Writer Mike Makowsky was a firsthand witness of sorts to the real-life events inspiring Bad Education, which debuted at the 2019 Toronto International Film Festival and now sees wide launch via HBO. He was a six-year-old student in Roslyn Public Schools when he first met Frank Tassone, and witnessed firsthand how revered and influential the superintendent was until he was busted in 2004 for embezzling millions from the district, engineering the largest school theft in American history. With Makwoskys close ties to the saga, and Hugh Jackman and Allison Janney cast as leads, will the movie be more than just another based-on-a-true-story story?

The Gist: Roslyn High School is fourth in the country in college-acceptance rates. Fourth! And its all due to Frank Tassone. He meticulously grooms himself in the morning, spritzing cologne on his neck and plucking stray nose hairs. He walks into his office, decorated with silver balloons shaped like 4s, a snow day magic wand and issues of Life Extension magazine. He says absolutely perfect things to a helicopter parent hyperventilating about her sons troubles in school. He inspires a young journalist from the school paper to write more than just a puff piece about the schools multimillion-dollar skywalk project. Hes thanked with a basket of candy from local real estate developers, who love him for making the district great and therefore inspiring skyrocketing property values.

At lunchtime, Frank sits in the football-stadium bleachers with assistant super/business manager Pam Gluckin (Allison Janney). He laments the health-food smoothie hes consuming. I would kill somebody for a carb right now, he says, and she feeds him a big honking bite of her pastrami-on-rye. He leads the local ladies book club, and attendees didnt even read the selection. Theyre in awe of him, in his crisp light-blue oxford with white collar and cuffs adorned with fancy cufflinks. He offers to help with the dishes, and the hostess leans in, but he leans away. The memory of his late wife is too fresh, he says.

He goes to Vegas for a conference, and dutifully attends snoozy lectures while his colleagues gamble. Afterward, he sits down for a drink and recognizes the bartender: Kyle Contreras (Rafael Casal), a former student from 15 years ago when he taught English. Frank remembers his name, because he remembers everybodys name, because he and Gluckin stay at work late so she can quiz him on everybodys name. He and Kyle have dinner, and then go back to Franks hotel room and make out and then the movie cuts away. Hey now.

So about that young journalist, Rachel (Geraldine Viswanathan). Shes no longer OK with writing a crappy puff piece, so she confidently plops down in Gluckins office and asks about project budgets and contractor bids. Gluckin is only slightly icy when she tosses Rachel the key to the firetrap basement records room, although if Rachel saw Gluckins seaside near-manse and Corvette convertible, she might have even more questions about how a public school administrators humble salary can indulge such extravagant tastes. I mean, Gluckins husband is a car salesman. Gluckins niece (Annaleigh Ashford) is the office secretary who helps Rachel make a zillion photocopies of school records with some big numbers on them, and it seems like only a matter of time before some of the people in charge around there are something that rhymes with glucked.

What Movies Will It Remind You Of?: Remember how Philip Seymour Hoffman totally owned Owning Mahowny, playing a buttoned-up gambling addict who bilked big stacks of cash from the bank he worked for? You dont? (Does anybody whos not a movie critic remember?) Well, watch the damn thing, and youll see a character whos pretty much the opposite of Frank Tarrone in a similar stressful situation.

Performance Worth Watching: This is easily one of Jackmans best performances possibly THE best, especially in the first act, when hes sparklingly charming. And the second act, when he tries to keep all the squirming puppies in the box And in the third act, when he shows how a life of subterfuge sad on one hand, infuriating on the other can quickly crumble, and he makes a hard left into villainy.

Memorable Dialogue: Skywalk is big. Gets us to first!, Frank chirps.

Sex and Skin: None.

Our Take: Director Cory Finley (Thoroughbreds) and Makowsky initially strike the perfect, slyly satirical gettin-away-with-it tone, then, as soon as Gluckin goes up in flames and locks angry eyes with Frank for throwing her under the bus, seamlessly segue to I-feel-like-Im-sitting-on-an-atomic-bomb-waiting-for-it-to-go-off suspenseful drama. They nurture uniformly excellent performances, from Jackmans multifaceted charisma to Janneys trademark irascibility to Ray Romanos fluster as the school-board president to Viswanathans earnestness, which anchors the story.

The filmmakers cleverly embed character bits in the movies little visual details. The way Frank is yanked off a beanbag chair while chatting with sixth-graders so he can be informed of Gluckins malfeasance, for example. Or, in a touch of shrewd symbolism, how he carefully applies concealer to his eye wrinkles. Or how Rachel spreads out the schools sketchy budget paperwork on the floor of her bedroom with a pile of period-specific Beanie Babies watching. This is a terrific movie, smart, character-driven, frequently funny and highly entertaining.

Our Call: STREAM IT. Bad Education bullseyes the sweet spot between realism and elevated drama, making it several cuts above the usual based-on-a-true-story fodder.

John Serba is a freelance writer and film critic based in Grand Rapids, Michigan. Read more of his work at johnserbaatlarge.com or follow him on Twitter: @johnserba.

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Stream It Or Skip It: Bad Education on HBO, a Funny White-Collar-Crook Bio Featuring Hugh Jackmans Best Performance Yet - News Lagoon

Recommendation and review posted by Bethany Smith

I awoke on Monday morning to the sad news that Max Randell had passed away on April 18. He would have been 23 on October 9.

Maxie wasnt expected to live past the age of 8, or even much past toddlerhood, according to some doctors. But gene therapy, and his incredible family, had something to say about that. COVID-19 didnt claim him his body just tired of fighting.

Max Randells legacy is one of hope, to the rare disease community whose family members step up to participate in the clinical trials that lead to treatments. In this time of the pandemic, attention has, understandably, turned somewhat away from the many people who live with medical limitations all the time. Ill explore that story next week.

A Devastating Diagnosis

Max was diagnosed at 4 months of age with Canavan disease, an inherited neuromuscular disease that never touched his mind nor his ability to communicate with his eyes, even though his body increasingly limited what he could do. Fewer than a thousand people in the US have the condition.

Canavan disease is an enzyme deficiency that melts away the myelin that insulates brain neurons. Gene therapy provides working copies of the affected gene, ASPA.

Babies with Canavan disease are limp and listless. Most never speak, walk, or even turn over. Yet their facial expressions and responses indicate an uncanny awareness. A child laughs when his dad makes a fart-like noise; a little girl flutters her fingers as if they are on a keyboard when a friend plays piano. Theyre smart.

Today, with excellent speech, occupational, and physical therapy and earlier diagnosis, people with Canavan disease can live into their teens or twenties. Those with mild mutations live even longer.

Maxs passing is a tragedy, but he taught researchers about gene therapy to the brain. And that may help others.

Gene Therapy for Canavan

Max had his first gene therapy at 11 months of age and a second a few years later, after slight backsliding when clinical trials halted in the wake of the death of Jesse Gelsingerin a gene therapy trial for a different disease.

Ive written about Maxs journey through many editions of my human genetics textbook, in my book ongene therapy, and in several DNA Science posts, listed at the end.

Ive had the honor to attend two of Maxs birthday parties, which celebrate Canavan kids and the organization that his family founded, Canavan Research Illinois. At one party I brought along birthday cards that students whod read my gene therapy book made for him. And his grandma Peggy, who emailed me of his passing this past Monday, showed me how Max communicated with eyeblinks of differing duration and direction.

Heres what his mom Ilyce wrote about one yearly gathering:

This year will be the 20th Annual Canavan Charity Ball. Each year as I plan this event Im faced with the undeniable reality that theres a chance Maxie wont be here by the time the day rolls around. With each passing year this fear grows stronger and it becomes increasingly difficult to put into print that our annual event is in honor of Maxies birthday. Ive been talking to Maxie a lot lately about his life. He feels happy, strong, loved, content, productive, and fulfilled and he is looking forward to his upcoming 21st birthday. Im excited to celebrate this incredible milestone.

Maxs parents and brother Alex have had the unusual experience of time, of being able to watch their loved one as the years unfolded following gene therapy. They were able to see more subtle improvements than can the parents whose children have more recently had gene therapy to treat a brain disease. Parents watch and wait and hope that language will return, or that a child will become more mobile or less hyperactive, depending on the treated condition. The changes may be subtle, or slow, or restricted and thats what Max taught the world.

For him, the viruses that ferried the healing genes into his brain seem to have gathered at his visual system. His parents noticed improvements in the short term, just before his first birthday, as well as long term.

Within two to three weeks, he started tracking with his eyes, and he got glasses. He became more verbal and his motor skills improved. His vision is still so good that his ophthalmologist only sees him once a year, like any other kid with glasses. She calls him Miracle Max, Ilyce told me in 2010.

In 2016 I heard from Ilyce again:

I wanted to give you an update on Maxie. Hes going to be 19 on October 9th. He graduated from high school in June and is beginning a work program on Monday. Its been very exciting to watch him grow into a young man!

Max had an appointment with his ophthalmologist this week and his vision continues to improve. His doctor said that the gene is still active in his brain because his optic nerve shows absolutely no signs of degeneration and looks the same each year. I wish we could have been able to express the gene throughout more of his brain, but I am grateful for the treatments because of the progress hes made.

Even though gene therapy wasnt a cure for Max, the things we are experiencing definitely give me a lot of hope that once the delivery system is perfected, I can see a potential cure for Canavan disease in the future. Just knowing that the gene is still there 15 years later gives me confidence that a one-time gene transfer would actually work!

Maxs gene therapy circa 2002 targeted less than 1% of brain cells, with fewer viral vectors than are used to deliver healing genes in todays clinical trials. But it looks like some of the vectors may have made their way beyond the optic nerves, judging by the interest in math he had in high school and his critical thinking skills.

A Choice of Gene-Based Therapies

When the Randell family decided to pursue gene therapy, it was pretty much the only game in town. Thats changed.

Only two gene therapies have been approvedin the U.S. But a search at clinicaltrials.gov yielded 602 entriesdeploying the technology. The list still rounds up the usual suspects of years past mostly immune deficiencies, eye disorders, or blood conditions, with a few inborn errors of metabolism.

But one clinical trial mentions the gene-editing tool CRISPR, which can replace a mutant gene, not just add working copies as classical gene therapy does. TheCRISPRtrial is an experiment on stem cells removed from patients with Kabuki syndrome, which affects many body systems.

Spinal muscular atrophy now has two FDA-approved treatments, one an antisense therapy (Spinraza) that silences a mutation and the other (Zolgensma) a gene therapy that infuses copies of the functioning gene. Without treatment, the destruction of motor neurons in the spinal cord is usually lethal by age two.

In 2018, FDA approved the first drug based on RNA interference (RNAi), yet another biotechnology. It silences gene expression, which is at the RNA rather than the DNA level of the other approaches. Onpattro treats the tingling, tickling, and burning sensations from the rare condition hereditary transthyretin-mediated amyloidosis.

When I wrote my book on gene therapy in 2012, the technology was pretty much the only choice of research to pursue besides protein-based therapies like enzyme replacement. Now families raising funds for treatments for single-gene diseases can add antisense, RNAi, and CRISPR gene editing to the list of possibilities.

In any battle, a diversity of weapons ups the odds of defeating the enemy.

RIP Max Randell.

DNA Science posts:

Fighting Canavan: Honoring Rare Disease Week

A Brothers Love Fights Genetic Disease

Gene Therapy for Canavan Disease: Maxs Story

Celebrating the Moms of Gene Therapy

To support research:Canavan Research Illinois

Read more from the original source:
A Tribute to Max Randell, Gene Therapy Pioneer - PLoS Blogs

Recommendation and review posted by Bethany Smith

The lungs are ground zero, but COVID-19 also tears through organ systems from brain to blood vessels.

Science's COVID-19 coverage is supported by the Pulitzer Center.

The coronavirus wreaked extensive damage (yellow) on the lungs of a 59-year-old man who died at George Washington University Hospital, as seen in a 3D model based on computed tomography scans.

On rounds in a 20-bed intensive care unit one recent day, physician Joshua Denson assessed two patients with seizures, many with respiratory failure, and others whose kidneys were on a dangerous downhill slide. Days earlier, his rounds had been interrupted as his team tried, and failed, to resuscitate a young woman whose heart had stopped. All of the patients shared one thing, says Denson, a pulmonary and critical care physician at the Tulane University School of Medicine. They are all COVID positive.

