After COVID-19 vaccines rolled out, many families said “good riddance” to Zoom and resumed in-person holiday gatherings—and with increasing numbers of people embracing pre-pandemic lifestyles, it’s safe to assume that will be the norm this year in the U.S. But the virus still infects tens of thousands of Americans each day, and experts fear another winter surge may be coming, just in time for the holidays. If you’re planning to travel or gather with loved ones this holiday season, follow these expert recommendations to maximize your chances of staying safe and healthy. Get boosted nowShould you get your Omicron booster now, or wait until right before the holidays? Dr. Kristin Moffitt, an infectious disease physician at Boston Children’s Hospital, suggests getting your shot now, rather than trying to time it for right before holiday events. After getting vaccinated, it takes a week or two for your immune response to develop. That protection should stay strong for at least two months, so “if people got boosted now, their maximum immunity from that booster would get them through the end of 2022,” Moffitt says. Before thinking about boosters, of course, you should make sure everyone in your family has had their primary vaccinations, says Dr. Lilly Immergluck, a pediatric infectious disease specialist at the Morehouse School of Medicine. That’s especially important advice for families with kids, given the dismally low vaccination rates among young children. Rapid test before you gatherWhen new variants emerge, there’s often concern that at-home tests won’t be able to detect them. But Dr. Roy Gulick, chief of infectious disease at Weill Cornell Medicine and NewYork-Presbyterian, says rapid tests should still pick up BQ.1 and BQ.1.1 infections, since those variants are Omicron relatives. Frequent testing can help prevent those in your circle from unknowingly spreading the virus at holiday events. When Immergluck’s relatives stayed together over the Fourth of July weekend, she asked everyone to take a rapid test every day. “That’s not a 100% [guarantee],” she says, “but it’s about as good as we could get.” If you test negative but have classic COVID-19 symptoms such as sore throat, chills, and body aches, it’s still best to stay home, Gulick adds. Stay safe during travelMasks aren’t required for most travel anymore, but Gulick still advises wearing one—at least during certain portions of your trip. In general, air quality on planes is better than on buses and trains, so your chances of getting sick in the air are fairly low. But Gulick recommends masking while in the airport and when your plane is taxiing, since filtration systems may not be turned on when the plane is grounded. And if you’re traveling by bus or train, it’s a good idea to mask during the entire journey. Keep an eye on the dataCOVID-19 case counts are not as accurate as they once were, in large part because so many people now test themselves at home instead of using laboratories where results are then reported to public-health authorities. But there are still some metrics you can watch to get a sense of viral prevalence in your area. Hospitalization and death rates are still solid indicators of how widely the virus is spreading, Immergluck says. Moffitt also recommends paying attention to test positivity rates. Even if fewer people get tested in laboratories, knowing the percentage of tests that come back positive is “a fairly reliable marker because it’s relative to the number of tests that are being performed,” she says. Consider who you’re seeingIf you’ll be spending time with loved ones who are immunocompromised, unvaccinated, or elderly, you may want to increase your precautions, perhaps by masking indoors or keeping festivities outside. “We need to protect [vulnerable] people by not giving them the virus,” Gulick says. Don’t forget about other virusesCOVID-19 has dominated our thinking for the last few years, but influenza and RSV are also sickening lots of people right now. Moffitt says that’s all the more reason to take precautions like masking during travel and avoiding high-risk settings, such as crowded indoor events, in the week or so before your holiday plans. Getting a flu shot is also an important winter health measure, Gulick says, and one that can be done when you’re getting your COVID-19 booster. from https://ift.tt/xYW0aZ9 Check out https://takiaisfobia.blogspot.com/
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NEW YORK — The head of the U.S. Centers for Disease Control and Prevention has tested positive again for COVID-19. Dr. Rochelle Walensky had mild symptoms Sunday and is isolating at her home in Massachusetts, the CDC said Monday. Walensky, 53, first tested positive on Oct. 21. She took a course of the antiviral pill Paxlovid, and later tested negative. But the symptoms returned and Walensky is again in isolation, working and holding virtual meetings, the CDC said. Paxlovid has proven effective at preventing serious disease and death among those at highest risk, including older people and those who are immune compromised. But the pill appears to provide little or no benefit for younger adults. Some who take the drug have experienced a return of symptoms after completing Paxlovid’s five-day regimen of pills. Read More: For Kids with Long COVID, Good Treatment Is Hard to Find CDC officials said Walensky is up to date on her vaccines. Walensky took over the CDC in January 2021. She is one of several U.S. health officials who have gotten COVID-19. from https://ift.tt/XW1PUNj Check out https://takiaisfobia.blogspot.com/ The U.S. led the world in quickly developing COVID-19 vaccines—one of the few bright spots in the country’s otherwise criticized response. But while injectable vaccines are effective in protecting people from getting sick with COVID-19, they are less able to block infection. In order to put the pandemic behind us, the world will need a way to stop infections and spread of the virus. That’s where a different type of vaccine, one that works at the places where the virus gets into the body, will likely prove useful. Here, though, the U.S. is losing its edge. In September, India approved a nasal COVID-19 vaccine, and in October, China began administering an inhalable one—the world’s first such vaccine against any disease. Both countries conducted their own clinical safety and efficacy tests in humans (but have not yet published the complete and latest results). U.S. researchers have created several nasal vaccines that have been tested in animals, and some—like the booster Dr. Akiko Iwasaki and her Yale University colleagues developed—look promising; their group published encouraging results in the journal Science on Oct. 27. But such vaccines are at least several years away in the U.S. Moving to the next step—human testing—is stalled for several big reasons, including a lack of funding. “There is a lot of science that needs to be done to see if developing mucosal vaccines against COVID-19 is possible,” says Dr. Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations (CEPI), an organization that funds research into innovative solutions to responding to disease outbreaks. CEPI helped to fund Moderna’s mRNA vaccine and is currently supporting several nasal-vaccine programs around the world. “But we ought to make major investments in understanding the immunology of COVID-19, understanding the immune response, and testing various approaches to delivering vaccines with the goal of producing mucosal immunity.” The challenges of nasal vaccinesCreating a nasal vaccine that proves effective may be difficult, as AstraZeneca executives learned when they announced disappointing results in October from their trial of a nasal vaccine. The company turned its injected COVID-19 vaccine, which was developed with researchers from Oxford University, into a mucosal version given through the nose, but early trials in 30 people showed weak antibody responses in their nasal mucosa, where the vaccine was expected to have its greatest effect. They also found lower immune responses in the rest of the body when compared to injected vaccines. AstraZeneca scientists speculated that much of the vaccine, which uses a disabled virus to deliver SARS-CoV-2 genes, might have bypassed the lungs and ended up in the digestive tract, where it was destroyed before it could adequately activate the immune system. Another pitfall of this approach is that people might already have significant immunity built up to the disabled virus, weakening the effect (although AstraZeneca used a virus that normally infects chimps in an effort to avoid this problem). AstraZeneca’s experience shows how unpredictable vaccine development can be and why the U.S. has so far have favored existing, proven shots based on mRNA technology. These first-generation vaccines against SARS-CoV-2 were about 95% effective at reducing the risk of severe disease, and though efficacy has diminished as SARS-CoV-2 has mutated into more transmissible variants, they continue to protect people from hospitalizations and deaths. Health officials are hopeful that the updated Omicron booster shots currently being administered will rebuild waning immunity. With so much invested in the mRNA platform—money, time, and considerable public-health messaging to get people to trust these specific vaccines—it’s a challenge to shift to a different type. There is also the perception, among both political leaders and the public, that COVID-19 is no longer an urgent health threat, and that the current strategy of boosting with mRNA vaccines will be enough to protect people. But that false sense of security could be shattered this winter, as more people gather indoors and respiratory viruses like SARS-CoV-2 tend to spread more efficiently. “I am concerned that the relaxed attitude toward COVID-19 is going to lead to further spread, more disease, and more Long COVID-19 among people who do get infected,” says Iwasaki, professor of immunobiology, molecular, cellular and developmental biology at Yale University. “All of these things point toward the need for a next generation vaccine.” With many people around the world vaccinated against SARS-CoV-2 but experiencing waning immunity, nasal vaccines could be the next step in building up that protection again. Why nasal vaccines make sense as a boosterThere’s a reason why scientists are pursuing a nasal vaccine that works through the mucosal tissues in the nose, mouth, and lungs. SARS-CoV-2 is a respiratory virus that preferentially finds and infects cells in the respiratory tract, from the nose and throat all the way down to the lungs. A vaccine that works in these tissues might do more to hamper the virus from infecting cells than one that’s injected into the arm and needs to travel throughout the body’s circulatory system to do its work. “If you give a vaccine in the nasal cavity, then you create a localized immune response, and that is fundamentally different from what you get with an intramuscular vaccine,” says Iwasaki. “Being local has the advantage of capturing the virus before it even enters