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Protections for NHS staff to speak out about wrongdoing may be insufficient to prevent another big scandal like that at the Mid Staffordshire hospital trust, an expert has told BBC News.
Sir Robert Francis led the inquiry into hundreds of patient deaths at Stafford Hospital more than a decade ago.
He says despite subsequent attempts to encourage whistleblowing, some still pay a heavy price for speaking up.
And this victimisation discourages others from coming forward.
The NHS National Guardian Dr Jayne Chidgey-Clark, whose job it is to protect whistleblowers in England, also says too many managers in the health service are still not protecting those who raise concerns from victimisation or bullying.
A record number of more than 25,000 NHS whistleblowers came forward last year - up by a quarter on the year before - raising issues such as patient safety and bullying.
Tristan Reuser, a senior eye surgeon at the main hospital trust in Birmingham, became a whistleblower when he complained about a lack of nursing staff, after he felt he had to use a non-medical colleague to help with an urgent operation.
But instead of addressing the issue, management turned on him, he tells BBC News.
"If you whistleblow, you criticise, essentially, systems - systems designed by senior management," Mr Reuser says.
"So you criticise senior management - and if you're in the position of a senior manager, you don't like that. So what can we do about this?"
Mr Reuser was investigated, suspended and then sacked and reported to the General Medical Council - which found there was no case to answer.
A subsequent employment tribunal found he had been unfairly dismissed.
Mr Reuser seems robust - but asked how he had coped with the emotional burden of the investigation, the GMC case, the employment tribunal, he falters.
"It was pretty bad," he says. "And at times, I thought this is the end of it."
There is a long pause as he gathers himself.
"It's tough, career-changing," he says. "Sometimes for some people, I'm sure, life-changing."
Asked if, like some others who have spoken to BBC News he had thought about suicide, Mr Reuser says: "I've had those thoughts, yup. But you know, a supportive wife makes it go away."
A University Hospitals Birmingham official says the trust takes safety concerns raised by staff seriously.
It accepted and apologised for errors made in Mr Reuser's case but said it had acted in the interest of patient welfare.
Like every NHS trust in England, UHB employs freedom-to-speak-up guardians to help whistleblowers be heard.
This system was set up in the wake of the Mid Staffordshire scandal that saw hundreds of patient deaths due to poor care between 2005 and 2009.
But when Sir Robert is asked whether he is confident it will prevent another catastrophe, he says: "Am I confident, 100%? No.
"There is a danger of it happening again when pressures similar to those that existed at the time of Mid Staffs come about.
"But I think the way to stop it is to think all the time about the culture and make sure you've got an open culture, a supportive one and one that treats the patient first by listening to the staff's concerns about them."
Being victimised
Failing to listen to staff concerns is often a sign of poor leadership, Sir Robert tells BBC News.
"Principally, it is a matter of the leadership of the organisations," he says, "because the leadership, by which I mean the chief executive, the board, have to buy into and understand what this is all about.
"And probably people at that level - of a certain type - find it difficult to let go of control and one of the things about allowing people to speak up is... you're not entirely in control."
One of the problems reporting on this story is finding people willing to speak publicly about their experiences.
Many of those who did speak to BBC News did not want to be identified - they spoke of being victimised and isolated at work, of the risk that, like Mr Reuser, they could be referred to the medical regulator or lose their jobs and careers.
And many spoke of a climate of fear.
'Absolutely horrendous'
Dr A, so terrified of management reprisals BBC News has had to disguise their identity, also raised issues around patient safety only to find themselves being investigated.
"I've had sleeping difficulties, I've had counselling - it's been absolutely horrendous," Dr A says.
"It really has been a dismantling of me as a person - it's made me more fearful, more anxious."
And the culture in their hospital is best described as "management by fear".
"My concern about doing this interview is that they would find out who I was and then the punishment that would come my way - because I'm absolutely certain punishment would come," Dr A says.
"It comes straight from the top - it's from the executive team.
"They have been instrumental in causing it but yet they are tasked with trying to sort it out - and that cannot be the case."
Dr Chidgey-Clark says the main healthcare regulator - the Care Quality Commission (CQC) - and NHS England itself could do more to protect individual whistleblowers and rein in rogue managers.
"I do call on them to do everything they can within their power to ensure there is accountability and these serious issues are looked into," she says, "because without that, more high-profile cases will happen and, potentially, more patient harm and worker harm will happen. And in our society, in our healthcare system, we don't want to see that.
"Nobody should suffer for doing the right thing."
NHS England admits too many staff remain afraid to raise issues - but, an official says, it wants all employees to feel they work in an organisation where their voices count.
The CQC, meanwhile, tells BBC News it examines how all hospital trusts respond to whistleblowers, as part of its inspection regime - and for any trust to restrict this information would be absolutely unacceptable.
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Health Policy
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Many people use gendered language when they talk about endometriosis, a common and often painful condition in which cells similar to those in the lining of the uterus grow in other parts of the body.Â
But while endometriosis is rare in cisgender men (those assigned male at birth who identify as male), it can also happen in people who are transgender, nonbinary, or gender-expansive and have female reproductive organs.Â
âItâs like youâre invisible and donât exist in the world,â says Katrina Martin, 46, a nonbinary endometriosis advocate in Aurora, CO.Â
That feeling can be a barrier to getting medical care or talking about it with your doctor, Martin says. âThereâs a little bit of mental gymnastics that happens to try to even show up to get care.âÂ
Doctors and researchers are starting to recognize that endometriosis can happen in this community, even in some people whoâve had gender-affirming treatments, which support a person in their transition.
âYou can still have it if youâve had a hysterectomy and do not have a uterus or youâre not menstruating and your ovaries are fully suppressed,â says Hugh Taylor, MD, an endometriosis expert and chair of obstetrics and gynecology at the Yale School of Medicine and Yale New Haven Hospital.Â
Itâs important for anyone, including transgender people who were assigned female at birth and identify as male, to tell their doctor about any pelvic or period pain, says Robert Pollard, MD, director of minimally invasive gynecologic surgery at the MetroHealth Medical Center in Cleveland.Â
âDo you have a history of bad female problems in the past you want to discuss, but youâve never seen a gynecologist because youâve never felt comfortable?â Pollard says.
Overlooked in the Statistics
Exactly how common endometriosis is in transgender people born with female pelvic organs isnât clear. The World Health Organization notes that at least 1 in 10 women have it. But that figure refers to reproductive-age women assigned female at birth. Transgender men, nonbinary people, and gender-diverse people donât see themselves reflected in those numbers.
Some small studies suggest that endometriosis may affect transgender men who report pelvic pain at a higher rate than cisgender women. But more research is needed to confirm that and to find out if thatâs true for the larger gender-expansive community.Â
Based on their professional experience, Pollard and Taylor speculate that a similar percentage of all people born with a uterus probably have endometriosis, regardless of their gender identity. But there isnât enough data to know for sure.
Painful Periods, and More
When Pollard treats anyone with a uterus, he asks these questions about their menstrual history:Â
- Do you have painful periods?
- Do you have pain with sex, especially intercourse?
- Do you have bowel changes around your period?
- Have you missed school or work because of your period?
Pollard strongly suspects endometriosis if a patient answers yes to one or more of those questions.Â
Keep in mind that endometriosis can affect more than the pelvic area.Â
âIt can cause pain, whole-body inflammation, and numerous systemic effects that are sometimes overlooked today,â Taylor says. âItâs not always the classic painful menstrual cramps.â
Symptoms beyond the pelvis can include:
- Leg pain or lower back aches
- Belly pain or bloating
- Digestive problemsÂ
- Bowel or bladder pain
- Fatigue and brain fog
- Anxiety, depression, or other mood changes
- Higher pain sensitivity
Itâs less common, but endometriosis lesions can grow in your chest, such as on your lungs. This is called thoracic endometriosis. It can bring on cyclical shortness of breath, chest pain, or coughing.Â
Les Henderson, 38, who describes herself as a âmasculine-of-center lesbian,â recalls her shoulder aching along with severe pain overall when she had her period. âIt was the weirdest traveling pain,â she says.Â
She spent more than a decade trying to get treatment for severe period pain. It wasnât until she had a series of lung collapses that a surgeon diagnosed her with endometriosis in the lungs. Even after that, she felt that doctors didnât take her symptoms seriously due to her physical appearance.
âMy partner is more feminine, and doctors immediately think sheâs the one who needs help,â says Henderson, who lives in Prince Georgeâs County, MD. âIâm the one whoâs in distress. Iâm the one whoâs sick. I need the assistance, and Iâm dealing with this pain.â
Treating Endometriosis in Transgender People
Not everyone with endometriosis needs the same treatment. Hormonal medication, including birth control or testosterone, may ease symptoms for some people. âBut plenty of people are resistant to the effects of hormones,â Taylor says. If those donât help enough, surgery may be an option.Â
Zach McCallum, 56, started with nonsurgical treatment. But hormonal birth control didnât help with his worst endometriosis pain and heavy bleeding. He says that over the course of 20 years, doctors found endometriosis on his uterus, ovaries, fallopian tubes, bladder, intestines, and diaphragm. Theyâre keeping an eye on a suspicious spot in his lungs, too.Â
McCallum had surgery to remove his ovaries and uterus at 40, specifically to treat his endometriosis. Soon after, he started gender-affirming hormone therapy. His worst pelvic pain eased when his periods disappeared.Â
Even so, the finality of that operation wasnât easy for him to accept. âA hysterectomy meant I would 100% never ever carry a child,â says McCallum, of Portland, OR. âEven though I'm a trans guy, that was hard.âÂ
Like McCallum, Henderson and Martin also had multiple operations, including having their ovaries and uterus removed, to treat their endometriosis.
Does Gender-Affirming Treatment Help With Endometriosis?
Some transgender people who choose to have surgery to transition can address their endometriosis at the same time. But endometriosis experts suggest you bring up your symptoms ahead of time to make sure your doctor is up to the task.
âYou want to be seen by somebody who has expertise in that disease whoâs not going to miss it, whoâs going to be able to do the extra surgery to get (the endometriosis) all out,â Taylor says. âAnd thatâs often more than a hysterectomy.âÂ
Pollard agrees that not every surgeon who can do a gender-affirming hysterectomy has the skill and experience to treat endometriosis. He recommends finding a specialist trained in minimally invasive gynecologic surgery (MIGS), his area of expertise.
Pollard says if heâs operating, he can âtake care ofâ the endometriosis, and so can other MIGS experts. âBut not all of us are the same, and I don't think patients know that.âÂ
As for gender-affirming testosterone therapy, it isnât a cure for endometriosis. But it dials down how much estrogen the body makes. This may mean less pain and active disease if estrogen is low and someone doesnât have a regular menstrual cycle.
But it doesnât suppress ovulation or get rid of pelvic pain and periods for everyone who takes it.Â
How to Find a Transgender-Friendly Endometriosis Doctor
Many transgender people with endometriosis seek referrals from their regular doctors or ask people they know or meet through social media, online message boards, or word of mouth. Henderson founded endoQueer, a website and Facebook group, to give people in the LGBTQIA+ community a safe space to share information, experiences, and resources about endometriosis and similar conditions.Â
âThatâs the beautiful thing about the internet, despite all the evil that happens sometimes online,â Henderson says. âItâs a place of connectivity.â
Other resources include:Â
- World Professional Association of Transgender Health Provider Directory (WPATH)
- LGBTQ+ Healthcare Directory (from GLMA, formerly the Gay & Lesbian Medical Association)
- Local gender health clinicsÂ
- Local LGBTQ+ community center websites
Whatâs most important, Taylor says, is that you find somebody who takes your concerns seriously, knows that endometriosis might be the cause, and can describe all your treatment options.
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Women’s Health
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Nov. 3, 2023 -- Intermittent fasting has become a popular, and effective, way to lose weight. According to the International Food Information Council, the weight-loss method surpassed all others in the past year as the most popular way to achieve results. Around 10% of Americans between the ages of 18 and 80 have given the eating approach a go.Â
For the uninitiated, intermittent fasting is when you only eat during specific hours of the day, generally a much smaller window of time than normal. Rather than waking, eating breakfast, and then going about your day, youâd more likely delay your first meal until later in the morning. At the end of the day, youâd shut down food intake earlier than normal. The theory is that by closing the period of time in which you eat, youâll consume fewer calories.Â
Because weight loss is often a goal and avenue to better health for many people with type 2 diabetes, researchers are looking at how intermittent fasting might help. The latest study, âEffect of Time-Restricted Eating on Weight Loss in Adults With Type 2 Diabetes,â published last week in the journal JAMA, found that the technique shows promise.Â
The randomized clinical trial compared the effects of an 8-hour, time restricted eating plan with a daily calorie restriction diet, and a control group in adults with type 2 diabetes and obesity. Researchers measured both weight loss and blood sugar markers.Â
Krista Varady, PhD, a professor of nutrition at the University of Illinois Chicago, was the lead author, and has studied intermittent fasting for two decades. âPrior to our research, there was very little that focused on this diet and type 2 diabetics,â she said. âBecause type 2 diabetics now make up about 10% of the population and the number is rapidly increasing, we thought it was important to study intermittent fastingâs potential.â Â
The Plan in Action
For the new study, 75 people with diabetes took part and ate only between noon and 8 p.m. each day for 6 months. At the end of the trial, the time restricted eating group had lost nearly twice as much weight â on average 10 pounds -- Â as the group counting calories, which averaged six pounds over the period.Â
Researchers had participants record the food they ate and found that those eating in the 8-hour window ate 300 to 500 fewer calories each day, Varady said. . Those only on a calorie-restricted diet only cut their number of calories by 200 per day.Â
When it came to the blood sugar marker A1C, both groups saw a drop of about one point, from around eight to seven. Diabetes remission begins below 6.5, so that improvement was also promising.Â
Daisy Duan, MD, associate program director and endocrinology fellow at Johns Hopkins University in Baltimore, said that many people with type 2 diabetes also fall into the category of obese, often at the âsevereâ level. âThe mean BMI in this trial was 39, which is very high, so weight loss is part of the recommended treatment for this population,â she said. âWeight loss could help with their diabetes in general, and help them lower the amount of medication needed, too.â
The usual approach to this recommended weight loss is calorie reduction combined with physical activity. Duan found the results of the time-restricted eating plan intriguing. âClinically, we say the best diet for diabetics is the one they will adhere to,â she said. âIf this time restricted approach leads to better adherence, and itâs also safe, thatâs encouraging.âÂ
Varady said the authors made the safety of the approach a priority, because managing medications along with fasting can be tricky. âWe were worried about low blood sugar with the approach, but the rates were no different than with the control group or calorie restricted group,â she said.Â
What made the time-restricted eating so effective? Varady says the participants said it was easy to follow. Most were able to follow the approach at least 6 days out of the week, and still achieve results. âWe did surveys that showed they are all tired of counting calories,â she said. âTime-restricted eating was a refreshing alternative for them. They only had to watch the clock, and they found that much easier.âÂ
This checks with what Duan sees with her patients. âIf you think about the burden on the patient when they are counting calories, itâs a big investment of time and energy,â she said. âWith time restricted eating, itâs much less complicated.âÂ
While Duan sees many strengths to the research, she did point out that one of the medications many of the participants take â GLP-1 receptor agonists like Wegovy and Ozempic â sometimes leads to weight loss. âThat could be a limiter of this study,â she said. âIâd like to know the effect of the drugs on the outcome.âÂ
Regardless, Duan views the study as both reassuring in its safety and encouraging. âThis is a great study in terms of looking at real type 2 patients to see if they could lose weight,â she said. âItâs good to know thereâs a diet approach that patients preferred over others.â
Because the study was limited to 6 months, Varady would like to see if a longer period might bring blood sugar markers down even lower, potentially placing patients into remission. âWe need more data and bigger studies if it were to lead to clinical guidelines,â she said. âBut when this population loses weight, they can make significant progress and reduce medications. If this is the approach that allows them to do that, weâre encouraged by its potential.âÂ
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Nutrition Research
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The U.S. is seeing a significant rise in COVID-19 cases and hospitalizations as it enters Labor Day weekend.
According to the latest data from the Centers for Disease Control and Prevention, there were 15,067 new COVID patient hospitalizations for the week ending Aug. 19. That marked an 18.8% jump from the week before, and a staggering 86.9% increase over the past month. However, that is still down almost 61% compared to the same time last year.
New COVID hospital admissions are expected to continue rising. The CDC said it expects anywhere from 1,700 to 9,700 daily COVID admissions by the end of September.for seven straight weeks and
Los Angeles County has seen cases double in the last month, according to data from the L.A. County Department of Public Health, with nursing homes particularly affected.
"There have only been a few times in the past year and a half when we saw this many new outbreaks in skilled nursing facilities," L.A. County Public Health Director Barbara Ferrer said Thursday. "And these were during the previous summer and winter surges."
In New Jersey, about one in four nursing homes are reporting an outbreak, according to the New Jersey Department of Health.
Retailers and pharmacies are seeing increased demand for in-person and at-home COVID testing. Walgreens told CBS News in a statement Friday that it was "seeing greater demand in this category nationwide, which may cause temporary and isolated shortages."
CVS told CBS News in its own statement that it was seeing a "slight uptick in requests for point-of-care COVID-19 testing at our pharmacies and clinics, and in purchases of at-home COVID-19 test kits." CVS noted, however, that it has "ample supply to meet our customers' and patients' testing needs both in-store, in-clinic and at CVS.com."
Contributing to the spread are estimated Friday that EG.5 is making up 21.5% of all new cases, while FL.1.5.1 is making up 14.5% of new infections and BA.2.86 makes up less than 1%.— EG.5, FL.1.5.1 and BA.2.86. The CDC
Dr. William Schaffner, who specializes in infectious diseases at Vanderbilt University Medical Center in Nashville, told CBS News there is cause for concern.
"I think we ought to take note of it because there has been some spillover into hospitalizations," Schaffner said.
Some hospital systems and medical facilities, including United Health Services and Upstate Medical Hospitals in New York, Kaiser Permanente Santa Rosa Medical Center in Northern California and UMass Memorial Health in Massachusetts.
"People who are older, who have underlying chronic medical conditions, who are immune compromised, and who are pregnant — we ought to get those masks out again, to protect ourselves," Schaffner said.
The CDC has said ais expected to be available to the public by the end of September.
"This is a nasty, sneaky virus," Schaffner said. "Your protection will over time diminish. So even if you've had COVID in the past, once this new booster becomes available, you should get it."
— Alexander Tin contributed to this report.
for more features.
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Epidemics & Outbreaks
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It’s getting hot again – and that means sweat. With the possible exception of Prince Andrew, humans are constantly producing “insensible perspiration” – the baseline level of sweat – to some degree. Despite that, we know surprisingly little about it. According to Sarah Everts, the author of The Joy of Sweat, which explores the science, culture and history of sweat and our attempts to fight it, there is “a dearth of sweat research; there’s so much more fundamental research on every other body fluid”. So what do and don’t we know?
It’s a gift to humanity
Other mammals sweat, but not quite like we do. Humans have between 2m and 4m eccrine (eternally secreting) sweat glands; that is 10 times as many as a chimpanzee. Our fine hair makes the evaporation of sweat from the skin surface, which is how we cool down, easier.
“In terms of our efficiency, in cooling down with sweat, we are a complete superpower,” says Everts. In the past, our cooling ability enabled us to continue hunting in the hottest parts of the day, when other mammals had to stay in the shade and limit activity. If you end up dripping when you run out to buy your lunchtime sandwich, drip proudly: you are showing off the hunting strategy of your forebears; it is partly what made us more successful than other, hairier mammals.
It’s a lot better than the alternatives
We may find sweating embarrassing, but there are worse cooling strategies: storks defecate on their legs (it’s more palatably called urohidrosis); fur seals urinate on rocks to wet their bellies and flippers, then hold up their wee-soaked flippers to cool, and honeybees essentially vomit on themselves. When hippos “sweat blood”, as the myth goes, it is neither sweat nor blood: it’s more of a moisturiser.
Meanwhile, if it applies to the whole body, anhidrosis – the medical condition that renders you unable to sweat – can be life‑threatening, as can hypohidrosis, where you sweat less than usual. Without this essential cooling strategy, sufferers risk heat exhaustion and heatstroke.
Sweat is revealing
Because sweat is in part sourced from interstitial fluid – essentially the liquid parts of blood – there is all sorts in there: testing sweat can detect the presence of caffeine, alcohol, cocaine – or even spicy tomato NikNaks. Everts tells a story in her book of a South African nurse who was terrified when her sweat turned red; it turned out she had been bingeing on the luridly coloured snacks. The diagnostic test for cystic fibrosis is a sweat test that measures the amount of salts (chloride) that sweat contains, as people with that condition have far higher levels than those who don’t.
Men and women sweat similar amounts …
Women tend to have more sweat glands than men, but research suggests that neither sex sweats “more” than the other. The amount you sweat seems to be more dependent on body size and shape than sex.
… but we probably smell quite different
A new study suggests that it may be possible to distinguish between men and women on odour alone. Researchers asked 60 volunteers to squeeze cotton gauze in their unwashed hands for 10 minutes, then analysed the chemical profile of the volatile organic compounds (mainly derived from sweat) that make up a person’s scent. They were able to distinguish gender with 97% accuracy.
Armpit sweat is a different beast
We have eccrine sweat glands almost all over our bodies, but our armpits, groin and the skin around our nipples also house apocrine glands. These are activated at puberty and produce sweat with a different composition than that from the rest of our bodies; it is fattier, more viscous and higher in protein.
BO is a complex cocktail
“Body odour is a mix of different chemicals,” says Prof Gavin Thomas as he shows me around his BO laboratory (he doesn’t call it that) at the University of York. Thomas and his team have been studying how particular skin bacteria (staphylococcus hominis) interact with sweat from the apocrine glands to create the bouquet of eau de sweaty human that scents our summers.
“The smell comes from microbial transformation,” he says. “Microbes ‘eat’ odourless molecules that are in our sweat and turn them into things that they can grow on. A byproduct that they ‘poop’ out is a molecule called a thioalcohol that is one of the key molecules we recognise as body odour.” One of the lab’s big breakthroughs has been identifying the enzyme that allows bacteria to do that.
Thioalcohol contains sulphur, which humans are able to detect at extremely low thresholds. That makes the PhD student Reyme Herman, who kindly whips me up some BO, quite unpopular in the lab: “All the nasty looks come to me.” He synthesises it for me in a fume cupboard and gives me a sniff. “Does it smell like body odour to you?” he asks. It’s oniony, I say. “Exactly. This molecule is quite oniony.”
There are other compounds in BO, particularly volatile fatty acids, which are also “eaten” by bacteria, creating a musky stench, but everyone’s bouquet is different.
We don’t know why we smell
The biochemical phenomenon that Thomas’s team have identified – a microbe transforming an odourless molecule – is also seen around hyena anuses. Also, it’s what cats do when marking their scent with their pee: use smell as social communication. That might be the original purpose of human BO, too. Some interesting research published last year on friends who instantly “clicked” suggests they tend to have similar smell profiles. However, as Thomas says: “We have no idea.”
You might be able to get an armpit transplant one day
If you have bad BO – or “axillary malodour”, to give it its technical term – Dr Armpit, the Belgian bioengineer Dr Chris Callewaert, might be able to help you one day. His lab is trialling armpit microbiome transplants, replacing stinky ones with a “non-odorous microbiome”. A donor, usually a close family member, stops washing for several days, while the recipient washes thoroughly and uses topical antibiotics to kill their armpit bacteria. They then “transplant” the donor bacteria to the pristine pit. Results on 18 trial patients have been “very promising”, apparently.
Antiperspirant deodorants haven’t really changed since they were invented
One of the earliest antiperspirants from the turn of the 20th century, Odorono, was so acidic that it was described in an American Medical Association investigation as a “violent irritant”; it also turned your armpits red. But the basic mechanism for stopping sweat and odour has not changed in more than 120 years, with most formulations still based on an aluminium salt, which clogs sweat pores, cutting off bacteria from their food source. There are, however, alternatives in the offing. Callewaert’s lab has trialled “probiotic deodorant” – spray-on good armpit bacteria – with encouraging results.
There is an artificial sweat industry
“It’s a delight to me that it exists,” says Everts, who bought some while researching her book. Artificial sweat comes in almost as many varieties as Heinz, depending on what it is needed for. Clothing, shoe, jewellery, musical instrument string and phone and tablet manufacturers all want to explore how saltiness and pH (sweat is slightly acidic) affect their products, while forensic laboratories need a different blend for creating control fingerprints.
The ‘sweating sickness’ is still a mystery
An epidemic characterised by profuse, foul-smelling sweating ravaged England in five deadly waves between 1485 and 1551, possibly even killing Henry VIII’s older brother Arthur, but we still don’t know what it was.
Suggested causes have included typhus, a tick- or mosquito‑borne virus or a hantavirus (a group of viruses mainly transmitted by rodents). But, as a 2014 paper speculating on its origins concluded, it’s a medical mystery – “and will most probably remain so”.
Sweating won’t detox you
A sauna won’t help your body remove impurities – that is what your kidneys are for. “It’s the most common misconception,” says Everts. “Quite frankly, if you were to detox by sweating, this would ultimately kill you, so it’s really great we don’t.” Anything in your bloodstream will be present in your sweat.
Everts believes this misconception derives from the fact sweating a lot feels good. “You definitely produce a lot of molecules that make you feel good – ‘runner’s high’ molecules. So you think that you have this emotional catharsis, but there is not a corresponding chemical catharsis.”
You wouldn’t want to sweat in space
In space, sweat doesn’t evaporate. Without gravity to wick moisture away from the skin, sweat sort of hangs around unless you wipe it away. During spacewalks, when they can’t do that, astronauts have to use other strategies, including wearing special cooling underwear and sweat-absorbing headbands and gloves.
Fearful sweat is different and we can smell it (or, at least, women and dogs can)
The chemical composition of what we sweat when we are scared is different from what we sweat when we are hot. Researchers at Utrecht University’s Smell Lab collected samples from men who had watched either horror films or neutral, relaxing shows (one was called Rail Away, a TV show filmed from a train travelling through meditative landscapes). The sweat collected from the horror movie group had a different chemical composition from that of Rail Away viewers.
In an earlier experiment by the same lab, women exposed to fear sweat generated by horror movie viewers screwed their faces up in a “fear response”, even when they were themselves watching something neutral. Men, however, did not. In a separate study, dogs accurately identified a stress sweat sample 94% of the time. I leave you to draw your own conclusions.
Smelling other people’s sweat may assist with social anxiety (even if they were scared)
Early research this year from the Karolinska Institute in Stockholm explored whether sniffing sweat from strangers might help alleviate social anxiety. In conjunction with a mindfulness therapy session, it seemed to (although the sample size was tiny: 48 women). There was a 39% reduction in reported anxiety scores, compared with a 17% reduction in the therapy-only group. However, oddly, it did not appear to matter whether the sweat donor had been watching Mr Bean’s Holiday or a horror film.
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Disease Research
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The human brain can change—but usually only slowly and with great effort, such as when learning a new sport or foreign language, or recovering from a stroke. Learning new skills correlates with changes in the brain, as evidenced by neuroscience research with animals and functional brain scans in people. Presumably, if you master Calculus 1, something is now different in your brain. Furthermore, motor neurons in the brain expand and contract depending on how often they are exercised— a neuronal reflection of “use it or lose it.”
People may wish their brains could change faster—not just when learning new skills, but also when overcoming problems like anxiety, depression, and addictions.
Clinicians and scientists know there are times the brain can make rapid, enduring changes. Most often, these occur in the context of traumatic experiences, leaving an indelible imprint on the brain.
Social scientists call events like these psychologically transformative experiences or pivotal mental states. For the rest of us, they’re forks in the road. Presumably, these positive experiences quickly change some “wiring” in the brain.
How do these rapid, positive transformations happen? It seems the brain has a way to facilitate accelerated change. And here’s where it gets really interesting: Psychedelic-assisted psychotherapy appears to tap into this natural neural mechanism.
Psychedelic-assisted psychotherapy
Those who’ve had a psychedelic experience usually describe it as a mental journey that’s impossible to put into words. However, it can be conceptualized as an altered state of consciousness with distortions of perception, modified sense of self, and rapidly changing emotions. Presumably there is a relaxation of the higher brain control, which allows deeper brain thoughts and feelings to emerge into conscious awareness.
Psychedelic-assisted psychotherapy combines the psychology of talk therapy with the power of a psychedelic experience. Researchers have described cases in which subjects report profound, personally transformative experiences after one six-hour session with the psychedelic substance psilocybin, taken in conjunction with psychotherapy. For example, patients distressed about advancing cancer have quickly experienced relief and an unexpected acceptance of the approaching end. How does this happen?
Research suggests that new skills, memories, and attitudes are encoded in the brain by new connections between neurons—sort of like branches of trees growing toward each other. Neuroscientists even call the pattern of growth arborization.
Researchers using a technique called two-photon microscopy can observe this process in living cells by following the formation and regression of spines on the neurons. The spines are one-half of the synapses that allow for communication between one neuron and another.
Scientists have thought that enduring spine formation could be established only with focused, repetitive mental energy. However, a lab at Yale recently documented rapid spine formation in the frontal cortex of mice after one dose of psilocybin. Researchers found that mice given the mushroom-derived drug had about a 10 percent increase in spine formation. These changes had occurred when examined one day after treatment and endured for over a month.
A mechanism for psychedelic-induced change
Psychoactive molecules primarily change brain function through the receptors on the neural cells. The serotonin receptor 5HT, the one famously tweaked by antidepressants, comes in a variety of subtypes. Psychedelics such as DMT, the active chemical in the plant-based psychedelic ayahuasca, stimulate a receptor cell type, called 5-HT2A. This receptor also appears to mediate the hyperplastic states when a brain is changing quickly.
These 5-HT2A receptors that DMT activates are not only on the neuron cell surface but also inside the neuron. It’s only the 5-HT2A receptor inside the cell that facilitates rapid change in neuronal structure. Serotonin can’t get through the cell membrane, which is why people don’t hallucinate when taking antidepressants like Prozac or Zoloft. The psychedelics, on the other hand, slip through the cell’s exterior and tweak the 5-HT2A receptor, stimulating dendritic growth and increased spine formation.
Here’s where this story all comes together. In addition to being the active ingredient in ayahuasca, DMT is an endogenous molecule synthesized naturally in mammalian brains. As such, human neurons are capable of producing their own “psychedelic” molecule, although likely in tiny quantities. It’s possible the brain uses its own endogenous DMT as a tool for change—as when forming dendritic spines on neurons—to encode pivotal mental states. And it’s possible psychedelic-assisted psychotherapy uses this naturally occurring neural mechanism to facilitate healing.
A word of caution
In her essay collection “These Precious Days,” author Ann Patchett describes taking mushrooms with a friend who was struggling with pancreatic cancer. The friend had a mystical experience and came away feeling deeper connections to her family and friends. Patchett, on the other hand, said she spent eight hours “hacking up snakes in some pitch-black cauldron of lava at the center of the Earth.” It felt like death to her.
Psychedelics are powerful, and none of the classic psychedelic drugs, such as LSD, are approved yet for treatment. The US Food and Drug Administration in 2019 did approve ketamine, in conjunction with an antidepressant, to treat depression in adults. Psychedelic-assisted psychotherapy with MDMA (often called ecstasy or molly) for PTSD and psilocybin for depression are in Phase 3 trials.
Edmund S. Higgins, Affiliate Associate Professor of Psychiatry & Family Medicine, Medical University of South Carolina. This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Mental Health Treatments
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Shaquita Estes recalls being in total disbelief when the doctor told her she may have breast cancer. âI absolutely lost it,â Estes says. âI remember falling to the floor just telling him that I heard what he was saying, that this could not be true.â
Estes, a 45-year-old pediatric nurse practitioner from Palmetto, GA, says she was caught off guard because she didnât have any family history of cancer except for a grandfather with prostate cancer. While a family history of cancer is a risk factor, cancer can still happen if it doesnât run in your family. Most women who get breast cancer donât have a family history of the disease.
As a health care worker, Estesâ medical instincts pushed her to get what felt like a mastitis breast pain, clogged milk ducts that may happen when you breastfeed, checked out. âI knew that I didn't have mastitis because I was not [breast]feeding.â
A Range of Emotions
A life-changing diagnosis like breast cancer can dig up a lot of emotions. Itâs not uncommon to have depression, anxiety, uncertainty, fear, loneliness, and body image issues, among others. In fact, about 1 in 4 people with any type of cancer may have major or clinical depression and benefit from its treatment. One day youâre just going about your life and the next minute, youâre scrambling to get tests and scans as you try to make sense of complex medical information and your fast-changing reality.
After getting the diagnosis, some women may feel âsignificant distress,â says Kathleen Ashton, a clinical health psychologist in the Breast Center, Digestive Disease, and Surgery Institute at Cleveland Clinic. âThey may not know what the next steps are.â
The word âcancerâ itself may be a source of worry for many women, Ashton says. The fears can include worries about treatment costs, anxiety, and uncertainty about how it will impact your life or even your mortality, how the cancer may change your physical body, and how it may affect your loved oneâs lives.
After the diagnosis, youâll meet with your doctor to go over a treatment plan based on the type and degree of cancer you have. Ashton says itâs easy to feel âvery overwhelmed,â as there are multiple steps and lots of information to take in. Itâs a good idea to take a support person along to help you through it and to take notes on whatâs said.
âI really recommend that patients focus on one step of the plan at a time and to remain flexible because sometimes the plan changes as you get more information at each step,â Ashton says. This may help you feel less anxious.
Issues Related to Physical Changes
Breast cancer treatments like chemotherapy, radiation, or surgery may bring about a lot of physical changes. Depending on the type of treatment you have, surgical breast tissue removal or reconstruction may result in scars. You may lose hair through chemotherapy. Some people with breast cancer may also have weight gain and go through early menopause. These physical changes may bring about issues with self-image and confidence.
For Estes, losing her hair was a big point of worry. âIn the African American culture ... it's really our crown, our strength. It's who we are,â Estes says. âI had a lot of pride and joy in my hair.â Once Estes started to lose hair, she says she decided to embrace it. âI just went and got it shaved completely off.â
Snehal Ponde also had strong feelings about her hair. âThe only thing I thought of was, âI don't want to lose my hair.â It's like your hair, your breast -- it's a reflection of who we are as women.â
Ponde, a 37-year-old Indian expat living in Singapore, gave birth to her son in April 2020. Three months later, like Estes, she felt a lump that turned out to be stage IV cancer.
During chemo, she chose to try a cooling cap to reduce hair loss. The cap, which is worn before, during, and after each treatment, is designed to circulate a cooling liquid around your head. The cold temperature may stop the chemo from damaging your hair follicles.
âRight now, I almost have 60%-70% of my hair,â Ponde says. The research on cooling caps has been mixed, with better results from the newer types of these caps, some of which have FDA clearance. There are some theoretical questions about whether the cold temperatures might let some cancer cells stick around in the scalp, but no signals of safety problems in studies so far. If youâre thinking about adding a cooling cap, ask your doctor for their take on them and what to look for. And check on whether your insurance covers the capâs cost.
Handling the Uncertainty
For Shayla Wishloff, the sudden sense of uncertainty was jarring. âI thought I had such control of my life. I'm always the girl who had the year planner. I planned my vacations 6 months down the road. I had a 5-year plan, and I was doing it.â
Wishloff, now 25, was 24 when she got her breast cancer diagnosis. She had just finished nursing school in Alberta, Canada and was talking about buying a home, getting married, and having kids. One day, while applying lotion after a shower, she felt a lump in her breast. âHaving my nursing background, I was like, âWell, that's not good.ââ
Doctors assured her that itâs very rare for someone in their 20s to get breast cancer. Studies show that only 5% of all breast cancers are found in people younger than 40; breast cancer is most often diagnosed in women age 50 and older. But Wishloffâs biopsy led to a diagnosis of an aggressive form of stage II breast cancer. âI thought I could beat it,â Wishloff says.
After 6 months of chemotherapy that she says did not really work, Wishloff got surgery to remove both breasts -- a double mastectomy -- followed by reconstructive surgery. Wishloff also got radiation treatments to try to kill any remaining cancer cells. She recalls being told there was âno evidence of diseaseâ afterward.
But a few months later, bad news came. Wishloff says that a follow-up CT scan showed multiple tumors in her lungs and breastbone. It was stage IV breast cancer, which can be treated but not cured. Wishloff says that in October 2020, her doctors estimated she had approximately a year to live. âIt's just such a shock. The only way to put is it feels like the whole world is crumbling on you,â she says.
It took a while to come to terms with it all. âI don't think so far into the future and get so anxious about it,â Wishloff says. âI realize now -- today -- I'm OK. Today, I'm happy. Today, I can live a good day.âÂ
Getting Support
Going through breast cancer and its treatment may exhaust you physically and emotionally. Having family and friends who act as a support system can be a comfort.Â
Estes feels fortunate to have close family members nearby. But itâs her best friends who really help lift her up when she needs it. They call themselves the Ta Group.
âItâs five of my best friends,â she says. âWe would just get together and pray. I'll go into my prayer closet -- I call it my war room. If I needed to talk, I would just talk to them in there.â
Professional therapy may also help. Check with your health care team if you want a referral. âI think my counselor has really helped me go through everything, all my traumas ... and deal with them,â Ponde says.
Talking and bonding with people who are going through breast cancer may help you feel understood and less alone. You can find support groups on social media sites like Facebook and you can join local organizations.
You can also speak to a social worker or your counselor for more resources. When youâre seeking a community, Ashton notes that hearing peopleâs stories or reading too many negative posts online may make you more anxious. Her advice: Notice whatâs helping you.
âWomen with breast cancer come into their diagnosis with many strengths, and it's important to use those strengths along the way to help you in your journey,â Ashton says.
Self-Care and Relaxation Techniques
Breast cancer diagnosis and treatments demand a lot from you and your body. You owe it to yourself to take time -- even a few moments every now and then -- to unwind and take care of yourself.
Here are a few things you can do:
- Yoga and meditation. These mindfulness practices can help to lower your fatigue and stress. Any kind of exercise is also a good outlet for stress.
- Go for walks. âIt could be the worst day of my life, and then I go outside for a walk. That's the only thing I can do that I know 100% will change my mood,â Wishloff says.
- Imagery. Many people with cancer find imagery exercises can help manage pain and stress. To get started, close your eyes and think of a happy image in your mind. You can also think of an activity you like and let your mind linger. This may make you feel calmer.
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Women’s Health
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WASHINGTON -- The U.S. Department of Health and Human Services has delivered a recommendation to the Drug Enforcement Administration on marijuana policy, and Senate leaders hailed it Wednesday as a first step toward easing federal restrictions on the drug.
HHS Secretary Xavier Becerra said Wednesday on X, the platform formerly known as Twitter, that the agency has responded to President Joe Biden's request “to provide a scheduling recommendation for marijuana to the DEA.”
“We’ve worked to ensure that a scientific evaluation be completed and shared expeditiously,” he added.
Senate Majority Leader Chuck Schumer said in a statement that HHS had recommended that marijuana be moved from a Schedule I to a Schedule III controlled substance.
“HHS has done the right thing,” Schumer, D-N.Y., said. “DEA should now follow through on this important step to greatly reduce the harm caused by draconian marijuana laws.”
Rescheduling the drug would reduce or potentially eliminate criminal penalties for possession. Marijuana is currently classified as a Schedule I drug, alongside heroin and LSD.
According to the DEA, Schedule I drugs "have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse."
Schedule III drugs “have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.” They currently include ketamine and some anabolic steroids.
Biden requested the review in October 2022 as he pardoned thousands of Americans convicted of “simple possession” of marijuana under federal law
Senate Finance Committee Chairman Ron Wyden, D-Ore., issued a statement calling for marijuana to be completely descheduled. “However, the recommendation of HHS to reschedule cannabis as a Schedule III drug is not inconsequential," he added. “If HHS’s recommendation is ultimately implemented, it will be a historic step for a nation whose cannabis policies have been out of touch with reality.”
Bloomberg News first reported on the HHS recommendation.
In reaction to the Bloomberg report, the nonprofit U.S. Cannabis Council said: “We enthusiastically welcome today’s news. ... Rescheduling will have a broad range of benefits, including signaling to the criminal justice system that cannabis is a lower priority and providing a crucial economic lifeline to the cannabis industry.”
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Health Policy
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WASHINGTON -- In one of the biggest actions the administration has taken against fentanyl trafficking, the U.S. on Tuesday announced a series of indictments and sanctions against 14 people and 14 firms across China and Canada related to the import of the drug to the United States.
Leaders from the Treasury, Justice and Homeland Security departments, the Drug Enforcement Agency and the U.S. Postal Inspection Service are set to gather at Justice Department headquarters Tuesday afternoon to outline the administration's latest action against what it calls a “major China-based syndicate” that sold chemicals to American drug dealers and Mexico-based cartels. All but two of the firms and one of the people targeted are based in China.
Mexico and China are the primary sources for fentanyl and fentanyl-related substances trafficked directly into the U.S., according to the Drug Enforcement Administration, which is tasked with combating illicit drug trafficking. Nearly all the precursor chemicals that are needed to make fentanyl are coming from China.
“It’s the latest step in the rapid scaling up of our work targeting the financial flows that power the global illicit drug trade,” said Treasury’s Deputy Secretary Wally Adeyemo in a prepared speech. Adeyemo said Treasury is also seeking out the friends, family members, and affiliates of the people who benefit from drugs sales.
“If you benefit from the proceeds of this illicit activity, we are going to come after your assets,” he said.
U.S. officials said the operation targeted networks that traffic xylazine, a powerful sedative for veterinary use that is routinely mixed with fentanyl, into the U.S.
Among the firms targeted is a pharmaceutical company that officials say advertises the sale of fentanyl precursors to Mexican customers as well as sales representatives alleged to have done business with a Mexico-based drug trafficking organization.
Other targets include a China-based company that officials say has provided pill dies for counterfeit oxycodone M30 tablets.
This latest action comes after a series of actions were taken this year against members of the Sinaloa cartel out of Mexico, cash couriers and cartel fraud schemes.
Republicans have complained, however, that the administration isn’t doing enough to stop fentanyl and the issue is likely to figure prominently in next year's presidential campaign.
In February, 21 Republican state attorneys general wrote a letter to President Joe Biden and Secretary of State Antony Blinken calling on them to designate Mexican drug cartels as foreign terrorist organizations. And last year a group of Republican attorneys general asked the president to declare fentanyl a weapon of mass destruction. No such actions have been taken.
Fentanyl, a powerful opioid, is the deadliest drug in the U.S. today. The Centers for Disease Control and Prevention states that drug overdose deaths have increased more than sevenfold from 2015 to 2021.
More than 100,000 deaths a year have been linked to drug overdoses since 2020 and about two-thirds of those are related to fentanyl. The death toll is more than 10 times as many drug deaths as in 1988, at the height of the crack epidemic.
The U.S. has taken a slew of actions to stem the tide of fentanyl coming into the country. Overall, the Biden administration has imposed over 200 sanctions related to the illegal drug trade.
And state lawmakers nationwide are responding to the deadliest overdose crisis in U.S. history by pushing harsher penalties for possessing fentanyl.
In a speech at the Family Summit on Fentanyl last week, Attorney General Merrick Garland said the Justice Department is sending out some $345 million in federal funding over the next year, including money to support mentoring for at-risk young people and increase access to the overdose-reversal drug naloxone.
On Capitol Hill, a bipartisan group of legislators out of the Senate Banking and Armed Services committees have introduced legislation that would declare fentanyl trafficking a national emergency and prod Treasury to use its sanctions authority to quell the proliferation of the drug in the U.S.
It would also impose reporting requirements and enable the president to confiscate sanctioned property of fentanyl traffickers to use for law enforcement efforts.
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Associated Press reporter Lindsay Whitehurst in Wilmington, Delaware, contributed to this report.
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Drug Discoveries
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When delivering medications to patients, one of the most effective methods is direct injection into the bloodstream using a needle. But this can be an uncomfortable experience, especially for kids or adults with a fear of needles. While patients do have the option to take oral pills instead, drugs containing large molecules—such as those for diabetes—are not absorbed effectively this way.
Now, researchers from China and Switzerland have designed a needle-free alternative: a tiny, drug-filled cup that sticks to the inside of the cheek like an octopus sucker. The device is easily accessible, can be removed at any time and prevents saliva from dissolving the drug, which gets absorbed through the lining of the inner cheek, the team reports in a paper published Wednesday in the journal Science Translational Medicine.
“Oral delivery really is kind of a holy grail,” Arturo Vegas, a chemist at Boston University who was not involved in the patch development, tells Annalisa Merelli of STAT News. “It’s still the preferred form of administration for patients […] which means higher compliance, better outcomes for the patient, less adverse effects overall.”
Usually, delivering drugs through the dense, inner cheek tissue is not very effective, according to a statement. But the suction cup stretches the cheek, creating a larger surface area for the drug to pass through.
To test the design, the team 3D printed their rubber, 1.1- by 0.6-centimeter suckers. They loaded each with the diabetes drug desmopressin and stuck them inside the cheeks of three beagles, which have a similar inner cheek lining to humans. For comparison, they also delivered the drug to beagles via a pill and via injection. After three hours, the team found that drug plasma concentrations in dogs with the patch were more than 150 times higher than in the dogs that took a tablet.
“We were really impressed by the level of absorption that we would get with such a simple system,” Jean-Christophe Leroux, a co-author of the study and researcher of drug formulation and delivery at ETH Zurich in Switzerland, tells Popular Science’s Jocelyn Solis-Moreira. However, the oral patches were less effective than drugs delivered via injection.
The team further tested the patches by filling them with the drug semaglutide, which has molecules four times larger than desmopressin does, reports Nature’s Miryam Naddaf. After 30 minutes, they found that beagles with the patch had a similar amount of semaglutide absorbed by the bloodstream as those that took a tablet, per the publication.
Finally, 40 healthy human volunteers self-applied water-filled patches to see how well they would stay on while talking, moving and rinsing their mouths. After 30 minutes, only five of the 40 patches had fallen off, which the study authors write was because of improper placement or manipulation. Most volunteers said they would prefer a patch over injections for daily, weekly and monthly applications.
Though the patches need further testing to determine how repeated use affects patients, the researchers conclude that their technique is “noninvasive, simple and readily self-applicable by patients,” they write. “Its simplicity and modularity make this technology potentially suitable for administration of a wide range of compounds that are rapidly degraded or poorly absorbed in the GI [gastrointestinal] tract.”
Next, the team wants to bring their suction-cup design to market. They will have to conduct more tests before starting human clinical trials, and they’re currently looking for industry partners and funders.
“We have a prototype and have already patented the technology,” Nevena Paunović, a pharmacist who will lead the effort to sell the product, says in the statement. “Our next step is to manufacture the suction cup in a way that meets current pharmaceutical regulations.”
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Medical Innovations
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The global fitness industry will generate over US$80 billion in revenue in 2023, estimates suggest. And why not, given the many excellent reasons to exercise? Better cardiovascular health, lower risk of Type 2 diabetes, stronger immune system – the list goes on.
One of the biggest reasons many people choose to exercise is to lose weight. As a biobehavioral scientist, I study links between behavior and health, and I heed the time-honored advice that eating less and exercising more are necessary to lose weight. But a recent debate in the scientific community highlights the growing suspicion that the "exercising more" part of this advice may be erroneous.
At the center of the debate is the constrained total energy expenditure hypothesis, which asserts that exercise won't help you burn more calories overall because your body will compensate by burning fewer calories after your workout. Thus, exercise won't help you lose weight even if it will benefit your health in countless other ways.
Obesity researchers take issue with this hypothesis, because it's based on observational research rather than randomized controlled trials, or RCTs, the gold standard of scientific evidence. In RCTs, participants are randomly assigned to either a treatment or a control group, which allows researchers to determine whether the treatment causes an effect. Randomized controlled trials have shown that exercise causes weight loss.
The verdict is actually more mixed when considering all the gold-standard evidence available.
What the evidence says
Spectators of this hypothesis have emphasized the importance of systematically reviewing the evidence from all gold-standard trials. They pointed to a 2021 review of more than 100 exercise studies that examined the effect on weight loss in adults of aerobic, resistance or high-intensity interval training in combination or alone. The review concluded that supervised exercise regimens do cause weight loss, even if only a modest amount.
So that settles the debate, yes? If you eat too much dessert, then you can just go on an extra run to burn off those extra calories, right?
Well, not exactly.
If extra physical exertion burns extra calories overall, then exercise should also keep the weight from coming back after low-calorie dieting. But keeping those lost pounds off after dieting is a common challenge. The same 2021 review includes the few randomized controlled trials that address the question of whether exercise facilitates weight maintenance. However, the results weren't as good as they were for weight loss. The researchers found that six to 12 months of aerobic exercise, resistance training or both after dieting did not prevent weight regain in adults.
Exercise adherence
But what about compliance? Did all the people in those studies actually exercise regularly?
The 2021 review found only one randomized controlled trial on weight maintenance that reported an objective compliance rate, meaning each exercise session was supervised by a trainer. This tells us the percentage of time that participants in the study actually exercised as prescribed.
In that trial, the compliance rate was only 64% for 25 post-menopausal women who completed a resistance training program after diet-induced weight loss. This was for a regimen in which participants had to come in and exercise two to three times per week for an entire year. From the perspective of keeping up with a program for that long, doing so 64% of the time doesn't seem so bad.
But they still gained back as much weight as the 29 women in the control group who were not enrolled in the exercise program.
Energy balance
Many people would say that it's all about balancing energy in from food and energy out from exercise. If exercise didn't keep the weight off, then maybe a bigger dose of exercise was needed.
The American College of Sports Medicine highlighted this issue of exercise dose in its 2009 position statement on physical activity for weight maintenance, stating that the amount of physical activity needed for weight maintenance after weight loss is uncertain. Moreover, it stated that there is a lack of randomized controlled trials in this area that use state-of-the-art techniques to monitor the energy balance of participants.
Fortunately, some of the authors of the position statement went on to use state-of-the-art techniques to monitor energy balance in their own randomized controlled trial. In 2015, they enrolled overweight adults into a 10-month aerobic exercise program and compared the energy intake of those who lost weight with the energy intake of those who didn't lose weight while on the program. They found that those who didn't lose weight were indeed taking in more calories.
Mystery of the disappearing calories
But there's something else in that 2015 study's energy measurements that is quite interesting. By the end of the study, the number of total daily calories the exercisers burned was not significantly different from what the nonexercisers burned. And this was in spite of the fact that trainers verified the exercisers burned an extra 400 to 600 calories per session at their nearly daily exercise sessions. Why didn't those extra exercise calories show up in the total daily calories burned?
The answer to that question may help explain why exercise doesn't always help you keep the weight off: Your metabolism responds to regular exercise by decreasing the number of calories you burn when you're not exercising. That's according to the constrained total energy expenditure hypothesis that spurred the current debate.
Researchers recently tested the hypothesis by measuring the nonexercise calorie burn of 29 obese adults over a nearly 24-hour period, both before and after a six-month exercise program. They found that the calories they burned when they weren't working out did decrease after months of regular exercise – but only in those who were prescribed the higher of two different exercise doses.
Those who exercised at the lower dose for general health, meaning they burned an extra 800 to 1,000 calories per week, saw no change in their metabolic rate. But those who exercised at the higher dose to lose weight or maintain weight loss, meaning they burned an extra 2,000 to 2,500 calories per week, had a decrease in their metabolic rate by the study's end.
Exercise for health
Perhaps both sides of the debate are right. If you want to lose a modest amount of weight, then a new exercise routine might make a modest contribution toward meeting that goal.
However, as others have said, don't fool yourself into thinking you can "outrun a bad diet" by simply exercising more. There is a diminishing marginal return to exercise – you eventually take less weight off for the additional exercise you put in.
But even if extra exercise might not help you lose weight and keep it off, there are still the other great health dividends that regular exercise pays out.
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I received my Ph.D. in health psychology from the University of Iowa before completing post doctoral training in neuroimmunology and cancer biology at UCLA. My research focuses on biobehavioral mechanisms in cancer control, including associations among psychosocial factors, stress biology, and physical exercise. Using preclinical models of cancer and bioinformatic analysis of functional genomics, I test hypotheses on how stress physiology may affect progression of malignancy, particularly in regard to the sympathetic nervous system and during physical exercise. With an eye toward translation to clinical populations, I also collaborate with clinical investigators at the UCLA Jonsson Comprehensive Cancer Center.
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Weightlifting & Bodybuilding
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An invasive mosquito species from Central and South America has taken root in South Florida, raising concerns that the pests might spread dangerous viruses, like West Nile.
The mosquito species, called Culex lactator, was first detected in Florida in 2018 by researchers affiliated with the University of Florida's Institute of Food and Agricultural Sciences (UF/IFAS). The researchers reported their findings in a new study, published Wednesday (March 22) in the Journal of Medical Entomology (opens in new tab).
The UF/IFAS team ran a DNA analysis on the mosquitoes to determine their species. After the researchers initially found C. lactator in Miami-Dade County, other scientists uncovered additional populations in nearby Collier and Lee counties.
The mosquitoes, which physically resemble many others in Florida, may have already seeded populations in additional counties, study lead author Lawrence Reeves (opens in new tab), a mosquito biologist at the UF/IFAS research center in Vero Beach, said in a statement (opens in new tab). It's likely that the pest will continue to spread to more locations in the state.
"Introductions of new mosquito species like this are concerning because many of our greatest mosquito-related challenges" — namely, the bug's ability to spread disease — "are the result of nonnative mosquitoes," Reeves said. "And in a case like this, it's difficult to anticipate what to expect when we know so little about a mosquito species."
C. lactator belongs to the genus Culex, other members of which are known to transmit dangerous pathogens, such as the West Nile and St. Louis encephalitis viruses. For now, though, scientists don't know whether C. lactator can also spread the diseases.
"It's too early to know whether Culex lactator will exacerbate these challenges, but the implications are often difficult to predict because not all mosquito species are equally capable of transmitting a particular virus or other pathogen," Reeves said.
At least 17 nonnative mosquito species have established populations in Florida — 11 within the past 20 years, and six within the last five. Climate change could exacerbate the spread of new mosquitoes to Florida from the tropics, by making the state's environment more hospitable to the pests and increasing the frequency of storms that could carry the invasive species over in the first place, according to the UF/IFAS statement.
Since spotting the C. lactator in Florida, researchers have found specimens carrying the blood of warbler birds, Reeves told The Tampa Bay Times (opens in new tab). "That's probably something that we don't want to see," he said. "Public health-wise, the viruses that we're most worried about — that this mosquito would serve as a vector for — are really viruses of birds."
