Early detection: Bioimpedance used in new portable breast cancer screening device

Photo provided
NewsUSA - The ScanEase OneSense device is a screening tool for diagnosing breast cancer. The device facilitates an examination that is accessible to patients of any age and body type, allowing for self-examination due to its user-friendly design in the privacy of their home. The results help assess the risk of new tissue formations in the breast. The higher the risk factor on the BI-RADS scale, the greater the likelihood of malignant tissue degeneration. In light of this, the OneSense scanning device is recommended for the primary diagnosis of breast tumors in outpatient settings and for at-home self-examinations. The scan results are visible through an app on your smartphone, which will advise whether you should consult with a physician.

Measurement method:
The device measures the distribution of conductivity between the electrodes on the surface of the breast, which is influenced by the distribution of blood flow in the breast tissue. The device utilizes the well-known principle of bioimpedance, measuring the difference in electrical conductivity between healthy and cancerous tissues, as tumor growth significantly increases blood flow. This allows the device to demonstrate a high specificity in breast cancer diagnostics. The results obtained from using the device will enable physicians to enhance the diagnostic quality of fibroepithelial and non-epithelial breast formations, as diagnostic errors occur in 20% to 60% of cases during routine patient examinations. The widespread use of ScanEase scanning technology will reduce the reliance on X-ray mammography and MRI examinations as routine methods for assessing breast health, thereby decreasing radiation exposure.

A unique software with a proprietary AI-based algorithm has been developed, enabling users to determine the risk factor for the presence of neoplasms in breast tissue immediately after screening, with an accuracy of up to 85%. The bioimpedance method identifies areas of increased electrical conductivity in a woman's mammary gland, that are formed due to increased blood flow, which is characteristic of tumor development.

The interpretation of the obtained data is performed by an AI-based system using the international BI-RADS scale, which indicates a complex 'risk factor' parameter on a specialized point scale. This approach standardizes and digitizes the data description using original algorithms, allowing for an assessment of the patient's risk according to the BI-RADS scale. The method makes it possible to reliably divide patients into 3 groups of threats based on the magnitude of the risk factor: low, medium and high risk.

The user of the scanning device can immediately view the results through an app on their smartphone. If a medium or high-risk result is indicated, the person should promptly contact their physician for further diagnosis.

In early 2025, the device will enter FDA clinical trials on a fast-track basis for a non-invasive medical trial. Upon final FDA approval, the device will be available for purchase online, with a projected cost of $350. The device can be shared among friends and family, reducing the cost per person using it. View the Company’s website at www.scanease.co or send an email to info@scanease.co to request more detailed information.

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Regenerative reconstruction offers hope and fuller lives to amputees

Photo: Daniel Odame/Unsplash
by Matt Sheehan
OSF Healthcare

PEORIA - There’s a new hope for people facing amputations, and it’s in a mix of fascinating, perhaps unexpected methods.

Roughly 465,000 amputations take place in the United States each year, with 83% of them being lower limb amputations like toes and legs, according to the Amputee Coalition.

Eric Martin, DO, the chief of Vascular Surgery at OSF HealthCare Saint Francis Medical Center in Peoria, Illinois, has crafted a predictable and consistent method that provides reliable outcomes for heroic limb salvage. He does it through procedures referred to as regenerative reconstruction, a treatment currently reserved for the most serious of cases like severe bacterial infection, traumatic crushed limbs, and lower limb ulcers that have become infected and spread throughout the body. These procedures normally accompany a lower limb revascularization with either a bypass procedure or angioplasty and stenting.

“We're here to treat people who have a lot of disadvantaged anatomy and protoplasm (living part of cells) with many medical comorbidities, who otherwise would not be able to heal. Through regenerative reconstruction, we're able to accelerate wound healing and accelerate healing of other diseases processes much quicker,” Dr. Martin says. “In the past, amputation or death was the end point. Now we're able to save lives, have a much more robust limb salvage program here at OSF HealthCare which also makes a difference in terms of affecting mortality in certain patients."

OSF Saint Francis is the only location in Illinois performing advanced regenerative reconstruction procedures at this high of a level.

"We like to pride ourselves on being at the tip of the spear at regenerative reconstruction in the state of Illinois," Dr. Martin says. “We've built that up by having good relationships with companies and getting our hands on the latest and greatest products on the market. We’re always trying to optimize our arsenal of regenerative medicine to provide the best results for our patients. Not only to help with the regenerative reconstruction phase, but also to help address chronic biofilm (bacteria) in the inflammatory phase of wound healing.”

Fish skin, pig intestine, pig bladder and more!
Dr. Martin’s algorithm is built by a group of surprising products made up of animal tissue (xenografts) and human tissue (allografts). This includes fish skin, pig intestine, pig bladder, cow tendon and tissue from human umbilical cords that come from planned procedures with women who have planned, elective C-sections.

Photo provided
Dr. Eric Martin
"The healing capabilities of the fish skin have been quite remarkable," Dr. Martin says. “One of the big reasons is that it's very homologous (same make up) to human skin. The characteristics and composition of the fish skin are nearly identical to what you'd see with human skin. If you'd take a slice of human skin and a slice of fish skin and put it under an electron microscope and look at it, it'd almost look identical.”

The fish skin manufactured by Kerecis, a company in Iceland, spurs on new blood vessel growth and collagen deposition, and eventually helps encourage growth of the outer layer of skin. The fish are caught from the northern Atlantic Ocean near Iceland, and are then skinned and manufactured in plants located in Ísafjörður, Iceland. Dr. Martin started using the fish skin products in August 2023.

Smith calls regenerative reconstruction “medical miracles

Joe Smith, executive vice president of Research and Development and Product Life Cycle at Kerecis, traveled with other researchers to Peoria to learn more about Dr. Martin’s case studies. He says through these techniques, the world is going to see patients healed in ways we never have before.

“We harvest the fish skin right out of the ocean, take the scales off, and put it through a very gentle process,” Smith says. “What comes out is a medical device, homologous to human tissue, and totally absorbs in the body in seven days.”

Smith calls regenerative reconstruction “medical miracles,” and says with the combination of talented surgeons and top tier products these life-saving procedures can be done more and more.

"We also use pig bladder and pig intestine. One company (Organogenesis) has been able to take pig intestine and cross link it to increase its structural integrity and combine it with type 1 collagen. They then add PHMB (Polyhexamethylene biguanide) which is a very powerful antimicrobial agent. When this tissue is put into the human body, it's very good at killing recalcitrant bacteria that are resistant to antibiotics taken by mouth or through the veins," Dr. Martin says.

When Dr. Martin’s patients arrive at the hospital, their wound’s cross-sectional area can cover an entire lower leg or foot, depending on where the infection is. But the wounds don’t start that way. Even a quarter size ulcer on the bottom of someone’s foot, if left untreated, can grow substantially.

Pyoderma gangrenosum cure
A recent case is the first of its kind in the world of medicine. Dr. Martin and his team were able to cure a patient with a rare autoimmune disease called pyoderma gangrenosum. Traditionally, this disease did not have a cure and was treated with corticosteroids and immunosuppressive agents only. These medications had many unwanted side effects for patients.

“This is the first surgical cure in the history of medicine, where we were able to eradicate the ulcers that formed in his leg and were present for over a decade through the use of surgery and regenerative medicine," Dr. Martin says. "It was really the regenerative medicine that helped provide immunomodulation and benefit to him to help suppress his body's own immune system and allow him to heal and recover so nicely.”

Many people get amputations because after undergoing treatment time and time again, their wounds just won’t heal

Who could benefit from this treatment?
Dr. Martin says in the past, medication was offered to patients, but oftentimes the medicine would have side effects with it.

“So now by avoiding long-term use of medicine with many deleterious side effects, the surgery was curative for this patient, and he's done very, very well,” Dr. Martin says.

Most of his patients have diabetes and a history of compromised circulation or have peripheral artery disease. Most are people who smoke and have high levels of cholesterol and blood pressure as well. These people often go on to develop non-healing ulcers in their lower limbs that are arterial, venous or neuropathic in origin.

“Others are patients who have venous stasis disease where vein valves are not working properly, and they go on to develop a venous ulcer,” Dr. Martin adds. “You must first treat the reflux disease and ablate the incompetent vein, before going on to treat the ulcer. The treatment for this is either radio frequency ablation (RFA) or using glue, in the form of VenaSeal.

Many people get amputations because after undergoing treatment time and time again, their wounds just won’t heal. Dr. Martin calls these “chronic wounds.” He says they’re much more difficult to treat than acute wounds because the biofilm (bacteria) doesn’t respond to treatment like antibiotics.