our body. By limiting the amount of replication at the site of entry, you can also prevent infection, and the potential consequences of infection, including Long COVID. If you limit the amount of virus in the body, you also prevent transmission and spread of disease.” The type of immune response generated by cells in the mucosal passages of the nose, mouth, and airways also differs from that produced by a vaccine given in the muscle. Nasal vaccines produce a type of antibody called IgA, which injected vaccines don’t produce as much of; vaccines injected in the muscle tend to generate more IgG antibodies. One is not necessarily better than the other, but the two antibodies have different functions. IgA antibodies are more localized—they live in areas like the respiratory tract, reproductive system, or the gut—and are produced in the mucous layer in parts of the body where viruses are most likely to invade. IgG molecules are systemic, and trigger the body to bind and inactivate viruses circulating in the blood. When IgG antibodies are produced, they create systemic immunity, and the body is better prepared to fight back if those viruses or bacteria return to cause infection again. Read More: The Virus Hunters Trying to Prevent the Next Pandemic There may be some advantages to generating a more localized, IgA-heavy response—especially at this point in the pandemic, when blocking people from getting infected with the virus in the first place has become more of a priority. Antibody-producing cells in tissues like the mucosa tend to produce IgA antibodies that clump viruses like SARS-CoV-2 together, making them easier to neutralize en masse. An international group of scientists also reported in December 2020 that IgA antibodies dominate the first wave of people’s immune response in their saliva, blood, and lungs, in an effort to block the virus from infecting more cells. In a study published in June, researchers at the National Institute of Allergy and Infectious Diseases (NIAID) found that intranasal COVID-19 inoculation dramatically lowered the amount of virus detected in animals’ respiratory tract. “We couldn’t find virus in either the upper or lower respiratory tract, and we know the intranasal vaccine either prevented infection or eliminated infection within two days,” says Bernard Moss, distinguished investigator at NIAID and senior author of the paper. Studies also show that people who have had COVID-19 tend to have high levels of IgA in the nose, and they are less likely to get infected if exposed to SARS-CoV-2 than people who haven’t had COVID-19. That further suggests the importance of generating IgA antibodies to protect people from getting infected. Because much of the world’s population now has some type of immunity to SARS-CoV-2, whether from vaccination or infection, Iwasaki believes it’s time to use nasal boosters instead of injected ones, in what she describes as the “prime and spike” strategy. Her latest results support this strategy, as she and her team reported in Science that mice given an intranasal vaccine after receiving mRNA vaccination produced higher levels of IgA antibodies in the nose and mouth than either mRNA shots or a dose of the nasal vaccine alone. The prime and spike model also produced robust immune responses, involving more immune T cells, which are more durable than antibodies. That belief is gaining ground among immune-system experts. “We are at a different stage in the pandemic,” says Stephanie Langel, instructor in the department of surgery at Duke University who developed a nasal COVID-19 vaccine based on a modified cold virus and tested it in hamsters. “Boosting people with a nasal vaccine could help to reduce things like infection and transmission, which is going to be beneficial at a time when we are all going to be spending more time indoors in poorly ventilated spaces during the winter.” CanSino Biologics’ vaccine was approved by Chinese health authorities as a booster dose for this reason. It’s the same vaccine as the company’s injected shot—which is about 60% effective in protecting against COVID-19 symptoms one month or more after vaccination—but in liquid-turned-mist form that is sprayed using a nebulizer in the mouth. Both vaccines use a disabled cold virus engineered to no longer be infectious, to deliver genes coding for the SARS-CoV-2 spike protein for the immune cells to recognize and target. While the results from late-stage human studies of the mucosal vaccine aren’t available, the company published early-stage data that showed people receiving the inhaled dose generated similar levels of virus-fighting antibodies as people getting the injected form of the booster. An October release summarizing later stage trials said these levels of antibodies were higher among the people receiving the inhaled dose compared to the injected one. Indian health officials approved a nasal vaccine for primary vaccination in two doses given through the nose, but also have not yet published the results of the human studies supporting that decision. Its nasal vaccine also uses another modified virus to deliver SARS-CoV-2 spike genes. Iran and Russia also reportedly approved nasal vaccines developed by researchers in their respective countries, but without publicly available data. Will nasal vaccines work?Whether these vaccines will reduce infections won’t be clear until more people have taken them. Real-world analysis of how well vaccinated people can fend off infections is likely going to be the most efficient way to measure whether nasal vaccines are working. That’s because there are no widely accepted ways to document the effects that a mucosal vaccine is having on the immune system. Scientists have much less experience with mucosal vaccines, and only a handful are approved, including one for influenza and the oral polio vaccine. That makes it difficult for health authorities to measure what the vaccines are doing and to know whether they’re providing protection above and beyond existing vaccines. Most people make more IgA than any other major antibody, and these levels can vary among people, so it’s hard to determine a standard level, which makes tracking changes nearly impossible. Read More: A New Lab-Made COVID-19 Virus Puts Gain-of-Function Research Under the Microscope “For intranasal vaccines, we don’t have good biological correlates of immunity,” says Hatchett, the CEO of CEPI. “There are other questions of whether mucosal immunity against COVID-19 will be protective against disease, and whether that immunity will be enduring.” That was also true of the other mRNA-based COVID-19 vaccines before they were approved, but regulators relied on measuring levels of neutralizing antibodies circulating in the blood, because those could be documented more easily than levels in tissues in the mucosa. It’s impossible to answer such questions without testing nasal vaccines in people in clinical trials. That uncertainty has dissuaded biotech and pharmaceutical companies from investing in mucosal-based vaccines. While unprecedented financial support from the U.S. government fueled the development of mRNA vaccines, no such public sector resources are available for companies trying to develop a nasal vaccine. About a dozen companies have completed or are nearly finished with preliminary animal studies of various nasal vaccines, but they lack the funding needed to test their candidates in people through expensive clinical trials. “They have no financial support, no de-risking, nothing. They are in their own orbit,” says Dr. Eric Topol, director of the Scripps Research Translational Institute; along with Iwasaki, Topol wrote an editorial in July supporting the need for broader vaccine research, including on nasal vaccines. Next steps for nasal vaccinesPhilanthropic organizations including CEPI, the Wellcome Trust, and the Bill and Melinda Gates Foundation are convening a workshop in early November to formulate ways to bridge the gap between animal and human studies of nasal vaccines. The groups are focused on finding sustainable and broadly applicable vaccine strategies for fighting infectious diseases—including a pan-coronavirus vaccine that targets multiple and potentially future strains—and a nasal-based approach is one of them. CEPI partnered with the U.S. National Institutes of Health to support more basic research on mucosal COVID-19 vaccines, and in October it also announced a partnership with Dutch biopharmaceutical company Intravacc to develop a SARS-CoV-2 nasal vaccine that would protect against a broad range of coronaviruses, including the latest SARS-CoV-2 variants. Intravacc developed a technology that exploits the fact that some bacteria shed non-infectious components called vesicles, which trigger the immune system. Intravacc’s vaccine is designed to neutralize the bacteria so they can’t cause harm, while taking advantage of their ability to alert immune cells by packing the vehicles with SARS-CoV-2 spike protein. In animal studies in rodents and rabbits, the vaccine lowered the viral load in the animals’ respiratory tract and generated high levels of IgA antibodies. Forty volunteers are now testing the vaccine in Australia in the company’s first human intranasal trial, and those results are expected in early 2023. Dozens of other nasal vaccines in development are showing promise in animal studies. To avoid the potential challenges of vaccines such as AstraZeneca’s, which used another virus to deliver the SARS-CoV-2 genes, Iwasaki is exploring two other strategies for a nasal vaccine. One involves introducing a modified viral spike protein to awaken the immune system, the method described in the latest Science paper, while the other uses mRNA from SARS-CoV-2, but in a delivery system distinct from the intramuscular vaccine that’s more tailored to the nasal cavity. “These are fundamentally different approaches, and we need to test them,” she says. The approach is promising in animal studies, and Iwasaki co-founded a company, Xanadu Bio, to test the vaccine further and look for industry partners to test it in people. If successful, nasal vaccines could also help to improve vaccination rates in lower-resource countries where vaccination with the current vaccines, which require proper storage at ultra-low temperatures, has hampered immunization rates. Increasing vaccination with a shot that significantly decreases transmission is the only way to lower spread of the virus and ultimately contain it. “This is going to be a decades-long engagement with this virus,” says Hatchett. “Having easy-to-administer intranasal vaccines to reduce transmission will help us in terms of global access to vaccines. It’s way too early to talk about eradication of COVID-19, but we’re never going to eradicate COVID-19 if we can’t prevent transmission.” from https://ift.tt/0I1jA82 Check out https://takiaisfobia.blogspot.com/ If only there existed a simple set of rules for managing blood sugar when you have Type 2 diabetes—it would be the most-requested pamphlet in a doctor’s office. Instead, as many people find, there’s no