For example, mosquitoes pick up both West Nile virus (opens in new tab) and St. Louis encephalitis virus (opens in new tab) by feeding on infected birds and can then spread the pathogens to people, according to the Centers for Disease Control and Prevention. (There's no evidence of birds spreading the viruses directly to humans.)
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Epidemics & Outbreaks
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For most of us, having one metal chip implanted under our skin would be more than enough – but imagine getting 52.
California performer Anastasia Synn has done just that, and in the process got her name in the new book of Guinness World Records.
Functions of her 52 implants include opening locks, finding metal objects, calling phone numbers, and performing magic tricks, while one in her hand even vibrates.
Synn is a magician, stunt performer and 'biohacker' - someone who makes alterations to the body with technology to make life easier.
She said: 'I can officially announce that I'm the world's most technologically implanted human! Since it's a first, they had to create a new record category.'
Ms Synn's insertions include the largest magnet ever implanted into a person, as well as a sound-transmitting magnet implanted into the tragus of her ear.
'The largest is two and a half inches across and half an inch thick and its twin is in the other arm,' she said.
Her most used implant is a chip in her hand that opens the front door of her home.
About half of her implants are microchips, which she programs to give herself heightened senses and abilities, such as opening locks and turning on computers.
Others are magnetic and give her a 'sixth sense', such as feeling live wires behind a wall and whether or not a transformer or power box is receiving power.
'I can tell you if your microwave is leaking too much radiation – my hand vibrates,' she said.
'Finding someone's lost earring backing has also come in very handy throughout the years.'
Her implants also allow her to perform magic tricks and memorialise her favourite pastimes and her late husband, The Amazing Johnathan.
Dubbed the 'Freddy Krueger of comedy', he was famed for his gory tricks including appearing to swallow his own eyeballs and skewering his own tongue.
'The chip over my heart when scanned will play our wedding,' Ms Synn said.
'The one in my left wrist calls my daughter's phone and the one in my right wrist calls my husband's phone.'
To become the record holder, she had to provide a list of what they do, have an X-ray to show they were there and demo each of them.
Although 52 implants sounds like more than enough for anyone, Ms Synn – who is originally from Canada – is still not finished and hopes to add more to her collection.
She said she'd like to put a near-field communication (NFC) scanner in her leg and NFC tags inside playing cards.
In a game of poker, she'd be able to run the cards over her leg to read them with her eyes closed without other players knowing what was going on.
'The computer would scan the card and know it was the queen of hearts, send that information to my phone via Bluetooth which would then send that information to the Bluetooth hair piece that would vibrate the magnets in my ears,' she said.
Ms Synn is part of a global community of biohackers who make enhancements to their body and often meet up at conventions to admire each other's implants.
One astonishing example is Neil Harbisson from Spain, who has an implanted antenna hanging over his face that lets him 'hear' colours as different musical frequencies.
Meanwhile, one US YouTuber removed the RFID chip from the key to her Tesla car and had it implanted into her arm to make unlocking the vehicle quicker.
One of the original biohackers was British engineer Professor Kevin Warwick, who got a chip in his arm to turn on the lights of his lab with a wave.
But the practice is highly controversial as many perform operations without proper medical assistance, leading to complications such as nerve damage and long-term pain.
According to Ms Synn, her modifications were surgically performed by a nurse and an underground 'do it yourself' surgeon.
About half of the implants were inserted with a thick hypodermic needle and a plunger, while the rest were inserted with a scalpel with the skin sewn up afterwards.
'I put quite a few in myself and I had a friend help me with ones I couldn't do on my own,' she said.
Once implanted, biohackers must monitor them to make sure that they're not degrading or breaking in any way, and if they are they have to come out.
Ms Synn said she has to remove and inspect her implants every once in a while, because of their 'experimental' chemical coatings.
The degradation of the implant coatings can expose her to the toxic elements of printed circuit boards, copper wire, and neodymium.
Not all procedures on the biohacker's body have been successful, however.
In one instance, she had all of her teeth pulled out in the hopes of replacing them with cyborg dentures that she could snap in and out – a painful process that she doesn't recommend.
Whatever the exact function of the dentures, the plan fell apart when her doctor 'could not fully understand what she wanted'.
'I was left without teeth for six months, causing my lower face shape to change and a subsequent slew of problems,' Ms Synn said.
'I've given up on my desire to make cyborg dentures.'
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Medical Innovations
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Health Care — Sponsored By: BCBSA
CDC: E-cigarette sales spiked nearly 50 percent between 2020 and 2022
Sales of e-cigarettes spiked during the first two years of the COVID-19 pandemic, driven largely by fruity and candy-flavored disposable products, according to new data released Thursday by the Centers for Disease Control and Prevention (CDC) and the advocacy organization Truth Initiative.
E-cigarette sales rose by 46.6 percent from January 2020 to December 2022, from 15.5 million units in January of 2020 to 22.7 million units in December of 2022, researchers found. During that time, sales of tobacco-flavored and mint-flavored products decreased, whereas sales of other flavors increased.
E-cigarettes often contain high concentrations of nicotine, and the U.S. sets no limits on the nicotine content of any tobacco product.
The 2022 National Youth Tobacco Survey found that over 2.5 million kids still use e-cigarettes, and 85 percent of them use flavored products.
Advocacy groups said the data show a disheartening picture of attempts to regulate the e-cigarette market.
The Food and Drug Administration (FDA) announced during January 2020 that it would prioritize enforcement against prefilled e-cigarettes in flavors other than tobacco and menthol, because of the popularity of sweet flavors with underage kids.
Yet the new data show the market changed. After the FDA’s announcement, retail sales of mint- and other-flavored prefilled cartridges effectively stopped, while there were notable increases in sales of fruit- and mint-flavored disposable products.
Disposable e-cigarettes in youth-appealing flavors are now more commonly sold than prefilled units, the study found.
“Today’s study underscores that we will not end the youth e-cigarette crisis until the FDA clears the market of all flavored e-cigarettes. When the FDA takes action only against some flavored products, as it did in February 2020, sales – and kids – shift to the flavored products that are left,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids.
The survey looked at the brands and flavors of e-cigarettes sold, but it did not differentiate between legal adult sales and unlawful underage sales. It also only included sales from brick-and-mortar retailers.
During the two years analyzed in the study, the number of e-cigarette brands shot up from 184 to 269 brands, an increase of nearly 50 percent
In January 2020, JUUL was the top monthly seller, followed by Vuse, NJOY, My Blu and Puff, respectively. By the end of the study period in December 2022, Vuse was the top-selling brand, followed by JUUL, Elf Bar, NJOY and Breeze Smoke, respectively.
The study found that Elf Bar was the top-selling disposable brand in the United States and has been responsible for driving sharp recent increases in e-cigarette use among youth in England.
“The dramatic spikes in youth e-cigarette use back in 2017 and 2018, primarily driven by JUUL, showed us how quickly e-cigarette sales and use patterns can change,” Deirdre Lawrence Kittner, director of the CDC’s Office on Smoking and Health, said in a statement. “Retail sales data are key to providing real-time information on the rapidly changing e-cigarette landscape, which is essential to reducing youth tobacco use.”
The FDA was given the authority to regulate the marketing, manufacturing and distribution of tobacco products in 2009 when Congress passed the Tobacco Control Act, and the agency said it would regulate e-cigarettes beginning in 2016.
The FDA struggled to review companies’ applications for marketing, and allowed all e-cigarettes already on the market to stay while their manufacturers applied for the permission.
Public health groups sued the agency in 2018, and while a court ordered the FDA to finish the job by September 2021, the FDA missed the deadline.
The FDA issued its first marketing denial orders for approximately 55,000 flavored e-cigarette products in August 2021, and its first marketing denial order for a menthol-flavored, cartridge-based e-cigarette on October 2022.
Thursday’s report was released at the same time the FDA announced a new crackdown on vape shops for selling unauthorized disposable vapes, specifically Elf Bar and Esco Bars products.
Both brands come in flavors known to appeal to youth, including bubblegum and cotton candy, the FDA said.
The agency said it issued 189 formal warning letters to vape shops.
“This latest blitz should be a wake-up call for retailers of Elf Bar and Esco Bars products nationwide,” Brian King, the head of the FDA’s tobacco center, said in a statement.
Elf Bar and Esco Bars products are illegal to sell because they don’t have the required FDA marketing permission. To date, the FDA has authorized 23 tobacco-flavored e-cigarette products and devices. These are the only e-cigarette products that currently may be lawfully sold in the U.S.
Both Esco Bars and Elf Bar products are made in China, and the FDA said an import alert gives the agency the authority to detain the products without physically examining them at the time of entry.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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Epidemics & Outbreaks
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Idiopathic hypersomnia (IH) is a sleep disorder without a cure. Itâs not well-understood. Even experts donât know what causes it.
Your sleepiness might get in the way of your daily life. When that happens, you might find that people around you donât get how hard your symptoms are to manage.
But remember that IH is a medical condition. Itâs not your fault.
âItâs really important that people realize they are not their illness,â says Lynn Marie Trotti, MD, associate professor of neurology at Emory University School of Medicine in Atlanta. âTheir illness is a thing that has happened to them.â
Your doctor can help you come up with a treatment plan. You might need medication, talk therapy, or lifestyle changes. It can be a challenge to adjust to life with IH. But there are strategies that can help.
Make Sleep a Priority
Most adults need about 7 to 9 hours of sleep every day. Â But people with IH are different.
âThey can sleep more than 11 hours every single night,â says Sabra Abbott, MD, assistant professor of neurology and sleep medicine at Northwestern Feinberg School of Medicine in Chicago.
You may not feel very awake even if you sleep a lot. But you still need to get a good nightâs rest. The effects of not getting enough sleep will likely hit you harder than someone who doesn't have IH.
âSleep is less of an optional thing,â Abbott says. âNot that sleep is optional for anybody, but [people with IH] are going to be much less likely to be able to function well if they [stay up late] and only get 5 to 6 hours of sleep.â
Get Help at Work and School
Abbott says she knows some people with IH whoâve tried all kinds of alarm clocks, yet they still oversleep.
âWeâve gone through all the technology thatâs out there: the alarm clock that jumps off the table and rolls across the room, the alarm clock that requires you to do math equations to turn it off.â
If you have trouble waking up in the morning, Abbott says you should put some workplace accommodations in place. That could be a flexible or later start time or a conversation with your boss to raise awareness about IH. Itâs important for your employer to know your tardiness is due to a medical condition, she says, not âlaziness or irresponsibility.âÂ
The same goes for school. If your child has IH, their teacher or an administrator should be aware of their condition. They might be late sometimes because they âliterally couldnât wake up,â Trotti says.
IH can affect learning in other ways. Trotti says it can cause symptoms such as brain fog, poor memory, or trouble concentrating. So when it comes to longer classwork, she says it can be really helpful for people with IH to get extra time or breaks.
âI have [people] who need to stand up during prolonged classes or tests to help them stay awake,â she says. âSometimes people will have a small snack. Anything to try to maintain alertness.â
Try Behavioral Therapy
Cognitive behavior therapy (CBT) is a type of talk therapy. The goal is to change unhelpful thoughts and behaviors to boost your quality of life. These techniques should fit alongside other kinds of medical treatment for IH.
CBT might work for you in a few different ways. It might:
Help reframe your thoughts. Abbott says many people with IH âspend their whole lives being told, âOh, youâre lazy; you donât try hard enough; youâre not doing the right things.ââ She says it can be helpful to think about IH as a biological disorder. Thatâs something a counselor can help you do.
Ease anxiety and depression. Thereâs plenty of evidence that CBT can ease mental health symptoms for all kinds of ongoing illnesses. Thatâs good news because âthereâs a lot of overlap between almost all sleep disorders and anxiety and depression,â Abbott says. âAs you probably know, if you donât sleep well, you donât feel very well. And if you donât target one, then the other one is going to get worse.â
Manage your time. Psychologist Jason C. Ong, behavior sleep medicine director for Nox Health and adjunct associate professor of neurology and sleep medicine at Northwestern Feinberg School of Medicine in Chicago, created a pilot program called CBT for hypersomnia (CBT-H). His early research shows that people with IH can get more done while sleepy when they break up their day.
âPeople with hypersomnia might not be able to approach the day like others do -- in one big chunk --Â because they get sleepy much faster,â Ong says. âBy splitting up the day into smaller chunks of time, it becomes more manageable and easier to take corrective action.â
Ongâs CBT-H program isnât widely available just yet, though he says some therapists are using it. But based on his research, you should:Â
- Keep a diary of how you spend your day.
- Rate how sleepy you are throughout the day.
- Divide your day into blocks: morning, afternoon, and evening.
- Find ways to manage your energy during those smaller chunks.
Ask your counselor about ways to recharge and stay alert. That might include:
- Medication
- Exercise
- Light exposure during the day
- Relaxation techniques, such as mindfulness
Unlike people with narcolepsy, experts donât suggest daytime naps for people with IH. In fact, if you do take a nap, you may get âsleep drunkennessâ afterward. That means itâll be really hard to wake up or you may get a strong urge to go back to sleep.
Educate Those Around You
IH can feel like youâve taken a sleeping pill that never wears off. But people without a sleep disorder may not grasp what that really feels like for you. Thatâs because âsleepiness is the sort of thing that every human being has experienced at one time or another,â Trotti says.
âItâs easy for people without hypersomnia to say, âWe all get sleepy. Just suck it up. Have some coffee and take a nap.ââ
You might be able to shed some light on your symptoms if you bring your loved ones to your appointments. Your doctor can go over why everyday strategies donât work for you, and they can explain how your sleepiness isnât something under your control.
âWhen I have the opportunity in that setting, I try very hard to make it clear that this is a disease that has happened to someone,â Trotti says. âThis is not something that someone is doing to themselves.â
Find Support
You might feel less alone if you connect with others who know what youâre going through. âEspecially since people who are diagnosed with idiopathic hypersomnia -- itâs something theyâve never heard of before,â Trotti says.
Search for support through national organizations such as the Hypersomnia Foundation or online through social media. Ask your health care provider or social worker if there are groups in your area that can help.Â
Show Sources
Photo Credit: Robert Kneschke / Getty Images
SOURCES:
Lynn Marie Trotti, MD, associate professor, department of neurology, Emory University School of Medicine.
Sabra M. Abbott, MD, PhD, assistant professor of neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine
Jason C . Ong, PhD, behavioral sleep medicine director, Nox Health; adjunct associate professor, department of neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine.
Genetic and Rare Diseases Information Center: âIdiopathic hypersomnia.â
Sleep Medicine Clinics: âIdiopathic Hypersomnia.â
Journal of Clinical Sleep Medicine: âDeveloping a cognitive behavioral therapy for hypersomnia using telehealth: a feasibility study.â
Hypersomnia Foundation: âParticipating in Support Groups as a Person With Idiopathic Hypersomnia.â
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Mental Health Treatments
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Terry Dubrow is doing fine after suffering a recent medical emergency.
Terry's family became worried when he briefly started slurring his speech during the meal. This prompted The Real Housewives of Orange County star to have Nicholas call 911. While paramedics said his vitals were normal, Heather wanted further testing and ultimately convinced Terry to visit the hospital. And it appears her instincts were spot on.
After conducting tests, doctors confirmed Terry experienced a TIA, which is a brief blockage of blood flow to part of the brain that can temporarily cause stroke-like symptoms. Thankfully, the brief episodes typically don't cause lasting damage.
During the exam, doctors also discovered the 64-year-old had a patent foramen ovale (or PFO) which is a hole in the heart that didn't close the way after birth. Terry was told a blood clot passed through the PFO, traveled to his brain and caused the TIA.
Fortunately, doctors were able to treat Terry on the spot and he's fully recovered. Now, Terry is reflecting on the surprising health scare.
"I learned many things from this terrifying experience," the famed plastic surgeon exclusively told E! News on Aug. 9. "One: If you or anyone around you shows possible signs of a stroke time is critical, you have five hours to get to a hospital to save your life. Two: If you have traveled recently, make sure you move frequently to keep blood flowing to prevent clots. Three: PFO is more common (20-30%) than people realize and TIAs and strokes can occur in anyone at any age."
Giving credit to Heather, Terry added, "Listen to your partner. If they are concerned about something don't argue, don't ignore and get it checked out right away. What they see may be very different than what you perceive. Be grateful for those who love you. I love my wife, thank god for Heather and her persistence and insistence. She truly saved my life."
TMZ was first to report the news.
"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 shared with fans 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."
Hailey underwent the same PFO procedure to the close the hole in her heart. On the one-year anniversary of her surgery in April, the model shared she's "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."
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Disease Research
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Dorissa White has known since she was 12 that she would get a nose job one day. In 2022, after years of being teased and bullied for her distinctive nose, a feature that she said “goes back many generations” in her family, the 30-year-old content creator sat in a plastic surgery clinic in Istanbul, ready to undergo an ethnic rhinoplasty.
Unlike the traditional nose job, an ethnic rhinoplasty, a term that has been used since 2003, is intended to change the appearance of the nose without diminishing its cultural and ethnic markers. The end result is usually more subtle than a typical nose job.
After two years of researching and WhatsApp consultations with representatives for prospective clinics abroad, White settled on Dr. Yusuf Orhan. She traveled from New York City to Turkey for her procedure and documented the process for her YouTube channel.
For $4,500, White was able to get the procedure and also a 10-day stay at a five-star hotel to recover.
White had compiled a mood board of dream noses that included images of various models and P-Valley actor Shannon Thornton, who herself has refuted claims that her nose is the work of a surgeon.
“I showed it to Dr. Orhan, and each one he said was unrealistic for my anatomy; at one point, he said, ‘I’m not even going to try that,’” White said. “I appreciated that because I knew that he was not going to give me this small pinched nose. Just because we think something looks good doesn’t mean that it will look good on us.”
In White’s case, to create more projection and reduce the size of her prominent nose, cartilage from her rib was removed to form a stiff graft that the skin would heal against. The need to harvest cartilage from elsewhere in her body is often a component of an ethnic rhinoplasty, which differs from a traditional rhinoplasty.
Three months after the operation, White has no regrets. “Many people tried to talk me out of it, and they told me that I needed to love myself,” she said. “But the thing is, you can love yourself until you’re blue in the face. But if you don’t like something, there’s nothing that is going to convince you otherwise.”
Today, TikTok is awash with examples of nose transformations, with around 4 billion views on videos with the #ethnicrhinoplasty hashtag. According to Google Trends, interest in the procedure has climbed over the past 12 months.
“I think ethnic rhinoplasty begins with the awareness that there are cultural variations and deviations in relationship to facial appearance,” Dr. Anthony Brissett, director of facial plastic surgery at Houston Methodist Hospital, told BuzzFeed News.
Deciding on the best course of action when doing an ethnic rhinoplasty is “an interesting conundrum,” Dr. Nima Shemirani, a plastic surgeon in Beverly Hills, told BuzzFeed News. “Can you respect someone’s ethnicity yet still make it look attractive and nice as if that person was born with it? I think that’s where the artistry comes in. We morph images to see what would fit on that person’s face.”
White desired a slimmer bridge, finished with a rounded tip, sometimes referred to as a button nose. While it’s still early in her recovery — it could take up to a year for her nose to fully heal — she is already satisfied with the work. “I feel like it is still fairly big, but it fits my face,” she said. “It’s much smaller than my original nose, but it’s not this super small nose that doesn’t look realistic on my face.”
Beyond its biological function, the nose is considered a defining feature in establishing facial harmony and symmetry. In addition, certain characteristics came to be associated with different groups of people and maligned thanks to harmful biases and designations.
In Sander L. Gilman’s 1999 book Making the Body Beautiful: A Cultural History of Aesthetic Surgery, the literary historian details how in the 18th and 19th centuries, the nose was a signifier of beauty and an indicator of moral standing and character. “The noses of the black and the Jew were signs of their ‘primitive’ nature,” he writes. “This was primarily because the too-flat nose came to be associated with the inherited syphilitic nose. In this view, flattened noses are nature’s moral comment on the hygiene of a ‘race’ in terms of both racial difference and dangerousness.”
Decades and several trend shifts later, the archetypal Black nose, with its wide bridge and flare nostrils, is still a source of shame for some Black people, who use methods like contouring, a makeup technique that uses shadow and product to create the illusion of a slimmer nose. But some critics have spoken out against such techniques. “Somewhere along the way, Black women have started to drink the proverbial ‘kool-aid,’” Briana McCarthy wrote for Essence magazine in 2020. “We’ve allowed a standard that doesn’t even consider us to seep into our beauty routines. We’ve begun to believe the lie that ‘our’ noses are bad and ‘theirs’ are better. Why else would we contour them?”
Similarly, in 2022, beauty entrepreneur Bobbi Brown, who is Jewish, pushed back against the contouring trend and shared how she turned down her mother’s offer to get a nose job as a young girl, once a popular trend for affluent Jewish teenagers.
Historically, Black celebrities who got plastic surgery opened themselves up to intense scrutiny and speculation about what procedures they may or may not have had while fighting accusations of self-loathing. Digital publication Atlanta Black Star didn’t hold back when it published a 2013 list of “10 Black Celebs Caught Expressing Self-Hate” and included the likes of Lil’ Kim, NeNe Leakes, and Tyra Banks as offenders for their decision to undergo plastic surgery. In 2020, talk show host Wendy Williams told her studio audience how she was “vilified, hung, suspended without pay” in the ’90s for her various surgical procedures, which she spoke openly about.
The Jackson family and their evolving faces have long been the subjects of speculation and tabloid ridicule. Janet, the youngest of the siblings, spoke candidly about undergoing a nose job at 16 years old. “Would I do it again? I don’t know. I’ve seen a lot of women that have been pulled and snatched, and it’s not too cute,” she told Extra in 2006.
For the past two decades, according to Houston Methodist Hospital’s Brissett, “the aesthetic norm was more strongly based on Western influence. And so, when a patient of ethnic descent, whether it be Black, Hispanic, Asian, or any of the above, went to see a plastic surgeon, and it was for a rhinoplasty, oftentimes what they were getting was a change in nasal appearance based on Western norms and standards.”
Brissett said he often saw clients who weren’t happy with the results. “I was then forced to do a racial or cultural restoration, trying to bring patients back more towards what their noses could or should look like in relationship to their racial features,” he said.
Research from the American Society of Plastic Surgeons confirms that the pandemic has had a general influence on the rising number of people getting plastic surgery for various reasons, including the so-called Zoom boom, or the phenomenon of people becoming hyperfixated on their on-camera appearance because of remote working.
People of color have been among the most rapidly growing category of patients. According to the American Society of Plastic Surgeons, from 2000 to 2013, the number of procedures performed on ethnic patients increased by 243%.
This is likely due to several factors. Among them is the fact that plastic surgery is less taboo than ever, especially in racial and ethnic minority communities.
The boom of reality TV makeover shows in the 2000s demystified the process, showing viewers what was possible. And more celebrities have spoken candidly about their procedures. In 2011, Kelly Rowland made it clear that she had no regrets after undergoing breast augmentation back in 2007. And after years of gossip, rapper Cardi B confirmed during an Instagram Live that she had had a rhinoplasty back in 2020, telling fans, “I had my daddy’s nose. That had to go.”
When celebrities aren’t ready to speak up, the litany of social media posts dedicated to determining what work they may or may not have gotten has threatened the veil of secrecy. YouTubers like Lorry Hill have built entire brands by offering their assessment of how famous faces and bodies are being augmented.
There’s also the fact that cosmetic procedures are increasingly affordable. A rhinoplasty, which can cost north of $15,000 in Beverly Hills, can now be bought for a third of that price in Turkey, with an all-inclusive vacation to go with it. This accessibility has been a major driving force in determining who has the means to make their aesthetic revisions a reality.
Most importantly, perhaps, new developments in the procedure itself have meant patients can be optimistic about obtaining better results than in the past. “We’re still learning new things about the nasal anatomy to this day that we didn’t know 20 years ago,” Shemirani said. “The evolution has changed from removing too much cartilage to adding cartilage grafts, and now to respecting the anatomy and reshaping and restructuring.”
Shemirani, who has nearly two decades of experience as a surgeon, performed around 200 rhinoplasties last year, around half of which he says were for nonwhite patients.
“I’ve had Middle Eastern patients who have a big hump [on their nose], but they want to leave a little bump to maintain their ethnicity. That’s a common request,” Shemirani said.
Performing a rhinoplasty on people of color is a process that comes with certain considerations for anatomy, which Shemirani says surgeons plan and prepare for. “Black noses are very similar to Asian noses, the skin’s a little bit thicker, so if someone wants a little bit more definition, you have to address the skin. [Also] the cartilage, which is underneath, is the framework that the skin rests on [and] is a little bit weaker, so you really have to reinforce the nose,” he explained. “We take cartilage grafts from inside the nose. In some cases, especially with Asian and Black noses, there isn’t enough cartilage inside the nose, so sometimes we take rib cartilage because you want a strong post so that when the skin heals against it, it’ll shrink-wrap nicely and it won’t just crumple under the pressure of healing.”
Saima Kay’s decision to undergo a rhinoplasty was primarily medical but also an opportunity to address the simple truth that she was not the biggest fan of her nose.
“I've always disliked my nose, but it was never something that I was insecure about,” said the 29-year-old, who is Pakistani and based in Dubai. “My logic when thinking about something is that if you can change it, then do it. Life's too short to not go ahead.”
“Being South Asian, you have your features, right? I didn’t want to lose that completely,” Kay said. “Don't get me wrong; my nose is very different from what it was. But I felt like if it had gotten any smaller or changed anymore, then that would take away the ethnic element.”
After months of experiencing difficulties breathing and repeat sinus infections, Kay got an X-ray last January that confirmed she had a deviated septum.
“From that point, I was like, OK, cool, this is my confirmation to get a nose job. So initially, I looked at septoplasty,” she said, referring to the procedure that corrects a deviated septum.
After researching septoplasty, Kay decided that the most cost-effective option for addressing her medical and aesthetic concerns would be to get a combined rhinoplasty and a septoplasty, known as a septorhinoplasty. The procedure would reposition her nasal septum to the middle of her nose and also address its shape and size.
Within weeks, the content creator had done thorough research, compiled spreadsheets of her options, and consulted with doctors in the UK, the United Arab Emirates, and Turkey before settling on a surgeon in Istanbul for a fee of just over $3,000.
“I read everything that I possibly could to see which doctor was the best because I’ve seen bad nose jobs, and I didn’t want to go through a procedure where I end up hating it even more at the end and was incurring double the cost,” Kay said.
Nine months after the operation, while Kay can acknowledge that she is “a lot more confident,” she hasn’t ruled out any further procedures.
“I spoke to my doctor about that, and if I’m still not happy with it once it completely heals, he said that we’ll do a slight procedure to just shave a bit of it away,” she said.
Her decision to alter her appearance generated mixed responses when she shared it with her followers online; people were particularly vocal on TikTok, where she has just under 5,000 followers.
“I had a lot of people saying, ‘Oh my god, you’re getting rid of your ethnic features; your Pakistani nose was nice.’” she said. “And I made a [response] video where I was like, ‘why are you holding just my nose to my ethnicity? I’m not praised for holding on to my curly hair, so why is it this one thing that I am doing, my personal preference, being attacked?” Presently, Kay’s nose is three months shy of the projected healing time, and its subtle changes have been noticed by some friends, while others say “they can’t tell the difference.”
But Kay said she can now sleep through the night. And she feels positive about her profile when she tilts her head to the left, which she considers her “good side.”
It’s been two years since Ayeshah Atsegbua had her procedure done. Like White and Kay, she traveled to Turkey for the rhinoplasty, which cost around $5,000.
“When I got to the point where my nose was fully healed, my confidence level was just on another level, and I’m so happy that I got it done,” she said.
The 26-year-old nurse, who is from New York, spent some of her formative years at a high school in Nigeria, where her nose didn’t necessarily deviate from the standard but still wasn’t entirely to her satisfaction. “When you’re around African people in Nigeria, you don’t think about your features, because everyone there has a big nose, big lips, you know what I mean? So it wasn’t really a thing. I did always know that I didn’t really like it that much, but it wasn’t like, oh my god, I’m gonna go fix this one day,” Atsegbua said.
After relocating to the UK, the registered nurse began considering the available options for revising her nose. “I literally saw one girl from the UK post a YouTube video,” she said. “I loved how her nose looked, and she showed the doctor. She did a vlog of the whole situation. So I’m like, OK, this is perfect. I hit him up on his Instagram.”
Atsegbua was clear in her request, telling her doctor that she wanted a slimmer nose, and a higher tip, but most importantly, she didn’t want the result to be “super small, where it looks like a white person’s nose.”
Concerned that her immediate family would disapprove or try to dissuade her from getting the surgery, Atsegbua did not disclose her plans to them.
“My mom lives in the UK, and I live in New York with my aunt, so I was hiding from her for like a month. When she finally saw me, she’s like, ‘Hmm, you look different,’” Atsegbua said.
She told her aunt that she had undergone a rhinoplasty and eventually explained her decision to her mother. “My mom called me and gave me the whole speech — Oh my god, why would you get it done? — but when she finally saw me in person, she actually said she loved my nose job.”
Fear over how people would react also meant that Atsegbua did not initially share her transformation with her online followers and friends.
“I guess I was still afraid some people might judge,” she said. “You didn’t hear about Black people getting their noses done often. You hear about it now, but when I got it done, I didn’t really know any person that had ever done it.”
In a world where the aesthetic decisions of Black women, especially, are frequently scrutinized and politicized, neither White nor Atsegbua are interested in defending their decision to get plastic surgery or debating critics who make assumptions about how they feel about their Blackness.
“I don’t think it takes away from my being African or hides my features. I’m always like, if you don’t like something, change it,” Atsegbua said.
White echoed that sentiment. “I think it’s possible to embrace yourself, but I look at a nose job like I look at braces. People will try to convince you not to get a nose job. But they won’t convince you not to get braces. Why don’t you love your teeth the way they are?” White said. “I don’t think that we can say, ‘Love yourself more.’ It’s deeper than that.” ●
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Medical Innovations
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The Centers for Disease Control and Prevention is warning U.S. residents about a possible increase in mpox, formerly known as monkeypox, this spring and summer, according to a memo the health agency issued Monday morning.
The increase could come as people ditch their homes in favor of festivals and events with lots of crowds this spring and summer, the health agency said.
In fact, the CDC is currently looking into 12 confirmed mpox cases and one possible case in the Chicago area. The cases were reported between April 17 and May 5 to the Chicago Department of Public Health.
The cases in Chicago were reported by the CDC just days after the World Health Organization said the mpox public health emergency was over.
What is mpox, formerly known as monkeypox?
Mpox is an uncommon disease that's triggered by an infection from the mpox virus and, in rare cases, can be fatal, the CDC states.
The disease was previously known as monkeypox, but the World Health Organization renamed it mpox to get rid of the stigma that associated the disease with monkeys. (Monkeys don't spread the virus, but it was first identified in them decades ago, hence the original name.)
A global mpox outbreak started in May 2022 and as of May 10, more than 30,000 cases have been reported in the United States. In July 2022, WHO Director-General Tedros Adhanom Ghebreyesus declared there was an mpox global emergency.
Mpox cases are down but it may not stay that way, CDC says
Cases of mpox peaked in August and have gone down since then, but "the outbreak is not over," the CDC said Monday.
In reference to cluster of cases in Chicago, the CDC said all of them were among symptomatic men. None of the people involved were hospitalized.
The CDC also said that among the 13 cases confirmed or probable cases in the Chicago area:
Nine out of 13 were among men who had received multiple vaccine doses.
Nine were non-Hispanic White men, two were non-Hispanic Black men and two were Asian men.
The median age was 34 years old (between 24 and 46 years old).
Four people had recently traveled to areas including New York City, New Orleans and Mexico.
Experts from Northwestern University Feinberg School of Medicine in Chicago encouraged people in the area to be cautious.
“Clearly, this gives us pause that vaccine immunity may not be lasting long in some patients despite full vaccination,” said Dr. Alexandre Carvalho, an infectious diseases fellow at Northwestern, in a news release. “People will likely let their guards down in this first post-pandemic summer, go out to meet others, have fun. However, with the virus circulating, we must encourage people to take precautions and practice safe sex.”
What are the symptoms of mpox?
Symptoms include a rash, possibly on the hands, feet, chest, face, mouth and near the genitals, the CDC said on its website. The agency said the mpox incubation period is 3 to 17 days and during this period, people won’t have symptoms and may feel OK.
The rash starts off by looking like pimples or blisters and may be itchy and painful. Before the patient heals, the rash will undergo several stages, the CDC said, including scabbing.
Some people also have flu-like symptoms before the rash sets in, the CDC said, while others may develop a rash first and then suffer from other symptoms.
According to the CDC, other symptoms of mpox include:
Fever
Chills
Swollen lymph nodes
Exhaustion
Muscle aches and backache
Headache
Respiratory symptoms such as sore throat, nasal congestion or cough
Patients mqy experience some symptoms but not all of them, the agency said.
How long do symptoms last and how is the disease transmitted?
Once a person develops symptoms, they’re capable of spreading mpox, the CDC said. Spreading can continue until the rash has fully healed.
The CDC also cited new data showing that as of February 2023, some people can spread mpox one to four days before their symptoms begin.
“There is currently no evidence showing that people who never develop symptoms have spread the virus to someone else,” the CDC said.
What should I do if I think I have mpox?
The CDC says people who think they have the disease or have been in contact with someone who tested positive should contact a doctor. From there, the doctor can determine if they need to be tested.
Until that happens, the CDC recommends avoiding close contact such as sex until they have been seen by a doctor.
For those without health insurance, public health clinics are an option.
What the CDC says about mpox vaccines
The CDC said it does not recommend routine immunization against mpox for the general public and instead urged healthcare providers to offer it to people at high risk for exposure to the disease.
Those at higher risk include people who were exposed to someone who tested positive for it or people who have had sexual contact in the past two weeks with someone was diagnosed with mpox.
The CDC also said the list of potentially high-risk mpox patients includes gay people, bisexual people, men who have sex with men and transgender or nonbinary people who have been diagnosed with a sexually transmitted disease in the past six months.
People who have sexual contact at commercial sex venues and sex workers are also at risk, the CDC said.
“To help prevent a renewed outbreak during the spring and summer months, CDC is urging clinicians to be on alert for new cases of mpox and to encourage vaccination for people at risk,” the CDC said in its announcement Monday.
“If mpox is suspected, test even if the patient was previously vaccinated or had mpox. Clinicians should also refamiliarize themselves with mpox symptoms, specimen collection, laboratory testing procedures, and treatment options.”
More USA TODAY health coverage:
This article originally appeared on USA TODAY: What is mpox? What to know about symptoms, vaccines, cases
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Epidemics & Outbreaks
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What's happening Supernatural, a popular VR fitness app bought by Meta last year, is creating workout playlists focused on individual artists. Why it matters Fitness is one of the big reasons non-gamers have started adopting virtual reality, but VR fitness still has a long way to go. What's next Workouts on Katy Perry tracks will land June 27, followed some for Imagine Dragons, The Weeknd, Swedish House Mafia, Kid Cudi, Coldplay and Lady Gaga. Meta's virtual reality fitness subscription Supernatural is launching new workout collections with one artist's music fueling the playlist for boxing and cardio target smashing in VR. The first "Supernatural Artist Series" will feature Katy Perry tracks in a boxing routine and a "flow" workout -- the kind of target-slicing and obstacle-dodging concept that most people first tried in Beat Saber. The planned line-up of more Artist Series workout collections includes Imagine Dragons in July, The Weeknd in August, Swedish House Mafia in September, Kid Cudi in October, Coldplay in November and Lady Gaga in December. The workouts, like everything in the Supernatural app, are part of a standard subscription, which costs $19 a month or $180 a year. The app itself works on the Quest and Quest. It connects with Apple Watches and other fitness trackers to log real-time heart rate, working similarly to Apple Fitness Plus and Amazon's Halo fitness video service.Supernatural was one of the first subscription-based services on the Oculus Quest (now the Meta Quest). Meta bought the company behind Supernatural in October. That happened to be soon after COVID-19 lockdowns suddenly trapped much of the world inside their homes, without open gyms or even the certainty, at the time, that outdoor exercise would be safe if you entered the proximity of a stranger. Interest in virtual reality -- and VR fitness -- jumped during the pandemic. VR was one of technology's buzziest trends a few years ago, but hype fizzeld as widespread adoption of VR remained elusive for years. But interest in virtual reality -- and VR fitness -- jumped during the pandemic, as COVID-19 lockdowns suddenly trapped much of the world inside their homes. The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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Aerobics & Cardio
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The government-backed 988 Suicide & Crisis Lifeline's LGBTQ pilot program is now offering text and chat services 24/7 in what officials are calling a "major step forward" for the multimillion-dollar prevention program.
"We are thrilled that the 988 Lifeline LGBTQ+ pilot line will be expanding services across all modalities," said Dr. Tia Dole, the chief lifeline officer at Vibrant Emotional Health, which administers the service. "We know that LGBTQIA youth are one of the most at-risk communities for suicide. Vibrant, SAMHSA and 988 want to be there to change that through affirming care."
"Expanding this service is a major step forward in strengthening 988, the mental health safety net for all people in America," Dole added.
The lifeline's LGBTQ-specific pilot program launched in September after an initial $7.2 million investment from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).
The users have already been able to dial 3 after calling to reach a crisis counselor trained to support LGBTQ youth and young adults, with call services available 24/7, but chat and text had only been available during select hours.
From the beginning of the program in September through Feb. 26 (the most current available data), about 11% of chats and texts coming through the lifeline have been for the LGBTQ line, along with 6% of calls -- accounting for about 138,000 total contacts -- a spokesperson for SAMHSA told ABC News.
"We want all young people who are experiencing a mental health or substance use crisis or who are feeling suicidal to know they can call, text or chat 988 any time of day without fear of judgment and with the expectation that when they do reach out for help, they are met with affirming, compassionate support," said Dr. Miriam Delphin-Rittmon, the head of SAMHSA. "So far, the demand for the services provided by this pilot program have exceeded even our own expectations. This response has shown us the value in providing a specialized service for LGBTQI+ young people, who we know are at higher risk for suicide."
In January, $29.7 million in additional money was appropriated to help expand training and access for this program through the fiscal year 2023 federal government funding bill.
About 45% of LGBQ students seriously considered suicide and more than 20% attempted suicide in 2021, according to the Centers for Disease Control and Prevention's Youth Risk Behavior Survey trends report for 2011-2021. That compares to about 15% of heterosexual students who seriously considered suicide and about 6% who made an attempt during that same year, according to the CDC report.
Kasey Suffredini, vice president of advocacy and government affairs for The Trevor Project, an LGBTQ suicide prevention group, said that his organization is "incredibly excited" about the expansion of the chat and text offerings.
"Increasing access to LGBTQ-inclusive crisis care services is critical for addressing the public health crisis of youth suicide, as we know LGBTQ youth continue to face unique challenges, victimization, and barriers to care across all 50 states," he said.
"When an LGBTQ young person reaches out for help in a moment of crisis -- where every second counts -- it's vital that they are met with compassion and care from a trained counselor who understands them," Suffredini said. "This expansion of services is another step forward in reimagining crisis care in the U.S., as we continue the collective work to raise awareness of the 988 Lifeline among the most marginalized communities and build upon its infrastructure to expand access to non-police crisis intervention responses and long-term mental health, behavioral health and addiction care."
If you are experiencing suicidal, substance use or other mental health crises, please call or text the new three-digit code at 988. You will reach a trained crisis counselor for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org.
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Mental Health Treatments
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Scientists have unearthed 188 previously unknown types of CRISPR systems buried in the genomes of simple microorganisms.
Best known as a powerful gene-editing tool, CRISPR actually comes from an inbuilt defense system found in bacteria and simple microbes called archaea. CRISPR systems include pairs of "molecular scissors" called Cas enzymes, which allow microbes to cut up the DNA of viruses that attack them. CRISPR technology takes advantage of these scissors to cut genes out of DNA and paste new genes in.
The new study, published Nov. 23 in the journal Science, expands the known diversity of CRISPR systems in microorganisms and could open new avenues for precise gene editing with fewer "off-target" effects, the researchers said.
The team discovered the new CRISPR systems by scanning millions of genomes of microorganisms using an algorithm called fast locality-sensitive hashing-based clustering, or FLSHclust (pronounced "flash clust"). The algorithm works by very efficiently grouping similar objects together and is designed to hunt down genes related to CRISPR. The researchers used FLSHclust on three massive public datasets that contain billions of DNA and protein sequences from bacteria.
"This new algorithm allows us to parse through data in a time frame that's short enough that we can actually recover results and make biological hypotheses," co-first study author Soumya Kannan, formerly a doctoral student and now a postdoctoral scholar in the Broad Institute/MIT Department of Biology, told MIT News.
FLSHclust accomplishes in weeks what previous algorithms would achieve in months, MIT News reported.
After finding the new types of CRISPR, the researchers experimented with four of the systems to start understanding how they work.
The CRISPR systems that scientists previously knew about came in six flavors — types I through VI — which differ in size, the enzymes they use and how they latch onto genetic material, Nature reported. (The first CRISPR system ever identified is a type II system and uses a single enzyme called Cas9 to cut through DNA, while other types use different or multiple Cas enzymes.)
Out of the four CRISPR clusters the team experimented with, two were variants of type I CRISPR systems and one was type IV. Both type I systems made small, precise cuts in DNA in human cells, the team demonstrated. Scientists think that type I systems could potentially be less prone to making accidental, off-target cuts than CRISPR-Cas9, so they could be useful for gene editing, according to MIT News.
The final cluster was a whole new type of CRISPR, which the team dubbed type VII. Like some other CRISPR types, it targets RNA, a molecular cousin of DNA that's key for building proteins. So in theory, type VII systems could be useful for RNA editing.
That said, it's too soon to say whether type VII CRISPR systems or any of the other genes identified by FLSHclust will be helpful for genetic engineering, co-first study author Han Altae-Tran, formerly a graduate student at Broad Institute/MIT Department of Biology and now a postdoctoral scholar at the University of Washington, told Nature.
The next step will be to sift through more of the newfound systems to see how their component parts work and whether they could feasibly be used in gene editing, Nature reported.
Ever wonder why some people build muscle more easily than others or why freckles come out in the sun? Send us your questions about how the human body works to community@livescience.com with the subject line "Health Desk Q," and you may see your question answered on the website!
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Nicoletta Lanese is the health channel editor at Live Science and was previously a news editor and staff writer at the site. She holds a graduate certificate in science communication from UC Santa Cruz and degrees in neuroscience and dance from the University of Florida. Her work has appeared in The Scientist, Science News, the Mercury News, Mongabay and Stanford Medicine Magazine, among other outlets. Based in NYC, she also remains heavily involved in dance and performs in local choreographers' work.
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Medical Innovations
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They’re being hailed as an effective way to lose weight, but diabetes drugs like Ozempic may come with a heightened risk of severe gastrointestinal problems.
That’s according to new research from the University of British Columbia showing that medications known as GLP-1 agonists—which includes brands like Wegovy, Ozempic, Rybelsus and Saxenda—are associated with an increased risk of serious medical conditions including stomach paralysis, pancreatitis and bowel obstruction.
While previous studies highlighted some of these risks in patients with diabetes, this is the first large, population-level study to examine adverse gastrointestinal events in non-diabetic patients using the drugs specifically for weight loss. The findings were published today in JAMA.
“Given the wide use of these drugs, these adverse events, although rare, must be considered by patients thinking about using them for weight loss,” said first author Mohit Sodhi, a graduate of UBC’s experimental medicine program and fourth year UBC medical student studying the adverse events of commonly prescribed medications. “The risk calculus will differ depending on whether a patient is using these drugs for diabetes, obesity or just general weight loss. People who are otherwise healthy may be less willing to accept these potentially serious adverse events.”
GLP-1 agonists were originally developed for managing Type 2 diabetes, but exploded in popularity over the past decade as an off-label weight-loss tool, reaching approximately 40 million prescriptions in the U.S. in 2022.
It was only in 2021 that some forms of the medications were approved as a treatment for obesity. However, randomized clinical trials examining the efficacy of the medications for weight loss were not designed to capture rare gastrointestinal events due to their small sample sizes and short follow-up periods.
“There have been anecdotal reports of some patients using these drugs for weight loss and then presenting with repeated episodes of nausea and vomiting secondary to a condition referred to as gastroparesis,” said senior author Dr. Mahyar Etminan, an epidemiologist and associate professor in the department of ophthalmology and visual sciences at the UBC faculty of medicine. “But until now, there hasn’t been any data from large epidemiologic studies.”
To help fill this knowledge gap, UBC researchers examined health insurance claim records for approximately 16 million U.S. patients and looked at people prescribed either semaglutide or liraglutide, two main GLP-1 agonists, between 2006 and 2020. They included patients with a recent history of obesity, and excluded those with diabetes or who had been prescribed another antidiabetic drug.
The researchers analyzed the records to see how many patients developed one of four gastrointestinal conditions, and compared that rate to patients using another weight-loss drug, bupropion-naltrexone. Compared to bupropion-naltrexone, GLP-1 agonists were associated with a:
- 9.09 times higher risk of pancreatitis, or inflammation of the pancreas, which can cause severe abdominal pain and, in some cases, require hospitalization and surgery.
- 4.22 times higher risk of bowel obstruction, whereby food is prevented from passing through the small or large intestine, resulting in symptoms like cramping, bloating, nausea and vomiting. Depending on the severity, surgery may be required.
- 3.67 times higher risk of gastroparesis, or stomach paralysis, which limits the passage of food from the stomach to the small intestine and results in symptoms like vomiting, nausea and abdominal pain.
The study also found a higher incidence of biliary disease, a group of conditions affecting the gall bladder, but the difference was not found to be statistically significant.
The researchers say that although the events are rare, with millions around the world using the drugs, it could still lead to hundreds of thousands of people experiencing these conditions.
“These drugs are becoming increasingly accessible, and it is concerning that, in some cases, people can simply go online and order these kinds of medications when they may not have a full understanding of what could potentially happen. This goes directly against the mantra of informed consent,” said Sodhi.
In the meantime, the researchers hope that regulatory agencies and drug makers will consider updating the warning labels for their products, which currently don’t include the risk of gastroparesis.
“This is critical information for patients to know so they can seek timely medical attention and avoid serious consequences,” said Sodhi.
Interview language(s): English, Punjabi (Sodhi), Farsi (Etminan)
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Drug Discoveries
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The U.S. Drug Enforcement Administration stripped one of the nation's largest drug distributors of its license to sell highly addictive painkillers Friday after determining it failed to flag thousands of suspicious orders at the height of the opioid crisis.
The action against Morris & Dickson Co. that threatens to put it out of business came two days after an Associated Press investigation found the DEA allowed the company to keep shipping drugs for nearly four years after a judge recommended the harshest penalty for its “cavalier disregard” of rules aimed at preventing opioid abuse.
The DEA acknowledged the time it took to issue its final decision was “longer than typical for the agency” but blamed Morris & Dickson in part for holding up the process by seeking delays due to the COVID-19 pandemic and its lengthy pursuit of a settlement that the agency said it had considered. The order becomes effective in 90 days, allowing more time to negotiate a settlement.
DEA Administrator Anne Milgram said in the 68-page order that Morris & Dickson failed to accept full responsibility for its past actions, which included shipping 12,000 unusually large orders of opioids to pharmacies and hospitals between 2014 and 2018. During this time, the company filed just three suspicious order reports with the DEA.
Milgram specifically cited testimony of then-president Paul Dickson Sr. in 2019 that the company’s compliance program was “dang good” and he didn’t think a “single person has gotten hurt by (their) drugs.”
“Those statements from the president of a family-owned and operated company so strongly miss the point of the requirements of a DEA registrant,” she wrote. “Its acceptance of responsibility did not prove that it or its principals understand the full extent of their wrongdoing ... and the potential harm it caused."
Shreveport, Louisiana-based Morris & Dickson traces its roots to 1840, when its namesake founder arrived from Wales and placed an ad in a local newspaper selling medicines. It has since become the nation's fourth-largest wholesale drug distributor, with $4 billion a year in revenue and nearly 600 employees serving pharmacies and hospitals in 29 states.
In a statement, the company said it has invested millions of dollars over the past few years to revamp its compliance systems and appeared to hold out hope for a settlement.
“Morris & Dickson is grateful to the DEA administrator for delaying the effective date of the order to allow time to settle these old issues,” it said. “We remain confident we can achieve an outcome that safeguards the supply chain for all of our healthcare partners and the communities they serve.”
Morris & Dickson’s much larger competitors, a trio of pharmaceutical distributors known as the Big Three, have already agreed to pay the federal government more than $1 billion in fines and penalties to settle similar violations. Cardinal Health, AmerisourceBergen and McKesson also agreed to pay $21 billion over 18 years to resolve claims as part of a nationwide settlement.
While Morris & Dickson wasn’t the only drug distributor who the DEA accused of fueling the opioid crisis, it was unique in its willingness to challenge those accusations in the DEA’s administrative court.
In a scathing recommendation in 2019, Administrative Law Judge Charles W. Dorman said Morris & Dickson’s argument that it has changed its ways was too little, too late.
Anything less than the most severe punishment, the judge said, “would communicate to DEA registrants that despite their transgressions, no matter how egregious, they will get a mere slap on the wrist and a second chance so long as they acknowledge their sins and vow to sin no more.”
But as the ensuing years passed, neither the Biden-nominated Milgram nor her two predecessors took any enforcement action. Past DEA officials told the AP such decisions usually take no more than two years.
As the pills kept flowing, Morris & Dickson attempted to stave off punishment, appealing directly to Milgram to order a reopening of the proceedings, arguing it would introduce new evidence showing it had implemented an “ideal” compliance program with the help of a consultant who is now second-in-command at the DEA, Louis Milione. The DEA said that Milione has recused himself from all agency business related to Morris & Dickson.
Milione retired from the DEA in 2017 after a 21-year career that included two years leading the division that controls the sale of highly addictive narcotics. Like dozens of colleagues in the DEA’s powerful-but-little-known Office of Diversion Control, he went to work as a consultant for some of the same companies he had been tasked with regulating.
Milione was hired by Morris & Dickson in 2018 as part of a $3 million contract and later testified that the company “spared no expense” to overhaul its compliance systems, cancel suspicious orders and send daily emails to the DEA spelling out its actions.
A footnote of the DEA’s order Friday said that since Milione returned to the DEA as principal deputy administrator in 2021, he has not had any contact with Milgram or other agency staff about the Morris & Dickson case due to his prior involvement with the company.
___
Goodman reported from Miami, Mustian from New York. Contact AP’s global investigative team at Investigative@ap.org.
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Drug Discoveries
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"I remember just getting scratch-cards, winning, losing, opening more and more accounts online - and before I knew it, I was a gambling addict," says 28-year-old Rebecca, whose gambling began when she was struggling with post-natal depression.
After the scratch cards, Rebecca started betting on horses, even though she knew nothing about racing. "I was looking for this dopamine hit - that side of my brain was going: gamble, gamble, gamble," she says.
Last summer, Rebecca spent five weeks at the UK's first women-only residential gambling centre, where addicts who have hit rock-bottom get a chance to turn their lives around.
The BBC was given exclusive access to the centre - an unassuming terraced house in Birmingham.
Rebecca says it was upsetting to be away from her children for so long, but since leaving the clinic she hasn't gambled, and she is feeling positive about the future. She says relapsing "isn't an option".
Letter of desperation
Like Rebecca, gambling completely took over 34-year-old Caroline's life. She once spent £30,000 online in three months.
She would stay up gambling in her bedroom until the early hours of the morning.
"You've got no concept of time. You isolate yourself," she says. "It was the lowest point of my life, because everything around me, I was destroying."
Before getting treatment at the clinic last October, things got so bad that she contemplated ending her life. It's clearly still painful to talk about, but she wants to share her story in the hope it might help others.
"I felt that the only way was to not be here," Caroline says. "Life would be easier for everybody. It would be cheaper for everybody."
She chokes up when she tells me that she sat in her car last May and wrote a final letter to her parents - until she had a change of heart.
"It wasn't worth taking that way out because I knew I could get better if the help was there - I keep that letter as a reminder to myself now."
A safe space
The treatment centre is in central Birmingham. As you walk through the door of the terraced house, you're immediately greeted with a poster full of messages of support, written by women who've been through the programme themselves.
One message reads simply: "This place saved my life."
Artwork and messages of positivity decorate every surface - even inside kitchen cupboards.
The place feels homely, with comforting touches. Each resident is welcomed with a letter written by the woman who last stayed in their room.
The clinic is run by the charity Gordon Moody, and this is the first time they've allowed the media in since opening towards the end of 2021.
In that time the number of women applying for treatment at the clinic has more than doubled, from 77 in the first year to 210 at the end of March this year.
Women can refer themselves to the centre, or it can be done by a health professional or another gambling organisation.
The centre's manager, Harp Edwards, says the women who are treated here are at the "top level" of need, because they may be self-harming or feeling suicidal.
"They feel like it's the last straw for them, so coming into treatment is kind of like their last option," she says.
During their stay, the women have limited access to phones, money and any online services, so that they can't gamble. But the centre also limits the women's exposure to their daily lives, "so all the stresses of the outside world are kind of gone", says Edwards.
The residential programme has been designed around women's needs.
"I think the importance of having a female-only treatment is that it allows a woman to be in a safe space and focus on women-only issues as well," Edwards says.
Information and support
If you or someone you know needs support these these organisations might be able to help you
The stay for women is shorter - just five weeks compared with 14 weeks for men - because they often have children to care for. And Edwards says there are other differences too, for example women want to focus more on what personal experiences may have led to their gambling, and how it affects their relationships.
"Men tend to talk about the gambling first before we look at trauma, whereas women go straight in with the impact that gambling might have had on them," she says.
The intensive five-week programme involves daily therapy and psycho-educational sessions, as well as creative workshops, where the women are encouraged to express their feelings.
Elissa, 36, admits she didn't get involved in the workshops when she first arrived, saying she was too "rigid" - now she jokes that she's "not rigid, just rubbish" at the crafts.
She tells me she started gambling on slot machines in arcades when she was just nine years old.
She managed to keep it a secret from her friends and family for years, but things really escalated when she started gambling online at all times of day - even at work.
"In between every job I would be gambling. If I was on call at work, I'd be gambling," Elissa says.
"I'd be coming home from work, gambling before the kids or me missus came home. I started taking my phone into the bathroom with me when I was having a bath, things like that."
Since leaving the centre, Elissa has moved to a different part of the country, and is now training to run gambling recovery groups herself.
Tighter regulations?
An estimated 22 million people gamble each month in the UK. The numbers of women receiving support for gambling addiction has more than doubled in five years, with 1,134 women receiving treatment in 2015-16 and 2,423 in 2020-21, according to figures from the charity GambleAware.