As the number of confirmed cases of COVID-19 approaches 2.5 million globally and deaths surpass 166,000, clinicians and pathologists are struggling to understand the damage wrought by the coronavirus as it tears through the body. They are realizing that although the lungs are ground zero, the virus' reach can extend to many organs including the heart and blood vessels, kidneys, gut, and brain.

[The disease] can attack almost anything in the body with devastating consequences, says cardiologist Harlan Krumholz of Yale University and Yale-New Haven Hospital, who is leading multiple efforts to gather clinical data on COVID-19. Its ferocity is breathtaking and humbling.

Understanding the rampage could help doctors on the front lines treat the roughly 5% of infected people who become desperately and sometimes mysteriously ill. Does a dangerous, newly observed tendency to blood clotting transform some mild cases into life-threatening emergencies? Is an overzealous immune response behind the worst cases, suggesting treatment with immune-suppressing drugs could help? And what explains the startlingly low blood oxygen that some physicians are reporting in patients who nonetheless are not gasping for breath? Taking a systems approach may be beneficial as we start thinking about therapies, says Nilam Mangalmurti, a pulmonary intensivist at the Hospital of the University of Pennsylvania (HUP).

What follows is a snapshot of the fast-evolving understanding of how the virus attacks cells around the body. Despite the more than 1500 papers now spilling into journals and onto preprint servers every week, a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen. Without larger, controlled studies that are only now being launched, scientists must pull information from small studies and case reports, often published at warp speed and not yet peer reviewed. We need to keep a very open mind as this phenomenon goes forward, says Nancy Reau, a liver transplant physician who has been treating COVID-19 patients at Rush University Medical Center. We are still learning.

WHEN AN INFECTED PERSON expels virus-laden droplets and someone else inhales them, the novel coronavirus, called SARS-CoV-2, enters the nose and throat. It finds a welcome home in the lining of the nose, according to a recent arXiv preprint, because cells there are rich in a cell-surface receptor called angiotensin-converting enzyme 2 (ACE2). Throughout the body, the presence of ACE2, which normally helps regulate blood pressure, marks tissues potentially vulnerable to infection, because the virus requires that receptor to enter a cell. Once inside, the virus hijacks the cell's machinery, making myriad copies of itself and invading new cells.

As the virus multiplies, an infected person may shed copious amounts of it, especially during the first week or so. Symptoms may be absent at this point. Or the virus' new victim may develop a fever, dry cough, sore throat, loss of smell and taste, or head and body aches.

If the immune system doesn't beat back SARS-CoV-2 during this initial phase, the virus then marches down the windpipe to attack the lungs, where it can turn deadly. The thinner, distant branches of the lung's respiratory tree end in tiny air sacs called alveoli, each lined by a single layer of cells that are also rich in ACE2 receptors.

Normally, oxygen crosses the alveoli into the capillaries, tiny blood vessels that lie beside the air sacs; the oxygen is then carried to the rest of the body. But as the immune system wars with the invader, the battle itself disrupts healthy oxygen transfer. Frontline white blood cells release inflammatory molecules called chemokines, which in turn summon more immune cells that target and kill virus-infected cells, leaving a stew of fluid and dead cellspusbehind (see graphic, below). This is the underlying pathology of pneumonia, with its corresponding symptoms: coughing; fever; and rapid, shallow respiration. Some COVID-19 patients recover, sometimes with no more support than oxygen breathed in through nasal prongs.

But others deteriorate, often suddenly, developing a condition called acute respiratory distress syndrome. Oxygen levels in their blood plummet, and they struggle ever harder to breathe. On x-rays and computed tomography scans, their lungs are riddled with white opacities where black spaceairshould be. Commonly, these patients end up on ventilators. Many die, and survivors may face long-term complications (see sidebar, p. 359). Autopsies show their alveoli became stuffed with fluid, white blood cells, mucus, and the detritus of destroyed lung cells.

Some clinicians suspect the driving force in many gravely ill patients' downhill trajectories is a disastrous overreaction of the immune system known as a cytokine storm, which other viral infections are known to trigger. Cytokines are chemical signaling molecules that guide a healthy immune response; but in a cytokine storm, levels of certain cytokines soar far beyond what's needed, and immune cells start to attack healthy tissues. Blood vessels leak, blood pressure drops, clots form, and catastrophic organ failure can ensue.

Some studies have shown elevated levels of these inflammation-inducing cytokines in the blood of hospitalized COVID-19 patients. The real morbidity and mortality of this disease is probably driven by this out of proportion inflammatory response to the virus, says Jamie Garfield, a pulmonologist who cares for COVID-19 patients at Temple University Hospital.

But others aren't convinced. There seems to have been a quick move to associate COVID-19 with these hyperinflammatory states. I haven't really seen convincing data that that is the case, says Joseph Levitt, a pulmonary critical care physician at the Stanford University School of Medicine.

He's also worried that efforts to dampen a cytokine response could backfire. Several drugs targeting specific cytokines are in clinical trials in COVID-19 patients. But Levitt fears those drugs may suppress the immune response that the body needs to fight off the virus. There's a real risk that we allow more viral replication, Levitt says.

Meanwhile, other scientists are zeroing in on an entirely different organ system that they say is driving some patients' rapid deterioration: the heart and blood vessels.

IN BRESCIA, ITALY, a 53-year-old woman walked into the emergency room of her local hospital with all the classic symptoms of a heart attack, including telltale signs in her electrocardiogram and high levels of a blood marker suggesting damaged cardiac muscles. Further tests showed cardiac swelling and scarring, and a left ventriclenormally the powerhouse chamber of the heartso weak that it could only pump one-third its normal amount of blood. But when doctors injected dye in her coronary arteries, looking for the blockage that signifies a heart attack, they found none. Another test revealed the real cause: COVID-19.

How the virus attacks the heart and blood vessels is a mystery, but dozens of preprints and papers attest that such damage is common. A 25 March paper in JAMA Cardiology found heart damage in nearly 20% of patients out of 416 hospitalized for COVID-19 in Wuhan, China. In another Wuhan study, 44% of 36 patients admitted to the intensive care unit (ICU) had arrhythmias.

The disruption seems to extend to the blood itself. Among 184 COVID-19 patients in a Dutch ICU, 38% had blood that clotted abnormally, and almost one-third already had clots, according to a 10 April paper in Thrombosis Research. Blood clots can break apart and land in the lungs, blocking vital arteriesa condition known as pulmonary embolism, which has reportedly killed COVID-19 patients. Clots from arteries can also lodge in the brain, causing stroke. Many patients have dramatically high levels of D-dimer, a byproduct of blood clots, says Behnood Bikdeli, a cardiovascular medicine fellow at Columbia University Medical Center.

The more we look, the more likely it becomes that blood clots are a major player in the disease severity and mortality from COVID-19, Bikdeli says.

Infection may also lead to blood vessel constriction. Reports are emerging of ischemia in the fingers and toesa reduction in blood flow that can lead to swollen, painful digits and tissue death.

In the lungs, blood vessel constriction might help explain anecdotal reports of a perplexing phenomenon seen in pneumonia caused by COVID-19: Some patients have extremely low blood-oxygen levels and yet are not gasping for breath. In this scenario, oxygen uptake is impeded by constricted blood vessels rather than by clogged alveoli. One theory is that the virus affects the vascular biology and that's why we see these really low oxygen levels, Levitt says.

If COVID-19 targets blood vessels, that could also help explain why patients with pre-existing damage to those vessels, for example from diabetes and high blood pressure, face higher risk of serious disease. Recent Centers for Disease Control and Prevention (CDC) data on hospitalized patients in 14 U.S. states found that about one-third had chronic lung diseasebut nearly as many had diabetes, and fully half had pre-existing high blood pressure.

Mangalmurti says she has been shocked by the fact that we don't have a huge number of asthmatics or patients with other respiratory diseases in her hospital's ICU. It's very striking to us that risk factors seem to be vascular: diabetes, obesity, age, hypertension.

Scientists are struggling to understand exactly what causes the cardiovascular damage. The virus may directly attack the lining of the heart and blood vessels, which, like the nose and alveoli, are rich in ACE2 receptors. By altering the delicate balance of hormones that help regulate blood pressure, the virus might constrict blood vessels going to the lungs. Another possibility is that lack of oxygen, due to the chaos in the lungs, damages blood vessels. Or a cytokine storm could ravage the heart as it does other organs.

We're still at the beginning, Krumholz says. We really don't understand who is vulnerable, why some people are affected so severely, why it comes on so rapidly and why it is so hard [for some] to recover.

THE WORLDWIDE FEARS of ventilator shortages for failing lungs have received plenty of attention. Not so a scramble for another type of equipment: kidney dialysis machines. If these folks are not dying of lung failure, they're dying of renal failure, says neurologist Jennifer Frontera of New York University's Langone Medical Center, which has treated thousands of COVID-19 patients. Her hospital is developing a dialysis protocol with a different kind of machine to support more patients. What she and her colleagues are seeing suggests the virus may target the kidneys, which are abundantly endowed with ACE2 receptors.

According to one preprint, 27% of 85 hospitalized patients in Wuhan had kidney failure. Another preprint reported that 59% of nearly 200 hospitalized COVID-19 patients in China's Hubei and Sichuan provinces had protein in their urine, and 44% had blood; both suggest kidney damage. Those with acute kidney injury were more than five times as likely to die as COVID-19 patients without it, that preprint reported.

The lung is the primary battle zone. But a fraction of the virus possibly attacks the kidney. And as on the real battlefield, if two places are being attacked at the same time, each place gets worse, says co-author Hongbo Jia, a neuroscientist at the Chinese Academy of Sciences's Suzhou Institute of Biomedical Engineering and Technology.

One study identified viral particles in electron micrographs of kidneys from autopsies, suggesting a direct viral attack. But kidney injury may also be collateral damage. Ventilators boost the risk of kidney damage, as do antiviral compounds including remdesivir, which is being deployed experimentally in COVID-19 patients. Cytokine storms can also dramatically reduce blood flow to the kidney, causing often-fatal damage. And pre-existing diseases like diabetes can increase the chances of kidney injury. There is a whole bucket of people who already have some chronic kidney disease who are at higher risk for acute kidney injury, says Suzanne Watnick, chief medical officer at Northwest Kidney Centers.

ANOTHER STRIKING SET of symptoms in COVID-19 patients centers on the brain and nervous system. Frontera says 5% to 10% of coronavirus patients at her hospital have neurological symptoms. But she says that is probably a gross underestimate of the number whose brains are struggling, especially because many are sedated and on ventilators.

Frontera has seen patients with the brain inflammation encephalitis, seizures, and a sympathetic storm, a hyperreaction of the sympathetic nervous system that causes seizurelike symptoms and is most common after a traumatic brain injury. Some people with COVID-19 briefly lose consciousness. Others have strokes. Many report losing their sense of smell and taste. And Frontera and others wonder whether, in some cases, infection depresses the brain stem reflex that senses oxygen starvationanother explanation for anecdotal observations that some patients aren't gasping for air, despite dangerously low blood oxygen levels.

ACE2 receptors are present in the neural cortex and brain stem, says Robert Stevens, an intensive care physician at Johns Hopkins Medicine. And the coronavirus behind the 2003 severe acute respiratory syndrome (SARS) epidemica close cousin of today's culpritwas able to infiltrate neurons and sometimes caused encephalitis. On 3 April, a case study in the International Journal of Infectious Diseases, from a team in Japan, reported traces of new coronavirus in the cerebrospinal fluid of a COVID-19 patient who developed meningitis and encephalitis, suggesting it, too, can penetrate the central nervous system.

But other factors could be damaging the brain. For example, a cytokine storm could cause brain swelling. The blood's exaggerated tendency to clot could trigger strokes. The challenge now is to shift from conjecture to confidence, at a time when staff are focused on saving lives, and even neurologic assessments like inducing the gag reflex or transporting patients for brain scans risk spreading the virus.

Last month, Sherry Chou, a neurologist at the University of Pittsburgh Medical Center, began to organize a worldwide consortium that now includes 50 centers to draw neurological data from care patients already receive. Early goals are simple: Identify the prevalence of neurologic complications in hospitalized patients and document how they fare. Longer term, Chou and her colleagues hope to gather scans and data from lab tests to better understand the virus' impact on the nervous system, including the brain.

