presentation that includes changes in mental status.
"Meningoencephalitis can be caused by a viral infection of the brain and its coverings and depending on the virus type causing the infection, the associated syndrome may also result in strokes and brain bleeding," Okun said.
As time progresses, patients may start to have mental status changes, problems with memory, thinking and reasoning.
"If caught early, these disorders may possibly be treatable by antiviral drug therapy," he added.
"It is important to recognize that identifying which virus is involved, VZV or herpes, can make a huge difference in treatment and in outcome."
Although encephalitis due to shingles can occur in people without significant medical problems, it is more common in people with immunocompromised conditions, such as cancer, according to previous research.
How does shingles cause encephalitis?
"Encephalitis [after] shingles is a rare but important complication of shingles — which is a viral infection that is a late complication of chickenpox," Dr. Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau Hospital on Long Island, New York, told Fox News Digital.
He pointed out that people cannot get shingles if they've never had chickenpox.
"These viruses are usually present and in ‘hiding’ in our bodies, and can be commonly reactivated later in life, especially when there is a weakened immune system," Okun added.
When the virus moves centrally toward the brain, it can cause encephalitis.
What are the symptoms?
People who have encephalitis often have symptoms that worsen over days to weeks, per Johns Hopkins medicine’s website.
It can be caused by infections — often due to a virus or to inflammatory conditions in which the body’s immune system attacks the brain.
A patient’s specific symptoms will vary according to the part of the brain that’s infected or the particular antibody causing the inflammation.
Encephalitis due an infectious cause starts with non-specific symptoms that can be difficult to distinguish from the flu, including a headache.
"It was really a bad flu," Feinstein told CNN when she went to the hospital with symptoms.
As time progresses, patients may start to have mental status changes, problems with memory, thinking and reasoning.
In the case of an infectious cause, a patient’s specific symptoms will vary according to the part of the brain that’s infected or the particular antibody causing the inflammation — when it’s an autoimmune etiology.
Encephalitis secondary to shingles often presents with a patient’s mental status changing within days after developing a group of painful blisters along one or more nerve distributions, according to previous research.
How can shingles be prevented?
"Fortunately, there are excellent vaccines that are available to prevent chickenpox," Glatt tox Fox News Digital.
"And if you had chickenpox, as most people above 40 years old have had, taking the shingles vaccine to prevent shingles — a potentially very serious complication — is very effective." | Disease Research |
The following is a transcript of an interview with Dr. Scott Gottlieb that aired on "Face the Nation" on Sunday, March 5, 2023.
MARGARET BRENNAN: And we are back now with former FDA commissioner advisor board member, Dr. Scott Gottlieb. Good morning. Welcome back. Good to see you.
DR. SCOTT GOTTLIEB: Good morning.
MARGARET BRENNAN: Dr. Gottlieb. I wanted you to sort of give us some context here, because I know you've said in the past on this program that we will likely never know the origin of COVID-19, short of finding the exact animal that carried the virus or a smoking gun, proving that it accidentally leaked out of the lab. You said both theories were plausible. Has anything changed that makes you more certain now?
DR. GOTTLIEB: Well, look, I think that there's enough information in the public domain to create a presumption that this could have come out of lab, maybe a strong presumption. We have seen some incremental reporting, there's classified information that hasn't been made public, you heard the Congressman even refer to classified information that even Congress hasn't seen in this instance. And I think based on that premise, that there's, you know, a likelihood that this came out of a lab. We may never be able to prove it with certainty. We should start behaving like it did come out of a lab and start taking the steps to make sure that that couldn't happen again. There's a lot of things that happened around the labs in China, particularly the WIV in Wuhan, the Wuhan Institute of Virology that created sloppy conditions. They were doing high risk research in low level, low security labs. They were doing risky research. You heard the Congressman talk about the gain of function research that was going on in that lab. We know the Chinese military was operating in that lab simultaneously. So we need to look at all those things. I would be focusing on the activities in and around that lab, and deriving from that, what steps we need to take going forward to make sure that we get better security around high risk research that if this did come out of a lab, it's- it's not going to happen again.
MARGARET BRENNAN: And we've talked on this program to Matt Pottinger, who served in the Trump administration who said, intelligence needs to be a more robust part of pandemic protection. And I know you agree with that. You know, there was a piece in The New York Times by David Wallace Wells, an opinion piece called, "We've been talking about the lab leak theory all wrong." And the argument is that lean into the lab theory and just look at how to prevent lab leaks. He's calling for things like a national registration on research based on risks and benefits, new safety standards, global governance to go with this as well. Why doesn't that exist? And why isn't that being created?
DR. GOTTLIEB: Yeah, I think it should be. I mean, we're three years into this, there's some recommendations that are on the President's desk. I think we need to start getting serious and looking at what steps need to be put into place. You know, we're still stuck on a debate about whether it was or wasn't a lab leak. I don't think we're going to prove that. I think we should work on the assumption that there's a probability that it was a lab leak, and start putting in place the kinds of protections that we need. The Congressman talked about gain of function research. He made the point that there isn't a real commercial prerogative for doing that kind of research. I agree with him. We ought to look at whether we outlaw that kind of research. And certainly, if it's going to take place, conducted in BSL-4 labs, high security labs under very strict conditions, where we know what's going on, and don't outsource it to labs in China. Sometimes the highest risk experiments get outsourced to the worst labs around the world, because they're the ones willing to do those experiments. And so if we're going to do high risk research, because we think it's important from a national security standpoint, and that's the only context with which this would make sense, there really isn't a commercial context in which this would make sense; we need to get better control over it. And to Matt's point, Matt Pottinger's point, we need to get the intelligence agencies engaged in this as a national security- as a part of their national security mission, and look at public health preparedness through a national security lens. I think we're doing that now. But we need to be very explicit about that. And that does mean also surveillance around some of the high risk activities that can create these kinds of risks.
MARGARET BRENNAN: So- but that's the White House, and that's the intelligence agencies, rather than a congressional mandate.
DR. GOTTLIEB: Look, Congress certainly has a role here. I think that Congress could start coming up with a list of recommendations to the administration. The administration has recommendations from independent bodies. Ultimately, this is going to be federal rules that get imposed on research that gets funded by the federal government, as well as what we try to do through international conventions, working with the WHO and the World Health Assembly to try to get international agreements in place on what countries are and aren't going to be willing to do. Now you can't prevent rogue regimes from doing this kind of research. That's where the intelligence agencies come in to do monitoring, to see if rogue regimes are doing high risk research that could create conditions for a lab leak, either inadvertently or deliberately.
MARGARET BRENNAN: And the Biden administration has called on China to release more information, and they have not delivered it. Dr. Fauci talked about that in November on this program. I also want to ask you about what we just learned about President Biden's health. He had this skin cancer diagnosis of basal cell carcinoma lesion removed. Given his age, is there any reason to worry more about it?
DR. GOTTLIEB: There's no reason to be concerned about this particular lesion. This is a slow growing cancer, usually confined to the surface of the skin that can be completely excised with a small surgical procedure. It sounds like the President had this fully removed. It shouldn't recur, it typically doesn't spread. These kinds of lesions typically occur in regions of the body that are exposed to sun. It is related to exposure to UV light, so typically you see it on a neck or the face. Just for awareness, it's not like a melanoma where it appears as a very dark, irregular lesion. Typically it'll appear as sort of a clear and waxy kind of lesion, maybe scaly, so it has a different kind of appearance. But the President should be fully cured of this through a small surgical procedure to remove it.
MARGARET BRENNAN: Dr. Gottlieb, always good to talk to you.
for more features. | Epidemics & Outbreaks |
DENVER -- Months after Colorado’s voters decided to join Oregon in decriminalizing psychedelic mushrooms, Denver is hosting a conference this week put on by a psychedelic advocacy group bringing together an unlikely cohort of speakers — including an NFL star, a former Republican governor and a rapper.
The conference and the thousands attending is an indication of the creep, or perhaps leap, of cultural acceptance for psychedelic substances that proponents say may offer benefits for things like post-traumatic stress disorder and alcoholism. Still, medical experts caution that more research is needed on the drugs' efficacy and the extent of the risks of psychedelics, which can cause hallucinations.
NFL quarterback Aaron Rodgers, who’ll soon debut with the New York Jets after years with the Green Bay Packers, will speak with a podcaster Wednesday about his ayahuasca experience and how he believes it helped his game. Rapper and actor Jaden Smith, the son of Will Smith who has publicly shared the “ego dissolution” he felt when using psychedelics, will speak, too, as will former Texas Republican Gov. Rick Perry, who is an advocate for researching psychedelics’ potential benefits for veterans experiencing PTSD.
The hosting organization, the Multidisciplinary Association for Psychedelic Studies, is the largest U.S. advocacy group. It has strategized to reach the full political spectrum, said Nicolas Langlitz, a historian of science who’s researched the boom and bust of psychedelic movements.
“Overall, this strategy has been tremendously successful,” he said. “At the time when any topic gets politically polarized, ironically, these super-polarizing substances now get bipartisan support.”