one-size-fits-all solution for the millions of Americans with the condition. It takes time and effort to discover what works best, and the right combination will differ for everyone. Determining what type of medication and which lifestyle factors will be most effective for managing blood sugar could take years. One way to speed up the discovery? Learn from others who are living with the condition. Here, seven people with diabetes share the most important insights they’ve gleaned about managing their blood sugar on a day-to-day basis. Pay close attention to food and medication effectsWhen Agnes Czuchlewski, 68, was diagnosed with Type 2 diabetes more than 20 years ago, her first thought was that she had to implement iron-clad restrictions on her eating and would never have a sugary treat again. That didn’t last long. “You can become obsessed with what you ‘should’ be doing, but that’s exhausting,” she says. “Instead, it’s much better to educate yourself about how your choices affect you. For example, have that candy bar, but look at what happens to your blood sugar—how much it goes up and how quickly—when you do. Then you can implement controls based on what you need.” Paying attention to how medication affects you is also important. Czuchlewski’s initial medication lowered her blood sugar so dramatically that she became hypoglycemic at night, a dangerous situation in which blood sugar drops too low. At one point, she feared she wouldn’t wake up. Tracking the effect over several nights provided her with the data she needed for another conversation with her doctor, and for a medication switch. “Learn about your body, and be more aware of how medication is affecting your numbers, how each food choice is affecting you,” she says. “When I was diagnosed, four other people in my work group were diagnosed within six months of each other. Each one of us reacts to their meds and to different foods in unique ways. Don’t assume you’ll react a certain way just because someone else with diabetes does.” Without truly observing how each affects your body in specific ways—a sudden wave of fatigue, for instance, or symptoms like increased thirst or weakness—it’s difficult to understand the subtle and overt ways that blood sugar may be affecting you overall. Taking time to slow down and build body awareness can go a long way toward managing blood sugar more effectively. Read More: People With Diabetes Are More Vulnerable to Heart Disease. How to Reduce the Risk Consider a continuous glucose monitorTim Jones, 56, has lived with Type 1 diabetes for 35 years—and the greatest lesson he’s learned is that blood-sugar regulation can change over time. It’s not just a matter of calculating how carbohydrates affect insulin, he says. All kinds of factors, including exercise and fat intake, create variations that need to be monitored, especially since they can change how much insulin Jones needs to take. Switching from an insulin pump to a hybrid closed-loop artificial pancreas system with a continuous glucose monitor (CGM) has been a game-changer. CGMs are small wearable devices that track blood-sugar levels throughout the day. Even though Jones still needs to count carbs and make adjustments for fat content, the continuous glucose monitor allows him to tighten control without worrying about his levels dropping too low. “Diabetes is something I deal with every hour of every day. It’s relentless,” he says. “It’s nice to have a little something in my pocket that takes over some of the attention, especially when I’m sleeping. It’s a relief. I’ve never been in better control than I am right now, and I’m expecting technology to get better.” Using a CGM may be particularly useful for those who have found traditional manual methods of monitoring blood sugar to be challenging. For example, Max Androsiuk, 34, tried managing his blood sugar for five years after his Type 1 diabetes diagnosis, but found it so difficult that he had to quit playing basketball with his friends—a decision that crushed him. “I just couldn’t get my blood sugar under control enough to play,” he recalls. “It was made worse by being nervous when I’d start to get active, which makes blood sugar increase.” Then, two years ago, he started wearing a CGM and can check his blood sugar level with a quick glance at an app on his smartphone. That gave him the confidence to return to the sport he loves. “I can easily control my blood sugar by applying measures I know will work if I see my numbers go up or down,” he says. Establish a routineWith Type 2 diabetes, you’re not just managing blood sugar: you’re also dealing with potential overwhelm, says Emilee Harringshaw, 28. Factors like food, sleep, stress, work, exercise, and medication can feel like a juggling act. Just getting a high reading might send her into a tailspin: Should she go for a walk or a run? Drink some water? Contact her doctor? What helps keep her steady is having a regular routine, so she can be less reactionary when fluctuations happen. “My daily regimen is reliable yet modifiable,” Harringshaw says. It involves reviewing her blood sugar at specific times, being mindful of the timing of her medications, focusing on stress-management practices, and doing food preparation in advance so she knows the carbs, protein, and fat content in each meal. “Before I formed habits that made me more aware of managing blood sugar, I wasn’t able to identify trends, and that made me feel out of control,” she says. “Getting into a regular pattern of tracking, exercise, and preparation makes me feel physically and mentally better.” That includes a solid sleep routine. According to the U.S. Centers for Disease Control and Prevention (CDC), getting less than seven hours of sleep per night can make diabetes harder to manage. Shorter sleep can also make you hungrier the next day and delay your fullness signals, increasing your risk of overeating—affecting your blood sugar along the way. Keep a consistent exercise scheduleJenny Lyn Belleza, 35, says getting enough physical activity is a cornerstone of how she manages her Type 2 diabetes. “A big part of managing blood sugar is exercising regularly, and I try to stay on top of my fitness by going to the gym a few times a week and doing some sort of cardio or strength training,” she says. “I’ve found this helps keep my blood sugar in check, and prevents any spikes or dips throughout the day.” According to the CDC, being active makes the body more sensitive to insulin, and not only helps control blood sugar but also lowers the risk of heart disease and nerve damage related to the condition. The American Diabetes Association adds that physical activity effects vary depending on how long you’re active and the intensity of your workout, but in general, exercise can lower blood sugar for 24 hours or more. Because of that, it’s important to check in with your doctor or diabetes educator when putting together an exercise plan. If you’re taking insulin, for example, you may need to adjust the dose before exercise to lower your risk of hypoglycemia. Much like tracking how food affects your blood sugar hour by hour, keep on top of blood-sugar changes before, during, and after activity to understand how working out is affecting you. Work with a care teamFor years, Melissa Almeida, 48, managed her Type 2 diabetes by herself, but struggled with nearly every aspect, from medication timing to food choices—in part because she was just a teenager when she was first diagnosed. “I felt overwhelmed, and as a result, I was only taking one of three prescribed medications,” she says. “I wasn’t able to maintain a steady level of energy and it affected every aspect of my life, including being able to work. By the time I started taking enough medication, I was a full-time working mother and it was becoming increasingly difficult to find adequate time to manage my disease.” Almeida turned to a diabetes care coach program from UMass Memorial Health, which helped her establish a plan to gradually improve her medication regimen. She also received counseling on the medications she was taking to learn how they affected her blood sugar and what side effects could occur. And she received detailed nutrition guidance that made a big difference for her blood sugar and energy levels. “I felt like I was part of my own care team, helping to ensure my care plan and individual goals were being met,” she says. Plenty of research backs up this strategy. For example, a 2019 study in the International Journal of Environmental Research and Public Health looked at customized diabetes education programs and used CGMs to track results. Researchers found that those enrolled for just three months saw a significant difference in how well they managed their Type 2 diabetes. Read More: The Link Between Type 2 Diabetes and Psychiatric Disorders Keep mental health in mindAfter 25 years as an endocrinology patient at Geisinger Health in Pennsylvania, Shivaun O’Donnell, 62, decided to get more involved not just with her own care, but with other patients, and became a diabetes educator for the health system 10 years ago. Along the way, she’s learned a wide array of strategies for blood-sugar management, and one she’s found personally meaningful is focusing on emotional wellbeing. “This condition can come with depression and, honestly, life-stopping anxiety,” she says. For example, Stanford Medicine research found in 2021 that insulin resistance can double the risk for major depression, and bring symptoms like fatigue, sleep disturbance, and loss of appetite—all of which can impact blood-sugar regulation. As few as 25% of people with diabetes who have depression get diagnosed, according to the CDC. “A large part of diabetes management is mental,” says O’Donnell. “You can do everything right, but if you’re feeling anxious or defeated, that might end up sabotaging your efforts.” That’s why it’s important to focus on tactics that will boost your brain as well as your body, such as getting adequate sleep, exercising, staying on top of medications and appointments, and making time for activities you find fun. “This isn’t just about your blood sugar,” O’Donnell says. “It’s about learning to love your life.” from https://ift.tt/5h3Tqm1 Check out https://takiaisfobia.blogspot.com/ Squeezing exercise into a busy schedule can be tough. However, new research suggests that doing just 15 minutes of physical activity over the course of a week is linked to a lower risk of dying prematurely compared to not exercising at all—as long as the movement gets your heart pumping. In the study, published Oct. 27 in the European Heart Journal, researchers used a data set to track nearly 72,000 people in the U.K., who were ages 40 to 69 and didn’t have cardiovascular disease or cancer when they enrolled, for about seven years. The researchers zeroed in on a week at the start of the study during which everyone wore an activity tracker on their wrist. People who did no vigorous activity during that week had a 4% risk of dying sometime during the study, but for people who got at least 10 minutes, that risk was cut