Elissa, Caroline and Rebecca all feel that more regulation is needed in the gambling sector, as well as more treatment programmes like this one - which are largely paid for by the gambling industry. But Rebecca questions the motive behind this funding.
"Do they do it because they have general concerns for their customers that are spending thousands and thousands of pounds on their website?" she asks. "Or do they have to put that in place because that's the law?"
The Betting and Gaming Council - which represents the industry in the UK - told the BBC in a statement: "We are encouraged by the latest figures from the independent regulator, the Gambling Commission, which show the rates of problem gambling among UK women is 0.1% - down from 0.2% the previous year."
They added that the industry will donate £110m by next year to tackle harmful gambling, and that advertising and sponsorship must comply with strict guidelines.
The house in Birmingham is a temporary base for the clinic, which is moving to a more permanent and bigger site in Wolverhampton later in the year. Then it will be able to accommodate three more women on each programme - at the moment it can just take five at a time.
They'll also have recovery beds for people who need to stay longer at the end of their treatment.
It means they'll be able to help more women like Rebecca, Elissa and Caroline, who credit the clinic with changing their lives for the better.
"Thank you for everything," Elissa tells the staff. "You've taught me how to love myself."
Photography by Dave Bull
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Mental Health Treatments
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Aug. 7, 2023 â The FDA has approved the first oral drug for postpartum depression, a condition that affects an estimated one in seven mothers in the United States.
The pill, zuranolone (brand name Zurzuvae), is a steroid that acts on certain receptors in the brain that regulate mood, arousal, behavior, and cognition, according to drugmaker Biogen. The recommended dose for Zurzuvae is 50 milligrams taken once daily for 14 days, in the evening with a fatty meal, according to the FDA.
Postpartum depression often goes undiagnosed and untreated. Many mothers are hesitant to reveal their symptoms to family and doctors, fearing they'll be judged on their parenting. A 2017 study found that suicide accounted for roughly 5% of deaths before or after delivery among women in Canada, with most of those deaths occurring in the first 3 months in the year after giving birth.
"Postpartum depression is a serious and potentially life-threatening condition in which women experience sadness, guilt, worthlessness â even, in severe cases, thoughts of harming themselves or their child,â Tiffany R. Farchione, MD, director of the Division of Psychiatry at the FDA's Center for Drug Evaluation and Research, said in a statement about the approval.
It can also impact the maternal-infant bond, she said, and "have consequences for the child's physical and emotional development" as women cope with âextreme, and sometimes life-threatening, feelings."
The other approved therapy for postpartum depression is an IV drug. But the product requires long infusions in hospital settings and costs $34,000.
FDA approval of Zurzuvae was based in part on data reported in a 2023 study in the American Journal of Psychiatry, which showed that the drug led to significantly improved depressive symptoms at 15 days, compared with a placebo group. Improvements were seen on day 3, the earliest assessment, and were sustained at all visits during the treatment and follow-up period (through day 42).
Patients with anxiety who received the active drug showed improved symptoms, compared with patients who received a placebo.
The most common side events reported in the trial were sleepiness, drowsiness, and headaches. Weight gain, sexual dysfunction, withdrawal symptoms, and increased suicidal behavior were not seen.
The packaging for Zurzuvae will include a boxed warning noting that the drug can affect a user's ability to drive and perform other potentially hazardous activities, possibly without their knowledge of the impairment, the FDA said. As a result, the agency said that people who use Zurzuvae should not drive or operate heavy machinery for at least 12 hours after taking the pill.
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Drug Discoveries
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The Centers for Medicare and Medicaid Services (CMS) said in a statement Thursday that it will cover the medications once they are fully approved by the Food and Drug Administration, but will also require providers to collect data for patient registries about how the drugs perform in the real world.
That policy is in line with the commitment the CMS made in 2022 when it first announced its plans to restrict coverage.
The treatments in question are monoclonal antibody infusions that target brain plaque known as amyloid. The medications are intended for early stage Alzheimer’s patients, and are meant to slow the progression of memory loss, but are not a cure.
Currently, Medicare will only pay if a patient receives the treatment through a clinical trial.
Eisai’s Leqembi is one of two treatments that have already been granted accelerated approval. It costs $26,500 a year, and could get full approval within the next month.
Critics said no other medication has a similar requirement, and questioned whether coverage would really be able to start the same day a drug gets approved.
The Alzheimer’s Association in a statement called the registry an “unnecessary barrier” and pressed CMS to provide more details.
“What specific data will CMS require for the registry? What is the registry system and how accessible is it? What is the plan for clinician and health system education?” said Robert Egge, the group’s chief public policy officer.
Registries can be time consuming for physicians, and their practices need to have the right infrastructure to support CMS data collection requirements. Patients also need to be able or willing to participate.
“Every time burdens are placed on physicians, we know fewer will offer a treatment resulting in fewer in need having access to treatment,” Egge said. “Those in already underserved communities are the most likely to be impacted.”
CMS in its statement said registries are “common tools in clinical settings that have successfully gathered information on patient outcomes for decades. There is strong precedent for using registries to gather more information on a newly-approved treatment.”
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Health Policy
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Men undergoing treatment for prostate cancer could be safely given far less radiotherapy, a major trial has found.
Doses can be cut by three-quarters meaning five higher doses is enough, instead of the 20 or so given now.
The international trial involved nearly 900 men with medium-risk prostate cancer that had not spread.
Lead researcher Prof Nicholas van As from the Royal Marsden Hospital said the results were "outstanding" and "fantastic" for patients.
Prostate Cancer UK said the finding had the potential to save time and money for the NHS, while still giving men the best outcomes.
It means thousands of men could be given larger doses of radiotherapy - also known as multi-beam radiotherapy - at each hospital visit, but less overall.
The study found that after five years, 96% of the men who received five doses of the multi-beam radiotherapy were cancer-free, compared to 95% who received at least 20 doses of standard radiotherapy.
Side effects, such as needing to pass urine more often, were low in both groups.
The top-line results of the PACE-B trial will be released at the American Society for Therapeutic Radiation and Oncology (Astro) conference in San Diego.
Prof van As said he expected the results to lead to "enormous change" in the way radiotherapy was delivered.
'I was treated so rapidly'
Alistair Kennedy-Rose, 64, from the West Midlands, was diagnosed with prostate cancer in 2014 after a blood test which showed his prostate-specific antigen (PSA) levels were raised.
"I had no symptoms at all so it was a shock to find I had cancer," he told the BBC.
He was treated at the Royal Marsden as part of the trial using Cyberknife, a robotic radiotherapy machine, and had all five sessions in the same week and did not receive hormone therapy.
"The treatment was pretty easy. There were no side effects and it was all over very quickly, allowing me to continue living my life to the full," he said.
"I was treated so rapidly it's hard to come to terms with the fact that I ever had cancer."
He has annual tests for his PSA levels, which remain extremely low, and says doctors have told him his treatment is likely to have cured him.
Doses saved
Prof van As said he expected that the NHS would "rapidly adopt" the lower-dose treatment.
"Across the whole NHS that's hundreds of thousands of doses of radiotherapy that are going to be saved," he said.
"And in a system which is quite under pressure, that's going to be very welcome."
Prof van As says an estimated 8,000 men a year might meet the criteria of having intermediate risk prostate cancer which had not spread.
They could therefore benefit from the change by having all their treatment in a week rather than spread over at least a month.
In the UK, 20 doses of radiotherapy are the standard treatment, but in other countries like the US they use up to 40 doses.
Another key element of the trial was that none of the 874 men were given any hormone therapy to block testosterone, a driver of prostate cancer.
Hormone therapy has multiple side effects including severe tiredness, hot flushes and low libido.
Simon Grieveson, assistant director of research at Prostate Cancer UK, said: "It's fantastic to see that this new type of multi-beam therapy appears to be just as effective as traditional radiotherapy, and could help men get treated more quickly, and with far fewer visits to the hospital."
Mr Kennedy-Rose encouraged other men to get checked out.
"It's vital that men over 50 have a routine PSA test, or, if their doctor deems it necessary, an MRI scan," he said.
"Then, if cancer is found early they can have easy treatment with the fewest side effects, which I fortunately have benefited from."
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Medical Innovations
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Three weeks after one of the deadliest school shootings in U.S. history, some relatives of students gunned down at Robb Elementary School say they're hopeful about the federal anti-gun violence proposal announced by a bipartisan group of senators Sunday.But others say they're dissatisfied with the extent of the proposed legislation and the lack of answers in their community.The agreement, if passed into law, would provide funding for mental health, including behavioral health centers, and create incentives for the creation of so-called "red flag" laws to remove firearms from people who are a danger to themselves or others; increase money for school safety; and strengthen the federal background check system as it relates to convicted domestic violence abusers or those with restraining orders.Amelia Sandoval, whose grandson Xavier Lopez was killed in the attack, told ABC News that she has not been watching news coverage while she processes her grandson's death. But when briefed on the proposed legislation, she choked up, saying, "Praise God. This is just the beginning, but praise God."Briana Ruiz, whose child survived the shooting, told ABC News that the proposed measures just aren't enough."I feel like it's a pathway to hopefully, eventually get to what many are asking for ... but the age limit should have been raised as well," she said, referring to the requirements to purchase an AR-style weapon like the one used in the attack.Ruiz, who at one point was a teacher's aide in accused shooter Salvador Ramos' class, said she laments how an 18-year old in Texas cannot buy beer or cigarettes, but can purchase an AR-15.Flowers are laid at a makeshift memorial at Robb Elementary School in Uvalde, Texas, May 28, 2022.Chandan Khanna/AFP via Getty Images, FILETwenty-two people, including 19 young children, were killed in the attack in Uvalde, Texas, on May 24.Some in Uvalde said the proposed legislation is important, but it's not their primary focus right now.Monica Garza-Herrera, a relative of fourth-grade victim Amerie Jo Garza, said she was glad to hear about the federal framework -- but she said she's looking for local answers as well."What I want to know is what they're going to do as far as here in our hometown to change things for our students that are still in school," Garza-Herrera told ABC News.She said there's pain in the community, and she worries about whether her grandchildren and her sister, who is a teacher in the school district, are safe. She also wants to know if faster action on the part of law enforcement could have saved more children's lives."Could they have been saved, even though they were shot?" she said. "Would they have gotten in there sooner? What do they plan to do about that? That's what I'm waiting for them to tell us."While those answers may take time, President Joe Biden said he hopes to move quickly to get the legislative framework adopted into law. The framework has the backing of 10 Republicans, which suggests that, if adopted, the proposal would have enough votes overcome its biggest hurdle in the Senate."Each day that passes, more children are killed in this country," Biden said. "The sooner it comes to my desk, the sooner I can sign it, and the sooner we can use these measures to save lives."
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Mental Health Treatments
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About 500 patients in the Western Isles could have appointments disrupted because some flights to the mainland are to be suspended for six weeks.
Airline Loganair announced the planned suspension last week saying it was due to industrial action by airport staff.
Services are set to be affected from 17 March until at least the end of April.
NHS Western Isles said it was potentially facing some of the worst disruption to patient services it had experienced.
The health board said about 230 of the patients involved had medical appointments booked on the mainland, while up to 270 more were due to be seen by a visiting consultant.
Affected people include ear, nose and throat, eye and urology patients.
But BBC Scotland has also spoken to a cancer patient who has raised concerns his previously cancelled tests may need to be rescheduled again.
NHS Western Isles said it had been able to ensure patients travelling between Uist and Stornoway in Lewis for chemotherapy would be unaffected.
It also said blood and chemotherapy deliveries were also currently operating as normal.
So far, NHS Western Isles has also been able to make alternative arrangements for about 100 patients. The workarounds have included booking ferry travel for visiting consultants, or for patients to attend clinics in Inverness.
Efforts continue to help get appointments for other patients facing possible disruption.
'Worst possible time'
The health board said there was no capacity in either Glasgow or Edinburgh to accept additional patients from the Western Isles.
Chief executive Gordon Jamieson said: "With the exception of the pandemic, this action potentially presents us with the most significant disruption to patient services that we have experienced.
"Whilst there would never be a 'good' time for a service reduction, this action has come at the worst possible time when there is already significant pressure on the NHS, which makes it difficult to secure alternative options for patients."
A number of unions at Highlands and Islands Airports Ltd (Hial) rejected a pay offer last year, and their members' industrial action has involved working to rule and strikes.
On Friday, Loganair said the industrial action was unpredictable and that it was impossible to reasonably assure the provision of a service.
It said services from Inverness to Stornoway and Benbecula, and from Inverness to Kirkwall and Sumburgh, could be affected until at least Sunday 30 April.
Earlier this week, Hial and unions involved in the industrial action said there were hopes of resolving the pay dispute.
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Epidemics & Outbreaks
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New device allows the brain to function independently from the bodyThe innovative system is known as extracorporeal pulsatile circulatory control (EPCC).Mrigakshi DixitPublished: Nov 20, 2023 05:45 AM ESTscienceRepresentational imageGrafissimo/iStock Get a daily digest of the latest news in tech, science, and technology, delivered right to your mailbox. Subscribe now.By subscribing, you agree to our Terms of Use and Policies You may unsubscribe at any time.Researchers have created a novel technology that allows the brain to work independently without relying on biological input from the rest of the body.This innovation opens new avenues for studying pure brain activity, detached from the body's influences.“This novel method enables research that focuses on the brain independent of the body, allowing us to answer physiological questions in a way that has never been done,” said Juan Pascual of UT Southwestern Medical Center, who led this development, in an official release.The innovative system is known as extracorporeal pulsatile circulatory control (EPCC).The potential applications of this deviceThe brain plays a major role in the execution of various physiological processes, like heart rate, breathing, and the sleep-wake cycle, to name a few. See Also Related Alzheimer’s impact beyond memory, study finds broader brain effects Prolonged time on tech devices does harm children’s brains: 33 studies Simultaneously, the brain's performance is subject to influences originating from the body, such as blood sugar levels, blood pressure, and oxygenation.According to the authors, until now, there has been no practical approach for separating the brain from the body to research how these factors impact brain function. But now, the EPCC provides a unique chance to investigate the complexity of brain activity in a regulated, isolated setting.As per the official release, this device functions by isolating blood flow to the brain, thereby sustaining the organ and enabling it to operate independently from the rest of the body for several hours.The device underwent testing using a pig brain model. In this experimental model, researchers diverted the blood flow to the brain via a pump, allowing them to control blood pressure, volume, temperature, oxygenation, and nutrition levels. Over five hours, the researchers noticed little to no change in brain activity and other factors. They've already utilized this technique to learn more about the impact of hypoglycemia, or low blood sugar, in isolation from other influencing factors.This device can potentially improve heart-lung bypass technology by simulating natural blood flow to the brain.“Cardiopulmonary bypass devices replicate some functions of the heart and lungs, delivering a continuous flow of oxygenated blood throughout the body. In contrast, the new device delivers blood using a pulsative flow, much like the human heart, a difference that may prevent brain-related side effects sometimes caused by cardiopulmonary bypass machines," explained the release. The results were reported in the journal Scientific Reports.Study abstract:Selective vascular access to the brain is desirable in metabolic tracer, pharmacological and other studies aimed to characterize neural properties in isolation from somatic influences from chest, abdomen or limbs. However, current methods for artificial control of cerebral circulation can abolish pulsatility-dependent vascular signaling or neural network phenomena such as the electrocorticogram even while preserving individual neuronal activity. Thus, we set out to mechanically render cerebral hemodynamics fully regulable to replicate or modify native pig brain perfusion. To this end, blood flow to the head was surgically separated from the systemic circulation and full extracorporeal pulsatile circulatory control (EPCC) was delivered via a modified aorta or brachiocephalic artery. This control relied on a computerized algorithm that maintained, for several hours, blood pressure, flow and pulsatility at near-native values individually measured before EPCC. HomeScienceAdd Interesting Engineering to your Google News feed.Add Interesting Engineering to your Google News feed.SHOW COMMENT (1) For You How much water is there on the Moon? Maybe not enoughLow oxygen levels prompted the appearance of first multicellular organismsPower meets precision in Noble's latest masterpiece, the M500Astronauts use circadian lightning, and so can youPlant-based meat sales are plummeting. Here’s why.World's tallest, longest & fastest rollercoaster to debut in Saudi ArabiaOpenAI employees to board: You resign, or we willInto the unknown: How Sun dimming to save ice is both bold and riskyUK turns to AI, robotic dogs to reduce bomb-disposal risksThe first bomber of the 21st century is a marvel of engineering! Job Board
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Medical Innovations
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Despite what some of the truest of believers might contend, legalization of marijuana would come with costs to Ohioans. But an economic analysis that was released last week found that the benefits would outweigh those costs by a quarter-billion dollars a year.
Issue 2, an initiative that would legalize recreational marijuana for people over 21 in Ohio, is on the ballot in next Tuesday’s election.
A study by Columbus-based Scioto Analysis attempts to identify the pluses and minuses that would come with such a move in a state where medical marijuana is already legal.
To do the analysis, the group used studies from states such as Washington and Colorado, where recreational weed has long been the law. To examine how the pros and cons identified in those states might play out in Ohio, the researchers looked at economic and census data, as well as at crime statistics.
The biggest benefit they identified has to do with the extra revenue passage of Issue 2 would produce, with its 10% excise tax on top of Ohio’s normal sales tax. But the report explains that the benefit isn’t merely from the $190 million a year legalization is expected to generate, but instead from how a big portion of those funds would be spent.
“Tax revenue on its own is not a social benefit, but rather a transfer from taxpayers to the public sector that is then used to pay for goods and services purchased by the government,” it says. “Thus, benefits are only generated when goods and services purchased by governments have positive spillovers.”
The positive spillovers the researchers identified were the 36% of revenue Issue 2 earmarks for the Cannabis Social Equity and Jobs Fund and the 25% earmarked for the Substance Abuse Addiction Fund.
Working with analyses of similar funds in other states, the group estimated that the Ohio equity and jobs fund would create $5.76 in benefits for every dollar spent and the substance abuse fund would create $9.19. Thus, the Scioto Analysis report said, directing revenue to those two funds could be expected to create $820 million worth of benefits for Ohioans each year.
Then there are the jobs the new industry would create directly.
“Our models predict that Ohio will add roughly 3,300 new jobs in the first year after legalization,” the report said. “Assuming these jobs are full time and pay matches the average wage across the state of Ohio, this will amount to about $190 million in wage benefits for workers across the state. Since these jobs are likely to include part-time work and may be lower than the average wage across the state, this may represent an upper bound on the value of employment generated by legalization.”
There also would be benefits for recreational weed users themselves. The study estimates that by creating a legitimate recreational market, Issue 2 would allow that group to pay $98 million a year less for marijuana than they otherwise would be willing to pay.
And if weed is no longer illegal for adults over 21, it stands to reason that there will be fewer arrests.
“One study on arrest rates in Washington found that marijuana arrests fell by 87% for adults aged 21+ and by 46% for adults aged 18-21 after legalization of the sale and purchase of cannabis for recreational purposes,” the study said. “This confirms that for the population that would be allowed to legally use cannabis recreationally, arrests almost completely disappear, but the effect is smaller for the population where it would still be illegal to use cannabis.”
It added, “Using data from the FBI’s Uniform Crime Report on the number of cannabis-related arrests in Ohio, we estimate that there would be about 4,400 fewer arrests per year if recreational cannabis were legalized. Adding up the cost of those arrests, and assuming that 6% of those people would have been convicted of felonies, this amounts to over $38 million in savings for Ohio.”
But the expected benefits of legalized recreational marijuana have to be weighed against the expected costs.
A big one stems from the fact that in states that have already legalized, workers became less productive.
“One study from 2017 found that across four industries (mining; construction; arts, entertainment, and recreation; and accommodations and food Service) average productivity per worker fell by just over 1% in states that legalized recreational cannabis,” the report said. “Monetized, this equates to roughly $900 of lost productivity per worker for Ohio.”
There are a lot of workers in Ohio, and using federal employment data, the report said, “we estimate that legalizing recreational cannabis will cost workers across the state about $760 million in lost productivity in the first year of legalization.”
There are also negative public-safety implications associated with legalizing recreational pot. Namely, more intoxicated drivers would be on the road, and “this will lead to more car crashes that cause property damage, injury, and death,” the report said. It estimated that legalization would lead to an additional 1,700 intoxicated-diving arrests each year in Ohio and come at a cost of $130 million.
Balancing benefits and costs, the study estimated that Ohioans would receive $260 million in annual benefits if Issue 2 passes next Tuesday.
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Health Policy
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Wales does not have a functioning NHS and people do not have faith in it, claims the head of a doctors' union.
Dr Iona Collins, of the British Medical Association in Wales, said people suffering with chest pain "don't even know" if an ambulance will come.
Latest figures show a higher percentage of people are waiting two years or more for treatment in Wales than England.
The Welsh government said it's spending more to help the NHS recover from the pandemic and cut waiting times.
One patient who has given up waiting for a hip replacement will travel to Lithuania for treatment on Monday, paying £10,000.
Nicky Morris from Aberaman, Rhondda Cynon Taf, waited 18 months before she saw a consultant.
She was shocked when she then called her local hospital, the Royal Glamorgan in Llantrisant, for an update and said she was told no orthopaedic operations had been performed there since 2020.
Mrs Morris asked: "'Am I safe to say that in two years' time is when you're going to be catching up?", and said the person she spoke to could not even say that would be the case.
But time is not on Mrs Morris's side, as she has a muscle wasting condition which means delaying the operation could mean she would never be able to walk again.
She will go to Lithuania to get the hip operation done privately, which is costing her £10,000 and has meant her partner has had to take out a loan on his house.
"It's going to take me five years to pay off this hip replacement, and yet for 35 years I've paid National Insurance, I've paid my taxes. I've never been out of work, never needed the NHS more than I do now," she said.
Mrs Morris added: "If I don't go to Lithuania and I wait for the operation, I've got the potential that my underlying condition will now get to the point where I have no muscle to actually walk.
"If I'm no longer able to have surgery, that's it. My life will be over at 52."
'People do not have faith'
Figures for February show more than 37,000 people are waiting more than two years for treatment in Wales, around 5% of those waiting.
That is down from around 60,000 last July, or 8% of the total.
But the figures for England are much lower, currently standing at 0.014%.
Dr Collins said despite the fall in numbers, Mrs Morris's case was "a symptom of failure", and the situation was desperate.
"We do not have a functioning service now. People do not have faith in the service," she said.
"If you have chest pain you don't even know if an ambulance is necessarily going to come. We see really tragic reports in the press where people arrive too late."
However, Mark Dayan from the health think tank the Nuffield Trust, said there had been some improvement.
"If you look at figures from the last few months, on the one hand there has been some progress in a number of things in waiting times in Wales," he said.
"They've actually improved for urgent care, and at the same time the gap for the average person on the waiting list has shrunk with England.
"However, when you compare Wales to Scotland and England, the absolute amount of time that people are waiting is still considerably longer, particularly at the longest end."
On the different figures for the longer waiting lists, he added: "It's probably true that the health services in England and Scotland have put a particularly aggressive emphasis on cutting off the longer waiters first, and had some success in doing that.
"But it's not indisputably a good thing, because actually there is a really difficult moral choice to make between the person who's been on the list for longest and the person who actually needs care most."
Age Cymru head of policy Heather Ferguson said: "There is much that can be done to reduce the effects of long waiting times such as clinicians providing their patients with advice on waiting well to help prevent conditions deteriorating.
"We are worried that if older people are forced to wait too long for their procedures that their condition will deteriorate, leading to a loss of self-confidence, and a gradual withdrawal from life."
In response to the waiting list issue, a Welsh government spokesperson said: "We count more referrals in our waiting times statistics than England - such as referrals for non-consultant treatment by allied healthcare professionals, diagnostic and therapy waits and audiology waits.
"We are cutting longer waiting times in Wales. Total waits of over two years fell by 47% in February 2023 compared to their peak in March 2022, and the lowest since October 2021."
On Dr Collins's comments, the spokesperson added: "We are proud of our NHS, the first universal health system of its kind.
"We have committed more than £1bn extra this Senedd term to help the NHS recover from the pandemic and cut waiting times.
"We are working with health boards and have set ambitious but realistic targets to tackle the pandemic backlog for planned care, backed by significant extra long-term funding."
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Health Policy
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An experimental gene therapy that uses a modified herpes virus shows promise as a brain cancer treatment, according to new research. The Phase I study found evidence that the virus could safely induce an immune response that attacked the often-fatal cancer. It also seemed to extend the length of survival in those who had pre-existing antibodies to the virus.
Brain cancers are some of the hardest to successfully treat, particularly glioblastomas (GBM), the most commonly diagnosed form. GBMs are incredibly aggressive and can quickly spread to other parts of the brain, making total surgical removal next to impossible. Existing radiation and chemotherapy treatments usually fail to finish off the cancer, and GBM is currently considered incurable, with the average length of survival hovering around eight months, according to the National Brain Tumor Society.
But researchers from Brigham and Women’s Hospital and elsewhere believe that they may have found a new way to attack these cancers, using a ubiquitous microbial foe of ours. Their therapy relies on a genetically modified herpes simplex I virus, a germ that usually causes cold sores and, less commonly, genital herpes.
“A reason for failure is that GBM is able to escape your own immune cells that actively fight against the tumor,” study author E. Antonio Chiocca, chair of the department of neurosurgery at Brigham and Women’s, told Gizmodo in an email. “We engineered in our laboratories a tumor selective biologic agent (based on the cold sore virus, herpes simplex virus type 1) to inject into the GBM of patients with the goal to see if we could reshape the GBM to become less able to escape the patient’s immune cells.”
There are other cancer-killing treatments based on the herpes virus, either in development or already approved for specific cancers like melanoma. The team’s creation, dubbed CAN-3110, is a bit different from other therapeutic versions since it still contains a gene that helps the wild herpes virus cause disease in humans, called ICP34.5. Chiocca and his team believe that ICP34.5 is needed to provoke a strong enough immune response to brain cancer cells, but they’ve tried to genetically program CAN-3110 to not attack healthy cells.
In their latest research, published Wednesday in Nature, the therapy appears to be off to a promising start.
The team gave 41 patients with high grade brain and spinal cord tumors, including 32 people with recurrent GBM, a single dose of CAN-3110. Phase I trials are mainly intended to confirm the short-term safety of an experimental treatment, and the treatment did appear to be generally well-tolerated (two patients did experience seizure possibly linked to it). About two-thirds of patients had existing antibodies to the herpes virus, and in these patients, the researchers also found evidence that the treatment boosted the immune system’s response to the cancer. Importantly, the median survival of these patients was around 14 months, compared to just under 8 months for those without previous exposure to herpes.
“Unlike other therapies so far, we have been able to show that one single timepoint administration of CAN-3110 is sufficient to activate the patient’s own immune cells to traffic and fight off the cancer and we show that this links to survival responses,” Chiocca said.
It will take much more research to confirm whether CAN-3110 could be a viable treatment for brain cancer, including in people without past herpes exposure (that said, a majority of people worldwide do carry antibodies to it). CAN-3110 has since been licensed for further development by the company Candel Therapeutics. And thanks to a funding grant from the research foundation Break Through Cancer, Chiocca and his team are already working on their next study, which will hopefully determine the optimal dosing of the therapy.
“We are now doing multiple timepoint injections of CAN-3110 into patients to longitudinally treat the cancer over four months, as well as sampling the GBM being treated to ensure that these immunoactivating programs remain operative,” he told Gizmodo.
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Medical Innovations
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People with post-traumatic stress disorder (PTSD) process sad, non-traumatic memories differently to traumatic memories, new research suggests.
People with PTSD experience intrusive, recurrent flashbacks of traumatic events that are often accompanied by high levels of anxiety and emotional distress.
When people with PTSD experience a flashback, they feel as though they're experiencing the traumatic event again in the present moment, rather than thinking back on it like a typical memory. Now, scientists think they may know why.
A new study in patients with PTSD, published Thursday (Nov. 30) in the journal Nature Neuroscience, revealed that sad, non-traumatic memories are processed in a part of the brain called the hippocampus, while the traumatic memories associated with PTSD activate a region above it known as the posterior cingulate cortex (PCC). Although both brain regions are involved in memory and emotional processing, the PCC is more focused on internally directed thought, such as daydreaming or being aware of one's thoughts and feelings.
By comparison, the hippocampus is responsible for organizing and contextualizing memories.
In the study, the authors wanted to explore what happens in the brain when people with PTSD recall memories. They recruited 28 people with PTSD who recounted three types of memory to a clinician: calm memories, such as walking in a forest; non-traumatic, sad memories, such as the loss of a loved one; and traumatic memories, such as being in a car accident.
Each of these memories was then converted into a script that was read out to patients in two-minute clips while their brains were scanned using a magnetic resonance imaging (MRI) machine. The scans focused on the hippocampus, which helps store long-term memories of events and is also involved in retrieving those memories.
"This brain region is critical for memory, if you have damage in the hippocampus you cannot form new memories," co-senior study author Daniela Schiller, a professor of neuroscience at the Icahn School of Medicine at Mount Sinai, New York, told Live Science.
Patients who had sad, non-traumatic memories that were about the same topic had similar levels of activation in the hippocampus to each other. "What it tells us is that the hippocampus cares or is involved because it is sensitive to these degrees of similarity," Schiller said.
However, the same wasn't the case for traumatic memories, which instead activated the PCC. The more severe a patient's PTSD symptoms were, the greater the PCC activity was.
Using a machine learning algorithm, the researchers determined whether a pattern of brain activation corresponded to a sad or a traumatic memory — meaning they could predict what type of memory a patient was experiencing based on activity in their brain.
More research is needed in larger groups of people, the authors wrote in the paper. However, they hope that the findings could lead to the development of new therapies that tweak brain function to turn these traumatic memories into ones that more closely resemble non-traumatic memories.
"If we find that sad memories are in the hippocampus and these are memories that are not disruptive to you, treatment could aim to make these traumatic memories more like regular memories," Schiller said.
"If treatment works, maybe we will see that they engage the hippocampus when they become more benign," she said.
However, these are currently still aspirations, so it may be a while before any such treatment is available.
This article is for informational purposes only and is not meant to offer medical advice.
Ever wonder why some people build muscle more easily than others or why freckles come out in the sun? Send us your questions about how the human body works to community@livescience.com with the subject line "Health Desk Q," and you may see your question answered on the website!
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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. (emily.cooke@futurenet.com)
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Mental Health Treatments
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A protester waves a sign near the Country Club Plaza Starbucks store where dozens of Starbucks employees and union supporters protested alleged anti-union tactics by the company Thursday, March 3, 2022.Jill Toyoshiba | Tribune News Service | Getty ImagesStarbucks is telling its baristas that unionizing could jeopardize the gender-affirming health care coverage for transgender employees that the company offers, according to a complaint filed with the federal labor board.The complaint comes after more than 100 of the coffee chain's 9,000 U.S. cafes have voted to unionize under Workers United in the last seven months. Under interim CEO Howard Schultz, Starbucks has been trying to counter the union push by emphasizing the potential shortcomings of collective bargaining, such as federal labor laws that prohibit the company from unilaterally hiking wages across unionized cafes without contract negotiations.The union's latest complaint against Starbucks, first reported by Bloomberg, was filed Monday. A transgender employee at an Oklahoma City location told the publication that she believed her manager used a "veiled threat" in a conversation. The manager reportedly told the employee that her benefits could improve, stay the same or worsen if the store unionized and referred specifically to her use of the trans health-care benefits.Starbucks spokesman Reggie Borges told CNBC that the claim is false.The company's health insurance has covered gender reassignment surgery since 2012 and a wider array of gender-affirming procedures, like hair transplants or breast reduction, since 2018. Last month, the coffee chain announced it would cover travel expenses for gender-affirming surgeries as state lawmakers target transgender rights.As of mid-March, more than 150 anti-trans bills had been introduced in state legislatures seeking to limit access to health care, sports, bathrooms and education, according to NBC News. Oklahoma, for example, has passed three anti-trans laws this year.Starbucks often touts its long history of supporting LGBTQ+ workers and the broader community, particularly during Pride Month in June. The company notes its decades-old policies including health care coverage for same-sex domestic partnerships and employees with terminal illnesses, inspired by Starbucks worker who died of complications from AIDs.
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Health Policy
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After surviving a brain tumor, Victoria Vesce was faced with another major health scare.
It was in late 2022 when the model, like many others, was in Miami for Art Basel. The 29-year-old was at a late-night event when she realized something was not right.
"I just didn’t feel good," Vesce recalled to Fox News Digital. "I remember telling my friends, and they were like, ‘Victoria, you need to call a doctor and get checked.’ But I was so busy being out and about. I was so caught up in the swirl of all the parties and everything that was going on."
"I was having so much fun during this weekend of art and parties," she shared. "But then I went in shock when my left side was starting to go completely numb. That’s when I thought, ‘I gotta go to the hospital now.’ It was a really scary situation. I hadn’t felt that since my brain tumor diagnosis. It was a wake-up call."
SI SWIM MODEL VICTORIA VESCE RECALLS OVERCOMING ‘NIGHTMARE’ BRAIN TUMOR: ‘I HAD EVERY SYMPTOM IN THE BOOK’
In 2017, the former finalist for Sports Illustrated’s Swim Search was diagnosed with multiple paraganglioma, a brain-skull tumor and a carotid body tumor that required surgery and pinpoint radiation treatment. Following her recovery, Vesce was told she had a ministroke.
Doctors previously had to leave remnants of Vesce’s tumor alone because it wraps around her brain stem. Vesce said if touched, she could be "instantly paralyzed or have a stroke." She is fully deaf in her right ear and suffers from tinnitus.
"With my tumor, there are complications that I can experience with it," Vesce explained. "Thankfully, the ministroke was kind of on the low end. But it was a wake-up call like, ‘Hey, let’s stay in tune with your health and keep those stress levels low.’ When I had some numbness on the left side of my face, I didn’t realize what was going on. I was just so busy, on the go. But I’ve been more in tune with my health."
"There were periods where I kind of went back to my old ways before my tumor and just kind of dilly-dally along," admitted the former NBA dancer for the Charlotte Hornets. "Sometimes you just have to have another little wake-up call to be like, ‘Hey, at the end of the day, you’ve gotta put your health first. You’ve got to get all your checkups and talk to your doctors periodically.’ It doesn’t matter if you can do all the things you can do – having good health needs to always come first if you want to continue doing the things you love."
Vesce said she had a close-knit circle of friends and family who were on hand during her recovery. She also relied on her faith in God, especially on days she felt blue.
"Sometimes I have to backtrack because I’ll lose that sight," she explained. "I’ll sit there and go, ‘Why me? How am I still going? Why am I still here?’ But honestly, it’s my faith in God that gives me hope. Without that, I would be nothing. And with it, I’m everything. My faith is what gets me through every day. It’s what got me through my whole journey. There have been some dark periods where I’ve just thought that maybe it’s better if I’m not here. My faith always brings me back. It brings me back to life. My faith is my hope, and my hope is my faith."
"There are days when I go through something that brings me down," Vesce continued. "But at the end of the day, as long as I have God and I have a heartbeat, and I’m still here, then I still have a purpose. And there are still so many things I want to accomplish. You’re going to hear a lot of nos. You’re going to get a lot of rejection. But that hasn’t stopped me. It used to affect me badly, but my faith is what pushes me forward. My faith is the fuel to my fire."
The star said that getting a diagnosis of a ministroke "made my heart drop." However, she was determined to come out of it stronger. There are new goals that need to be fulfilled, like traveling to 80 countries. Vesce wants to honor her late mother, whose passion was traveling.
VICTORIA VESCE, SI SWIM MODEL AND BRAIN TUMOR SURVIVOR, RECEIVES HONOR DURING MIAMI SWIM WEEK: 'THIS FUELS ME'
"I knew it’s something that can happen with my brain tumor," said Vesce about her ministroke. "I always knew in the back of my mind that there’s a possibility there could be complications and these things could happen. I just didn’t think it would happen now. It was not at the forefront of my mind. But thankfully, I just really rested. I took probably two weeks to just stay in a very low-stress environment. I feel like I was really in a high-stress situation when that happened, and I just wasn’t taking care of myself as I should have. I was doing way too much and not putting my health first."
Vesce said the left side of her face is still numb. Smiling can be a struggle. As part of her regimen to prioritize her health, she has been exercising more, cutting back on alcohol and getting adequate sleep daily. Vesce said she is taking a smarter approach to staying busy.
"I just got back from traveling abroad," she said. "I have taken rest periods, but I also had the opportunity to go to Egypt, Morocco and New York City for Fashion Week. I continue to exercise and get proper rest, which everybody needs. I’m always go-go-go, so it’s not always easy, but I feel everybody needs that rest period. I don’t push myself. And I’m on top of all my tests to make sure my vitals are good, and I can get back into the swing of things with ease… I’m going to get those stamps on my passport, but I want to also make sure I am at the top of my game health-wise."
One dream that Vesce has fulfilled is appearing in last year’s SI Swimsuit issue. She was chosen among thousands of submissions to be photographed by acclaimed SI photographer Yu Tsai.
"It opened so many doors for me," she gushed. "But it also gave me the ability to share my story with so many people. It came during a dark time in my life when I just really needed that spark of joy again… It pushed me to do more things and have a vision for myself that’s larger than life. It inspired me that I could make my dreams a reality. I’m extremely grateful for what SI did for me."
"I was able to achieve something so wonderful during a horrible period in my life," she shared. "When I look at those photos today, it shows me that I am resilient. I am powerful. I can conquer my dreams even in the darkest hour… I went through so much, and I was able to break through and cross out something that’s been on my bucket list for so long. It doesn’t matter what situation you’re in or what’s going on in your life. You still can achieve those dreams as long as you keep trying. Those photos are so much more than just beautiful photos. They tell my story."
Since her appearance in SI, Vesce has crossed more things off her list. She launched a podcast titled "Valid By Victoria," she is immersing herself in travel blogging and is planning a book. Most recently, she launched a business called Victoria Vesce Agency, which helps influencers shine on social media.
Sometimes, Vesce is faced with the occasional troll online who mocks her photos. However, like with everything else, that has not stopped her.
"When you share something so publicly, you’re bound to deal with haters," she chuckled. "We’re still in a society that thinks scars aren’t beautiful, or you need to have the so-called perfect body to be accepted. My scars are what make me unique. It shows how powerful I am from this tumor, something I continue to battle day after day. Sometimes the trolls get to me because I’m only human. But at the same time, it empowers me to be myself more because others might be feeling alone in their journeys. So I continue to show who I am and be my powerful self."
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Disease Research
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The claims are enticing. “Helps decrease belly fat.” “Improves ovulation.” “Prevents recurring UTIs.” “Reduces inflammation levels.” “Lowers cholesterol.” “Improves depression.”These splashy promises don’t appear on the side of a bottle, a billboard, or a TV commercial. Instead, they come from social media posts from regular people gushing about their new favorite dietary supplement: a chemical called berberine. They’ve nicknamed the product “nature’s Ozempic,” a play on the popular type 2 diabetes drug that became a phenomenon when it was discovered to cause weight loss. One prominent berberine booster on TikTok calls it “natures ozempyyy” and swears that it has reduced his food cravings. The popularity of these videos has translated into a major surge in sales this summer. Thorne, a supplement company selling the product, told WIRED that its berberine sales increased 275 percent from May to June.Berberine isn’t new. It’s been an ingredient in traditional Chinese and Ayurvedic medicine for centuries, and can be found in a variety of plants, including barberry, a shrub with tart berries, and goldenseal, a perennial herb with a thick, knotty root. But as the Ozempic craze took off, berberine’s devotees began talking it up as a kind of kinder, gentler alternative to prescription medications. Now, Western wellness types, who take it a la carte in pill form, evangelize for it enthusiastically. “I can’t think of another example where something has gone viral to this extent,” says Craig Hopp, a deputy division director at the National Center for Complementary and Integrative Health, the National Institutes of Health office tasked with researching alternative medicines.Amid all this hoopla, one specific claim about berberine got my attention. I saw it over and over: “Lowers blood sugar.” It was as if the algorithms knew precisely what would push me over the edge to actually purchase the stuff. I developed gestational diabetes a few years ago; to keep my blood sugar in check, I followed a carb-restricted diet and went through my pregnancy staring longingly at bagels and pricking my finger three times a day. It sucked. Now, with an increased chance of developing type 2 diabetes, I’ll do just about anything to avoid it. After a few consecutive nights getting served these giddy pro-berberine videos, I ordered two different kinds of berberine capsules online. What was the harm? It was natural, after all.They arrived on my doorstep the next day. One bottle contained 200-milligram capsules of berberine, while the second contained pills with berberine and cinnamon, divided into 2,000-milligram capsules. The first option touted “GI support” and “immune support.” The second highlighted its gluten-free, “non-GMO” formulation.Shaking the pills out onto my palm, it was impossible to tell which was which—they were both translucent, oblong, and filled with a yellow powder that resembles turmeric. Yet despite their identical appearances, they were very different dosages. I had no idea which one to take.Instead of swallowing either pill, I called Cassandra Quave, a doctor and research scientist who studies medicinal plants, to ask whether berberine was even wise to take at all.Her response? “It’s crazy to me that these things are available.”When people criticize alternative medicine, it’s often for being new-fangled snake oil. But some alternative medicines sold as supplements are worth scrutinizing not because they’re ineffective but because they’re so potent. A supplement like berberine can be as beneficial as a pharmaceutical, but also as strong as one. Yet, culturally, people often view supplements as benign additions to their diets, rather than remedies that can be both effective and intense.Quave is wary of the easy availability of single-ingredient supplements like berberine, which are sold in powerful compound form with few warnings about potential side effects, and without the same regulatory scrutiny as over-the-counter or prescription medications. She finds the fad for casually taking berberine to lose weight troubling for several reasons. “Berberine is a natural antibiotic, so it interferes with the growth of different bacteria in the intestines,” she says. “This is not something you’re supposed to take on on a long-term basis, because you are changing the dynamics of your gut microflora.” Plus, berberine is known to interfere with enzymes in the body that break down other drugs, so it can cause dangerous interactions.Berberine has antibiotic properties, as Quave noted, which is why it is often used to treat bacterial diarrhea on a short-term basis. Studies also suggest that it can indeed reduce insulin resistance. It is a remarkable substance, and it’s easy to understand why people are excited about its benefits. But that does not mean it’s wise to start ingesting this powerful pharmacological compound as casually as a cough drop. And even alternative healthcare practitioners have concerns.“It does get a little scary to me when we’re talking about extracts of particular herbs, because that gets to be as strong as a pharmaceutical medication,” Jaquelyn Taylor, an herbalist in Chicago, says. “I’d worry about antibiotic resistance with using berberine.” Taylor does not instruct her clients to take berberine to lower blood sugar or for weight loss. When she does incorporate herbs containing berberine into a recipe, she pairs them with other herbs that will help temper its effects, following traditional methods.Lisa Makeeva, an Ontario-based dietician who often treats digestive disorders, has recommended berberine to some of her patients for years. Makeeva has even made TikTok videos about berberine’s effects—but she has reservations about how the supplement has turned into a fad diet product. “I think any supplement you’re introducing should be monitored by a health care practitioner,” she says; when her clients start on it, Makeeva orders blood work to watch how and if it impacts their blood sugar. She does not recommend it for shedding body mass. Despite TikTok claims about berberine’s weight-loss benefits, its functionality as a dieting aid hasn’t actually been proven in peer-reviewed studies.“We don’t really have much data to show that taking berberine will lead to weight loss,” she says.Although they are sometimes embraced as alternatives to modern medicine, botanical ingredients are an undeniably vital component of mainstream pharmacology. Aspirin comes from willow bark; metformin, the diabetes medicine to which berberine is often compared, is derived from a plant known as French lilac. If a plant-derived substance is classified by the US Food and Drug Administration as a pharmaceutical drug, it must undergo rigorous testing before it’s approved.But if a plant-derived substance is classified as a supplement, rigor goes out the window. There’s no mandatory development and approval process for supplements. In 1994, the Dietary Supplement Health and Education Act (DSHEA) changed how the FDA could regulate supplements, undermining its power within a rapidly-growing market. While the FDA evaluates medications for safety and efficacy before they go to market, the agency only has the power to ban a supplement after it has been sold and there is evidence it is harmful. (To understand more about this dynamic, read this investigation WIRED published in 2020 into why the memory supplement Prevagen stayed on the market despite questions about its safety.)Despite several high-profile public health disasters related to supplements, including the herbal stimulant ephedra causing a wave of heart attacks and other adverse effects, regulatory control over the supplement industry remains startlingly lax—even as the market has exploded in popularity. According to Patricia Deuster, acting executive director at the Uniformed Services University’s Consortium for Health and Military Performance and chair of the Department of Defense’s Dietary Supplement Subcommittee, there were only around 3,000 dietary supplements on the market when DSHEA became law. Today, there are between 80,000 and 150,000. Some of these supplements are demonstrably safe and beneficial, like Vitamin D. But many of them are not.This explosion in popularity has not led to a commensurate spike in rigorous research. “The biggest problem with dietary supplements is that there really isn't much funding to do randomized controlled trials,” Deuster says. “It's usually funded by the supplement company if it's done at all, so that the opportunity for good evidence is almost nonexistent.”This laissez-faire regulatory atmosphere has led to a wide variety of products that simply don’t do what they say they’re going to do—or much of anything at all. It has also led to cases like berberine, where the danger isn’t that the supplement will be ineffective so much as it is that people taking it aren’t made aware of how powerful it can be in ways they weren’t expecting. They may think they’re taking a gentle, all-natural weight-loss remedy with lots of traditional uses; instead, what they are taking is a powerful antimicrobial that may interfere with other medications, isolated and sold in a pill form that resembles traditional preparations only as much as a caffeine pill resembles a guarana leaf.Although it hasn’t been subject to the same trials that a pharmaceutical goes through during its approval process, and although berberine is not regulated like a medication, it can still function like one. The body doesn’t know or care, after all, how a substance is classified. “There's no difference between a pharmaceutical drug and the sort of compounds like berberine that are sold in supplements. They're exactly the same,” says Pieter Cohen, an associate professor of medicine at Harvard Medical School who studies supplements. “The law creates these artificial categories.”Some supplement companies do make efforts to at least offer some educational materials for their customers. For example, when I asked Thorne whether it is putting out any messaging about how powerful berberine is, and how it may not be suitable for long-term use, a spokesperson told me that the company had run a Q&A with an in-house doctor via Instagram Stories. (It is now available to rewatch if you sit through an earlier Q&A about an unrelated supplement in the Highlights tab.) The most easy-to-find information about berberine on the company’s Instagram account is a Reel promoting the ingredient as “a supplement you don’t want to miss.” In addition to GI support, the promotion hails berberine for its “weight-management” properties. There’s nothing about side effects or about its suitability for long-term use, nor is there anything to that effect on the bottle itself—just a warning not to use while pregnant. (If you navigate to Thorne’s website, the company does offer a warning not to use while pregnant there, too, in addition to a warning about potential allergies and drug interactions.)Some supplements have origins that are startlingly medical; melatonin, for example, is widely viewed as a mild sleep aid. While it is generally safe, melatonin is a potent hormone, originally extracted from a cow’s pineal gland, and it can have a number of adverse effects and drug interactions, ranging from nausea to increased blood pressure. When its bovine origins raised concerns that it could become contaminated with mad cow disease, manufacturers largely shifted over to deriving the hormone synthetically. In his illuminating 2006 book Natural Causes: Death, Lies, and Politics in America’s Vitamin and Herbal Supplement Industry, journalist Dan Hurley points out how odd it is that this kind of product is widely considered something less serious than medication. “One has to wonder how a synthetic brain hormone ever wound up being sold as a ‘dietary supplement’ in the first place,” Hurley writes.The way metformin and berberine are treated makes this false dichotomy obvious. In addition to getting called “nature’s Ozempic,” berberine is also frequently discussed as “nature’s metformin.” But metformin is already nature’s metformin. The primary difference, then, isn’t that metformin is unnatural while berberine is natural, or that one works and one doesn’t. It is that metformin has been evaluated within a far more stringent system, and obtaining it requires a prescription, whereas berberine is subject to far less scrutiny and is available to order online with no medical oversight or third-party quality control checking the purity of the ingredients.“Herbal supplements can be especially dodgy when it comes to issues with contamination,” says Nicholas Milazzo, the lead researcher at nutrition and supplement database Examine.com. The industry has an alarming track record regarding unlisted and sometimes hazardous ingredients turning up in supplements.Although many people turn to supplements out of a desire to avoid Big Pharma, the quality control problems within the industry mean that they may end up inadvertently consuming prescription medications anyways. An analysis of 800 over-the-counter dietary supplements sold between 2007 and 2016 found more than one pharmaceutical ingredient in 20 percent of the products, ranging from antidepressants to anabolic steroids—and the FDA doesn't have the authority to recall these kinds of tainted supplements.This spring, for example, Illinois-based supplement company NOW discovered that counterfeiters were selling fake versions of its products on Amazon; the counterfeit supplements contained a pharmaceutical drug called sildenafil. If that name isn’t familiar to you, it’s likely because sildenafil is the generic name for a very popular brand-name drug: Viagra.Berberine isn’t a new supplement, but it is an intensely timely one. It’s a fad because people are enthralled by Ozempic and eager to find a “natural” alternative. Without the breakthrough in semaglutide drugs, it might’ve remained just another obscure herb somebody’s acupuncturist recommended. “Because it’s riding that anti-pharma wave, it doesn’t surprise me that berberine has taken off,” says Derek Beres, a writer and podcaster who covers the intersection of wellness culture and conspiratorial thinking. Berberine’s boosters gave it an unbeatable marketing hook by positioning it in opposition to Ozempic, the pharmaceutical industry’s most recent blockbuster drug.Above all, it’s a fad because of how desiccated trust in public health is. Alternative medicine has been popular for decades, but in recent years, it has moved from the fringes into an increasingly mainstream and politically extreme position. Wellness communities are drifting politically rightward and define themselves in opposition to the medical establishment.Berberine’s rise did not happen in a vacuum. Its popularity is emblematic of a rising worldview, one championed by Democratic presidential primary contender Robert F. Kennedy Jr., which rejects evidence-based medicine in favor of contrarian pseudoscience. It’s no coincidence that some major players pushing berberine include figures like Joseph Mercola, an osteopath whose immensely popular alternative-health websites push anti-vaccine conspiracy theories.Supplements are the self-help aisle—pulling yourself up by your bootstraps, living your best life—made manifest in pills and powders. Why wait for some old fogey in a white coat to fix your body, when you could simply purchase elixirs yourself? While medications are prescribed by an elite medical authority figure, supplements are peddled by entrepreneurs beholden only to the market.And social platforms, especially TikTok, are making it easier than ever for anyone to take on the role of supplement peddlers. The industry had already used multilevel marketing schemes to rope regular people into shilling herbs for decades—Herbalife, which launched in 1980, remains one of the largest MLMs in the world—but influencer culture has accelerated this blurring of lines between customer and seller.“I started seeing it blow up on Instagram and TikTok, being compared to ‘nature’s Ozempic,’” says Shelby Worth, a bubbly, earnest nursing assistant based in Prince Edward Island, Canada. “That’s when I decided to give it a try.”Worth is not a stereotypical wellness influencer. She doesn’t do fancy matching workout sets or use a ring light. She mostly posts tossed-off videos of herself wearing sweatshirts in her kitchen, often goofing around with her fiancé. But she’s interested in leading a healthy lifestyle and was curious enough about berberine to order her own. When Worth posted her own series of videos detailing her experience with the remedy, she racked up millions of views. She even nabbed a sponsorship deal from a supplement company after her initial video on berberine went viral on TikTok; it’s her first brand partnership. Afterward, she was approached by two companies about trying Ozempic and posting about the experience; she declined, eager to continue her focus on alternatives to prescriptions.Worth’s quick jump from new customer to active seller demonstrates how quickly regular people can get pulled into the sprawling supplements industry. Even though I ended up throwing my berberine out, in the course of reporting this story, new videos hawking the product continued to appear in my feeds daily.“Order berberine,” Worth’s TikTok bio now reads, linking potential customers out to her affiliates.
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Nutrition Research
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Sharon Stone confirmed the death of her brother Patrick Joseph Stone at the age of 57 in a tearful clip she posted to social Monday to thank people for the outpouring of support.
'Hello everybody, this message is to confirm that, yes, we did lose my brother, Patrick Joseph Stone, to a heart attack yesterday,' the Basic Instinct actress, 64, said in a clip on Instagram Monday.
Stone referenced a previous family tragedy - her baby nephew River's tragic death at 11-months-old in 2021 from organ failure - in her confirmation of her sibling's death.
'Yes, he is the man who was the father to River who we lost last year at 11-months-old,' she said. 'He is survived by his wife Tasha and his son Hunter and his daughter Cailee.'
The Oscar-nominated Casino actress made clear her gratitude for the kindness she has received in the wake of the sad news.
'Like any family, we thank you for your love and support in this time of immeasurable grief and we appreciate all of your condolences,' Stone said. 'Yes we've had a tremendous amount of loss in these last couple of years, as so many of you also have.'
The Sliver actress wrapped up the clip in saying, 'I thank you very much for the love and support that you're showing us and we just ask you to continue to be kind. Thank you.'
She captioned the clip, 'Godspeed Patrick Joseph Stone' and added a broken heart emoji, and in another post with images, wrote, 'RIP my brother Patrick Joseph Stone.'
Stone received a number of sympathetic responses in the thread adjacent to the clip, including actor Jeremy Renner, who himself remains recovering from a New Year's Day accident in which he broke more than 30 bones.
Renner posted four heart emojis with the caption, 'Bless you,' while actress Jaimie Alexander said, 'I’m so sorry for your loss, Sharon. Sending you so much love.'
The Real Housewives of Beverly Hills personality Lisa Rinna said, 'My deepest condolences Sharon sending you so much love,' while actress Kate Beckinsale said, 'Lots of love xx.'
TMZ earlier posted news of Patrick's death in Pennsylvania at the age of 57 as result of a heart attack brought on by heart disease.
The iconic Hollywood actress was last seen on Saturday as she smiled while leaving the Beverly Hills restaurant E Baldi with a female friend.
DailyMail.com has reached out to a spokesperson for Stone, whose family is from Meadville, Pennsylvania.
Patrick's wife Tasha took to social media to share the heartbreaking news of her husband's shocking death.
She shared, 'My heart feels like it's been ripped out of my chest. Patrick went to be with our sweet River... I don't know what else to say, he was my world.'
She continued, 'I'm not sure what life is supposed to look like without my husband by my side and quite honestly I don't want to, but I will of course.
'I just hope that you always stay by my side watching over Hunter, Kaylee and I.'