Still, Langlitz said, this conference is “purely designed to promote the hype," which can exaggerate potential benefits but also drive further funding.
“Any kind of overselling is not good for science because science should be accurate rather than pushing things," he said. “It’s a tradeoff. (The conference) generates interest, it generates ultimately more research, even though the research might be skewed toward positive results.”
Psychedelics are illegal at the federal level, though acceptance and interest in studying their potential benefits has grown. For example, some researchers believe psilocybin, the compound in psychedelic mushrooms, changes the way the brain organizes itself and can help users overcome things like depression and alcoholism.
The drugs themselves — and the interest in them — are not new. Mid-last century, Aldous Huxley, Timothy Leary and Ken Kesey helped spur the use of psychedelics during the counterculture movement, and optimism brimmed among some psychologists over the drugs’ potential to augment the human psyche.
But the Nixon administration criminalized psychedelics, pushing them underground.
“In both cases you have this upwelling of exuberance that may or may not be irrational,” said author Michael Pollan, who wrote a book on psychedelics and will be speaking at the conference. “But I think a big difference (now) is that the enthusiasm for the potential of psychedelics cuts across a much more representative slice of the population — it’s not about a counterculture."
Republican strongholds, including Utah and Missouri, have or are considering commissioning studies into the drugs, partly inspired by veterans’ poignant stories. That’s why, though he stops short of promoting recreational use, Perry has become an unlikely flagbearer and helped get a bill passed in the Texas legislature in 2021 to fund a study of psilocybin for treating PTSD.
In Congress, successful proposals to fund psychedelic research for PTSD in veterans brought progressive Democratic Rep. Alexandria Ocasio-Cortez from New York and far-right Rep. Matt Gaetz from Florida into an unlikely alignment.
Public interest also appears to be growing. Just six years ago in Oakland, California, the Multidisciplinary Association for Psychedelic Studies held a conference with roughly 3,000 attendees and a smattering of lesser-known speakers and die-hard proponents.
This time, organizers estimate at least 10,000 attendees. Other famous speakers will include former NHL player Daniel Carcillo, who owns a company specializing in psychedelic therapies; Olympic silver-medal figure skater Sasha Cohen; comedians Reggie Watts and Eric Andre, top-10 podcaster Andrew Huberman; and Carl Hart, the chair of Columbia University's psychology department.
Rick Doblin, founder of the advocacy group, kicked off the conference Wednesday in front of an overflowing theater espousing grandiose goals, such as “net-zero” trauma by 2070 through the use of psychedelics.
The American Psychiatric Association has not endorsed the use of psychedelics in treatment, noting the Food and Drug Administration has yet to offer a final determination. The FDA did designate psilocybin as a “breakthrough therapy” in 2018, a label that’s designed to speed the development and review of drugs to treat a serious condition. MDMA, often called ecstasy, also has that designation for PTSD treatment.
Both Pollan and Langlitz believe further research is key — especially as the nation faces an unprecedented mental health crisis and people struggle to find adequate treatment. But, Langlitz said, it's important to let research shape the narrative.
“I would just try to keep my mind open to the possibility that in retrospect we will tell a very different story from the one that the protagonists of psychedelic therapies are currently predicting,” he said.
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Bedayn is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. | Disease Research |
Researchers untangle the relationships between bacterial languages
A combination of machine learning and lab experiments has given researchers a peek into the different languages bacteria use to communicate. Understanding how bacteria communicate—and when they can't—has implications for treating drug-resistant bacteria and for developing biocomputing tools.
The study builds on an earlier project in which the researchers showed that disrupting bacterial communication is an effective way to fight multidrug-resistant bacteria. Bacteria use small molecules to communicate with one another and coordinate infection, and the team showed that interfering with bacterial communication by blocking these molecules reduced inflammation and made the bacteria more vulnerable to antibiotics.
Now, the researchers have taken a closer look at the languages that bacteria use to communicate. The team used a combination of machine learning and wet-lab experiments to examine all the roughly 170 known bacterial languages. This analysis provides an understanding of the similarities and differences between the languages, which can be used both to disrupt harmful bacteria and to build useful "bacterial logic circuits." The findings are published in the journal Angewandte Chemie International Edition.
The first step was a machine learning analysis that grouped the languages into clusters based on the structure of their molecules. The resulting groups consisted of languages more similar to each other and different from languages in other groups. This is comparable to human languages: English, French and Dutch are in one group of languages, while Arabic and Hebrew are in another, for example.
Next, the team experimentally showed that bacteria can somewhat understand related languages. "We did a 'bacterial language check' and found that bacteria using very similar languages can understand each other, just like a Dutch person might understand some German. We also tested communication between bacteria using very different languages and found that they couldn't understand each other at all—just like a conversation between people speaking Finnish, Dutch and Arabic wouldn't get far," says Christopher Jonkergouw, the doctoral student who led the study.
With these tools, the researchers have shown that we can accurately estimate the connections between bacterial languages and predict whether they can be understood. These findings will be valuable in further refining the team's new treatment approach, and they also have implications for biotechnology—bacterial languages can be used to coordinate tasks between groups in bacterial communities, or even in bacterial microprocessors.
More information: Christopher Jonkergouw et al, Exploration of Chemical Diversity in Intercellular Quorum Sensing Signalling Systems in Prokaryotes, Angewandte Chemie International Edition (2023). DOI: 10.1002/anie.202314469
Journal information: Angewandte Chemie International Edition
Provided by Aalto University | Disease Research |
- Hamas militants were high on Captagon pills during the October 7 terrorist attacks, reports say.
- Captagon is a brand name of the synthetic stimulant fenethylline hydrochloride.
- Militant groups use the drug to increase "aggressiveness, alertness, and fearlessness."
Captagon pills fueled Hamas militants during the October 7 terrorist attacks, Israel's Channel 12 News reported.
The drug, which is also known as "poor man's cocaine," is a highly addictive, synthetic stimulant that is widely consumed across the Middle East.
The Hebrew-language news channel reported that pills of the drug had been found on the bodies of Hamas prisoners and fighters killed in the conflict, suggesting that they had taken the drug before carrying out their "inhumane murders."
The IDF told Insider by email that it did "not have information or a comment on this subject."
Israeli security guards in the southern West Bank stopped thousands of Captagon pills hidden in a shipment of refrigerators from being smuggled into Gaza in January, The Times of Israel reported.
More than 1,400 people were killed in Israel during the attacks earlier this month, while over 200 people were also taken hostage by Hamas.
Fenethylline hydrochloride and the Middle East
Captagon is the brand name of the drug fenethylline hydrochloride. The substance was created in the 1960s in West Germany to help treat conditions such as attention deficit disorder, depression, and narcolepsy.
Its highly addictive nature led to it being banned in the 1980s, but a clandestine trade of counterfeit versions of the pills began in the Middle East. Its popularity particularly blossomed in Gulf states like Saudi Arabia, Qatar, and the United Arab Emirates.
Following Israeli military action against the militant group Hezbollah in Lebanon in 2006, production of Captagon increased in Lebanon as the group sought to build up its depleted finances, and production became rife along the Syrian border.
The drug, a mixture of amphetamine and theophylline, often cut with other substances such as caffeine and paracetamol, became particularly popular with fighters in the Syrian civil war and with Islamic State (ISIS), as they sought to stave off sleep and remain focused.
According to the American Chemical Society, militant groups use the drug to increase what they deem to be "desirable characteristics" in their fighters, such as "aggressiveness, alertness, and fearlessness."
The drug has since become a "significant revenue stream" for Syrian President Bashar Assad's regime, helping it "stay afloat as sanctions and other economic measures are squeezing it," Natalie Ecanow, a research analyst at the think tank The Foundation for Defense of Democracies (FDD), which focuses on Lebanon, Jordan, and the Levant, told Insider.
According to the UK government, around 80% of the global supply of the drug is produced in the country, and Assad "has been able to leverage the drug trade" to gain concessions from other Arab leaders, Ecanow added — which led to his eventual welcome back into the Arab League.
"The Syrian regime's trafficking of billions of dollars' worth of captagon has helped to spread violence across the region; Hamas terrorists' reported use of the drug only adds to the carnage," David Adesnik, Senior Fellow and Director of Research at the FDD, said.
A key link to Assad's regime came in 2018, when the cargo ship Noka, sailing from the Syrian port of Latakia to eastern Libya, was raided as it passed the Greek island of Crete.
On board, authorities discovered more than $100 million worth of cannabis and Captagon pills that had been hidden among sawdust, coffee, and spices.
Two years later, Italian police seized one of the largest hauls of Captagon after they found 14 tonnes of the drug, worth around 1 billion euros, just over $1 billion, at the port of Salerno, near Naples in southern Italy.
According to the Organized Crime and Corruption Reporting Project (OCCRP), a combination of ship tracking data, court documents, company data, and information from authorities linked many of these Captagon hauls back to the Mediterranean port of Latakia, Syria's main port.