No one knows when or how the virus might penetrate the brain. But Chou speculates about a possible invasion route: through the nose, then upward and through the olfactory bulbexplaining reports of a loss of smellwhich connects to the brain. It's a nice sounding theory, she says. We really have to go and prove that.

A 58-year-old woman with COVID-19 developed encephalitis, with tissue damage in the brain (arrows).

Most neurological symptoms are reported from colleague to colleague by word of mouth, Chou adds. I don't think anybody, and certainly not me, can say we're experts.

IN EARLY MARCH, a 71-year-old Michigan woman returned from a Nile River cruise with bloody diarrhea, vomiting, and abdominal pain. Initially doctors suspected she had a common stomach bug, such as Salmonella. But after she developed a cough, doctors took a nasal swab and found her positive for the novel coronavirus. A stool sample positive for viral RNA, as well as signs of colon injury seen in an endoscopy, pointed to a gastrointestinal (GI) infection with the coronavirus, according to a paper posted online in The American Journal of Gastroenterology (AJG).

Her case adds to a growing body of evidence suggesting the new coronavirus, like its cousin SARS, can infect the lining of the lower digestive tract, where ACE2 receptors are abundant. Viral RNA has been found in as many as 53% of sampled patients' stool samples. And in a paper in press at Gastroenterology, a Chinese team reported finding the virus' protein shell in gastric, duodenal, and rectal cells in biopsies from a COVID-19 patient. I think it probably does replicate in the gastrointestinal tract, says Mary Estes, a virologist at Baylor College of Medicine.

Recent reports suggest up to half of patients, averaging about 20% across studies, experience diarrhea, says Brennan Spiegel of Cedars-Sinai Medical Center in Los Angeles, coeditor-in-chief of AJG. GI symptoms aren't on CDC's list of COVID-19 symptoms, which could cause some COVID-19 cases to go undetected, Spiegel and others say. If you mainly have fever and diarrhea, you won't be tested for COVID, says Douglas Corley of Kaiser Permanente, Northern California, co-editor of Gastroenterology.

The presence of virus in the GI tract raises the unsettling possibility that it could be passed on through feces. But it's not yet clear whether stool contains intact, infectious virus, or only RNA and proteins. To date, We have no evidence that fecal transmission is important, says coronavirus expert Stanley Perlman of the University of Iowa. CDC says that, based on experiences with SARS and with the coronavirus that causes Middle East respiratory syndrome, the risk from fecal transmission is probably low.

The intestines are not the end of the disease's march through the body. For example, up to one-third of hospitalized patients develop conjunctivitispink, watery eyesalthough it's not clear that the virus directly invades the eye.

Other reports suggest liver damage: More than half of COVID-19 patients hospitalized in two Chinese centers had elevated levels of enzymes indicating injury to the liver or bile ducts. But several experts told Science that direct viral invasion isn't likely the culprit. They say other events in a failing body, like drugs or an immune system in overdrive, are more likely causes of the liver damage.

This map of the devastation that COVID-19 can inflict on the body is still just a sketch. It will take years of painstaking research to sharpen the picture of its reach, and the cascade of effects in the body's complex and interconnected systems that it might set in motion. As science races ahead, from probing tissues under microscopes to testing drugs on patients, the hope is for treatments more wily than the virus that has stopped the world in its tracks.

Excerpt from:
A rampage through the body - Science Magazine

Recommendation and review posted by Bethany Smith

Doctors are hoping stem cell therapy could be a weapon in the fight against coronavirus. On Friday, regenerative medicine company Mesoblast announced a 300-person trial to determine whether stem cell treatments will work in COVID-19 patients suffering from severe lung inflammation.

One hospital in New York tried it as an experiment with 12 patients, 10 of whom were able to come off of ventilators.

"What we saw in the very first patient was that within four hours of getting the cells, a lot of her parameters started to get better," Dr. Karen Osman, who led the team at Mount Sinai, told CBS News' Adriana Diaz.

The doctor said she was encouraged by the results, though she was hesitant to link the stem cell procedure to her patients' recovery.

"We don't know" if the 10 people removed from ventilators would not have gotten had they not gotten the stem cells, she said. "And we would never dare to claim that it was related to the cells."

She explained that only a "randomized controlled trial" would be the only way "to make a true comparison."

Luis Naranjo, a 60-year-old COVID-19 survivor, was one of Mount Sinai's stem cell trial success stories. He told Diaz in Spanish that he was feeling "much better."

Naranjo's daughter, Paola, brought him to the emergency room, fearful she would not see her father again. Like so many families struck by the coronavirus, she was not allowed inside with him.

"I forgot to tell him that I love him," she said. "All I said was go inside, I hope you feel better."

During his hospital stay, Naranjo was unconscious and on a ventilator for 14 days.

Doctors proposed giving him stem cells from bone marrow in hopes it would suppress the severe lung inflammation caused by the virus.

Now, Naranjo credits the doctors who treated him for his survival. Though income from his family's jewelry business has been cut off and they found themselves falling behind on rent, Naranjo said he is focused primarily on his recovery and regaining the 25 pounds he lost at the hospital.

Although stem cell treatment, usually reserved for other diseases like rheumatoid arthritis, might end up being another step toward helping coronavirus patients recover, Dr. Osman was quick to say it would not be a "miracle treatment."

"The miracle treatment will be a vaccine," she said.

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Coronavirus Doctors experiment with stem cell therapy on COVID-19 patients CBS News 9:39 AM - KTVQ Billings News

Recommendation and review posted by Bethany Smith

I dont know why people pay attention only to vaccines and treatments against the new coronavirus. Stem cell therapies are more useful to treat Covid-19.

So claimed Lee Hee-young, president of the Korean Association of Stemcell Therapy, at a news conference in Seoul, Monday. He called for active use of stem cell therapies to treat Covid-19 patients.

Several studies have proved the effects of autologous stem cells in treating acute respiratory distress syndrome (ARDS), which is the leading cause of death in Covid-19 patients, Lee said. The concept of stem cell therapy is the same as that of blood transfusion or bone marrow transplantation. Decades of cell therapies have proved that stem cell therapy is safe.

While the development of a treatment or a vaccine against Covid-19 takes a long time and it may not be able to treat patients immediately because of virus mutation possibilities, stem cell therapies can restore damaged lungs directly, Lee claimed.

It is more important to restore damaged lungs than to fight the virus. Stem cell therapy restores the lungs, giving patients time to beat the virus, he went on to say. However, people are paying attention to vaccine or treatment candidates only. This is why I am holding a news conference.

Lee pointed out that the local environment makes it difficult to use stem cell therapies. Thus, the government should ease regulations on the management and use of cell culture facilities so that doctors can perform stem cell therapies with simple cell culture, he said.

As long as physicians have a positive pressure facility and a culture kit, they can separate and culture cells with simple training, he said. If the authorities allow doctors to perform stem cell therapies with a disposable mobile culture autonomously, the cost of stem cell therapies will go down significantly.

Lee added that he asked related officials to include such rules in the Act on Safety and Support for Advanced Regenerative Medicine and Advanced Biopharmaceuticals, which is to take effect in the second half of the year.

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In some patients, COVID-19 has triggered a cytokine storm, an immune system response in which the body attacks its own cells. Jung painted a picture of a boxing match in which "fighter" immune cells are being called upon to battle the virus. This battle generates lots of fluid, waste and pus, making it difficult for the alveoli to pick up the oxygen a person breathes in, leading to multi-organ failure.

"These immune cells, neutrophils and other fighter immune cells, are like that. They don't care if it's a virus or our own cells. If you're infected, they're all enemies," Jung said. "So what they're going to do is they're going to start to kill everybody, basically."

Why exactly some people's immune systems go into overdrive, Jung said, is unknown, but he said it can happen to anybody.

"If we are up to the level where we can fight well without going into a coma or anything, then 14 days later, our body can provide an antibody," Jung said. "An antibody will neutralize this virus very quietly."

Strengthening the immune system

Eating certain foods can help keep your immune cells strong. Jung said vegetables, for example, stimulate the circulation of blood cells from bone marrow.

"Those bioactive reagents can support our immune systems by sending them the appropriate amount of stem cells, just in case some tissue cells are damaged and we need to replenish them. For example, if your lung cell has been damaged and they need to be replaced, that could be done by the stem cell that has been moved from the bone marrow and located around the lung area," said Jung, who encourages eating a variety of different colored vegetables.

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BCU biology professor offers tips to prevent COVID-19 infection - Sioux City Journal

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According to some of the more dramatic pandemic predictions, as many as 150 million Americans will come down with COVID-19 before a vaccine becomes widely available. While avoiding it altogether is the ideal scenario, as the virus continues to spread, for many, infection is inevitable.

Given that unfortunate reality, building up a personal defense system against an invisible enemy is paramount, according to the experts.

In March, Banner Health published a blog post: How You Can Boost Your Immune System, with the message: A strong immune system is the ultimate defense against illness, whether its COVID-19, seasonal flu, or something else. The posts advice is largely mundane: Get eight hours of sleep, eat nutritious foods, exercise, hydrate, and do what you can to reduce stress in an incredibly stressful time.

Most people understand that adopting healthier habits is a good idea, but can these habits really boost your immune system so that a coronavirus infection looks more like, say, a common cold? Jessica Lancaster, an immunologist researcher at the Mayo Clinic, thinks its a distinct possibility.

If you had two people with the same virus exposure and very similar genetic makeup, Lancaster said, and if one had been better overall sleeping, eating well, and exercising that person would most likely be much better off than the person who is not caring for themselves as well.

The microscopic novel coronavirus typically enters the body through the nose, she said. From there, it begins a deliberate and dangerous process of multiplying and penetrating deeper down the respiratory tract and into the bloodstream. A spry immune system bolstered by exercise, healthy food, and plenty of sleep will harass the virus before it wreaks the kind of havoc that requires hospitalization, ICU admission, or a ventilator.

Essentially, the immune system is a collection of cells, surveilling our body for unwelcome visitors: viruses, bacteria, various toxins, and cancer. When something isnt right, alarm bells go off and the immune system springs into action to make things right.

Jessica Lancaster, immunologist at the Mayo Clinic

YouTube/Mayo Clinic

Our immune systems ability to react to alarm bells and fight off foreign intruders depends on a multitude of factors. Among them are our age, where we live, what we do for work, and three biggies: good sleep, low stress, and healthy eating. These things have a profound effect on two major contributors to our immune systems sharpness: chronic inflammation and cortisol levels.

In the case of COVID-19, the virus hijacks lung cells and eventually damages them to where they become inflamed. But when there is chronic inflammation in people, such as those with preexisting conditions like heart disease or lung disease, the immune cells are worn out or lulled to sleep.

In these cases, Lancaster said, [immune cells] are kind of used to hearing these signals over and over again. When they have to actually respond to something, they're already exhausted.

For example, if you are regularly exposed to toxic chemicals that cause inflammation, like cigarette smoke, you can have a boy that cried wolf situation, where the body gets jaded to these constant warning signs of trouble and is slower to respond.

For someone with COVID-19, any kind of delayed immune response can be catastrophic.

When you have something that is quite aggressive like coronavirus, which can strike really quickly if you have a lagging immune response, that can be devastating because by the time everything is mobilized, its too late. There's too much damage to the lungs, Lancaster said.

One simple way to avoid inflammation is to avoid overeating. If you eat too many calories, it can be hard for your body to regulate its blood sugar. And that leads to inflammation, Lancaster said, adding that this kind of blood sugar-induced inflammation tends to affect the kidneys, liver, and pancreas.

When it comes to supplements, Lancaster is ambivalent. But she admitted that when she gets sick herself, she takes zinc lozenges. She cited some inconclusive evidence that Vitamin C may have some antiviral properties or may be simply reducing inflammation across the body.

Cortisol is another of the bodys loud alarm bells. It is our primary stress hormone, and according to Lancaster, it can cause drastic changes to the way that your cells can function on a genetic level. A burst of cortisol here or there can help you spring into action to avoid a threat, but too much, too often can leave your body stuck in an uncomfortable, unhealthy kind of overdrive.

Lab research shows that immune cells can't fight viruses as well when they are injected with cortisol. In 2018, researchers at the University of Kent found cortisol levels to be a critical factor at play in leukemia cases, showing that the stress hormone hinders the immune systems ability to incapacitate intruders before they really get destructive.