The biofilm fixes in on one place, and something called quorum sensing takes place. Dr. Martin calls this a “bacterial forcefield,” which causes the medical team to be much more aggressive in treatment. Biofilm develops an extracellular polymeric substance (EPS) consisting of lipopolysaccharide (LPS). This substance made by biofilm, makes it much more resistant to degradation with standard antimicrobial therapy.

This calls for debridement to clear away the damaged tissue, normally from a saline jet system called VERSAJET, which aims to reduce the bacterial bioburden in wound beds. Then through a bottled wound lavage solution called Irrisept (chlorhexidine gluconate), Dr. Martin’s team can irrigate the area. In addition to sharp debridement with a scalpel, Dr. Martin’s team has other adjunctive means to address the biofilm.

Now it’s time to aggressively treat the area with human allograft tissue, fish skin and mammalian-based skin products.

Story straight from the operating room
While operating on a patient at OSF Saint Francis, Dr. Martin discussed his process. The patient’s Achilles’ heel was eroded because of the infection from her chronic wound that had grown for over a year. After debridement, Dr. Martin found a healthy part of the Achilles’ tendon sheet and was ready to treat the area.

“We’re going to be able to regenerate the tendon sheet by using an umbilical cord graft and a piece of fish skin called SurgiBind designed to help reconstruct tendon and cover bone,” Dr. Martin says. “This fish skin tends to be very homologous to human tissue, including similarities in the extracellular matrix (ECM) like laminin, fibronectin, glycosaminoglycan, hyaluronic acid, proteoglycans, collagen and elastin.” Dr. Martin remarks these characteristics are all important for the health of human tissue.

It’s easy to amputate, that would be the simple solution to this problem. This is the harder course and the road less traveled

Jessica Collins, a medical device representative and surgical specialist with Kerecis has seen the success stories from regenerative reconstruction.

“The massive amount of technology and products that Dr. Martin has figured out how they all work together synergistically and uses on these patients to help them save body parts, is remarkable,” Collins says.

This patient was suffering from a rare, serious disease called calciphylaxis in both of her legs. She had gone on to develop end stage renal disease (ESRD) with stage 5 chronic kidney disease and was in dire need of a kidney transplant. However, the calciphylaxis in her legs kept her from being eligible for a kidney transplant. In addition, the patient presented in septic shock to the emergency room because the area of skin ulcerations in her lower legs had become secondarily infected with an aggressive fungal infection and polymicrobial bacterial organizations. Because of this, Dr. Martin was consulted to help treat the patient, and the course of action became regenerative reconstruction. Her other option was bilateral above knee amputations (AKAs).

“It’s easy to amputate, that would be the simple solution to this problem. This is the harder course and the road less traveled,” Dr. Martin said during the regenerative reconstruction procedure.

Dr. Martin calls the start of his procedure a “triple stack” of different tissue products.

“We’ve put down the amniotic membrane grafts, we’ve selectively placed umbilical cord grafts and then I’ve wrapped the leg with Kerecis fish skin,” Dr. Martin says. “Why I’m doing this is because the amniotic membrane grafts will incorporate (attach) within three to five days. They contain an abundance of growth factors that are involved in cell signaling and cellular recruitment. The umbilical cord grafts tend to incorporate within 10-14 days, and they contain the progenitor stem cells that help to signal other stem cells to migrate to the wound bed. The fish skin takes more like 14 to 18 days to incorporate, and it contains many components of the extracellular matrix and collagen. It’s a sequential absorption of these grafts into the tissue which helps to build up the granulation tissue from the bottom up and to make this wound more superficial.”

After wrapping the leg, Dr. Martin injects a porcine (pig-derived) bladder xenograft around the wound. He says it addresses the “zone of injury” and will recruit cells to improve cell signaling, pulling healthy cells from the area around the wound bed into it. This pig bladder contains four types of collagens that help with cellular recruitment. He says this maneuver will help skin regenerate within a month in that area, starting to close the wound from the outside in.

“I’ve been doing this for about 10 years in over 350 patients. I’ve never had an adverse reaction, complications, or side effects from doing this,” Dr. Martin says. “Every time, I get a fairly consistent result of helping wounds shrink in size.”

The next step is to cover the wound with a layer of collagen-based product stemming from bovine tendon made by Integra Lifesciences.

“The tendon has two layers. An outer silicon layer that serves as a protection from the environment, similar to what the epidermis would do,” Dr. Martin says. “On the inside, it contains type 1 collagen and chondroitin sulfate from shark cartilage. This helps to generate cell migration into the wound bed.” This process benefits the healing process for patients, Dr. Martin continues, adding that it also protects the grafts underneath.

While the regenerative reconstruction is a very in-depth procedure, it actually decreases the amount of time someone is being treated and lessens long-term morbidity.

The bovine layer will then be stapled to the outer skin surrounding the wound bed. Before finalizing the wrapping of the bovine tendon, Dr. Martin places additional powdered fish skin in between the fenestrations of the fish skin product already sewn in place. This helps to promote granulation tissue, which develops during the process of healing. The bovine layer will be left in place for about 22-25 days.

Goals of regenerative reconstruction
The hope of the regenerative reconstruction is to heal wounds from the outside in. In other words, “shrink the wound.” Some of Dr. Martin’s patients had wounds for over a decade before they came in, and by that time their wounds are exponentially worse off.

“I definitely think if patients are able to get to us at a much earlier stage, and not so late because now they're facing sepsis as a result from their wounds becoming infected, now they have a blood stream infection, their blood pressure is low, their heart rate is elevated, and certain organ systems are beginning to fail (kidneys, lungs, liver, heart). A lot more goes into having to resuscitate them and keeping them alive in addition to treating their wounds,” Dr. Martin says. “So definitely before they get to the end stage of full-blown septic shock, it would be nice if patients could get to us at an earlier stage of their clinical presentation so we could treat them more aggressively and get them healed much quicker.”

While the regenerative reconstruction is a very in-depth procedure, it actually decreases the amount of time someone is being treated and lessens long-term morbidity. Someone’s life expectancy after a major amputation is normally around five years, Smith says.

While the cost of surgery can be a lot up front, Dr. Martin says by healing the wound quicker, it will decrease the cost in the long run for both patients and the hospital system. He adds the products used at OSF are all covered by the major health insurances as well.

Dr. Martin was invited to Iceland this June by Kerecis and was the 2024 grand prize winner for the most outstanding regenerative reconstruction in the United States and Europe for one of his cases. He’s slowly becoming one of the country’s foremost leading authorities in regenerative reconstruction, speaking to many research scientists around the country about his work.

Now his goal is to train other doctors around the world, using his techniques in regenerative reconstruction and offer patients new hope and a promise for a better tomorrow.

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Can an AI therapist help you through the day?

by Ben Rein

Would you let an AI chatbot be your therapist?

A recent study wanted to know if this would work, so they asked AI about 200 questions from the “Ask the Doctors” page on Reddit. Then they put those answers next to responses from real human doctors and asked healthcare providers to judge which was better, without knowing which one was AI. What do you think happened? They rated the chatbot’s answers as better 78% of the time and found that they were more likely to be empathetic.

But this raises a key point: empathy.

Everybody knows that ChatGPT can’t feel emotions. Therefore, it’s not capable of empathy, because it can’t really understand what you feel. And some scientists think that this is where AI loses: Chatbots will never work as therapists because humans won’t accept or appreciate empathy from a robot.

@dr.brein Can an AI chatbot really be your therapist? ________ This video was supported by the Pulitzer Center through the Truth Decay Grant Initiative, in collaboration with OpenMind Magazine. To read more about this topic, check out the accompanying article on OpenMind’s website, found in my bio 🔗. #PulitzerCenter #neuroscience #AI #therapy #empathy ♬ Mysterious and sad BGM(1120058) - S and N

When a real company, Koko, tried using chatbots, it didn’t work because people knew they were chatbots. The patients didn’t care when the chatbot said, “I understand how you’re feeling” because they knew it was an empty, emotionless statement.

But it makes me wonder, if chatbots continue gaining in use and acceptance, and we come to respect them more, this could change. And I’m curious how you’d feel about that.

If 100 years from now, AI chatbots are considered trained psychiatrists, would this be good or bad for society? It might seem ridiculous, but it’s real life. Right now, we essentially hold that decision in our hands. We are the first humans to coexist with these large language models, and we actively vote as consumers—with our clicks and our wallets—to determine the future of AI. In what capacity will we come to embrace AI? Where do we draw the line? It’s something to think about as we navigate this new virtual world. Thank you for your interest, and please follow for more science.