The OCCRP describes Latakia as "an impenetrable Assad fiefdom," is controlled by Assad's brother, Maher Al-Assad, and his notorious Fourth Division army.
In 2021, data on seizures in the region valued the Captagon trade at $5.7 billion, per the FDD. | Drug Discoveries |
More than 58 million domestic fowl in the US have died or been culled over the past 12 months due to a large outbreak of the avian flu — the deadliest outbreak in the country’s history, according to the Department of Agriculture.
The specter of an avian flu pandemic is always on health authorities’ minds. Should we be worried this time? According to the CDC, the risk to humans right now is low.
“They’re not considering this anything that needs to be on people’s minds continuously,” said Geoffrey Lossie, an avian diagnostician at Purdue University's College of Veterinary Medicine.
However, this avian virus — the H5N1 strain of influenza — has a mortality rate in humans of 50%, which is one reason scientists are keeping a close watch on it.
So many chickens have been killed it’s contributing to an egg shortage in the US that’s driving up prices. Egg prices more than doubled in 2022 but have since declined, and other factors, like inflation and demand, have played a role in the cost of eggs.
The H5N1 virus has been detected in more than 120 wild mammals in the US in 2022 and 2023, including red foxes, skunks, and even grizzly bears — a troubling step in the road toward human infection.
An outbreak at a mink farm in Spain suggested the virus can now spread in mammals, and 52,000 infected animals had to be culled. This week, four dead seals tested positive for bird flu in Scotland, as did 585 sea lions in Peru, suggesting cases are growing globally in mammals.
Past avian flus have moved from birds to other animals, but the number of mammals that have been infected recently is unusual, said Gregory C. Gray, an infectious disease epidemiologist at the University of Texas Medical Branch in Galveston. “There’s concern that it could further change and jump to humans,” he said.
The H5N1 strain of influenza is a mix of DNA from a Eurasian lineage of the virus and a North American lineage, Lossie said. The strain has had a 53% death rate among humans, based on 858 reported cases globally since 2003, according to the World Health Organization. The “H” and “N” refer to proteins on the surface of the influenza virus that affect how the virus behaves.
What is bird flu?
Different influenza viruses tend to target different species, said Dr. William Schaffner, a spokesperson for the Infectious Diseases Society of America.
Avian flu is carried by wild migratory birds like wild ducks and geese and usually follows certain patterns. The virus typically doesn’t sicken or kill wild birds, though it does kill domestic fowl. In this case, though, influenza is making some wild birds sick, Lossie said.
Usually the virus passes from wild birds to domestic birds through feces. In the current outbreak, there is some evidence that the avian flu is also passing through respiratory droplets in wild birds. It’s definitely being shed through the respiratory route in domestic birds like chickens and turkeys, Lossie said.
And while the number of birds who have perished from the avian flu is about the same as in a 2015 avian flu outbreak, the outbreak has now visited double the number of states.
“This does suggest that bird flu is more widely distributed geographically,” Schaffner said.
Also, Lossie added that scientists have detected far more infections in wild birds during this outbreak than in past outbreaks.
How does bird flu get to humans?
It’s rare for the exact same virus that infects birds to reach humans. “The appropriate receptors in the mucous membranes in our throats, noses, and upper part of our respiratory tract are not very receptive to bird flu,” Schaffner said.
When it does happen, it’s usually in someone who lives and works closely with birds — and the infection stops there. Since the outbreak began, there have only been four cases in humans and one death.
“Quite a number of different strains of avian flu have spilled over to humans, but they’ve had limited, if any, human-to-human transmission,” Gray said. “Often it’s a dead end.” Only one person in the US, a poultry worker in Colorado, was infected by the current strain in April while culling poultry infected with H5N1. He reported only fatigue and was treated with antivirals. He has since recovered, Lossie said. (There was also a second human case in South West England detected at the end of 2021.)
Usually there’s another step involved: The virus has to mutate enough to infect a mammal and mutate again to infect people. Every time a virus replicates, DNA can mutate, giving it opportunities to infect different life forms. New strains of a virus also happen through genetic drift, which is when two virus strains — say one human and one avian — combine to create a new variant, Lossie said.
“Most pandemics generate when there is a species jump and usually with an intermediate host where the virus can evolve,” said Dr. Cesar Arias, chief of infectious diseases at Houston Methodist Hospital. “The concern here is the Spanish report of mink transmission. There could be a genetic adaptation in which the virus can become airborne from human to human.”
So far, the CDC said that the circulating virus lacks the genetic changes that would allow it to easily cause illness in humans.
How deadly is bird flu in humans?
It can be very deadly, with a mortality rate as high as 50% in the cases where bird flu has jumped directly from birds to farmers and other handlers, Schaffner said.
Every time the virus replicates, it can mutate into a version the human immune system has never seen before. “That makes it harder for our immune systems to fight the infection,” Arias said. “When they get to humans, the adaptations tend to be accompanied by high virulence, which means infections are severe with high mortality.”
Basically, our bodies have never encountered these new viruses and have no defenses. This is effectively what happened with SARS-CoV-2, the virus that causes COVID.
How worried should we be?
Right now, the avian flu doesn’t warrant five-alarm concern, experts said.
But things could change. While it takes time for a pandemic to develop, “I think we’re headed in that direction,” Arias said.
Right now, the biggest risk is to humans who have a lot of contact with birds, especially poultry, Lossie said. That includes not only people in commercial poultry operations but also people with backyard flocks, which are on the rise due to the rising price of eggs in stores.
Are there ways to protect ourselves?
The current outbreak remains a matter mainly for public health organizations for the foreseeable future. The USDA has a surveillance system in place to track avian flu in birds — one they say is the strongest in the world.
“We need to be sure the US government is very vigilant through surveillance and be alert for novel viruses that might spill into humans,” Gray said.
There aren’t any avian flu vaccines widely available, but there are prototypes. “The vaccines have basically been constructed then the question would be how quickly to manufacture them,” Schaffner said.
The CDC cautions against unprotected contact with wild or domestic birds. They recommend wearing an N95 respiratory or surgical mask, eye protection, disposable gloves, and boots as well as washing your hands after any contact and don’t touch your mouth, nose, or eyes, all possible points of entry for the virus.
If you have chickens or other birds (including pet birds), keep them protected from wild birds. “Try to shelter your backyard herd or flocks of chickens from migratory birds,” Schaffner said.
Avian flu in wild and domestic birds isn’t in and of itself a cause for panic, Schaffner added. “There’s no immediate threat but public health authorities are on the alert.” ● | Epidemics & Outbreaks |
LONDON -- U.K. Prime Minister Rishi Sunak on Wednesday proposed raising the legal age that people in England can buy cigarettes by one year, every year until it is eventually illegal for the whole population and smoking will hopefully be phased out among young people.
Setting out his plan at the annual Conservative Party conference, Sunak said he wanted to “stop teenagers taking up cigarettes in the first place."
It is currently illegal for anyone to sell cigarettes or tobacco products to people under 18 years old throughout the U.K.
Sunak’s office said the incremental changes would stop children who turn 14 this year and those younger than that now from ever legally being sold cigarettes in England.
If Parliament approves the proposal, the legal change would only apply in England — not in Northern Ireland, Scotland and Wales.
“People take up cigarettes when they’re young. Four in five smokers have started by the time they’re 20," he said. “Later, the vast majority try to quit ... if we could break that cycle, if we could stop the start, then we would be on our way to ending the biggest cause of preventable death and disease in our country.”
The government said that smoking won't be criminalized, and the phased changes mean that anyone who can legally buy cigarettes now won't be prevented from doing so in the future.
The number of people who smoke in the U.K. has declined by two-thirds since the 1970s, but some 6.4 million people in the country — or about 13% of the population — still smoke, according to official figures.
Britain's government raised the legal age of sale for tobacco from 16 to 18 in 2007. That succeeded in reducing the prevalence of smoking among 16 and 17-year-olds by 30%, Sunak's office said.
Health experts welcomed the prime minister's plan to steadily increase the legal smoking age. A similar measure was approved in New Zealand last year.
“This government’s plan to introduce ‘smoke-free generation’ legislation could become its defining legacy, righting a century-old wrong, with tobacco products being the only legally available commodity that, if used as intended, will kill over half of its lifelong users," said Lion Shahab, an academic who co-directs the tobacco and alcohol research group at University College London.
Sunak also said his government would introduce measures to restrict the availability of vapes, or e-cigarettes, to children. It is currently illegally to sell vapes to children under 18 in the U.K., but officials say youth vaping has tripled in the past three years and more children now vape than smoke.
Officials will look into options, including restricting flavored vapes and regulating packaging and store displays to make the products less appealing to young people.
Shares in tobacco firms fell after Wednesday's announcement. Dunhill and Lucky Strike owner British American Tobacco saw its shares slide from roughly flat to 1% lower immediately after the announcement, while Imperial Brands saw shares fall 2.4% after Sunak's speech. | Health Policy |
Last summer, Eloise Reynolds paid the bill for her husband’s final stay in the hospital.