Tasha continued, 'Until we meet again I will forever hold you and our wonderful (and some not so wonderful but just as important) memories close to my heart and will visit those memories always. I love you honey babe.
'My wish through all of this is that now at least River has his daddy with him and I hope the two of you are having the best time.'
Sharon also has a sister named Kelly Stone and a brother named Michael Stone who has worked was an actor and starred in The Quick and the Dead (1995), Eraser (1996) and Renaissance Man (2021).
In her book The Beauty of Living Twice, she said she was close to Patrick and in more recent years has gotten along better with Michael.
The last time Sharon posed with media shy Patrick for an Instagram photo was in September 2018 when they went on a trip with their children to Alaska.
The baby passed away just days after he was found in his crib suffering 'severe organ failure' that left him in a coma.
The actress posted a video of the baby boy along with the caption: 'River William Stone. Sept. 8, 2020 - Aug. 30, 2021.'
River was the youngest child of Stone's younger brother Patrick and his wife, Tasha, who live in Ohio with their three children.
Sharon, whose video tribute was set to Eric Clapton's Tears In Heaven, did not share any other information about what exactly happened to River at the time.
She said that the youngster was suffering from 'total organ failure' and would need a 'miracle' to survive.
'My nephew and godson River Stone was found in his crib w[sic] total organ failure today,' she shared.
Stone then added, 'Please pray for him.
'We need a miracle,' she wrote at the time.
The actress was posting an image of River lying in a hospital bed while hooked up to numerous medical devices.
River's mother Tasha also wrote an impassioned plea for prayers on her Facebook page.
She revealed that her son had been airlifted to UPMC Children's Hospital in Pittsburgh, where he was fighting for his life in a coma.
He soon after died.
'This is the HARDEST thing I have ever had to post but I am BEGGING everyone and anyone who prays please pray HARD for River,' the devastated mother wrote. 'Every single second of this is literally killing me. I just want my sweet sweet boy back.'
There are a number of severe medical conditions that can lead to multiple organ failure in children, however the leading cause is sepsis, according to the National Center for Biotechnology Information.
Sepsis - which can be sparked by another infection in the body - is particularly dangerous for children, because the symptoms are more easily missed than they are in adult patients.
Birth defects and other undiagnosed illness can also lead to pediatric organ failure however, and it is not yet known whether any of these conditions caused River's severe illness.
Stone was traveling in Italy when she revealed the news of her nephew's devastating medical condition - having journeyed to Venice in order to take part in a photoshoot for Dolce & Gabbana.
River's passing comes amid a difficult time for the extended Stone family, which has seen several members dealing with serious health problems in recent months - including cases of COVID-19.
In 2020, a grief-stricken Stone revealed that her 'adopted grandmother' Eileen Mitzman and her godmother had died from complications associated with the virus.
The actress's sister, Kelly, who has lupus, and her husband, Bruce, had also contracted the disease and were left 'fighting for their lives' before eventually recovering.
While speaking about her sister's battle with the illness in an Instagram video shared in August 2020, Stone also shared that her mother, Dorothy, had suffered 'two heart attacks' in the five months leading up to her post.
Stone said her mother had to have 'five stents', which help to open the arteries and prevent blockages in the heart - and a pacemaker as a result.
It also appears as though River's mother Tasha has been struggling with health issues in 2021; comments left on her Facebook page in January 2021 suggested that she had to receive medical treatment that required her to spend time away from her family.
At the time, the mother-of-three revealed that she had returned home - but that she had an IV port in her arm, and would be undergoing continued treatment with the help of a home help nurse for several weeks.
'I was able to come home with a power glide IV port in my arm so I can continue to receive treatments from a home health nurse at home for the next couple of weeks,' she wrote.
'After that I will be switched to a pill form of the antibiotic. I am just thankful to be back with my family.'
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Disease Research
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Protective effect of plasma neutralization from prior SARS-CoV-2 Omicron infection against BA.5 subvariant symptomatic reinfection
Associated Data
From December 2022 to January 2023, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections caused by BA.5 and BF.7 subvariants of B.1.1.529 (Omicron) swept across mainland China. The infection wave was rapid and widespread, impacting a large proportion of the population.1,2 Previously, we recruited a cohort of individuals that experienced Omicron BA.1, BA.2, and BA.5 infections in Jan–Feb, Mar–Jul, and Aug–Sep 2022 in Beijing and Tianjin, China, confirmed by polymerase chain reaction (PCR) (Supplementary Fig. S1 and Table S1).3, 4, 5 A control cohort with no history of SARS-CoV-2 infection and similar vaccination profiles was also recruited in the same region (Supplementary Table S1). Frequent PCR testing and epidemiological investigations based on the zero-COVID interventions ensured no additional infections prior to the current outbreak.
BF.7 was the predominant subvariant in Beijing and Tianjin during the December outbreak, with BF.7/BA.5 accounting for 68%/32% and 58%/42%, respectively.6,7 We found that in the previously uninfected cohort, the total symptomatic infection rate surveyed during December 2022 to January 2023 is 91.6%. Among individuals with prior Omicron BA.1 (n = 231), BA.2 (n = 191) and BA.5 (n = 470) infections, symptomatic infection rates were 32.9%, 10.5% and 2.8%, respectively, and median intervals of infections were 335, 225 and 94 days. Due to the differences in time intervals for different subvariants, it indicated mixed outcomes influenced by both variables (Fig. 1A). Note that the confirmation of infection was based on a survey with at least one of symptoms of fever, cough, pharyngalgia, nasal congestion, nasal discharge, diarrhea, emesis, allotriogeustia/heterosmia, cephalalgia, and fatigue, not by strict screening using PCR or antigen testing, which is a limitation of the study. Compared to previously uninfected individuals, prior Omicron infection was associated with reduced susceptibility to the current BF.7/BA.5 subvariant epidemic, with a relative protection rate of 64.1% (95% CI: 52.4%–73.1%), 88.6% (95% CI: 81.7%–93.1%) and 97.0% (95% CI: 94.3%–98.5%) for previous BA.1, BA.2 and BA.5 infections (Fig. 1B).
Samples of infections caused by the same subvariant at different time intervals are lacking in this study, which is difficult to achieve in the real world. Thus, the current data prevented us from evaluating whether the antigenic distance of subvariants or the interval from the initial infection causes the differences in protection rates. However, the effects of both variables were reflected in specific neutralising antibody titres, so we set out to estimate the correlation between the titres and the protection rates. The continuous follow-up of the cohort allowed us to collect plasma samples approximately 3 months prior to the infection wave in Dec 2022 (Supplementary Table S2 and Supplementary Data). Pseudovirus neutralization assays were performed in the plasma from previously Omicron BA.1-infected individuals to estimate the correlation between neutralising antibody titres and the protective effect against symptomatic reinfection. Importantly, the geometric mean of the 50% neutralising titres (NT50) against D614G, BA.5, and BF.7 were 2.0, 2.5, and 2.3-fold higher in individuals without symptomatic reinfection than in those with symptomatic reinfection (p < 0.01, Fig. 1C). And there was no difference in neutralising antibody titres between symptomatic reinfected individuals without confirmed pathogen detection and those with positive PCR/antigen detection results (Supplementary Fig. S2). We also collected plasma samples approximately 3 months prior to the current outbreak from those previously infected with BA.5 subvariant. Plasma NT50 showed high levels of neutralization against Omicron BA.5 subvariants, which accounts for the rare symptomatic reinfection cases (Fig. 1D and Supplementary Fig. S3). Low plasma neutralising antibody titer against BF.7 subvariant (below 15.5, the threshold calculated by the receiver operating characteristic curve, Supplementary Fig. S4) of the BA.1-infected cohort was associated with an enhanced cumulative risk of symptomatic reinfection, with a hazard ratio (HR) of 10.86 (95% CI: 4.019–29.36) (Fig. 1E). The same applies to NT50 against BA.5 subvariant (Supplementary Fig. S5). Multivariate regression suggested high neutralising titres against BF.7 and BA.5 were indicative of a reduced probability of being symptomatically reinfected in the current outbreak, with a relative risk (RR) of 0.063 (95% CI: 0.009–0.422) for BF.7 and a RR of 0.067 (95% CI: 0.009–0.506) for BA.5 by adjusting previous vaccination (Supplementary Table S3). Together, these results showed a robust correlation between the plasma neutralising titres and the protective effect against Omicron symptomatic reinfection. Notably, the reason such a significant correlation was observed here could be owing to the extensive viral exposure of the population during the outbreak, which minimizes the chance that uninfected individuals were due to the lack of viral exposure.
It is crucial to estimate the protective effect of the neutralising antibodies generated by such mass BF.7/BA.5 infections against the next SARS-CoV-2 reinfection wave, potentially driven by the newly-emerged Omicron variants CH.1.1, BQ.1.1, or XBB.1.5. A BF.7 cohort of 30 individuals initially infected with BF.7 subvariant were additionally recruited and plasma was collected at approximately 1 month after the infection (Supplementary Table S2 and Supplementary Data). Plasma samples from BA.5 cohort in Fig. 1D were also collected approximately 1 month post-infection. We measured the neutralising titres against BQ.1.1, CH.1.1, and XBB.1.5 in plasma collected from individuals one month after BF.7 (Fig. 1F) or BA.5 (Fig. 1D) infection. The NT50 values of plasma from BF.7 or BA.5 infection against CH.1.1 and XBB.1.5 (24–31) are similar to that threshold against BF.7 and BA.5 (15.5–29.5) of plasma from individuals with prior BA.1 infection with or without experiencing a symptomatic BF.7/BA.5 reinfection during the December outbreak. Given that the plasma of BA.1 cohort was collected 3 months before the outbreak and plasma from BF.7 or BA.5 patients were collected 1 month after infection, this suggests that the humoral immunity generated by the current BF.7 or BA.5 infection may provide at least 4 months of protection against the CH.1.1 and XBB.1.5 symptomatic reinfection wave, while the protection against a BQ.1.1 may last even longer. Of note, the higher hACE2 binding of XBB.1.5 may reduce the period of protection due to the potential increase of infectivity.8 Also, the lack of measurement of the mucosal and cellular immunity would add uncertainty to the estimation, which is a limitation of the study.
Contributors
Y.C. designed the study. X.C. and Y.C. wrote the manuscript. W.S., A.Y., F.S., and Y.C. performed the pseudovirus neutralization assays and analyzed the neutralization data. X.C., Y. Xu., Y. Xie, and S.Y. accessed and verified the underlying data, and performed the statistical analyses. Y. Xu., Y. Xie., L.G., H.G., S.Z., R.J., and Z.S. recruited and performed the follow-up in prior Omicron-infected cohorts and individuals with no SARS-CoV-2 infection history. X.C., Y.H., Y.W., and Y.S. collected plasma samples from previously Omicron-infected individuals. Y.C. were responsible for the decision to submit the manuscript.
Declaration of interests
Y.C. is a co-founder of Singlomics Biopharmaceuticals and inventor of provisional patents associated with SARS-CoV-2 neutralising antibodies. All other authors declare no competing interests.
Acknowledgments
We thank all the volunteers involved in this study for providing critical information and peripheral blood samples. This project is financially supported by the Ministry of Science and Technology of China and Changping Laboratory (2021A0201; 2021D0102), and the National Natural Science Foundation of China (32222030). The funders of the study had no role in study design, data collection, data analysis, interpretation, or writing of the report.
Footnotes
Appendix ASupplementary data related to this article can be found at https://doi.org/10.1016/j.lanwpc.2023.100758.
Appendix A. Supplementary data
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Disease Research
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Story at a glance
- Reported cases of Naegleria fowleri infection — more commonly known as an infection of brain-eating amoeba — have “significantly increased” over the past four to five years.
- Experts think climate change may be at least partly to blame, although doctors are also getting better at diagnosing the disease.
- The infection is usually fatal, so experts recommend prevention strategies.
(NEXSTAR) – Infections of brain-eating amoeba are on the rise — and the warming climate may only exacerbate the problem, according to one of the world’s preeminent experts on the subject.
“Yes, we are experiencing warmer temperatures, and these amoeba are thermal-tolerant … so the numbers of amoeba will be higher,” explains Dennis Kyle, the head of the cellular biology department at the University of Georgia and the scholar chair of antiparasitic drug discovery with the Georgia Research Alliance.
“Warmer climates means, yes, more exposure and more cases,” he added.
Kyle, speaking with Nexstar, confirmed that reported cases of Naegleria fowleri infection — more commonly known as an infection of brain-eating amoeba — have “significantly increased” over the past four to five years. But he warned that increased cases cannot be linked solely to warmer waters, but rather more awareness and fewer misdiagnoses than in previous years.
“There’s more recognition that these amoeba are possibly causing disease, when before, virologists were misclassifying these cases as bacterial meningitis or [other diseases],” he said.
Naegleria fowleri, the microscopic organism responsible for the infection, is primarily found in warm freshwater and soil, but also hot springs, improperly chlorinated pool water, improperly treated tap water, and, in lower concentrations, even cooler freshwaters. Infection of N. fowleri usually occurs after water is forced into the nose, allowing the organism to enter the nasal cavity and cross the epithelial lining into the brain, where it begins destroying the tissue of the frontal lobe.
This brain infection, known as primary amebic meningoencephalitis (PAM), can lead to symptoms including fever, headaches, stiff neck, seizures and hallucinations within two weeks of exposure. It is almost always fatal, with death occurring within another one to 18 days of the first symptoms, according to the Centers for Disease Control and Prevention (CDC).
Most infections tend to occur between June and September, but cases outside of these months are not entirely unheard of, Kyle said.
N. fowleri is also found in higher concentrations in warmer, smaller bodies of freshwater, but the organism can be found in pretty much any freshwater lake, including cooler, clearer waters, Kyle said. There was even a case in 2016 in which a teenager contracted a fatal infection of N. fowleri after going whitewater rafting — an activity generally undertaken in less-risky colder waters.
The highest concentrations, though, are generally found in freshwater with surface temperature readings of 75 degrees F or higher, especially for extended periods of time.
And climate change, as scientists have observed, is already having an impact on the temperature of the world’s freshwater lakes. The quality and color of the water can also change due to warming temperatures, recent studies have suggested.
“There’s a constant risk in warmer climates,” Kyle remarked.
The amoeba itself can’t be specifically targeted with current treatments either, leading to a fatality rate of 97%. In fact, Kyle only knows of four known cases in the U.S. where patients survived, and “maybe” seven globally.
“I’m not convinced that were any further along in getting better treatment,” Kyle told Nexstar of the current antifungal and antibiotic cocktails that are currently used. “But If people can get diagnosed earlier, even with the suboptimal treatments that we have, they have a better chance of survival.”
To that end, Kyle, and the families of some of the victims, are hoping to spread awareness of the disease. He and his colleagues have also worked to identify what they believe is a biomarker that can help doctors diagnose infection earlier than previously possible, but their test is not yet FDA-approved.
“Most tests use cerebral spinal fluid, but we don’t have to have that,” he told Nexstar. “We can use blood or even urine. In our analyst studies, we can detect it three or four days before symptoms develop. I’m pretty excited.”
Preventing infection in the first place is currently the best course of action, he added.
“Raising awareness helps. But I think any warm freshwater facility, or hot spring … and at splashpads, you have to look at it carefully,” he said. “It’s incumbent on people running these facilities to minimize risk and minimize exposure.”
People can also take precautions by avoiding bodies of warm freshwater, and especially refraining from jumping or diving into such waters, which increases the risk of having contaminated water forced into the nose. He also recommends using nose plugs, keeping your head above the surface, and properly cleaning and chlorinating wading pools, swimming pools and spas (or opting for salt-water pools or spa facilities).
Parents should also know that children are at the highest risk of infection, but likely for no other reason than that they’re more prone to be more active in the water.
“It’s difficult to define the risk,” Kyle said. “But think of it like a lightning storm. Everybody knows not to walk outside in a lightning storm with a golf club in their hands. But many parents don’t know the risk that their kids might be open to.”
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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Epidemics & Outbreaks
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Could the secret to lifelong health be … staying still? It sounds counterintuitive, but in a recent study, researchers assessing 270 randomised controlled clinical trials (involving more than 15,000 participants) found that isometric exercises, in which muscles are working but remain motionless, were more effective than a range of other options for reducing blood pressure.
To be clear, aerobic exercise training, dynamic resistance training, combined training and high-intensity interval training all helped, compared with non-exercise control interventions. But isometrics were most likely to reduce blood pressure, with full-body movements such as the wall squat showing bigger benefits than moves such as hand-gripping or leg extensions.
The first obvious question is: why? Followed by: how do I use this information?
To answer the first bit: isometric exercises are likely to cause the greatest increase in blood pressure during the exercise, when muscles are contracted and blood vessels narrow. When you stop doing them, of course, those same blood vessels relax – something researchers theorise might lead to improved blood flow regulation in the long run.
As for the second question, here’s how to incorporate isometric training into your week – whatever your fitness level.
How to use these workouts
Each set of moves below – beginner, intermediate and advanced – contains exercises designed to work the most important muscle groups of the body. The study authors suggest doing isometric movements alongside other modes of exercise to see the biggest benefit. To fit it all in, either do all five movements in a circuit, or add two to three moves at a time to your other weekly workouts, aiming between two and four sets of each.
You can hold each movement anywhere from 30 seconds to two minutes at a time, depending on your fitness level: the most important thing is not to let your form collapse. Oh, and remember to breathe: “We can often be tempted to hold our breath during isometrics, but that can be counterproductive,” says the personal trainer Tim Low. “Slow nasal breaths are the way to go when attempting all of the following.”
Beginner moves
Knee plank
This is a simplified version of the classic plank; it’s very effective if you pay attention to your form. Start on your knees and forearms, keeping your elbows aligned under your shoulders. “Engage your core muscles by drawing your belly button upwards towards your spine and squeezing your glutes,” says the fitness and wellness coach Lorena Savvidou. “Make sure to keep your body in a straight line from your head to your knees, and avoid dropping your hips or arching your back.”
Shoulder bridge
“We’ve all seen kids do a handstand into a back bridge, but as we get older and stiffen up, it seems like an unrealistic option,” says Low. The good news is that there are several regressions we can use. Start with a basic shoulder bridge: lie on your back with your feet shoulder-width apart and close to your buttocks, then press through your heels to bring your hips up in the air, and hold. “You’ll strengthen your spinal muscles, but also combat excessive sitting or forward-leaning posture by opening up the hip flexors,” says Low.
Fire hydrant
This move targets and activates the gluteus medius, making it a good warm-up for squatting or running, as well as an excellent standalone movement. Start on all fours with your wrists under your shoulders, your knees under your hips and your toes pointing down into the ground. Now, put one forearm on the floor and allow your body to rotate slightly to lift your opposite leg out, like a dog watering a fire hydrant. Aim to keep your knee in line with your hips both vertically and horizontally. If you’re doing it properly, you’ll probably feel your glutes “switch on”.
Tabletop crunch hold
This one strengthens your core muscles, particularly your abs and lower back. Start by lying on your back, engaging your core by drawing your belly button down towards the spine. Bring your legs off the floor and into a 90-degree “tabletop position”. Bring your shoulders off the floor, and reach forward with your arms, palms facing downwards and chin tucked in. “This can reduce the risk of back pain,” says Savvidou. “But it’s important to keep your back in contact with the floor and not allow it to arch, putting pressure on it.”
Squat hold
This static version of the squat will strengthen your leg muscles, especially the quadriceps, hamstrings and glutes. Stand with your feet shoulder-width apart and your toes pointing slightly outward. Keep your back straight. As you start bending your knees, push your hips backwards and downwards. Go as low as you can without lifting your heels off the floor – if you’ve got any small weight plates handy, putting your heels on them will help with the depth. Avoid arching your back or letting your knees move inwards.
Intermediate moves
Plank
For the classic version of the plank, start with your forearms and toes on the floor and your body in a straight line from head to heels. Engage your core and gluteus muscles, and aim to keep your legs as rigid as … well, the clue is in the name. Make the exercise tougher by keeping your heels together and elbows narrowly spaced, so that you’re working harder on balance. The world record for holding a plank is more than nine hours, but you can benefit from the position in minutes if you avoid sagging and stay straight.
Crab hold
The posterior chain, made up of the muscles on the backside of the body – including the back muscles, glutes, hamstrings and calves – is hugely important for most people, but easily neglected in traditional workouts. Fix it with this move, which engages most of those muscles together. Sit on the floor with your feet close to your bottom and hands under your shoulders, then drive your hips upwards until you’re in a sort of tabletop position. “Pointing your toes out slightly will help target the glutes effectively,” says Low. “But don’t hyperextend your hips.”
Bird dog
Technically, this one is a “contralateral quadruped hold”, but the more memorable name comes from the way it mimics a pointer suddenly sniffing a pheasant. Start on all fours with your wrists under your shoulders, your knees under your hips and your toes pointing down into the ground. Lift one hand and the opposite foot off the ground. “You may be tempted to shift at the hips,” says Low. “But imagine you have a tennis ball or a glass of water balancing on your lower back and you need to keep your spine as neutral as possible.” Pause, then repeat on the other side.
Side plank
This variation on the traditional plank hits your oblique muscles – part of your core – harder, while also engaging your shoulders and hips. Start by lying on your side with your feet either stacked on top of one another or one foot in front of the other. “You can rest on your forearm or hand,” says Low. “But if you have wrist issues I’d suggest the former.” Now lift your hips off the ground until your body is in a straight line, and then hold. If it’s too easy, lift the top leg so that you look like a sideways star: for a simpler version, keep your knees bent or use your top arm for extra support.
Hollow hold
This is a favourite of gymnasts. It can help out with other body-bracing exercises (think pull-ups and press-ups) – and is fairly easy to do while you’re watching TV. Lie flat on your back with your arms by your sides and legs fully extended. Lift your straight legs, shoulders and upper back off the ground, stopping the exercise if you can’t keep good posture. “A common mistake is keeping your back straight instead of letting it naturally curve up,” says Savvidou. “As with most of these movements, thinking about drawing your navel to your spine will help.”
Advanced moves
Extended plank
This is the toughest version of the plank, and not for the faint of heart or weak of shoulder. Start in a press-up position, then bring your hands slightly ahead of your shoulders – you can extend further if you’re feeling stronger. As with the other plank variations, brace your core and don’t let your hips sag.
Copenhagen plank
“I suffered from chronic groin injuries for many years as a young footballer and this is one of those exercises I wish I’d known about,” says Low of this little-used but effective side-plank variation, supposedly popularised by Danish athletes. Set yourself up on your side as you would for a side plank, keeping your top leg on a bench or (preferably padded) chair. From here, lift your hips up off the ground. “It’s important to keep your foot flexed and toe pointed to brace and secure your knee,” says Low. “We don’t want shear force going through the knee joint.” Too tough? Keep your lower foot on the ground to take some of the weight.
Aeroplane pose
This advanced movement from yoga (where it’s known as “dekasana”) targets all the areas we need to work on as we get older: stretching hamstrings and strengthening shoulders to encourage upright posture, while also building balance. Start from standing, facing forward, then simultaneously bend forward and lift one leg off the ground behind you, aiming to make a T shape with your body. With straight arms to the side, squeeze your shoulder blades back. “Imagine your head is the tip of an arrow as it stays in line with the standing foot and your back leg counterbalances,” says Low. “To make this much more difficult, try it with your eyes closed.”
Wall sit
The PE classic isn’t exactly pleasant, but it’s an excellent way to build up your leg muscles without the balance challenges of the squat. By slightly shifting your weight, you can shift the exercise’s emphasis to the muscle group you most want to work. Find a clear wall and stand with your back against it with your feet shoulder-width apart, lowering your body until your thighs are parallel to the ground – you should be able to put a broom handle on them without it rolling off. Hold until it’s mildly unpleasant, remembering to breathe.
Extended hollow hold
For this progression of the normal hollow hold, lie on your back and then lift your straight legs off the ground, extending your arms backwards behind your head. As with the hollow hold, keep your body in a shallow “dish” shape, stopping the movement before your form starts to fall apart.
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Stress and Wellness
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Keep Labs built a lockable storage container for medicine, and it doesn’t matter if the meds come in bottles, boxes, or dime bags. The Keep is designed to hold them safely and track their use. The company launched in 2019, won – and lost– an innovation award at CES 2020, and this week started shipping its first product to consumers.
The Keep device is lovely. I have a test unit sitting on my bathroom vanity, and it looks more like a smart speaker than a secure box. There’s a clock on the front and a soft matte finish. Click a button in the app, and the lid opens, revealing a space to hold about six bottles of pills. Or, with secure mode disabled, a double tap on the front opens the device without needing a smartphone.
Take a pill or two? The Keep uses a sophisticated scale to detect the bottles that were returned just a little bit lighter, and this is recorded in the app. Didn’t take your meds? The Keep knows and can trigger a smartphone notification on your or a companion’s phone.
To the founders, Keep is more than just a secure box; it’s a solution to harm reduction and medication management.
I recently spoke with co-founder, President, and Chairman Philip Wilkins about the company’s journey from a pre-order success story to finding an enterprise offering by partnering with Canadian healthcare providers.
From cannabis to medicine
Wilkins is an earnest entrepreneur. Spend a few minutes with him, and it’s clear he’s passionate about solving the problem of safeguarding medicine.
This was the second time I spoke with him. The first was back In 2019 when his company won an innovation award at CES 2020. This award was later rescinded because the device was marketed as a cannabis storage device. In 2019, going into 2020, the trade group hosting CES had a strict but convoluted stance on cannabis products. Somehow, Keep Labs won an award. Eventually, someone at the CTIA noticed Keep Lab’s marketing and pulled the prize. This set off a firestorm, eventually leading the CTIA to soften its stance on cannabis-adjacent products — after all, cannabis is legal in Nevada, where CES is held.
This experience has had a lasting affect on Keep Labs. Look at the website. Cannabis is not mentioned. The Keep is now marketed with the catch-all term, medicine.
“Cannabis is still there,” he said, noting that the company is still on the same mission of harm reduction (tk need a different phrase than harm reduction). “Cannabis was a great way to start a conversation because everyone wants to talk about cannabis, but no one wants to talk about getting high.”
By simply saying “medicine,” the company feels like it found a good middle ground with its messaging. As Wilkins told me, Google and Meta heavily restrict the term “cannabis” in advertising, which limits the marketing reach of such devices as Keep. In advance of the launch, Keep Labs had to conduct pre-orders using a Shopify store because Kickstarter and Indiegogo also didn’t allow products to be marketed with the term cannabis.
Pre-order success
Keep was born from a familiar story. Wilkins was using medication to treat a new condition, and his wife was concerned about their three-year-old getting into the drugs. It’s a growing struggle with many households, especially with the rise of cannabis edibles packaged to look like candy.
At the time, he looked at the market and saw several pill dispensing medications. “There were a lot of medication dispensing devices, but it was very clinical in nature. And so, like every crazy entrepreneur, [I said] ‘let me see if I can go solve this problem for myself.'”
The company saw early success despite not having a shipping product. They capitalized on the attention of getting kicked out of CES and in December 2019, launched a pre-order campaign. Over 15,000 people pre-ordered the device, with 5,000 paying in full. At the time, the pre-order noted that all sales were final, but the company reversed course and offered everyone a refund when COVID hit, and Keep Labs lost its manufacturer. Philip said that only 5% of the pre-orders were canceled.
A time out due to COVID
The COVID-19 pandemic changed Keep Labs. The company was heading towards production when the pandemic hit. Nearly overnight, all of their manufacturing contracts were canceled, leaving the pre-orders and the company up in the air.
“What the hell do we do now,” Philip said, adding that they took a step back and started talking to their pre-order customers—all of them. For the next year, the company spoke to two to three customers weekly about what made them pre-order the device. “What we found was that a lot people were buying [the Keep] for medication tracking, and not for the primary use case of locking medication in a box.”
This critical feedback led to Philip stepping down as CEO. He brought on Jeff Wandzura to lead the company.
Jeff Wandzura is a trained pharmacist who previously sold two digital health companies. Wilkins said he felt Jeff’s skills were complementary to his skill set, and it was the right thing to do for the company. “Honestly, it’s one of the best decisions I’ve made throughout my career as Jeff grounded the company, has driven our enterprise success, and become a close friend.”
“As you can imagine, the pandemic brought about a lot of uncertainty, and we lost some good people,” Wandzura told me. “After I started speaking to pre-order customers to understand why they bought Keep, it was clear that I needed a partner from the pharma/pharmacy world.
“The world of medication compliance is complex, and we needed the clinical knowledge on the team. I wasn’t comfortable. And two, I’ve always felt a strong fiduciary duty to my investors to make decisions in the company’s best interest, which meant checking my ego at the door.”
Wilkins continues to talk to customers. The company has an active beta program with 150 users, and he calls the top 10 users weekly to better understand their usage. He’s discovered people are now using their Keep for other critical items like keys, passports, and cash. He believes these additional use cases show users’ trust the device.
With Wandzura leading the company and with gobs of customer feedback, Keep Labs started exploring an enterprise offering focused on medication adherence along with harm reduction.
The company became part of the McKesson Digital Health Network in Canada to provide real-time data about whether patients are taking their medication. Keep Labs also has a partnership with Savvy Cooperative to give away free Keep devices to patients who are living with chronic conditions. These partnerships provide an invaluable feedback loop of front-line patients interacting with their devices.
“Let’s make it super easy to deploy to individuals who need support,” Philip said. “And we provide de-identified aggregate data to understand how many patients in the population are adhering [to their medications] and how many need intervention so they can understand patient behaviors at home. We charge a nominal subscription fee for that.”
I asked about how the company safeguards personal data and received the following statement that’s worth reprinting in full:
“Protecting user privacy and ensuring data security are paramount for KEEP. We adhere to stringent data protection regulations such as HIPAA in the U.S. and PIPEDA in Canada to safeguard customer information. All data transmitted through KEEP is encrypted both in transit and at rest, utilizing robust encryption algorithms. Our platform employs multi-factor authentication, regular security audits, and penetration testing to protect against unauthorized access. Furthermore, we conduct ongoing staff training and adhere to a strict privacy policy to ensure that all members of our team are vigilant and adhere to the highest standards of data protection and software development including RBAC. This comprehensive, multi-layered approach to security ensures that patient information remains confidential and secure at all times.”
Philip added that its encryption keys are generated on the fly within their production environment and securely stored. No individual has direct access to the keys. Data is transmitted using TLS 1.3 encryption, while data at rest is secured with AES-256 encryption. User passwords undergo hashing with PBKDF2 utilizing SHA256. The company uses automated tools such as Scan Hawk and Synk to test its security and provide code vulnerability assessments. He notes that their code is subject to peer reviews, and the company uses the Coalition Cybersecurity and Stendard to provide a final layer of external review.
It’s worth applauding Keep Lab’s security and privacy measures. The above shows a company that’s proud of its efforts and is comfortable making them public.
Cooling meds is next for Keep
With its first product shipping to consumers, Keep Labs is exploring raising capital at the end of 2023 or early 2024. The company has raised $2.18 million from venture capital sources, including StartUp Health’s Transformer Fund, Plug and Play Tech Center, Onbelay Capital, and 001 Ventures.
Angels have helped Keep Labs along the way, too. The company’s advisory board includes former IBM Watson head Michael Rhodin.
“We’ve got a lot of contracts we’ll be announcing over the next several months, which is super exciting,” Philip said. “And then after that, it’s the launch of our second gen product, which is the same as the original, except it’s got a cooling device.”
He explained that nearly 50% of the drugs in the FDA pipeline require cooling: “Ozempic is a great example, and people are keeping it in their fridge, next to their butter, and we’ve heard from customers and enterprise partners that [adding cooling] could be a huge win.”
Until then, the company’s first generation product is available from Keep Lab’s website. It comes in black and white and costs $299
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Medical Innovations
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Already grieving the loss of their loved ones in care homes, relatives of Covid victims tonight told how Matt Hancock’s bombshell texts on testing have only deepened their wounds.
And one called for a police investigation over claims the former Health Secretary rejected medical advice to check everyone going into homes not just those from hospitals.
In a series of leaked WhatsApp messages from early in the pandemic, Mr Hancock said the guidance from top doctor Chris Whitty “muddies the waters”.
Bereaved relatives have told of their fury. Matt Forest, 54, from Doncaster, South Yorks, whose mum Kaye died aged 89 on May 26, 2020, said of the ex-minister: “He’s betrayed my mum. This reopens the wounds and it’s just heartbreaking. They are twisting the knife into our wounds.”
Lindsay Jackson, from Derbyshire, lost her mum Sylvia, 87, in a care home on April 17 2020.
Now a spokeswoman for Covid-19 Bereaved Families for Justice, she said: “The consequences of this could not be more horrific and there needs to be an immediate and serious police investigation.”
Jenny Widdowson, 61, from Staffordshire, told how before her mum Olive Soutar died in a Devon care home aged 90 in November 2021, they lost nine months with her because families were kept out. She added: “It doesn’t surprise me in the least that Matt Hancock has lied and lied again.”
Chair of the Independent Care Group Mike Padgham said: “At face value, these messages seem to expose a tragic betrayal of those most vulnerable to the Covid-19 pandemic.”
Rights for Residents, Diane Mayhew, 57, said: “It is despicable. Just when you think you can’t be more shocked something else comes out.
“So much trauma could have been avoided and those that made these heartless decisions should take responsibility for them.”
Care home bosses also told of their anger at the messages from Mr Hancock, which were leaked to the Telegraph by Isabel Oakeshott, a journalist who ghost wrote his pandemic memoir. She tonight claimed the Tory MP sent her a “menacing message” after the texts were published.
Sheffield’s Palms Row Health Care director Nicola Richards lost 25 residents to Covid. She said: “We were lambs to the slaughter. We knew lies were being told when he [Hancock] talked about the ‘protective ring’. We knew people were not being tested.”
Sue Cawthray, 66, runs a care home in Harrogate, North Yorks. She said: “He should be taking responsibility for what he did.” John Godden manages homes in North Yorkshire. He said the protective ring claim has been exposed as a myth. John added: “Now we can actually have a conversation without a counter voice saying they did it, when they didn’t.”
A spokesman for Mr Hancock: “It is outrageous that this distorted account of the pandemic is being pushed with partial leaks, spun to fit an anti-lockdown agenda, which would have cost hundreds of thousands of lives if followed. What the messages do show is a lot of people working hard to save lives. The story spun on care homes is completely wrong. What the messages show is Mr Hancock pushed for testing of those going into care homes when it was available.
“Matt was supportive of Chris Whitty’s advice, held a meeting on its deliverability, told it wasn’t deliverable, and insisted on testing all those who came from hospitals.”
Guidance calling for testing those going to care homes from the community was not introduced until August 14. A total of 17,678 people died of Covid in care homes in England between April 17 and August 13.
1. Care home tests
Matt Hancock failed to follow advice from England’s chief medical officer Professor Sir Chris Whitty that there should be testing for “all going into care homes”. Messages with aides from April 14, 2020 show he approved tests for “all going into care from hospital”, but not those arriving from home.
The former health secretary’s allies tonight insisted this was only because of constraints on capacity at the time. New admissions to care homes from the community did not have to undergo mandatory tests until August 2020. Between April 17 and August 13, some 17,678 people died of Covid in care homes in England.
2. Rees-Mogg's son
A Covid test was sent by courier to Jacob Rees-Mogg’s home during a nationwide backlog. The kit was urgently dispatched after a test taken by the then Commons leader’s son went missing.
An aide messaged Mr Hancock to say: “The lab lost JRM’s child’s test, so we’ve got a courier going to their family home tonight, child will take the test, and courier will take it straight to the lab. Should have result tomorrow am.” There were reports of a backlog of 185,000 tests waiting to be processed on September 11, 2020.
3. 'Inhumane' rules
Social care minister Helen Whately warned Mr Hancock that strict rules on visits to care homes were “inhumane”. The messages from October 2020, published by the Telegraph, show she warned him against preventing “husbands seeing wives” as the country was put into tiered lockdowns, with tougher restrictions in places where the virus was spreading.
“I’m hearing there’s pressure to ban care home visiting in tier 2 as well as tier 3. Can you help? I really oppose that,” she wrote. “Where care homes have Covid secure visiting we should be allowing it. To prevent husbands seeing wives because they happen to live in care homes for months and months is inhumane.”
4. Target cheat
Mr Hancock met his 100,000 daily tests target by sending out thousands of kits he did not believe would be sent back to be processed. The health secretary promised to reach the goal by the end of April 2020, but he counted tests when they were despatched rather than when they were used.
On April 27, health minister Lord Bethell suggested Amazon could send out a load of tests on the day of the deadline. “If only 20% are being returned then we can send many many many more out,” Mr Hancock replied. “that’s true. since they count from the moment they’re sent,” added the Tory peer.
5. Shielding
More than two million people were told to “shield” at home despite an admission from one of the government’s top experts that it was not effective. In a message to a WhatsApp group that included Boris Johnson,
Chief Scientific Adviser Sir Patrick Vallance wrote in August 2020 that rules that kept those with health conditions at home had not been “easy or very effective”. Professor Whitty added that he would personally “think twice” about following the guidelines himself. Despite the reservations, the Government still reintroduced shielding during the second national lockdown that winter.
6. Osborne 'favour'
Former chancellor George Osborne gave Mr Hancock a front page story in the Evening Standard to help him meet his testing target. The health secretary asked for a prominent story encouraging people to go for tests in the newspaper where he was editor on the day before the deadline as a “favour”.
Mr Osborne replied: “Yes, of course.” In a text exchange a few months later in November 2020, the ex-minister warned his pal: “No one thinks testing is going well, Matt.”
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Epidemics & Outbreaks
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Most frontline medics believe ministers are seeking to “destroy the NHS” because they have starved it of cash and mistreated its staff, the leader of Britain’s doctors has said.
Prof Philip Banfield also warned that the health service, which on Wednesday will mark the 75th anniversary of its creation, is so fragile that it may not survive until its 80th.
Banfield, the British Medical Association’s chair of council, mounted an unusually strong attack on the government’s handling of the NHS in an interview with the Guardian.
“This government has to demonstrate that it is not setting out to destroy the NHS, which it is failing to do at this point in time,” he said. “It is a very common comment that I hear, from both doctors and patients, that this government is consciously running the NHS down. [And] if you run it down far enough, it’s going to lead to destruction.
“You’ll struggle to find someone [among doctors] on the frontline who thinks otherwise, because that’s what it feels like.”
Banfield said the NHS is in a state of “managed decline” because recent governments had made “a conscious political decision” to deny it adequate resources or tackle staff shortages.
He added: “It was a conscious political decision to underfund and undervalue the NHS as a national asset and its staff – not just doctors but [staff] across the board.”
He often hears doctors say that the government is not committed to the NHS, Banfield said. “And the end point of that is that the NHS does not survive another 75 years. I would be very surprised if the NHS in its current form survives the next five or 10 years, at the rate that it’s declining.”
The BMA boss said the NHS was performing well, despite the challenges it faces. “If you are sick, you cannot beat the NHS most of the time.” But, he added, “the problem with it continuing to be run down is that the frequency with which disasters happen will increase.”
Anita Charlesworth, head of research at the Health Foundation charity, also described the health service as undergoing “managed decline” and that it had ended up becoming overwhelmed because governments had made “a choice” to give it less money than it needed.
Rachel Wolf, a co-author of the Conservatives’ 2019 general election manifesto, has said that the government has broken its pledge to build “40 new hospitals” and that that is damaging the NHS.
The lack of new buildings is limiting the amount of care the service can provide, at a time when it has record staff and funding, she said.
Speaking to the Guardian, she said: “The 2019 manifesto promised more doctors and nurses – great – but also new and rebuilt hospitals.
“We needed to deliver on the second because we do have more staff but we don’t have the space and the beds and the machines for them to work at maximum efficiency. It’s one of those things that is so demoralising for staff.”
Wolf recently co-wrote a report for the Institute for Government thinktank about the NHS’s “productivity puzzle”.
Ministers need to embark on a massive programme of capital spending so the NHS can leave behind cramped, outdated buildings and offer care in larger, purpose-built facilities, she said – echoing a longstanding demand from organisations like NHS Providers and he NHS Confederation.
Hospitals also need to be able to access capital funding for building projects and buying new equipment far faster than the current system, which critics say is overly bureaucratic, takes far too long and in which the Treasury has too big a role, they claim.
Wolf added: “I’d radically simplify and speed up the process by which capital can hit the ground and be used: no endless planning system, no opaque mechanisms from central government.”
The Department of Health and Social Care declined to respond directly to Banfield’s remarks. A spokesperson said: “There are more staff than ever before working in the NHS, which has led to a record number of cancer patients being treated over the last two years. And in April there were a record number of diagnostic tests carried out per working day.
“The NHS has published the first ever long term workforce plan, backed by over £2.4bn [in] government funding to deliver the biggest training expansion in NHS history alongside measures to improve culture, leadership, and wellbeing.”
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Health Policy
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An Ivy League student with a heart condition died after drinking Panera Bread’s “charged lemonade,” a large cup of which contains more caffeine than cans of Red Bull and Monster energy drinks combined, according to a lawsuit.
The legal complaint, which was filed Monday morning in the Philadelphia Court of Common Pleas and was first obtained by NBC News, calls the beverage a “dangerous energy drink” and argues that Panera failed to appropriately warn consumers about its ingredients.
The suit was filed on behalf of the parents of Sarah Katz, a 21-year-old University of Pennsylvania student who had taught CPR in underserved communities and had been a research assistant at a children’s hospital. Katz had a heart condition called long QT syndrome type 1 and avoided energy drinks at the recommendation of her doctors, according to the filing.
In a statement Monday afternoon, a Panera spokesperson said: “We were very saddened to learn this morning about the tragic passing of Sarah Katz, and our hearts go out to her family. At Panera, we strongly believe in transparency around our ingredients. We will work quickly to thoroughly investigate this matter.”
Katz had purchased a charged lemonade from a Panera Bread in Philadelphia on Sept. 10, 2022, according to the suit. She went into cardiac arrest hours later, said her roommate and close friend, Victoria Rose Conroy.
“She was very, very vigilant about what she needed to do to keep herself safe,” Conroy said. “I guarantee if Sarah had known how much caffeine this was, she never would have touched it with a 10-foot pole.”
The charged lemonade was “offered side-by-side with all of Panera’s non-caffeinated and/or less caffeinated drinks” and was advertised as a “plant-based and clean” beverage that contained as much caffeine as the restaurant’s dark roast coffee, according to photos of both the menu and beverage dispensers in the store, which were included in the wrongful death lawsuit.
But at 390 milligrams, the large charged lemonade has more caffeine than any size of Panera’s dark roast coffee, the complaint says — numbers that the nutrition facts on Panera’s website confirm. The charged lemonade also has guarana extract, another stimulant, as well as the equivalent of nearly 30 teaspoons of sugar, the complaint continues, adding that 390 milligrams of caffeine is higher than the caffeine content of standard cans of Red Bull and Monster energy drinks combined. Katz had gotten the large cup, which is 30 fluid ounces, according to the attorney representing her family.
“I think everyone thinks lemonade is safe. And really, this isn’t lemonade at all. It’s an energy drink that has lemon flavor,” said Elizabeth Crawford, a partner at Philadelphia-based law firm Kline & Specter, PC. “It should have an adequate warning.”
The lawsuit alleges the charged lemonade is “defective in design because it is a dangerous energy drink.”
“These unregulated beverages include no warning of any potentially dangerous effects, even the life-threatening effects on blood pressure, heart rate, and/or brain function,” it says.
Conroy described Katz as an excellent student and “the most involved and passionate person I’ve ever met,” someone who would smile and wave to everyone on campus. She was careful to tell people that she couldn’t consume energy drinks and made other modifications for her health condition, but she “never let it stop her from achieving the things that she wanted to do,” Conroy said.
Katz had been diagnosed with long QT syndrome at the age of 5, according to Crawford. The American Heart Association describes long QT as a disorder of the heart’s electrical system that can cause abnormal heart rhythms as a result of exercise or stress; it can be well-managed with medication.
In addition to medication, Katz’s condition was controlled by regular doctor visits, where “everything was always normal,” Crawford said.
About 1 in 2,000 people have congenital long QT syndrome, with some showing no symptoms and others fainting or experiencing heart palpitations in response to triggers such as exercise or being startled, said Dr. Charles Berul, an electrophysiologist at Children’s National Hospital in Washington.
Berul, who did not treat Katz and is not involved in the lawsuit, said that caffeine is allowable in moderation for long QT patients.
“We tell people not to worry, it’s fine to have a Coke or a small coffee each day,” said Berul, who is on the board of trustees for the Sudden Arrhythmia Death Syndromes Foundation, an advocacy organization for those with heart rhythm abnormalities.
“But some of the smaller studies have shown that energy drinks, drinks that have caffeine plus other ingredients like taurine, other things, might be a little riskier,” Berul said.
The lawsuit says Katz purchased an Unlimited Sip Club membership from Panera, which allows customers to pay a monthly fee for unlimited drinks, about a week and a half before her death. Conroy said Katz had bought at least one other charged lemonade in the days prior to her cardiac arrest.
On the day of her death, Katz had purchased a charged lemonade and collapsed several hours later while at a birthday gathering for a friend at a restaurant, Conroy said. Emergency personnel transported her to the hospital, where she had another cardiac arrest, this time fatal, the lawsuit says.
“She was taken from us so soon, and she shouldn’t have been,” Conroy said. “She had so much more to give.”
A medical examiner’s report that Crawford shared with NBC News showed that Katz’s cause of death was cardiac arrhythmia due to long QT syndrome. The report does not mention the beverage as a contributing factor but notes that she had no drugs in her system, other than what the hospital used to try to resuscitate her.
A potential risk to other populations
Caffeine can have health consequences for people beyond those with long QT syndrome and other heart disorders. Large amounts can also pose risks to people with other underlying conditions as well as to pregnant or breastfeeding individuals and to children, the Food and Drug Administration says.
According to Panera’s website, the caffeine content of its charged lemonade ranges from 260 milligrams in the regular size to 390 milligrams in the large, 30-ounce size, while the caffeine content of its dark roast coffee ranges from 161 milligrams in a small to 268 milligrams in a large, which is 20 fluid ounces.
Panera’s charged lemonade has attracted attention on social media. In December 2022, a customer who said she didn’t know how caffeinated the drink was shared a viral TikTok of herself after consuming free refills of the mango yuzu charged lemonade and captioned the video, “this drink should come with a warning because it’s delicious and will lead to my cardiac arrest.”
On its website, Panera refers to its charged lemonades as “the ultimate energy drink,” although the lawsuit alleges that it was not advertised as such in-store at the time of Katz’s death. It is not clear how long that verbiage has been used on the restaurant chain’s site.
“If you’re going to market it that way and know it’s energy drink, how can you not market it that way in the actual store?” Crawford said. “The reasonable consumer is not going to go onto the website to compare it to see whether or not there’s any additional information.”
Katz’s parents, who declined to speak about the lawsuit, are desperate for people to understand exactly what is in Panera’s charged lemonade before they buy it, Crawford said.
“That has become their most important thing, is making the public aware of these dangers to make sure that it doesn’t happen to someone else,” she said.
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Epidemics & Outbreaks
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- Uninsured Americans pay nearly $98 on average for a vial of Eli Lilly's generic insulin, even after the company pledged to cut the product's list price to $25 per vial, according to a report released by Sen. Elizabeth Warren.
- Eli Lilly earlier this year vowed to slash the list price of its generic insulin, Lispro, from $82.42 per vial starting on May 1.
- The Massachusetts senator's report surveyed more than 300 pharmacies in the U.S. between June 9 and 28 to determine whether Eli Lilly's announced price cut "translated into real relief for patients."
- Warren said the report demonstrates that Congress needs to take additional steps to reduce the excessive prices of insulin from Eli Lilly, Sanofi and Novo Nordisk.
Uninsured Americans pay nearly $98 on average for a vial of Eli Lilly's generic insulin, even after the company pledged to cut the product's list price to $25 per vial, according to a report released Thursday by Sen. Elizabeth Warren.
Eli Lilly earlier this year vowed to slash the list price of its generic insulin, Lispro, from $82.42 per vial starting on May 1. The Indianapolis-based pharmaceutical company is one of the world's largest insulin manufacturers.
The Massachusetts senator's report surveyed more than 300 chain and independent pharmacies in the U.S. between June 9 and 28 to determine whether Eli Lilly's announced price cut "translated into real relief for patients."
The survey found that a third of pharmacies charged uninsured patients $164 or more for a vial of Eli Lilly's Lispro.
Seven pharmacies charged $200 per vial or more, and two sold the product for more than $300.
Chain pharmacies charged uninsured customers an average of $123 per vial for the generic insulin, compared with $63 on average at independent pharmacies.
Eli Lilly did not immediately respond to a request for comment on the survey.
The survey findings suggest that "Eli Lilly's promises of affordable, accessible insulin have not been realized for uninsured patients across the country," Warren said in a statement.
She said the data also demonstrate that Congress needs to take more steps to rein in excessive prices, such as capping insulin copays at $35 per month for all patients, regardless of their insurance status.
President Joe Biden's Inflation Reduction Act currently caps insulin copays at $35 per month for people covered by Medicare.
"My new report confirms that far too many uninsured Americans cannot access or cannot afford to pay astronomical prices for life-saving generic insulin – lawmakers need to step up and take action," Warren said in a press release.
Insured Americans typically pay a fraction of the list price for insulin. But uninsured people often have to pay the full cost, which can force them to ration or stop taking the life-saving diabetes treatment.
Nearly 30% of uninsured patients with diabetes reported skipping doses of insulin, taking less than prescribed or delaying purchases over the past year, Warren said, citing a 2022 study by researchers from Harvard and other institutions.
"No American should ever be forced to choose between life-saving medication, like insulin, and their ability to pay for food, shelter, and their everyday needs," Warren said.
Eli Lilly and Sanofi also capped monthly out-of-pocket insulin costs at $35 for people who have private insurance.
Together, the three companies control 90% of the global insulin market.
Their commitments drew applause from lawmakers and Biden, who was pleased that the companies finally answered calls to help make diabetes care more affordable in the U.S.
But Warren's survey raises questions about how effective their cost-cutting efforts will be.
About 37 million people in the U.S., or 11.3% of the country's population, have diabetes, according to the Centers for Disease Control and Prevention.
Approximately 8.4 million diabetes patients rely on insulin, the American Diabetes Association said.
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Health Policy
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On Monday, thousands of junior doctors in England will start a 72-hour strike. They want a 35% pay rise. Yet doctors are among the highest paid in the public sector. So why do they have the biggest pay claim?
The origins of the walkout by British Medical Association members - the biggest by doctors in the history of the NHS - can be found in a series of discussions on social media platform Reddit in late 2021.
A collection of junior doctors were expressing their dissatisfaction about pay.
The numbers chatting online grew quickly and by January 2022 it had led to the formation of the campaign group Doctors Vote, with the aim of restoring pay to the pre-austerity days of 2008.
The group began spreading its message via social media - and, within months, its supporters had won 26 of the 69 voting seats on the BMA ruling council, and 38 of the 68 on its junior doctor committee.
Two of those who stood on the Doctors Vote platform - Dr Rob Laurenson and Dr Vivek Trivedi - became co-chairs of the committee.
"It was simply a group of doctors connecting up the dots," Dr Laurenson says. "We reflect the vast majority of doctors," he adds, pointing to the mandate from the wider BMA junior doctor membership - 77% voted and of those, 98% backed strike action.
Among some of the older BMA heads, though, there is a sense of disquiet at the new guard. One senior doctor who has now stood down from a leadership role says: "They're undoubtedly much more radical than we have seen before. But they haven't read the room - the pay claim makes them look silly."
Publicly, the BMA prefers not to talk about wanting a pay rise. Instead, it uses the term "pay restoration" - to reverse cuts of 26% since 2008. This is the amount pay has fallen once inflation is taken into account.
To rectify a cut of 26% requires a bigger percentage increase because the amount is lower. This is why the BMA is actually after a 35% increase - and it is a rise it is calling for to be paid immediately.
The argument is more complicated than the ones put forward by most other unions - and because of that it has raised eyebrows.
Firstly, no junior doctor has seen pay cut by 26% in that period. There are five core pay points in the junior doctor contract with each a springboard to the next. It means they move up the pay scale over time until they finish their training.
A junior doctor in 2008 may well be a consultant now, perhaps earning four times in cash terms what they were then.
Secondly, the 26% figure uses the retail price index (RPI) measure of inflation, which the Office for National Statistics says is a poor way to look at rising prices. Using the more favoured consumer price index measure, the cut is 16% - although the BMA defends its use of RPI as it takes into account housing costs.
"The drop in pay is also affected by the start-year chosen," Lucina Rolewicz, of the Nuffield Trust think tank, says. A more recent start date will show a smaller decline, as would going further back in the 2000s.
Another way of looking at pay is comparing it with wages across the economy by looking at where a job sits in terms of the lowest to highest earners.
The past decade has not been a boom time for wage growth in many fields, as austerity and the lack of economic growth has held back incomes.
Last year, the independent Doctors' and Dentists' Remuneration Body looked at this. It found junior doctors had seen their pay, relative to others, fall slightly during the 2010s, but were still among the highest earners, with doctors fresh out of university immediately finding themselves in the top half of earners, while those at the end of training were just outside the top 10%.
Then, of course, career prospects have to be considered. Consultants earn well more than £100,000 on average, putting them in the top 2%. GP partners earn even more.
A pension of more than £60,000 a year in today's prices also awaits those reaching such positions.
Little control
But while the scale of the pay claim is new, dissatisfaction with working conditions and pay pre-date the rise of the Doctors Vote movement.
Studying medicine at university takes five years, meaning big debts for most. Dr Trivedi says £80,000 of student loans are often topped up by private debt.
On top of that, doctors have to pay for ongoing exams and professional membership fees. Their junior doctor training can see them having to make several moves across the country and with little control over the hours they work.
This lasts many years - junior doctors can commonly spend close to a decade in training.
It is clearly hard work. And with services getting increasingly stretched, it is a job that doctors say is leaving them "demoralised, angry and exhausted", Dr Trivedi says, adding: "Patient care is being compromised."
But while medicine is undoubtedly tough, it remains hugely attractive.
Junior doctor posts in the early years are nearly always filled - it is not until doctors begin to specialise later in their training that significant gaps emerge in some specialities such as end-of-life care and sexual health.
Looking at all doctor vacancy rates across the NHS around 6% of posts are unfilled - for nurses it is nearly twice that level.
Many argue there is still a shortage - with not enough training places or funded doctor posts in the NHS in the first place.
But the fact the problems appear more severe in other NHS roles is a key reason why the government does not seem to be in a hurry to prioritise doctors - formal pay talks to avert strikes have begun with unions representing the rest of the workforce
"If we have some money to give a pay rise to NHS staff," a source close to the negotiations says, "doctors are not at the front of the queue."