This story originally appeared on OpenMind, a digital magazine tackling science controversies and deceptions.
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Chemical contaminates found in Illinois rivers threaten food chain

SNS - Scientists tested nine fish species from four northern Illinois rivers for contamination with per- or polyfluoroalkyl substances, synthetic chemicals found in numerous industrial and commercial products and known to be harmful to human health. They found fish contaminated with PFAS in every one of their 15 test sites. Elevated levels of PFOS, one type of PFAS compound, were found in nearly all fish tested.

Study found that there were high levels of PFASs contamination levels in channel catfish found in Illinois waterways.
G.C./Pixabay

The qualities that make PFAS desirable for industrial uses — their durability and stability under stresses such as high heat or exposure to water, for example — also make these chemicals particularly problematic in the environment and hazardous to human and animal health, said Joseph Irudayaraj, a professor of bioengineering at the University of Illinois Urbana-Champaign who led the new study.

The findings are reported in the journal Science of the Total Environment.

Short-chain PFASs (per- and polyfluoroalkyl substances) are widely used as alternatives to long-chain PFASs. Long-chain PFASs become gradually regulated under REACH (EC No. 1907/2006) and other international regulations, due to having persistent, bioaccumulative and toxic properties and/or being toxic for reproduction. The increasingly used short-chain PFASs are assumed to have a lower bioaccumulation potential.

“PFAS contain multiple carbon-fluorine bonds, one of the strongest bonds in organic chemistry,” Irudayaraj said, who is also a professor in the Beckman Institute for Advanced Science and Technology and an affiliate of the Carl R. Woese Institute for Genomic Biology and the Carle Illinois College of Medicine at the U. of I. “Because of this, they are also very hard to break down. They persist for a long time because they are very, very stable.”

Considering such permanent exposure, it is very difficult to estimate long-term adverse effects in organisms. Enriched in edible parts of plants, the accumulation in food chains is unknown.

There are nearly 15,000 PFAS chemicals, according to the U.S. Environmental Protection Agency. These are classified either as short-chain PFAS, which have less than six carbon-fluorine bonds, and long-chain PFAS, with six or more of these bonds, Irudayaraj said.

Long-chain PFAS were widely used before awareness grew about the hazards of these chemicals. More recently, many industries switched to using short-chain PFAS.

“It was thought that the short-chain PFAS were less toxic, and that they could more easily degrade,” he said. “But surprisingly, that was not the case.”

Now, both types of PFAS are found in groundwater, soil and human tissues.

Short-chain PFASs have a high mobility in soil and water, and final degradation products are extremely persistent. This results in a fast distribution to water resources, and consequently, also to a contamination of drinking water resources. Once emitted, short-chain PFASs remain in the environment. A lack of appropriate water treatment technologies results in everlasting background concentrations in the environment, and thus, organisms are permanently and poorly reversibly exposed. Considering such permanent exposure, it is very difficult to estimate long-term adverse effects in organisms. Enriched in edible parts of plants, the accumulation in food chains is unknown.

“About 99% of people living in the U.S. have PFAS in their system,” Irudayaraj said.

Studies on animals have shown that short-chain PFAS (per- and polyfluoroalkyl substances) are almost completely absorbed when ingested or inhaled but not much through the skin. Both short- and long-chain PFAS don't break down easily in the body due to their strong chemical bonds. Even if these chemicals start off in different forms, they eventually turn into acids through several steps, which can be more toxic than the original chemicals. One such toxic substance, perfluorohexyl ethanoic acid (FHEA), has been found in various tissues from deceased people, according to research published by The Danish Environmental Protection Agency in 2015.

The time it takes for these acids to leave the blood varies depending on the specific chemical, the species, and even the sex of the animal. In general, sulfonates (a type of PFAS) take longer to be eliminated than carboxylates (another type), and longer chains take longer to leave the body than shorter ones. In animals, the time is often shorter for females due to differences in how their bodies process these chemicals. The time these substances stay in the blood can range from a few hours to days in rodents, a bit longer in monkeys, and much longer in humans, sometimes lasting years. However, shorter-chain PFAS tend to leave the body faster, except for PFHxS (a six-carbon chain PFAS), which has a longer half-life in humans than some other PFAS like PFOA and PFOS.

Despite a voluntary phasing out of some PFAS in industry in the U.S. and efforts to reduce PFAS pollution, these chemicals are still found in drinking water, household products, food packaging and agricultural products, he said.

Fish from the Rock River had the highest concentrations of PFAS in their tissues.

The manufacturers of chemical products using PFAS argue that the newer short-chain PFAS is safer than the widely known long-chain contaminants. Despite this assertion, the Auburn study's significant findings challenge these statements. The research indicates that short-chain chemicals are frequently present in drinking water systems and could potentially endanger human and environmental well-being. Additionally, current removal methods are relatively less efficient when it comes to eliminating short-chain PFAS in comparison to long-chain PFAS.

The Auburn study analyzed over 200 individual studies on PFAS finding that the short-chain contaminants may be just as harmful as the long-chain versions, if not more. The short-chain PFAS have been linked to hormonal and reproductive system harm.

The researchers in the U of I study focused on fish in northern Illinois rivers because they are close to urban and industrial areas. Industrial emissions and urban rainwater runoff may further contaminate local waterways with PFAS. Sport fishing is also popular across the state, including in areas inside and near Chicago. More than 666,000 fishing licenses were issued across the state of Illinois in 2020.

The researchers narrowed their research down to the fish in the Pecatonica River, Rock River, Sugar River and Yellow Creek from 2021-22. The team collected dozens of samples from nine species of fish, including bluegill, channel catfish, common carp, northern pike, smallmouth bass and walleye. The fish represented different levels of the food chain, from those that feed only on plants, like bluegill, to those eating other fish, such as channel catfish and northern pike.

Back in the lab, the scientists analyzed fish tissues for 17 PFAS chemicals. They found PFAS-contaminated fish in every river they tested and in every one of their 15 sampling sites. Fish from the Rock River had the highest concentrations of PFAS in their tissues. Contamination levels were highest in channel catfish, at the top of the food chain, and lowest in the plant eaters.

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Air quaity becoming a growing risk for premature CVD death and disability worldwide

by The American Heart Association

DALLAS — The impact of particulate matter air pollution on death and disability is on the rise worldwide, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

Previous research established the association of particulate matter (PM) pollution to CVD death and disability. However, questions remain about the worldwide impact from this type of pollution and how it has been changing over time, the study authors noted.

“We focused on examining the burden globally because particulate matter pollution is a widespread environmental risk factor that affects all populations worldwide, and understanding its impact on cardiovascular health can help guide public health interventions and policy decisions,” said Farshad Farzadfar, M.D., M.P.H., D.Sc., senior author of the study and a professor of medicine in the non-communicable diseases research center of the Endocrinology and Metabolism Research Institute at Tehran University of Medical Sciences in Iran.

The researchers analyzed PM pollution as a risk factor for death and disability using freely available data from 204 countries collected between 1990 and 2019 and detailed in the Global Burden of Disease (GBD) study. Exposure to PM pollution was estimated using a tool from the 2019 update to the GBD study that incorporated information from satellite and ground-level monitoring, computer models of chemicals in the atmosphere and land-use data.

Among the many types of heart disease, the current analysis of cardiovascular disease is restricted to stroke and ischemic heart disease (a lack of blood and oxygen supply to portions of the heart, usually due to plaque build-up in the arteries) because the 2019 GBD study on the global burden of disease attributed to PM pollution only examined these two diagnoses. The Institute for Health Metrics and Evaluation (IHME), which provides the GBD estimates, only reports data for a certain risk factor if there is a large body of evidence about its association with a disease, Farzadfar noted.

“Until now, only the association of PM pollution with ischemic heart disease and stroke has been demonstrated in a large number of studies,” Farzadfar said. “The IHME may include other CVDs in the future. Moreover, ischemic heart disease and stroke contribute to a significant majority of CVDs, and our estimates, despite having limitations, may be used as a good estimate of PM pollution burden on CVDs.”

The investigators analyzed changes over time in years of life lost due to premature death (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs). DALYs is a measure that considers both the loss of life and the impact on quality of life to assess the full impact of a health condition on a population. The cardiovascular disease burden was assessed both overall and with age standardization, which compares health outcomes across a population with a wide range of ages.

The analysis found:

  • The total number of premature deaths and years of cardiovascular disability from cardiovascular diseases attributable to PM air pollution rose from 6.8 million in 1990 to 8.9 million in 2019, a 31% worldwide increase.
  • The increase in overall deaths was unevenly distributed, with a 43% increase among men compared to a 28.2% increase among women.
  • Between 1990 and 2019, there was a 36.7% decrease in age-standardized premature deaths attributed to PM pollution, meaning that while fewer people had died from cardiovascular disease, people are living longer with disability.
  • Regions with higher socioeconomic conditions had the lowest number of lost years of life due to cardiovascular disease attributed to PM pollution, yet also the highest number of years lived with disability. The opposite was true in regions with lower socioeconomic conditions, with more lives lost and fewer years lived with disability.
  • Between 1990 and 2019, changes in the cardiovascular impact of PM pollution differed between men and women. In all measures, increases in disability and death from ambient PM air pollution were higher in men than women, while declines in disability and death from household PM air pollution were lower in women than men.