In February 2022, doctors said that Kent, her husband of 33 years, was too weak for the routine chemotherapy that had kept his colon cancer at bay since 2018. He was admitted to Barnes-Jewish Hospital in St. Louis, not far from their home in Olivette, Missouri.
Doctors discovered a partial blockage of his bowel, Reynolds said, but she remained hopeful that his treatment would soon resume.
“I remember calling our kids and saying, ‘OK, this is all really good news. We just need to get him kind of bolstered back up and feeling well,’” she said.
But years of chemotherapy had taken a toll on his body, and he told his wife that he couldn’t go on any longer.
Kent was discharged and began hospice care at home. He died the next month at age 62.
When Reynolds received the bill for the hospital stay, she paid the $823.15 it said her husband owed. She scribbled “paid” on the bill, memorializing the date, June 30, 2022 — the financial endpoint, she thought, of Kent’s years of treatment.
Then the bill came (again).
The Patient: Kent Reynolds, deceased, had been covered by Blue Cross and Blue Shield of Illinois through his Illinois-based employer.
Medical Service: A 14-day hospital stay related to complications from colon cancer, including a partially blocked bowel.
Service Provider: BJC HealthCare, a tax-exempt health system that operates 14 hospitals, mostly in the St. Louis area, including Barnes-Jewish Hospital.
Total Bill: The hospital charged $110,666.46 for the stay before any payments or adjustments. The insurer negotiated that price down to $60,348.77, and Reynolds paid the $823.15 the hospital said the patient owed. Then, a year after her husband’s death, she received a new version of the bill from the hospital, charging her an additional $1,093.16.
What Gives: Reynolds encountered a perplexing reality in medical billing: Providers can — and do — come after patients to collect more money for services months or years after a bill has been paid.
The new bill said Kent Reynolds had been enrolled in a payment plan and that the first “monthly installment” on the nearly $1,100 balance was soon due.
She said she called both the hospital and Blue Cross and Blue Shield of Illinois in search of answers but didn’t get an explanation that made sense to her.
According to Reynolds, a BJC HealthCare representative told her that the insurer had paid more than it owed, meaning the health system had to reimburse the insurer and charge the patient more.
Reynolds said she grabbed a yardstick to use as a straight edge and went line by line, comparing both bills, to see what had changed, a task that evoked painful memories of her husband’s last days. The amount for each individual charge — medications, lab tests, supplies, and more — was the same on both bills. The total had not changed.
Only three aspects of the bill had changed: the adjustments; the amount paid by the insurance company; and what the patient owed.
Adjustments, or discounts, are amounts that may be subtracted from a medical bill, typically under the provider’s pre-negotiated contract with an insurer. Insurers and providers agree to lower, in-network rates for services provided to patients covered by the insurer.
Reynolds also received an EOB, or “explanation of benefits,” notice showing the insurer reviewed the bill again in February, a year after the hospital stay. The document said the hospital’s charges for her husband’s private room — amounting to nearly $77,000 — were more than his health plan’s negotiated room rates, which did not cover the full cost.
The EOB noted that the patient could still owe the hospital $50,216.31 for the room charges — a startling amount — although Reynolds ultimately received no bill indicating she owed that much.
Reynolds said she spent hours trying to understand the items on the hospital and insurance paperwork, since they used medical abbreviations and were grouped differently on the documents.
“It shouldn’t be this hard for a widow to figure out what the medical bills were,” said Erin Duffy, a research scientist at the University of Southern California’s Schaeffer Center for Health Policy and Economics.
Blue Cross and Blue Shield of Illinois declined to comment despite receiving a signed release from Reynolds waiving federal privacy protections.
The Resolution: Unclear about what had changed and how much she owed, Reynolds held off on paying the second bill. After KFF Health News contacted BJC HealthCare, Laura High, a media relations manager for the system, said the charges were the result of a “clerical error.” Reynolds no longer has a balance, High said in an email in May.
“I was shocked by it,” Reynolds said. “I’m convinced most of the people I know would have paid this.”
High did not answer questions about the cause of the billing error or how often such errors occur.
However, Duffy provided a different explanation for the charges. “This doesn’t seem like an error,” she said. “It seems consistent with their insurance plan design.”
She said it appeared the additional $1,100 charge — assessed a year later — represented Kent’s coinsurance share of the private room charges, which she found as a recurring line item on each page of the bill under the heading “Oncology/PVT.”
While his coinsurance responsibility could have amounted to 10% of what the insurer paid in room charges — potentially a huge amount — Kent had met his out-of-pocket payment maximum for the year, so the charges did not reach the full 10% of the room costs, Reynolds said.
The Takeaway: In the United States, medical bills and insurance statements create a burdensome puzzle for patients to sort through to determine what is actually owed. The first rule of thumb is: “Don’t pay the bill before you’ve gotten the EOB,” which is the insurer’s accounting of what you owe and what the insurer will pay, said Kaye Pestaina, co-director of KFF’s Program on Patient and Consumer Protections.
In addition, ask for an itemized breakdown of charges and compare it against the EOB.
Medical billing experts said standardizing terms and other details on medical bills and EOBs would help patients enormously in this undertaking.
A few states have taken steps toward giving patients more information about health care charges, including by simplifying medical bills. In 2019, New York state lawmakers proposed requiring hospitals to provide patients with bills in plain language, including an itemized list of services labeled as paid by the insurer or owed by the patient. The proposal, which did not advance, required hospitals to send patients a single bill within seven days of leaving the hospital.
Reynolds’ experience highlights the lack of laws and standards around how long providers have to bill — and review bills — for medical services. Insurers may dictate in their contracts how long providers have to submit claims; the Medicare program has a 12-month limit to file claims, for instance. However, Dave Dillon, a spokesperson for the Missouri Hospital Association, said no laws restrict how long providers have to send a bill to patients.
Creditors may seek payment from a deceased person’s estate to collect whatever they can, said Berneta Haynes, a senior attorney at the National Consumer Law Center. In Missouri, a living spouse can be held responsible for a deceased spouse’s medical bills in certain instances, said Terry Lawson, a managing attorney for Legal Services of Eastern Missouri.
Experts said they did not pinpoint anything Reynolds could have done differently, noting that it is the system that needs to change.
“When can she move on from these hospital bills?” Duffy asked.
Stephanie O’Neill Patison reported the audio story.
Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it! | Health Policy |
Scientists 3D-print hair follicles in lab-grown skin
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Scientists 3D-print hair follicles in lab-grown skin
The technique represents an important step in engineering skin grafts, drug testing
A team led by scientists at Rensselaer Polytechnic Institute has 3D-printed hair follicles in human skin tissue cultured in the lab. This marks the first time researchers have used the technology to generate hair follicles, which play an important role in skin healing and function.
The finding, published in the journal “Science Advances,” has potential applications in regenerative medicine and drug testing, though engineering skin grafts that grow hair are still several years away.
“Our work is a proof-of-concept that hair follicle structures can be created in a highly precise, reproducible way using 3D-bioprinting. This kind of automated process is needed to make future biomanufacturing of skin possible,” said Pankaj Karande, Ph.D., an associate professor of chemical and biological engineering and a member of Rensselaer’s Shirley Ann Jackson, Ph.D. Center for Biotechnology and Interdisciplinary Studies, who led the study.
“The reconstruction of hair follicles using human-derived cells has historically been a challenge. Some studies have shown that if these cells are cultured in a three-dimensional environment, they can potentially originate new hair follicles or hair shafts, and our study builds on this work,” Karande said.
When it comes to engineering human skin, hair may at first seem superfluous. However, hair follicles are quite important: They produce sweat, helping regulate body temperature, and they contain stem cells that help skin heal.
Hair follicles are also an entry point for topical drugs and cosmetics, making them an important part of dermatological testing. But today, initial safety testing is done on engineered skin tissues that lack hair follicles.
“Right now, contemporary skin models — the engineered structures that mimic human skin — are quite simple. Increasing their complexity by adding hair follicles would give us even more information about how skin interacts with topical products,” said Carolina Catarino, Ph.D., first author of the study, who earned her doctorate at Rensselaer and is now a researcher developing new skin testing methods at Grupo Boticário, a cosmetics company in her home country of Brazil.
“Dr. Karande’s lab is at the forefront of skin tissue engineering. This team has already successfully printed skin with working blood vessels, and this latest research is an exciting next step in developing and testing better treatments for burns and other skin conditions,” said Deepak Vashishth, Ph.D., director of the Shirley Ann Jackson, Ph.D. Center for Biotechnology and Interdisciplinary Studies.
“Dr. Karande’s work is a great example of advances being made by RPI researchers at the interface of engineering and life sciences with impact on human health,” said Shekhar Garde, Ph.D., dean of Rensselaer’s School of Engineering. “Bringing multichannel 3-D printing to biological realm is opening exciting opportunities that would have been hard to imagine in the past.”
The researchers created their follicle-bearing skin with 3D-printing techniques adapted for printing at the cellular level.