Reading, meditating, and especially exercising may lower cortisol levels in people.

Exercising has the added benefit of helping you get your eight hours of sleep, all of which helps reduce inflammation and regulate stress hormones.Last week, a cardiovascular researcher at the University of Virginia released findings suggesting that an antioxidant that is naturally released during exercise can significantly reduce the risk of suffering fromacute respiratory distress syndrome, a severe problem that occurs in 20 to 42 percent of hospitalized COVID-19 patients. Exercise, the research found, boosts production of an antioxidant known as extracellular superoxide dismutase, or EcSOD, which "hunts" atomic free radicals that can harm the body's cells.

Beth Jacobs

University of Arizona

"We cannot live in isolation forever, said Zhen Yan of the University of Virginia School of Medicine in an April 15 University of Virginia news release. "Regular exercise has far more health benefits than we know. The protection against this severe respiratory disease condition is just one of the many examples.

Beth Jacobs, a nutritional epidemiologist at the University of Arizona, is wary about making any promises about how any type of immune boosting can influence ones chances of coming down with a bad case of the virus.

"We know essentially nothing about COVID19 yet," she said in a recent interview.

In lieu of more specific knowledge about the virus, she echoes Lancasters sentiments about the importance of healthy habits. When it comes to immunity, she said, it is all about the three interlocked concepts, which are diet, physical activity, and sleep.

Essentially, [sleep] is the time when you're repairing what's happened during the day, Jacobs said. It allows you to heal up to take on the next day.

While science has yet to uncover the inner workings of sleep, Jacob says we can infer its value from its incredible cost. Our ancient ancestors risked being eaten while they laid motionless for hours a day for it, she pointed out.

She urges persistence and patience in developing new, healthy habits, stressing that we are still at the very beginning of the pandemic. Try new recipes and get outside, Jacobs urged.

Use the time to go outside and walk," she said. "And if you've never walked before, just take a 10-minute walk, and then a 15-minute walk next week. Just keep going."

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Boosting the Immune System Really Does Help With COVID-19, Experts Say - Phoenix New Times

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In the United States, across the countries various medical clinics are actively involved in the advertising activities for hormone treatment. Many people believe that hormonal treatment as a source of youth. Medical clinics marketing and selling hormonal treatment as an alternative therapy to make individuals feel and look younger. Though, the further research and investigation of CBS News found that the particular claim regarding hormonal treatment is not right and may be harmful to the patient life.

In 2018, Cindy Kinder-Binge, a woman of 60 years had admitted to a hospital-based in New Albany, Indiana, for the high blood pressure and excess heart rate related issues. She had registered with the four times heart rates, which are very high as compared to the normal one. Prior to this incidence, she had undergone an emergency situation with the palpitations. Cindy Kinder-Binge was treated by a nurse practitioner at 25 Again clinic. In this clinic, she had been prescribed hormone of thyroid for the menopausal symptoms such as hot flashes, irregular periods, night sweats, mood changes, and weight gain and slowed metabolism despite having normal thyroid blood levels. CBS News found that there are many more clinics throughout the country which are prescribing testosterone and thyroid hormones to individuals with standard levels.

According to the Cardiologist, hormonal therapy was the major cause of abnormal heart rates in the case of Cindy Kinder-Binge. Doctor Leighann Decker, who is currently working as an ultrasound technician and previously employed with OB-GYN in Owensboro, Kentucky stated that she had also given prescription of testosteroneto the many patients who had normal level testosterone. She also stated that many medical practitioners are involved in hormonal therapy as there is a huge profit in practice. Some research studies suggest that the adoption of hormonal therapy, such as thyroid and testosterone, may lead to an increased risk of stroke or heart attack.

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Hormone Therapy May Lead To The Heart Rates Abnormalities And Possibilities Of Stroke - TheLoop21

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Accessing NHS fertility treatment involves a tremendous amount of patience at a period in your life when you have least time to spare. It was 14 months after my first tearful appointment with my GP that I lay on an operating table at Manchesters Saint Marys hospital last year, squeezing the anaesthetists hand as he put me under heavy sedation so that a doctor could stick a needle up my vagina to hoover out my eggs. I was 38 and had been told there was a 20% chance IVF would result in me finally becoming a mother.

My clinical commissioning group started a consultation on cutting all funding for fertility treatment

I felt miserable, a failure. Id failed to meet the right man until I was 35 and now my ovaries were failing me too. Coming round from the egg collection, I started blabbering deliriously about a school friend who fell pregnant at 16. We all thought she was nuts to keep the baby. But maybe she had the right idea, I wailed at the nurse, as she handed me a cup of tea and a biscuit.

All of the resulting embryos were frozen so that my body, battered after the hormone injections, could go back to normal. Christmas approached and the clinic began its annual shutdown. More waiting. It wasnt until early March that the doctors allowed me to finally prepare for an embryo transfer and I started taking HRT to override my natural menstrual cycle. It seemed particularly cruel that in order to outsmart my ageing reproductive organs I had to take menopause pills. Still, I thought, it would all be worth it if it worked.

I was supposed to have the transfer the week beginning 23 March. You know what happened next. All fertility treatment was suspended. My embryos would stay in the freezer. For how long? Nobody knows. Ive had a lot of time to brood during lockdown. Sure, being pregnant during a global pandemic wouldnt be much fun, but what if coronavirus takes away my one-in-five shot at motherhood? Where I live, women under 40 are entitled to two NHS-funded IVF cycles (one fewer than recommended by Nice, the national body that advises clinicians). It is not clear whether I will get my second if the clinic does not reopen before I turn 40 next year.

Now I hear Saint Marys the first ever NHS IVF clinic and my local centre may close for ever in April 2021 after hospital bosses said they could not afford a 10m refurbishment. Reproductive medicine is not, it seems, a priority, even when it comes with world-class research in tow. I knew the hospital had seen better days. The day I went for egg collection it had been raining and there were buckets and what looked like incontinence pads catching the drips from the ceiling. Im glad the lift was working that day: I discovered later that for a while staff had had to practise carrying a loaded stretcher downstairs in case they had to evacuate a patient who fell ill under sedation in the weeks before the lift engineer arrived.

It now feels inevitable that IVF will be rationed even further, particularly at a time when the NHS is under so much pressure. Can it afford to help create new life as well as sustain those already in existence? Last year my local clinical commissioning group started a consultation on cutting all funding for fertility treatment, which it said would save almost 700,000 a year. Five other CCGs have already stopped paying for any IVF cycles, according to the Fertility Network. Its a classic postcode lottery: if our house were half a mile away we would get three cycles on the NHS.

The NHS is currently buckling under the strain of coronavirus, and I know Im part of a long line of patients waiting for deferred operations or specialist appointments, many far more urgent than mine. When the worst of the pandemic has passed, a huge backlog awaits not to mention an almighty budgetary black hole, which will surely exacerbate the decline in publicly funded fertility treatment.

I also know that some people may have no sympathy for people like me. We should have procreated at least a decade earlier, maybe even two, like my high-school chum. Having a child is not a human right, particularly on our overpopulated planet.

Perhaps you have your own children, conceived the traditional way. But what if you, like me, were infertile? Would you have sought out NHS treatment to have your precious offspring? Should fertility assistance be yet another luxury available only for the rich? I dont have the answers. I just feel sad.

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Coronavirus has slashed my chances of IVF treatment - The Guardian

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NewsHealthHuman Fertilisation and Embryology Authority has stopped all fertility treatment at NHS and private clinics due to lockdown measures

Thursday, 23rd April 2020, 4:46 pm

Thousands of women are increasingly fearful they will miss their last chance of becoming a mother due to the ongoing shutdown of fertility services across the UK amid the pandemic.

Last week, the Human Fertilisation and Embryology Authority (HFEA) decided to stop NHS and private clinics providing treatment and leaving patients with no idea when their IVF treatment is likely to resume. Women who had already begun a cycle of treatment, which includes being injected with a fertility hormone which increases the number of eggs your ovaries produce, were also told they could not continue.

Those affected say they have been left in limbo. One woman, Sian, who was about to start her second cycle of IVF before it was halted said: "My clinic, although I'm NHS funded, is a private clinic, and they do have the resources and the staff to be able to afford treatments in some cases.

"I do worry if this goes on for longer that it will be too late for me. We have been trying for a baby for a long, long time, and the effect it's having on my mental health, as well as my husband's, is enormous at times. While you do try to keep positive, ultimately I've sacrificed much of my 30s trying to achieve a pregnancy that just hasn't happened.

"I feel especially sorry for those women who have already had their injections because unless you've been through this process, you don't understand the toll fertility treatment has on you."

Unable to guarantee safe service

Sally Cheshire, chair of the HFEA, said one of the reasons why clinics closed was because they could not guarantee a safe service due to NHS staff being moved elsewhere to help with the coronavirus outbreak.

"A lot of equipment in embryology labs is now being used for coronavirus testing as well, so it's a mix of factors," she said. "We have huge sympathy for the thousands of patients who are not able to continue their treatment. In our 30 years of existence this is the most difficult decision the HFEA has had to take."

Exit strategy

The HFEA said in a statement: "We understand what a difficult and emotional time this is for fertility patients with fertility treatment ceasing from 15 April 2020 in line with other NHS and private healthcare.

"Any decision to allow fertility clinics to re-open will consider the views of the UK professional fertility societies and the impact that resuming treatment would have on NHS services. We also need to be assured that clinics are able to provide a safe service to patients and a safe working environment for clinic staff.

"We recognise the distress this closure is causing any patients awaiting fertility treatment and hope that those relying on NHS funding will be allowed to continue their treatment as they expected. We want to reassure patients and clinics that we are actively working on an exit strategy to enable fertility treatment to resume when Government restrictions on social contact and travel are lifted."

Dr Marta Jansa Perez, director of embryology at the British Pregnancy Advisory Service, said: We would advise that patients to contact their local Clinical Commissioning Groups as soon as possible to ask for written confirmation that funding will be maintained for treatment in the future, as we know this is a huge cause of concern for many. Individual IVF services should be able to provide their patients with up-to-date information about their current position, and also professional counselling."

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CNA Staff, Apr 24, 2020 / 12:17 pm MT (CNA).- The president of the Scottish bishops' conference wrote Friday to the Scottish health secretary, saying the permission for women to self-administer both stages of a medical abortion at home during coronavirus is born of ideology rather than true concern for women.

I believe it is profoundly depressing that in the midst of this unprecedented global pandemic when the resources of almost every government on earth are being diverted towards the preservation of life, especially the lives of the weak and vulnerable, the Scottish Government continues to act to end the lives of the weakest and most vulnerable members of society, the unborn, Bishop Hugh Gilbert of Aberdeen wrote April 24 to Jeane Freeman, Scotland's Cabinet Secretary for Health and Sport and a member of the Scottish National Party.

It is more than disheartening that the Scottish Government should see fit to promote abortion at home as though this were a trivial matter equivalent to taking any other medication at home. A position like this appears to be more a matter of ideology than of genuine and dispassionate concern for womens wellbeing, the bishop, a Benedictine, wrote.

The Scottish government has lifted restrictions on at-home medical abortions during coronavirus.

A medical abortion is a two-step process that involves the ingestion of mifepristone and misoprostol. Mifepristone blocks the effects of the progesterone hormone, inducing a miscarriage. Misoprostol is taken up to two days later, and induces labor.

Women in Scotland have been able to self-administer misoprostol in their homes since 2018. However, until recently, they had to take mifepristone at a clinic.

The medications will be delivered by mail.

Because of coronavirus-related lockdowns, the Scottish government has allowed at-home self-administration of mifepristone as well, following a phone or video consultation with a doctor.

A similar permission was made in England last month, and Sinn Fin's leader in Northern Ireland has pressed for a similar change in that region.

Bishop Gilbert said he found the Scottish government's decision deeply troubling.

He said that while mifepristone and misoprostol not only end the life of an unborn child, they are also a risk to the health of its mother, noting that even in the best of circumstances administration at a clinic with several hours of clinical observation there is a real risk of severe bleeding and sepsis in a small number, and a need for further surgery in a larger proportion, depending on the stage of the pregnancy.

The bishop added that vulnerable women in unsatisfactory domestic circumstances are particularly at risk.