“The declines in deaths may be considered positive news, as they indicate improvements in health care, air pollution control measures and access to treatment. However, the increase in disability-adjusted life years suggests that although fewer people were dying from cardiovascular disease, more people were living with disability,” Farzadfar said.

The researchers also found that between 1990 and 2019, age-standardized CVD death and disability attributed to outdoor PM pollution rose by 8.1%, while age-standardized cardiovascular death and disability attributed to household PM pollution, which is produced by solid cooking fuels such as coal, charcoal, crop residue, dung and wood, fell by 65.4%.

“The reason for the decrease in the burden of household air pollution from solid fuels might be better access and use of cleaner fuels, such as refined biomass, ethanol, liquefied petroleum gas, solar and electricity. Moreover, structural changes, such as improved cookstoves and built-in stoves, chimney hoods and better ventilation, might be effective in reducing pollution exposure to solid fuels. Finally, the effects of educational and behavioral interventions should be considered,” Farzadfar said. “The shifting pattern from household air pollution due to solid fuels to outdoor, ambient PM pollution has important public policy implications.”

In a 2020 scientific statement and a 2020 policy statement, the American Heart Association details the latest science about air pollution exposure and the individual, industrial and policy measures to reduce the negative impact of poor air quality on cardiovascular health. Reducing exposure to air pollution and reversing the negative impact of poor air quality on cardiovascular health, including heart disease and stroke, is essential to reducing health inequities in Black and Hispanic communities, those that have been historically marginalized and under-resourced, and communities that have the highest levels of exposure to air pollution.

The study has several limitations. Because the assessment of exposure to particulate matter pollution in the study is based on regional estimates, it may not accurately reflect individual exposure. In addition, results from this analysis of the association between particulate matter pollution and cardiovascular outcomes may not be generalizable to other health conditions or other pollutants.

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Many of the heart-related emergencies seen in ERs are due to uncontrolled high blood pressure

DALLAS -- The top cardiovascular (CVD) diagnoses from U.S. emergency departments suggest that many cardiovascular emergencies are due to poorly controlled high blood pressure, according to a study of more than 20 million emergency department visits published Sept. 8 in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

The researchers found that 13% of all heart-related emergency department diagnoses, representing more than 2.7 million people, were for "essential" hypertension, which is high blood pressure not caused by other diseases. Most cases of high blood pressure are essential hypertension.

"These visits resulted in hospital admission less than 3% of the time and with very few deaths - less than 0.1%. This suggests that these visits were mostly related to the management of hypertension," said lead author Mamas A. Mamas, M.D., a professor of cardiology at Keele University in Stoke-on-Trent, and a consultant cardiologist at University Hospitals of North Midlands NHS Trust, both in the UK.

For the 15 CVD conditions detailed in the study, about 30% were hypertension-related diagnoses.

The study analyzed cardiovascular diagnoses made during emergency department visits that were part of the Nationwide Emergency Department Sample from 2016-2018. The sample was 48.7% women, and the average age was 67 years. The majority were Medicare or Medicaid participants. Men in the sample were more likely to have other diseases in addition to cardiovascular disease, such as diabetes, while women had higher rates of obesity, high blood pressure and medical conditions that affect blood vessels in the brain.

The most common heart- or stroke-related diagnoses for women seen in the emergency department were high blood pressure (16% of visits), high blood pressure-related heart or kidney disease (14.1%) and atrial fibrillation (10.2%). The most common diagnoses for men were high blood pressure-related heart or kidney disease (14.7%), high blood pressure (10.8%) and heart attack (10.7%).

"Previous studies have shown sex differences in patterns of CVD among hospitalized patients," Mamas said. "However, examining CVD encounters in the emergency department provides a more complete picture of the cardiovascular health care needs of men and women, as it captures encounters prior to hospitalization." He also points out that previous studies of CVD emergency visits are limited to suspected heart attack visits. "Therefore, this analysis of 15 CVD conditions helps to better understand the full spectrum of acute CVD needs, including sex disparities in hospitalization and risk of death."

The study found that outcomes from the emergency CVD visits were slightly different for men and women. Overall, women were less likely to die (3.3% of women vs 4.3% of men) or be hospitalized (49.1% of women vs 52.3% of men) after an emergency department visit for CVD. The difference may be due to women’s generally lower risk diagnoses, said Mamas, but there could be an underestimation of deaths in women.

"We did not track deaths outside of the hospital setting," said Mamas. "Given past evidence that women are more likely to be inappropriately discharged from the emergency department, and strong evidence for the systemic undertreatment of women, further study is warranted to track outcomes beyond the emergency department visit."

An additional limitation of the data includes potential misdiagnosis errors in cases where the final diagnosis did not match the emergency diagnosis, particularly after a hospitalization and additional bloodwork and other health information could be obtained. Furthermore, the data is limited in that it does not capture information related to severity of disease, which may make comparisons around mortality differences between different patient groups challenging.

"Our work with this large, nationally representative sample of cardiovascular emergency visits highlights differences in health care needs of men and women, which may be useful to inform planning and provision of health care services," said Mamas. "We also encourage further research into understanding the underlying factors driving the differences in CVD patterns and outcomes between men and women."

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Avoid keeping avocados in water to keep them fresh, it's not a healthy idea

Lee Batsakis
OSF Healthcare


Rachel Gustafson
URBANA -- Since the inception of the popular social media app TikTok, countless “life hack” videos have gone viral – some of which have prompted health concerns. The latest viral TikTok trend is a tip for keeping avocados “fresh” by submerging them in water and storing them in the refrigerator until you are ready to consume them. Some individuals have even stored their leftover avocado this way – slicing the avocado in half and saving the rest for later.

In May, the social media challenge prompted the Food and Drug Administration (FDA) to release a warning about the health risks associated with it.

"It gives bacteria a chance to harbor and multiply overnight, or even over months like some people are doing. It increases your risk for those GI infections such as listeria, salmonella, etcetera," says Rachel Gustafson, an OSF HealthCare family medicine advanced practice nurse.

The FDA says storing avocados this way may even cause pathogens on the surface to multiply during the time it is submerged in the water, adding that even disinfecting the avocado skin prior to slicing would not remove the contamination as it may have already infiltrated the skin.

Avocados are popular for many food dishes or even for just spreading on a slice of toast in the morning. Avocados typically have a short shelf life – the fruit tends to ripen quickly – and will rapidly turn a brown color after they are cut into. Individuals who have attempted this trend on TikTok have claimed it works wonders because it keeps the avocado that perfect shade of green.

While these avocados may look ripe and fresh on the outside due to their bright green color, the fact that they were stored in water means there is a good chance they are not as fresh as they appear. In fact, although it may not look as appealing as a bright green avocado, health experts add that the browning of an avocado is perfectly natural – and consuming a browned avocado is, in many cases, much safer than consuming a green avocado that has spent any amount of time being stored in a container of water.

"Think about an avocado like you would an apple. A sliced apple will turn brown if you leave it out for even just an hour or so. That is just because of the oxidative process. The oxygen hits the apple, making it a little bit discolored. The same thing happens with an avocado. That does not mean that it’s old, it just has changed colors because of being sliced in half and open to the air," Gustafson explains.

Photo: Pexels/Polina Tankilevitch
Some people may wonder if it is safe to consume an avocado that has been submerged in water for a day or two as opposed to weeks at a time. Gustafson recommends avoiding this type of storage altogether regardless of time.

"It probably gives it more of a chance for the bacteria to multiply when it is kept in the refrigerator for months at a time rather than one overnight. But even if after one day if the avocado gets that brown to it, it’s still good and ripe, so I probably would not take the chance and just use your avocado the next day as is," advises Gustafson.

Gustafson adds that the best way to store an avocado would be on the counter if it is not yet opened, and then keep it in a sealed container in the refrigerator once is had been sliced open – just make sure to avoid adding water. Once properly stored, the best time to finish your avocado is within two to three days.

If you are concerned you may have consumed an avocado that was not stored properly, pay attention to signs of a possible listeria or salmonella infection. Symptoms of these infections can include stomach cramps, nausea, vomiting, diarrhea, fever, and headaches.