The scientists begin by allowing samples of skin and follicle cells to divide and multiply in the lab until there are enough printable cells. Next, the researchers mix each type of cell with proteins and other materials to create the “bio-ink” used by the printer. Using an extremely thin needle to deposit the bio-ink, the printer builds the skin layer by layer, while also creating channels for depositing the hair cells. Over time, the skin cells migrate to these channels surrounding the hair cells, mirroring the follicle structures present in real skin.
Right now, these tissues have a lifespan of two to three weeks, which is not enough time for hair shafts to develop. The research team’s future work aims to extend that period, allowing the hair follicle to mature further and paving the way for their use in drug testing and skin grafts.
Contact
For general inquiries: [email protected]
About Rensselaer Polytechnic Institute
Founded in 1824, Rensselaer Polytechnic Institute is America’s first technological research university. Rensselaer encompasses five schools, over 30 research centers, more than 140 academic programs including 25 new programs, and a dynamic community made up of over 6,800 students and 104,000 living alumni. Rensselaer faculty and alumni include upwards of 155 National Academy members, six members of the National Inventors Hall of Fame, six National Medal of Technology winners, five National Medal of Science winners, and a Nobel Prize winner in Physics. With nearly 200 years of experience advancing scientific and technological knowledge, Rensselaer remains focused on addressing global challenges with a spirit of ingenuity and collaboration. To learn more, please visit www.rpi.edu. | Medical Innovations |
Almost 150,000 calls from members of the public seeking advice from NHS 24 in Scotland were abandoned before an operator responded during the first six months of 2023, new figures show.
One caller waited more than two hours and 45 minutes to speak to an operator in April.
January was the worst month for wait times overall, with 34,594 calls halted before being answered, and an average wait time of 19 minutes and 51 seconds.
The data was obtained by the Scottish Conservatives through freedom of information requests.
NHS 24 is the Scottish equivalent to NHS 111, providing urgent care advice and dental support out of hours.
The Scottish Government has urged people to take advantage of NHS 24 - which was first set up in 2001 - to alleviate pressure on emergency departments.
Scottish Conservative Dr Sandesh Gulhane blamed the long wait times on what he called "the SNP's chronic mismanagement of Scotland's NHS".
He went on: "Scots should not be forced to endure ridiculous wait times to speak to an operator about their health concerns.
"The average wait time of almost 13 minutes is simply not good enough - and it beggars belief that someone actually waited nigh on three hours to have their call answered."
The member of the Scottish parliament also said people would be pushed back into calling their GP or attending A&E due to the significant waiting times for NHS 24.
Government says 'improving' service better than England's
A spokesperson for NHS 24 said "winter pressures" had impacted demand for their services, which along with increased calls during public holidays had led to temporarily increased wait times.
They also said some callers would have hung up after listening to the recorded message directing them to alternative care, including 999, their local pharmacy or symptom checkers on NHSinform.scot.
The spokesperson added: "NHS 24 is constantly improving its services and continues to recruit extra frontline staff to answer every call as quickly as possible, and to continue to provide safe and effective care to patients across Scotland 24/7."
Read more from Scotland:
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In response to the data, the Scottish Government said: "[We] increased NHS 24's funding last year by over £20 million for additional recruitment and the addition of a new call centres in Dundee and Glasgow. We will continue to invest in the service as it continues to expand both its services and workforce."
Additionally, they made a comparison with figures from NHS 111, which they said showed the average wait time in England was 25 minutes - nearly double the Scottish wait time - and that 111 dropped almost 3.7 million calls last year, which they said per head of population was around 19% higher in than in Scotland. | Health Policy |
An Opioid-Like Drink Is Masquerading As A Wholesome Alcohol Alternative
Kratom is growing in popularity in the US, despite its addictive potential.
(Bloomberg) -- When Krista Marquick discovered kratom, it filled a hole in her life that quitting alcohol had left — kratom is often served at specialized bars, so it provided a way to socialize with friends and unwind after work without, she thought, the risk of addiction.
Within a few months, Marquick found herself with a brand new addiction that left her feeling, as she put it, “out of control.” On bad days, she spent $80 on kratom. She bought $10 kratom drinks and $20 concentrated extracts, drinking them when she woke up, during her lunch hour and after work. Some nights, she wouldn’t be able to sleep because of withdrawals, leaving her house at midnight to get her fix.
“Your tolerance builds up so fast on kratom,” Marquick said. “So you're constantly spending more and more money, and you're having to use more and more kratom.”
Kratom is a drink extracted from a plant native to Southeast Asia that’s become increasingly popular in the US for its pleasant, alcohol-free buzz. It’s known to be an energy booster, mood enhancer and pain reliever. The product is sold online, in smoke shops, convenience stores and, perhaps most notably, at bars popping up around the country that sell a different plant-based beverage, kava. While kava doesn’t have the same addictive properties, the bars that sell it have become a common entry point to kratom for consumers.
And while kratom has gained a reputation for producing an innocent buzz, it can have addictive, opioid-like properties, according to the National Institutes of Health — and in some extreme cases, it has even led to fatal overdoses. As it has grown in popularity, so too have concerns over its risks. Some states are trying to regulate kratom, but there’s been little regulatory action on the federal level. The US Food and Drug Administration warns consumers against using kratom, suggesting that it’s unsafe and there are no approved uses for it. The US Drug Enforcement Administration has listed it as a “drug of concern.”
Oliver Grundmann, a professor at the University of Florida who has studied kratom since 2016, said the adverse effects of the plant in low doses typically result in little more than mild stomach problems. But more concentrated forms are associated with addiction, as well as liver and cardiovascular toxicity, he said. Still, he said, that so far there have been no rigorous clinical studies on how much kratom can lead to dependency. In other words, the full effects of kratom are still unknown.
Kratom made its way into the zeitgeist through kava, which is also frequently pitched as an alcohol alternative. As more people have cut back or quit booze, kava bars took off as a happy hour replacement. Over the last decade, the number of kava bars has grown about 30 to around 400, according to data collected by Jimmy Price, a moderator for the kava subreddit and owner of an online kava community page. More recently many of those bars have also begun selling kratom, introducing patrons like Marquick to the drink. While kava and kratom are two completely different substances — the former without risk of addiction, the latter with far greater risks — because they are often sold in the same places, consumers can view them as similar.
Jeff Bowman, a major kava distributor who opened one of the first US kava bars in the early 2000s, said that for many bars like his, kratom sales have far outpaced kava. Bowman said he had to add kratom to his offerings when his patrons left for a competitor who introduced it.
“Kava is a kratom-dominated industry,” said Bowman. “None of the kava bars in the United States sell enough kava to survive.”Because kava is generally considered non-addictive, it’s apparently not as good for business.
But the same qualities of kratom that keep people coming back also make it more dangerous. Poison control calls that mention kratom tripled from 2017 to 2021.
In its raw plant form, kratom contains about 2% mitragynine, a chemical compound that binds to opioid receptors, according to Grundmann. Kratom products on the market can contain more than 20 times that amount. Grundmann points to a spate of wrongful death lawsuits that cite a higher than normal use of kratom.
In July, a 12-person jury awarded $2.5 million to the family of Patrick Coyne, 39, who died in his home in Oregon after consuming a large amount of kratom. The product Coyne used before his death was marketed as a “miraculous cure-all with ‘absolutely’ no negative health effects, and no risk of overdose,” according to the lawsuit.
A class-action lawsuit was filed against 7-Eleven and Botanic Tonics, the producer of a popular kava tonic known as Feel Free. Described as a “feel-good wellness tonic that’s made with kava and other ancient plants,” Botanic Tonics misleadingly fails to disclose in its marketing materials that Feel Free’s main ingredient is not kava, but kratom, according to the lawsuit.
“We will vigorously defend our product in court,” Botanic Tonics Founder JW Ross said. “Botanic Tonics products are safe and manufactured, marketed, and distributed to the highest industry standards.” At present, the product’s ingredient list does include kratom, but at least some marketing materials still do not. The subreddit r/QuittingFeelFree, created earlier this year, has more than 900 members, and acts as a forum for users to share their experiences struggling with the tonic. Bethany Stevens, a 41-year-old mother of two who goes by the username BeeStee13, posted in early July: “1 week free from the free fall of Feel Free today.” Now, it’s been more than three months since she last touched the tonic.
At her most addicted point, Stevens said she drank eight bottles of Feel Free daily. Like Marquick, Stevens said she was so restless that she would go to the store in the middle of the night to calm her nerves.
“My anxiety was so crippling,” Stevens said. “I needed more just to be able to sleep.”
Botanic Tonics said that the appropriate serving size for its beverages is labeled. “We clearly label our products and website to advise on proper consumption behavior, recommending that customers consume no more one serving (half bottle of tonic) at a time and no more than two servings (one bottle of tonic) per day,” the company said in a statement. “Recommended use and caution statements can be seen on the back of every tonic bottle and on every page of our website.” The DEA tried to curtail kratom usage by putting it in the highest tier of restricted drugs in 2016. But public backlash, combined with lobbying efforts from groups like the American Kratom Association, killed those efforts. The FDA and DEA both declined to comment.