in half. Among people who got 60 minutes or more, that risk fell to 1%. Overall, the researchers estimated that getting 15 to 20 minutes a week of vigorous physical activity was linked to a reduction in the risk of dying by 16% to 40%. It comes as no surprise that the more time people spent doing vigorous physical activity, the greater the longevity benefit. But the “sweet spot” where people benefited the most was about 60 minutes a week, says Matthew Ahmadi, a research fellow at the University of Sydney in Australia and lead author of the study. (That’s not to say exercise beyond an hour was necessarily worse, noted Ahmadi; because the study didn’t include many people who got more vigorous physical activity, potential maximum benefits of getting more intense physical activity are unknown.) Read More: Struggling to Get Back Into a Workout Routine? These 5 Strategies Could Help Even if people don’t have the time to go to the gym, the study shows it’s possible to get health benefits from day-to-day activities because short-duration exercise can add up, says Ahmadi. He suggests picking up your pace or working more intensely at things you already do—for instance, walking, gardening, or even doing chores. “Any physical activity a person is doing provides an opportunity to do vigorous physical activity, if they can do the activity at a faster pace or higher intensity for just short periods of time,” he says. What counts as vigorous physical activity varies depending on your level of fitness, he notes, but a good sign that you’re doing it is having difficulty holding a conversation. A similar observational study, also published Oct. 27 in the European Heart Journal by a different group of researchers, also suggests that the intensity of physical activity—not just the time spent moving—is important to reduce cardiovascular disease. In the study, which also looked at adults of the same age in the same U.K. data set, researchers tracked about 88,000 people for about seven years. After analyzing data from the week during which people used activity trackers, researchers found that doing physical activity with greater intensity was linked to a reduction in people’s cardiovascular-disease, even without increasing the amount of time people exercised. For example, people who walked quickly for seven minutes instead of slowly for 14 minutes during that week had a lower risk of cardiovascular disease later on. The studies were both observational, which means that the research can’t prove that physical activity was the reason why people who did it lived longer—or had less cardiovascular disease—than those who didn’t. The week of physical activity was also just a snapshot in time, and people’s habits may have changed later. However, other studies have also found that short bursts of movement can reduce risk of death. One 2011 study published in the Lancet found that just 15 minutes of physical activity a day could reduce the risk of early death. A 2014 study in the Journal of the American College of Cardiology found that just 5 to 10 minutes a day of running could reduce early death from any cause. The new research doesn’t mean the total time you spend moving isn’t important, says Paddy Dempsey, an author of the cardiovascular-disease study and a research fellow at the University of Cambridge. People with the very lowest rates of cardiovascular disease got more physical activity overall and got the most moderate-to-vigorous physical activity. Although any movement is valuable, Dempsey says, if you’re strapped for time, “adding in a bit of intensity can provide unique health benefits, while also potentially making workouts more time efficient.” from https://ift.tt/clNFj2M Check out https://takiaisfobia.blogspot.com/ Not long ago, the treatment options available to people with metastatic kidney cancer were few and feeble. Surgical removal of the affected tissue was an effective and often durable fix for people with cancer that was confined to the kidneys. But for the roughly 30% to 40% of people with kidney cancer that spreads to other parts of the body, the prognosis was dispiritingly grim. Fortunately, things are much different today. “Since the early 2000s, we’ve had a class of drugs called blood-vessel inhibitors, and these made an immediate impact,” says Dr. Primo Lara, a professor, clinician, and director of the Comprehensive Cancer Center at the University of California, Davis. Also known as angiogenesis inhibitors or targeted therapies, these drugs prevent the formation of the kinds of blood vessels that feed cancer cells with oxygen and nutrients. “These drugs are able to prolong life, shrink tumors, and create meaningful remissions,” Lara says. More recently, immunotherapies—drugs that help a person’s immune system identify and eradicate cancer cells—have also emerged as a highly effective treatment for metastatic kidney cancers. Today, patients often take a combination of both immunotherapy and angiogenesis-inhibitor drugs. This combination therapy has led to remarkable benefits for people with advanced kidney cancer, Lara says. While these new drugs save lives, they can also cause side effects ranging from diarrhea and skin rashes to fatigue and hypertension. Meanwhile, people with localized cancers have their own set of treatment-related difficulties to manage. And all kidney-cancer patients face the psychological burden of grappling with a life-threatening illness. While each person’s kidney-cancer journey is unique, experts recommend an arsenal of strategies that can help people control their symptoms and side effects. “In most cases, we can help patients manage them so they’re able to carry on with minimal hassle,” Lara says. Here, you’ll find a guide to the most common symptoms of kidney cancer, side effects of treatments, and some of the methods doctors and other clinicians may employ to help people mitigate these challenges. Loss of kidney functionNearly all people who have kidney cancer that has not spread to other organs undergo a surgical procedure called a nephrectomy. During the procedure, part or all of the affected kidney is removed. “A complication of nephrectomy that frequently occurs is that you lose some kidney function,” says Dr. Pavlos Msaouel, a clinician and cancer biologist at MD Anderson Cancer Center in Houston. A little loss of function isn’t a big deal. (Msaouel points out that people can live normally with just one kidney.) However, the job of your kidneys is to clean your blood. If their function deteriorates significantly, this can cause dangerous accumulations of waste products or fluid imbalances in your blood. “At first, it’s not really a side effect you feel—it usually just shows up in blood tests,” Msaouel explains. But over time, loss of kidney function can cause a host of symptoms including fatigue, nausea, weakness, and brain fog. In severe cases, it can be deadly. A mixture of lifestyle tweaks and medications can help counteract this loss of function. “A lot of these lifestyle changes are things we should all do regardless,” Msaouel says. They include getting regular exercise and watching your sodium and sugar intake. In some cases, you may also need to adjust the amount of protein in your diet. Drugs, including blood-pressure medications or those that lower blood cholesterol, are also mainstays. Read More: Changing Cancer Care, So Patients No Longer Feel Like a Number Hand-foot syndromeThis is one of the most common side effects among people taking blood-vessel inhibitors for metastatic kidney cancers. “These therapies are much more targeted than classic chemotherapy—they’re more focused on cancer cells—but sometimes they do hit other tissues,” Msaouel says. In the case of hand-foot syndrome, also known as palmar-plantar erythrodysesthesia, these drugs can affect the skin of the palms or the soles of the feet. “This usually manifests as blisters,” he explains. It can also cause redness and swelling. Sometimes these skin issues can be so extreme that people can’t drive a car or engage in other necessary activities. To prevent hand-foot syndrome, clinicians often tell people on these drugs to take special care of their hands and feet. Msaouel says over-the-counter moisturizers can help prevent dry skin and blisters. “We might recommend that people avoid exposing their hands and feet to really hot water, or to avoid wearing tight shoes,” he says. “We don’t want too much friction or things that can irritate the skin.” If these preventative measures fail and someone does develop redness or blisters, he says topical steroids—prescription skin creams that reduce inflammation—can be helpful. So can pain-relief creams like those containing lidocaine. “If despite all this it persists, then we might have the patient take a break for a few days or even weeks until the symptoms subside; then we can restart at a lower dose,” Msaouel says. “Often when we do that, if it does come back at all, it’s not going to be as bad.” HypertensionHigh blood pressure (hypertension) is a common side effect of several kidney-cancer drugs, particularly the blood-vessel inhibitors that have become a pillar of treatment for patients with metastatic cancer. High blood pressure can also arise because of poor kidney function. “This is one of most important side effects to manage because if we can’t control it, it knocks out this whole class of drugs that are one of the most effective we have,” says Victoria Sinibaldi, a nurse practitioner and research associate in oncology and urology at the Johns Hopkins University School of Medicine. Sinibaldi says that some lifestyle measures—again, a healthy diet and exercise—can be helpful. But most people will need to take medications to ensure their blood pressure remains at safe levels. “It’s not uncommon to have people taking two or three drugs to manage their blood pressure,” she says. In many cases, your primary-care physician—not your oncology team—will lead the way when it comes to managing your blood pressure. “We do a lot of referring back to primary-care doctors because they’re the ones who really have clinical expertise in managing blood pressure,” she says. DiarrheaUnfortunately, diarrhea is another common difficulty for people with kidney cancer who are taking either targeted therapies, immunotherapy drugs, or both. “Some patients have to go as much as every two hours, which is significant,” Sinibaldi says. Diarrhea is not only uncomfortable and inconvenient, but frequent diarrhea can also cause unhealthy weight loss, nutritional deficiencies, or severe dehydration. Sinibaldi often tells patients to keep a diary logging all their bowel movements as well as what they ate, which can help their care team identify problem foods or activities. “Over-the-counter medications like Imodium can help,” she says. Diet changes can also make a difference. These may include cutting back on lactose, a type of sugar found in milk and other dairy products. “We usually refer people to a nutritionist who can help them modify their diet,” says MD Anderson’s Msaouel. While probiotics may be useful in some cases, they