He asked whether, under the new policy, women are receiving information on all available options including details of organisations which can offer support to both the mother and the baby, if enough time is given to counselling during the consultation, and is it appropriate for drugs which end the life of a human being to be sent by post, trivialising what is an extremely serious and life-changing procedure.

Aside from the Scottish Bishops Conferences absolute opposition to abortion, there are also serious practical concerns involved here, he said. The decision to allow women to take potent abortifacient medications in a largely unsupervised manner at home is not only fatal for the innocent human beings in the womb but also constitutes a real risk to womens present and longer term health and wellbeing.

Bishop Gilbert added that it is of particular concern that there is no way of establishing that a woman is not being coerced into an abortion in the context of a poorly safeguarded online consultation.

In the current situation, there is already an increase in complaints about domestic abuse since the Coronavirus restrictions were put in place. It is far from clear how the Scottish Government proposes to set in place the prudent support procedures which permit all the relevant factors in each individual case privately and without coercion.

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This article originally appeared on VICE Spain.

When I mentioned on Instagram that I've been having the weirdest dreams during quarantine, dozens of people replied telling me about their own dreams. I won't recount them here, because it's a universal truth that it's extremely boring to hear about other people's dreams.

But the fact is, my unscientific research revealed I'm certainly not alone in having more intense dreams during the pandemic or at least remembering them more. People said their dreams had been more disturbing, and often with highly unsubtle coronavirus symbolism: if we're not dreaming of empty supermarket shelves, we're fighting in the trenches. It appears our subconscious doesn't agree that war is a bad analogy for the pandemic.

Symbolism or not, the best thing about dreams is that they can't be completely explained. "Scientifically, dreams have always had, and still have, a certain essence of mystery surrounding them," said psychologist and private practitioner Francisco Lpez Cnovas, explaining that psychologists approach dreams like "detectives approach a crime".

"Doctors are interested in whether or not a patient has nightmares, because it can indicate that someone has suffered an experience that was difficult to take in psychologically," he said. "Sleep tends to be an activity that 'compensates' or reflects our psyche throughout the day."

A simple example would be that if we go to bed hungry, we could dream we're in a restaurant waiting for a great meal. During a pandemic we might dream of the various fears our subconscious is busy suppressing during the day.

Clinical psychologist Juan Antonio Membrive, who recently published a Twitter thread about why we've been having weird dreams during the pandemic, argued there is only so much we can know about what's happening in our subconscious but he did have a few theories.

Depressingly, Membrive basically said we're remembering more of our dreams because they're all we've got at the moment. "Throughout the day, when we have experiences that are meaningful or out of the ordinary, they function as 'markers' in our memory," he wrote. "We pay more attention to these events. During confinement, we have fewer experiences throughout the day, so it's easy for our dreams to stand out."

His second hypothesis concerned our attention and mood. "Dysphoric mood (or discomfort) and low stimulation are two conditions that increase your self-focus (focus on yourself and your own psychological reactions)," he said. "So we know that an altered mood can cause us to have more dreams and, above all, dreams with a greater emotional charge. Among them, nightmares."

Lpez Cnovas said the subject of our dreams was less to do with external events that happen to us, and more to do with our internal thoughts during the day. "To make dreams, the brain can start with events and real people, but we also find that it can create unknown images. Therefore, both children and adults can end up having a dream about something that they have never seen or lived through."

But how to interpret them? "In The Interpretation of Dreams, Freud explained that in his experience a dream is usually a hallucinatory realisation of more or less conscious wishes of the dreamer," said Lpez Cnovas.

As for dreams about conflict, threats and war, Membrive said, "The content of our dreams usually refers to aspects related to survival, such as threats to our integrity and our own health or other related themes such as aggression." He thinks our memories are more likely to grab onto these subjects in the current climate.

So if we can understand the mechanisms behind our dreams to some extent, can we control them? The simple answer is no. "There are people who naturally experience the ability of 'choosing' what to dream about or what to do within a dream. But even for these people, sleep is a largely autonomous process," explained Membrive. "You can train yourself in lucid dreaming. It's been used to treat chronic nightmares, with good results in some cases."

One technique is known as systematic desensitisation. "Basically, we repeat the problematic dream in our imagination while we are awake, but with a different ending or while trying to relax, as an alternative behaviour to the anxiety-inducing, threatening nature of the dream," Membrive explained. This technique is often used when a patient's nightmares get so bad they interfere with everyday life.

What we can do to try to prevent quarantine nightmares is keep our sleep patterns healthy, said clinical neurophysiologist Javier Albares, a specialist in sleep medicine from the Teknon Clinic of Barcelona. Our sleep patterns work to a circadian rhythm, which self-isolation can mess with. "Our internal clocks need three external synchronisers: light and dark, food and physical activity. Three factors that are very easy to lose in quarantine." He cited social relations as a fourth factor something that's currently especially hard to maintain.

But there are small things we can do. "Opening the curtains and blinds as soon as we get up tells our body that it's daytime, and gets us activated," said Albares. "The sooner you get some light, the sooner you'll be tired. The same goes for darkness: two or three hours before sleeping, we should start telling our bodies that it's night, so that we secrete the sleep hormone melatonin."

Maintaining some semblance of an eating routine, even if that means routinely eating cereal in bed, will help to "mark the rest of the routines in our day", he explained, while physical activity also aids sleep. Lastly, he recommended we put ourselves on an "information diet" regulating the time we spend scrolling constant news updates and trying some meditation or mindfulness instead.

But if none of the above works and your dreams still feel like a Tarantino remake of Apocalypse Now, maybe it's time to start a dream journal. Just remember: the excitement you feel when retelling a dream is directly proportional to the torture experienced by the person forced to listen.

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This Is Why You're Having Such Wild Quarantine Dreams - VICE

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If your motivation to exercise and eat right has flatlined, youre not alone.

Falling out of routine is a normal reaction to change at the best of times, and were certainly in unique times. Having more time to forage through the pantry or refrigerator while binge-watching the news is wreaking havoc on fitness plans and waistlines everywhere.

Hey, if youve got time right now, use it to do productive things such as exercise. If youre trying to survive financially, balance work with taking care of kids and keep the house in order, its OK to cut yourself some slack.

You decide what you can commit to. If fitness helps maintain your sanity, like it does for me, keep making it a priority, but dont stress if you cant. Fitness is not a race and your goals can wait. Trust me, most of us, even fitness professionals, are sucking wind right now. Theres been a lot of change, added stress, and uncertainty.

However, if youre eating recklessly and not getting any form of exercise in, youre probably making things worse. Try to do your best to create an environment that minimizes the damage, and thats what this article is all about.

First off, its awfully tough to gain pounds of actual body fat over the span of a couple weeks.

What your body cannot process for storage, it tries to burn (your temperature rises) and excrete (you end going to the bathroom a bit more in the following 12 to 24 hours).

The only way you couldve gained an actual pound of fat overnight is if you ate something like five fast food burgers in excess of your BMR (the baseline calories needed to maintain your weight).

So you probably didnt eat 5,000-plus calories in one sitting, am I right? Yes, your scale weight will be up a lot. The excess stomach content and water weight will drastically skew the number for a day or two. Its temporary if you cut yourself some slack and use the tips in this article to help guide you forward.

Junk Food Cravings Explained

First, though, what is it about chocolate, pizza and sweets that make it so hard to stop at "just one"? You know these foods arent good for you in excess, so why do you indulge? Is it the forbidden fruit mentality? You want what you cant have?

For starters, your brain loves junk food. They are energy-dense (i.e. high in calories). Good news if youre a hunter-gatherer and nutrients are scarce, but bad news nowadays with endless food at your fingertips.

Your brain releases dopamine when your mouth and small intestine detect the base materials in sugar, fat, and protein. The more concentrated the nutrients, as in junk food, the greater the surge in dopamine and the more immediate your craving. Essentially, your brain is doing its job by encouraging you to pursue calorie-dense foods, but your brain chemistry simply wasnt built for the world you live in today.

You need simply take a passing glance at that timely pizza promotion in your mail and crave it because the sensory cues are so innate. Then, with a few clicks on your smartphone, that cheesy delight arrives at your doorstep.

Other factors that exasperate cravings can be brought on by high stress and poor sleep.

Inadequate sleep decreases levels of leptin, the hormone that signals satiation, and increases levels of the hunger-signalling hormone ghrelin. A joint study by the National Institutes of Health, the Minnesota Obesity Center, and the Mayo Clinic showed that when the test subjects were sleep-deprived, they ate an extra 549 calories per day.

Similar problems are encountered when the stress hormone, cortisol, is chronically elevated.

Tiredness, of course, also affects motivation and leads to missed workouts, lower activity levels overall and poor food choices.

Overcoming Social Norms

Our society associates eating with leisure, however you may be spending more time on the couch. Which leads to watching more Netflix, which can lead to more grazing.

These are powerful social cues to overcome, but itll take replacing old habits with new, healthy ones to buck those trends. Start by eating a filling, healthy dinner so you arent so tempted to snack at night. Try to do some form of exercise before settling into your TV routine. Keep it simple and short to start with and build up from there.

Set up Your Environment

Now, heres a quick checklist to survive the remaining time in isolation with your health and waistline intact.

If its not immediately in your environment, youre probably not going to eat it: So keep it out. Yes, you may need to stock up on snacks for the kids, but limit exposure to your kryptonite foods.

If it has to be in the house, put up "walls" in front of it. Keep the junk food in less visible and less convenient locations. For example, if you need it in the house for your kids, keep ice cream in the downstairs freezer and hide it under a stash of frozen vegetables if necessary.

On the opposite end of the spectrum, take down the "walls" in front of making healthy food choices. For example, keep a fruit bowl out on the counter, not a bowl of candies. Keep refrigerated vegetables on the front and middle shelves of your refrigerator, and keep more "off plan" refrigerated items near the back (or perhaps in the drawers).

Keep to a schedule of planned dinners you prepare and food prep some lunch essentials ahead of time, particularly proteins and starchy carbs, which cant really be figured out on the fly.

Dont buy super-sized portions you might binge on only indulge in controlled amounts.

If you live with others who bring junk food home, get their support by at least getting them to agree to hide it in a place only they will know to find it.

Prepare your meals as you normally would for your job and have them ready in the fridge, eating meals on the same schedule.

Eat more whole, fresh, minimally processed foods with a balance of macronutrients, protein, carbs and fats so you arent "shortchanging" your brain from much-needed nutrients (i.e. limit cravings)

Eat slowly and mindfully. No matter what you eat, slowing down will help your digestive system do its job and also help your brain get the signal from your gut that its full.

The best kept secret is not to depend on willpower but to have an alternative option at the ready that meets your goals. Find your go-to healthy meal or snack options and make sure theyre staring at you when you open the fridge or pantry or are offered something youre trying to avoid. Hey, if you slip up, dont see fitness so black and white. A few slices of pizza arent going to ruin your progress if you see it that way.

Mitch Calvert is a Winnipeg-based weight loss coach who regularly contributes to Mens Health and has helped over 1,100 people realize their fitness goals. Visit mitchcalvert.com to grab yourself a free diet secrets checklist to get started.

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Food, fitness and the virus - Winnipeg Free Press

Recommendation and review posted by Bethany Smith

This week, reports emerged that former baseball player Alex Rodriguez and his fiance Jennifer Lopez are eyeing a bid to buy the Major Leagues Baseball (MLB) team, New York Mets. However, with Rodriguez's extensive history with using performance-enhancing drugs, should such a sale be allowed?

In an earlier report, we had written that Rodriguez had opened up to 'The Tonight Show' host Jimmy Fallon about his inclination towards launching a future bid for the Mets and also confessed how he grew up a Mets fan before winning a world series with the Yankees. "I will say this, if the opportunity came up (to buy the Mets), I would certainly look at it," he told Fallon. He also went on to say how the 1986 championship-clinching game was one the best nights of his life after the birth of his daughters.

While Rodriguez now has a thriving career as a baseball analyst, commentator and host and enjoys the limelight coming from being engaged to actor, dancer and singer Jennifer Lopez it is difficult to erase his baseball career. Even though he was once dubbed the greatest baseball player of his generation, his achievements were marred by cheating scandals.

His playing career had resulted in one World Series title, three MVP awards, 14 All-Star appearances, 696 home runs and earnings of $452M the most in the history of Major League Baseball.