In several countries like Japan and Poland, its use has been banned or restricted.
Mac Haddow, the kratom lobbying group’s senior fellow in public policy, said that kratom-related deaths are tied to multiple drug use or unrelated health conditions. The National Institute on Drug Abuse echoes some of Haddow’s perspective, saying that only a very small number of deaths have been linked to kratom products.
“None of it was related to kratom alone,” Haddow said.
One of the reasons that it has been difficult to ascertain how dangerous kratom actually is, said Grundmann, is that it’s often used alongside other substances. That can make it hard to pinpoint the role that kratom may have played in a death. The World Health Organization has said there is not sufficient evidence to add kratom to its list of internationally controlled substances, though it’s continuing to monitor the situation.
The goal of the kratom lobbying group, according to its website, is “protecting the rights of all Americans to legally consume safe kratom.” In a bid to keep it on the market, the kratom lobby is advocating for limited regulations. In June, Florida joined several other states in passing the Kratom Consumer Protection Act, which makes it illegal to sell kratom to those under the age of 21. Florida’s bill followed similar ones passed in Virginia, West Virginia and Texas this year. By creating limited regulations — akin to those for tobacco products — the lobby hopes to create a legal marketplace for the substance. The lobbying group estimates there are as many as 15 million kratom consumers and that the substance made $1.5 billion in sales in 2020, up from $1.3 billion in 2019.
But some lawmakers are taking a more critical eye to the substance. Alabama, Arkansas, Indiana, Vermont and Wisconsin have banned it altogether. Earlier this year, Missouri’s governor Michael Parson vetoed the state’s Kratom Consumer Protection Act, arguing that the bill conflicted with the FDA’s stance that kratom cannot be legally sold in the US as a drug product, a dietary supplement or food additive. Louisiana, meanwhile, has asked the state Department of Health to study acute and long-term adverse health events from kratom. The health department recommended that kratom be banned from general consumption in the state in 2019 and urged residents to heed the FDA’s warning.
Marquick has been kratom-free for more than a year now. But getting there was no easy road. She’s not sure whether she thinks it should be banned, but she does think it requires some regulation. “I was spending too much money every night. It was affecting my relationships,” she said. “It was comparable to another drug or alcohol at the end of my use.”
©2023 Bloomberg L.P. | Drug Discoveries |
AI helps create better, simpler hepatitis, COVID-19 tests
Going beyond pregnancy and COVID-19, the world could someday soon come to rely on at-home tests for many diseases thanks in part to AI-fueled improvements.
University of Florida scientists have used artificial intelligence tools to simplify a test that works for both hepatitis C and SARS-CoV-2, the virus that causes COVID-19. The simplified test happens in one small test tube in just a few minutes. With further refinement, it could arrive at doctor’s offices soon and, one day, become available as home tests that are as easy as a pregnancy test.
“We are trying to build a home-based test that is as reliable as a lab-based test,” said Piyush Jain, a UF professor of chemical engineering who led the latest research. “Our objective is to develop a simple test that eliminates the need for expensive equipment and provides results in just 10 to 20 minutes.”
To accomplish those goals, Jain’s group is innovating on a system known as a one-pot reaction because the entire test happens in one small test tube. These tests, based on a technology known as RT-LAMP, can amplify small portions of a virus’s genome and produce a visible signal when it detects the virus. Reading these tests can be as simple as looking for a blue color or using a small device that detects a change in the test tube.
The FDA has approved some at-home, one-pot tests for COVID-19, as a part of the emergency use authorization, but they have a relatively high false positive rate, meaning they aren’t as reliable as they could be.
“We are combining another technology called CRISPR to determine the difference between a false positive and a true positive,” Jain said.
CRISPR has become known in the biotech world for its ability to drive rapid genetic engineering improvements, which have the potential to one day cure inherited diseases by repairing genomes. Jain’s group relies on the CRISPR system’s ability to home in on particular genetic sequences. Only if the sequence for, say, the hepatitis virus is really present will the test show a positive result.
The only problem? The RT-LAMP technology requires a temperature of 150 degrees (F), while CRISPR works best at 100 degrees. That difference makes tests far more complicated requiring two separate reactions– too complicated for at-home use. Jain’s team has been trying to bridge this gap by developing a CRISPR system that can withstand higher temperatures.
From a heat-loving species of bacteria, the researchers recently discovered a CRISPR enzyme that thrives at 140 degrees. In their latest work, Jain’s group turned to AI tools to analyze this enzyme and discover how they could make it survive at 150 degrees. The AI programs suggested a few dozen changes to the enzyme, which Jain’s group tested in the lab. They eventually found four changes to the enzyme that let it work at 150 degrees.
“It’s very challenging for any human to do this kind of analysis on an enzyme. We didn’t have to spend years; we could make these improvements in months,” Jain said. “With everything working at the same temperature, now we are able to combine everything in a true one-pot reaction we call SPLENDID.”
The team verified their simplified SPLENDID test on clinical samples from patients with hepatitis C or COVID-19. The test was 97% accurate for SARS-CoV-2 and 95% accurate for the most prevalent version of the hepatitis C virus found globally. Although it didn’t work well against all other less predominant versions of the hepatitis C virus, straightforward changes to the test should quickly improve its accuracy, Jain says. His team published their findings May 8 in the journal Cell Reports Medicine.
The work was funded by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in hopes of developing simple tests for viruses like hepatitis C so they can be identified and treated early, when treatments work best. Jain’s group will now work to refine the test, improve its ability to distinguish between hepatitis C strains and verify it in hospital settings in hopes of one day providing at-home tests as well. | Disease Research |
A new study shows that what time a person chooses to work out might have an impact on their weight loss.
There have been years of discussion about what time of day works best. Research and other studies have had conflicting answers, and medical weight loss physician Dr. Sue Decotiis told CBS News that really, the best exercise is whatever you can do.
"What I tell my patients is work out when you can. If it's easier and more convenient for you to get to the gym in the morning, then go ahead and do that. If you can't get there until the afternoon, then do that," Decotiis said.
The new study used a pre-existing National Health and Nutrition Examination Survey, which surveyed over 5,000 people from 2003 to 2006, to see what time of day the participants engaged in moderate-to-vigorous physical activity and whether they lost weight. Researchers observed a "strong linear association" between working out and lowered obesity for the group that worked out in the morning. People in the morning groups also had the lowest body mass index and smallest waist circumference, the study found.
Participants in the morning groups had a mean 25.9 BMI and 91.5-centimeter waist circumference. Afternoon exercisers had a mean 27.6 BMI and 95.8-centimeter waist circumference, while people who worked out in the evening had a mean 27.2 BMI and 95-centimeter waist circumference.
The morning groups also had the highest percentage of female participants, and those in the morning groups were older on average, though the BMI and waist circumference data controlled for those factors. Self-reported information about the participants' diets also showed that the people in the morning groups consumed fewer calories.
Decotiis said that she wouldn't consider the study enough evidence to tell her patients to change their workout times.
"I don't necessarily think that the evidence shows that you're going to burn more calories in the morning. Your ability to burn fat and to lose weight with exercise really depends on how well your insulin's working and how all your other hormones are working," she said, suggesting that people struggling to lose weight should consider talking to their physicians about their hormone levels, since they can impact how effective exercise and dieting are.
The study's authors also said that more research was necessary.
"The promising role of morning (moderate-to-vigorous physical activity) for weight management warrants further investigation," the study said.
for more features. | Nutrition Research |
Researchers have known that a lack of quality sleep can increase a person’s risk of diabetes. What has remained a mystery, however, is why.
Now, new findings from a team of sleep scientists at the University of California, Berkeley, are closer to an answer. The researchers have uncovered a potential mechanism in humans that explains how and why deep-sleep brain waves at night are able to regulate the body’s sensitivity to insulin, which in turn improves blood sugar control the next day.
“These synchronized brain waves act like a finger that flicks the first domino to start an associated chain reaction from the brain, down to the heart, and then out to alter the body’s regulation of blood sugar,” said Matthew Walker, a UC Berkeley professor of neuroscience and psychology and senior author of the new study. “In particular, the combination of two brain waves, called sleep spindles and slow waves, predict an increase in the body’s sensitivity to the hormone called insulin, which consequentially and beneficially lowers blood glucose levels.”
The researchers say this is an exciting advance because sleep is a modifiable lifestyle factor that could now be used as part of a therapeutic and painless adjunct treatment for those with high blood sugar or Type 2 diabetes.
Scientists also noted an additional benefit besides the potential new mechanistic pathway.
“Beyond revealing a new mechanism, our results also show that these deep-sleep brain waves could be used as a sensitive marker of someone’s next-day blood sugar levels, more so than traditional sleep metrics,” said Vyoma D. Shah, a researcher at Walker’s Center for Human Sleep Science and co-author of the study. “Adding to the therapeutic relevance of this new discovery, the findings also suggest a novel, non-invasive tool — deep-sleep brain waves — for mapping and predicting someone’s blood sugar control.”