can also cause problems, such as making diarrhea worse. “People get excited and think they can fix everything with probiotics, but they can be harmful,” he says. “This is something each patient needs to discuss with their oncologist.” Psychological distressToo often, talk of cancer’s complications can focus solely on the body while ignoring the mind. “For people with kidney cancer, it’s not only the physical symptoms but also the emotional symptoms that need to be addressed,” says Dr. Jennifer S. Scherer, an assistant professor of nephrology and a palliative-care specialist at the New York University Grossman School of Medicine. At all stages of a person’s cancer journey, she says, worry, fear, uncertainty, and spiritual distress can make life challenging. These can also contribute to a person’s experience of pain, fatigue, and other physical symptoms. Scherer and other palliative-care specialists can help people navigate these psychological roadblocks. “Patients also face uncertainty and complex medical decisions they may need help understanding,” she says. Financial strain is another source of stress. “Palliative care looks at the patient from a holistic perspective and makes sure their care plan can address all these different domains.” She and her team often connect people with a psychiatrist or psychologist. They also arrange visits with a spiritual adviser like a chaplain. But in many cases, her work involves spending time talking with patients and helping them work through their feelings and difficulties. “We try to meet patients where they are, and to give them an open and safe space to talk about their illness,” Scherer says. Read More: 4 Important Steps to Take After a Cancer Diagnosis Side effects of immunotherapyUnlike blood-vessel inhibitors or other kidney-cancer treatments, immunotherapy medications are not inherently toxic. These drugs work by turning up immune-system activity in ways that are intended to help it identify and eradicate cancer cells. “Most people on immunotherapy—60% to 70%—will have only minimal side effects,” Lara says. “But the other third will have more significant side effects, and these can be very unpredictable because they’re the result of the immune system overreaching and attacking healthy cells.” He says inflammation of the lungs, skin, thyroid, or gut are all relatively common among people on these drugs. This inflammation could result in symptoms like fatigue, skin rashes, breathing problems, weight loss, or diarrhea. “But any part of the body is fair game, so just about any side effect is possible,” he says. If these sorts of complications do arise, Lara says steroids, anti-inflammatories, or other medications that dampen immune activity can help bring them under control. Temporarily reducing or even stopping the immunotherapy may also be necessary. A careful balancing actEvery person is unique. Likewise, every person’s response to cancer treatment is one of a kind. Experts say finding what works for a given person tends to involve periods of tinkering. Your care team will probably have to try different medications in various doses before they identify the optimal regimen for you. This is likely to be an ongoing process. A game plan that is effective for a few weeks or months may eventually need to be adjusted. Understanding this from the outset can help you prepare for bumps in the road. “It’s important to manage patient expectations and to provide lots of information so they know what to expect,” Lara says. Side effects are an unfortunate part of life for people with kidney cancer. But in most cases, they’re manageable. As Lara put it, “I would say that over 95% of the time, we will find that sweet spot where the side effects are reasonably well tolerated and the quality of life is good.” from https://ift.tt/H1qijmU Check out https://takiaisfobia.blogspot.com/ About 20% of adults in the U.S.—more than 50 million people—have chronic pain. Though the causes are many, including arthritis, cancer, musculoskeletal skeletal disorders, migraines, fibromyalgia, and more, solutions are limited. Over-the-counter analgesics often do little. Physical therapy, massage, and acupuncture help sometimes—but not always. Prescription opioids may provide short-term relief, but at a price. At least three million Americans are currently addicted to the drugs. Researchers are now exploring another potential alternative that is safe, affordable, and comes with few or no side effects and no risk of addiction: green light exposure. Though the science is young and the research is by no means conclusive, in recent years, studies have found that exposing people to light across the green wavelength—either by having them sit in a dark room illuminated by green LED light strips or by giving them green-tinted glasses to wear—can reduce both their severity of pain and the frequency of episodes of migraines, fibromyalgia, and chronic musculoskeletal pain. It can also relieve the anxiety and fear associated with chronic pain. In a study presented Oct. 23 at the annual meeting of the American Society of Anesthesiologists in New Orleans, Dr. Padma Gulur, vice chair of the department of anesthesiology at Duke University, reported on an experiment she conducted in which 34 fibromyalgia patients were assigned to wear tinted glasses of different shades, four hours per day for two weeks. Ten of the patients wore glasses with blue lenses, 12 wore clear ones, and another 12 wore green. At the end of the study period, the people who wore green glasses were four times likelier than those in either of the other two groups to report that their anxiety over their pain had declined, as had their reliance on opioids. Read More: Inside Ibogaine, One of the Most Promising and Perilous Psychedelics for Addiction Gulur used commercially available glasses for the study and tested each with a spectrophotometer to ascertain exactly which wavelength of green light each pair produced. She also tested each person’s pair of eyeglasses at the end of the study to confirm which person got which wavelength. “What struck us the most was that at the end of the study, the patients were so pleased with the results, they didn’t want to return the green glasses,” she says. Though small, Gulur’s study is not the only one of its kind. At the University of Arizona, Dr. Mohab Ibrahim, professor of anesthesiology, neurosurgery, and pharmacology; along with Laurent Martin, assistant professor of anesthesiology; and other colleagues have published half a dozen papers in the past four years demonstrating the power of green light to reduce pain. In one, published in 2020 in the journal Cephalalgia (which means “headache”), the investigators recruited 29 migraine sufferers and exposed them to one to two hours of green LED lights—which the university provided people to set up in their homes—every day for 10 weeks in an otherwise dark room. The treatment reduced headache days by 70% in people suffering from episodic migraines compared to their baseline frequency of headaches, and by nearly 60% in those suffering from more frequent, chronic migraines. (The group exposed to white LEDs experienced no change.) In another paper, published the following year in the journal Pain Medicine, Ibrahim recruited 21 fibromyalgia patients, conducted similar therapy and found that people who reported their pain as an eight out of 10 when they were exposed to white light dropped their rating to below five when they were exposed to green. “There are neural pathways that start from the eyes and can be traced back to several brain regions,” says Ibrahim, who also works as medical director of the Comprehensive Pain and Addiction Center at the Banner-University Medical Center. “Some of these regions are heavily involved in pain modulation.” Through a mechanism that’s not yet fully understood, the green light appears to interrupt this connection, providing relief without medication, or at least not as much. “This is such a simple approach,” Ibrahim says. “There’s still some skepticism, and rightfully so. When you make an extraordinary claim, you have to have extraordinary evidence. But the more studies and research that get funded, the closer we get to reaching a critical mass of evidence that says, OK, something is really happening here.” Breaking the cycleFor Jennifer Dinardo, 64, a Tucson retiree who previously worked in the hospitality industry, the trouble began when she was 18 and went skateboarding after, as she describes it, drinking more wine than she put in the spaghetti sauce she was making that evening. She took a spill and landed face first on the sidewalk, breaking her nose and fracturing a bone in her neck. The pain was acute, and as she was being treated, the doctor responded promptly with pills. “He said, ‘Here, Take these. These will make you feel better,’” she recalls. They did—for a while. But that one bad night led to complications including fibromyalgia and migraine headaches, and eventually required surgery to fuse two disks in her neck. Her pain turned chronic, and she took powerful pain relievers for years. “I tried everything,” Dinardo says. “Massage therapy, stretching exercises, tai chi. And multiple times, I ended up back with the prescription in my hand.” Read More: Why Overdose Deaths Skyrocketed After Opioid Prescriptions Dropped Finally, in 2020, she showed up at the Comprehensive Pain and Addiction Center just as Ibrahim was beginning one of his trials with green light therapy. “He said, ‘Would you be interested in this study?’’’ she recalls. “I said, ‘I will do anything.’” For the next 70 days, Dinardo would spend two hours every day in a room in her home lit only by the green LEDs, reading and listening to music to pass the time. After 30 days, her chronic pain began to fade. Not long after, she quit using all painkillers, and she has been free of any medications since she began the treatment two years ago. She kept the LEDs, and while she doesn’t use them every day any longer, she turns them on whenever her neck pain, headaches, or fibromyalgia flare. “You can feel the difference,” she says. “It really is amazing.” How does green light relieve pain?Scientists don’t yet know exactly why green light seems to help painful conditions like fibromyalgia and headaches, but they have some ideas. Gulur believes the answer may lie in green light’s ability to trigger melanopsin, a light-sensitive neurotransmitter present in the eye that’s responsible for regulating pupil dilation and contraction. Melanopsin also interacts with the periaqueductal gray matter, a structure in the upper brainstem that plays a role in processing pain. She speculates that melanopsin may activate an inhibitory pathway that doesn’t process pain, but rather, shuts it down. And not just any old green light will do the trick, she’s found, but rather specific frequencies of it. “You would think it would be the peak of the green wavelength—absolute green—that would be most effective,” she says. “But what we found for chronic pain was that it’s the lower wavelengths and the higher wavelengths—more towards the ends of the green spectrum—that seem to be helping patients.” That limits people’s options to try this therapy out for themselves, since simply buying any green glasses available in a store does not guarantee the proper wavelength, which can only be tested with a spectrophotometer. For now, this is just a theory. But Gulur is currently developing a new study in which the brains of pain patients wearing green glasses will be scanned with functional magnetic resonance imaging (fMRI) to see if the inhibitory pathway indeed exists. Ibrahim and his colleagues are looking at other brain regions that play a role in processing pain, especially the rostral ventromedial medulla (RVM), which is also located in the brain stem. A particular type of brain cells, known as GABAergic neurons, produce a protein known as c-Fos, which in turn activates the RVM, completing a neural circuit that results in pain. In animal studies, rats exposed to green light produced less c-Fos, reducing the activity of the GABAergic neurons and disrupting the pain pathway. “We evaluated the amount of GABAergic cells that were expressing c-Fos, and we found that green light was lowering their output,” Ibrahim says. “Overall, the light reduces the activity of the cells, which, if they were stimulated, would promote pain.” Read More: 5 Ways to Cope with Migraines at Work In other studies, Ibrahim has looked at the front end of the inhibitory pathway—the cells in the eye that react to green light and get the analgesic process rolling. In one 2022 study, published in Clinical Medical Insights: Case Reports, he found that green light had pain-relieving effects even in a color-blind patient who also suffered from chronic headaches. That study might seem to suggest that nothing more than the placebo effect is at work, in which the person expects to experience pain relief and so does. But Ibrahim says otherwise. The two principal types of cells in the eye that process light and color are known as cones and rods, for their signature shapes, and it is the cones that malfunction in color-blindness. But there is a third type, too, known as intrinsically photosensitive retinal ganglion cells, and these are not affected in color-blind people. It is these cells, Ibrahim believes, that might be the ones responsible for pain relief. “It’s one of our hypotheses,” he says, “that the effect of green light goes at least in part through these photosensitive cells.” Gulur agees with this idea, pointing out that those same cells also contain melanopsin, which in her models plays such a central role in pain relief. Far more research in humans is needed. And not even its proponents believe that green light therapy will entirely replace other forms of pain treatment—including pharmacological ones. “Will it ever replace traditional medicine?” says Ibrahim. “I don’t think so. That’s not the intent. The intent is to decrease the reliance on medications right away because realistically speaking, these are all tools.” Still, green light treatment is already going commercially mainstream. Multiple manufacturers sell green LED lighting systems online and market them for pain relief, though there is no guarantee that the wavelength of green used in the products will be effective. To try to create something that is, Ibrahim and Luxxon Therapeutics are combining the glasses and LED method: building green LEDs directly into the frame of a pair of glasses so that they shine in the eyes of the user during treatment sessions. Green light exposure checks so many therapeutic boxes, Ibrahim says. “The first one is safety, then efficacy, then price, then adherence,” he says. It’s that last one—the adherence, or the patients’ commitment to sticking with the treatment—that might be the most telling. “Chronic pain patients will do almost anything to get rid of the pain,” Ibrahim says. Dinardo agrees. “Just sitting in that room with the green light,” she says, “is such a change for me—and such a blessing.” from https://ift.tt/3TsImPe Check out https://takiaisfobia.blogspot.com/ On October 14, a team of scientists at Boston University released a pre-print study reporting that they had created a version of SARS-CoV-2 combining two features of different, existing strains that boosted its virulence and transmissibility. Scientists and the public raised questions about the work, which refocused attention on such experiments, and prompted the U.S. government to investigate whether the research followed protocols for these kinds of studies. The concerns surround what is known as gain-of-function studies, in which viruses, bacteria, or other pathogens are created in the lab—either intentionally or unintentionally—that possess more virulent and disease-causing features than is found in nature. The controversy is especially fraught in the context of COVID-19, as questions about where the virus originated—whether it jumped from animals to people or whether it was created in the Wuhan Virology Institute by scientists studying earlier coronaviruses—remain unresolved. Those questions continue to plague experiments involving SARS-CoV-2, and heighten scrutiny on such experiments, especially by government regulators, and might have been unremarkable had they involved other viruses, says a scientist who requested not to be on the record. In fact, lab studies pushing the virus toward becoming resistant to known drugs are requested by the U.S. Food and Drug Administration—such work helps doctors and patients have a clear idea of the likelihood that a virus would become resistant to new therapies. The B.U. scientists were trying to answer a different, but related question of what made Omicron better able to escape the protection provided by the immune system and vaccines. To do so, they created chimeric viruses that contained some genetic material from the original SARS-CoV-2 virus, and some from the Omicron BA.1 strain, focusing on the virus’ key feature, the spike protein, which alerts the immune system into action. By comparing the altered viruses to the original version of SARS-CoV-2, they could determine whether mutations in Omicron’s spike region were responsible for making the virus resistant to vaccines, or if different sections of the viral genome contributed to this escape. In the process, however, the team created a version of the virus that they found was 80% lethal in lab mice. That finding was reported in the pre-print study that had not been peer-reviewed by other scientists. The Daily Mail cited the result, raising alarms about a lab-created, highly lethal version of SARS-CoV-2. The work exposed unresolved questions about what gain-of-function research entails, how it should be regulated, and who bears responsibility for such studies. What Boston University researchers actually didThese questions aren’t new, nor is the B.U. study the first to focus attention on them. Most experts support the need to conduct such studies, arguing that they are essential for understanding new pathogens, from SARS-CoV-2 to HIV. Others, however, feel such work is an unnecessarily dangerous way of getting those answers, and adamantly believe alternative strategies should be used. In the U.S., the Department of Health and Human Services (HHS), which oversees the National Institutes of Health (NIH), the largest funder of biomedical research, calls such entities enhanced potential pandemic pathogens, and has guidelines for reviewing such studies before they are approved—but only if the work is funded using public monies from that specific federal department. If not, then oversight responsibilities are unclear. “The layer of HHS oversight is over HHS grants,” says Marc Lipsitch, professor of epidemiology at the Harvard T.H. Chan School of Public Health. Lipsitch is among a number of experts who have advocated for stronger review of such studies since concerns were raised by similar experiments with the influenza H5N1 strain in the 2010s that generated more virulent versions of the virus in the lab. “If the grant is from another federal department, there is no required oversight. If you use private funding, there is no oversight.” In a statement provided to TIME, the agency said that the National Institute of Allergy and Infectious Diseases (NIAID), which is part of NIH, “did not review nor issue awards” for the experiment described in the B.U. pre-print study that has triggered the current discussion. The NIH is investigating whether indirect federal dollars were used in conducting the experiment, and if so, whether B.U. scientists failed to follow federal policies governing research into potentially dangerous pathogens. For its part, Boston University officials said the experiment was performed using university funding, and that NIAID was acknowledged in the manuscript because of “tools and platforms that were used in this research; they did not fund this research directly. We believe that funding streams for tools do not require an obligation to report.” B.U. also said in a statement that the research did not involve gain of function. It’s a gray area, says Dr. David Ho, professor of microbiology and immunology and director of the Aaron Diamond AIDS Research Center at Columbia University, and that’s part of the problem when it comes to deciding if anyone should be overseeing such work, and if so, who. “I think this [work] is borderline gain-of-function,” he says. “It does provide a valuable scientific contribution in that they showed that the virulence factor is outside the spike chain. That science is important.” What does ‘gain-of-function’ mean?The back and forth over whether the experiment involved gain of function work, and what role, if any, government health officials have in overseeing it, reflects the ambiguous state of this precarious research that has remained unresolved for decades. Even with government-funded studies, scientists don’t have clearcut instructions for exactly what constitutes gain-of-function research that would require additional scrutiny. Would modifying viruses to understand which mutations made them more virulent, and more able to evade drugs and vaccines, fall into this category? Virus experts do such work routinely, says Ho, and he himself has conducted such experiments for years with HIV, as well as with SARS-CoV-2. What’s more, these new versions of viruses and bacteria are constantly being created by nature as well, in response to natural selection pressures. That’s why scientists mutate viruses like SARS-CoV-2 to understand which changes the virus might develop next out in the real world, and what they would mean for existing vaccines and treatments. “These mutations are going to occur naturally,” says Ho. “We are trying to get ahead of it—that’s just routine for many virus studies. The problem right now is there is a lack of clear guidelines, both from the government and from the [scientific] journals.” That lack of clarity is both confusing and hindering understanding of SARS-CoV-2, says Ho. His lab has scaled back some of its experiments exploring how the virus becomes resistant to existing vaccines and