The Biogenesis scandal, which resulted in Rodriguez's suspension, broke out in 2013 and was the biggest baseball performance-enhancing drugs (PED) scandal, but Rodriguez had been caught using performance-enhancing drugs much before that.

In July 2007, former outfielder and steroid-user Jose Canseco called Rodriguez a "hypocrite" and alleged that the latter was using steroids something Rodriguez vehemently denied.

In 2009, Sports Illustrated reported that Rodriguez had tested positive for two anabolic steroids, testosterone and Primobolan, during his 2003 season playing for the Texas Rangers. This was the same season in which he captured his first American League Most Valuable Player award, broke 300 career home runs (hitting 47 that year) and earned one of his 10 Silver Slugger Awards.

The same year, Rodriguez told ESPN that he had used PEDs when he first started out, stating, "When I arrived in Texas in 2001, I felt an enormous amount of pressure. I felt like I had all the weight of the world on top of me and I needed to perform, and perform at a high level every day."

In 2003, as the result of a collectively bargained union agreement, there was no penalty or punishment for a positive test during an anonymous drug survey and mandatory drug testing only began in 2004 after more than 5% of the samples taken from players in 2003 came back positive. In 2013, the New York Times alleged that Rodriguez tested positive for a banned stimulant in 2006.

It was the Biogenesis scandal that broke out the same year that catapulted the MLB, Rodriguez and other players of note to infamy. A disgruntled former employee of Biogenesis in America a health clinic briefly operating in Coral Gables, Florida, specializing in weight loss and hormone replacement therapy released records of the clinic's real business. These records showed that players such as Rodriguez, Melky Cabrera, Bartolo Coln, Ryan Braun and Nelson Cruz were getting access to PEDs, thanks to an unlicensed doctor.

Over the next two months, MLB suspended 14 players. Meanwhile, penalties for getting caught increased. First-time offenses went from 50 to 80 games, while second-time offenses went from 100 games to an entire season. Any offender caught doping is now ineligible for that year's playoffs, no matter when the infraction occurs.

For a long time, Rodriguez insisted he was innocent and even alleged that the MLB engaged in a "witch hunt" to get him out of baseball when he sued the league in 2013. Rodriguez and his team voluntarily dropped the suit in February 2014.

In 2019, Billy Corben's documentary on the scandal titled 'Screwball' released and oddly, news of Rodriguez's engagement to Lopez broke a day after the trailer for the documentary released. In an interview with Rolling Stone, Corben described the scandal as Florida f**kery distilled like freebasing Florida f**kery and crony capitalism".

Although Rodriguez has since apologized for his role in the Biogenesis scandal, Corben was suspicious of Rodriguez's image rehab. Corben told Rolling Stone, "This is the guy who was never beloved. He was booed by his own fans, for crying out loud. Without so much as a mea culpa tour, he hasnt rehabilitated his image, hes created an entirely new one that never existed before."

In August 2013, Rodriguez was suspended through the 2014 season (211 games at the time of the decision), but was allowed to play in 2013 pending his appeal of that decision. His suspension was upheld in January 2014 after being allowed to play in the 49 games between the decision and the hearing, technically reducing the suspension to 162 games. In July 2014, Rodriguez was sued by his lawyers for $380,000 in unpaid legal fees.

In November that year, it was revealed that Rodriguez had admitted to the Drug Enforcement Administration that he had used performance-enhancing drugs as early as January of the same year and Rodriguez got immunity from prosecution.

Many have also called into question MLB's handling of the Biogenesis scandal, suggesting that the MLB's actions were motivated to save face rather than to take serious action on the use of PEDs among players.

Given Rodriguez's lengthy history of association with PEDs, it stands to question whether the one-time-great baseball player ought to be given the power of owning an entire baseball team and whether the MLB would even allow it.

However, with Rodriguez's new image and with Lopez's name included in the deal, it stands to reason that the MLB would be okay with Rodriguez being one of the owners of the New York Mets, even if that may leave baseball lovers with a sour taste in their mouths.

As 'Screwball' filmmaker Corben said on the Biogenesis scandal, "When Alex was useful as a heel, he was the villain. When Bud Selig needed to salvage his own reputation as the steroid commissioner and was trying some kind of redemption and legacy-saving measures, Alex was the villain. And now that Bud Seligs gone, (current commissioner) Rob Manfred, who was responsible for this entirely botched, potentially illegal investigation of Biogenesis, ascends (within MLB) into a position of power and decides, "Oh, Alex is an ally." They let bygones be bygones now? Like after the s**tshow that they put each other through? It certainly goes to show how not legitimate MLBs concerns are about steroids and shooting up in baseball, because its obviously good for business."

Link:
Given Alex Rodriguez's history with doping scandals, should he be allowed to own New York Mets? - MEAWW

Recommendation and review posted by Bethany Smith

Following the announcement of the UK lockdown in March, we have all had no choice but to quickly adapt to a different way of living in order to ensure the safety of ourselves and others.

Our daily routines have been completely altered, many of our plans postponed or cancelled, and we have been unable to meet relatives and friends who we may ordinarily have seen on a regular basis. It has been tough for everyone. Unfortunately, the situation is especially difficult for the younger members of our community who are in lockdown with unsupportive families.

Research by LGBTQ youth charity, Just Like Us, suggests that LGBTQ young people may struggle more at home than cis straight young people, as they are more likely to initially confide in friends rather than a family member; the reverse is true for their non LGBTQ peers.

For so many closeted young people including some Just Like Us volunteer ambassadors moving out of home for college, university or work is an opportunity to come out and build a support network. Meeting other LGBTQ young people and moving away from home has been a life-changing experience for many of us, who kept our identities hidden from our families for many years.

The closure of universities, colleges and workplaces means that many LGBTQ young people are now separated from their chosen friends and family, and are having to re-enter unsupportive households. My co-ambassador Nicole said, Having to go from being out and living on my own, then back to being closeted in a homophobic household, has hit hard.

Anna, another ambassador, whose family is Catholic, says, I came out to my family last year after I began my second year at uni and started dating a girl. I knew they wouldnt take it well initially, but thought they would at least be able to process what Id told them by the time I came home. Now Im back home [early] they barely speak to me and when they do, they criticise me for my sinful lifestyle Being back at home with my family has definitely taken its toll on my mental health.

Our trans ambassadors face additional problems. Joel says, Im really lucky to be isolating with people who are very trans friendly and affirming, but its medical stuff thats my concern. Its causing a lot of worries around my transition. Ive recently changed from getting my Hormone Replacement Therapy (HRT) injections to gel. Im due a blood test in two weeks, but my GP isnt doing any face to face appointments so I cant have one, and if I cant have my bloods okayed at safe levels on the new HRT, my endocrinologist will probably stop it until we can prove my liver is coping.

There are other trans folk who are in similar boats. My friend has missed one injection, as he has a condition meaning he cant self-inject, and the nurse wont make an appointment to inject him at this time. Others have had their gender affirming surgeries cancelled. Theres also the fact that Gender Identity Clinics are all closed right now, so the already ridiculous wait times (currently around 26 months from referral to first appointment and 20 months between appointments for the Newcastle clinic) are only going to be longer when all this is over.

At Just Like Us, we work with LGBTQ young people in schools, many of whom are not yet out to their friends and relatives. Now that schools are closed, these kids are with their families 24/7, and if they have not yet had the chance to build a support network, this could be incredibly isolating. Many will be suppressing their identities due to the fear of being rejected by their families, and with most currently entirely dependent on their families, akt (Albert Kennedy Trust), the LGBTQ youth homelessness charity, has advised LGBTQ young people not to come out to family during the lockdown, because of the consequences of a potential negative response. In addition, the possibility that university and college courses may commence online in September will come as a huge disappointment for those who are hoping to move away from unsupportive households.

But despite this, were coming together to support one another during these difficult times, and our LGBTQ young adults are finding great ways to support themselves and one another. As an example, the Just Like Us ambassadors have set up a WhatsApp group aimed at sharing (both LGBTQ related and more general) quarantine tips, including recipes, craft ideas and self-care advice. I think we may have also broken the world record for the number of pet photos shared in one group chat, and I am completely living for it. Ive learned so much from hearing about how other ambassadors are looking after themselves during this time.

Im looking after myself by trying new hobbies, connecting with friends and not beating myself up about everything, says Sophie. Ive found that making lists with friends of stuff you guys want to do once were out of lockdown has really given me some perspective on whats important.

Just Like Us have also launched a new social media campaign, #JLUatHome, in order to support young LGBTQ people during lockdown. The campaign has consisted of a range of content so far, including messages of support to isolated LGBTQ young people, film and book recommendations, as well as the opportunity to ask Just Like Us ambassadors questions. Through this period, we are really seeing the benefits of being part of an LGBTQ community that is still connected from afar.

If you are a LGBTQ young person, we would love you to join us by listening to our latest podcast episode, which you can listen to here. This month, ambassadors Isaac, Elly and Arber will discuss more in depth what its like being LGBTQ at home. If youre an LGBTQ teenager in the UK, we also want to welcome you into our digital ambassador team which is another way to be part of this incredible community.

Finally, if youre reading this article and want to help us to help LGBTQ young people during this difficult time, you can also make a donation to Just Like Us, but only if you are in a position to do so. You can make a gift here. Thank you!

Related: Volunteering for Just Like Us gave me confidence in my identity as a young, gay, mixed race Muslim.

Related: The invisible have voices too listen to trans youth.

Read the rest here:
School is out. Many young people are not - the impact of lockdown on LGBTQ youth - Gay Times Magazine

Recommendation and review posted by Bethany Smith

According to a national study conducted by The Williams Institute in Jan. 2017, West Virginia had the highest population of teens, ages 13 to 17, who identified as transgender, but according to data recently collected by Fairness West Virginia, 70 percent of transgender West Virginians said they have delayed accessing healthcare due to fear of discrimination. Following the collection of this data, Fairness West Virginia sought out to improve the livelihood of trans West Virginians by improving LGBTQ+ education in the states healthcare system.

Despite facing obstacles during the beginning of her transition, Natasha Stone, the transgender visibility coordinator for Fairness West Virginia, a statewide civil rights advocacy organization dedicated to the equal treatment of LGBTQ West Virginians, was able to find her way to medical resources, even if it meant chipping in while creating those resources.

As discussions related to transgender individuals begin to grow throughout the state, providing the community an attempt to become normalized, resources related to trans care are also beginning to grow throughout the nation. In West Virginia this process has been slow, providing limited opportunities for trans care.

While the state historically has been bombarded with various health issues over the past decades, the condition of West Virginias transgender health care system, or the lack thereof, may be one of the next issues the state must face.

Before I came on, Fairness West Virginia put a call out for information about the state of healthcare for trans people in the state of West Virginia and heard a lot of horror stories, Stone said.

The collected data set a baseline of insight centered around the experiences that trans West Virginians may face when navigating the states health care system. Stone said that among the topics researched were experiences of discrimination, necessary travel to receive care and the impact of medical costs.

According to Rebecca Denning, a board-certified child and adolescent psychologist, instances of transgender discrimination may be connected to a general misunderstanding of gender-nonconforming individuals.

Historically, training in culturally competent care has not been a standard in many healthcare programs, Denning said. We know this adversely impacts care for people of diverse backgrounds.

For Evan Wiseman, a 21-year-old trans man from Parkersburg, West Virginia, the journey to transition brought on many of those obstacles due to a lack of resources and general understanding about transgender individuals.

Starting in 2014, my parents, eldest sister and I searched all throughout the state looking for hormone therapy before I eventually started, Wiseman said. We looked everywhere but eventually accepted the fact that I would have to travel to Cleveland Clinic. All of the primary physicians in Parkersburg werent interested in helping me.

Due to the lack of resources in the state, trans individuals such as Wiseman are often times left to travel out of state in order to receive the care they need. In its surveying, Fairness West Virginia found that 36% of transgender West Virginians traveled out of state to receive care while 46% of transgender West Virginians had to travel more than one hour to receive care.

In addition to a lack of resources, Wiseman said trans West Virginians may also travel extended distances in order to receive educated, understanding care from medical professionals who are knowledgeable on how to interact with transgender individuals.

In Wisemans experience, he said any time hes received care from an emergency room, he has been treated extremely poorly.

(Doctors) in the ER will use she/her pronouns because my gender is not legally changed and theyll ask for my dead name even though I list my preferred name, Wiseman said. Often times male doctors wont even look me in the eyes and will say the bare minimum to me.