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Health Policy
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The health watchdog has demanded monthly updates on maternity services at two hospitals run by the East Kent Hospitals University NHS Trust.
The Queen Elizabeth the Queen Mother in Margate and the William Harvey in Ashford must provide reports on safety to the Care Quality Commission (CQC).
A review in 2022 found dozens of babies died unnecessarily at the trust.
Carolyn Jenkinson from the CQC said an inspection in January found "a number of concerns", including "the availability of regularly serviced equipment, processes for monitoring women and babies whose conditions deteriorate and risks of cross infection due to poor standards of cleanliness".
She said: "Some of the issues identified are directly connected to the state of repair of the building and the limitations of the physical estate, which we recognise will require resources and greater external support to fully address.
"However, we have significant concerns about the ongoing wider risk of harm to patients and a need for greater recognition by the trust of the steps that can be taken in the interim to ensure safety and an improved quality of care."
The CQC has told both hospitals that by 20 February they "must implement an effective system for assessing, managing and monitoring the safety of the environment and equipment".
The trust must also provide updates to the CQC by the last Friday of each month, including details of daily quality and equipment checks and clinical audits.
The CQC said the monthly report for the William Harvey must also include "setting out the actions taken to ensure the system in place for assessing, managing and monitoring the safety of women and babies using cardiotocography (CTG) monitoring and fresh eyes/ears at the maternity service is effective."
The QEQM has also been told to give regular updates on repairs to "leaking roofs and bowing doors in the midwifery led unit".
'Monitoring the situation closely'
It is also understood Canterbury Christ Church University has removed its trainee midwives from the William Harvey.
Canterbury MP Rosie Duffield said she would be "monitoring the situation closely".
Writing on Facebook, she said: "Unfortunately, it seems since the publication of the Kirkup Report there has been little progress and systems are still not in place to ensure the safety of women".
The trust has been approached for comment.
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Women’s Health
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In a world first, scientists discover 'roadmap' to beating bowel cancer
According to the American Cancer Society, around 150,000 new cases of rectal and colon cancer are diagnosed each year. And while the number is slowly trending downward, thanks to an increase in pre-emptive age-related screening, it’s still the third biggest cancer in the US, affecting around one in 23 men and one in 26 women.
It’s also difficult to treat, with just 10% of patients responding to current immunotherapies. This means that treatment is more often than not surgery, removing all the cancerous tissue. As such, while it might improve survival rate, it can have a huge impact on quality of life outcomes for patients.
Now, researchers at the Olivia Newton-John Cancer Research Institute at La Trobe University in Australia have found that how a patient responds to cancer comes down to how effective a group of immune cells in the large bowel are.
"Gamma delta T cells act as our frontline defenders in the bowel,” said lead researcher Dr Lisa Mielke, Head of the Mucosal Immunity and Cancer Laboratory at the Olivia Newton-John Cancer Research Institute. “What makes these immune cells extraordinary is that they constantly patrol and safeguard the epithelial cells lining the bowel, acting as warriors against potential cancer threats.
"When we analyzed bowel cancer patient samples, we found that when more gamma delta T cells were present in the tumors, these patients were reported to have better outcomes and improved survival."
However, this was only half of the story. Looking at the entire microbiome in the large bowel, the researchers also found a much higher concentration of the molecule transcription factor 1 (TCF-1) on gamma delta T cells. The T cell-specific TCF-1 is also a central regulator of T cell development and function.
“We discovered that the amount, and diversity of, the microbiome in the large bowel resulted in a higher concentration of a molecule called TCF-1 on Gamma delta T cells compared to other areas of the gut,” said lead co-author of the study, Marina Yakou. “This molecule suppresses our natural immune response, the gamma delta T cells, from fighting off bowel cancer.
"When we deleted TCF-1 in gamma delta T cells using pre-clinical models, this fundamentally changed the behavior of these immune cells and we saw a remarkable reduction in the size of bowel cancer tumors," said Yakou. "Our world-first research breakthrough paves a new roadmap for developing targeted combination immunotherapies to more effectively treat bowel cancer patients.”
This research is an exciting step forward in understanding the complex microbiome and how immune cells and the bowel function together, with huge potential in new screenings for cancer and better treatment to improve both bowel cancer risks and therapeutic outcomes.
The study was published in the journal Science Immunology.
For more on the discovery, the scientists present their findings in the video below.
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Disease Research
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Dr. Robert Redfield, former Centers for Disease Control and Prevention director and top virologist, had one of the highest levels of classified-information clearance among the members of President Donald Trump’s coronavirus task force.
He couldn’t reveal everything he knew to me back in June 2021 when I interviewed him, but it was clear even then he held deep suspicions based on what he knew that SARS-CoV-2 came from a lab.
His view was drowned out by Dr. Anthony Fauci’s unyielding dogmatic narrative that COVID must have come from nature.
More recently, Redfield told me the FBI was the agency best positioned to report what happened — and so it came as no surprise to me last week when FBI Director Chris Wray told Fox News that COVID most likely came from a lab incident.
Yet the White House still firmly supports the dangerous gain-of-function research that makes viruses more transmissible — which Fauci helped fund at the Wuhan Institute of Virology.
The White House also fails to acknowledge what the FBI knows, a serious oversight at this late date, especially as we consider how to prepare for the next pandemic, which may very well be artificially created.
Consider the facts.
- Most coronavirus-carrying bats are found in caves in southern China, where some are captured for their viruses and brought to labs (including the Wuhan Institute of Virology) to study.
- Redfield, despite his relationship with Dr. George Gao, China’s own CDC director, was not allowed to put “boots on the ground” in early 2020, when he might have discovered what really happened.
- Studies from a Defense Department contractor and others determined there was an influx of patients from the area around the lab to Wuhan hospitals in summer 2019.
- The virus itself has a furin cleavage site (lacking on bat coronaviruses) that allows it to attach easily to human cells. How did it get there?
- According to Redfield, SARS-CoV-2 no longer infects bats well but does spread widely among humans, including continued asymptomatic spread.
- Though it’s clear from studies there was substantial spread in the Wuhan seafood market, the more important question is how it got there, considering that bats are not generally sold in this market. All fingers point to lab origin — and not just accidental lab origin but deliberate manipulations of a bat coronavirus to test potential.
Why is it important to know for certain whether COVID came from a lab?
Because, as Redfield says, it fuels worries that the next pandemic might come from a lab as well.
This is especially concerning in the case of H5N1 bird flu.
Bird flu continues to infect millions of birds, both domestic and wild, and has a very high mortality rate.
There is spillover to mammals but no sustained spread from human to human.
Gain-of-function research in ferrets Ron Fouchier and his colleagues in the Netherlands performed back in 2012 showed that H5N1 bird flu was still several mutations away (in nature) from being able to transmit easily human to human, and the virus has not shown a major shift in that direction since then.
Unfortunately, generating these exact mutations provided a road map that a rogue scientist could use to engineer the exact mutations we are trying to avoid and introduce a very dangerous virus into the human community.
In the meantime, we are not doing a good enough job trying to limit bird flu in the bird population, where millions of infections increases the chance of major mutations.
The Fouchier experiments — which engineered the virus until ferrets (which respond to flu similar to humans) were able to transmit it through the air — led to a moratorium on gain-of-function research for H5N1 that even Fauci, National Institute of Allergy and Infectious Diseases then-director and gain-of-function-research believer, endorsed.
Unfortunately, this moratorium was lifted in 2019, amid protest in the scientific community — with Fauci’s NIAID funding research.
Top avian influenza researcher David Swayne told me many years ago that hemagglutinins with high numbers (including H5) are not conducive — in nature — to human-to-human spread. Still, he believes in carefully monitoring the spread in birds and trying to control it.
Hemagglutinin is the protein on the surface of the flu virus that enables it to attach itself to cells.
H5N1 is highly lethal to chickens but is harbored relatively asymptomatically in ducks, which then transmit it widely, though not generally to humans.
Unfortunately, the same soothsayers who missed COVID now think they are in a position to predict the next great threat.
But the biggest future threat to us is not a specific virus, but the manipulations we do to it to supposedly protect ourselves by gauging its potential to harm us.
It is likely COVID came from a lab, and it’s also likely that without an immediate change of global policy the next pandemic will too.
Marc Siegel, MD, is a clinical professor of medicine and medical director of Doctor Radio at NYU Langone Health and a Fox News medical analyst.
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Epidemics & Outbreaks
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Key points
- Depressed people often fail to use new positive information to update negative thoughts and views.
- Failure to update beliefs can maintain biased perceptions of oneself, others, and the world.
- Belief updating depends on mood, positivity of the new information, and the use of cognitive immunization.
Part of the reason could be that people with depression have difficulty taking in and integrating information that contradicts their negative beliefs.
Indeed, individuals experiencing depression often resist positive feedback. This means rejecting the idea that they might be, say, more knowledgeable, intelligent, attractive, competent, desirable, successful, kind, or compassionate than they believe.
In some situations, however, depressed individuals are less resistant to disconfirming evidence. When? A recent paper by T. Kube, a post-doctoral researcher at Harvard Medical School, attempts to answer this question.
The author’s findings, published in Clinical Psychology Review, are summarized below.
Depression and exposure to disconfirming evidence
Kube found individuals with depression do not necessarily change their beliefs after receiving positive information (i.e., evidence that disconfirms their beliefs). And this is especially true when:
- They are in a bad mood.
- The information presented is seen as either extremely or barely positive at all.
- It is quite easy to devalue the new information using cognitive immunization strategies.
Cognitive immunization strategies
Cognitive immunization refers to a defensive reinterpretation of evidence that contradicts one’s beliefs.
Specifically, it means making sense of new information in a way that allows one to maintain previous views and expectations.
To illustrate, a patient with depression who wants to maintain the view that she is unlikable may reinterpret other people’s compassion or kindness toward her as pretense, manipulation, mere politeness, etc.
Similarly, a depressed person who receives positive feedback on a test may reason that the test was uncharacteristically easy, he had an easy marker, or he simply got lucky.
Improving psychotherapy for depression
So, given these obstacles, what are some potential strategies for improving psychotherapy for depression?
One, since negative mood appears to have an adverse effect on belief updating, it is important to be in a neutral or good mood before receiving any belief-disconfirming evidence.
Mood-enhancing activities include, among others, engaging in aerobic exercise, listening to music, and spending time with pets.
Two, because it is easy to ignore slightly positive feedback and be suspicious of extremely positive feedback, the information presented must be only moderately positive.
Three, the use of cognitive immunization strategies should be inhibited. Since these strategies are used to devalue disconfirming evidence, the solution is to underline its value and significance instead.
More research is needed to determine how to do this effectively, but to speculate, writing down the positive feedback, being reminded of it regularly, or practicing mindfulness and self-compassion may help.
Indeed, practicing mindfulness can prevent automatic dismissal and facilitate deliberate analysis of the positive evidence. Another way of doing this is by changing the information presentation. For example, in case of written feedback, by changing line spacing or the font style, color, or size.
Takeaway
Patients receiving CBT are usually instructed to carry out behavioral experiments—planned experiential exercises to test negative beliefs. The assumption is that people with depression will update their beliefs when exposed to evidence that contradicts their negative expectations.
But many do not respond to CBT and similar psychotherapies partly because the above assumption is not true all the time. Those with depression may hold on to their negative beliefs by ignoring or devaluing the new evidence.
For example, after an enjoyable interaction with a group of strangers at a party, to think, “They were just pretending to like me.”
To increase the likelihood of belief updating, research shows, depressed individuals need to be in a neutral or positive mood, view the new evidence as “moderately” positive, and be prevented from using defensive cognitive strategies that devalue the positive feedback’s credibility and reliability.
These strategies are a promising way to increase the effectiveness of CBT and other psychotherapies for depression and promote more flexible thinking.
To find a therapist, please visit the Psychology Today Therapy Directory.
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Mental Health Treatments
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Former Health Secretary Matt Hancock pushed to have schools closed in January 2021, messages published by the Daily Telegraph suggest. He eventually got his way with ministers making a U-turn on their initial decision to keep them open. But was it the right call?
The WhatsApp debate between ministers happened in late December 2020, at which point rates of Covid infection were rising, driven by the new Alpha variant. It reportedly prompted Mr Hancock to warn reopening schools would be a "policy car crash" with children spreading the disease.
The BBC has not seen or independently verified the WhatsApp messages, so cannot judge the context in which they were sent.
But we have been told that at the time scientific advisers were torn. The government advisory body Sage had made it clear that its modelling suggested if schools were to stay open it would be difficult to curb the rise in infections.
However, as always, it said there were other considerations to take into account than just curbing the spread of the virus. The most obvious was that closing schools again after the March to September shutdown could have a devastating impact on children's wellbeing and education.
Keeping primary schools open discussed
Some of the scientists most closely involved in the modelling had suggested keeping primary schools open - the evidence at the time suggested younger children were less likely to transmit the virus and would find remote learning more challenging.
But this option was, in the end, rejected, and schools in England closed until early March. The country started to see infection rates fall quite sharply and soon we had one of Europe's lowest levels of Covid.
But that does not necessarily mean the decision was right or that closing of schools was what tipped the balance. Within weeks there were signs that the winter peak had already been reached by the time ministers were arguing over WhatsApp.
Why? One thing the modelling done for the government consistently failed to do was take into account human behaviour. With infection rates rising over Christmas, the public had already started to curb their mixing even ahead of what became the third national lockdown in the first week of January 2021.
In the following months, several government scientists lamented the failure to do more to keep schools open, at least for some age groups.
Could it have been different? England - and for that matter the rest of the UK where schools were closed too - was not unique in closing schools.
In late March 2020, 167 countries had fully or partially closed their schools and by that December, that number was 85.
But there were countries in Europe where schools were not closed for as long, or at all. Sweden kept primary school and younger secondary school pupils in class throughout, for example.
There are questions to answer about prioritisation too. There were periods, for example, when hairdressers and bars were open, but schools were not.
The wider forces at play
Ministers could, of course, have kept schools open in January 2021 and accepted there was a greater risk of the virus spreading, safe in the knowledge that children were at low risk of severe illness.
At the time, the vaccine programme had just started rolling out, and the teaching unions were once again putting up objections to having schools fully open, arguing it would put their members at risk. Although throughout the pandemic teachers were at no higher risk of being infected than average. Shop workers and health staff, for example, were much more likely to get Covid.
The evidence at that point was that schools were not a particular driver of infections, rather they simply mirrored what was happening in society.
It later became clear that the dominant Alpha variant would lead to higher rates of infection among children and young people than other age groups. But that is hardly surprising given they consistently mixed more after the first lockdown, which was the most stringent.
Some have argued an earlier lockdown - perhaps in mid-December once Alpha was identified and with the vaccine programme under way - would have given ministers more wriggle room to keep schools open.
But the debate about school opening also needs to consider what was and was not done for pupils.
Schools never fully closed during lockdowns. They remained open for vulnerable children and key workers - accounting for between 11% and 20% of children in England from January to early March 2021.
The cost to pupils
With teachers switching to remote learning for those out of school, education continued during national lockdowns for most pupils.
But not everyone had the same access to laptops and other technology to help them learn from home.
Research by the University of Sussex found that nearly one in five less advantaged parents said they struggled with home-learning during the first lockdown.
The Department for Education announced it was rolling out extra laptops to help disadvantaged children in mid-January 2021 - nine months into the pandemic.
There is, of course, no doubt that the pandemic had an impact on children's education. Last year, 59% of England's pupils met the expected standards in reading, writing and maths in Year 6 Sats tests, down from 65% in 2019.
The government said at the time that this was to be "expected due to the impact of the pandemic" and that there was "more work to do" to help pupils catch up.
The pandemic has had social and emotional impacts too. BBC analysis published in February and October last year showed there had been a 77% rise in the number of children needing specialist treatment for severe mental health crisis, while the number of five and six-year-olds who needed speech and language support at school had risen by 10%.
In the end, it came down to a judgement call by politicians. They could have kept schools open, or kept them closed for less time.
What is clear is that their decision had huge consequences for children.
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Epidemics & Outbreaks
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If you want to calculate the age of your dog, multiply the number of years they've been alive by seven.
That is the old cliché — but is it true?
Sadly it's not that simple, experts say, firstly because it differs from breed to breed but also because our canine companions age at a different rate to us.
For example, it takes humans 18 years to reach adulthood. But because dogs often undergo puberty – or their teenage phase – at around six months, they are only puppies until about nine months at the latest.
So how else can we work out a dog's 'true age'? MailOnline takes a look — including how a biological calculator is just one of the alternatives to the 7:1 year ratio.
HOW DO YOU CALCULATE THE AGE OF YOUR DOG IN 'HUMAN YEARS'? In simpler terms human age is the same as 16 times the natural logarithm of dog age plus 32. To get to the age of your dog in 'human years' you multiple the the natural logarithm of your dogs real age by 16 then add 31. You can use the 'ln' button on a calculator to get the natural logarithm of your dogs age. You can also use an online tool to calculate the natural logarithm. Just enter the dog age to get the correct value. You then multiply that figure by 16 and add 31 to the total. If your dog is 7 then its natural logarithm number will be 1.9459. You times this by 16 to get to 31 when rounded down. Then add 31 to find out your 7 year old dog is 62 in 'human years'.
This new formula was created by researchers at the University of California and is based on the rate that molecules are added to DNA as we age.
These molecules are known as methyl groups, which can change functions and are known as 'epigenetic' changes.
The scientists looked at these changes in the nucleic acid (called methylomes) of 104 labradors and compared them with those of humans.
They found that although the relationship was not linear, there were similarities in the timing of major milestones between dogs and us.
These were particularly strong when similar age dogs and humans were compared.
However, as discussed above, the team did find that there were periods in the life of dogs where the clocks didn't match humans, including during puberty as they mature earlier in their lifecycle than humans.
Nevertheless, the research allowed them to create a 'biological calculator' to establish a dog's 'true age'.
To establish this human equivalent, the formula involves taking the log of that age, multiplying it by 16, and then adding 31.
On this basis, an 18-year-old dog would be 77 and a 2-year-old dog would be 42 in 'human years'.
Try out our calculator above to see how old your dog is by comparison.
Of course, part of the problem of trying to create a one-size-fits-all approach to a dog's age is that it often differs depending on the breed, size and gender of the pooch.
For example, female dogs live slightly longer than male dogs, while small canines have lifespans that are quite a bit longer than those that are bigger.
One study estimates that small dogs live on average 16.2 human years, compared to 12 years for large dogs. Mixed-breed dogs also tend to live a bit longer than pedigrees, meanwhile.
However, generally speaking if we're looking at dogs as a whole the life expectancy is around 12.69 years on average.
That is according to a recent study of almost two million dogs who are clients of more than 1,000 vet clinics in the US.
Separate research has also revealed how dogs become teenagers at just six months old, fully-fledged adults by two and 'seniors' at around seven.
'Dogs mature more quickly than we do,' said lead study author Dr Naomi Harvey, a research manager at Dogs Trust and an academic at the University of Nottingham.
Disputing the 7:1 year cliché, she added: 'Many one-year-old dogs have reached their full height and most will have gone through puberty or be approaching the end of it, so they're definitely not the equivalent of a seven-year-old child!'
Her findings show that a one-year-old dog is a juvenile just finishing puberty, and is akin to a 15-year-old human.
But just 12 months later, at two years old, dogs have reached full maturity in the same way as a 25-year-old person.
Dr Harvey found dogs can be considered to be entering their senior years at age seven and are deemed geriatric at age 12 and over.
The former is defined as being when the animal is older, but healthy, and the latter is when poor health and death become likely.
The research shows that aging is defined by various behavioural and cognitive traits and trends.
For example, a dog's brain is still developing until it is around seven, after which its attentiveness declines, indicting it is now a senior pooch.
Geriatric dogs aged 12 may show signs of being in a bit more pain and also may suffer memory issues, akin to people with dementia.
So just how can you help your dog live longer? Well, keep an eye on its weight for a start.
One study found that a normal-weight Labrador lives 13.6 years if female and 13.3 if male, but if overweight that drops to 13.0 and 12.7 respectively.
Meanwhile, a normal weight Yorkshire Terrier lives 15.5 years (female) or 16.2 (male), but that drops to 13.5 or 13.7, respectively, if overweight.
Research has also suggested that better dental care may help, too.
But if one thing's for certain, trying to estimate your dog's true age on the 7:1 year ratio is perhaps not the most accurate way of doing so.
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Disease Research
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As syphilis cases continue to spike across the U.S. — with some cities and states recently reporting outbreaks — there is a growing concern about the availability of Bicillin, the injectable penicillin that is used to treat the sexually transmitted infection in adults and kids.
The city of Houston, Texas, officially declared a syphilis outbreak on July 13. It cited a 128% increase in cases among women and a nine-fold rise in congenital syphilis in Houston and Harris County, according to an announcement from the Houston Health Department.
Last month, the Food and Drug Administration (FDA) announced that it expects a "limited supply and impending stock out situation" for select Bicillin medications.
Spike in syphilis cases
Cases of syphilis, a bacterial infection that is spread through sexual contact or from a mother to an unborn child, have been on the rise in the U.S. for the past several years.
Since 2017, all stages of the disease have risen by 74%, with over 176,000 cases reported in 2021, according to the Centers for Disease Control and Prevention (CDC).
Between 2020 and 2021 alone, syphilis cases increased by 32%.
Cases of congenital syphilis, which occurs when a mother passes the infection on to her baby during pregnancy, also rose by 32% — resulting in 220 stillbirths and infant deaths.
Certain regions of the country have seen an even more dramatic spike. In Texas, congenital syphilis cases have risen by 650% since 2016, per the Texas Department of Health and Human Services.
James Hodges, M.D., an internist in Waco, Texas, has been in practice for more than 20 years.
He shared with Dr. Marc Siegel, professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, that two Texas prisons have seen a surge in positive syphilis cases among their women’s intake units.
"They’ve seen somewhere in the neighborhood of twice the amount compared to just 18 months ago," he told Fox News Digital. "Those inmates are mostly coming from Houston and San Antonio, and more now from Dallas-Ft. Worth."
"They are not concerned about it, and are often quoted as saying, ‘It’s no big deal, there is a cure.’"
Hodges estimated that young White women and young Black women comprise the largest share of cases in women’s prisons.
Some county sheriffs he spoke with were unaware of the syphilis problems, as the county jails don’t typically test for the disease, Hodges added.
Syphilis screenings at the border
The CDC provides guidance for all physicians performing medical screening examinations for immigrants and refugees entering the U.S., according to Letitia Bligh, the agency’s health communications specialist in Atlanta, Georgia.
Immigrants with certain communicable diseases are not eligible to obtain a visa or enter the country, according to Section 212(a)(1)(A) of the Immigration and Nationality Act (INA).
Syphilis is one of the diseases on that list, in addition to tuberculosis, gonorrhea, COVID-19, polio, smallpox, pandemic flu and others.
The CDC "does not track diseases by immigration status."
"CDC has comprehensive surveillance systems to track communicable diseases (diseases that can be transmitted to others) for people in the U.S.," Bligh said. "However, CDC does not track diseases by immigration status."
Between 2014 and 2019, approximately 445 out of every 100,000 tested immigrants and refugees were positive for some form of syphilis, per the CDC.
The CDC website states that "syphilis tests must be performed at the time of the immigration medical examination and at the laboratory stated in the panel physician agreement" — but some doctors are skeptical.
"They are not being tested for COVID as they come across [the border], much less for syphilis," Hodges, the Texas physician, told Siegel.
The Texas-Mexico border region "has the lowest rates of gonorrhea and primary and secondary syphilis, but has the highest rate of congenital syphilis," according to the Texas Department of State Health Services.
A spokesperson for the Texas Department of State Health Services told Fox News Digital on Thursday, July 20, that they are unable to quantify the impact of immigration on reported syphilis cases in Texas.
"The data source used for geographical reporting of syphilis diseases within Texas is the client’s home address reported by the provider," the spokesperson continued.
"We attempt to obtain [information about] sexual partners from newly diagnosed individuals to facilitate their testing and treatment, but we’re unable to distinguish Mexico residents from Texas from the information provided."
The spokesperson also said, "Of the reported 25,469 syphilis cases in Texas during 2022, 143 of those cases were reported to acquire the infection from Mexico."
Dr. Jason E. Zucker, assistant professor of medicine at Columbia University Irving Medical Center in New York, told Dr. Marc Siegel that while he’s unsure of the exact percentage, he does treat some immigrants with syphilis.
"That said, syphilis rates in the domestic population have been increasing for years — so anecdotally, while we are seeing some recent immigrants, the majority of our patients with syphilis are not recent immigrants," he said.
Pfizer says Bicillin is ‘limited’ but no official shortage
Pfizer is the only pharmaceutical company that makes Bicillin, producing the drug in its Rochester, Michigan facility.
A Pfizer spokesperson told Fox News Digital said the drug is "definitely taxed" and in "constrained supply," but denied that there is an official shortage.
In 2022, during the convergence of RSV, flu and COVID, there was a shortage of the popular antibiotic amoxicillin. This led doctors to begin prescribing Bicillin as a backup to treat strep throat and other bacterial infections in children, which hadn’t happened before, the Pfizer rep said.
Those factors, coupled with the spike in syphilis cases, led to the dwindling supply.
"We’re pushing hard to produce more Bicillin and supply the market," the spokesperson added.
After amoxicillin became widely available again, Pfizer switched its focus to making more of the adult form of Bicillin, pausing production of the children’s version.
"We made a decision to deprioritize the pediatric version of the drug — which is rarely ever used by pediatricians for antibiotic purposes with kids — and to prioritize the adult version for the patient community that needs it most," the spokesperson said.
"It's vital for pregnant women with syphilis to get the drug, because if they don't, their babies could die or be born with birth defects. So it was a relatively straightforward call."
The pediatric version is expected to run out eventually, the rep confirmed, but he also said, "There will not be a stock-out of the adult drug."
Currently, the drug is "not as readily available as we would like, but there is supply," he said.
Mark C. Poznansky, M.D., PhD, an infectious disease physician at Massachusetts General Hospital and an associate professor at Harvard University, told Siegel that the potential shortage of Bicillin didn’t affect them much until the past few weeks.
"The hospital does still have some Bicillin, and we are able to procure some from the state directly, but currently the drug is being prioritized for pregnant people with syphilis and their contacts, or people who, for whatever reason, cannot receive doxycycline," he explained.
"The state supply can also be used for people with primary/secondary/early latent syphilis."
At Columbia University, physicians are seeing an increase in syphilis cases across gay, bisexual and other men who have sex with men (MSM) as well as people born female, Dr. Zucker told Siegel.
"That is coupled with the nationwide shortage of Bicillin, driven by increased demand, which has led us to develop protocols to try and reduce Bicillin usage whenever possible," he said.
In Nashville, Tennessee, Dr. Zachary Hoy, a board-certified pediatric infectious disease specialist and medical director at Pediatrix Medical Group, mainly sees cases of congenital syphilis, which happens when an infant is born to a mother with the infection.
"Currently we have not experienced a shortage of Bicillin at my facility, but there are some hospitals in Nashville that are concerned about a shortage," he told Fox News Digital.
Pfizer expects to reach "full recovery mode" — which is when there is an "ample backup supply" of six to eight weeks’ worth of excess supply on the shelves — by mid- to late-2024, the company spokesperson told Fox News Digital.
What to know about syphilis: Diagnosis, treatment, prevention
The first sign of syphilis is usually a painless sore on the mouth, genitals or rectum, according to the Mayo Clinic. Later symptoms can include a body rash, hair loss, muscle aches, sore throat, fever and swollen lymph nodes.
In its early stages, syphilis can be treated with an injection of penicillin (Bicillin).
If left untreated, up to 30% of people may develop tertiary syphilis, which can eventually damage the brain, nerves, eyes, heart, blood vessels, liver, bones and joints, per the Mayo Clinic.
With congenital syphilis, an infected mother can pass the disease on to her unborn baby, which can cause fetal death, premature birth or birth defects.
Those most at risk include people who engage in unprotected sex, have sex with multiple partners, are men who have sex with men, or are infected with HIV, the Mayo Clinic states.
There is currently no vaccine for syphilis.
"Many sexually transmitted infections are treatable, but have to be diagnosed and followed with a treatment plan," Hoy told Fox News Digital.
"STI screening is free or at a significantly reduced cost at public health departments," he added. "Some screening can even be done via urine or swab testing and may not require a blood draw."
Those who suspect they may be infected should seek screening right away, the doctor advised.
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Epidemics & Outbreaks
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(Vienna, 29 September 2023) Up to 15 percent of children and five percent of adults are affected by the chronic inflammatory skin disease atopic dermatitis. Despite advanced therapy measures, the severe itching and eczema, especially on the elbows or knees, cause great distress to the patients. In the course of a study conducted at MedUni Wien a research team led by Wolfgang Weninger, Head of the Department of Dermatology, has discovered a new approach: bacteriophages, which colonize the skin as viral components of the microbiome and can drive the development of innovative atopic dermatitis therapies. The research results were recently published in the scientific journal "Science Advances".
Until now, the importance of bacteriophages ("bacteria eaters", also called phages) in the human body has been known primarily from analyses of the intestine. In the search for innovative therapeutic measures for atopic dermatitis (AD), the MedUni Vienna research team has now investigated the interaction of phages and bacteria in the skin for the first time. After all, it has long been known that the progression of AD is accompanied by massive changes in the skin microbiome. The microbiome is the sum of all microorganisms on the skin and has been primarily investigated for its bacterial constituents. It has been unknown whether viruses also contribute to the nature of the bacterial microbiome in healthy and diseased skin. Phages are viruses of different types and functions whose sole aim is to infect bacteria, thereby either destroying them - or stimulating them to multiply.
New phages identified
"In our study, we discovered previously unknown phages in the microbiome of the skin samples of AD patients, which help certain bacteria to grow faster in different ways," note first authors Karin Pfisterer and Matthias Wielscher from the Department of Dermatology at MedUni Vienna. The resulting shift in the balance between phages and bacteria was not detected in the comparative samples from healthy individuals and may be one explanation for the overpopulation of the skin microbiome with bacteria called Staphylococcus aureus found in AD. These findings contribute significantly to a better understanding of the skin bioflora in AD patients and pave the way for the development of new targeted therapeutic interventions: By identifying and culturing phages specialized for Staphylococcus aureus, a promising new option is available.
Specialists for targeted therapy
Bacteriophages are found not only in the body, but in every habitat populated by bacteria. There are 1031 different phage species, which makes a number with 31 zeros. One of their characteristics is that they prove to be extremely specific when it comes to choosing their target of infection: Most phages specialize in a particular genus, and in many cases in only a single species of bacteria. While that makes it a challenge for scientists to identify the type of phage needed for a particular purpose, it also enables them to use them in a targeted manner. Bacterial viruses do not make any difference between antibiotic-resistant and other bacteria, thus they are being researched as possible weapon in the fight against multi-resistant pathogens. Further studies are now planned to confirm phage therapy for topical use in atopic dermatitis.
Publication: Science Advances
The phageome in normal and inflamed human skin
M. Wielscher, K. Pfisterer, D. Samardzic, P. Balsini, C. Bangert, K. Jäger, M. Buchberger, B. Selitsch, P. Pjevac, B. Willinger, W. Weninger
science.org/doi/10.1126/sciadv.adg4015
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Disease Research
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New research from the University of Aberdeen has, for the first time, found evidence that the brain controls vitamin balance in the body.
Previously thought to be the duty of other organs in the body including the liver and kidneys, this is the first-time that scientists have identified a role for the brain in vitamin regulation and could have implications for diagnosis and treatment of vitamin-related diseases from anaemia to infertility to blindness.
In this study, the scientists looked at vitamin A and how the brain reacts to it. Vitamin A is essential for life but until now it was not known how it is maintained in the body.
The study was conducted initially on rats and found that a region of the brain called the hypothalamus may be responsible for controlling the levels of vitamin A, and that there may be top-down control of vitamin A function around the body.
Published in iScience, this is the first time that the hypothalamus, which regulates many body systems including temperature, appetite and thirst has been implicated in the control of vitamins in the body.
Professor Peter McCaffery and Dr Peter Ikhianosimhe Imoesi, whose research was funded by the University of Aberdeen Elphinstone scholarship, conducted the study which was also partially funded by the Biotechnology and Biological Sciences Research Council (BBSRC).
Like all vitamins, vitamin A, also known as retinol, is essential for life - it is important for vision, the immune system, reproduction, growth and development of the foetus, as well as function of many organs, including the heart, lungs and brain. Recently, vitamin A has been considered important for the survival of cells in the brain and it may even be protective for neurodegenerative disorders such as motor neurone disease.
The body cannot make vitamin A by itself and it must be obtained from the diet in the form of leafy green vegetables, orange and yellow vegetables or beef liver, milk or eggs. It is already known that vitamin A is stored in the liver but until now there was little understanding as to how levels were maintained in the body. This is a delicate balancing act, vitamin A deficiency can lead to disastrous weakening of the immune system as well as visual and skin problems and while excess vitamin A is less common it can lead to problems again with vision, the skin, as well as swelling of the brain.
The study showed that application of very small amounts of vitamin A directly to the hypothalamus of the rat brain impacted the amount of vitamin A in the storage area of the liver and the amount of the vitamin distributed to cells of the body via the blood. This, the authors suggest, implies that a vitamin A sensor system is present in the hypothalamus that controls how it is distributed in the body.
The study also showed that the type of cells in the rat hypothalamus that may act to sense vitamin A are also present in the human hypothalamus.
Dr Imoesi explains: “What we found is radically new. No one before has even suggested that the brain may control vitamin balance in the body and this is the first study to imply a “vitaminostatic” role of the hypothalamus.
“Our results suggest that vitamin A imbalance may not be simply due to irregular intake but that an abnormality in hypothalamic function due to disease or inflammation, may lead to inadequate supply of vitamin A to the body. Diseases that effect the hypothalamus may have some of their symptoms due to disordered vitamin A levels in the body. Measurement of vitamin A levels in the blood may provide a guide to whether the hypothalamus is functioning normally.
“Understanding the regulation of vitamin A balance in the body is important given that both deficiency and excess are detrimental to human health. Worldwide an estimated 250 million people are marginally deficient of vitamin A while 140 million pre-school children and around 7.2 million pregnant women are believed to be vitamin A deficient. Normal hypothalamic function may be necessary to balance vitamin A and act to reduce such harmful effects. “
ENDS
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Nutrition Research
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A court ruled the owners of Purdue Pharma, the Sackler family, will be protected from civil lawsuits linked to the opioid crisis in exchange for a $6 billion settlement. Purdue, which filed for bankruptcy in 2019 amid thousands of lawsuits, made drugs like OxyContin and is blamed for fueling the opioid epidemic. William Brangham discussed the settlement with Aneri Pattani of KFF Health News.
Geoff Bennett:
A federal appeals court has ruled that the billionaire owners of Purdue Pharma, the Sackler family, will be protected from civil lawsuits linked to the opioid crisis in exchange for a $6 billion settlement.
Purdue, which filed for bankruptcy in 2019 amid thousands of lawsuits, made drugs like OxyContin and is blamed for fueling the opioid epidemic.
William Brangham has more.
William Brangham:
Geoff, Purdue's opioid sales earned the Sackler family billions of dollars. And the $6 billion that they will pay in this settlement will be given to state, cities and individuals harmed by opioid addiction and overdoses. It also requires that the Sacklers give up control of Purdue Pharma.
In total drug manufacturers, pharmacies and distributors have pledged around $54 billion to state, local and tribal governments for their respective role in the opioid epidemic.
So, to understand where that money might be spent, we are joined by Aneri Pattani. She is tracking all of this for KFF Health News.
Welcome to the program.
Just remind us of the contours of this deal, the Sackler settlement, what it means for the Sacklers and what it means for the people who are suing them.
Aneri Pattani, KFF Health News:
So, this deal has been in the works for a long time. There's been almost a year that folks have been waiting on this next step in the bankruptcy.
And with the federal judge in New York clearing this for the next round, what it means is that the Purdue Pharma bankruptcy for the company can move forward. And when the bankruptcy moves forward, for people who filed lawsuits for the governments, state and local governments, they will be getting payouts from a total of $6 billion about.
And what it means for the Sacklers is that the individual Sackler family members are protected from any lawsuits against them. So that was sort of the trade-off in moving this deal forward that the judge OKed.
I mean, it seems like there are these two competing forces here, the very demonstrable anger against the Sackler family, for which there's a good documentary evidence that they knew how bad this crisis was and yet kept going forward, and yet also this desire on behalf of all these states and communities to get that money to try to ameliorate.
That's a very difficult tension to navigate.
Aneri Pattani:
Yes, I think I have been hearing this from a lot of folks, where people have been waiting for this bankruptcy to move forward for a long time.
Individual families want the money, right? I hear from grandparents who are raising their grandkids because their sons or daughters died of the opioid crisis. And those bills are coming in now, right, like the caring for them, their school, their health, whatever it is, families that are dealing with funeral costs for people who have died of overdoses, so they need the money now.
And then there — you talk about the governments that want to start addiction treatment programs or recovery housing. But, at the same time, the way this money is moving forward and actually getting out to people is by protecting the Sackler family from any personal responsibility.
And those same family members who want the money and the same communities that need it also feel like there should be some personal responsibility for what happened.
Right. And, like, I guess that's just what they're going to have to live with now, that the money comes in it comes with this other stipulation.
As you and many others have been reporting, the Sackler money is just part of this other bit bigger pot of money from a lot of different — from pharmacies, from distributors, from other manufacturers, 50-plus billion dollars that's out there.
Give us a sense of how that money is going to be spent, generally speaking.
Right.
So the money, as you said, is coming from a lot of different companies. And they each have slightly different settlement agreements. Most of them require that at least 85 percent of the money that any state gets be spent on what's called opioid remediation, essentially, programs that will address addiction as it exists now or prevent it in the future.
But what that actually looks like is really varying from state to state. There are some state and local governments that are investing heavily in mental health programs, in prevention in schools, in addiction treatment for people who are uninsured, in naloxone. There are others that are investing in their law enforcement, in police efforts and criminal justice, drug courts, things like that.
So it really runs the gamut and kind of depends on each local entity, what they think is important when it comes to addressing the opioid crisis.
I mean, which, on some level, you can understand. You want to give communities the flexibility to say, hey, we really need the money for this.
But there are no stipulations as far as the term that you used as far as how this money has to be spent. There's no — it doesn't have to always go to what we most directly think of as drug prevention and drug treatment.
Yes, so the settlement agreements have this list called Exhibit E that puts out potential strategies that local governments might want to use. And it includes a lot of the things that I just listed, but it's non-exhaustive.
So, if you're a government official, you can choose to use the money in something that's not on that list either. And this is where you get into the loose interpretation sometimes. So, there are some governments — I reported on one local county in Tennessee that used a lot of the money to pay back their debt and their capital projects fund because they said, for years, we have been paying for improvements to the jail because it's been housing people largely due to addiction-related crimes.
And so how folks interpret what is related to the opioid crisis really varies widely.
This is kind of what the concern was back in the '90s with the big tobacco settlement too, that we don't know — we think that money is going to go to tobacco prevention and smoking cessation, but not always.
Yes, exactly. And most of that money didn't go to tobacco or anti-smoking programs at all.
In fact, the Campaign for Tobacco-Free Kids, which tracks it, says about 3 percent of the annual payout.
Three percent?
Yes. The rest of it has gone to everything you can imagine, like filling state budget gaps, transportation, paving roads and filling potholes. In North Carolina and South Carolina, they actually used it to subsidize tobacco farmers.
The one difference I will mention, though, is, the tobacco settlement didn't have any requirements for the money to be spent on it, so sort of assumed that because the money was coming because of the public health crisis caused by cigarettes that it would be used for that. But it wasn't actually a legal requirement.
In the opioid settlements, it does have that requirement that 85 percent of the money be spent on opioid remediation. I think there's still a lot of questions about how that will be enforced and if that will really come true. But that clause was in there because people did not want to see a repeat.
Interesting.
So, if I'm an individual or someone in a community, and I have been perhaps part of one of these suits and have been harmed in some very direct way, I don't really have a mechanism to say, hey, we need to be spending this money on this versus that?
You may. It really depends where you're located.
So, first, I want to clarify, because I know a lot of people ask this, are the families getting money directly? From the Purdue bankruptcy, yes, and from one other Mallinckrodt bankruptcy, they — there are payments to individuals who filed claims.
But the vast majority of that $54 billion we talked about with opioid settlements is going to governments. And so individuals can reach out to their county commissioners, can reach out to their elected officials, can reach out to their attorney general's offices and say, I think it should be spent in this way, but they won't have direct control over that.
Aneri Pattani of KFF Health News, thank you so much.
Thanks for having me.
William Brangham is a correspondent and producer for PBS NewsHour in Washington, D.C. He joined the flagship PBS program in 2015, after spending two years with PBS NewsHour Weekend in New York City.
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Epidemics & Outbreaks
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Vaping by high school students dropped this year, says US report
A new government report shows fewer high school students are vaping
NEW YORK -- Fewer high school students are vaping this year, the government reported Thursday.
In a survey, 10% of high school students said they had used electronic cigarettes in the previous month, down from 14% last year.
Use of any tobacco product— including cigarettes and cigars — also fell among high schoolers, according to the Centers for Disease Control and Prevention report.
“A lot of good news, I’d say,” said Kenneth Michael Cummings, a University of South Carolina researcher who was not involved in the CDC study.
Among middle school student, about 5% said they used e-cigarettes. That did not significantly change from last year’s survey.
This year's survey involved more than 22,000 students who filled out an online questionnaire last spring. The agency considers the annual survey to be its best measure of youth smoking trends.
Why the drop among high schoolers? Health officials believe a number of factors could be helping, including efforts to raise prices and limit sales to kids.
The Food and Drug Administration has authorized a few tobacco-flavored e-cigarettes intended to help adult smokers cut back. The age limit for sales is 21 nationwide.
Other key findings in the report:
— Among students who currently use e-cigarettes, about a quarter said they use them every day.
— About 1 in 10 middle and high school students said they recently had used a tobacco product. That translates to 2.8 million U.S. kids.
— E-cigarettes were the most commonly used kind of tobacco product, and disposable ones were the most popular with teens.
— Nearly 90% of the students who vape used flavored products, with fruit and candy flavors topping the list.
In the last three years, federal and state laws and regulations have banned nearly all teen-preferred flavors from small, cartridge-based e-cigarettes, like Juul.
But the FDA has still struggled to regulate the sprawling vaping landscape, which now includes hundreds of brands sold in flavors like gummy bear and watermelon. The growing variety of flavored vapes has been almost entirely driven by a wave of cheap, disposable devices imported from China, which the FDA considers illegal.
The CDC highlighted one worrisome but puzzling finding from the report. There was a slight increase in middle schools students who said they had used at least one tobacco product in the past month, while that rate fell among high school students. Usually those move in tandem, said Kurt Ribisl, a University of North Carolina researcher. He and Cummings cautioned against making too much of the finding, saying it might be a one-year blip.
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Perrone reported from Washington.
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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.
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Epidemics & Outbreaks
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Bleeding between periods can be unnerving, although most people who menstruate experience this at some point in their lives.
"Intermenstrual bleeding" broadly refers to bleeding from the vagina that occurs between a person's expected menstrual periods, and it includes "spotting," which refers to relatively light blood loss. Intermenstrual bleeding is different from having irregular periods, where the length of the menstrual cycle fluctuates such that one's period doesn't come at regular intervals.
But why does spotting happen between periods? And is it ever something to worry about?
The short answer is that spotting can happen for harmless reasons, but at times, it may be linked to more serious underlying conditions. To know why spotting happens, it helps to understand the mechanisms that regulate menstrual bleeding.
Menstruation is the process of shedding the endometrium, the layered tissue that lines the inside of the uterus, according to the medical resource StatPearls. Prior to menstruation, one layer of the endometrium, called the stratum functionalis, thickens to prepare for the potential implantation of a fertilized egg. If pregnancy does not occur, this layer breaks down, leading to the bleeding and "sloughing" of tissue tied to a period, and the cycle starts again.
This thickening and shedding of the endometrium is controlled by reproductive hormones, such as estrogen and progesterone; blood clotting factors; and the constriction of the uterine and ovarian arteries. In a typical menstrual cycle, bleeding happens every 24 to 38 days and lasts two to seven days, StatPearls states.
Causes of bleeding between periods
Some reasons for bleeding between periods are relatively harmless, such as hormonal changes brought on by puberty, Dr. Amanda Black, a professor of obstetrics and gynecology at the University of Ottawa in Canada, told Live Science by email. Shifts in a person's hormone levels in the years before menopause can also spur bleeding between periods, StatPearls notes.
That's because hormonal fluctuations can cause the endometrium to thicken and partially shed at various times throughout the menstrual cycle.
Intermenstrual bleeding can also stem from hormonal contraception, including birth control pills with only progesterone and "combined" pills with both progesterone and estrogen, Dr. Keemi Ereme, an obstetrician-gynecologist and complex family planning fellow at the University of Illinois Hospital in Chicago, told Live Science. For example, the transition onto hormonal birth control can cause breakthrough bleeding — another term for spotting — as the body adjusts to the new influx of hormones. Spotting can also happen when users miss a pill in their regimen.
"However, the bleeding caused by [oral contraceptives] is usually not harmful," Ereme said.
But bleeding between periods can also stem from medical conditions, such as polycystic ovary syndrome (PCOS), a hormonal disorder where fluid-filled cysts swell in the ovaries, and endometriosis, in which endometrium-like tissue grows outside the uterus, Black said. Spotting is also tied to endometrial hyperplasia (an abnormal and excessive thickening of the endometrium), uterine cancer and cervical cancer, she said.
Noncancerous growths, such as polyps and uterine fibroids, can also interfere with the normal thickening and shedding of the endometrium and cause intermenstrual bleeding, Ereme added. Spotting can also stem from bleeding disorders, such as Von Willebrand disease, a hereditary condition that disrupts blood clotting. And spotting can occur due to infections of the reproductive tract, including the bacterial sexually transmitted infections (STIs) gonorrhea and chlamydia, Ereme said.
Low levels of thyroid hormones "essentially stops ovulation or decreases the frequency of ovulation," Ereme added. Without ovulation, the body doesn't produce enough progesterone to properly stabilize the endometrium as it thickens, leading to irregular and heavy shedding.
Although spotting is common and often not a cause for concern, it's a good idea to seek medical guidance from a health care professional if you are experiencing bleeding between periods, Black and Ereme both told Live Science.
This article is for informational purposes only and is not meant to offer medical advice.
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Anna Gora is a health writer at Live Science, having previously worked across Coach, Fit&Well, T3, TechRadar and Tom's Guide. She is a certified personal trainer, nutritionist and health coach with nearly 10 years of professional experience. Anna holds a Bachelor's degree in Nutrition from the Warsaw University of Life Sciences, a Master’s degree in Nutrition, Physical Activity & Public Health from the University of Bristol, as well as various health coaching certificates. She is passionate about empowering people to live a healthy lifestyle and promoting the benefits of a plant-based diet.
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Women’s Health
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Para el verano de 2021, Gilbert Milam Jr. estaba teniendo una buena vida. Rapero que se presenta bajo el nombre de Berner, Milam también disfrutaba de la expansión global de Cookies, una marca de productos de cannabis y ropa que cofundó y dirigía como CEO.
Pero Milam se sentía atormentado por una historia familiar de cáncer, incluida la muerte de su madre por cáncer de estómago a los 54 años. Así que, a los 37, le dijo a su médico en San Francisco que quería tomar todas las precauciones para evitar un diagnóstico tardío y poder vivir una vida plena. Su médico le dijo que había una nueva prueba que podía intentar.
La prueba de sangre, llamada Galleri, detectó una señal de ADN para el cáncer de colon. Después que una colonoscopía confirmara que era de estadio 3, Milam se sometió a ocho horas de cirugía, seguida de radiación y quimioterapia. Hoy, dice que está libre de cáncer.
“Esa prueba salvó mi vida, y eso es un hecho”, dijo Milam, hablando con California Healthline desde su autobús de gira en julio.
Galleri, que cuesta $949, es la primera de una ola de pruebas de detección temprana de cáncer múltiple (MCED), que analizan fragmentos de ADN en la sangre en busca de anomalías asociadas con el cáncer.
Grail, la empresa de biotecnología con sede en Menlo Park que creó Galleri, afirma que verifica más de un millón de sitios específicos de ADN en busca de señales de cáncer y puede identificar más de 50 tipos de cáncer, incluidos los de cuello uterino, colon, mama y próstata. Más de una docena de competidores potenciales están desarrollando sus propios productos de detección de cáncer.
Sin embargo, la comunidad médica aún no ha llegado a un consenso sobre el valor de las pruebas MCED. La idea de realizar pruebas a personas aparentemente sanas ha generado preocupación entre aquellos que ya lamentan la tendencia del sistema médico estadounidense a hacer pruebas excesivas y, a menudo, a tratar en exceso a los pacientes en función de los resultados de las pruebas. Algunos señalan la controversia en torno a las pruebas de antígeno específicas de la próstata para el cáncer de próstata como ejemplo.
“Una prueba de detección tiene que ser magnífica, matemáticamente, para ser beneficiosa”, dijo Jerome Hoffman, profesor emérito del Departamento de Medicina de la Universidad de California en Los Ángeles y crítico de larga data de las pruebas excesivas y el sobrediagnóstico. “La mayor amenaza en el horizonte es el sobrediagnóstico, encontrar cosas que no importan pero en las que intervenimos de todos modos”.
Muchos expertos dicen que aún no está claro si las pruebas hacen más bien que mal, y que tener una ya disponible comercialmente les preocupa.
“Entrevista a cien personas y diles que hay una prueba que podría detectar 20, 30 o 50 tipos de cáncer con una sola muestra de sangre, y muchas de ellas dirán: ‘Quiero eso'”, dijo Philip Castle, director de prevención del cáncer en el Instituto Nacional del Cáncer. “Pero este es un mundo nuevo y valiente. No sabemos nada sobre estas pruebas, realmente”.
La historia de Milam comenzó en San Francisco cuando le estaban sacando sangre para verificar los anticuerpos de covid-19. Le contó a su médico, Jordan Shlain, sobre su miedo a desarrollar un cáncer mortal y sobre la historia de su familia con la enfermedad.
Shlain, fundador de la práctica concierge Private Medical con sede en San Francisco, le habló a Milam sobre Galleri.
“Nuestra práctica había revisado la ciencia durante 12 a 18 meses. Interrogamos a las personas de Grail”, dijo Shlain. “La versión corta es: nueva prueba, resultados prometedores y sabemos que la genética y la genómica han transformado la forma en que se trata el cáncer. Tienes que ser escéptico si eres un científico, pero también hay una tensión entre los responsables de tomar decisiones y los médicos de atención primaria. Yo cuido de individuos, no de poblaciones”.
Shlain dijo que no recomienda la prueba para todos los pacientes; dependería de sus antecedentes y factores de riesgo. Por otro lado, dijo: “No puedes prevenir el cáncer, pero puedes evitar que te mate si lo detectas temprano. Eso es simplemente una verdad”.
Milam, quien sigue actuando y dirigiendo Cookies (la empresa ha sido objeto de demandas recientes), se ha convertido en un evangelista de la prueba. A menudo ha hablado de su experiencia con sus más de 2 millones de seguidores en Instagram, y se pregunta por qué más médicos no recetan Galleri como lo harían con las pruebas estándar. Shlain dijo que incluso algunos médicos en su práctica son reacios, a pesar de la profunda investigación de Private Medical sobre el tema.
El camino de Grail no ha sido sencillo. La compañía fue originalmente una escisión de Illumina, pionera en secuenciación genética en San Diego, y después de recaudar fondos de capital de riesgo y demostrar su tecnología, Illumina la compró nuevamente el año pasado por 7.1 mil millones de dólares. Sin embargo, debido a que Illumina domina el mercado de los secuenciadores necesarios en las pruebas de detección temprana de múltiples tipos de cáncer (MCED, por sus siglas en inglés), la Comisión Federal de Comercio ha presentado una demanda para deshacer el acuerdo por motivos de competencia desleal.
Grail también reconoció en junio que aproximadamente 400 de sus clientes recibieron equivocadamente información de que podrían tener cáncer, no debido a un error en la prueba, sino porque se enviaron cartas incorrectas por error de parte de un proveedor.
Josh Ofman, presidente de Grail, dijo que la compañía está haciendo lobby en el Congreso “junto con muchos grupos de interés” para que se autorice a Medicare a cubrir el costo de las pruebas MCED, lo que podría desbloquear miles de millones de dólares en ingresos potenciales del gobierno federal. Grail recomienda un cribado anual, pero generalmente no está cubierto por las aseguradoras.
Said Castle, al hablar en general sobre las pruebas MCED, comentó: “No recuerdo haber visto algo [en pruebas de laboratorio] que se compare con el mercado potencial de esto. Esta es la clase de dinero que normalmente reservamos para las compañías farmacéuticas”.
Grail utilizó una excepción para pruebas desarrolladas en laboratorio para comenzar a comercializar Galleri sin la aprobación de la FDA hace dos años, una acción que llamó la atención en la comunidad médica porque ese proceso generalmente se usa para pruebas sin valor comercial. Otra prueba de sangre MCED, realizada por Exact Sciences, sigue el mismo camino hacia el mercado y se espera que esté disponible pronto.
“Supongo que veremos más de eso porque las compañías están ansiosas por comenzar a vender”, dijo Barnett Kramer, exdirector de prevención del cáncer en el NCI y miembro de la Fundación Lisa Schwartz para la Verdad en Medicina. “Pero eso a veces ocurre antes de que se demuestre el beneficio real, y creo que es el caso aquí”.
Estudios detallados sobre el beneficio neto de las pruebas MCED podrían llevar entre 10 y 15 años, dijo Castle. La FDA no tiene que esperar a que se complete un estudio federal a gran escala, pero aún podrían pasar años antes de que la agencia apruebe alguna prueba MCED.
El objetivo de un estudio más largo y a gran escala es comprender mejor tanto los beneficios como los riesgos asociados con la detección temprana del cáncer. Entre otras consideraciones: muchos tipos de cáncer carecen de tratamientos, y no todos los cánceres crecen significativamente o se convierten en un problema. Los escépticos de las pruebas MCED se preocupan por el diagnóstico y tratamiento de pacientes, a veces de manera intrusiva y con peligros potenciales, basados en un hallazgo que no representa una amenaza real.