"A lot of times, we will tell people to give it a day or two. With these salmonella and listeria infections, a lot of them will just get better on their own. The times that you want to investigate it further is if you are having symptoms such as significant amounts of diarrhea, you are not able to keep water down, and you’re getting dehydrated," Gustafson says.

If you are feeling ill and it continues for more than a couple days with worsening symptoms, Gustafson recommends seeking medical attention from your primary care provider or local emergency room. In some cases, antibiotics are needed.

Most importantly, keep food safety in mind when storing your fresh produce.

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For night owls the pandemic may have improved sleep habits

by Krishna Sharma, Kaiser Health News

Photo: Victoria Heath/Unsplash

Many so-called night people feel that, when it comes to society’s expectations about when the workday should start, they drew the short straw.

Research shows that “night owls” are hard-wired to sleep later, yet 9-to-5 work schedules force them to battle their physiology and wake up early. Research also has shown that conventional timetables leave them vulnerable to physical and mental health issues.

“It is harder for night owls to function in the world because they’re out of sync with the conventional schedule,” said Kelly Baron, an associate professor at the University of Utah who studies sleep health and clinically treats patients who have insomnia. She noted that poor sleep is also a driver of worker absenteeism and use of sick days. “We would get better performance out of employees if they were allowed to work at their best working time.”

Her research has found that keeping late evening hours can cause even healthy night owls to be prone to bad habits like eating fast food, not exercising, and socializing less.

But the covid-19 pandemic, which forced many people to telework, allowed more flexibility in work schedules, prompting sleep scientists to rethink assumptions about sleep and how to assess patients.

The pandemic “was an international experiment to understand how sleep changes when work hours and work environments change,” said Baron.

Researchers in Italy are among those tapping into this question. In a recent study, they found that many Italians who don’t typically fit into a traditional daylight timetable thrived and their health improved when the pandemic’s remote working conditions allowed them to work later hours.

Federico Salfi, a doctoral student at the University of L’Aquila and self-professed night owl, joined with colleagues late in 2020 to examine how the work-from-home trend influenced Italian sleep habits. Through social media, they identified 875 people who represented in-office and remote workers. They then used web-based questionnaires to discover the impacts of remote working on sleep health. The findings: The pandemic’s work-from-home flexibility helped the participants better align their work and sleep schedules — many of them for the first time.

More specifically, the researchers found evidence that evening-type people slept longer and better while working from home, with a corresponding decrease in symptoms of depression and insomnia.

They also pointed out an important theme that echoes other studies — that people who fall into the night-owl category regularly sleep less than early risers. On his podcast, Matthew Walker, a professor of neuroscience and psychology at the University of California-Berkeley and author of “Why We Sleep,” said it was the difference of 6.6 hours a night versus more than 7 hours a night, leading night owls to accumulate a chronic sleep debt. (The study is available as a preprint and has not yet been peer-reviewed.)

So why don’t such people just go to bed earlier? The answer is complicated.

To feel sleepy requires a biochemical cascade of events to kick into action, and that timing is determined by a person’s chronotype. A chronotype is an internal “body clock” that determines when people feel awake or tired during a 24-hour period. The cycles are genetically set, with about half of people falling into the midrange — meaning they neither wake at dawn nor fall asleep past midnight — and the others evenly split as morning larks or night owls.

In prehistoric times, a mix of mismatched bedtimes served an evolutionary purpose. Evening types would watch over morning types while they slept, and vice versa. Modern society, however, rewards early risers while stigmatizing those burning the midnight oil, said Brant Hasler, associate professor at the University of Pittsburgh and part of the university’s Center for Sleep and Circadian Science. “We are catering to one portion of our population at the expense of another.”

Walker has outlined specific health consequences on his podcast. Late-night types are 30% more likely than early birds to develop hypertension, which can lead to strokes or heart attacks, and 1.6 times as likely to have Type 2 diabetes since sleep affects blood sugar regulation. They are also two to three times as likely to be diagnosed with depression and twice as likely to use antidepressants.

A study published in February also found that evening people who slept more during the pandemic still had remarkably poorer mental health compared with morning larks.

Neither Walker nor Hasler was involved in the Italian study.

Still, some experts noted that the Italian study had limitations.

“I couldn’t find clearly included in the study: Were people always on those schedules? [Or did they change after the pandemic?] Because that is something that really matters,” said Stijn Massar, a senior research fellow at the National University of Singapore. Plus, since covid has drastically affected almost all aspects of life, pandemic-era sleep data can get muddied by the many lifestyle changes people have had to endure.

Moreover, sleep scientists are still wondering if it is always healthier for someone to sleep in sync with their chronotype.

It’s a question of prioritizing individual schedules versus community schedules. But “sleep is one of the great mysteries of life,” said Massar. “This is all somewhat speculative,” with each new study providing glimpses of the bigger picture.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Subscribe to KHN's free Morning Briefing.

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New AI technology detects sleep apnea while you snooze

NAPSI—- Roughly 20% of U.S. adults have sleep apnea, and as many as 90% of those cases go undiagnosed. The condition occurs when people stop breathing periodically throughout the night, potentially leading to severe health issues.

Conventional methods for diagnosing sleep apnea can get expensive and are known to be uncomfortable, requiring medical professionals to administer tests at a doctor’s clinic or hospital or needing the patient to purchase at-home monitoring devices. 

With this knowledge, Mintal—a wellness-focused technology brand—developed Mintal Tracker (available to download for free on iOS and Android), an AI-driven sleep analysis app that doesn’t require any hardware or external devices to generate thorough sleep reports and detect warning signs for sleep apnea. 

Detect Sleep Apnea From Home, Free

Leveraging industry-leading AI technology, the Mintal R&D team developed a sophisticated deep learning model that can maintain high accuracy with low hardware performance and storage requirements. Mintal Tracker can analyze your sleep sounds in real time, accurately identifying when you snore and/or display signs of OSAHS (Obstructive Sleep Apnea/Hypopnea Syndrome) to generate analysis reports in seconds and enable you to quickly understand your sleep habits.

Setup is easy; you just need to place your phone by your bed, and the app will record and analyze your sleep sounds throughout the night. Through testing, the app was found to be highly accurate in diagnosing moderate to severe sleep apnea, offering a starting point for further medical diagnosis. As such, users call this app “life saving”:

•“An excellent app. Did not expect the level of diagnosis provided. I was really impressed. I will be recommending this app to family and friends. I will also make sure my PCP is aware this app exist. Thank you for a very useful and possibly life saving app.”—Phillip M**, 12/05/2021, Google Play

•“This app help me see that I have issues when I sleep, especially with snoring, that I may have sleep apnea. This is a great app to have if you worry about why you are still tired when you wake up, you may not be getting a good quality of sleep.”—Nay N**, 12/06/2021, App Store

• “I love this because it is the alarm that has worked for me. It really knows when to wake me so I’m less moody... My sleep has only improved in all this time.”—Foran E** 12/23/2021, Google Play

After a night of sleep tracking, the app generates a summarized sleep report highlighting key metrics including how long and how frequently you snored and sleep talked, your risk of apnea and provides sleep cycle analysis and personalized sleep tips, which gives you or your doctor a whole picture of your sleep conditions. Moreover, you can listen to your snoring, dream talking and environment noises in the report.

Finally, Mintal Tracker goes beyond sleep tracking and sleep apnea detection—the app offers users hundreds of soothing sounds, anxiety relief exercises, a sleep encyclopedia and personalized advice for developing healthier sleep habits.

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14 U of I faculty members to become AAAS Fellows

University of Illinois chemistry professor Martin Burke and 13 other faculty members across campus join 551 scientists from around the world elected as 2021 Fellows by the American Association for the Advancement of Science.

AAAS Fellows are scientists, engineers, and innovators who are recognized for their ability to converge research, technology, and teaching sharing information in a format for the general public. Recipients are formally recognized at the AAAS Annual Meeting where they are presented with a certificate and blue and gold rosette.

The 13 other campus professors who were also named include crop sciences professor Brian Diers; physics professor Aida El-Khadra; physics professor Eduardo Fradkin; cell and developmental biology professor Brian Freeman; evolution, ecology, and behavior professor Mark Hauber; plant biology professor Katy Heath; bioengineering professor Joseph Irudayaraj; anthropology professor Lyle Konigsberg; anthropology professor Ripan Malhi; computer science professor David Padua; civil and environmental engineering and geography and geographic information science professor Murugesu Sivapalan; geography and geographic information science professor Shaowen Wang; and computer science professor Tandy Warnow.

The AAAS Fellowship is a lifetime honor that started in 1874.