The team’s findings were published today in the journal Cell Reports Medicine.
For years, researchers have studied how the coupling of non-rapid eye movement sleep spindles and deep, slow brain waves corresponded to an entirely different function — that of learning and memory. Indeed, the same team of UC Berkeley researchers previously found that deep-sleep brain waves improved the ability of the hippocampus — the part of the brain associated with learning — to retain information.
But this new research builds on a 2021 rodent study and reveals a novel and previously unrecognized role for these combined brain waves in humans when it comes to the critical bodily function of blood sugar management.
The UC Berkeley researchers first examined sleep data in a group of 600 individuals. They found that this particular coupled set of deep-sleep brain waves predicted next-day glucose control, even after controlling for other factors such as age, gender and the duration and quality of sleep.
“This particular coupling of deep-sleep brain waves was more predictive of glucose than an individual’s sleep duration or sleep efficiency,” said Raphael Vallat, a UC Berkeley postdoctoral fellow and co-author of the study. “That indicates there is something uniquely special about the electrophysiological quality and coordinated ballet of these brain oscillations during deep sleep.”
Next, the team then set out to explore the descending pathway that might explain the connection between these deep-sleep brain waves sending a signal down into the body, ultimately predicting the regulation of blood glucose.
The findings from the team reveal an unfolding set of steps that could help explain how and why these deep-sleep brain waves are related to superior blood sugar control. First, they found that stronger and more frequent coupling of the deep-sleep brain waves predicted a switch in the body’s nervous system state into the more quiescent and calming branch, called the parasympathetic nervous system. They measured that change in the body and the shift to this low-stress state using heart rate variability as a proxy.
Next, the team turned its attention to the final step of blood sugar balance.
The researchers further discovered that this deep sleep switch to the calming branch of the nervous system further predicted an increased sensitivity of the body to the glucose-regulating hormone called insulin, which instructs cells to absorb glucose from the bloodstream, preventing a deleterious blood sugar spike.
That’s particularly important for people trying to back away from hyperglycemia and Type 2 diabetes.
“In the electrical static of sleep at night, there is a series of connected associations, such that deep-sleep brain waves telegraph a recalibration and calming of your nervous system the following day,” Walker said. “This rather marvelous associated soothing effect on your nervous system is then associated with a reboot of your body’s sensitivity to insulin, resulting in a more effective control of blood sugar the next day.”
The researchers subsequently replicated the same effects by examining a separate group of 1,900 participants.
“Once we replicated the findings in a different cohort, I think we actually started to feel more confident in the results ourselves,” Walker said. “But I’ll wait for others to replicate it before I truly start believing, such is my British skepticism.”
The scientists said the research is particularly exciting given the potential clinical significance years down the line. Diabetes treatments already on the market can sometimes be difficult for patients to adhere to. The same is true of the recommended lifestyle changes, including different eating habits and regular exercise.
Sleep, however, is a largely painless experience for most people.
And while sleep is not going to be the single magic bullet, the prospect of new technologies that can safely alter brain waves during deep sleep that this new research has uncovered may help people better manage their blood sugar. That, the research team said, is reason for hope. | Disease Research |
Fertility treatment "add-ons" offered to patients in the UK do not always improve their chances of having a baby, according to a new ratings system from the fertility regulator.
It follows concerns clinics are offering unproven treatments costing hundreds or thousands of pounds.
Clinics must give clear information on costs and success rates, experts say.
Support groups hope the ratings will improve the stressful process of buying private fertility treatment.
Add-ons are optional, non-essential treatments that may be offered in addition to proven fertility treatments, such as IVF (in-vitro fertilisation), in private clinics.
Support group Fertility Network UK welcomed the new HFEA ratings system, which uses five colours - ranging from green to red - to indicate the amount of evidence an add-on is effective at improving the chances of having a baby.
Examples include:
- pre-implantation genetic testing for aneuploidy (PGT-A) - where a cell is removed from the embryo and tested for chromosomal abnormalities - rated red
- endometrial scratching - the theory is that this triggers the body to repair the site of the scratch, releasing chemicals and hormones that make the womb lining more receptive to an embryo implanting - rated amber
- immunological tests - rated red
None of those listed on the regulator's website had been rated green, Fertility Network UK pointed out, encouraging patients to look at all the information provided before making decisions.
"For defined patient groups, there are particular treatment add-ons that may be potentially beneficial - but we know that for the vast majority of patients, more rounds of proven treatment could be more effective," Prof Tim Child, who chairs the Human Fertilisation and Embryology Authority (HFEA) Scientific and Clinical Advances Advisory Committee, said.
'Difficult decisions'
"These emotionally and financially difficult decisions often centre on whether to try expensive fertility treatment add-ons and are typically made when patients are at their most vulnerable - desperate to try anything if there is a chance it may help them become parents," head of policy at Fertility Network UK Dr Catherine Hill said.
The HFEA said patients should not be left in the dark - and add-ons with no strong evidence of safety or effectiveness should be offered only as part of research.
"Clinics must give patients a clear idea of what any treatment add-on will involve, how likely it is to increase their chance of a successful pregnancy and how much it will cost, and link to the HFEA ratings system," chief executive Peter Thompson said. | Women’s Health |
People of South Asian descent may have a higher risk of type 2 diabetes than they might expect, even if they're not overweight.Â
South Asians â people who are from or trace their ancestry to the Indian subcontinent, which includes India, Pakistan, Afghanistan, Bangladesh, Bhutan, and Nepal â are up to four times more likely to have type 2 diabetes than people of other ethnic backgrounds. And many South Asians diagnosed with type 2 diabetes have a normal weight and body mass index (BMI).Â
Afreen Idris Shariff, MD, an endocrinologist and assistant professor at Duke University School of Medicine, has seen this risk in her patients, her family, and even herself. Here, she shares her thoughts on what people of South Asian background need to know to help prevent, get screened for, and manage or even reverse their type 2 diabetes.This interview was edited for length and clarity.
WebMD: What led you to become an endocrinologist and direct your concentration toward type 2 diabetes?
Shariff: After medical school, I applied and interviewed for nephrology [a medical specialty focused on the kidneys] and then changed paths to join endocrinology after I got diagnosed with gestational diabetes. Also, my father has had type 2 diabetes since I was a kid and since his early 40s, but a couple of years into me being an attending [physician] he started showing a very different pattern of diabetes. My journey started with my personal story and ended with me diagnosing and taking care of my own father.
WebMD: Why do South Asians who are thin have a risk of type 2 diabetes?
Shariff: That's because we have adipose tissue around our liver and our muscle that makes us insulin resistant. Call it visceral adiposity. It basically blocks the effect of insulin on these very important structures. Now, the brain and the muscle are two areas in your body that really don't need any insulin to uptake glucose. So ⦠even though people are exercising, they [can] develop insulin resistance and type 2 diabetes [if] their muscles are not able to soak up that blood sugar.
Â
WebMD: How do BMI and insulin play a role in South Asians who are diagnosed with type 2 diabetes?Â
Shariff: Most of my patients who come in with type 2 diabetes are typically very healthy. They have a normal BMI, they exercise, and they still cannot understand why they can't budge that A1c.[Editorâs note: The hemoglobin A1c test checks your average blood sugar level for the past 2-3 months. A normal A1c level is below 5.7%. An A1c level of 5.7% to 6.4% is in the prediabetes range. And 6.5% or higher is in the diabetes range. Youâd get that checked twice before diagnosing diabetes.]
A good example is myself; I have a low BMI yet I took 40 units of insulin when I was pregnant [and had gestational diabetes].
Typically when you have type 2 diabetes, you have insulin resistance. You have a lot of insulin, but it doesn't work as well. So you require a whole lot more insulin to do the job of what it should have done without the resistance.Â
South Asians have both insulin resistance and insulin deficiency. [One theory says that] Inherently as a race we have beta cell dysfunction, or what we call beta cell blunting. When you eat a meal, your sugar goes up, goes to the pancreas, and tells it to release insulin. You require a much higher amount of blood sugar to release insulin and your beta cells are not as active as they should be.
WebMD: If someone of South Asian descent goes to their primary care doctor, what risk factors necessitate screening for type 2 diabetes?
Shariff:Â
- A BMI greater than 23. [Editorâs note: This is below the BMI threshold for being overweight.]
- Any first-degree relative [parent, child, or sibling] that has type 2 diabetes
- Any other family member who has type 2 diabetes plus a history of heart disease, hypertension, and triglycerides greater than 250
- Females who have a history of polycystic ovary syndrome (PCOS)Â
 WebMD: How can someone of South Asian descent advocate for themselves to get tested for type 2 diabetes at their primary care doctorâs office?