“No basta con decir que se encuentra cáncer”, dijo Castle. “La pregunta es, ¿podemos encontrar cáncer y salvar vidas? También queremos conocer los daños asociados con esto, como los falsos negativos y positivos, y si la prueba funciona igual de bien en todas las poblaciones”.
Ofman dijo que Galleri ha sido objeto de múltiples pruebas a pequeña escala, incluido un estudio dirigido por investigadores de la Universidad de Oxford que encontró un valor predictivo positivo del 76%, es decir, la probabilidad de que un paciente con un resultado de prueba anormal realmente tenga cáncer. El estudio fue respaldado por el Servicio Nacional de Salud del Reino Unido, que ha llevado a cabo un ensayo clínico aleatorio de la prueba que finalmente involucrará a 140,000 adultos. Se esperan resultados preliminares el próximo año.
Actualmente, las pruebas establecidas solo detectan un puñado de cánceres, y generalmente identifican el cáncer en etapas más avanzadas, cuando se puede hacer menos para intervenir. Según investigaciones del NCI, el 73% de las personas que mueren por cáncer tenían cánceres que no fueron detectados por las pruebas estándar en uso.
“Tienes más opciones de tratamiento para los cánceres que se encuentran temprano, a veces incluso opciones curativas”, dijo Ofman. “Incluso con los cánceres en etapas 3 o 4, los tratamientos cuando se detectan asintomáticamente obtienen mejores resultados”.
Pero con más de 100,000 pruebas Galleri ya vendidas, Kramer, de la Fundación para la Verdad en Medicina, es uno de los que están preocupados de que la comercialización del producto esté avanzando más rápido que las pruebas a favor del mismo.
“La carga ética recae en la persona que intenta convencer a una persona sana de que se haga la prueba”, dijo Kramer. “El mejor escenario en este caso es que la prueba realmente pueda reducir el riesgo de morir por la segunda causa de muerte más común en la población adulta, y si lo hiciera con un bajo riesgo de sobrediagnóstico, eso sería un gran éxito. Pero estamos lejos de poder afirmarlo”.
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Medical Innovations
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A pioneering British scientist whose work developing antibiotics had her featured on Forbes' 30 under 30 Europe list has died from cancer aged 29.
Doctor Kirsty Smitten was co-founder and chief executive of MetalloBio, a company which has created new antibiotics aimed at saving millions of lives.
She featured on Forbes' 30 under 30 Europe list in 2020 for her work in helping combat antimicrobial resistance (AMR), which causes antibiotics to become ineffective in preventing and treating infections.
The Solihull biochemist died on 4 October after being diagnosed with cardiac angiosarcoma in late January - a tumour in the heart.
Kirsty's older brother, Matt Smitten, who described her as "determined, resilient and caring", told Sky News: "She could have gone down a different avenue and had a much better chance of success, because there's not much money in the area.
"But she saw this was the area where she could have the biggest impact and save lives. She was trying to help as many people as she could… she was very, very altruistic."
Kirsty's company, MetalloBio, is continuing its work to develop two lead compounds designed to counter AMR, which is responsible for 1.2 million deaths per year globally and has been marked up as an "urgent priority" by the World Health Organization.
Sukhi Smitten, Kirsty's sister-in-law and wife of her brother, Matt, added: "Her work was her passion and she was even working as she went through chemotherapy.
"She was still pitching and trying to get grants when she was struggling to breathe and to walk. She carried on trying to help push the research forward."
The 29-year-old's philanthropic nature went beyond work, as her diagnosis became a catalyst for helping other cancer patients deal with the disease.
Read more:
Diabetes cases could be diagnosed from A&E screenings
Tens of thousands of UK women 'dying needlessly from cancer'
Matt explained: "She took it hard, but only cried for about a minute [after the diagnosis]. And then she was straight on the internet looking at treatments and speaking to people who had gone through the same thing.
"As a family, we didn't even really know how much of an impact Kirst had had on other people with cancer.
"It was only through posts on comments on Facebook, Instagram, LinkedIn and TikTok [after Kirsty died] that we truly realised the impact she had.
"They were saying things like: 'Kirsty was the first person I spoke to after my diagnosis'. She didn't really speak about that. She was humble.
"But the reach she had in terms of helping people going through a similar thing to her is amazing."
Kirsty's family hopes that her legacy will continue through both MetalloBio and through a charity they plan to set up in her name. They have set up a fundraiser for that charity, which you can find here.
Her Instagram and TikTok accounts, where she shared information about her disease, are still available as a resource for those who wish to learn more about cardiac angiosarcoma.
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Drug Discoveries
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An anonymous reader quotes a report from VICE News: Canada will legalize medically assisted dying for people who are addicted to drugs next spring, in a move some drug users and activists are calling "eugenics." The country's medical assistance in dying (MAID) law, which first came into effect in 2016, will be expanded next March to give access to people whose sole medical condition is mental illness, which can include substance use disorders. Before the changes take place, however, a special parliamentary committee on MAID will regroup to scrutinize the rollout of the new regulations, according to the Toronto Star.
Currently, people are eligible for MAID if they have a "grievous and irremediable medical condition", such as a serious illness or disability, that has put them in an advanced state of irreversible decline and caused enduring physical or psychological suffering -- excluding mental illness. Anyone who receives MAID must also go through two assessments from independent health care providers, among meeting other criteria. [...] As Canada prepares to legalize MAID for people with mental disorders, each province will have to develop its own protocol for how to assess people. Dr. Simon Colgan, lead physician for the Community Allied Mobile Palliative Partnership which provides palliative care to homeless people, said MAID requests "must be understood within the context of a person's lived experience and this takes time and relationship." He said any MAID protocols for people with substance use disorders should be made with the input of people with lived experiences. "I don't think it's fair, and the government doesn't think it's fair, to exclude people from eligibility because their medical disorder or their suffering is related to a mental illness," said Dr. David Martell, physician lead for Addictions Medicine at Nova Scotia Health. "As a subset of that, it's not fair to exclude people from eligibility purely because their mental disorder might either partly or in full be a substance use disorder. It has to do with treating people equally."
On the flip side, some drug users and harm reduction advocates say they're upset drug users are being given access to MAID, as they feel other public health measures are lacking. "I just think that MAID when it has entered the area around mental health and substance use is really rooted in eugenics. And there are people who are really struggling around substance use and people do not actually get the kind of support and help they need," said Zoe Dodd, a Toronto-based harm reduction advocate.
Karen Ward, a drug user activist in Vancouver, said she considers the expansion of MAID to include people with substance use disorders a "statement in federal law that some people aren't really human." "The government has made death accessible while a better life remains impossible," she said. "Homes for all, guaranteed dignified incomes, access to healthcare, education and employment: these aren't radical demands."
Currently, people are eligible for MAID if they have a "grievous and irremediable medical condition", such as a serious illness or disability, that has put them in an advanced state of irreversible decline and caused enduring physical or psychological suffering -- excluding mental illness. Anyone who receives MAID must also go through two assessments from independent health care providers, among meeting other criteria. [...] As Canada prepares to legalize MAID for people with mental disorders, each province will have to develop its own protocol for how to assess people. Dr. Simon Colgan, lead physician for the Community Allied Mobile Palliative Partnership which provides palliative care to homeless people, said MAID requests "must be understood within the context of a person's lived experience and this takes time and relationship." He said any MAID protocols for people with substance use disorders should be made with the input of people with lived experiences. "I don't think it's fair, and the government doesn't think it's fair, to exclude people from eligibility because their medical disorder or their suffering is related to a mental illness," said Dr. David Martell, physician lead for Addictions Medicine at Nova Scotia Health. "As a subset of that, it's not fair to exclude people from eligibility purely because their mental disorder might either partly or in full be a substance use disorder. It has to do with treating people equally."
On the flip side, some drug users and harm reduction advocates say they're upset drug users are being given access to MAID, as they feel other public health measures are lacking. "I just think that MAID when it has entered the area around mental health and substance use is really rooted in eugenics. And there are people who are really struggling around substance use and people do not actually get the kind of support and help they need," said Zoe Dodd, a Toronto-based harm reduction advocate.
Karen Ward, a drug user activist in Vancouver, said she considers the expansion of MAID to include people with substance use disorders a "statement in federal law that some people aren't really human." "The government has made death accessible while a better life remains impossible," she said. "Homes for all, guaranteed dignified incomes, access to healthcare, education and employment: these aren't radical demands."
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Health Policy
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I have a severe, life-limiting form of muscular dystrophy; my condition is progressive. My parents’ home where I live contains lots of medical equipment that keeps me alive and in the community, saving the NHS hundreds of pounds per night and keeping a bed free for those in need. Needless to say, all of this equipment requires energy – and this costs a lot of money right now.
Keeping me out of hospital entails ensuring that lots of medical equipment is continually charged. I use two ventilators, two ventilator batteries, one power-chair battery, one gastrostomy feed-pump, two suction pumps, one electric bed, one electric hoist, one cough-assist machine, one microphone amplifier and monitors to check my breathing when no one is in the room. I also need three hot water bottles night and day, to keep me warm in my power-chair and in my bed. That’s the baseline; additionally, when I’m ill or tired, I have to use an oxygen concentrator, a nebuliser and Sats machines. I wouldn’t be able to survive without the above equipment.
Campaigners have suggested the government bring in a policy called a “social tariff”, whereby a lower-income household would receive a significant discount on energy bills, funded by taxation or by spreading the subsidy cost across better-off bill payers. It’s not that I want a free ride, but the benefits of such a policy outweigh the costs, as my being admitted to a high-dependency ward would result in a far higher bill.
If there were nurses coming into my house, we would have to keep the central heating on 24 hours a day, plus lighting, as well as running the above equipment. The cost would be phenomenal, probably somewhere between £12,000 and £15,000 a year if current estimates are correct. The government has promised “£1,200 to the most vulnerable” , but I do not qualify. The UK government did not make this clear in its statement when it said vulnerable households would receive £1,200; only some disabled people will receive £1,200, and only those who receive other benefits like pension credit and universal credit. I received a one-off payment of £150 and my parents will get the same £400 that is paid to all households in the UK.
Nearly all disabled people will tell you that it’s a constant fight to be recognised, to stay safe and well. The cost of living crisis has exacerbated the financial struggles many people are already experiencing, but disabled people have been struggling against the very systems supposed to support us for countless years now.
My own story is that of a closing window of opportunity to keep me alive, and of the medical politics at a London teaching hospital, which would have let me die had my parents not begged other hospitals to save me while there was still time. One of the amazing consultants who did save me asked: “Have they forgotten there’s a child in the middle of all this?”
In my final year at primary school, my request to have a school trip I could actually participate in, rather than the traditional outdoor activities trip, led to hate mail and accusations from parents of “compromising children’s human rights and the future of physical education classes”. I didn’t attend secondary school.
I hate the changes I see around me regarding the devaluation of human life. I saw first-hand during the pandemic how minority groups and vulnerable people’s lives are seen as dispensable. The cost of living crisis can only worsen the existing inadequacies in support systems as more people’s mental and physical health breaks down.
I know there are many other people in far worse situations than mine and it’s heartbreaking. But I still believe in the power of words to make some sense of the world, and effect change. I am alive; I shouldn’t be. I’ve had many close calls but they’ve not all been caused by my illness. And I still have a lot to say.
Karis Williamson is a 24-year-old poet and scriptwriter living in Inverness
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Health Policy
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Former professional footballer and reality TV star Ashley Cain is taking on his riskiest challenge so far for the little girl he lost to cancer.
"To the top of every mountain, to the bottom of every valley, along every road, across every ocean - I'll take you there, baby."
As he delivered his daughter's eulogy, Ashley Cain vowed to carry Azaylia Diamond Cain's name and legacy with him through every future challenge he faced.
So when anyone asks why he is attempting the Yukon 1000 - described as the world's toughest survival race - he replies: "When else would I get the chance to take my beautiful baby from Canada to the Arctic Circle to Alaska?"
Azaylia was diagnosed with acute myeloid leukaemia in October 2020 and died six months later at just eight months old.
Since then, Ashley - who played for Coventry City and has appeared on TV shows such as MTV's Ex on the Beach and BBC's Go Hard or Go Home - has taken part in many extreme challenges in her name. These have included running five marathons in five days and cycling from Land's End to John O'Groats.
The Yukon, which takes place in July, will see him kayak down the Yukon River from Whitehorse in Canada through the Arctic Circle to Dalton Highway Bridge in Alaska in the US. With only 10 days to complete the 1,000 mile race, 28 two-person crews will need to be able to survive in the wilderness - there are no support teams accompanying them, although their progress will be monitored.
Ashley and his teammate, Gary Johnson - a personal trainer, hope to complete it in seven to eight days - which means they will need to cover 120-125 miles (193-201km) each day.
"That will involve 18 hours a day kayaking with one hour to change, pitch your tent and find a safe place to eat your food in case you're in wolf or grizzly bear territory," he says. "Then five hours' sleep - if you can sleep - to start the day again."
As well as the threat of bear and wolf attacks, challengers also face the risk of hypothermia if they fall into the turbulent waters. "I'm willing to risk my life", says Ashley.
"There's a lot of things that go against you out there," he says, "especially as I'm going to be the least-experienced person by miles to have ever attempted it. I've only been kayaking since February."
Known for his speed and power, Ashley says these long distance challenges that involve endurance don't suit him.
He explains: "I'm big, I'm stocky, it goes against me, but in hospital [with Azaylia] I realised that life is a battle of endurance."
To make it through, all you can focus on is your next step he says - and in every challenge, Azaylia is the reason he keeps taking that next step.
"When I'm struggling, I look up to her and she gives me the strength that I need," he says.
Ashley has written a memoir, which will be published on 22 June, about the relationship with his daughter, her fight for life and the struggles he has faced since she died.
"After Azaylia passed away and I spoke her eulogy, I found myself spiralling a little bit into alcohol," he says.
"When I woke up one morning, I was in tears because I felt ashamed, I felt embarrassed. I thought, 'If this is the person that my daughter's looking down on, I need to hang my head.'"
He says he could lie to his parents about whether he had drunk alcohol, but he could not lie to himself or Azaylia.
"That's when I knew I needed to be changed⦠I needed to keep the promises that I'm making, not only to me, but to her."
With his ex-partner, Safiyya Vorajee, and the foundation they created in their daughter's name, Ashley is determined to fundraise and increase awareness of childhood cancer. He says it is an area of research that is severely underfunded.
"If there is no new research, it means there are no new cures, if there are no new cures, it means there are no better statistics," he says.
No child should have to go through what his daughter experienced, Ashley says, adding she taught him how to be brave when life was frightening.
The TV star says his Christian faith was tested throughout her illness, but he refuses to let Azaylia's short life be in vain.
"There has to be a reason why what happened, happened, and I'm not going to be that person that turns to stone as a result. I am going to be the hero of my story for her, for myself and for other people around me," he says.
Working seven-day weeks and 18-hour days, Ashley describes his schedule as relentless. Currently single, he says it wouldn't be fair to start a new relationship because he is committed to the path he is on. For now, he also cannot see himself having another child.
"I find it hard to be able to imagine that I could love anyone or anything else as much as I love Azaylia," he explains.
By pushing himself to the limits, Ashley says he is not running away from the pain of his loss, but running "head on into it". He wants to show others "no matter how tough your struggle was, there is strength at the other side."
He has chosen to go to the extremes, risking his life in challenges such as the Yukon 1000, because he wants to make the greatest impact for Azaylia.
"I will do something with that incredible and beautiful life and I will make her name live on for many more years."
If you are affected by any of the issues raised in this story, support and advice is available via the BBC Action Line.
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Disease Research
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They were just going to the movies. But the theater was way too hot. By the time they left, he couldnât even hold his head up. He couldnât speak. And he certainly couldnât walk.
âFortunately, I had my wheelchair,â says Zach McCallum. âBut I was a mess.â
McCallum, 55, was diagnosed with myasthenia gravis (MG) in 2015. Since then, heâs spoken a lot about his condition. But he felt âreally embarrassedâ that day. It was early in his illness, and he didnât want his sister to see him like that.
Then she gave him a message that stuck with him, and itâs one he brings to others in the MG community: It doesnât help your friends and family if you hide this.
âIt helps if youâre honest about what youâre living with,â McCallum says. Â
If youâve been diagnosed with MG, here are a few tips on how to talk to your loved ones.
How to Get the Conversation Going
MG is a rare neuromuscular disorder. If your experience is anything like McCallumâs, most people you talk to probably havenât heard of it. Itâs also a disease you canât see from the outside. That can make it tough for friends and family to grasp what youâre going through.
âItâs a different story if youâve lost a limb,â says Amit Sachdev, MD, assistant professor and director of the Division of Neuromuscular Medicine at Michigan State University. âBut in myasthenia gravis, the issue is fatigue and weakness.â
Families can sometimes have a hard time understanding why someone who looks fine canât get up and do the dishes or needs help to the bathroom, Sachdev says. But they might see things a little clearer if you explain some medical stuff.
Tell your friends and family that you have an autoimmune condition. Your immune system attacks certain muscle receptors faster than your body can make new ones. This extra inflammation âblocks the nerves from talking to the muscles,â Sachdev says.
With MG, that commonly affects how you move your eyes, mouth, arms, legs, or breathing muscles.
A not-so-scientific analogy may also help get your point across. McCallum likens MG to a broadcast station and a TV or radio set.
Your nerves send out a signal to âlift your arm or lift your leg,â McCallum says. âBut little jerks have been running around in the bloodstream destroying peopleâs receivers. So now the muscles arenât getting the signal ... and the more you use your muscles, the more receivers get blocked.â
If they want more info about the ins and outs of your condition, send them to the Myasthenia Gravis Foundation of Americaâs website.
Go Over Your Day-to-Day Life With MG
Richard Nowak, MD, director of the Yale Myasthenia Gravis Clinic, says your first talk with loved ones will differ depending on where you are in your disease course. Your symptoms may change or become easier to control as you decide on the best treatment plan, he says.
But whether youâve just been diagnosed or have lived with MG for a while, let your friends and family know which symptoms have a big impact on your day-to-day life.
For instance, double vision or droopy eyelids can make it hard to drive or read. As you learn to manage your MG, Nowak says, you may need help getting to your doctorâs appointments, picking up your prescriptions, or going to the grocery store. And tell those close to you that itâs common for some of your symptoms to come and go.
You may feel perfectly fine in the morning, Nowak says, but by midday, afternoon, or early evening, you may have trouble keeping your eyelids open or talking. That change might confuse your friends and family if they donât know what to expect.
âSometimes with slurred speech, people say, âHave you gotten enough rest, or have you been drinking?ââ Nowak says. âIt can be very easily misinterpreted as something else going on when thatâs not the case.â
Some MG symptoms can be serious. Tell your loved ones to keep note of any shortness of breath or swallowing issues. They should get medical help right away if youâre having trouble breathing.
Bring Up Long-Term Symptoms
Medication and other therapies can be a big help for the majority of folks with MG.
âWe can get most patients symptom-free or with minimal symptoms that donât necessarily affect their day-to-day activities,â Nowak says.
But treatment isnât a magic bullet for everyone. McCallum has a refractory form of the disease. Fast-acting medication helps some of his symptoms. But he still has a lot of weakness, especially in his legs. He uses a wheelchair or other aids for long distances.
âI can walk around in the house,â McCallum says. âWhen I use my forearm crutches, I can walk 40 feet before I have to stop, or Iâll fall down. Thatâs my limit.â
On top of tired muscles, McCallum gets a lot of general fatigue and brain fog. He says those close to him know how to spot the signs he needs to rest.
âWhen Iâm with my friends in the grocery store, and weâre looking at a bunch of grapes, and Iâm like, âOh yeah, letâs get some âbeads,ââ McCallum says. âItâs not because I donât know the word for grapes, and Iâm suddenly having aphasia. Itâs that my brain was just, like, âIâm too tired to find the right word so Iâm just going to pick one.ââ
Explain What Life With MG Feels Like
No one can ever know exactly how you feel. But there might be some tests thatâll give people a small idea of what some of your symptoms are like.Â
âThere are computer screens that will simulate what double vision looks like,â McCallum says. âOr you can say, âStrap on a 10-lb weight to each wrist and now do all the things you need to do.ââ
Sachdev says itâs tricky to try to find the right example. But you can tell someone without MG to bring to mind how weak and tired they feel after exercising really hard or going for a long run.
âThink about how much effort it took to get to that point,â Sachdev says. âNow think about your daily activities taking you to that point.â
How to Show Support for Someone With MG
McCallum lives alone, but he worked with an ADA-compliant designer to remodel his living space. His kitchen and bathroom are now wheelchair accessible, and he put in a stairlift. These kinds of adaptive changes are something to think about if you live with someone who has MG.
As a friend or family member, you can also pitch in with everyday things. McCallumâs pals may do a load of laundry or clean up his dishes. And they show they care in subtle ways.
âA lot of times theyâre just doing little thoughtful things: âI saw this reaching tool and I thought you would find it useful,â or âI read this interesting article about the way the immune system works, and I wondered what you thought about it.â
If you have MG, McCallum says to tell your friends and family when theyâre being unhelpful. Give them a chance to change for the better. But âif you come away from a conversation with somebody thinking, âWell, maybe I do really just need to try a little harder. Maybe I am just being a little bit lazy,â then thatâs not a good friend. Thatâs not somebody you want to be with.â
Show Sources
Photo Credit:Â gawrav / Getty Images
SOURCES:
Zach McCallum, myasthenia gravis advocate, Oregon.
Amit Sachdev, MD, assistant professor; director, Division of Neuromuscular Medicine, Michigan State University.
Richard Nowak, MD, director, Yale Myasthenia Gravis Clinic; assistant professor of neurology; director, Program in Clinical & Translational Neuromuscular Research, Yale School of Medicine.
Therapeutic Advances in Neurological Disorders: âWhen myasthenia gravis is deemed refractory: clinical signposts and treatment strategies.â
Myasthenia Gravis Foundation of America: âMG Education.â
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Disease Research
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New neuroimaging research suggests that prolonged use of cannabidiol (CBD) may influence the connections between key brain regions, namely the hippocampus and the amygdala, which are involved in memory and emotional processing. However, the implications of these changes for mental health are still unclear. The findings have been published in Cannabis and Cannabinoid Research.
Previous research has linked cannabis use to various psychosocial issues, including cannabis use disorders, elevated stress levels, and symptoms of depression, anxiety, and psychosis. These problems are partly attributed to the main psychoactive compound in cannabis, delta-9-tetrahydrocannabinol (THC), which interacts with brain cannabinoid receptors.
Neuroimaging studies have shown that cannabis use can lead to structural and functional changes in brain regions rich in cannabinoid receptors, such as the hippocampus and the amygdala. These changes have been associated with mental health problems, particularly psychotic symptoms. The study aimed to investigate whether CBD, another compound found in cannabis, could counteract these neurobiological differences observed in cannabis users.
CBD is known to antagonize the effects of THC and bind to cannabinoid type 2 (CB2) receptors in the brain and body. It has been suggested that CBD may reduce THC-related mental health symptoms, including psychosis, paranoia, intoxication, and anxiety. Additionally, preliminary evidence has shown that CBD can impact brain function and connectivity in various cognitive tasks, particularly in areas like the hippocampus and amygdala.
“As a neuroscientist, I am interested in understanding how brain-related changes in chronic cannabis users can be ameliorated and how this is associated with mental health implications. This new knowledge can be helpful for people who use cannabis, clinical practitioners and public health experts on the implications of medicinal cannabis products,” said study author Isabella Goodwin, an associate professor at the Australian Catholic University.
“Some people who use cannabis can experience psychosocial problems. Some scientists theorise that these problems could be attributable to the effect of cannabis’ main psychoactive compound: THC, particularly in brain areas that THC binds to to exert its effects. These areas include the hippocampus – a brain region shaped like a seahorse that supports learning and memory functions – and the amygdala – a brain region shaped like an almond, which is broadly responsible for the experience of emotions, attention, stress and craving.”
For their study, the researchers recruited 20 individuals who used cannabis recreationally, with 18 participants completing the entire study. Participants were given 200mg of CBD daily for 10 weeks, and their brain connectivity was assessed using functional magnetic resonance imaging (fMRI) scans.
The inclusion criteria for participants were an age range of 18 to 55 years, current cannabis use, and a minimum of six months of cannabis use at least once per month. Exclusion criteria included the use of other illicit substances, past dependence on substances other than cannabis, seeking treatment for substance use, and various medical and psychiatric conditions.
The primary goal was to examine whether prolonged exposure to CBD could lead to changes in resting-state functional connectivity in the hippocampus and amygdala. Resting-state functional connectivity measures the correlation between the activity of different brain areas when the brain is at rest and not engaged in specific tasks.
Participants had mild symptoms of cannabis dependence, depression, state anxiety, and psychotic-like symptoms at the beginning of the 10-week trial. After the trial, depressive and negative psychotic-like symptoms decreased, while state anxiety symptoms increased.
The study found significant changes in resting-state functional connectivity in two pairs of brain regions. Connectivity decreased between the left anterior hippocampus and the right precentral gyrus and increased between the left amygdala and the right lingual gyrus.
“We found it interesting that CBD changed how the brain connects different regions and in different ways,” Goodwin told PsyPost. “The functional connectivity of the hippocampus increased with a part of the brain involved in detecting salient stimuli in the environment (lingual gyrus). We also found a small increase in the volume of the hippocampus after the 10 weeks of CBD administration.”
“The functional connectivity of the amygdala instead decreased with a different part of the brain that supports motor control and reward processing (precentral gyrus). This suggests that CBD could affect the brain in complex ways that we are just beginning to uncover.”
Surprisingly, however, these changes in brain connectivity were not correlated with participants’ mental health symptoms, including depression and anxiety.
“The brain changes pre-to-post CBD were not associated with people’s mental health and wellbeing,” Goodwin said. “We don’t yet know what these brain changes mean for people’s mental health and wellbeing.”
Several limitations should be considered when interpreting the study’s results. These include the absence of a placebo group, a small sample size, and a predominantly male participant group. Future research should involve larger, more diverse samples and placebo-controlled conditions to confirm and expand upon these findings.
“We need to be cautious when interpreting the findings,” Goodwin explained. “First, we don’t yet know if CBD-related brain changes have implications for people’s mental health and wellbeing: the brain changes we found were not associated with mental health, but we only tested 18 people and this small sample could have been insufficient to find subtle effects.”
“Second, there was no placebo group, meaning that the brain changes in the CBD group over time could be caused by CBD, or be just normal changes that occur in the brain over time when people participate in a research study.”
“Even if this was a relatively small study, Professor Nadia Solowij has run the project with a very large team from many different disciplines (psychopharmacology, neuroscience, clinicians, engineers, MR technologists, MR data analysts, statisticians) and Dr Lisa Greenwood was one such key scientist to the project,” Goodwin added. “A large team was required to run this study over a number of years. This work would not have been feasible with the support of an extraordinary team.”
The study, “Daily Cannabidiol Administration for 10 Weeks Modulates Hippocampal and Amygdalar Resting-State Functional Connectivity in Cannabis Users: A Functional Magnetic Resonance Imaging Open-Label Clinical Trial“, was authored by Valentina Lorenzetti, Eugene McTavish, Samantha Broyd, Hendrika van Hell, Eleni Ganella, Akhil Raja Kottaram, Camilla Beale, Jennifer Martin, Peter Galettis, Nadia Solowij, and Lisa-Marie Greenwood.
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Mental Health Treatments
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More than 500,000 Americans could be sickened each year by Valley fever, the disease caused by breathing in the fungus Coccidioides, according to preliminary estimates developed by the Centers for Disease Control and Prevention.
The draft figures, which were disclosed in a CDC presentation to the National Academies of Sciences, Engineering, and Medicine, suggest the toll inflicted on Americans by the fungus could be more than triple the size of widely cited previous estimates.
"There's just not a ton of awareness or knowledge about the disease. We do see a lot of travel associated cases, we've seen reports of cases popping up in places where we wouldn't have typically expected Valley fever to be endemic," Samantha Williams, an epidemiologist with the CDC's Mycotic Diseases Branch, told CBS News.
Williams is part of the team that has been refining these forthcoming estimates of cases of Valley fever, which scientists call Coccidioidomycosis. It is one of a range of new projects aimed at ramping up the agency's response to the illness, which primarily occurs in the Southwest, from California to central Texas.
Though only a fraction of cases each year are reported to the CDC these tallies have also been rising: preliminary figures topped out at 20,197 cases reported through the end of 2021, the most on record in a single year since the last peak of cases in 2011.
In states where the fungus has historically caused the most hospitalizations, officials have been warning of signs of increased risk.
"When you compare the numbers now and in 2021 to 2014, they've increased pretty drastically since then. Within Arizona, it's basically doubled, and within California, more than tripled," Williams said.
What are the signs and symptoms of Valley fever?
Symptomatic cases of Valley fever often start mild, with signs similar to influenza or COVID-19 like fever, cough, and rash. People may also experience headaches, fatigue, night sweats, and muscle aches or joint pain, the CDC says.
Symptoms typically develop between 1 and 3 weeks after breathing in spores of the fungus, which occur naturally in the soil of some Western states, primarily across the Southwest.
While some people can recover on their own, dangerous complications can develop in as many as 10% of cases, the CDC says.
"Even with mild disease, it can still produce illness that last for weeks, unnecessary healthcare visits, time missed from work or school," said Williams.
While identifying cases has improved in recent years, Williams said many doctors — even in areas where Valley fever is more common — can sometimes take months to correctly diagnose cases. Instead, time can be wasted resorting to treatments like antibiotics that do not work for Valley fever.
That hurdle can be magnified when people catch the fungus while traveling, then try to seek treatment after they are back home from doctors that may never have seen Valley fever cases.
"Recognizing it early to treat it early is really important," said Williams.
What precautions should I take?
Officials acknowledge it is difficult to avoid catching Valley fever in areas where the fungus is endemic, given how spores can spread through the air.
In California, the state urges residents in areas with high rates of infections to mitigate dust stirred up by digging and minimize time outdoors during windy and dusty days.
People at higher risk of severe disease can wear N95 masks to cut down on their exposure if they have to be outdoors.
The Infectious Diseases Society of America also recommends considering some preemptive treatments for especially vulnerable patients, like organ transplant recipients.
What are the options for treating Valley fever?
Most recommended treatments for Valley fever rely on "off-label" unapproved uses of drugs the Food and Drug Administration has only approved for other fungi, though federal agencies have sought in recent years to foster new options for doctors.
"Coccidioidomycosis poses a major threat to public health in endemic regions, yet no vaccine has been developed, novel effective therapies are lacking, and drug development had stalled until recently," the FDA reported last year, from a recent workshop convened to discuss Valley fever.
The National Institutes of Health has also awarded new grants designed to encourage more scientists to focus on Valley fever, and it plans to encourage development of a vaccine to prevent the fungus. Promising potential vaccines have been tested in animals.
"Because Coccidioides infection in people usually provides protective immunity from reinfection, developing a safe and effective vaccine is generally thought to be feasible and would be expected to provide durable immunity," a working group convened by the National Institute of Allergy and Infectious Diseases wrote in a "strategic plan" released last year.
How is climate change linked to Valley fever?
"California's dry conditions, combined with recent heavy winter rains could [result] in increasing Valley fever cases in the coming months," California's state health department warned in a news release Aug. 1.
The department cited recent research linking climbing transmission of the fungus to increasing cycles of drought across the Southwest — just one of several growing linked to climate change. Other research has also linked upticks in the fungal infections to exposure to smoke from wildfires.
"The area we considered endemic, meaning the fungus can live in the soil, continues to move further north as the climate changes and gets a little bit warmer," Dr. Stuart Cohen, co-director for the Center for Valley Fever,.
"We want people to understand, and especially clinicians to understand, that these maps are not set in stone, right? And so even within the map, there are pockets of greater endemicity and lower endemicity, but it also could occur outside of those areas," said Williams.
for more features.
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Epidemics & Outbreaks
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Five hospitals that are deemed at risk of collapse because of deteriorating concrete infrastructure are to be rebuilt, the government has announced.
The hospitals - Airedale in West Yorkshire, Queen Elizabeth King's Lynn in Norfolk, Hinchingbrooke in Cambridgeshire, Mid Cheshire Leighton and Surrey's Frimley Park - were all built using reinforced autoclaved aerated concrete.
The lightweight concrete was used in roofs, floors and walls between the 1960s and 1980s.
It has a limited lifespan and all five are in urgent need of rebuilding.
At some sites roofs are having to be propped up with scaffolding and posts.
The sites have been added to the government's New Hospital Programme, which the government says will see 40 new hospitals built by 2030.
This though includes complete new-builds and sites undergoing major refurbishments and alterations.
A BBC investigation last week found work was yet to start on 33 of them.
The government also announced it would be spending more than £20 billion on the building programme.
Health Secretary Steve Barclay said: "These five hospitals are in pressing need of repair and are being prioritised so patients and staff can benefit from major new hospital buildings, equipped with the latest technology."
Another two hospitals - West Suffolk and James Paget in Norfolk - that have significant amounts of the lightweight concrete were already part of the hospital building programme.
Labour's Shadow Health Secretary Wes Streeting accused the government of over-promising and under-delivering. "It is not clear that the government has the money or the time to deliver 40 new hospitals by 2030.
"After 13 years of neglect, the NHS estate is crumbling. The Conservatives literally didn't fix the roof while the sun was shining and now patient safety is at risk. Their time is up," he said.
'Eye-watering cost'
Sir Julian Hartley, chief executive of NHS Providers, which represents hospitals, welcomed the announcement but said some trusts would be disappointed.
Eight schemes will now be completed later than originally planned, and after 2030, so these five new developments can be prioritised.
Sir Julian also said more than 90 other trusts had applied for funding but been rejected.
"The eye-watering cost of trying to patch up creaking infrastructure and out-of-date facilities is mounting, with a multi-billion-pound repairs backlog across the NHS growing at an alarming rate," he added.
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Health Policy
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Fatboy Slim and a cross-party group of MPs have condemned the Home Office’s decision to block onsite drug testing at festivals this summer as “shortsighted and dangerous”.
In a letter to Suella Braverman, the DJ, alongside musicians Billy Bragg and Olugbenga Adelekan of Metronomy has called for the government to allow the resumption of tests of confiscated pills in tents and temporary buildings at festival sites.
The letter, which is signed by 31 MPs including three Tories, came after the Guardian revealed that the Home Office told organisers of the Parklife festival in Manchester this month that for the first time since 2014 they would not be be able to check for dangerous drugs without a special licence.
Home Office officials said any tests on site without a licence would not comply with drug laws, even though the confiscated substances are held by police and security officers who take them to the onsite laboratories for testing before they are removed.
The development has deeply concerned those running the UK’s largest festivals, who warn attenders and the emergency services about possible casualties of dangerous batches.
The letter, co-ordinated by the Labour MP Sam Tarry, asks Braverman to reverse the decision in time for festivals this summer that have previously used onsite testing including Reading, the Secret Garden Party and Creamfields.
“As you will know, since 2014 festival organisers have tested drugs, confiscated by the police or security, in a cabin on site. If these tests show that the drugs are a serious threat to health, push notifications are sent to festivalgoers, warning them that the drug is dangerous and should not be taken. This service undoubtably saves lives, by helping drug users make better informed choices and significantly reduces the risk of overdoses,” the letter said.
It added that the Home Office was advocating that festivals should seek special licences “which can take more than three months to arrange, at significant cost. Furthermore, for these tests to be conducted, government legislation requires them to take place inside permanent buildings, despite these festivals taking place on temporary sites. This makes it impossible for organisers to plan a festival harm reduction policy,” the letter said.
“Regardless of your position or personal beliefs on drug usage, the simple fact remains that people will take them, and especially so at festivals this summer. The decision to prevent this testing from going ahead is short-sighted and dangerous. With Glastonbury this week and other festivals such as Boardmasters, Boom Town, Secret Garden Party, Creamfields and Reading fast approaching, we urge you to reconsider this decision and allow this vital testing to continue,” the letter said.
Other signatories include the Conservatives Adam Holloway, Crispin Blunt and the former culture minister Caroline Dinenage as well as the former Labour culture secretary Ben Bradshaw and MPs from the SNP, the Lib Dems and Plaid Cymru.
Tarry, the Ilford South MP, said: “To effectively ban drug testing services at these events removes a critical safety net that allows festival organisers to warn revellers and the emergency services about dangerous substances.”
Fatboy Slim, the musician and DJ whose real name is Norman Cook, has previously supported onsite tests of drugs. He played at Glastonbury on Saturday.
At Glastonbury, it is understood that organisers use an off-site testing agency.
Sacha Lord, the founder of Parklife, said festival organisers were considering a judicial review of the requirement for onsite licences.
The Home Office in 2021 said it supported back-of-house testing. “The government will continue to support back-of-house testing on [seized] substances as this can provide useful intelligence and enable festival organisers and other partners to implement harm reduction measures,” an official statement said in a reply to a select committee report.
A Home Office spokesperson said the government will enforce drug laws. “Our position hasn’t changed. Drug testing providers must have a licence to test for controlled drugs, including at festivals.
“We have consistently made this condition clear, and law enforcement have always had a responsibility to uphold this legal requirement.
“We continue to keep an open dialogue with any potential applicants. Festivals aiming to test drugs off their site this summer must work with the police and a Home Office licensed drug testing provider.”
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Drug Discoveries
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Students gasping for air and coughing while being led stumbling out of school into ambulances. Worried parents protesting in the capital, Tehran. And now a supreme leader calling for severe punishment for what would be an “unforgivable crime.”
The crisis over a wave of suspected poisonings that have hit thousands of schoolgirls across Iran escalated further this week, with the first arrests reported after Ayatollah Ali Khamenei made his first public comments on the issue.
Official suggestions that the mysterious incidents may be a deliberate effort to prevent girls from seeking an education have sparked growing public unease as well as questions over who or what might be behind them. They have also caused global alarm in light of the unrest that swept the country in recent months.
NBC News takes a look at what we know.
How big is the crisis?
At least 2,000 people have reported symptoms, according to the latest NBC News analysis of state and semiofficial media in Iran, though the numbers are fluid and clear reporting from Iran is difficult. However, one member of parliament tasked with investigating the incidents suggested that, although not confirmed, the number of potential cases could be as high as 5,000.
The first cases were reported in late November in the Shiite holy city of Qom at the heart of the Islamic Republic, according to local media, but have since spread to dozens of provinces across the country.
Details have been difficult to pin down — only fueling fears in a country already hit by months of tumult and mass unrest — but videos posted to social media and verified by NBC News give a glimpse of the situation inside Iran.
In one, girls cough profusely while being escorted out of school and into an ambulance, while in another a teenager is slumped on her knees as other students frantically try to help. It is not clear what exactly they are suffering from.
State TV has also aired footage of girls struggling to breathe in hospital beds. NBC News has not verified the local reports.
No deaths have been reported but the situation has led to growing concern, even sparking protests from parents and teachers.
In videos verified by NBC News, a group of women can be seen protesting with placards outside education ministry buildings in Tehran and a province just west of the capital.
What have officials said?
The suspected poisonings were only recently acknowledged in public by Iranian officials, who have provided little indication as to who or what may be behind the crisis.
After a series of comments from government officials and reports in local media, hard-line President Ebrahim Raisi said last week that he had ordered an investigation into the incidents.
On Sunday, Raisi told the Cabinet that the alleged incidents were "an inhumane crime" that was "aimed at intimidating the students, our dear children, and their parents," according to the state-run news agency IRNA.
Iran’s supreme leader said Monday that if confirmed as deliberate, the suspected poisonings would amount to "a great and unforgivable crime.”
"The culprits must face the toughest of punishments,” Ayatollah Ali Khamenei was quoted as saying by state TV, urging authorities to seriously pursue the matter and suggesting any culprits should face the death penalty.
Iran’s Interior Minister Ahmad Vahidi said over the weekend that “suspicious samples” had been gathered by investigators, without elaborating. He called on the public to remain calm and accused unnamed enemies of using “media terrorism” to incite fear and undermine the country's clerical establishment.
On Tuesday, Vahidi said that while investigations were ongoing, "a number of responsible people involved in disturbances in schools" had been arrested, according to the semiofficial ISNA news agency. He did not identify those arrested or give a possible motive.
Who might be responsible?
Many believe the Iranian government has been slow to act against the mysterious incidents that appear to be a threat to girls' education in the country.
After previously downplaying the issue, Iranian officials said last week that the suspected poisonings may have been deliberate attacks designed to prevent girls from seeking an education.
"Some people wanted all schools to be closed, especially girls’ schools,” said Iran's Deputy Health Minister, Younes Panahi, according to Iranian state broadcaster IRIB.
Some have drawn parallels with past attacks on women in Iran.
The most recent example was a wave of acid attacks around the central city of Isfahan 2014, which at the time were believed to have been carried out by religious hard-liners targeting women for how they dressed.
If the suspected poisonings are deliberate acts driven by a similar motive, it would represent a major escalation in a country where education for girls has never seriously been challenged in the four decades since the Islamic Revolution.
Some prominent critics of Iran’s government have said without providing evidence that the recent suspected poisonings may be an act of “revenge” for the unrest that erupted across the country when 22-year-old Mahsa Amini died after being detained by the morality police, who accused her of breaking Iran’s strict dress code.
Female students were at the forefront of the subsequent protests that rocked the Islamic Republic, as they stood up to strict sartorial codes by removing their headscarves and confronting officials.
“This is a government crime against children that is unprecedented in history,” the Iranian activist and journalist Masih Alinejad tweeted Monday.
Iranian authorities have not directly responded to the claims, but have accused “enemies” of using the attacks to undermine the regime.
The suspected poisonings prompted international condemnation and calls for a thorough and open investigation, including from the United States and United Nations.
“The possibility that girls in Iran are being possibly poisoned simply for trying to get an education is shameful, it’s unacceptable,” White House Press Secretary Karine Jean-Pierre said at a news briefing Monday. She called for an independent probe to determine if the poisonings were related to the protests, which would mean it falls within the mandate of the U.N. fact-finding mission on Iran.
In a statement, the United States Commission on International Religious Freedom said it was “outraged“ over the reports of poisonings.
“The United States and like-minded governments must pressure Iran’s government to take full responsibility for stopping the poisonings and“ hold perpetrators accountable in a manner consistent with international law,” said commission member Sharon Kleinbaum.
What could be causing the reported symptoms?
With little indication from within Iran over what might be behind the incidents, it has been difficult to determine the precise details of what has happened.
“The number one challenge is actually getting samples from an attack or an incident like this, and getting them properly verified,” said Hamish de Bretton-Gordon, a former commander of the United Kingdom’s and NATO’s chemical, biological and nuclear defense forces.
Given tense relations with the West, however, “it doesn’t seem that Iran is keen to expose this incident to the world. And it seems highly unlikely they’ll ask" the U.N. to help investigate, he told NBC News.
Some Iranian officials have said that nitrogen gas appeared during testing at affected schools, while reported symptoms have ranged from headaches and dizziness to girls feeling heart palpitations and pain in their legs.
“It could be something like sulphur dioxide, which is a toxic industrial chemical used in via a variety of industrial processes. There’s also been a suggestion that it might be nitrogen dioxide,” de Bretton-Gordon said of the potential cause. But those chemicals “are usually stored in sort of steel containers in a liquefied form or a gaseous form. So simply just opening the bowels of those cylinders would spread it over a relatively large area,” he said.
Taking blood samples from affected girls may offer the best hope of some answers, he said, but otherwise any conclusions may prove elusive. "If you’re looking for environmental samples, in the dust, or the dirt or in concrete, then that can be very fleeting, especially in a place where it’s hot,” de Bretton-Gordon added.
But what if most reported cases don't involve chemicals at all?
Iranian state media has at times referred to the wave of cases as “hysteric reactions” among the schoolgirls, hinting at another possibility that some experts have suggested may at least be playing a part in the crisis — especially given the context of the government crackdown on the nationwide protests and the absence of many boys reporting similar symptoms.
Deputy Health Minister Saeed Karimi said Monday that some students had been exposed to “a stimulating material through inhalation,” according to the semi-official Tasnim news agency, but said that this had likely affected fewer than 10% of cases that were investigated. Other suffered from anxiety or stress, he was reported as saying.
The news agency also reported that the interior ministry said fewer than 5% had been exposed to “stimulant chemicals” and that others had reported symptoms “due to anxiety and stress.”
NBC News has not independently verified those numbers.
A similar phenomenon was reported in Afghanistan from 2009 to 2012, with hundreds of girls across the country complaining of strange smells and poisoning, according to the Associated Press.
No evidence was found to support the suspicions, and the World Health Organization said it appeared to be “mass psychogenic illnesses.”
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Epidemics & Outbreaks
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Study: Strawberry consumption may reduce dementia risk for middle-aged individuals
Local 12 highlights UC research
New research from the University of Cincinnati found that daily strawberry consumption could help reduce the risk of dementia for certain middle-aged populations.
The research was recently published in the journal Nutrients.
Research background
In 2022, UC’s Robert Krikorian, PhD, and his team published research that found adding blueberries to the daily diets of certain middle-aged populations may lower the chances of developing late-life dementia. He said the current research into strawberries is an extension to the blueberry research.
“Both strawberries and blueberries contain antioxidants called anthocyanins, which have been implicated in a variety of berry health benefits such as metabolic and cognitive enhancements,” said Krikorian, professor emeritus in the UC College of Medicine’s Department of Psychiatry and Behavioral Neuroscience. “There is epidemiological data suggesting that people who consume strawberries or blueberries regularly have a slower rate of cognitive decline with aging.”
In addition to containing anthocyanins, Krikorian said strawberries contain additional micronutrients called ellagitannins and ellagic acid that have been associated with health benefits.
The beneficial effects we observed might be related to moderation of inflammation in the strawberry group.
Robert Krikorian, PhD
About 50% of individuals in the U.S. develop insulin resistance, commonly referred to as prediabetes, around middle age, which has been shown to be a factor in chronic diseases. Krikorian said the metabolic and cardiovascular benefits of strawberry consumption have been studied previously, but there were relatively few studies on its cognitive effects.
“This study assessed whether strawberry consumption might improve cognitive performance and metabolic health in this population and, if so, whether there might be an association between cognitive enhancement and reduced metabolic disturbance,” he said.
Research methodology
A total of 30 overweight patients between 50-65 years old with complaints of mild cognitive decline were enrolled and completed the study. Krikorian said this population has an increased risk for late-life dementia and other common conditions.
Over a period of 12 weeks, the participants were asked to abstain from berry fruit consumption of any kind except for a daily packet of supplement powder to be mixed with water and consumed with breakfast. Half of the participants received powders that contained the equivalent of one cup of whole strawberries (the standard serving size), while the other half received a placebo.
The participants were given tests that measured certain cognitive abilities like long-term memory. The researchers also tracked their mood, intensity of depressive symptoms and metabolic data over the course of the study.
Those in the strawberry powder group had diminished memory interference, which is consistent with an overall improvement in executive ability.
“Reduced memory interference refers to less confusion of semantically related terms on a word-list learning test,” Krikorian said. “This phenomenon generally is thought to reflect better executive control in terms of resisting intrusion of non-target words during the memory testing.”
The strawberry-treated participants also had a significant reduction of depressive symptoms, which Krikorian said can be understood as a result from “enhanced executive ability that would provide better emotional control and coping and perhaps better problem-solving.”
Other strawberry studies have found improvement in metabolic measures including lower insulin, but there was no effect found on the patients’ metabolic health in this study.
“Those studies generally used higher dosages of strawberry powder than in our research, and this could have been a factor,” Krikorian said.
Next steps
While more research is needed, Krikorian said the strawberry treatment may have improved cognitive function by reducing inflammation in the brain.
“Executive abilities begin to decline in midlife and excess abdominal fat, as in insulin resistance and obesity, will tend to increase inflammation, including in the brain,” he said. “So, one might consider that our middle-aged, overweight, prediabetic sample had higher levels of inflammation that contributed to at least mild impairment of executive abilities. Accordingly, the beneficial effects we observed might be related to moderation of inflammation in the strawberry group.”
Moving forward, Krikorian said future research trials should include larger samples of participants and differing dosages of strawberry supplementation.
Next Lives Here
The University of Cincinnati is leading public urban universities into a new era of innovation and impact. Our faculty, staff and students are saving lives, changing outcomes and bending the future in our city's direction. Next Lives Here.
Local 12 highlighted Krikorian's strawberry research. Watch or read the Local 12 story.
This research was supported with funding and donation of strawberry and placebo powders by the California Strawberry Commission, Watsonville, California 95076, USA. The research authors declare no conflict of interest. The funding organization had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript or in the decision to publish the results.
Featured photo at top of strawberries. Photo/Anton Darius/Unsplash.
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Nutrition Research
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How people feel about their sleep matters to their well-being, new research suggests
How people feel about their sleep has a greater impact on their well-being than what sleep-tracking technology says about their sleep quality, research led by the University of Warwick has found.
Across a two-week period, over 100 participants aged 18-22 years were asked to keep a daily sleep diary about the previous night’s sleep, including what time they went to bed, time they got ready to fall asleep, the amount of time it took them to fall asleep, what time they woke up, what time they got out of bed, and how satisfied they were with their sleep in general.
Five times throughout the following day, participants were asked to rate their positive and negative emotions and how satisfied they were with their life. Participants also wore an actigraph on their wrist which measures a person’s movement, for the duration of the study, to estimate their sleep patterns and rest cycles.
Researchers compared the actigraphy data with the participants’ perceptions of their sleep and how they felt throughout the following day. They wanted to find out how fluctuations from people’s usual sleep patterns and quality are related to their mood and life satisfaction the next day.
Lead author Dr Anita Lenneis, from the University of Warwick’s Department of Psychology, said: “Our results found that how young people evaluated their own sleep was consistently linked with how they felt about their well-being and life satisfaction.
“For example, when participants reported that they slept better than they normally did, they experienced more positive emotions and had a higher sense of life satisfaction the following day. However, the actigraphy-derived measure of sleep quality which is called sleep efficiency was not associated with next day’s well-being at all.
“This suggests there is a difference between actigraphy-measured sleep efficiency and people’s own perception of their sleep quality in how they link to people’s evaluations of their well-being.”
Professor Anu Realo, from the Department of Psychology at the University of Warwick added: “Our findings are consistent with our previous research that identified people's self-reported health, and not their actual health conditions, as the main factor associated with their subjective well-being and especially with life satisfaction.
“It’s people’s perception of their sleep quality and not the actigraphy-based sleep efficiency which matters to their well-being.”
Overall, the study suggests that evaluating your sleep positively may contribute to a better mood on the next day.
“Even though a sleep tracking device might say that you slept poorly last night, your own perception of your sleep quality may be quite positive. And if you think that you slept well, it may help better your mood the next day,” Dr Lenneis added.
“On the contrary, if a sleep tracker tells you that you slept well, but you did not experience the night as such, this information may help you to reassess how well you actually slept. A sleep tracker offers information about your sleep which is typically not accessible whilst being asleep. So, it may improve your subjective perception of last night’s sleep and thereby your overall next day’s well-being.”
The study, The Influence of Sleep on Subjective Well-Being: An Experience Sampling Study, is published in Emotion.
ENDS
University of Warwick media contact:
Natalie Gidley, Communications Officer (Media Relations)
Email: natalie.gidley@warwick.ac.uk Phone: 07824540791
4th August 2023
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Stress and Wellness
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- Young people are at risk of experiencing significant respiratory symptoms, including bronchitis and shortness of breath, after just 30 days of electronic cigarette use, according to a new study.
- Researchers reached the conclusion using four years of data from online surveys.
- Drug regulators should consider the findings and work to minimize the negative impact of e-cigarette use on young people, the researchers said.
Young people are at risk of experiencing significant respiratory symptoms, including bronchitis and shortness of breath, after just 30 days of electronic cigarette use, according to a new study released Tuesday.
Researchers from the Center for Tobacco Research at The Ohio State University Comprehensive Cancer Center and the Southern California Keck School of Medicine used four years of data from online surveys to examine the health impact of e-cigarettes — which create a vapor containing nicotine and other harmful substances — on teens and young adults.
They said the study, partly funded by the National Institutes of Health, contributes to existing evidence that e-cigarette use is associated with an increased risk of respiratory symptoms. Drug regulators should consider the findings and work to minimize the negative health impact of e-cigarette use on young people, the researchers added.
E-cigarettes have hooked a new generation on nicotine in less than a decade, putting the health of millions of children, teens and young adults at risk while threatening years of progress in reducing youth tobacco use.
E-cigarette usage is now substantially higher among youths and young adults than it is among adults overall in the U.S., according to the Centers for Disease Control and Prevention. Sales of e-cigarettes jumped nearly 50% during the first two years of the Covid pandemic, mainly driven by disposable products in sweet and fruity flavors that have long been popular among teens.
That surge in sales came despite a federal crackdown that placed more restrictions on the marketing and flavors of tobacco products.
Manufacturers are still flooding the market with thousands of addictive products that are often sold illegally. Brands such as Puff Bar, Elf Bar and Breeze Smoke are not approved by the Food and Drug Administration, and some have surpassed vaping pioneer Juul in popularity.
"An important point for consumers is just that e-cigarettes are not risk-free," Alayna Tackett, a pediatric psychologist and researcher at the Center for Tobacco Research. "We absolutely want to eliminate the initiation and use of e-cigarettes among young people. I think that's a critical public health goal."
She noted that the study examines only teens and young adults, and that in the demographic of all adults, people "often switch from using cigarettes to using e-cigarettes with likely fewer risks."
"I think we need to be thoughtful about policies to protect those young people, while also supporting adults who are interested in choosing a potentially less harmful alternative to cigarettes," Tackett added.
Researchers followed more than 2,000 young people with an average age of 17.3 years from the Southern California Children's Health Study.
In 2014, they asked the participants to complete an online survey about their respiratory symptoms and e-cigarette, traditional cigarette and cannabis use. Around 23% of participants reported a history of asthma at the time of the initial survey.
Researchers collected follow-up data from the majority of those participants during three additional survey waves, in 2015, 2017 and 2018.
Participants were specifically asked if they had ever used each of the three products. If they indicated yes, they were asked about the number of days they had used a product in the past 30-day period.
Those who had never tried a product were classified as "never users," while participants who had used a product on at least one of the past 30 days were classified as "past 30-day" users.
Past 30-day e-cigarette users were at an 81% higher risk of experiencing a symptom called wheeze than never users after accounting for survey wave, age, sex, race and parental education. Wheeze was defined as wheezing or whistling in the chest in the previous 12 months.
Past 30-day users were also at a 78% increased risk of experiencing shortness of breath and a 50% higher risk of experiencing symptoms of bronchitis, an infection of the main lung airways that causes them to become irritated and inflamed.
The link between e-cigarette use and respiratory symptoms was slightly weaker when researchers accounted for two factors: co-use of e-cigarettes with traditional cigarettes or cannabis, and secondhand exposure to any of the three products.