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Viewpoint: The most effective and powerful scientific theory is an enigma

by Prinistha Borah

What keeps you busy when you are bored of your everyday school curriculum? Maybe video games, books, some fun hobbies; great! One such thing that I find to be very fascinating is Theoretical physics, not the calculations as they are far beyond my scope, but the theories and speculations about everything: from the tiniest ‘quark’ to the most massive ‘universe and beyond’.

I’ve always been curious about the origin and the end of everything around me and beyond. Where did the universe come from? Will it come to an end? Are the fundamental particles, constituting matter, further divisible?

These questions would keep me captivated for hours on end. I decided to dig deep inside this world of mind-boggling possibilities, so I bought a few books by some bestselling authors of theoretical physics which include Michio Kaku, Stephen Hawking, Sean Carroll, and Carlo Rovelli. Those books made me wonder if I’d, one day, be able to find out what physicists now are trying to find: a Theory of Everything.

Well, a Theory of Everything is a theory, several inches long, which would probably describe the origin and fate of everything. Quantum mechanics and Relativity are probably the two giants of theoretical physics most common in debate among physicists.

Quantum physics is the prevalent theory of the microscopic world, which describes the atoms and molecules, the fundamental forces, and the subatomic realm. Whereas, relativity on the other hand begins to answer the questions such as: Is there a beginning and end of time? Where is the farthest point in the universe? What happened at the creation? Etc.

Now, to achieve a theory of everything would mean to merge these two supreme yet opposite theories. Is it a huge task? Yes, it is. Why?

Einstein in his theory of general relativity described gravity, not as a force at all but the bending of space-time caused by the presence of matter-energy. His theory of special relativity states that light always moves at the same speed regardless of perspective or reference frame. If this is the case, then it means that the speed of light in the presence of gravity will be the same as its speed in space. Since space-time is bent by gravity, the distance between two points in the presence of gravity would be a curve.

For light to travel with the same speed, as it will do in space, time itself will slow down, distorting time.

Despite that relativity describes how gravity works so perfectly, it is still incomplete. It predicts regions of space where space-time can get so distorted that nothing can escape including light: a black hole. Within the black hole lies a mass concentrated to an infinitely small point with infinite density, called a singularity. Here, even the laws of general relativity break down. To figure out what happens in such infinitely small regions we need the study of the very small: Quantum mechanics.

But Alas! The equations of quantum mechanics make no sense in terms of singularity or general relativity. At the microscopic level, the force of gravity is so weak that it barely has any effect on any single subatomic particle. Also, physicists find it difficult to incorporate general relativity into the microscopic world. But loopholes are not acceptable in a theory of everything.

As of now, the search for a unified theory of everything is still on.

I write this as a premature aspirant of physics, all these being based on only what I now know. You might think what led me to write all this. Science, as we all know, is subtle and complex. The fact that anyone and everyone can very precisely understand it is unbelievable.

People are often afraid of the complexities. But as we look into this abyss, we find a very beautiful interior decorated with some astounding achievements. We ought to complete what they had left for us to complete. Do you know what describes us as children? Curiosity.

Our curiosity to know things, determination to stick to a thing until achieved and our imagination are the qualities that make all of us scientists. We children are the future. If we are interested, then we can surely achieve it!

Prinistha Borah is 9th grade student at Kristo Jyoti High School in Bokakhat, Assam. Her dream is to attend college at MIT, Oxford University or the University of California Los Angles. "I want to be a theoretical physicist in future and I want to know the secrets of the physical world around me."
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Making Alzheimer's just a memory: An in-depth look and the work to find a cure

(Family Features) - Although the COVID-19 pandemic turned the world upside down, the rapid development of multiple vaccines has spurred hope that treatments – or even potential cures – may be found for other devastating conditions. One such candidate is Alzheimer’s Disease.

Understanding Alzheimer’s

The Alzheimer’s Association defines the disease as a type of dementia that affects memory, thinking and behavior. While some degree of memory loss is common with age, Alzheimer’s symptoms are significant enough to affect a person’s daily life and typically only grow worse over time.

Early signs of Alzheimer’s include trouble remembering new information, solving problems or completing familiar tasks. As the disease progresses, disorientation, confusion, significant memory loss and changes in mood or behavior may become apparent. Physical symptoms may include difficulty speaking, swallowing or walking.

Impact of Alzheimer’s

Among people aged 65 and older, 1 in 9 (11.3%) has been diagnosed with Alzheimer’s Disease, meaning more than 6 million Americans live with it. Worldwide, the World Health Organization estimates there are nearly 50 million people living with dementia, and Alzheimer’s likely accounts for 60-70% of those. By 2050, this number could rise as high as 13 million. Less commonly noted are the numbers of early-onset (under 65 years old) Alzheimer’s patients within those figures. Up to 9% of global Alzheimer’s cases are believed to be early onset, according to the World Health Organization.

According to a Harvard School of Public Health survey, Alzheimer’s is second only to cancer among America’s most feared diseases. However, data from the Alzheimer’s Association shows Alzheimer’s is the sixth-leading cause of death in the United States, a rate higher than breast cancer and prostate cancer combined.

Beyond the personal impact for those battling the disease and their loved ones, Alzheimer’s Disease also takes a significant economic toll. The Alzheimer’s Association predicts that in 2021, Alzheimer’s and other dementias will cost the nation $355 billion. By 2050, these costs could exceed $1 trillion if no permanent treatment or cure for Alzheimer’s is found. At the same time, more than 11 million Americans provide unpaid care for people with Alzheimer’s and other dementias, an estimated 15.3 billion hours of care, valued at nearly $257 billion.

Treatment Options

While there hasn't been enough significant progress in discovering a treatment or cure in the more than 100 years since Alzheimer’s was first identified in 1906, early diagnosis and treatment may improve the quality of life for patients. The disease affects each patient differently, so therapies vary widely depending on how far it has progressed and which symptoms are most prevalent. Some therapeutic approaches can address symptoms like sleep disruption and behavior while medication may be beneficial for treating other symptoms.

Founded in 2016 by Milton “Todd” Ault III, Alzamend Neuro, a preclinical-stage biopharmaceutical company, has been actively seeking a cure for Alzheimer’s and concentrates on researching and funding novel products for the treatment of neurodegenerative diseases and psychiatric disorders. With two products currently in development, the company aims to bring these potential therapies to market at a reasonable cost as quickly as possible.

Ault’s stepfather is currently battling Alzheimer’s, his mother-in-law died from the disease and he has three other family members suffering through it.

“Even though work has been done to find a cure for Alzheimer’s, to me it hasn’t been a full-court press,” said Ault, whose many personal encounters with Alzheimer’s have further fueled his passion to find a cure. “While there are no profound treatments today for Alzheimer’s disease, we believe we can change that.”

Practical Ways to Fast-Track a Cure

Some basic changes in the approach to disease research could accelerate progress for diseases like Alzheimer’s, said Milton “Todd” Ault III, founder of Alzamend Neuro.
Ault believes recent advancements in vaccines and medical technology, combined with these five approaches, can help advance the search for a cure for Alzheimer’s disease and other dementias.

Encourage public-private partnerships

The collaboration of government agencies and private industries was integral to the COVID-19 vaccine development. The cross-industry partnerships enabled a vaccine to get to market in less than one year despite detractors. Ault believes this model can be replicated for other diseases and conditions.

Diversify the search

Because of its complexity, a cure for Alzheimer’s will require expertise from a broad range of organizations including health and defense, biopharmaceutical firms, academic experts and those involved in Operation Warp Speed, the federal effort that supported multiple COVID-19 vaccine candidates simultaneously to expedite development.

Share standards and data

Focusing on a shared goal is vital to succeeding. This means looking for ways to share standards and collaborate with colleagues and competitors regardless of proprietary data, patents and other limitations.

Become the catalyst for a cure

When political will and government funding are insufficient or unable to drive change, the private sector can inspire action.

“The progress we are making is a result of the private investment dollars we secured and the way we have applied strategy and tenacity that comes from a successful business record,” Ault said.

Learning from past successes

Aside from the result, there is a great deal to learn from the successful development of past drugs and vaccines. Social awareness and cultural demand are potential ways to stimulate faster production and approvals between public and private entities.

To learn more about treatments and therapies in development visit alzamend.com .

 

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No one is going to tell you if you have a COVID variant

by Christina Jewett ann JoNel Aleccia, Kaiser Health News and Rachana Pradhan

Covid-19 infections from variant strains are quickly spreading across the U.S., but there’s one big problem: Lab officials say they can’t tell patients or their doctors whether someone has been infected by a variant.

Federal rules around who can be told about the variant cases are so confusing that public health officials may merely know the county where a case has emerged but can’t do the kind of investigation and deliver the notifications needed to slow the spread, according to Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists.