therapies out of concern it might fall into the category of gain-of-function research. “Science is being slowed down a little bit because of these concerns,” he says. “In the lab, we are selecting for viruses with drug resistance and antibody resistance, and from my HIV days, these studies are all routine and in fact required by the FDA. How will you generate the next generation of drugs or antibody therapies if you don’t know which mutations contribute to resistance? To me, a lot of these studies are not gain-of-function, they are relevant studies to advance our knowledge of the virus to guide us to the next generation of therapeutics.” FDA’s requirements that scientists demonstrate what it might take for viruses to become resistant to drugs conflict with what the HHS considers enhanced potential pandemic pathogens. HHS deems these to be “bacteria, viruses, and other microorganisms that are likely highly transmissible and capable of wide, uncontrollable spread in human populations and highly virulent, making them likely to cause significant morbidity and/or mortality in humans,” according to a fact sheet on the agency’s website. These include certain versions of the influenza virus capable of causing widespread disease, such as H5N1 and H7N9, as well as the original SARS and SARS-CoV-2 coronaviruses. Boston University maintains that the version of the virus its scientists created at the university’s National Emerging Infectious Disease Laboratories is actually less lethal, at 80%, than the original virus, which was 100% deadly in the mice when they were exposed to the virus at certain concentrations. The university also said its researchers were given permission to conduct the research by the university’s internal review board. But Lipsitch says that such boards often don’t have the expertise to evaluate whether a study has the likelihood of producing a potentially dangerous public health threat. “We’re all familiar with research that puts participants at risk, like vaccine trials,” he says. “But the idea of research that puts people who have no idea the risk is even happening, like people across the country who could get a virus if it spreads [from a lab] globally, that’s a relatively new phenomenon. And that’s why it’s so badly regulated, because we never really had to think about it before.” Under the current system, the burden of alerting authorities—either at a researcher’s own institution or at the HHS—lies with the individual scientist. Ho says if any of his research ended up creating something in the lab that was more virulent and potentially a threat to public health, he would inform both his institution as well as NIH and Centers for Disease Control, “regardless of whether the funding was coming from there. I think that’s what any responsible, diligent scientist would do.” The problem is that the incentives for sounding the alarm aren’t necessarily aligned to do so, since alerting authorities almost certainly would halt the research and potentially even trigger a wider review of the laboratory’s activities. What experts say needs to changeIn February 2022, the NIH and the White House Office of Science and Technology Policy asked the country’s biosafety board, the National Science Advisory Board for Biosecurity (NSABB) to review current policies regarding gain-of-function research—and consider whether more oversight is needed even on studies that are not funded with government dollars— and issue recommendations by the end of the year The debate over how best to manage research with dangerous pathogens moved from government and academic circles into the public eye during the last major infectious disease epidemic, involving influenza. In 2014, the White House Office of Science and Technology Policy issued a temporary ban on funding gain-of-function research involving flu, and the MERS and SARS coronaviruses, which halted 18 studies underway at the time. The moratorium stemmed from concerns over certain studies funded by NIH on H5N1 that could potentially create more virulent and even lethal versions of the virus that could be devastating if they escaped and spread among the world’s population. The ban was lifted in December 2017 by the NIH, after the HHS issued new guidelines for reviewing such research, including the creation of an independent panel of experts to review any proposals for these types of studies submitted to the HHS. Those reviewers were tasked with considering whether such research was absolutely necessary, and whether there was no alternative way to gain the same knowledge that proved less risky to both the scientists and society. Three research proposals have been awarded under these guidelines, two involving influenza in which the reviewers decided there were no alternative ways to answer the scientific questions posed, and another that was initially approved and required additional security measures but was ultimately replaced by alternative studies not requiring the more stringent review. Still, some experts feel more could be done to justify such studies, including being more transparent with the public about who is reviewing the experiments, their comments, and the risks and benefits of the work. The NSABB’s recommendations are likely to reflect the recent worries over SARS-CoV-2’s origins, and attempt to provide clearer guidance for researchers who are interested in undertaking gain of function research. And based on how the scientific community has responded to previous biosecurity concerns, Ho says it is likely that the government will lean toward requiring some type of review of all research that might lead to creating enhanced potential pandemic pathogens, even if the work is not paid for by public funds. Better oversight is necessary, as many in the field argue that these types of studies are essential in a world more easily threatened by virulent diseases. “I would not like to see a blanket ban on this kind of experiment, because we are learning things from it,” says Lipsitch. “I would like to see much more careful review of this type of experiment so we are doing them with the understanding of what the risks and benefits are.” from https://ift.tt/8qNKI31 Check out https://takiaisfobia.blogspot.com/ Extreme weather from climate change triggered hunger in nearly 100 million people and increased heat deaths by 68% in vulnerable populations worldwide as the world’s “fossil fuel addiction” degrades public health each year, doctors reported in a new study. Worldwide the burning of coal, oil, natural gas and biomass forms air pollution that kills 1.2 million people a year, including 11,800 in the United States, according to a report Tuesday in the prestigious medical journal Lancet. “Our health is at the mercy of fossil fuels,” said University College of London health and climate researcher Marina Romanello, executive director of the Lancet Countdown. “We’re seeing a persistent addiction to fossil fuels that is not only amplifying the health impacts of climate change, but which is also now at this point compounding with other concurrent crises that we’re globally facing, including the ongoing COVID-19 pandemic, the cost-of-living crisis, energy crisis and food crisis that were triggered after the war in Ukraine.” In the annual Lancet Countdown, which looks at climate change and health, nearly 100 researchers across the globe highlighted 43 indicators where climate change is making people sicker or weaker, with a new look at hunger added this year. “And the health impacts of climate change are rapidly increasing,” Romanello said. Read more: How Climate Change and Air Pollution Affect Kids’ Health In praising the report, United Nations Secretary-General Antonio Guterres put it even more bluntly than the doctors: “The climate crisis is killing us.” New analysis in the report blamed 98 million more cases of self-reported hunger around the world in 2020, compared to 1981-2010, on “days of extreme heat increasing in frequency and intensity due to climate change.” Researchers looked at 103 countries and found that 26.4% of the population experienced what scientists call “food insecurity” and in a simulated world without climate change’s effects that would have only been 22.7%, Romanello said. “Can I say that every bit of food insecurity is due to climate change? Of course not. But we think that in this complex web of causes, it is a very significant contributor and it’s only going to get worse,” said pediatrician Dr. Anthony Costello, Lancet Countdown co-chair and head of the University College of London’s Global Health Institute. Computerized epidemiology models also show an increase in annual heat related deaths from 187,000 a year from 2000 to 2004 to an annual average of 312,000 a year the last five years, Romanello said. Read more: Why Extreme Heat Plus Pollution Is a Deadly Combination When there’s a heat wave, like the record-shattering 2020 one in the Pacific Northwest or this summer’s English heat wave, emergency room doctors know when they go to the hospital “we’re in for a challenging shift,” said study co-author Dr. Renee Salas, a Boston emergency room physician and professor at the Harvard School of Public Health. The air pollution from burning coal, oil and gas also pollutes the air, causing about 1.2 million deaths a year worldwide from small particles in the air, the scientists and report said. The 1.2 million figure is based on “immense scientific evidence,” Harvard’s Salas said. “Burning gas in cars or coal in electricity plants have been found to cause asthma in children and cause heart problems,” Salas said. “Prescribing an inhaler isn’t going to fix the cause of an asthma attack for a young boy living next to a highway where cars are producing dangerous pollutants and climate change is driving increases in wildfire smoke, pollen and ozone pollution,” Salas said. Both air pollution and heat deaths are bigger problems for the elderly and the very young and especially the poor, said University of Louisville environmental health professor Natasha DeJarnett, a study co-author. Sacoby Wilson, a professor of environmental health at the University of Maryland who wasn’t part of the report, said the Lancet study makes sense and frames climate change’s effects on health in a powerful way. “People are dying now as we speak. Droughts, desertification, not having food, flooding, tsunamis,” Wilson said. “We’re seeing what happened in Pakistan. What you see happening in Nigeria. ” Both Wilson and emergency room physician and professor of medicine at the University of Calgary Dr. Courtney Howard, who wasn’t part of the study, said report authors are correct to call the problem an addiction to fossil fuels, similar to being addicted to harmful drugs. The Lancet report shows the increasing deaths from air pollution and heat yet people are “continuing in habitual behavior despite known harms,” which is the definition of addiction, Howard said. “Thus far our treatment of our fossil fuel addiction has been ineffective.” “This isn’t a rare cancer that we don’t have a treatment for,” Salas said. “We know the