For example, past 30-day e-cigarette users were at a 41% higher risk of experiencing wheeze than never users if they also used traditional cigarettes or cannabis at the same time or experienced secondhand exposure to any of the products.
"Wheeze was no longer significantly related to the respiratory symptoms associated with e-cigarette use when we controlled for co-use of cigarettes and cannabis," Tackett said. But she noted that bronchitis symptoms and shortness of breath remained significant.
The link between e-cigarette use and respiratory symptoms was persistent in a sub-analysis that excluded participants with a history of asthma. That indicates that the negative health effects of e-cigarette use were present in all participants, not just those with asthma, according to the study.
Tackett noted that there are limitations to the study that future research could address.
Additional studies could more objectively measure respiratory symptoms and product use instead of using surveys that participants filled out themselves, according to Tackett.
She added that future studies, including one she's currently working on, could further assess the "complex relationship" between the use of e-cigarettes and traditional cigarettes or cannabis.
— CNBC's Stefan Sykes contributed to this report.
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Disease Research
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James O'Brien 10am - 1pm
Surgeons perform world’s first eye transplant on man who suffered electric shock
10 November 2023, 09:34
Aaron James received the eye from a donor as part of a face transplant following an accident which left him with severe injuries.
Surgeons have performed the world’s first transplant of an entire human eye, an extraordinary addition to a face transplant – although it’s far too soon to know if the man will ever see through his new left eye.
An accident with high-voltage power lines had destroyed most of Aaron James’ face and one eye.
His right eye still works. But surgeons at NYU Langone Health hoped replacing the missing one would yield better cosmetic results for his new face, by supporting the transplanted eye socket and lid.
The NYU team announced on Thursday that so far, it’s doing just that.
James is recovering well from the dual transplant last May and the donated eye looks remarkably healthy.
“It feels good. I still don’t have any movement in it yet. My eyelid, I can’t blink yet. But I’m getting sensation now,” Mr James told the Associated Press as doctors examined his progress recently.
“You got to start somewhere, there’s got to be a first person somewhere,” added James, 46, of Hot Springs, Arkansas.
“Maybe you’ll learn something from it that will help the next person.”
Today, transplants of the cornea – the clear tissue in front of the eye – are common to treat certain types of vision loss.
But transplanting the whole eye: the eyeball, its blood supply and the critical optic nerve that must connect it to the brain; is considered a massive step in the quest to cure blindness.
Whatever happens next, Mr James’ surgery offers scientists an unprecedented window into how the human eye tries to heal.
“We’re not claiming that we are going to restore sight,” said Dr Eduardo Rodriguez, NYU’s plastic surgery chief, who led the transplant.
“But there’s no doubt in my mind we are one step closer.”
Some specialists had feared the eye would quickly shrivel like a raisin. Instead, when Rodriguez propped open Mr James’ left eyelid last month, the donated hazel-coloured eye was as plump and full of fluid as his own blue eye. Doctors see good blood flow and no sign of rejection.
Now researchers have begun analysing scans of James’ brain that detected some puzzling signals from that all-important but injured optic nerve.
One scientist who has long studied how to make eye transplants a reality called the surgery exciting.
“It’s an amazing validation” of animal experiments that have kept transplanted eyes alive, said Dr Jeffrey Goldberg, chair of ophthalmology at Stanford University.
James was working for a power line company in June 2021 when he was shocked by a live wire. He nearly died. He lost his left arm, requiring a prosthetic. His damaged left eye was so painful it had to be removed.
He had to undergo a face transplant – only the 19th in the US – in a 21-hour operation made more complicated by the additional eye transplant.
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Medical Innovations
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- More than 50,000 extra nurses are working in the NHS compared to September 2019
- Government hits target delivering largest ever sustained growth in NHS nursing workforce
Data published today by NHS England shows there were 51,245 additional nurses in September 2023 compared to 2019. This means the number of nurses have increased from 300,904 in 2019 to over 352,000 – hitting the government’s manifesto commitment to recruit an additional 50,000 nurses six months early.
This is the largest ever sustained growth in the NHS nursing workforce, with the expanded workforce delivering hundreds of thousands of extra appointments, helping to tackle waiting lists and improve access for patients.
Health and Social Care Secretary Victoria Atkins said:
There are 50,000 extra nurses in the NHS caring for our loved ones, delivering extra appointments and improving access for patients.
We have delivered on our promise but we won’t stop here. The first ever NHS Long Term Workforce Plan will help to retain our current workforce, reform clinical practice, and deliver the biggest training expansion in NHS history, almost doubling the number of adult nurse training places by 2031.
These additional nurses will help support cutting waiting lists – which is one of our five priorities – and getting patients the care they need, when they need it.
Building on this achievement, the NHS Long Term Workforce Plan will further expand the nursing workforce, with additional training numbers, improved retention and the introduction of new roles to support our hard-working nurses.
The 50,000 nurses commitment has been achieved through boosting training and education routes into nursing, ethically recruiting internationally and actions to improve the retention of the existing workforce. This includes a financial support package for nursing students – the NHS Learning Support Fund - providing eligible nursing, midwifery and allied health professions students with non-repayable grants of at least £5,000 per academic year to ensure course sustainability.
The data also shows there are over 1.3 million staff working in NHS Trusts and other core organisations in England, 68,900 (5.6%) more than a year ago.
There are almost 7,300 (5.6%) more doctors in the NHS compared to September last year.
The NHS Long Term Workforce Plan - backed by over £2.4 billion over five years – sets out three priority areas to train, retain and reform the health workforce.
The plan will significantly expand domestic education, training and recruitment and will deliver more nurses than ever before. It will almost double the number of adult nurse training places by 2031, with around 24,000 more nurse and midwife training places a year by 2031. This will include over 5,000 more mental and learning disability nurses a year.
By improving culture, leadership, and wellbeing, the government is aiming to ensure up to 130,000 fewer staff leave the NHS over the next 15 years. For example, the NHS and government will improve flexible opportunities for prospective retirees to keep them in the NHS workforce for longer; and make it easier for those who have already left to come back in flexible, contracted roles or as a temp.
Taken together, these recruitment and retention measures will mean the health service has at least an extra 170,000 more nurses in place by 2036/37.
Additionally, the plan commits to reforming training to support education expansion. The government will expand enhanced, advanced and associate roles to offer modernised careers, including increasing training places for Nursing Associates and is also working with regulators and others to explore how nursing students can gain the skills, knowledge and experience they need to practise safely and competently in the NHS in less time.
Notes to editors:
More information on the NHS Long Term Workforce Plan can be found here: NHS Long Term Workforce Plan fact sheet - Department of Health and Social Care Media Centre (blog.gov.uk)
Workforce statistics can be found here: NHS workforce statistics - NHS Digital
Background
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The 50,000 nurses target includes nurses working in the NHS in England, including in GP settings. This covers all NHS providers across acute, community, mental health and ambulance settings. It does not include non-NHS providers, including social care providers and social enterprises. For GP settings, it covers all nurses employed in general practice.
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The 50,000 nurses are Full Time Equivalent rather than headcount. This means that if a nurse works part time, they will be recorded as less than one FTE nurse (with the number depending on the degree to which they are part time).
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While nursing associates are a career progression to become a registered nurse they do not count towards the 50,000 target. Additionally, midwives, allied health professions and health visitors are not part of the registered nurse expansion work.
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The baseline for the target is numbers of FTE nurses in the NHS as of 30 September 2019. More details are available in the 50,000 Nurses Programme Delivery Update, published 7 March 2022: 50,000 Nurses Programme: delivery update - GOV.UK (www.gov.uk)
Regional breakdowns of nurse numbers across England can be found here:
|NHS England Region
||Sep-19
||Sep-23
||Change since Sep-19
||% change since Sep-19
|
|England
||300,904
||352,149
||51,245
||17.0%
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|London
||54,036
||61,689
||7,653
||14.2%
|
|South West
||27,789
||33,056
||5,267
||19.0%
|
|South East
||38,887
||47,664
||8,777
||22.6%
|
|Midlands
||55,596
||64,891
||9,295
||16.7%
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|East of England
||28,649
||33,350
||4,701
||16.4%
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|North West
||46,061
||54,608
||8,546
||18.6%
|
|North East and Yorkshire
||49,885
||56,891
||7,006
||14.0%
|
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Health Policy
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'Body Electric': Side effects of technology, such as sitting, are hard on our posture
A MARTÍNEZ, HOST:
Everywhere we go, there's a common sight - people are hunched over their phones or slumped in their chair, typing away at a laptop. Maybe this is you. In fact, I'm pretty much sure it's you because it's me, and it's everyone else. TED Radio Hour host Manoush Zomorodi has been joining us every week to talk about her special NPR series, Body Electric, which looks at the relationship between our technology and our health. And today, she's here to talk about what our bad posture from all that sitting, typing and tapping is really doing to us. Manoush, tell us what you found.
MANOUSH ZOMORODI, BYLINE: OK. So A, yes, slouching and hunching will give you tight muscles, maybe a lower backache. But also, the position that we put our bodies in when we're on our devices can help explain why we often feel so stressed out and drained at the end of the day. I talked to Peter Strick, a professor of neurobiology at the University of Pittsburgh Brain Institute. And a few years back, he was feeling very stressed out, and his kids suggested that he do yoga or Pilates to relieve some of his stress. And here's what he thought about that idea.
PETER STRICK: I thought they were nuts. I didn't think that there was any really objective data that suggested that yoga and Pilates have any real impact on stress.
ZOMORODI: Actually, A, Peter is a leading expert on the relationship between the brain and movement. So A, quick anatomy lesson - when we get stressed, the brain sends signals to the adrenal glands to release adrenaline. So the adrenal glands sit on top of your kidneys - which, if you put your hands around your waist, they're kind of there in your back, in your midsection. And until recently, scientists didn't think that the muscles around there - our core muscles - were involved with how the brain and these organs communicate. But Peter also happens to be the inventor of a method that can trace the signals that get sent between our brain and our muscles, and he discovered that those core muscles and the brain and the adrenal glands were all talking to each other.
STRICK: The muscles that control posture - our core muscles - have an impact on an organ that is involved in stress. That was sort of a wake-up call for me that I'd better do something about working on my core.
MARTÍNEZ: You know how many times, Manoush, I've been sitting up straight during our conversation? I've been doing it, like, 5 or 6 times already.
ZOMORODI: (Laughter).
MARTÍNEZ: And I want to check in on how the study you were doing with listeners and Columbia University Medical Center is going. So tell us about that.
ZOMORODI: Yeah. Quick reminder - in the lab, researchers at Columbia have found that if you mostly sit all day, doing regular five-minute movement breaks every half hour is the best way to keep that lifestyle from causing all kinds of health problems. But we wanted to find out - are all those interruptions even possible in our screen-filled lives? Over 20,000 NPR listeners signed up to give it a try, and here's how some of them have told us it's going.
UNIDENTIFIED NPR LISTENER #1: On the days when I got up and walked around, I had pretty consistent energy throughout the day. On the days when I didn't get up and walk around, I could feel my brain tightening, my anxiety increasing.
UNIDENTIFIED NPR LISTENER #2: I wish it was easier to take care of my body without, then, simultaneously being late to respond to an email.
UNIDENTIFIED NPR LISTENER #3: How can I work in five minutes of walking while driving?
UNIDENTIFIED NPR LISTENER #4: I truly believe that this change of a lifestyle is hopefully a game-changer for me.
MARTÍNEZ: I could feel the stress in their voices...
ZOMORODI: (Laughter).
MARTÍNEZ: ...So I'm glad you're doing this - everything that you're doing, Manoush.
ZOMORODI: Aw (ph), thanks.
MARTÍNEZ: That's Manoush Zomorodi, host of NPR's TED Radio Hour and also a special series, Body Electric. To hear more about what our technology is doing to our posture and other parts of our bodies, just go to the TED Radio Hour podcast feed or npr.org/bodyelectric.
(SOUNDBITE OF MUSIC)
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
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Stress and Wellness
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Critically ill patients “will inevitably die” because hospitals are having to cancel surgery as a direct result of next week’s junior doctors’ strike in England, leading heart experts have warned.
There were bound to be fatalities among people with serious heart problems whose precarious health meant they were “a ticking timebomb” and needed surgery as soon as possible, they said.
They added that patients would face an even greater risk than usual of being harmed or dying if their time-sensitive operation was delayed because NHS heart units would have too few medics available during the four-day stoppage by junior doctors to run normal operating lists.
The trio of cardiac experts are senior doctors at the Royal Brompton and Harefield specialist heart and lung hospitals in London. Those facilities, plus the cardiac unit at St Thomas’ hospital in the capital, have between them postponed between 30 and 40 operations they were due to conduct next week on “P2” patients, whose fragile health means they need surgery within 28 days.
“One of our trust’s core values is to put patients first and so I feel it is only right to warn that some patients will inevitably die due to the cumulative impact of delaying hundreds who are on the waiting list,” said Dr Richard Grocott-Mason, a cardiologist who is also the chief executive of the Royal Brompton and Harefield hospitals.
Those cancellations would mean that many of the 300 “P2” patients waiting for heart surgery at the three hospitals would have to wait even longer before they finally got it, he added. “P2s” are the NHS’s second-highest priority group of patients who need surgery of any sort, behind emergency cases who need it immediately as their life will otherwise be at risk.
“It is no exaggeration to say that delaying surgery for this group [P2s] will result in harm. For some, this may be life-changing. For others, it may mean premature death,” Grocott-Mason said.
Dr Mark Mason, a cardiologist who is the medical director for heart, lung and critical care at the Guy’s and St Thomas’ NHS trust that runs all three hospitals, said: “It’s a cliche but these [P2] patients really are sat on a ticking timebomb.”
The risk of them suffering a cardiac arrest rose the longer they had to wait for surgery, he added. “If they do, it’s then a question of how lucky they are to have a bystander perform CPR on them, and how quickly the ambulance gets to them. These patients are sat waiting for an unpredictable and potentially fatal cardiac event to happen.”
Last month’s first three-day strike by junior doctors in England over their demand for a 35% pay rise led to 175,000 outpatient appointments and operations being cancelled.
NHS bosses fear next week’s four-day stoppage, which starts at 7am on Tuesday 11 April, will force them to reschedule as many as 250,000 appointments.
Grocott-Mason, Mason and their colleague Mario Petrou, the Brompton and Harefield hospitals’ clinical director for cardiovascular services, decided to speak out to raise concerns – widely shared by senior doctors and NHS doctors – about patients with a range of serious health problems, including cancer, potentially coming to harm next week because their surgery is cancelled.
“We cannot, in all conscience, stand by and just let this happen without advocating for our current and future patients,” said Grocott-Mason, referring to his team’s cardiovascular patients.
Heart patients across the country will face the same risks, as most heart units are taking the same type of action and postponing operations listed for next week. “Sadly this [increased risk] is going to be true for patients needing planned heart surgery not just in London, but across England,” said Grocott-Mason.
The British Medical Association’s junior doctors committee decided not to offer any “derogations”, or exemptions, for any areas of life-or-death care next week, including A&E and intensive care and maternity services, in an attempt to ramp up pressure on the government.
The three surgeons urged the government and the BMA to hold talks to try to avert a strike, and asked the BMA to rethink its stance on derogations and instead allow junior doctors to keep working next week in critical care units and cardiovascular surgery.
Grocott-Mason said the BMA should follow the lead of the Royal College of Nursing, which exempted many areas of life-or-death care from the strikes it has held since December.
A BMA spokesperson said: “Ahead of the first round of industrial action NHS England worked with trusts across England to assess their readiness for the planned industrial action. In addition, a joint communication from NHS England’s medical director and Prof Philip Banfield, BMA chair of council, was shared with all trusts in England explaining the process to request a derogation.
“We met with NHS England four times per day during the strikes and not a single request was made over the course of three days of action. The same arrangements will exist this time and it will be up to NHS England to decide if they want to use them.”
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Epidemics & Outbreaks
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When Clarisse Agbégnénou won her sixth world judo title, confirming the reigning Olympic champion as one of the athletes to watch at next year's Paris Games, the French star's smallest but greatest fan was less wild about her mother's newest gold medal than she was about her breast milk.
After a peckish day of few feeds — because Mom had been busy putting opponents through the wringer — 10-month-old Athéna made amends that night.
"She didn't let my boobs out of her mouth," Agbégnénou said. "I was like, 'Wow, OK.' I think it was really something for her."
Breastfeeding and high-performance sports were long an almost impossible combination for top female athletes, torn for decades between careers or motherhood, because having both was so tough.
But that's becoming less true ahead of the 2024 Olympics, where women will take another step forward in their long march for equality, competing in equal numbers with men for the first time, and with pioneering mothers like Agbégnénou showing that it is possible to breastfeed and be competitive.
They don't pretend that late-night feeds, broken sleep, pumping milk and having to eat for two people are easy. But some female athletes are also discovering that juggling their careers with the rigors of motherhood can pay off with powerful emotional well-being.
Speaking in an interview with The Associated Press, Agbégnénou said she stunned even herself by coming back so quickly from childbirth to win at the worlds in May, with Athéna in tow and expecting to be fed every few hours.
In training, Agbégnénou would stop for quick feeds when Athéna needed milk, nestling her hungry baby in the folds of her kimono, while other athletes in the judo hall paid them no mind, carrying on with their bouts.
"I was sweating on her, poor baby," she said. "But she didn't pay attention. She just wanted to eat."
Women who have breastfed and carried on competing say that support from coaches and sports administrators is essential. Agbégnénou credits the International Judo Federation for allowing her to take Athéna to competitions. IJF officials sounded out other competitors and coaches about whether the baby was a nuisance for them and were told, "'No, she was really perfect, we didn't hear the baby,'" she said.
"It's amazing," she said of her peers' acceptance and support. "They are part of my fight and I am really proud of them."
As well as Agbégnénou, three other women also asked and were allowed to nurse their babies at IJF World Tour competitions in the past six years, with arrangements made each time that enabled the moms "to care for the child and to not disturb other athletes' preparation," said the governing body's secretary general, Lisa Allan. She says the IJF is now drawing up specific policies for judokas who are pregnant or postpartum because "more and more athletes are continuing their careers whilst balancing having a family."
The Paris Olympics' chief organizer, Tony Estanguet, said they're also exploring the possibility of providing facilities for nursing athletes at the Games.
"They should have access to their children — for the well-being of the mothers and the children," he said in an AP interview. "The status of athletes who are young mothers needs to evolve a bit. We need to find solutions to perhaps make it easier for these athletes to bring babies" into the Olympic village where athletes are housed.
For some breastfeeding athletes, being a pioneer is part of the kick.
Two-time Olympic rowing champion Helen Glover, now aiming for her fourth Summer Games, gave birth to twins at the start of the COVID-19 outbreak, breastfed them and then came out of what she'd intended to be retirement to compete at the pandemic-delayed Tokyo Games in 2021.
Glover was the first rower to compete for Britain at the Olympics as a mother.
Glover's eldest, Logan, lost interest in her milk about the time of his first birthday, but twins Kit and Willow kept feeding to 14 months old. She says that mixing her punishing rowing training with long feeds for two babies was "very draining. It was taking every calorie I had."
"But I could do it because it was my own time and my own choice," she said.
"Everyone should have the choice," Glover added. "Our bodies ... are sometimes very changed through childbirth and pregnancy and breastfeeding. So the answers are never going to be one-size-fits-all. But I think it's really exciting that these conversations are even being had."
For some athletes, Milk Stork has also been a help. The U.S.-based transporter ships working moms' milk when they're separated from their babies. It says it shipped milk pumped by athletes who competed at the 2021 Paralympic Games in Tokyo and also transported 21 gallons (80 liters) of milk from coaches, trainers and other support staff at the Olympics that year.
The daughter of British archery athlete Naomi Folkard was just 5½ months old and breastfeeding exclusively when her mother traveled to Tokyo for her fifth and final Olympic Games.
Nursing mothers successfully pushed to be able to take babies to those Olympics, held with social distancing and without full crowds because of the coronavirus pandemic. Rather than put her daughter, Emily, through the ordeal of having to live apart from her, in a Tokyo hotel outside of the athletes' village, Folkard reluctantly left her behind with a large stock of frozen milk. She built that up over months, pumping into the night so Emily wouldn't go hungry while she was in Japan.
But that created another problem: Because Folkard's breasts had become so good at making milk, she had to pump regularly at the Games to stop them from becoming painfully swollen. She threw that milk away.
"I was having to get up in the night and pump just because my supply was so much," she said. "It wasn't great for performance preparation really. But I did what I had to do to be there."
And with each drop, progress.
"There's still a long way to go, but people are talking about it now. Women aren't retiring to have children. They're still competing," Folkard said.
"I feel like things are changing."
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Women’s Health
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What happens in the human brain when we learn from positive and negative experiences? To help answer that question and better understand decision-making and human behavior, scientists are studying dopamine.
Dopamine is a neurotransmitter produced in the brain that serves as a chemical messenger, facilitating communication between nerve cells in the brain and the body. It is involved in functions such as movement, cognition and learning. While dopamine is most known for its association with positive emotions, scientists are also exploring its role in negative experiences.
Now, a new study from researchers at Wake Forest University School of Medicine shows that dopamine release in the human brain plays a crucial role in encoding both reward and punishment prediction errors. This means that dopamine is involved in the process of learning from both positive and negative experiences, allowing the brain to adjust and adapt its behavior based on the outcomes of these experiences.
The study was published today in Science Advances.
“Previously, research has shown that dopamine plays an important role in how animals learn from ‘rewarding’ (and possibly ‘punishing’) experiences. But, little work has been done to directly assess what dopamine does on fast timescales in the human brain,” said Kenneth T. Kishida, Ph.D., associate professor of physiology and pharmacology and neurosurgery at Wake Forest University School of Medicine. “This is the first study in humans to examine how dopamine encodes rewards and punishments and whether dopamine reflects an ‘optimal’ teaching signal that is used in today’s most advanced artificial intelligence research.”
For the study, researchers on Kishida's team utilized fast-scan cyclic voltammetry, an electrochemical technique, paired with machine learning, to detect and measure dopamine levels in real-time (i.e., 10 measurements per second). However, this method is challenging and can only be performed during invasive procedures such as deep-brain stimulation (DBS) brain surgery. DBS is commonly employed to treat conditions such as Parkinson’s disease, essential tremor, obsessive-compulsive disorder and epilepsy.
Kishida’s team collaborated with Atrium Health Wake Forest Baptist neurosurgeons Stephen B. Tatter, M.D., and Adrian W. Laxton, M.D., who are also both faculty members in the Department of Neurosurgery at Wake Forest University School of Medicine, to insert a carbon fiber microelectrode deep into the brain of three participants at Atrium Health Wake Forest Baptist Medical Center who were scheduled to receive DBS to treat essential tremor.
While the participants were awake in the operating room, they played a simple computer game. As they played the game, dopamine measurements were taken in the striatum, a part of the brain that is important for cognition, decision-making and coordinated movements.
During the game, participants’ choices were either rewarded or punished with real monetary gains or losses. The game was divided into three stages in which participants learned from positive or negative feedback to make choices that maximized rewards and minimized penalties. Dopamine levels were measured continuously, once every 100 milliseconds, throughout each of the three stages of the game.
“We found that dopamine not only plays a role in signaling both positive and negative experiences in the brain, but it seems to do so in a way that is optimal when trying to learn from those outcomes. What was also interesting, is that it seems like there may be independent pathways in the brain that separately engage the dopamine system for rewarding versus punishing experiences. Our results reveal a surprising result that these two pathways may encode rewarding and punishing experiences on slightly shifted timescales separated by only 200 to 400 milliseconds in time,” Kishida said.
Kishida believes that this level of understanding may lead to a better understanding of how the dopamine system is affected in humans with psychiatric and neurological disorders. Kishida said additional research is needed to understand how dopamine signaling is altered in psychiatric and neurological disorders.
“Traditionally, dopamine is often referred to as ‘the pleasure neurotransmitter,”’ Kishida said. “However, our work provides evidence that this is not the way to think about dopamine. Instead, dopamine is a crucial part of a sophisticated system that teaches our brain and guides our behavior. That dopamine is also involved in teaching our brain about punishing experiences is an important discovery and may provide new directions in research to help us better understand the mechanisms underlying depression, addiction, and related psychiatric and neurological disorders.”
This study was supported by grants from the National Institutes of Health: R01MH121099, R01DA048096, R01MH124115, P50DA006634, 5KL2TR001420, F31DA053174, T32DA041349 and F30DA053176.
Media Contact: Myra Wright, mgwright@wakehealth.edu
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Disease Research
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Last week, he was sitting his GCSEs. This week, he'll make his debut at Glastonbury.
Eli Crossley, who's just 16, will be one of the youngest performers ever to play the festival when he takes to the stage with his band, Askew.
And he's doing so in spite of the muscle wasting disease that's confined him to a wheelchair for the last year.
If the magnitude of the event is playing on his mind, it doesn't show.
"I've got three exams left, and then we've got this small concert," he laughs over the phone from his home in London, a week before the festival.
Eli has Duchenne muscular dystrophy, a progressive and life-limiting condition that gradually makes his muscles become weaker.
His big break came about almost by accident when, earlier this year, he appeared on BBC Breakfast to discuss his condition.
The teenager was showing off a new piece of technology called the Smart Suit that, it is hoped, will help him continue to move his upper body when he grows older.
Asked how comfortable the device was to wear, he replied: "It's very comfortable and I hope it will help me in fulfilling my dream of playing Glastonbury."
His mum, Emily Reuben, joins us on the call. "I don't think anyone thought you were going to mention Glastonbury," she laughs.
"It just sort of came out and the whole thing went viral. I was impressed. You put your dreams out there."
It didn't take long for social media to take up the cause, petitioning festival organiser Emily Eavis to give Eli and his band a slot.
After an initial flurry of activity, however, the requests died down. Then, a parent at Eli's school saw Askew performing in an end-of-term talent show.
That parent just happened to be Jon Turner of Island Records. The following morning, calls were placed to Eavis and her husband Nick Dewey, and the cogs turned.
"They saw the video of Eli and said, 'Yes, we'd absolutely love to have him'," Ms Reuben recalls.
That evening she posted a cryptic message on WhatsApp to the group's parents: "Major news incoming." Soon afterwards, Eli started making calls to his bandmates Alfie, 15, and Freddie, Jay and Will, all 16.
"I didn't believe him at all," says Will, who plays guitar. "I thought it was a little joke."
Then the news sank in...
"Will is fairly new to the band and he said, 'But I've never played a gig before'," Eli recalls.
"And I was like, 'Yeah, well you're playing Glastonbury now, mate.'"
"We've never played anything this big," says second guitarist Jay, admitting to a degree of nervousness.
"We've only really played in front of our parents and in small bars and stuff. We never thought we'd be here. "
Asked how he feels about the show, even Eli's bravado falters temporarily.
"I'm terrified about it, but really excited at the same time."
But the band have already got the support of one famous fan, actor Eddie Marsan, who implored festivalgoers to catch their set.
"Eli is not only a remarkable young man, he's a phenomenal musician," he wrote on Twitter.
"I saw his band Askew play in Paris and their set was incredible. They're going to blow Glastonbury away."
The group will play at 17:30 BST on Friday on the small and secretive Rabbit Hole stage - an underground venue where punters have to answer a riddle before they can enter.
Their half-hour set will mix originals like Rosemary and Last with covers of Queen's Crazy Little Thing Called Love and Supersonic by Oasis - "a few crowd pleasers to make sure everybody stays put", as Eli puts it - before they're set free for the rest of the weekend.
Eli is determined to see Royal Blood on the Pyramid Stage, while his mum has made it clear she'll be watching Sir Elton John on Sunday night.
After that, she will go back to the day job of running Duchenne UK, the charity she set up after Eli was diagnosed with muscular dystrophy 13 years ago. At the time, she was told her three-year-old might not live to see 20.
Along with co-founder Alex Johnson, she has raised more than £17m, which has been used to fund clinical trials across the UK, as well as partially funding 34 posts for doctors and nurses, creating guidelines for care for Duchenne patients and research into how technology can help them. Both women received OBEs from King Charles last weekend.
It was part of their research that led to Eli's initial appearance on BBC Breakfast, discussing the motor-assisted suit that will help him continue playing guitar when his arm muscles begin to waste away.
She says the suit will mean "being able to brush your teeth, give your mum a hug [or] put your arm up in class. All the little things that are actually the really big things".
With help from the Postcode Lottery, they have 10 prototypes in development, and hope to make the suit widely available within three years - helping not just children with muscular dystrophy, but other conditions including spinal injuries.
"She's an inspiration not just to me, but to many people around the world," says Eli.
Clearly, his mum feels the same way about her son.
"I just can't believe it. We never in our wildest dreams thought that dream of his would ever come true," she says.
"These boys work really hard and they rehearse a lot. I know they're going to smash it."
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Medical Innovations
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Patients face 10 days of “distress and disruption” from next week when a 96-hour strike by tens of thousands of junior doctors begins across England, senior health figures are warning.
Up to 60,000 doctors will be eligible to join four days of industrial action, which begins at 7am on Tuesday, 11 April, until 7am on Saturday, 15 April. Consultants said the strike’s effects will be felt for much longer as it takes place in between the Easter Bank Holiday and runs into the following weekend.
Hospitals will begin contacting patients from Monday to reschedule procedures. More than 200,000 appointments and operations are expected to be cancelled as a result of the action. No exemptions are planned, meaning areas such as A&E, intensive care and cancer treatment will be effected.
Dr Nick Scriven, a Yorkshire-based consultant and former president of the Society for Acute Medicine, told i: “It is going to be really challenging maintaining flow through the hospitals as it will be, in reality, 10 consecutive days on reduced workforce with the bank holiday, the strike and then a weekend.
“From what I know, the consultants are ready and willing to roll up their collective sleeves again, but there will be an ongoing risk of fatigue accumulating that will need to be factored in in the rush to try to get all those missed appointments/operations back in process.
“The service will be stretched, but a lot depends on if and how many [operations] are to be cancelled and if those consultants are then released to help out in the wards to give the rest of the senior team a hand.”
The public should have “no doubt about the disruption and distress for patients” that will be caused if next week’s four-day strike goes ahead, another senior NHS leader warned.
Sir Julian Hartley, chief executive of NHS Providers, said patients faced a “raised risk to safety” as a result of the latest round of industrial action by medics. He called for junior doctors and the Government to get back around the negotiating table in time to prevent the strike going ahead.
Sir Julian told i: “No one should be in any doubt about the disruption and distress for patients that will be caused if this strike goes ahead. Yet again trust leaders are doing all they can to mitigate the impact, but the timing and duration of the walk out will mean many more postponed appointments and procedures and a raised risk to safety.
“No one wins – not patients, not staff, and certainly not the NHS. There’s still time for both sides – the government and unions – to step back from the brink. They must redouble their efforts to find a rapid resolution to this damaging dispute.”
Health Secretary Steve Barclay is expected to write to the British Medical Association (BMA) on Monday to initiate a new round of talks. The BMA is campaigning for pay restoration, saying wages have fallen by 26.1 per cent in real terms since 2008. Achieving their aim would require a 35.3 per cent pay rise.
Hospital bosses have warned that the strike by NHS junior doctors threatens the safety of those arriving at A&E and will delay treatment for critically ill patients.
In a letter to The Sunday Times, the Shelford Group, which includes the leaders of hospitals in London, Cambridge, Oxford, Sheffield, Birmingham, Newcastle and Manchester, wrote: “The impact of these strikes on patient care will be extensive, and on a scale significantly beyond that of previous rounds of industrial action. We are now entering the fifth month of industrial action from different staff groups, with each round of strikes having a compound effect and an opportunity cost.”
The chief executives said that the timing of the strike is particularly problematic because it comes immediately after the long Easter weekend. Hospital bosses will have to “reduce or cancel most of our planned work”.
The letter added: “We estimate we will postpone tens of thousands of clinic appointments, diagnostic tests, and operations in our ten trusts alone. National figures will greatly exceed this.”
The previous junior doctors’ strike, held over three days in March, led to the cancellation of 175,000 appointments and procedures. Overall, more than 300,000 have been affected since the start of December as a result of action by health staff including nurses and ambulance workers.
NHS consultants fear patients will die during the next junior doctors’ strike, MPs were told last week. Shadow Health Secretary Wes Streeting told the Commons: “Patients are worried sick, consultants have written to me to say they are terrified for patient safety. They fear that patients will die as a result.”
Strike action set for Monday by Royal College of Midwives (RCM) members across Northern Ireland has been paused. It follows an offer from the Northern Ireland Health Secretary to meet the RCM and other unions this week to discuss pay. The RCM will also be suspending action short of a strike planned for 3-10 April.
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Health Policy
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One of my missions is to get more people enjoying the great outdoors without fearing the sun. We should respect the sun, sure. Sunlight is a powerful agent that, like so many enjoyable and beneficial things in life, can become harmful in excessive doses. But the sun is also a great life force, powering every living thing on the surface of this planet.
As you may know, I’m not a huge fan of sunscreen. I just don’t think it’s all that necessary. If you’ve had enough sun for one day, and you’re worried about burning up, using physical barriers like shirts, hats, umbrellas, and shade trees to impede the sunlight is my preferred course of action.
Our ancestors used various methods to protect themselves from blistering sun rays,1 but modern sunscreens were only invented in the last century. Since then people have become obsessed, with the encouragement of doctors, to slather their skin with powerful chemicals every two hours to avoid even a whiff of color, even as deadly skin cancer rates have risen since the mid-twentieth century.2
So no, I’m not on the side of Big Sunscreen. I certainly avoid the chemical compounds that most commercial sunscreens contain. These chemicals act as carcinogens, at least in animal models, and harm the oceans’ ecosystems.
Still, in the event that the only thing standing between you and a second-degree sunburn is the application of some sunscreen, that’s an obvious choice. You should always opt for safer sunscreen ingredients, though. That’s what we’re talking about today.
How Does Sunscreen Work?
Mineral vs. chemical sunscreen
The sunscreens you’ll see on your supermarket or pharmacy shelves work in one of two ways.
Chemical sunscreens contain chemicals that are absorbed into the skin. When UVA and UVB rays hit the skin, they react with these chemicals and dissipate as heat. Common chemical sunscreen active ingredients are oxybenzone, avobenzone, octocrylene, octisalate, and homosalate.
Mineral sunscreens sit on top of the skin and provide a barrier using zinc oxide or titanium dioxide to block UVA and UVB rays from penetrating the skin. That’s why these are also called physical sunscreens.
Pros and cons of chemical sunscreens (mostly cons)
The only good thing I have to say about chemical sunscreens is ease of use. They go on smoothly and are usually clear on the skin. That’s not enough to weigh all the cons in my book.
Con: endocrine disrupting UV filters
Most of your typical commercial sunscreens use chemical UV filters like benzophenone and oxybenzone that in addition to blocking UV possess a hidden feature: endocrine (hormone) disruption.
Certain forms of benzophenone, for example, inhibit the action of thyroid peroxidase, an enzyme necessary for the production of thyroid hormone.3 Another study showed that applying sunscreen containing benzophenone-2 for five days lowered T4 and T3 thyroid hormones in rats.4
Other researchers applied a UV filter called octyl-methoxycinnamate to rat skin and found that amounts typically present in sunscreen were enough to disrupt hormonal function and exert other, non-endocrine health effects.5
That might not be a problem if UV filters in sunscreen weren’t designed to be absorbed into the skin, and therefore the body, but they are. The only way the chemical sunscreens work is if they are absorbed into the skin—and into systemic circulation. Two studies in 20196 and 20207 demonstrated that common chemical sunscreen ingredients are readily absorbed into the body. More worryingly, even after a single application, these chemicals were present at levels higher than the FDA’s limit for requiring additional safety testing.
Con: imbalanced UV protection
Another downside of chemical sunscreens is that they’re selective screeners. They tend to block UVB while allowing UVA passage.89
UVB rays penetrate the epidermis, the upper layers of our skin, and trigger vitamin D production. UVA rays, on the other hand, penetrate more deeply into the basal section of the dermis, which is where most skin cancer develops. Excessive UVA exposure is also associated with wrinkling, immune suppression, oxidative stress, and related aging. Research shows that concurrent exposure to UVB actually serves to counteract skin damage and inflammation from UVA. We need both together. Blocking one while exposing our skin to the other is a recipe for danger.
Con: environmental concerns
There’s clear evidence that chemical sunscreen ingredients are damaging to coral reefs and sea life.10 This is such a concern that Hawaii, the U.S. Virgin Islands, Aruba, and other countries have banned chemical sunscreens in their waters. Only mineral sunscreens are allowed. Other regions are sure to follow suit, so if you have a seaside vacation planned, look for non-chemical sunscreens with the Protect Land + Sea Certification seal.
Pros and cons of mineral sunscreens (mostly pros)
Physical sunscreens contain either zinc oxide or titanium dioxide. These are the only sunscreen active ingredients recognized as safe by the FDA. The active ingredients in chemical sunscreens are permitted for use by the FDA, but as of 2019, the agency admits that there isn’t enough evidence to give them the GRASE (generally regarded as safe and effective) stamp of approval.11 Yikes.
Mineral sunscreens are also broad spectrum: they block both UVA and UVB. Because they don’t dissipate UV rays as heat, they are better for people with skin conditions that can be exacerbated by heat. They’re generally less irritating for those with sensitive skin, too.
The biggest con to physical sunscreens is that they can be unsightly because they don’t absorb into your skin, often leaving a ghostly white cast that people don’t like. On the plus side, if you can see the sunscreen on your skin, you know it’s still working, unlike chemical sunscreens that may rub or wash off without you noticing. Manufacturers have also started to develop better formulations, including clear and tinted versions that are better suited for darker skin tones.
Physical sunscreen in nanoparticle form does rub in, but there’s conflicting evidence about the degree to which it’s absorbed and whether it matters from a health perspective. I wouldn’t want to inhale them in any case.
Zinc oxide and titanium dioxide nanoparticles are also not considered reef safe, so read labels carefully if you’re headed to the beach. Choose mineral sunscreens with regular, non-nano, active ingredients.
Sunscreen ingredients to avoid
Look at both the active and inactive ingredients lists on the back of the bottle or tube. If you see any of these, just say no.
Oxybenzone
Avobenzone
Octocrylene
Benzophenone
Homosalate
Octisalate
Octinoxate
Cinoxate
Dioxybenzone
Ensulizole
Meradimate
Padimate O
Sulisobenzone
PABA (aminobenzoic acid) and trolamine salicylate have been banned by the FDA, but you might see them in sunscreens if you’re traveling internationally. Strictly avoid these.
There are two other ingredient categories to avoid:
Parabens
Parabens are ubiquitous preservatives used in cosmetic and skincare products, including sunscreens. They show up in our urine because humans can readily absorb parabens from topical application.12 Although the health effects haven’t been explicitly proven, human studies suggest a link between urinary paraben levels and certain health conditions, such as sensitivities to airborne and food allergies,13 elevated stress hormones in pregnant mothers and their newborn children (who, by the way, are showing up with parabens in their first urine!),14 and DNA damage to sperm.15
Retinols
Vitamin A in the diet is protective against sun damage, so manufacturers figured they’d start putting it in topical sunscreens. Except a 2012 study in hairless mice found that applying retinyl palmitate to bare skin and exposing it to UV increased tumor incidence and skin damage.16 Now, humans aren’t hairless mice, and the results from the 2012 paper may not apply to us. But even if retinyl palmitate isn’t carcinogenic, it’s useless. Avoid sunscreens containing retinyl palmitate, retinol, or vitamin A just to be safe.
Sunscreen Best Practices
Here’s what I recommend when it comes to enjoying the benefits of the sun while also protecting yourself against the harms of overexposure.
1. Use sunscreen alternatives first.
Given the option, I’ll always go for hats, clothing, and shade first when I feel myself baking. Lightweight wool garments are surprisingly suited to warm and cold environments alike and provide good sun protection.
2. Opt for zinc oxide or titanium dioxide sunscreens.
SPF 30 is probably as high as you need. There’s no harm in going up to SPF 50, but there’s also no benefit to going higher.
3. Apply wisely.
Don’t forget the backs of your hands, tops of your ears, and your part or areas of thinning hair if you’re not wearing a hat. Mineral sunscreens generally have good staying power, but reapply as needed.
4. Toss expired sunscreen.
The active ingredients can break down, and there’s no point in dousing yourself with stuff that isn’t even effective.
I hear all the time from folks who go Primal and find themselves less prone to sunburns than they were before. I can’t say for sure what’s going on here, but my hunch is that it has something to do with the link between chronic inflammation and skin damage.17 A healthy Primal lifestyle probably factors in here, too. Our ability to repair UV-derived damage depends on a well-functioning circadian rhythm.18Sleeping well and maintaining a good eating schedule both entrain your circadian rhythm appropriately.
Whatever it is, I’ve seen it often enough to believe that there’s something to this phenomenon. I spend tons of time in the sun and know for a fact that I am less likely to burn now than I was when I was younger. I’m still smart about my sun exposure. No hubris here. I know that in a battle of me versus one of the most powerful forces in the universe, I’m no match when it comes down to it.
But I also don’t fear the sun like it seems so many medical agencies and doctors want me to. I want all the vitamin D I can get. I rely on time outside on my bike or paddle board, hiking with Carrie, or just reading poolside to balance the unavoidable stresses of modern life. The sun recharges me, and I have no intention of avoiding it.
What about you? What steps do you take to make sure your fun in the sun doesn’t leave you burned?
Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.
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Nutrition Research
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The Metropolitan police has won its battle to stop attending most of the mental health calls it receives after a tense behind-the-scenes row with the health service, the Guardian has learned.
From 31 October it will start implementing a scheme that aims to stop officers being diverted from crime fighting, to do work health staff are better trained to do.
The Guardian in May revealed that the Met commissioner Sir Mark Rowley had written to health and social care leaders setting a deadline of 31 August – leading to furious reaction from health chiefs who wrote to the commissioner protesting that it could not be done.
The agreement sees Rowley push his deadline back by two months. In return, the health service will not publicly criticise the police decision, and will try to put measures in place to pick up the work.
A formal announcement is expected as soon as tomorrow and follows weeks of tense talks.
The Met was armed with legal advice from a senior barrister – a king’s counsel – arguing the law meant they did not have to do the work of the health service and would probably win any legal challenge.
Police will continue to attend calls if there is a risk to life, a danger to the public or a crime is believed to be taking place.
One health source with knowledge of the discussions told the Guardian the commissioner’s hard line was disliked, but had worked: “He got us round the table, got our attention and got us talking.
“It’s not malice but the NHS is notoriously slow. If he [Rowley] did not give a deadline we would have been here for 10 years.”
The scheme is called Right Care Right Person (RCRP), and has been agreed nationally by government departments and national police and health bodies.
Actually implementing it is down to local areas. NHS London has already started sending guidance to staff about what the new scheme might mean.
Among police forces the Met is thought to be an outlier, in effectively making a threat and giving an ultimatum, police and health sources say.
The Met cited figures showing that 78% of people detained by police under section 136 of the Mental Health Act were discharged home after an assessment, as opposed to being admitted, “suggesting mental health is being overpoliced”, the Met claimed.
Rowley’s letter in May summoned health and social care chiefs to meetings, which were held at the Met’s Scotland Yard central London headquarters and NHS offices in Waterloo.
One health source with close knowledge of the negotiations said: “There is nothing in their presentation you could disagree with.
“There has been a kneejerk reaction from health and social care, to call the police.”
RCRP was pioneered by Humberside police who believe it freed up 7% of officer time to do what the police are legally responsible for.
Health chiefs in London do not know how they will meet the new demand.
A source said: “The health service is already overloaded, the winter crisis is coming, and London ambulance service already faces big performance pressure.”
One reason for the Met to delay, other than giving the health sector more time to prepare, is so that police call centres are better prepared to deal with the new system, a police source said.
When people call the police via 999 in an emergency or 101 for less urgent calls, they are routed to three Met call centres.
There were concerns the Met call centres were struggling with the time taken to pick up the phone exceeding national guidelines. On the 101 service more than three out of 10 callers were hanging up because they were so fed up with the wait.
The 101 service is crucial for RCRP to work as it is the number health and social care partners will often ring the police requesting help. The source said the call handling centres were improving and it is they who will make the call by call decision on when the new “threshold” for police being sent will apply.
The RCRP scheme has four stages. The first the Met is expected to implement is calls to check on welfare, for instance where a mental health patient has missed an appointment and where there is no intelligence of harm.
The second stage is where a patient leave a health facility, having been there voluntarily.
The third is handing over patients to the health sector, where officers can endure long waits of up to 14 hours.
The fourth stage is transporting people to a mental health facility.
For more than a decade police have been exasperated about picking up work they claimed was the responsibility of the health service. Austerity made the situation worse and the health sector, especially the mental health sector, have been struggling to fill vacancies.
Rowley in his May letter said that Met police officers spend 10,000 hours a month dealing with mental health issues, and that it takes up to 14 hours to hand a patient over to medical staff.
A litany of failings saw the Met placed in special measures and Rowley – who marks a year as commissioner next month – has vowed to clean up the force and boost its crime fighting.
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Mental Health Treatments
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No matter where you are on the gender spectrum, you might choose to use birth control if thereâs a chance you could get pregnant and you donât want to.
Not all people who are transgender, nonbinary, or gender expansive choose to get gender-affirming care. But some people do take hormone therapy as part of their medical care to help align their sex characteristics with their gender identity. If you do, keep in mind that gender-affirming hormone therapy isnât made for birth control, so you shouldnât rely on it for that purpose.Â
Some people might also consider certain types of hormonal birth control for other reasons. For example, gender dysphoria â distress when your gender doesnât match the sex assigned to you at birth â can get worse if you identify as male but were assigned female at birth and get your period. Some birth control options can lessen or stop your period.
Birth control is not designed for any particular gender identity. Anything that cisgender people might choose is available for everyone. The type of contraceptive thatâs best for you depends on your situation.Â
âIf itâs for a patient with no other risk factors, any option is available,â says Beth Cronin, MD, an obstetrician-gynecologist in Providence, RI. Things that may affect your decision include your health, family planning goals, and what side effects youâre willing or able to live with.
Contraceptive counseling can help you decide which option best matches your goals, says Adam Bonnington, MD, an obstetrician-gynecologist in San Francisco. (Contraceptive is another word for birth control.)
Â
Who Needs Birth Control?
If your goal is to avoid pregnancy, you may want to consider birth control if:
- You have ovaries and a uterus, you have not gone through menopause, and you have vaginal sex with someone who has testicles and a penis.Â
- You have testicles and a penis, and you have vaginal sex with someone who has ovaries and a uterus who hasnât been through menopause and doesnât want to get pregnant.
You and your partner may want to discuss what you each want and what the options are.
Trans men and nonbinary people:Â If you take testosterone therapy (T) to curb feminine traits and bring out masculine ones, it will stop your periods. Some people assume that means they canât get pregnant. But while a pregnancy for someone in this situation is unlikely, itâs not impossible, Cronin says.
âWe generally counsel patients that if theyâre on T and are having that type of sex, they could get pregnant and they should be using contraception,â she says.Â
If you take testosterone as part of your gender-affirming care, and you want to get pregnant, youâll have to stop taking it.
Trans women and nonbinary people:Â Some trans women and nonbinary people take estradiol therapy as a feminizing hormone. That treatment wonât work as birth control. Neither will hormonal therapy that curbs masculine traits, because it doesnât completely stop sperm production.
If you havenât had a vasectomy (when a doctor cuts and seals the tubes that carry sperm) or orchiectomy (surgery to remove the testicles), and you have vaginal sex with your partner, make sure they use birth control if they donât want to get pregnant. You can also use a barrier method, such as a condom, but condoms do not work as well as other forms of birth control.
Other types of hormonal therapies that arenât birth control methods include:
- Cyproterone acetate
- Finasteride
- Gonadotropin-releasing hormone (GnRH) analogues
Birth Control Types and How to Use Them
There are several types of birth control. The type thatâs right for you might not be right for someone else.Â
Things that can affect your decisions include:
- How easy it is to use
- Cost
- Possible side effects
- Misconceptions you have about it
- Things that make it hard to get birth control
- Discrimination or bias
- Your relationship with your doctor
Talk to your doctor if you have questions about your options.
Condoms
Condoms will help protect you from sexually transmitted diseases (STDs). But to avoid pregnancy, you should also use another form of birth control.
If condoms are the only form of contraception you use â and you use them perfectly, every time you have vaginal sex â thereâs about a 2% chance that you could get pregnant. But most people donât always use them correctly, driving up the odds of getting pregnant to about 13% if youâre not using a second form of contraception.Â
IUDs
Intrauterine devices (IUDs) are shaped like a T. A doctor inserts an IUD into your uterus for long-term, highly effective contraception. Itâs a quick process, but youâll want to make sure youâre comfortable with that.
There are 5 types of IUDs approved in the U.S. Four of them release very small amounts of the hormone progestin, which will not cause any feminizing effects. The fifth type is a nonhormonal copper intrauterine device (you might hear these called Cu-IUDs).Â
Side effects can include vaginal spotting (where thereâs only a little bit of blood) and bleeding. Some people also get cramps related to their IUD. But most people stick with the IUDs, according to a 2021 study published in the Journal of Midwifery and Womenâs Health. That study was based on a survey of 105 trans men and gender diverse people with IUDs who had been assigned female at birth. The IUDs were âwell tolerated,â the researchers wrote, with few people seeking to remove them because of side effects.Â
Progesterone-only methods
Progesterone is a hormone that your body makes. Progestin is a synthetic version of it.Â
Progesterone-only methods of birth control include some IUDs (levonorgestrel intrauterine systems), implants, shots, or pills. Talk to your doctor about it first.Â
Shots or IUDs could help you stop or lessen bleeding from your vagina. To avoid bleeding, you may want to choose a method like the progestin-only implant, IUD, or shot, Bonnington says.
Combined hormonal contraceptives (CHCs)
Combined hormonal contraceptives (CHCs) include patches, pills, and the vaginal ring. They contain estrogen and progestogen. There isnât enough feminizing hormone in these contraceptives to affect testosterone therapy.
If youâve had top surgery (surgery to remove breast tissue to create a more masculine chest), medications with estrogen â such as birth control pills, patches, or the ring â might make your breasts feel tender or sore. âSome people note some bloating and things like that, but itâs really going to depend on the person,â Cronin says.
More permanent options
There are also more permanent forms of birth control. Either partner can get a vasectomy or tubal ligation (surgery to cut, tie, or block the fallopian tubes). Both procedures will help prevent conception.
How to Talk to Your Doctorâs Office and Pharmacy
Many transgender and nonbinary people say theyâve been discriminated against or otherwise not treated respectfully in health care settings.
Sometimes the best way to find LGBTQ-friendly providers is through word of mouth from family or friends, Cronin says. Local LGBTQ organizations often have a list of providers they refer people to, Bonnington says.
Signs the provider is LGBTQ-friendly can include:
- A posted sign with nondiscrimination policies that include gender identity and expression protections
- A waiting room with educational brochures, magazines, or posters about transgender health
- A bathroom labeled for all-gender use
- Intake forms that ask for your correct name, pronouns, gender identity, and sex assigned at birth
- Providers who have their pronouns on their name badges
Still, he says, these arenât guarantees that a provider or clinic is LGBTQ-friendly.
Related:
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Women’s Health
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Nicotine e-cigarettes are among the best tools to help people quit smoking.
That's according to an analysis of more than 300 clinical trials that collectively included more than 150,000 adult smokers worldwide. The data suggest that nicotine-containing e-cigarettes, or vapes — handheld devices that deliver nicotine via an aerosol with flavoring — and two pills called varenicline and cytisine were associated with the greatest chance of quitting smoking for at least six months.
These stop-smoking aids' success rates were closely followed by those of dual nicotine replacement therapy (NRT), an approach that involves using two aids at the same time, such as a nicotine patch alongside taking gum or lozenges. However, the evidence for dual NRT was less certain than that for vapes and the medications.
The authors of the new review, published Tuesday (Sep. 12) in the Cochrane Database of Systematic Reviews, hope the findings will provide more clarity on the relative effectiveness of these stop-smoking aids.
"Our findings provide clear evidence of the effectiveness of nicotine e-cigarettes and combination nicotine replacement therapies to help people quit smoking," Jamie Hartmann-Boyce, senior study author and assistant professor at the University of Massachusetts Amherst, said in a statement.
Related: Is vaping healthier than smoking?
"The evidence also is clear on the benefits of medicines, cytisine and varenicline, but these may be harder for some people to access at the moment," he said.
Varenicline, although currently available in the U.S., is not accessible in many countries worldwide due to recent shortages. Meanwhile, cytisine is not widely available because it's been licensed in only some countries in eastern and central Europe and western Asia, and in Canada. That said, the drug is in late-stage clinical trials in the U.S. and thus moving toward approval.
"We're in a kind of weird position with this review where we're saying these are the top three most successful, but actually only one of them is widely available at the minute and that's e-cigarettes," Nicola Lindson, lead study author and a senior researcher and lecturer at the University of Oxford, told Live Science.
The review revealed that, on average, 14 in 100 people who are trying to quit smoking are likely to succeed for at least six months using e-cigarettes, varenicline or cytisine. That's compared to 12 in 100 who use dual NRT, 9 in 100 who use one form of NRT, and 6 in 100 who don't use any stop-smoking aids.
In the paper, the authors highlighted the need for further data to determine the long-term consequences of using these aids, beyond the six-to-12-month timeframe that most of the trials they analyzed considered. Lindson added that, in the future, more trials could directly compare the effectiveness of these different treatments, for example, by pitting cytisine against e-cigarettes in addition to a placebo, or could potentially test the use of multiple treatments together.
The rising popularity of e-cigarettes has raised concerns about their potential environmental impact and their use by young people who have never smoked. Given that vapes are a relatively new stop-smoking aid — developed in 2003, compared to NRT, which has been approved in the U.S. since the 1980s — scientists are still researching their potential health effects.
According to Lindson, though, the message for people trying to stop smoking is clear.
"What we would always recommend is that people should be encouraged to use e-cigarettes to stop smoking if they've already smoked," she told Live Science. "But it's best not to use them if you have never smoked, because they're not going to be completely risk-free — they're just, we believe, a lot safer than smoking."