Shariff:Â Itâs important that South Asians advocate for themselves and tell their primary care physician, âI understand that you would typically not have gotten an A1c in someone like me, but because I'm South Asian, my risk is much higher at a lower BMI and I'm at a higher risk for having type 2 diabetes. This is why you should screen me.â
WebMD: How do you counsel your patients regarding diet and exercise?
Shariff: I never say you need to stop eating something [if you have] diabetes, which is a breath of fresh air for most patients. I say, âI want you to understand what you can eat less of and what you should be eating more of and how to balance your diet.â
Many South Asians are vegetarian and itâs a heavy carb diet. Whatever type of carb youâre going to eat, itâs going to raise your blood sugar. Try to stay true to your flavors and be creative with how you can modify the carb portions of your meals into less carbohydrates, or high fiber, high protein options.Â
Sometimes people exercise and other times they donât. I put 70% emphasis on your diet. If you eat foods that work with your diagnosis of diabetes, your sugars are going to be better. This allows your insulin resistance to come down.Â
 WebMD: What message do you want to send South Asians regarding a type 2 diabetes diagnosis?Â
Shariff: You have to balance sustainability and understand you need to seek help. You donât want diabetes to define you.Â
 | Disease Research |
COVID-19 is no longer a global public health emergency, the World Health Organization announced May 5.
The organization pointed to two factors: Dropping COVID-19-related deaths and hospitalizations, and high levels of immunity to SARS-CoV-2, the virus that causes COVID-19, from vaccination or prior infection. While the pandemic is not over, those trends signal that it’s time to transition to more long-term prevention and control of the disease, WHO said in a statement.
“It’s reasonable, it makes sense,” says infectious disease specialist Peter Chin-Hong of the University of California, San Francisco, noting that “it follows on the heels of many countries” doing the same thing. The U.S. public health emergency is officially set to end May 11 (SN: 5/4/23).
But, Chin-Hong adds, “this doesn’t mean that it’s not still a global health threat.”
Worldwide, more than 750 million confirmed cases of COVID-19 have been reported to the WHO as of May 3. And nearly 7 million people have died from the disease, including more than 1.1 million people in the United States alone.
WHO declared COVID-19 a public health emergency of international concern, or PHEIC, on January 30, 2020. It’s the highest level of alarm under international law. Two months later, the organization also named the SARS-CoV-2 outbreak a pandemic, indicating it was not containable (SN: 3/11/20).
These declarations came at a scary and chaotic time: Countries initiated lockdown measures to prevent spread of the disease; there were way more questions than answers about the deadly disease, and no treatments or vaccines.
WHO’s designations prompted nations to work together, collaboratively collecting and sharing COVID-19 data including confirmed cases, hospital admissions, deaths and research. Since then, tests, vaccines and treatments have been developed. More than 13 billion doses of COVID-19 vaccines have been administered worldwide.
Even as the global public health emergency ends, the WHO noted remaining challenges to keeping the disease in check, including global inequities in accessing care and vaccines, an evolving virus and “pandemic fatigue” (SN: 1/13/23).
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What long-term management of the disease will look like remains to be seen; WHO plans to form a committee to examine that question. The agency will also continue monitoring the disease, but it will be integrated into a system that’s used to survey global influenza data.
But the end of the PHEIC may also mean that COVID-19 tracking data — already incomplete for a variety of reasons including the proliferation of at-home testing — will likely decline even more, Chin-Hong says. And researchers might have less available funding, which could slow the development of new vaccines and treatments. “There are repercussions both from a research perspective and a clinical care perspective,” he says.
In a May 5 news conference, WHO Director-General Tedros Adhanom Ghebreyesus urged countries to keep their COVID-19 systems in place and remind people that SARS-CoV-2 is still dangerous.
“This virus is here to stay,” he said. “It’s still killing, and it’s still changing.” | Epidemics & Outbreaks |
Iranian authorities have confirmed they are investigating reports that several schoolgirls have been poisoned as “revenge” for the role young women played in recent protests against the mandatory hijab.
Iran’s deputy education minister, Younes Panahi, told reporters yesterday: “After the poisoning of several students in [the city of] Qom … it was found that some people wanted all schools, especially girls’ schools, to be closed.”
He added: “It has been revealed that the chemical compounds used to poison students are not war chemicals … the poisoned students do not need aggressive treatment and a large percentage of the chemical agents used are treatable.”
Dr Homayoun Sameyah Najafabadi, a member of the parliament’s health commission, also confirmed the poisoning of schoolgirls “in cities such as Qom and Borujerd has been done intentionally”.
Speaking to the Guardian on condition of anonymity, a doctor who specialises in the treatment of poisoning victims said: “With the data that’s available, the most probable cause of this poisoning could be a weak organophosphate agent. Even if some of the poisoned pupils show a sign of severe sweating, excess salivation, vomiting, intestinal hypermotility and diarrhoea, then the attack was done using this agent.”
The doctor said they believed the motive was to “scare the protesters by using extremist groups [radical Islamists] inside and outside the country”.
“They want to take revenge on schoolgirls who are the pioneers of the recent protests,” the doctor said. “Never before have I treated someone who was poisoned with organophosphate agents. The only cases I treated were workers who were exposed to these agents in agricultural pesticides.”
The attacks have led to girls staying away from school. A teacher from Qom – which is about 85 miles south of the capital Tehran – told Radio Farda that out of 250 students, only 50 attended classes. Last week angry parents protested outside the governor’s office in Qom and several schools have been closed due to the pending investigation.
Masih Alinejad, an Iranian human rights activist based in New York, told the Guardian: “In my opinion, this chemical attack is revenge by the Islamic Republic against the brave women who [rejected] the mandatory hijab and shook the ‘Berlin Wall’ of [Ayatollah Ali] Khamenei.
“As the Islamic State Iranian regime hates girls and women, I call on women across the globe – especially schoolgirls – to be the voice of Iranian students and call on the leaders of democratic countries to condemn this series of poisonings and isolate Khamenei’s regime,” she said.
“I call this biological terrorism, and it should be investigated by the UN. We need an outside organisation to investigate as soon as possible.” | Epidemics & Outbreaks |
Labour would give people greater choice over where they receive hospital treatment, the shadow health secretary has pledged.
Wes Streeting said organising waiting lists by region would give patients more freedom and help tackle backlogs.
Labour leader Sir Keir Starmer is expected to commit to delivering the idea across England during a speech on Monday.
The address is also expected to include new pledges on NHS targets.
It will be the third in a series of speeches he is making on Labour's five "missions" for government if it wins power. These missions are likely to form the backbone of the party's manifesto at the next general election, expected in 2024.
Speaking on the BBC's Sunday with Laura Kuenssberg programme, Mr Streeting said organising waiting lists on a regional basis would give patients "real choice" over where they are seen.
The party says this would allow patients to get treatment more quickly if queues are shorter at nearby hospitals.
Under Labour's plan, it is understood that waiting lists would be shared across integrated care systems - coalitions of several neighbouring NHS trusts that usually cover populations of between 500,000 and 3 million people.
Patients already have some rights to choose where they receive non-urgent care under NHS England's constitution, but the party sees this option as under-used.
In his BBC interview, Mr Streeting said many patients were unaware about their rights to choice over treatment, or don't "feel the freedom to exercise that choice".
He said that a trial in West Yorkshire, where NHS trusts are sharing waiting lists for conditions affecting blood vessels, showed the approach worked.
The change would also "build more capacity in the system", he added, to help tackle waiting lists that have ballooned since the pandemic.
More spending outside hospital
Elsewhere, Mr Streeting said Labour also wanted to see a greater share of NHS spending outside of hospitals to tackle health problems earlier.
He said that the proportions of spending were "very different" in other developed economies that have "much better outcomes than we have here in the UK".
"We under invest in primary care, community services, mental health, diagnostics, and capital, and we've got to shift that focus," he added.
"Lots of hospital trust leaders are already doing this. They recognise that the pressure we see in hospitals is in part driven by the clogged front door to the NHS in primary care and community services as well as delayed discharges in social care."
Speaking on Sunday with Laura Kuenssberg, former Tory chairman Sir Jake Berry rubbished Labour's approach, saying the party was aiming to "do more of what the Conservative government is already doing".
The government says it wants to boost community NHS services. It recently announced plans to let high street pharmacies prescribe a greater range of common prescription drugs, including antibiotics, to ease the pressure on GPs.
And as part of efforts to cut waiting lists, ministers say new community "diagnostic centres" opening this year will allow people to access checks and scans for conditions such as cancer, heart disease or lung disease without travelling to a hospital.
Labour does not want to make multiple expensive promises. But it might be tricky to translate its ambitions into concrete plans that the public believe will make an immediate difference - and getting voters excited about structural changes to the NHS might be a tall order.
Mr Streeting also confirmed that a review of social care policy carried out for the party will be published next month.
The report, by a Labour-affiliated think tank, is expected to inform the party's position on social care ahead of the next election.
He did not offer details of what will be in the blueprint, but said Labour has previously stressed the need to improve pay in the sector, as well supporting people more in their own homes. | Health Policy |
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