treatment we need. We just need the willpower from all of us and our leaders to make it happen.” from https://ift.tt/PB4Oo63 Check out https://takiaisfobia.blogspot.com/ Raise your hand if you’ve recently engaged in an insult-slinging argument that started as an attempt at a civil discussion about some hot-button issue. Many of us have, and with high-stakes elections looming, the already fiery discourse will likely only intensify. Though it might feel satisfying in the moment, calling someone a bleeping—insert your favorite derogatory term here—is never going to help them understand your point of view. Rather, experts in persuasive communication say, it’s crucial to focus on curiosity and compassion, and to make it clear that you don’t think the person you’re talking to is the enemy—or look down on them. “I’ve always believed that more collaboration and happiness was possible if only people knew how to talk to each other better,” says David Campt, founder of the Dialogue Company, which trains people to approach hard conversations more effectively. “Especially now, with a higher level of polarization, it’s vital that we learn how to have a good conversation across different points of view.” Every year, Kurt Gray asks the students in his classes if they’ve had a conversation that changed their mind about subjects like abortion or immigration. “The percentage isn’t zero, but it’s not high,” says Gray, an associate professor in psychology and neuroscience at the University of North Carolina at Chapel Hill, where he directs the Deepest Beliefs Lab and the Center for the Science of Moral Understanding. “It is possible, but it’s not easy, and it’s not frequent.” Certain strategies, however, can make the attempt more effective. Here, experts share research-backed strategies that can help you actually change someone’s mind. Go in calmEntering the conversation in the right mindset is key—and that means striving to be cool, calm, collected, and open to learning. If you’re fired-up, and know you might snap, revisit the issue another time, Campt advises. He also suggests disclosing any nervousness or vulnerability to your conversation partner. “Our tendency is to want to hide that, but owning up to the fact that you’re nervous is actually helpful, because it tends to soften people.” Research by Gray and others, published in Nature Human Behavior in September, provides additional helpful guidance: Don’t assume the person you’re talking to hates you, even if you hold different political views. Republicans and Democrats both overestimate the extent to which the other side dehumanizes them by up to 300%, according to the findings. “If you start a conversation thinking that this person hates your guts and doesn’t want to listen, it’s going to be a bad conversation,” Gray says. “Research shows that correcting that one misconception—that the other side doesn’t hate your side as much as you thought—is a really powerful way to reduce partisan animosity.” Practice empathyWhatever your conversation partner shares, it’s crucial to listen non-judgmentally and with empathy, says David McRaney, author of the 2022 book How Minds Change: The Surprising Science of Belief, Opinion, and Persuasion and host of the science podcast You Are Not So Smart. “If you communicate that they should be ashamed, or that they’re stupid or gullible, they’re going to push against you in a way that ruins the possibility of moving forward to a conversation that would actually change their mind in some way or get them to reevaluate the matter,” he says. Read More: The Art of Persuasion in a Polarized Age Research published in Psychological Science in October found that empathizing with the people you disagree with may make your political arguments more persuasive. Using terms like “I agree,” “we all want,” and “I understand that” can help indicate empathy. If your empathy tank is running low, Campt suggests three ways to help fill it up: First, picture the person you’re talking to when they were a small child. Then, zoom in on a positive moment you’ve had with them, or think about some aspiration they have that you support. These exercises can help us “open up our hearts” and foster the best possible environment for a tough conversation, he says. Find some common groundIf you’re trying to change someone’s mind, the conversation can’t be all about correcting: It has to be about connecting, Campt says. He recommends opening the conversation by finding something you can both agree on. Read More: It’s Time For White People to Have Tough Conversations With Their White Friends and Relatives If somebody declares that protests against police need to stop, for example, you could agree that good police officers certainly do exist. “Your strategy is to agree to the extent that you can with something embedded in their statement, even if you disagree with part of it,” says Campt, who consults on areas of diversity, inclusion, and equity and is the creator of the White Ally Toolkit, an anti-racism workbook. He thinks of the strategy as ABC: agree before challenging. It can help put people in an open mindset before you invite them to new thinking. Tell stories, not just factsFiring facts at the person you’re talking to is never going to be effective, Gray stresses. Sharing personal experiences and narratives is far more likely to resonate. Research published in 2016 supports that notion: Door-to-door canvassers who were advocating for trans rights engaged in deep reflection with voters about transphobia, talking about their experiences and views, and these conversations substantially reduced the voters’ transphobia for the next three months, as measured by follow-up surveys. “Sharing and connecting on a human level was more effective than arguing,” Gray says. Often, people “think the best thing to do is to argue as aggressively as possible,” but that’s not the case. It’s easy for someone to refute facts, but harder to refute experiences, Campt says. That’s why it can be helpful to ask questions about a person’s experiences, rather than their beliefs, that inform their point of view—and to avoid attacking them. Say you’re talking to someone who doesn’t vote, he says, and you’d like to change their mind. The person might say that no politicians actually listen; instead of telling them that’s not true, share a story about a time in your life when you felt like politicians didn’t hear you. This will help you and your conversation partner feel like you’re on the same side. Then, tell them another story: an experience that helped prove to you that politicians were, in fact, listening—and how you knew and why it mattered. Sharing stories helps build trust and encourages each person to open up, while widening perspectives, Campt says. Open the door to introspectionMany people feel strongly about divisive issues but never stop to catalog the specific reasons why, McRaney says. There are ways to “hold a space for this person to actually develop their first opinion about the matter,” he adds. For example, you might start by asking someone: On a scale of 1 to 10, how strongly do you feel about gun control? Suppose the person responds with a 7. Why not a 6 or a 10? Often, when you pose that follow-up question, they’ll pause and say, “Well…” before delivering an explanation—perhaps the first they’ve ever articulated, even to themselves. At that point, the person you’re talking to might discover their opinions aren’t as strong as they had thought, and that there’s room for flexibility. “What you want to do is create a space where you go shoulder to shoulder, and you say, ‘I think you’re a rational, reasonable person,’” McRaney says. “‘I think we both probably agree on a lot of the same problems in this world. I’m wondering why on this particular issue we disagree, and I’d love your permission to investigate that together.’” Know when to take a breakInevitably, some conversations will dissolve into arguments. If the person you’re talking to insults you, Campt recommends saying: “I want to go back to just before you said X,” and rewinding the conversation. It’s also OK to take breaks. If things start to escalate, step away with the excuse of visiting the restroom, Campt suggests, and take a moment to compose yourself before deciding whether and how to continue. If you’re online, set boundariesFor proof that productive conversations on social media are rare, look no further than antagonistic Twitter threads and long-winded, belligerent Facebook comments. Online, you’re often anonymous, you can’t see the other person’s face, and it’s easy to misconstrue their words and intentions, Gray says. But Dr. Karin Tamerius, a psychiatrist who’s the founder of the website Smart Politics—which teaches people how to communicate more productively and persuasively—considers online platforms one of the most fruitful places for political discourse. She recommends following these four steps: 1. Humanize yourself. Social-media users often forget they’re talking to real people, not robots devoid of feelings. When she joins a new conversation, Tamerius always introduces herself, telling others her name and that it’s nice to meet them. “In 90% of cases, that’s enough for them to immediately change their orientation, ” she says. “It puts them into a different script.” 2. Set boundaries. Pose the request like this, Tamerius suggests: “I want to have this conversation with you, but we can’t have it if you’re calling me names or questioning my motives. Can we agree to treat each other with respect and try to understand each other’s perspective?” Most of the time, she says, people agree. 3. If those boundaries are crossed, issue a reminder. Someone might get so caught up in rapid-fire replies that they forget to follow the rules governing the conversation. In that case, call them out and give them one more chance. 4. If the behavior remains problematic, block or mute. Don’t feel bad cutting off contact, especially if the conversation has become abusive. “I let them know what I’m doing and why I’m doing it,” Tamerius says. “And then I tell them, ‘If at some point you’re ready to engage in a more productive way, you’re welcome to come back.’ I leave the door open, so they know this isn’t personal.” Keep a certain degree of detachment from the outcomeHave you ever tried to catch a butterfly in your hands? What happens, Campt says, is that “you often push the butterfly away by the wind you create reaching for it.” The same risks surround pushing your conversation partner too hard. Instead, keep a healthy amount of detachment from the outcome. Your emotional and mental health shouldn’t depend on the other person changing their mind about a certain issue. It can be helpful, Campt adds, to keep in mind that this is the first attempt, not the only—or final—opportunity you’ll have to talk. “You’re trying to learn, and to understand,” he says, collecting information that you’ll utilize in the next conversation, and the one after that. from https://ift.tt/5Y81OBj Check out https://takiaisfobia.blogspot.com/ |
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