"It could be associated with a person in a high-risk congregate setting or it might not be, but without patient information, we don’t know what we don’t know," Hamilton said. The group has asked federal officials to waive the rules. "Time is ticking."

The problem is that the tests in question for detecting variants have not been approved as a diagnostic tool either by the Food and Drug Administration or under federal rules governing university labs ― meaning that the testing being used right now for genomic sequencing is being done as high-level lab research with no communication back to patients and their doctors.

... "legally we can’t" tell him or her about the variant because the test is not yet federally approved ...

Amid limited testing to identify different strains, more than 1,900 cases of three key variants have been detected in 46 states, according to the Centers for Disease Control and Prevention. That’s worrisome because of early reports that some may spread faster, prove deadlier or potentially thwart existing treatments and vaccines.

Officials representing public health labs and epidemiologists have warned the federal government that limiting information about the variants ― in accordance with arcane regulations governing clinical labs ― could hamper efforts to investigate pressing questions about the variants.

The Association of Public Health Laboratories and the Council of State and Territorial Epidemiologists earlier this month jointly pressed federal officials to "urgently" relax certain rules that apply to clinical labs.

Washington state officials detected the first case of the variant discovered in South Africa this week, but the infected person didn’t provide a good phone number and could not be contacted about the positive result. Even if health officials do track down the patient, "legally we can’t" tell him or her about the variant because the test is not yet federally approved, Teresa McCallion, a spokesperson for the state department of health, said in an email.

"However, we are actively looking into what we can do," she said.

Lab testing experts describe the situation as a Catch-22: Scientists need enough case data to make sure their genome-sequencing tests, which are used to detect variants, are accurate. But while they wait for results to come in and undergo thorough reviews, variant cases are surging. The lag reminds some of the situation a year ago. Amid regulatory missteps, approval for a covid-19 diagnostic test was delayed while the virus spread undetected.

... the B117 variant, first found in the United Kingdom, could be the predominant variant strain of the coronavirus in the U.S. by March.

The limitations also put lab professionals and epidemiologists in a bind as public health officials attempt to trace contacts of those infected with more contagious strains, said Scott Becker, CEO of the Association of Public Health Laboratories. "You want to be able to tell [patients] a variant was detected," he said.

Complying with the lab rules "is not feasible in the timeline that a rapidly evolving virus and responsive public health system requires," the organizations wrote.

Hamilton also said telling patients they have a novel strain could be another tool to encourage cooperation ― which is waning ― with efforts to trace and sample their contacts. She said notifications might also further encourage patients to take the advice to remain isolated seriously.

"Can our investigations be better if we can disclose that information to the patient?" she said. "I think the answer is yes."

Public health experts have predicted that the B117 variant, first found in the United Kingdom, could be the predominant variant strain of the coronavirus in the U.S. by March.

As of Tuesday, the CDC had identified nearly 1,900 cases of the B117 variant in 45 states; 46 cases of B1351, which was first identified in South Africa, in 14 states; and five cases of the P.1 variant initially detected in Brazil in four states, Dr. Rochelle Walensky, the CDC director, told reporters Wednesday.

A Feb. 12 memo from North Carolina public health officials to clinicians stated that because genome sequencing at the CDC is done for surveillance purposes and is not an approved test under the Clinical Laboratory Improvement Amendments program ― which is overseen by the U.S. Centers for Medicare & Medicaid Services ― "results from sequencing will not be communicated back to the provider."

Earlier this week, the topic came up in Illinois as well. Notifying patients that they are positive for a covid variant is “not allowed currently” because the test is not CLIA-approved, said Judy Kauerauf, section chief of the Illinois Department of Public Health communicable disease program, according to a record obtained by the Documenting COVID-19 project of Columbia University’s Brown Institute for Media Innovation.

The CDC has scaled up its genomic sequencing in recent weeks, with Walensky saying the agency was conducting it on only 400 samples weekly when she began as director compared with more than 9,000 samples the week of Feb. 20.

The Biden administration has committed nearly $200 million to expand the federal government’s genomic sequencing capacity in hopes it will be able to test 25,000 samples per week.

“We’ll identify covid variants sooner and better target our efforts to stop the spread. We’re quickly infusing targeted resources here because the time is critical when it comes to these fast-moving variants,” Carole Johnson, testing coordinator for President Joe Biden’s covid-19 response team, said on a call with reporters this month.

Hospitals get high-level information about whether a sample submitted for sequencing tested positive for a variant, said Dr. Nick Gilpin, director of infection prevention at Beaumont Health in Michigan, where 210 cases of the B117 variant have been detected. Yet patients and their doctors will remain in the dark about who exactly was infected.

"It’s relevant from a systems-based perspective," Gilpin said. “If we have a bunch of B117 in my backyard, that’s going to make me think a little differently about how we do business.”

It’s the same in Washington state, McCallion said. Health officials may share general numbers, such as 14 out of 16 outbreak specimens at a facility were identified as B117 ― but not who those 14 patients were.

There are arguments for and against notifying patients. On one hand, being infected with a variant won’t affect patient care, public health officials and clinicians say. And individuals who test positive would still be advised to take the same precautions of isolation, mask-wearing and hand-washing regardless of which strain they carried.

"There wouldn’t be any difference in medical treatment whether they have the variant," said Mark Pandori, director of the Nevada State Public Health Laboratory. However, he added that “in a public health emergency it’s really important for doctors to know this information.”

Pandori estimated there may be only 10 or 20 labs in the U.S. capable of validating their laboratory-based variant tests. One of them doing so is the lab at the University of Washington in Seattle.

Dr. Alex Greninger, assistant director of the clinical virology laboratories there, who co-created one of the first tests to detect SARS-CoV-2, said his lab began work to validate the sequencing tests last fall.

Within the next few weeks, he said, he anticipates having a federally authorized test for whole-genome sequencing of covid. "So all the issues you note on notifying patients and using [the] results will not be a problem," he said in an email.

Companies including San Diego-based Illumina have approved covid-testing machines that can also detect a variant. However, since the add-on sequencing capability wasn’t specifically approved by the FDA, the results can be shared with public health officials ― but not patients and their doctors, said Dr. Phil Febbo, Illumina’s chief medical officer.

He said they haven’t asked the FDA for further approval but could if variants start to pose greater concern, like escaping vaccine protection.

"I think right now there’s no need for individuals to know their strains," he said.

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How COVID-19 attacks the immune system, what science is unraveling

• Some covid survivors have developed serious autoimmune diseases
• Long haulers suffer from a wide range of symptoms
• Recent discoveries excite the scientific community
by Liz Szabo

There’s a reason soldiers go through basic training before heading into combat: Without careful instruction, green recruits armed with powerful weapons could be as dangerous to one another as to the enemy.

The immune system works much the same way. Immune cells, which protect the body from infections, need to be "educated" to recognize bad guys — and to hold their fire around civilians.

In some covid patients, this education may be cut short. Scientists say unprepared immune cells appear to be responding to the coronavirus with a devastating release of chemicals, inflicting damage that may endure long after the threat has been eliminated.

"If you have a brand-new virus and the virus is winning, the immune system may go into an ‘all hands on deck’ response," said Dr. Nina Luning Prak, co-author of a January study on covid and the immune system. "Things that are normally kept in close check are relaxed. The body may say, ‘Who cares? Give me all you’ve got.’"

While all viruses find ways to evade the body’s defenses, a growing field of research suggests that the coronavirus unhinges the immune system more profoundly than previously realized.

Some covid survivors have developed serious autoimmune diseases, which occur when an overactive immune system attacks the patient, rather than the virus. Doctors in Italy first noticed a pattern in March 2020, when several covid patients developed Guillain-Barré syndrome, in which the immune systems attacks nerves throughout the body, causing muscle weakness or paralysis. As the pandemic has surged around the world, doctors have diagnosed patients with rare, immune-related bleeding disorders. Other patients have developed the opposite problem, suffering blood clots that can lead to stroke.

In some patients, covid triggers autoantibodies that target the immune system itself
All these conditions can be triggered by "autoantibodies" — rogue antibodies that target the patient’s own proteins and cells.

In a report published in October, researchers even labeled the coronavirus "the autoimmune virus."

"Covid is deranging the immune system," said John Wherry, director of the Penn Medicine Immune Health Institute and another co-author of the January study. "Some patients, from their very first visit, seem to have an immune system in hyperdrive."

Although doctors are researching ways to overcome immune disorders in covid patients, new treatments will take time to develop. Scientists are still trying to understand why some immune cells become hyperactive — and why some refuse to stand down when the battle is over.

Key immune players called "helper T cells" typically help antibodies mature. If the body is invaded by a pathogen, however, these T cells can switch jobs to hunt down viruses, acting more like"killer T cells," which destroy infected cells. When an infection is over, helper T cells usually go back to their old jobs.