While recently receiving care for kidney stones at Ruby Memorial Hospital in Morgantown, West Virginia, Wiseman said he felt violated and not cared for after receiving care from one of the physicians.

I had a doctor who was using a scope for a vaginal procedure and, before telling me what was going on, he started the procedure, Wiseman said. When I made a sound because of the pain, he told his nurses to restrain me and told me to be quiet because its not that bad.

While medical professionals may not understand how their actions can be harmful, Denning said unfavorable medical experiences can have traumatizing effects of trans patients.

We know that when transgender patients encounter messages that their identity and gender expression are a problem, they are at a significantly increased risk for a range of poor health outcomes, Denning said. These experiences actively cause harm.

Regarding mistreatment in a medical setting, data collected by Fairness West Virginia found that 60% of transgender West Virginians said a healthcare provider intentionally misgendered them. 20% of transgender West Virginians said they had been refused care due to their gender identity and 25% of transgender West Virginians said that unrelated health issues were blamed on their gender identity.

Even still, outside of obstacles created by a lack of cultural differences and a general lack of understanding, trans individuals may still come into contact with barriers that prevent them from receiving the care that Wiseman deems life threatening.

Once Wiseman decided to look into top surgery, a medical procedure which removes breast tissue to produce a masculine appearance, he said that finding the one and only trans educated surgeon in the state was not hard, but trying to get the procedure covered by insurance was difficult.

I was supposed to get surgery heading into my senior year of high school in 2018 but my insurance said they wouldnt pay for it until I turned 18, Wiseman said. Come November 2018, I turned 18 but the insurance said they wouldnt pay for it because it was elective, despite receiving numerous letters from my therapists about how the surgery could save my life.

In order for Wiseman to eventually receive the procedure, he and his family had to pay $7,000 out of pocket.

According to Stone, in contrast to Wiseman, the cost of medical care can be debilitating to West Virginians, but can be particularly troublesome for LGBTQ citizens who historically have been shown to live in poverty.

Overall, Denning said in order to truly understand the condition of West Virginias transgender health, its important to take a look at the states overall health system.

In West Virginia we have challenges with healthcare overall, with many West Virginians struggling with access to healthcare, Denning said. When you consider that some portion of that workforce is not able to provide gender affirming care, its easy to see that accessibility is a significant barrier to care.

Joelle Gates can be contacted at [emailprotected]

See the article here:
Lost in Transition: Understanding West Virginia's transgender health care system - MU The Parthenon

Recommendation and review posted by Bethany Smith

CUH has avoided the planned-for surge in Covid-19 cases, for now at least, but doctors concern for non-Covid patients has never diminished, writes Catherine Shanahan.

Ward staff, Cork University Hospital. Photo: Daragh Mc Sweeney/Provision

With the daily slew of statistics around the level of coronavirus infection almost relentlessly grim, some cheering news is emerging from Cork University Hospital (CUH) where just 33 staff have tested positive for Covid-19.

The number of confirmed cases among in-patients is stable at around 30, and the number in intensive care on any given day is staying constant at five or six. The hospital had planned for upwards of 100 in the ICU.

A number of outpatient clinics are resuming off-site this week, albeit on a reduced scale, among them Care of the Elderly, Rheumatology, Gastroenterology, and Respiratory Medicine.

Cancer surgery and cancer treatment is continuing, although some patients due to undergo chemotherapy are unable to do so because it weakens the immune system, which puts them at risk of Covid-19.

There are also concerns that patients who suffer minor strokes are not coming to hospital the number of stroke attendances halved in the first few weeks of the pandemic, but these figures have now begun to improve.

Mary Horgan, consultant physician in infectious disease at CUH and president of The Royal College of Physicians of Ireland (RCPI), says good planning and fantastic public compliance with Government restrictions designed to limit the spread of the virus have fed into the hospitals success.

Ive been on the last two weekends and it was so nice to see the number of positive tests markedly reduced for those people coming into the hospital.

At the weekend, there was just one positive case of someone who presented to the hospital, and in actual fact, they were known positive, so we were just re-swabbing them to see if they had cleared it.

Dr Horgan, who has more than 30 years experience in acute medicine and infectious disease, says she has never seen anything like Covid-19.

I suppose why it is different is it doesnt affect children, yet it affects everybody else.

And while most people have no symptoms, or mild symptoms, others will get a lot sicker.

If I looked at two [ostensibly healthy] 50-year-olds, I wouldnt be able to say: You are going to do really well and you are not going to do so well.

Dr Horgan doesnt like what she has seen: Im doing this for 30 years and I can tell you after looking after patients - I would not like to get this infection.

CUH has devised two separate patient pathways for Covid and non-Covid patients.

If theres an index of suspicion, they go into the Covid pathway, where they are swabbed and isolated, and staff put on their PPE (no shortages at the moment).

Oxygen levels are monitored and once the test is back, they are treated accordingly.

Dr Horgan says most of those who are admitted require some level of breathing assistance. They usually have viral pneumonia.

Its a lack of oxygen that results from the viral pneumonia that gets a patient into trouble. The virus is gone down into their lungs.

Some patients have ended up on ventilators, including some in their 30s. Some people recover quickly, others dont.

As of the end of March, about one-third of those admitted had been discharged, Dr Horgan says.

"About 50% of those admitted are under the age of 60 and otherwise healthy.

The big question now, she said, was what the impact on the hospital system will be as restrictions are gradually lifted.

I think what we are going to be looking at in the health system is cranking up non-Covid activity again, so that we are giving care in the way we always have, as well as having a parallel life of Covid care delivery.

We have to start planning for us to increase outpatient numbers, to ensure people come into hospitals when they are getting sick, Dr Horgan says.

Her sentiments are echoed by CUH clinical lead for stroke services, Liam Healy and clinical lead for cancer services, Richard Bambury.

Dr Bambury, a consultant medical oncologist, says as of last weekend, there were 146 empty beds in the hospital.

Pre-Covid CUH was pretty much running at max capacity, so in a way this [empty beds] is welcome, but this is an unusual situation.

CUH has not made much use of private hospitals in the region some acute medical patients have been transferred to the Mater Private, but no-one so far to the Bon Secours. Dr Bambury says there are ongoing discussions.

At CUH, they have worked to make the hospital as safe as possible for cancer patients, creating a separate entrance and triage area, swabbing any suspected cases, and if they test positive we dont recommend chemotherapy.

This is because chemotherapy suppresses the immune system, which heightens the risk to cancer patients in the event of Covid-19.

The risk:benefit ratio in some situations has changed. For some, the risk might outweigh the benefits so if alternative therapy is available we are looking at that.

"Its a case-by-case decision.

Alternative treatments include the use of hormone therapy in treating prostate cancer.

Postponing treatment where it is safe to do so is another. For those on annual check-ups or who are in remission, their appointments can be postponed for a month or two until the Covid situation stabilises, Dr Bambury says.

Theres been some decrease in non-urgent activity to reduce the footfall and help with social distancing, Dr Bambury says but in saying that, in the past six weeks they have 200 new patients on radiotherapy and 50 on chemotherapy.

Rapid assessment clinics for anyone with a high suspicion of cancer are continuing.

On Ward 3B, Dr Healy, consultant geriatrician, is happy to see they are nearly back to the normal cohort of around 25-30 stroke patients, after seeing figures halve, dropping back to 10 or 15, in the early days of the pandemic.

I suppose the general message has been one should not come to hospital unless one absolutely needs to - but there are some conditions, like stroke, whereby if someones having symptoms, the only right thing to do is come in as quickly as you possibly can.

Theres a worry, he says, that people with a minor stroke may have stayed away, but theres plenty we can do for them in terms of optimising their treatment, or seeing if its something we can reverse," Dr Healy says.

Theyve had no Covid-19 staffing issues on his ward and very few patients affected by Covid-19, even though some of the early indications in this outbreak were that a higher percentage of people with the virus would have strokes.

Theres not a case that I can think of whereby weve had a stroke patient whos been disenfranchised by it or has had any kind of problems because of Covid-19, he says.

Consultant geriatrician at CUH, Paul Gallagher, is playing a role in the care of Covid patients in residential care facilities.

They have set up four teams to cover Cork and Kerry, each with senior nurses, and led by a geriatrician.

They are taking calls from care homes in the community - of which there are c100 in the region - and giving expert advice and guidance.

In some cases there are site visits to assist with care on the ground, for example at Clonakilty Community Hospital where there has been an outbreak and, tragically, a number of deaths.

Dr Gallagher says some elderly people have typical Covid symptoms, but others have atypical symptoms, such as a tummy upset, as well as fever and shortness of breath.

Within CUH itself, the number of Covid patients he sees remains stable, which has allowed us to manage it in a more planned way.

We had planned for upwards of 100 in ICU, that hasnt happened at all.

Dr Gallagher resumed his outpatient clinic for Care of the Elderly this week, albeit a scaled-down version.

The clinic is being run off-site on Model Farm Road.

At the moment, we are seeing urgent new referrals.

"Hopefully it will ramp up, but we have to be very cautious. Appointments will be staggered and time allowed between appointments to clean the rooms, for protection of patients and staff.

As CUH looks to returning to a more normal service, the medics do have certain concerns.

As Dr Gallagher points out, the fear now is of a non-Covid surge.

If people who need it dont seek treatment now, the risk is that we will be overwhelmed down the line.

The latest restrictions in operation since Friday, March 27 mandate that everyone should stay at home, only leaving to:

Go here to see the original:
Catherine Shanahan: Cautious optimism is order of the day at Cork University Hospital - Irish Examiner

Recommendation and review posted by Bethany Smith

At the moment, it feels like life has been put on pause... Literally. The government has advised us to stay at home to help control the spread of coronavirus. So what does this mean for women who are struggling to fall pregnant and embarking on IVF?

IVF is already a daunting, stressful and emotionally-draining process. But now, there are a whole new cohort of people with the added layer of uncertainty of whether they will ever get pregnant because treatment has been postponed indefinitely.

On 24 March, the official regulator for fertility clinics, Human Fertilisation and Embryology Authority (HFEA) announced no new treatment can begin. It means patients whod already started an IVF cycle can finish it, but all treatment after 15 April has been stopped.

On the face of it, HFEAs measures are simply complying with government social distancing advice to flatten the curve and ease the burden on the NHS which is already under huge pressure. Sounds reasonable. But that doesnt change how upsetting this is for so many who now feel helpless in their pursuit of parenthood.

We have had many calls from patients who are upset and distressed by the indefinite delay, said Dr Geeta Nargund, Medical Director at CREATE Fertility and abc IVF. Not knowing when they're able to start treatment brings with it a potentially serious mental health impact, particularly when patients know that time is of the essence and that it may impact upon their chance to become biological mothers.

Dr Nargund says that once a patient is given medication to stimulate ovaries, it can take up to two weeks to mature the eggs and prepare them for egg collection. First, she is given stimulation medication and monitored with ultrasound scans and blood tests, before an egg-collection procedure is booked in. Next, the eggs are fertilised with sperm in a lab to create embryos. Embryo/s are either transferred as fresh embryos three or five days later or frozen for later use.

Nargund says the treatment suspension has been particularly hard for women who have waited a long time for IVF or those diagnosed with a very low egg reserve, for whom time is of the essence.

Matilda*, 37, from Cheshire has a low Anti-Mullerian hormone level for her age, indicating a decreased egg reserve. Shes had two unsuccessful rounds of NHS-funded IVF, in August 2019 and January 2020. She and partner Eric*, 41, scraped together savings and borrowed from family and friends for private treatment, costing around 7,000.

At first, I was reluctant, Matilda says. If you have another round of heartbreak, you lose all that money. But you also feel, if I dont do it, will I live the rest of my life in regret?

We decided, finding all the funds, going into debt, using our life-savings, its such a huge risk. Sometimes I feel physically sick about spending that amount on a small chance and potentially ending up with nothing at all, she explains.

The clinic put Matilda on the pill and scheduled her egg collection for 17 April. But her treatment was cancelled as it had surpassed HEFAs deadline by two days. As Matildas turning 38 in a couple of months, shes concerned the delay for someone her age could mean not having a biological child.