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. (emily.cooke@futurenet.com)
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Drug Discoveries
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MoneyWatch June 13, 2022 / 11:59 AM / AP U.S. regulators have historically inspected baby formula plants at least once a year, but they did not inspect any of the three biggest manufacturers in 2020, according to federal records reviewed by The Associated Press.When they finally did get inside an Abbott Nutrition formula plant in Michigan after a two-year gap, they found standing water and lax sanitation procedures. But inspectors offered only voluntary suggestions for fixing the problems and issued no formal warning.Inspectors would return five months later after four infants who consumed powdered formula from the plant suffered bacterial infections. They found bacterial contamination inside the factory, leading to a four-month shutdown and turning a festering supply shortage into a full-blown crisis that sent parents scrambling to find formula and forced the U.S. to airlift products from overseas. The gap in baby formula plant inspections, brought on by the COVID-19 pandemic, is getting new scrutiny from Congress and government watchdogs investigating the series of missteps that led to the crisis. A recent bill would require the Food and Drug Administration to inspect infant formula facilities every six months. And the government's inspector general for health has launched an inquiry into the FDA's handling of Abbott's facility, the largest in the U.S.FDA skipped thousands of inspections Abbott resumed production at the plant early this month under a legally binding agreement with the FDA, but the shutdown and nationwide shortage exposed how concentrated the industry has become in the U.S., with a handful of companies accounting for roughly 90% of the market. As COVID-19 swept across the U.S. in early 2020, the FDA pulled most of its safety inspectors from the field, skipping thousands of routine plant inspections.The FDA did conduct more than 800 "mission critical" inspections during the first year of the pandemic, the agency said in a statement. Regulators selected facilities for inspections based on whether they carried a specific safety risk or were needed to produce an important medical therapy.Only three of the nation's 23 facilities that make, package or distribute formula made the cut. The FDA resumed routine inspections in July 2021.The inspection records reviewed by the AP show gaps as large as 2 1/2 years between FDA's 2019 inspections and when regulators returned to plants owned by the three leading formula manufacturers: Abbott, Reckitt and Gerber. In fact, the FDA still has yet to return to one key plant owned by Reckitt and two owned by Gerber, according to agency records. All those facilities are operating around the clock to boost U.S. formula production."The FDA would have had more chances to catch these issues if they'd been inspecting during the pandemic," said Sarah Sorscher, a food safety specialist with the Center for Science in the Public Interest. She acknowledged the difficult trade-off the FDA faced in pulling its inspectors to reduce their exposure to COVID-19. "Certainly there was a price to pay for protecting their workers during that time.""High priority"Baby formula manufacturers were "consistently identified as a high priority during the pandemic," and there is currently no backlog of inspections, the agency told the AP in response to inquiries about the gaps. The agency said it skipped about 15,000 U.S. inspections due to COVID, but it has already made up about 5,000 of those, exceeding its own goals.Under current law, the FDA is only required to inspect formula facilities every three to five years, but the agency has consistently inspected facilities annually — until the pandemic."Our top priority now is addressing the urgent need for infant formula in the U.S. market, and our teams are working night and day to help make that happen," FDA stated. Big shipment of baby formula arrives in Los Angeles 00:44 But outside experts say the gap in inspections speaks to a blind spot in the government's response effort, which was successful at preventing shortages of drugs and other medical supplies.FDA Commissioner Robert Califf says regulators knew shutting down Abbott's plant would create supply problems, but there was little evidence of urgency between when inspectors shuttered the plant in February and recent emergency measures to allow more imports from abroad. Drugs over food safetyLongtime food safety specialists see a deeper problem at the highest levels of the FDA, where physicians and medical scientists for decades have prioritized oversight of drugs and medical products over food."It's very challenging for them to get engaged at all in this area because they don't have the background, the knowledge and the experience in it," said Steven Mandernach, executive director of the Association of Food and Drug Officials, which represents state-level inspectors.The FDA shares oversight of food production and safety with the U.S. Department of Agriculture. FDA inspections of food facilities peaked in 2011 and have declined most years since, despite increased funds and powers by Congress. The FDA said that while U.S. inspections have declined, foreign facility inspections have increased.There's no certainty that extra inspections during COVID-19 would have prevented the contamination problems at the Sturgis, Michigan, plant that was shut down. And Abbott says that its products have not been directly linked to the infections, two of which were fatal.But the plant did have earlier problems, including a 2010 formula recall due to possible contamination with insect parts."I think facilities that had known problems that could cause a food safety risk should have been part of FDA's mission critical work," Mandernach said. "And this facility would have been among those."Not having regular inspections — or even the threat of them — can lead to changes in culture at plants like Abbott's, Mandernach noted. "If you're driving down the highway and you know the state troopers have been furloughed, might you go a little faster than if you knew there was a trooper on duty?" Mandernach asked.
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Health Policy
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The UK's biggest ever medical research project - Our Future Health - has signed up its one millionth volunteer just over a year since it started recruiting.
Funded by government and industry, the eventual goal is to enrol five million adults.
They will share genetic, health and lifestyle information.
Researchers then analyse the causes of disease and look for new treatments, or ways to prevent diseases.
Once people sign up online they are invited to have a series of health checks performed at a mobile health centre, which are often located in supermarket car parks.
I went to one of the centres in a retail park on the outskirts of Oxford, and spoke to some of the volunteers. Each gave a blood sample, and had cholesterol, height and blood pressure measurements taken. The whole appointment takes around 15 minutes. Volunteers also fill out lifestyle and medical questionnaires online.
Jaap Van Der Werf, 45, who is originally from the Netherlands, cycled six miles for his appointment. He knows the importance of keeping fit when it comes to maintaining good health, but also realises that genetics play a part.
He told the BBC: "My parents have heart issues, so I wanted to make sure that I don't have them. And if I have something, I can make sure my children are well prepared for their future."
Gillian Ebberson, 67, is already a member of UK Biobank, a similar project set up two decades ago, which is following the health of 500,000 adults in the UK. She was wearing a heart monitor as part of UK Biobank research. She has grandchildren and wants any health advances to help them.
"I just think going forward for the future health of our children, our grandchildren and for everyone, it's a good thing."
Dr Raghib Ali, the Chief Medical Officer of Our Future Health, is an intensive care consultant in Oxford, so spends most of his time in A&E.
He told the BBC: "Most of my patients come in with things like a heart attack, stroke or cancer, and we know these diseases have developed over many years. With Our Future Health we are trying to move our model of healthcare from the treatment of disease at a late stage when people have symptoms, to one where we identify those at high risk earlier, intervening and preventing those diseases in the first place."
He also said it was important that people from all backgrounds signed up to prevent any further widening health inequalities, after a relative lack of diversity in previous studies.
Our Future Health is funded by the government and industry. The project team say volunteers' data is being kept in a "very secure environment" and only scientists whose research has a public health benefit will be given access.
I am also a member of both UK Biobank and Our Future Health. The new project has more personal health feedback - you come out of your appointment with a small folder of health-related measurements from heart rhythm to cholesterol levels and blood pressure.
UK Biobank has been an extraordinary success. More than 30,000 researchers from 100 countries have been approved to use it. Over 6,000 peer-reviewed papers have been published using its research.
Our Future Health won't complete enrolment until 2028, so has a long way to go to catch up. But its strength is its scale: it is 10 times bigger than UK Biobank. In decades to come - as the data and the participants mature - it should yield powerful insights into a range of diseases and how best to prevent, diagnose and treat them.
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Disease Research
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Timing is everything. For early risers and late-nighters alike, listening to your internal clock may be the key to success. From the classroom to the courtroom and beyond, people perform best on challenging tasks at a time of day that aligns with their circadian rhythm.
Circadian rhythms are powerful internal timekeepers that drive a person's physiological and intellectual functioning throughout the day. Peaks in these circadian rhythms vary across individuals. Some people, known as larks or morning chronotypes, peak early and feel at their best in the morning. Others, known as owls or evening chronotypes, peak later in the day and perform best in the late afternoon or evening. And some people show neither morning nor evening preferences and are considered neutral chronotypes.
As a researcher seeking ways to improve cognitive function, I've explored whether your chronotype affects your mental performance. Understanding the kinds of mental processes that vary — or remain stable — over the course of a day may help people schedule their tasks in a way that optimizes performance.
Why your chronotype matters
Chronotype can be measured with a simple questionnaire that assesses things like your perceived alertness, preferred rising and retiring times and performance throughout the day. Even without a questionnaire, most people have a sense of whether they are a lark or an owl or fall somewhere in between. Do you wake up early, without an alarm, feeling sharp? Are you mentally drained and ready for pj's by nine? If so, you are likely a morning type. Do you sleep late and wake feeling sluggish and foggy? Are you more energized late at night? If so, you are likely an evening type.
People perform best on many challenging mental tasks — from paying attention and learning to solving problems and making complex decisions — when these actions are synchronized with their personal circadian peaks. This is known as the synchrony effect. Whether you are an air traffic controller scanning the radar, a CFO reviewing an earnings report or a high school student learning chemistry, synchrony can affect how well you perform.
Much of the evidence for synchrony effects comes from lab studies that test both larks and owls early in the morning and late in the day. People with strong chronotypes are more vigilant and better able to sustain attention at their peak relative to off-peak times. Their memories are sharper, with better list recall and more success in remembering "to-do" tasks like taking medication.
People are also less prone to mind wandering and less distracted at their optimal time. For example, a study I conducted gave participants three weakly related cue words (such as "ship," "outer" and "crawl"). They were tasked to find another word that linked all three (such as "space"). When my team and I presented misleading words alongside the cue words (such as "ocean" for ship, "inner" for outer and "baby" for crawl), those who were tested at synchronous times were better at ignoring the misleading words and finding the target solution than those who weren't.
Synchrony also affects high-level cognitive functions like persuasion, reasoning and decision-making. Studies on consumers have found that people are more discerning, skeptical and analytical at their peak times. They invest more time and effort in assigned tasks and are more likely to search for important information. Consequently, people make better investment decisions, are less prone to bias and are more likely to detect scams.
At off-peak times it takes people longer to solve problems, and they tend to be less careful and more reliant on mental shortcuts, leaving them vulnerable to flashy marketing schemes. Even ethical behavior can be compromised at non-optimal times, as people are more likely to cheat at their off-peak times.
In the classroom and the clinic
The basic mental abilities that are affected by synchrony — including attention, memory and analytical thinking — are all skills that contribute to academic success. This connection is especially significant for teens, who tend to be night owls but typically start school early.
One study randomly assigned over 700 adolescents to exam times in the early morning, late morning or afternoon. Owls had lower scores relative to larks in both morning sessions, but this disadvantage disappeared for owls taking the exam in the afternoon. Early start times may put student owls a step behind larks.
Time of day may also be a consideration when conducting assessments for cognitive disorders like attention-deficit disorder or Alzheimer's disease. Scheduling time may be particularly significant for older adults, who tend to be larks and often show larger synchrony effects than young adults. Performance is better at peak times on several key neuropsychological measures used to assess these conditions. Failing to consider synchrony may affect the accuracy of diagnoses and subsequently have consequences for clinical trial eligibility and data on treatment effectiveness.
Of course, synchrony doesn't affect performance on all tasks or for all people. Simple, easy tasks — like recognizing familiar faces or places, dialing a close friend's phone number or making a favorite recipe — are unlikely to change over the day. Furthermore, young adults who are neither larks nor owls show less variability in performance over the day.
For those who are true early birds or night owls, tackling the toughest mental tasks at times that align with their personal circadian peaks could improve their outcomes. When small improvements in performance offer an essential edge, synchrony may be one secret to success.
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Stress and Wellness
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Ex-health secretary Matt Hancock has criticised the UK's pandemic planning ahead of Covid, saying it was too focused on dealing with deaths rather than averting them.
He told the Covid inquiry the focus was to plan for the consequences of a disaster: "Can we buy enough body bags, where are we going to bury the dead? That was completely wrong."
He said he was "profoundly sorry" for each death, but acknowledged that - for some - his apology would be "hard to take".
As Mr Hancock arrived at the inquiry, a widow showed him images of her husband, who died from Covid.
Lorelei King, 69, was holding two A4 posters, which she showed to the former health secretary as he stepped out of a black Jaguar.
One poster displayed an image of Mr Hancock with Mrs King's husband, Vincent Marzello, who died in a care home in March 2020, aged 72.
"You shook my husband's hand for your photo op," the photo was captioned.
Mr Hancock didn't respond as he walked in to the building.
Mrs King told journalists: "Care homes became charnel houses because there was no testing, there was insufficient PPE, but, most disastrously, it's because they discharged people from hospitals without testing them."
She called on Mr Hancock to "tell the truth" to the inquiry, adding: "The bereaved families deserve that much."
'Lions led by structural donkeys'
Inside the inquiry, KC Hugo Keith asked Mr Hancock why, if he was so critical of the UK's approach to pandemic planning, was it not changed while he was health secretary.
Mr Hancock said: "The only answer I can give is because I was assured that we had the best system in place in the world.
"In hindsight, I wish I'd spent that short period of time [before the pandemic] changing the entire attitude to how we respond to a pandemic."
He praised workers across health and social care during the pandemic, to which Hugo Keith makes the analogy: "Lions led by structural donkeys, Mr Hancock. Personally, everyone gave their all but the system was not fit for purpose, was it?"
Mr Hancock replied: "That's absolutely right."
The former health secretary was repeatedly asked about the recommendations from Exercise Cygnus, a three-day test run in October 2016 to find out how prepared the UK was for a influenza pandemic.
It concluded that the UK's plan was not sufficient to "cope with the extreme demands of a severe pandemic"
The Inquiry has seen evidence that only eight of the 22 recommendations made after that exercise had been fully addressed by the time Covid hit with work on the other 14, including to prepare the social care sector, still ongoing.
Mr Hancock said that some of that work had been paused because of the need to prepare the country for a no-deal Brexit.
But he said that he was "not convinced" that, even if all those recommendations had been addressed, the country would have been in a better place to deal with Covid.
He described Exercise Cygnes as "flawed in its central assumption" that a pandemic was a disaster that needed to be "cleaned up" rather than something that needed to be stopped or contained in the first place.
He said: "The doctrinal flaw was the biggest by a long way because if we'd had a flu pandemic, we still would have had the problem of no plan in place for lockdown, no prep for how to do one, no work on what, how best to lock down with the least damage.
"I understand deeply the consequences of lockdown and the negative consequences for many, many people - many of which persist to this day."
He said he had to overrule initial advice not to quarantine people being brought back from Wuhan early in the pandemic, and that everybody in the Western world missed that lockdowns would be necessary.
He said the government also had no idea whether care homes had the right protections in place, describing the situation as "terrible" - the government didn't even know how many care home residents there were at the start of the pandemic.
What is the Covid Inquiry?
- It is about going through what happened and learning lessons
- No-one will be found guilty or innocent
- Any recommendations made do not have to be adopted by governments
- The inquiry has no formal deadline but is due to hold public hearings until 2026
- Scotland is holding a separate inquiry in addition to the wider UK one
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Epidemics & Outbreaks
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The number of patients dying in emergency departments increased by a third last year compared with before the pandemic, an analysis suggests.
More than 23,000 patients died in accident and emergency in 2022, compared with 17,502 in 2019.
The new figures, released under freedom of information laws, come after patients experienced record waits in A&E last year.
Last year almost 350,000 patients waited 12 hours in A&E after a decision was made to admit them. That means an average of 1,000 patients a day were waiting that long, which is almost the entire figure for all of 2015.
More than 1.6 million patients waited more than four hours in 2022, according to NHS England data.
NHS trusts must admit, transfer or discharge 76 per cent of patients within four hours by March 2024, under a new target. Only 61 per cent of patients in April were seen within this time frame.
The number of patients dying also increased by more than 4,000 between 2021 and 2022, according to figures obtained by the Labour Party.
The figures obtained and analysed by Labour relate to responses received from 62 NHS trusts in England, which were then extrapolated out to relate to all 124 acute trusts.
The Royal College of Emergency Medicine has previously said 23,000 "excess patient deaths" may have occurred due to long A&E waits in England in 2022.
It warned that long waiting times can have "catastrophic consequences for patient safety and mortality".
A study published in the Emergency Medicine Journal found every 82 patients delayed 6-8 hours in A&E corresponds to one extra death within 30 days.
Labour has vowed to cut A&E waits for patients as part of its mission to reform the NHS for the future.
NHS 'broken'
Wes Streeting, Labour’s shadow health secretary, said: “People turning to the NHS in an emergency should know they will be seen and treated before it’s too late. The Conservatives’ failure over 13 years to properly staff or reform the NHS has a cost in lives.
“When Labour was last in government, patients in an emergency were treated in good time. It took 13 years for the Conservatives to break the NHS – it won’t be fixed overnight. But it will be the mission of the next Labour government to build an NHS that is there for you when you need it once again.”
Steve Barclay, the Health Secretary, admitted in January that the pre-pandemic four-hour target was no longer achievable.
As part of its attempts to improve urgent and emergency care, the Government established the less ambitious interim goal that by March 2024, 76 per cent of A&E patients would be dealt with in four hours. The official target is 95 per cent.
A&E departments had more than 25.1 million attendances in 2022, compared with 22.7 million in 2021, 18.7 million in 2020 and 25.6 million in 2019.
Maria Caulfield, a health minister, pointed to the fact that the NHS in Wales has consistently failed to meet its waiting times targets under a Labour government.
“Meanwhile, we are delivering a record number of tests, speeding up discharge from hospitals, and cutting waiting lists as we also work to halve inflation, grow the economy, reduce debt, and stop the boats,” she said.
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Epidemics & Outbreaks
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Sept. 13, 2023 -- America's most popular oral nasal decongestant, phenylephrine, is not effective and no better than a placebo, an FDA panel said Tuesday.Â
The Nonprescription Drug Advisory Committee discussed the efficacy and how phenylephrine moves in the body. The committee's next move is to determine if the drug's status as Generally Recognized as Safe and Effective (GRASE) should be revoked. This would mean manufacturers would have to come up with new formulations, or products containing the drug would be removed from store shelves. The committee did not say how long the review will take.  Â
The unanimous vote was in line with a review of pharmacology and clinical data the FDA presented Monday. It found the rate at which the drug is absorbed by the body to be less than 1%, compared to 38%, a number often cited in literature and based on outdated technology.
Products that contain phenylephrine include Sudafed PE, Mucinex, Dayquil, Tyenol Sinus and Advil Sinus Congestion, as well as store brands based on the same formulations. These products are available over the counter and do not include those sold behind pharmacy counters.Â
The side effects of phenylephrine include headaches, insomnia, and nervousness. At higher doses, it can also increase blood pressure.Â
The review also found that original studies used to support the drugâs effectiveness were inconclusive at best and contained potential methodological, statistical, and data integrity issues.
Pseudoephedrine is the only other nonprescription oral nasal decongestant on the retail market but is behind-the-counter due to its use as a potential narcotic.Â
Manufacturers have used phenylephrine instead of pseudoephedrine in many products to make it easier to buy. Revoking the safe and effective status of the drug would leave patients without an over-the-counter option.Â
According to the FDA's review, 242 million packages or bottles of phenylephrine products were sold in 2022, resulting in $1.76 billion in sales. A little over 50 million packages of pseudoephedrine were sold that same year, resulting in $542 million in sales.
"I think there's a huge potential for consumer concern," Diane B. Ginsburg, PhD, the pharmacy practice division associate dean for health care partnerships at the University of Texas, said during the committee meeting.
She said patients may be confused and concerned about the panel vote, especially those people who feel they have benefitted from phenylephrine products. In the event of its status as safe and effective is removed, she said doctors should reassure patients that phenylephrine is being pulled from shelves because itâs ineffective, and not because it is dangerous.Â
"The real positive here to me is the opportunity from an educational perspective to show consumers the fact that there are a lot more ways to treat" conditions that include congestion. Â
According to the FDA review, "most consumers may simply need instruction on the alternatives, including how to obtain 'behind-the-counter' pseudoephedrine or to use alternative treatments, including intranasal decongestants (including intranasal PE), intranasal steroids, intranasal antihistamines, or intranasal saline products."Â
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Drug Discoveries
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- Americans, regardless of their insurance status, can now access Sanofi's most widely prescribed insulin for $35 through prescription drug savings company GoodRx.
- Patients with a valid prescription can specifically access a coupon for Sanofi's Lantus product on GoodRx's site and redeem it at U.S. retail pharmacies, including CVS, Walgreens and Walmart.
- The partnership with GoodRx aims to make the $35 price point for Lantus more widely accessible to Americans, even after Sanofi – along with its rivals Eli Lilly and Novo Nordisk – announced sweeping insulin price cuts earlier this year.
Patients with a valid prescription can specifically access a $35 coupon for Sanofi's Lantus on GoodRx's site and redeem it at more than 70,000 retail pharmacies across the U.S., including CVS, Walgreens and Walmart.
The effort aims to make the $35 price point for Lantus more widely accessible to Americans, even after Sanofi – along with its rivals Eli Lilly and Novo Nordisk – announced sweeping insulin price cuts and out-of-pocket cost caps earlier this year.
Those three companies, which control over 90% of the global insulin market, moved to slash prices after years of political pressure and public outrage over the high costs of diabetes care in the U.S. Americans pay roughly eight times more for insulin than other developed countries, making diabetes the country's most expensive chronic condition.
Sanofi said in March that it would lower list prices for Lantus and cap out-of-pocket costs for people with insurance at $35 a month. But the change won't be effective until January.
The French company also has an existing patient assistance program to cap insulin prices for uninsured diabetes patients at the same price. But some patients have struggled to access the $35 price point, even with that program in place.
That's due to low awareness among patients about copay cards and patient savings programs that can assist with out-of-pocket costs. Health experts and patient advocates have raised concerns that those programs, which manufacturers run, often require people to jump through hoops just to save money.
Pharma companies spend more than $5 billion on marketing patient support programs every year, but only 3% of patients actually use them, according to a 2021 survey from Phreesia Life Sciences.
Roughly 37 million people in the U.S., or 11.3% of the country's population, have diabetes, according to the Centers for Disease Control and Prevention. Approximately 8.4 million diabetes patients rely on insulin, the American Diabetes Association said.
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Drug Discoveries
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Plasma tech transforms blue-green algae into a wound-healing wonder
Researchers have used plasma technology to transform a species of blue-green microalgae into a bioactive coating with incredible wound-healing properties. They say the novel coating can be applied to dressings and medical devices to protect patients from infection, speed up healing and reduce inflammation.
Plasma is formed from gas so superheated that the electrons are ripped away from the atoms, resulting in a soup of positively charged ions and negatively charged electrons. An atmospheric pressure plasma jet (APPJ) provides a plasma discharge at ambient pressure using a noble gas/molecular gas mixture passed through a powerful electric arc discharge.
Researchers at Flinders University, South Australia, have used an argon APPJ to convert blue-green microalgae into an ultrathin bioactive coating that can be added to medical dressings to kill bacteria, reduce inflammation and promote wound healing.
“We are using the plasma coating technology to turn any type of biomass – in this case Spirulina maxima – into a sustainable high-end coating,” said Vi Khanh Truong, one of the study’s corresponding authors. “With our technology, we can transform biomass into coatings on wound dressing.”
Extract of S. maxima, a species of blue-green microalgae, is often used as a dietary supplement. The unicellular organism possesses a simple reproductive system that generates a biomass containing bioactive compounds with potent antioxidant and antibacterial properties that can assist with wound healing.
However, the thick cell walls of the microalgae pose a significant obstacle to extracting these valuable compounds. That’s where APPJ comes in. The researchers used the technology to selectively break down the microalgae’s thick walls, which resulted in a significant transformation. S. maxima lost its native structure, completely disintegrated, and subsequently reformed into ultrathin films.
The antibacterial activity of the argon APPJ-treated S. maxima was assessed and found to be highly effective against Pseudomonas aeruginosa and Staphylococcus aureus, with 93% and 73% cell death, respectively, and inhibited biofilm formation. Bacteria inside biofilm are much more resistant to antibiotics.
In addition to being biocompatible, the S. maxima coating exhibited anti-inflammatory properties. And a wound created by the researchers using wound scratch assay was completely closed in two days when the coating was used.
The researchers say this novel technique holds promise as a wound treatment, including the treatment of chronic wounds, particularly given the rise in antibiotic resistance.
“This new, plasma-facilitated downstream processing can improve extraction and purification of useful compounds from biomass without the need for harmful solvents and a lot of energy input,” said Krasimir Vasilev, the other corresponding author of the study. “We are now exploiting avenues for commercialization of this unique technology. Currently, there is no commercial wound dressings that simultaneously fight and protect from infection, favorably modulate inflammation and stimulate healing.”
The study was published in the journal Small.
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Medical Innovations
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The omicron variant’s family tree has grown substantially over the last year. The brood now encompasses a subvariant soup with alphanumeric names such as BA.2, BA.5 and BF.7. The U.S. Centers for Disease Control and Prevention estimates that two versions — BQ.1 and BQ.1.1 — caused just over half of new infections in the United States during the week ending January 7. Now, a newcomer dubbed XBB.1.5 seems poised for a rise to dominance. According to CDC estimates, it accounts for more than 80 percent of new cases in parts of the northeastern United States. For the week ending January 14, it was responsible for 43 percent of new cases across the country. Science News headlines, in your inbox Headlines and summaries of the latest Science News articles, delivered to your email inbox every Thursday. But while previous variants such as alpha, delta and the original omicron were linked to massive surges of new infections, it’s not yet clear whether XBB.1.5 is destined for a similar path (SN: 12/21/21). Preliminary evidence suggests the subvariant, nicknamed the Kraken in some circles, is more transmissible than its predecessors. That trait, however, is a hallmark of viral evolution — successful new variants must be able to outcompete their siblings (SN: 5/26/20). For now, experts at the World Health Organization are keeping a close eye on XBB.1.5. But it’s too early to say whether it might take over the globe. Most cases currently come from the United States, the United Kingdom and Denmark. Science News spoke with infectious diseases specialist Peter Chin-Hong of the University of California, San Francisco about the latest coronavirus variant to make headlines. The conversation has been edited for length and clarity. SN: What is the difference between XBB.1.5 and earlier versions of omicron? Chin-Hong: There are lots of variants that get produced all the time. It’s a normal thing for the virus as the virus makes more copies of itself. It’s not exactly precise or accurate, so it makes errors, [which are the variants]. It’s kind of like a bad photocopy machine in the office. XBB, a sibling of XBB.1.5, was scary — and that was seen in the fall of 2022 — because it was one of the most immune-evasive variants around. But the reason why XBB never took off around the world — it was really in Singapore and India — was that it didn’t really infect cells quite as well. XBB.1.5 has the immune slipperiness of XBB, but it also has this new mutation that makes it easy to infect cells. So it’s kind of like a bulldog in not wanting to let go of the cell. Whereas XBB was kind of invisible, like it had the invisibility cloak from Harry Potter, it didn’t have the bite. But XBB.1.5 has the invisibility cloak, plus the bite. Subscribe to Science News Get great science journalism, from the most trusted source, delivered to your doorstep. SN: Is that why it’s spreading so effectively in some areas? Chin-Hong: We think so. Because to be very efficient at infecting cells is a really important superpower if you are a virus. You can be invisible [to the immune system] all you want, but if you’re not infecting cells efficiently, you probably won’t be as infectious. That could be [the reason] XBB.1.5 is spreading, because it has both of those things going for it. Seeing how it’s crowding out the other variants now makes us worried that it’s something to pay attention to. And it’s accompanied by increasing cases and hospitalizations. SN: Previous variants were linked to big surges of infections. Can we expect the same of XBB.1.5? Chin-Hong: It’s complicated. If it were March 2020, it would be a very simple answer: Yes. But in January of 2023, you have so much variation in the amount of experience people have toward COVID, even if it’s a different type. You can have somebody who got infected two or three times plus they got vaccinated and boosted. That’s going to be somebody who’s going to be really, really well protected against getting seriously ill. Maybe they might get a cold. Maybe they wouldn’t even know they had an infection versus somebody who didn’t get vaccinated and never got exposed and they’re older. It might as well be March of 2020 for them. That [second] kind of person is, for example, in China. In China, XBB.1.5 might cause a lot of problems. But XBB.1.5 going to, you know, the middle of Manhattan might not cause as many problems in a highly vaccinated and exposed group of people. [Timing also matters] because we saw a lot of BQ.1, BQ.1.1 recently, and a lot of people got infected after Thanksgiving. This rise of XBB.1.5 is coming after a lot of people already got infected recently. So it probably won’t do as much damage as if you had a long lull and all of a sudden you have this new thing. SN: Do vaccines and treatments still work against it? Chin-Hong: The new updated boosters generally work a little better than the old vaccines in terms of overall efficacy and preventing infection. But with these new slippery variants like XBB.1.5 … if you’re looking to prevent infections, even a mild infection, the vaccines are probably going to last maybe three months. But if you’re talking about preventing me from dying or going to the hospital, those vaccines are going to give me a boost of protection for many, many months, probably until next winter for most people. For older people, older than 65, if they’re not boosted today, then it’s a problem. [Drugs such as] Paxlovid and remdesivir work independent of the spike protein [the part of the virus targeted by vaccines but where many of the defense-evading mutations are (SN: 3/1/22)]. So it doesn’t matter what invisibility cloak the variant has. They’re going to work because they work on shutting down the virus factory, which is one of the early steps, before the spike protein gets made. So they will work no matter what [spike] variant comes along, which is a good thing. Even if you didn’t get vaccinated or never got exposed, if you got diagnosed and you get early therapy, it will cut down your hospitalization rates substantially. Now, all monoclonal antibodies don’t work. [The virus has changed too much (SN: 10/17/22).] SN: Why is it that only omicron variants are popping up? Chin-Hong: I think omicron has hit on a magical formula. It’s going to be hard to kick it off the gold medal stand. It’s so good at transmission, and all these other aspects that are good for the virus. In the [earlier] days, it was two or three months, and you had a new coronavirus variant somewhere in the world. Now it’s been omicron since two Thanksgivings ago. SN: With each variant more transmissible than the last, is it inevitable that everyone will get COVID? Chin-Hong: The people who didn’t get infected before are going to have a really, really hard time escaping this one. But it’s not impossible. It’s just going to be harder and harder, not only because XBB.1.5 is so transmissible, but also because we don’t have so many restrictions anymore. You’re going to the grocery store, nobody’s wearing a mask or you don’t feel like you have peer pressure to wear masks. So you’re going to get exposed just like you get exposed to colds…. But you can reduce the risk in the short term by getting a booster, if you haven’t already gotten one. And certainly [the booster] can reduce the risk of dying, particularly if you’re older or immune-compromised…. [People still wearing masks] have to wear really good quality masks [such as KN95s] because you can’t rely on everybody else wearing masks anymore. SN: How worried should people be about XBB.1.5? Chin-Hong: The world is divided into two groups of people. The people whose bodies are very, very experienced with COVID — it’s gotten vaccines or boosting or … a couple of infections. And then there are people whose body isn’t well-experienced with COVID. For that [latter] group, they should be worried. For someone, you’re looking around and your neighbor got it and nothing happened, or your cousin or a person at work, and it’s like it’s no big deal. But there are still 500 people dying every day in the United States [from COVID]. And to those people, it’s a huge deal…. It’s a weird situation because it’s not one-size-fits-all anymore, and different people have different levels of risk.
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Epidemics & Outbreaks
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Thousands of older women are struggling with the cost of living because of a pensions “injustice” dating back years that has never been put right, according to campaigners.They say large numbers of women born in the 1950s are having to go without, or can only afford basics, often because they have used up their savings and do not have the financial cushion to cope with soaring living costs.Fresh demands for action from the group known as Waspi (Women Against State Pension Inequality) have coincided with a separate campaign to highlight errors that have led to women being wrongly told they are not entitled to a state pension.This is being spearheaded by former pensions minister Steve Webb, who says some women who have been told they weren’t entitled to anything were actually due payments of more than £4,000 a year.While these are separate issues, both have particularly affected women born in the 1950s.Waspi was founded seven years ago to fight for compensation for women who lost out because of the way changes to the state pension age (SPA) were made.For decades the SPA for women was 60. An increase to 65, phased in between 2010 and 2020, was included in the Pensions Act 1995, but in 2011 the coalition government pushed through a speeding-up of the process. As a result, the SPA for women increased to 65 by November 2018, and then to 66 by October 2020.Many say they had always expected to receive their pension at 60, then discovered their SPA had increased by four, five or six years. The government did not write to any woman affected by the rise for nearly 14 years after the law was passed in 1995.Hundreds of thousands of women say they didn’t have enough time to make alternative plans. Some say they gave up work because they had calculated they could afford to manage until they got their state pension, then discovered they would have to wait much longer to get the cash.Waspi has always said it agrees with equalising the state pension age for men and women, but not with the way the shake-up was implemented. It is calling on the government to agree compensation for all those affected by the lack of notice “to reflect their financial losses, the sustained damage to their mental health and wellbeing, and the additional impacts”.In July last year it received a major boost when the Parliamentary and Health Service Ombudsman (PHSO) found the Department for Work and Pensions guilty of maladministration in its handling of the changes. This related to specific failings dating back to 2005 and 2006. However, this was only stage one of the investigation.The PHSO is now looking at whether these failings led to an injustice for the complainants. This could be followed by stage three, where it makes recommendations to put things right – which could include paying compensation. The ombudsman uses a compensation scale where the amounts range from zero to more than £10,000.Last week Waspi renewed its calls for “answers and action” from the government, saying there was nothing to stop it awarding “fair, fast compensation” now. Campaign chair Angela Madden says: “Women born in the 1950s have been even more acutely affected by this cost-of-living crisis than we would have been.”Some only received 12 months’ notice of a six-year delay to their pension, she adds. “In consequence, most in our age group have had to use up all their savings on day-to-day living. We don’t have the cushion we would have had to deal with the cost of living shooting up as it is.“It means we can only afford the basics when we might otherwise have had some comfort, after years of saving up and paying into the system.”It was also claimed last week that despite a major correction exercise being undertaken by the DWP to deal with historic errors in state pension calculations, mistakes are still being made. Steve Webb, now a partner at actuaries LCP, says many of the errors affect women who previously paid a reduced rate of national insurance contributions – commonly known as the “married woman’s stamp”.They may find that under the rules of the new state pension they lack the 10 years of full-rate contributions necessary to qualify for any payment.But the new system has a special concession for these women, provided they were paying the reduced stamp 35 years before they retired. They can automatically get a state pension of £85 a week if they are married, or £141.85 if they are widowed or divorced (these are the 2022-23 amounts).A previous freedom of information request from Webb revealed that the DWP discovered in 2019 that it was making errors on such cases, and a correction exercise started. But the former minister says he has continued to hear from women who have wrongly been told they have no pension entitlement.He has written to pensions minister Guy Opperman, and is calling for action to be taken to stop this from happening in future.Estelle Henley, 66, was shocked when she was told she wasn’t entitled to a state pension. Photograph: Handout“In some cases … women were told they had zero entitlement when the correct figure was over £4,000 a year,” says Webb. “What concerns me most is how many other women there may be who simply trusted what the DWP has told them and are now struggling to get by without the pension which is rightfully theirs.”Estelle Henley reached state pension age in April this year when she turned 66, and was shocked to be told that she wasn’t entitled to a pension.Before retiring, she worked full-time in her daughter’s pub for 15 years. She lives near Southampton with husband Rob, 72, who is still working part-time.Henley claimed the benefit in the usual way, but received a letter from the DWP saying that “we cannot pay you UK state pension” because she did not have the required number of years of contributions.As a result of previous correspondence with the department, she was aware of the special rules for people who paid reduced-rate national insurance contributions, so she challenged the DWP directly and also contacted Webb.Webb says the department has now accepted its error, contacted Henley to apologise and paid arrears back to the start of her claim.In response to Webb’s campaign, the DWP said: “This year we will spend over £110bn on the state pension and our priority is ensuring every pensioner receives all the financial support to which they are entitled. Where errors do occur, we are committed to identifying and rectifying them.”It added: “The government decided over 25 years ago that it was going to make the state pension age the same for men and women as a long-overdue move towards gender equality. Both the high court and court of appeal have supported the actions of the DWP, under successive governments dating back to 1995, and the supreme court refused the claimants permission to appeal.”
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Health Policy
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Could a simple blood test detect Alzheimer’s disease years before symptoms appear?
New research from Resonant, a Utah biotech company that develops diagnostic tests for neurodegenerative diseases, suggests it may be possible.
Researchers said its new test achieved 100% accuracy in identifying patients with Alzheimer's disease and individuals with mild cognitive impairment (MCI) who went on to develop Alzheimer's disease within five years.
In the study, a total of 50 blood plasma samples were tested. These included 25 older control individuals, 13 patients who had been diagnosed with Alzheimer's, six patients with mild cognitive impairment who later developed Alzheimer's, and six MCI patients who did not develop Alzheimer's.
The findings were published in Frontiers in Neurology on Oct. 31.
The blood test works by detecting the presence of DNA released from the brain’s neurons, or nerve cells, when they die, according to lead researcher Chad Pollard, a doctorate student and research assistant at Brigham Young University.
"All cells, to some degree, release fragments of DNA called cell-free DNA (cfDNA) into their environment," Pollard, who is also a co-founder of Resonant, told Fox News Digital in an email.
"Under normal, healthy conditions, cfDNA from neurons is undetectable in blood circulation, but during neurodegeneration, the amount of cfDNA that is released from these cells significantly increases and can be detected in the blood."
The presence of neuron cfDNA in the blood indicates neurodegeneration, Pollard added.
Beyond Alzheimer’s disease, the researchers are also actively working to apply this technology to other neurodegenerative diseases, including Parkinson’s disease and amyotrophic lateral sclerosis (ALS, also called Lou Gehrig's disease), noted Pollard.
Study limitations
Pollard pointed out one limitation of the study.
"While the majority of patients with mild cognitive impairment who did not develop Alzheimer’s disease within five years displayed low levels of neuron cfDNA in the blood, some displayed elevated levels," he said.
"Due to limitations of the dataset, the researchers were not able to obtain more information about these patients to determine whether this minority remained cognitively stable or eventually developed Alzheimer’s disease."
The team is actively working to improve the specificity and predictive power of the test, Pollard said.
Joseph Antoun, M.D., PhD, a longevity expert and CEO of the nutrition tech company Prolon in Los Angeles, was not involved in the study but offered his input on the findings.
"Though the sample size for the study is relatively low, with only 50 participants, this method of measuring DNA methylation shows interesting potential," Antoun told Fox News Digital.
"I would love to see it performed at a larger scale, with a bigger population size, and with other neurodegenerative disorders," he said.
In future studies, Antoun said he would recommend ensuring that the results aren’t being polluted by a different preexisting condition, as Alzheimer’s patients tend to have other comorbidities such as dementia, depression, obesity and cardiovascular disease.
"We believe that such early identification is the key to improving outcomes for patients with neurodegenerative disease."
"Additionally, I would also be curious to look at the cost of a blood test like this, particularly one that promises such exciting developments in the medical field," he said.
"Overall, I’m interested to see more expansive, specific research to further support this data."
Resonant expects to launch its Alzheimer’s test in the first quarter of 2024.
There are a few blood tests that are currently available to health care providers to help with diagnosis, but they are not yet approved by the U.S. Food and Drug Administration (FDA), according to the Alzheimer’s Association.
"At this time, it is recommended that blood tests only be used by specialty care doctors who are seeing patients with memory complaints," states the association on its website. "They are not recommended for individuals who do not have any cognitive or memory symptoms."
More than six million Americans are living with Alzheimer's, which is the most common form of dementia, according to the Alzheimer’s Association.
That number is projected to reach nearly 13 million by 2050.
Diagnosis has traditionally occurred after symptoms of cognitive decline appear — but identifying the disease sooner could enable patients to access preventive drugs and dramatically slow progression, according to Resonant researchers.
"These data demonstrate significant potential for this technology's use as a clinically actionable predictor of neurodegeneration, which could allow for pre-symptomatic interventions," said Timothy Jenkins, PhD, co-founder of Resonant, in a press release.
"We believe that such early identification is the key to improving outcomes for patients with neurodegenerative disease."
People can view the company’s peer-reviewed research or join the waitlist for the test at its website, www.resonantdx.com.
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Disease Research
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Increasing demand for Covid vaccine injury payments has seen the number of staff processing claims increase 20-fold, figures show.
The Vaccine Damage Payment Scheme (VDPS) has scaled up operations and boosted its administrative staff from four to 80 to handle the claims.
A project is also under way to digitalise the application process to make it simpler and quicker for claimants.
But MPs, campaigners and families have called for the process to be reformed, arguing that the payment cap of £120,000 is too low, too slow and bureaucratic, and the eligibility criteria is too strict.
If a person is left severely disabled as a result of receiving certain vaccines they could be entitled to the one-off payment from the Government.
Families can also apply for the payment if a loved one died as a result of a vaccination.
It is not treated as compensation, meaning claimants can still seek damages in court.
“Inadequate funds to families’
A group of patients and families are now taking legal action against AstraZeneca after they suffered injury or bereavement as a result of complications from the Covid vaccine.
The Hausfeld Claimant group, which includes 13 bereaved families and 28 survivors, says the VDPS offers “inadequate funds to families”.
Sarah Moore, leading the litigation, said: “No amount of compensation will bring back loved ones or restore those injured to health but it can make life a little bit easier for the mothers, fathers, children, parents and partners who are now reshaping their lives.”
Figures released under a Freedom of Information (FOI) request in March show more than 4,000 claims related to a Covid-19 vaccine have been submitted since Nov 1 2021.
The payment scheme was taken over by the NHS Business Services Authority in November 2021, after previously being handled by the Department for Work and Pensions.
Of the 4,017 claims made, 334 relate to a claimant who has died.
Some 48 claims have been approved so far, Maria Caulfield, a health minister, told MPs in February.
A separate FOI document published in February revealed 3,842 claims had been received, meaning the number submitted has increased by almost 200 in one month alone. Of those, 814 claims were unsuccessful and a further 37 did not meet the eligibility criteria.
Under the VDPS, severe disablement means a patient must be at least 60 per cent disabled to qualify, based on the Social Security (General Benefit) Regulations 1982.
‘Balance of probabilities’
A patient’s medical records along with “all scientific evidence” will be considered in the application by an independent medical assessor.
They will decide if the person is due a payment based on whether “on the balance of probabilities” the vaccine caused the disability, and if the level of disability is 60 per cent.
Many claimants have been diagnosed with vaccine-induced thrombocytopenia and thrombosis, a rare condition linked to the Covid-19 jab.
Data from the Medicines and Healthcare products Regulatory Agency, up to Nov 23 2022, show 445 cases of major thromboembolic events (blood clots) with concurrent thrombocytopenia (low platelet counts) in the UK following an AstraZeneca jab. The overall case fatality rate was 18 per cent with 81 deaths.
The Government says it can take “at least six months” to process a VDPS claim, but a claim about a Covid-19 vaccine “will take longer”.
Jeremy Wright, Conservative MP for Kenilworth and Southam, raised the issue in the Commons this week and called on the Prime Minister to revamp the scheme.
He told The Telegraph: “It's good news if they're improving the resources to handle claims. There are a lot of claims and it's taking a very long time to process them.”
He added there were still “structural problems” with the scheme, including the low cap and 60 per cent disablement cut off.
Rishi Sunak said on Wednesday: “We are taking steps to reform vaccine damage payments schemes by modernising the operations and providing more timely outcomes, but of course I'd be happy to talk to the honourable gentleman further about it.”
The Telegraph has spoken to families who have waited more than a year for the payment.
Sheila Ward, whose husband Stephen, 57, died after having the Covid vaccine, said the compensation scheme was “not fit for purpose”.
Her husband, who was retired, had the Oxford AZ jab in March 2021. Mr Ward had no pre-existing conditions but after a few days developed a headache and had to stay in bed.
“We just thought he had been doing too much,” said Mrs Ward, 55, who lives in Newcastle.
When she went upstairs to check on him she found him unable to speak. He was taken to hospital where he was treated for a stroke. The doctors found bleeds and clots on his brain.
Compensation took a year
Later Mrs Ward was told by doctors that her husband had suffered seizures. He died before he could receive an operation.
A coroner’s certificate listed the vaccine as one of the causes of death but obtaining compensation took a year.
“The whole process was very slow and they never gave me updates unless I chased them,” said Mrs Ward, whose claim was finalised in June 2022.
“Personally, I don't think the compensation families receive is enough. I'm in a fortunate position that my husband had a pension, so my income has been subsidised that way.
“For anyone who has been left with a lifelong disability or young children, it simply wouldn’t be enough to replace somebody's income.”
Mrs Ward said the Government should consider raising the cap but also make the process faster. “It is not fit for purpose,” she said. “I’ve heard of cases where it takes 20 months for a decision. That is far too long”.
Vikki Spit, 40, lost her partner Zion of 21 years in May 2021 after he suffered a blood clot linked to the AZ vaccine.
It took more than a year for Ms Spit, who campaigns for Vaccine Injured Bereaved UK, to receive the VDPS.
“The [60 per cent disabled] criteria is a really big [issue], because there are so many people just left with nothing after being severely injured, and have life-changing disabilities, and they’re just told ‘well you’re not interested enough’,” she said.
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Vaccine Development
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Engineers develop breakthrough 'robot skin'
Smart, stretchable and highly sensitive, a new soft sensor developed by UBC and Honda researchers opens the door to a wide range of applications in robotics and prosthetics.
When applied to the surface of a prosthetic arm or a robotic limb, the sensor skin provides touch sensitivity and dexterity, enabling tasks that can be difficult for machines such as picking up a piece of soft fruit. The sensor is also soft to the touch, like human skin, which helps make human interactions safer and more lifelike.
"Our sensor can sense several types of forces, allowing a prosthetic or robotic arm to respond to tactile stimuli with dexterity and precision. For instance, the arm can hold fragile objects like an egg or a glass of water without crushing or dropping them," said study author Dr. Mirza Saquib Sarwar, who created the sensor as part of his Ph.D. work in electrical and computer engineering at UBC's faculty of applied science.
Giving machines a sense of touch
The sensor is primarily composed of silicone rubber, the same material used to make many skin special effects in movies. The team's unique design gives it the ability to buckle and wrinkle, just like human skin.
"Our sensor uses weak electric fields to sense objects, even at a distance, much as touchscreens do. But unlike touchscreens, this sensor is supple and can detect forces into and along its surface. This unique combination is key to adoption of the technology for robots that are in contact with people," explained Dr. John Madden, senior study author and a professor of electrical and computer engineering who leads the Advanced Materials and Process Engineering Laboratory (AMPEL) at UBC.
The UBC team developed the technology in collaboration with Frontier Robotics, Honda's research institute. Honda has been innovating in humanoid robotics since the 1980s, and developed the well-known ASIMO robot. It has also developed devices to assist walking, and the emerging Honda Avatar Robot.
"Dr. Madden's lab has significant expertise in flexible sensors and we're happy to collaborate with this team in developing tactile sensors that can be applied to robots," said Mr. Ishizaki Ryusuke, one of the study's lead authors and chief engineer at Frontier Robotics.
Practical and scalable
The researchers say the new sensor is simple to fabricate, which makes it easy to scale to cover large surface areas and to manufacture large quantities.
Dr. Madden noted that sensors and intelligence are making machines more capable and lifelike, increasingly allowing people to work and play alongside them, but much more can be achieved.
"Human skin has a hundred times more sensing points on a fingertip than our technology does, making it easier to light a match or sew. As sensors continue to evolve to be more skin-like, and can also detect temperature and even damage, there is a need for robots to be smarter about which sensors to pay attention to and how to respond. Developments in sensors and artificial intelligence will need to go hand in hand."
The paper is published in the journal Scientific Reports.
More information: Mirza S. Sarwar et al, Touch, press and stroke: a soft capacitive sensor skin, Scientific Reports (2023). DOI: 10.1038/s41598-023-43714-6
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Medical Innovations
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For the first time ever, a human has successfully received an implanted device to enable movement of the arms, hands and fingers after a paralyzing spinal cord injury.
Onward Medical NV, a medical technology company based in the Netherlands, announced on Wednesday the surgical implant of its ARC-IM Stimulator, which is designed to restore function to the upper extremities of paralyzed patients.
The patient, a 46-year-old man, suffered a spinal cord injury nearly two years ago, which left his left side almost fully paralyzed, doctors told Fox News Digital.
The ARC-IM implantation took place on Aug. 14 at Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland.
During the procedure, the surgeon, Switzerland-based Dr. Jocelyne Bloch, placed electrodes over the man’s cervical spinal cord.
"There are a total of 32 electrodes that are linked to two different pacemakers," she told Fox News Digital in an interview. "There are two neurostimulators that are able to produce electricity and give impulses to the spinal cord to activate the muscles of the arm."
Nine days later, in a follow-up procedure, a wireless brain-computer interface (BCI) was implanted.
"We did a very small craniotomy, which means we removed a bit of bone and replaced it with 64 electrodes," Bloch said.
Working in tandem with the stimulator, the BCI uses artificial intelligence to connect the brain and spinal cord, the company stated in a press release — essentially capturing the intentions of the paralyzed person, "decoding" those thoughts and then stimulating the spinal cord to convert them into actions.
The successful surgery has been 20 years in the making, noted Professor Grégoire Courtine, co-director of NeuroRestore, a Switzerland-based research, innovation and treatment center that coordinates neurosurgical interventions to restore neurological functions.
NeuroRestore has worked in partnership with Onward throughout this study.
"When you want to move part of your body, the brain has to send a command to that region to activate the muscles," Courtine told Fox News Digital in an interview. "When there's a spinal cord injury, this communication is interrupted. The consequence is paralysis of the limbs."
With this implant surgery, Courtine said, "We are establishing this communication with a digital bridge that turns thoughts into actions."
The procedures both went smoothly, the doctors agreed.
Although it’s still too early to provide full results, Bloch said the technology works as expected and appears to "successfully reanimate the patient's paralyzed arms, hands and fingers."
"It’s a gradual thing," she noted. "It’s too early to tell how long it will take — we will be much more knowledgeable in a few months. But it’s not instant — it requires some training."
Courtine is optimistic, as he said the devices are "fulfilling expectations" and the stimulation "works very effectively."
This news comes just a few months after Onward’s May announcement that its ARC-IM and BCI implant had enabled a patient to gain "augmented control" over movement of his paralyzed legs.
"It worked for walking, and so we decided to apply exactly the same technology for hand movement," Bloch said.
In the coming months, Onward expects to share more information about the surgery and the results in a peer-reviewed publication.
"At this stage, the technology is very experimental," Courtine noted.
Years of large-scale clinical trials will need to be completed — and most likely, it won’t be until the end of the decade when this technology is widely available, he said.
"As the unit will possess learning capacity, the patient’s brain will also ‘learn’ to use the device to its fullest capacity."
Every year, around the world, between 250,000 and 500,000 people suffer a spinal cord injury, according to the World Health Organization (WHO).
Most of these are due to trauma during which a segment of the spinal cord is injured or severed, resulting in neurologic problems at and below the level of the injury, according to Dr. Brett Osborn, a neurosurgeon who practices in Florida. (He was not involved in Onward’s study or the surgery.)
"The spinal cord is mostly a bundle of nerve fibers that descend from the brain like wires," he said. "If you cut or damage the cables, everything below the injury malfunctions. In a human, this manifests as weakness or paralysis."
He added, "But what if there was a way to ‘bypass’ the injured region of the spinal cord and directly stimulate the nerve cells that interface with the axons at every spinal level? This is precisely what Onward is attempting to do."
As Osborn explained, Onward’s technology aims to reestablish the connection between the brain and the nerve roots, bypassing or bridging the level of the spinal cord injury.
"The wiring is not being repaired — that’s many years in the future. But this is a fancy workaround utilizing state-of-the-art implant technology and AI," he said.
Echoing Bloch’s and Courtine’s earlier comments, Osborn noted that restoring movement will require a cooperative effort between the patient and the implanted unit.
"As the unit will possess learning capacity, the patient’s brain will also ‘learn’ to use the device to its fullest capacity," he said. "It will be akin to learning a new skill — to juggle, for example."
"The brain makes the necessary changes at the cellular level to produce the motor patterns needed to successfully coordinate the rhythmic tossing of the balls, or, in this case, make a muscle."
"Our nervous system is the most complex object in the universe."
"AI is our friend here — without which spinal cord-injured patients have little hope," Osborn added. "After all, our nervous system is the most complex object in the universe."
Dr. Harvey Castro, an emergency medicine physician in Coppell, Texas, is also a consultant and speaker on AI in health care.
"As an ER doctor with two decades of experience in patient care, I find the first in-human implant of ONWARD® Medical's ARC-IM Stimulator with a Brain-Computer Interface (BCI) to be a significant milestone in spinal cord injury treatment," he told Fox News Digital.
"However, as with any groundbreaking technology, ethical considerations, pros, cons and unknowns should be scrutinized."
Among ethical considerations, Castro emphasized the need to clarify the informed consent of potential risks and benefits, data privacy measures and accessibility of the technology.
He also pointed out that many unknown factors remain, specifically in terms of safety concerns, long-term effectiveness and potential interference with other bodily functions or existing medical devices.
"While this technology heralds a promising future for SCI patients, rigorous clinical trials, ethical safeguards and long-term studies are essential for its validation and broader application," Castro concluded.
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Medical Innovations
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UK workers are taking more sick days than at any point in the last decade, new research suggests.
Staff took on average 7.8 sick days in the past year, up from 5.8 before the pandemic, the Chartered Institute for Professional Development (CIPD) found.
The trade group said the rise was a "worry" and blamed stress, Covid and the cost-of-living crisis.
These conditions were having "profound impacts on many people's wellbeing", it added.
The research analysed rates of absence in more than 900 organisations, representing 6.5 million employees.
It was conducted by Simplyhealth, a healthcare company that provides outpatient support.
The study found the most common reasons for short-term absence to be:
- Minor illnesses (94%)
- Musculoskeletal injuries (45%)
- Mental ill health (39%).
Meanwhile, more than a third of organisations also reported Covid-19 was still a significant cause of sick days.
Staff on long-term sick leave tended to blame mental health issues, musculoskeletal injuries or conditions such as cancer and stroke.
Changes in working culture since the pandemic coupled with the cost-of-living crisis have left some employees feeling disengaged and stressed, the CIPD said.
Working from home could also present an issue for staff that lived alone or had limited social contact.
Most of the organisations surveyed offered sick pay, while around half had a strategy to improve staff wellbeing. However, the CIPD said rates of absence were still rising and employers needed to do more.
"This means managing the main risks to people's health from work to prevent stress as well as early intervention to prevent health issues from escalating where possible," said Rachel Suff, senior employee wellbeing adviser at the CIPD.
"It's important that organisations create an open, supportive culture where employees feel they can come forward."
Are you finding you're taking more time off from work? We'd like to hear from you. Get in touch by emailing haveyoursay@bbc.co.uk.
Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways:
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Stress and Wellness
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Subsets and Splits
List Unique Topics
Simple retrieval of unique topics from the dataset, useful for basic exploration but lacks deeper insights.