In some people with severe covid, however, helper T cells don’t stand down when the infection is over, said James Heath, a professor and president of Seattle’s Institute for Systems Biology.

About 10% to 15% of hospitalized covid patients Heath studied had high levels of these cells even after clearing the infection. By comparison, Heath found lingering helper T cells in fewer than 5% of covid patients with less serious infections.

COVID deranges the immune system
In affected patients, helper T cells were still looking for the enemy long after it had been eliminated. Heath is now studying whether these overzealous T cells might inflict damage that leads to chronic illness or symptoms of autoimmune disease.

"These T cells are still there months later and they’re aggressive," Heath said. "They’re on the hunt."


Friendly Fire

Covid appears to confuse multiple parts of the immune system.

In some patients, covid triggers autoantibodies that target the immune system itself, leaving patients without a key defense against the coronavirus.

In October, a study published in Science led by Rockefeller University’s Jean-Laurent Casanova showed that about 10% of covid patients become severely ill because they have antibodies against an immune system protein called interferon.

Disabling interferon is like knocking down a castle’s gate. Without these essential proteins, invading viruses can overwhelm the body and multiply wildly.

New research shows that the coronavirus may activate preexisting autoantibodies, as well as prompt the body to make new ones.

In the January study, half of the hospitalized covid patients had autoantibodies, compared with fewer than 15% of healthy people. While some of the autoantibodies were present before patients were infected with SARS-CoV-2, others developed over the course of the illness.

Other research has produced similar findings. In a study out in December, researchers found that hospitalized covid patients harbored a diverse array of autoantibodies.

While some patients studied had antibodies against virus-fighting interferons, others had antibodies that targeted the brain, thyroid, blood vessels, central nervous system, platelets, kidneys, heart and liver, said Dr. Aaron Ring, assistant professor of immunology at Yale School of Medicine and lead author of the December study, published online without peer review. Some patients had antibodies associated with lupus, a chronic autoimmune disorder that can cause pain and inflammation in any part of the body.

In his study, Ring and his colleagues found autoantibodies against proteins that help coordinate the immune system response. "These are the air traffic controllers," Ring said. If these proteins are disrupted, "your immune system doesn’t work properly."

Covid patients rife with autoantibodies tended to have the severest disease, said Ring, who said he was surprised at the level of autoantibodies in some patients. "They were comparable or even worse than lupus," Ring said.

Although the studies are intriguing, they don’t prove that autoantibodies made people sicker, said Dr. Angela Rasmussen, a virologist affiliated with Georgetown’s Center for Global Health Science and Security. It’s possible that the autoantibodies are simply markers of serious disease.

A study published online in January, for example, found rogue antibodies in patients’ blood up to seven months after infection.
"It’s not clear that this is linked to disease severity,” Rasmussen said.

The studies’ authors acknowledge they have many unanswered questions.

"We don’t yet know what these autoantibodies do and we don’t know if [patients] will go on to develop autoimmune disease," said Dr. PJ Utz, a professor of immunology and rheumatology at Stanford University School of Medicine and a co-author of Luning Prak’s paper.

But recent discoveries about autoantibodies have excited the scientific community, who now wonder if rogue antibodies could explain patients’ differing responses to many other viruses. Scientists also want to know precisely how the coronavirus turns the body against itself — and how long autoantibodies remain in the blood.


‘An Unfortunate Legacy’

Scientists working round-the-clock are already beginning to unravel these mysteries.

A study published online in January, for example, found rogue antibodies in patients’ blood up to seven months after infection.

Ring said researchers would like to know if lingering autoantibodies contribute to the symptoms of "long covid," which afflicts one-third of covid survivors up to nine months after infection, according to a new study in JAMA Network Open.

"Long haulers" suffer from a wide range of symptoms, including debilitating fatigue, shortness of breath, cough, chest pain and joint pain, according to the Centers for Disease Control and Prevention. Other patients experience depression, muscle pain, headaches, intermittent fevers, heart palpitations and problems with concentration and memory, known as brain fog.

Less commonly, some patients develop an inflammation of the heart muscle, abnormalities in their lung function, kidney issues, rashes, hair loss, smell and taste problems, sleep issues and anxiety.

The National Institutes of Health has announced a four-year initiative to better understand long covid, using $1.15 billion allocated by Congress.

Ring said he’d like to study patients over time to see if specific symptoms might be explained by lingering autoantibodies.

"We need to look at the same patients a half-year later and see which antibodies they do or don’t have," he said. If autoantibodies are to blame for long covid, they could "represent an unfortunate legacy after the virus is gone."


Widening the Investigation

Scientists say the coronavirus could undermine the immune system in several ways.

For example, it’s possible that immune cells become confused because some viral proteins resemble proteins found on human cells, Luning Prak said. It’s also possible that the coronavirus lurks in the body at very low levels even after patients recover from their initial infection.

"We’re still at the very beginning stages of this," said Luning Prak, director of Penn Medicine’s Human Immunology Core Facility.

Dr. Shiv Pillai, a Harvard Medical School professor, notes that autoantibodies aren’t uncommon. Many healthy people walk around with dormant autoantibodies that never cause harm.

For reasons scientists don’t completely understand, viral infections appear able to tip the scales, triggering autoantibodies to attack, said Dr. Judith James, vice president of clinical affairs at the Oklahoma Medical Research Foundation and a co-author of Luning Prak’s study.

For example, the Epstein-Barr virus, best known for causing mononucleosis, has been linked to lupus and other autoimmune diseases. The bacteria that cause strep throat can lead to rheumatic fever, an inflammatory disease that can cause permanent heart damage. Doctors also know that influenza can trigger an autoimmune blood-clotting disorder, called thrombocytopenia.

Researchers are now investigating whether autoantibodies are involved in other illnesses — a possibility scientists rarely considered in the past.

Doctors have long wondered, for example, why a small number of people — mostly older adults — develop serious, even life-threatening reactions to the yellow fever vaccine. Three or four out of every 1 million people who receive this vaccine — made with a live, weakened virus — develop yellow fever because their immune systems don’t respond as expected, and the weakened virus multiplies and causes disease.

In a new paper in the Journal of Experimental Medicine, Rockefeller University’s Casanova has found that autoantibodies to interferon are once again to blame.

Casanova led a team that found three of the eight patients studied who experienced a dangerous vaccine reaction had autoantibodies that disabled interferon. Two other patients in the study had genes that disabled interferon.

"If you have these autoantibodies and you are vaccinated against yellow fever, you may end up in the ICU," Casanova said.

Casanova’s lab is now investigating whether autoantibodies cause critical illness from influenza or herpes simplex virus, which can cause a rare brain inflammation called encephalitis.


Calming the Autoimmune Storm

Researchers are looking for ways to treat patients who have interferon deficiencies — a group at risk for severe covid complications.

In a small study published in February in the Lancet Respiratory Medicine, doctors tested an injectable type of interferon — called peginterferon-lambda — in patients with early covid infections.

People randomly assigned to receive an interferon injection were four times more likely to have cleared their infections within seven days than the placebo group. The treatment, which used a type of interferon not targeted by the autoantibodies Casanova discovered, had the most dramatic benefits in patients with the highest viral loads.

Lowering the amount of virus in a patient may help them avoid becoming seriously ill, said Dr. Jordan Feld, lead author of the 60-person study and research director at the Toronto Centre for Liver Disease in Canada. In his study, four of the placebo patients went to the emergency room because of breathing issues, compared with only one who received interferon.

"If we can bring the viral levels down quickly, they might be less infectious," Feld said.

Feld, a liver specialist, notes that doctors have long studied this type of interferon to treat other viral infections, such as hepatitis. This type of interferon causes fewer side effects than other varieties. In the trial, those treated with interferon had similar side effects to those who received a placebo.

Doctors could potentially treat patients with a single injection with a small needle — like those used to administer insulin — in outpatient clinics, Feld said. That would make treatment much easier to administer than other therapies for covid, which require patients to receive lengthy infusions in specialized settings.

Many questions remain. Dr. Nathan Peiffer-Smadja, a researcher at the Imperial College London, said it’s unclear whether this type of interferon does improve symptoms.

Similar studies have failed to show any benefit to treating patients with interferon, and Feld acknowledged that his results need to be confirmed in a larger study. Ideally, Feld said, he would like to test interferon in older patients to see whether it can reduce hospitalizations.

"We’d like to look at long haulers, to see if clearing the virus quickly could lead to less immune dysregulation," Feld said. "People have said to me, 'Do we really need new treatments now that vaccines are rolling out?' Unfortunately, we do."

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