Your chances diminish every month. This could have been my month, this could have been my cycle. Im losing that chance and its getting less likely it will ever work. If this lasts six or twelve months, Ive spent all that money and its going to be pointless, she says. Ive lived from appointment-to-appointment for close to a year, trying to keep healthy, not drinking alcohol, doing things to prepare and now theres no appointments, theres nothing. I dont know how to carry on. Im depressed and angry at just how hopeless you are as a woman in this situation.

Matilda says she will try again once the suspension lifts, but knows her chances will be slimmer.

Leanne Jones, 31, from Hampshire is having pre-implantation genetic diagnosis (PGD) IVF because her husband Kyle, 30, has a genetic disorder called PKD1 which affects life-expectancy and has a 50% chance of being hereditary..

During five years of treatment, Leannes had two cycles resulting in early miscarriages in September 2019 and February 2020. When you have a positive pregnancy test, a door opens. Youre planning the next 35 years of your life and your emotions run away with you. Then someone goes nope and shuts the door. Its grief. My emotions were like someone had died. I felt like someone had taken my right to breathe and I couldnt catch my breath at all, she explains.

As a midwife, Leanne sympathises for NHS staff, both in the face of COVID-19 and the suspension: It must be horrendous. Its hard but its the right thing.

What can you do if youre in a similar situation?

Dr Nargund suggests:

1. Use this time to make sure your body is ready for treatment. Make sure you're maintaining a healthy weight, getting regular exercise and following a balanced diet. While it may be difficult during this time, trying to stay relaxed and giving up vices such as smoking will all help to optimise your fertility status.

2. Do your research. There are multiple discussion groups and webinars being hosted that will allow you to better understand the treatment suspension and what it means for you, as well as ask questions of experts and decide on what treatment is right for you.

3. Explore getting treatment started online. Some clinics are offering virtual consultations that can be conducted over video call and using hormonal blood tests conducted at home. This will allow you to get the process moving and ensure that once the lockdown is lifted treatment can be started as soon as possible.

Help:

HFEA are updating patient guidance on their website.

The Fertility Network UK support line (0121 323 5025) is open Monday, Wednesday and Friday between 10am-4pm.

Professional Infertility Counselling Association(BICA) have a Find A Counsellor section on their website.

Professor Dr Geeta Nargund at CREATE Fertility is hosting webinars twice a week to provide information and guidance for all those considering starting treatment after the suspension.

*Matilda and Eric are fictional names

Read this article:
The Impact of Suspended IVF Treatment On Women - GLAMOUR UK

Recommendation and review posted by Bethany Smith

By now, so many cyborg-esque technologies exist that were living in what was the imagined future of yesterday think Neuralink, brain-computer interfaces, and mind-controlled weapons. Its almost like living in Star Trek or The Matrix.

Cortical Labs is not your average robotics startup. Instead of creating artificial technology that is programmed to function like the human brain, they have developed silicon computer chips that merge with actual neurons to think on their own. SYFY WIRE interviewed co-founders Dr. Hon Weng Chong and Andy Kitchen to find out more about this extraordinary biotech that puts the brain into the computer rather than putting a computer in the brain.

So how do neurons and tech connect? There are no invasive procedures involved. The neurons used are actually human skin cells that have been morphed into stem cells (which have the potential to become anything) and then morphed again into neurons. These become integrated with a micro-electrode array that is really a physical grid of microscopic electrodes that are about 17 microns apart. Under a microscope, it kind of looks like the flat, iridescent chips inside of a DSLR camera. The sci-fi tech that comes closest is those bio-neural gel packs from Star Trek: Voyager, whose organic circuitry allowed them to think as if they were alive.

It takes up very very faint electrical signals in microvolts, meaning one millionth of a volt, so very slight changes in the electrical voltage, Kitchen explained. Then what we do is we basically grow cells in contact with that electrode grid so the cells are spread out on top of this grid of electrodes. The cells are so close and the electrodes are so sensitive that you know when neurons are firing.

Such hypersensitive electrodes can pick up when there is action potential, and this is when a spike in neuron firing, which goes up to millions of microvolts, can be observed. Younger cells will fire less strongly while older cells have more firepower. You need to get information out, but you also need to get information in by using biologically compatible stimuli to stimulate the neurons with highly precise and targeted volts. Neurons need to fire with a frequency that will effectively encode a message or other information into this bio-neural network. Its basically the inverse of something like Neuralink.

By the way, these things can play Atari. Anyone who ever spent way too many hours in the arcade playing Pong will know what the neuron chips are up to.

Its about input and output, said Chong, comparing them to denizens of the simulated world in The Matrix. Theres a matrix and these neurons actually live in a vertical simulation where they are constantly stimulated, so they basically live in a virtual simulation where they see a ball, feed themselves that input, then give the output.

He then echoed that eerie Morpheus speechabout consciousness really being just a computer simulation working off electrical impulses in our brains.

But how do these things even concentrate on a video game? They are trained in a computational task called lines of separation. Think of being at a party where the music is blasting, people are shouting over the music and youre the one in the corner struggling to keep a conversation going. Now imagine if you could just focus on whatever youre talking about and filter all that extraneous noise out. The neuron chips can actually separate signals so they know what theyre going. Chong and Kitchen have visions for them that go far beyond the pixelated world of retro video games.

I want to use it in robotics biological systems are really good for that since theyve been evolved to sort of operate in highly stochastic, highly variable environments where they always have to model the world they live in and also learn to remodel themselves to new environments for the betterment of humanity, said Chong. One of the things that Id really love to do is open up this technology to researchers and expand it around the world so it can be applied in whatever way it would be useful.

Of course, the tech wont be running entire data centers right away, though Chong hopes that is one of the things it will eventually be capable of. Just like it started out playing Pong (will it attack Space Invaders next?), its early tasks could be turning thing on and off or making basic calculations that could save you time putting together those spreadsheets you were dreading. Later it might be able to think for something like a Roomba.

Fast-forward to when the chips get more advanced, and the cells will be genetically engineered with specific computation elements, so while they are still the bio-component of this technological Frankenstein, they will evolve enough to break away from basic biological functions and be able to target more specific computational purposes. They could even be the actual brains of humanoid robots.

In terms of where this is going, weve roughly figured out three phases, and we kind of see between them several orders of magnitude in terms of size, number of neurons, number of connections, and the amount of information you get in and out, Kitchen said. So phase one would involve thousands of electrodes and hundreds of thousands of neurons. Then I think we would be moving to hundreds of thousands of electrodes, millions of neurons and so on.

There is one issue with a hybrid computer system like this that you probably dont think of when your smartphone is at 2 percentpower and you have to plug it in to recharge. Neurons need nutrients to keep going. Any device that will use Cortical Labs technology will need refills of nutrient-rich material, which its creators imagine kind of like a Keurig machine. Youd put the refill cartridge in the top much like a K-cup. Unlike our phones, which are always dying at the most inconvenient moments, that would be enough to supply a device using the neuron chips with weeks' and even months' worth of power.

In the future, you will probably have to excuse yourself because you have to feed your computer, Chong laughed.

So is Westworld going to be our new reality? Probably not, if you ask Chong and Kitchen, but they also admitted its too early to tell. Fluid intelligence is what theyre going for right now. The more complex devices that think with these chips should be capable of creativity, not just crunching numbers or other data. They do someday want to see if they can teach the chips right and wrong, starting from correct and incorrect and moving into ethics that are often nebulous.

Humans will someday give robots the ability to decide whether what its doing its right or wrong, and then be able to push it down the right path. This is going to take a while. What seems ethically right to some people could freak others out.

Consciousness is technically possible, but we dont know what it is or how to measure or define it yet, Chong said. These are the very early days, but I do believe that consciousness is achievable. If one of our cultures escapes the lab, well give you a call.

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Good morning,

Crucial data gaps are hurting Canadas ability to fight the COVID-19 pandemic, leaving Canadians in the dark about who is being infected or struggling with the devastated economy.

Canada has a long-standing problem of information gaps, The Globe and Mail found in a year-long series, and that has left us vulnerable during public health crises before. But now, these blind spots could blunt the federal economic rescue effort, hide inequities in deaths from the disease and slow our emergence from self-isolation in the months ahead.

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Father Victor Fernandes puts on personal protection equipment prior to visiting with a patient in the COVID-19 intensive care unit at St. Paul's hospital in downtown Vancouver on April 21, 2020.

JONATHAN HAYWARD/The Canadian Press

This is the daily Morning Update newsletter. If youre reading this on the web, or it was forwarded to you from someone else, you can sign up for Morning Update and more than 20 more Globe newsletters on our newsletter signup page.

Nova Scotia shooting: Premier Stephen McNeil is urging his mourning province to help investigators unravel questions around a gunmans weekend rampage. A new tip line was created specifically for the killings. He acknowledged there is anger over the RCMPs decision not to use the provincial emergency alert system during the 12-hour manhunt, but he asked people to be patient, and wait for answers.

New details are emerging about the chaos that ensued as police tried to capture the killer disguised as an RCMP officer. Audio recordings of first responders communicating on two-way radios provide a glimpse of frantic attempts to help the first victims in the village of Portapique.

A couple pays their respects at a memorial in Portapique, N.S., on April 22, 2020.

Andrew Vaughan/The Canadian Press

Economy: Saskatchewan has laid out a detailed, comprehensive plan to reopen its economy, and is the first province in the country to do so. On May 4, the five phases will begin, opening non-essential medical procedures, and the reopening of provincial parks, campgrounds and golf courses.

In Quebec, Premier Franois Legault is preparing to lay the groundwork next week for a plan to gradually restart the provinces economy and get children back to school.

Rent: Ottawa is proposing to offer commercial rent relief, in the form of loans for landlords of small and medium-sized businesses, that would cover up to 75 per cent of tenants payments for three months, according to sources familiar with the negotiations.

When it comes to investment properties, small landlords across Canada might not qualify for government assistance and are scrambling to figure out how to accommodate rent reductions while making their mortgage payments.

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World news:

Researchers at the University of Oxford are racing to develop a vaccine for COVID-19 and plan to make a million doses of it this summer. The team has been working since January, and clinical trials involving more than 500 volunteers began yesterday. The testing is expected to take several months, but the researchers have already teamed up with manufacturers globally to produce the doses September and millions more by the end of the year. The Globes Paul Waldie reports.

An aerial view of people queuing outside a bank in downtown Quito, Ecuador, on April 22, 2020.

RODRIGO BUENDIA/AFP/Getty Images

Got a news tip that youd like us to look into? E-mail us at tips@globeandmail.com Need to share documents securely? Reach out via SecureDrop

Scheer, Tories refrain from criticizing MP accused of racist comments: People of Asian descent have faced a spike in hate crimes and slurs since the COVID-19 pandemic began in China last year and experts say the comments from an elected official give licence for the attacks to continue.

Child protection organizations seeing significant uptick in predators: In dark-web forums, sexual predators are increasingly discussing the COVID-19 pandemic as an opportunity to exploit children online as they spend more time out of school and on the internet.

Ontarios Serious Fraud Office investigates Bondfield: A special unit of Ontario police officers and prosecutors launched the investigation in 2019, looking into allegations of wrongdoing by a major builder of hospitals, transit stations and other public infrastructure across the province.

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Parents of teen girls killed by Paul Bernardo seek to obtain his file with the parole board: The two families filed for judicial review this month after their requests for the documents under access to information legislation were denied.

MPs seek to overcome hurdle in getting WHO adviser to testify: A parliamentary committee scrutinizing the response to the pandemic is working to get key World Health Organization adviser Bruce Aylward to testify. The WHOs legal counsel has said that Dr. Aylward cannot testify unless he receives authorization from WHO Director-General Tedros Adhanom Ghebreyesus.

World stocks fall on worries over EU stimulus details, coronavirus drug: Global shares fell on Friday, spurred by delays to an agreement on divisive details of the European Unions stimulus package and doubts about progress in the development of drugs to treat COVID-19. In Europe, Britains FTSE 100 was down 0.93 per cent around 6 a.m. ET. Germanys DAX and Frances CAC 40 fell 1.07 per cent and 1.03 per cent, respectively. In Asia, Japans Nikkei fell 0.86 per cent. Hong Kongs Hang Seng fell 0.61 per cent. New York futures were flat. The Canadian dollar was trading at 71.05 U.S. cents.

Canada must protect itself from Americas response to COVID-19

Robyn Urback: It is not implausible that Mr. Trump would retaliate in some sort of petty but potentially grave economic way on supply lines for essential goods, for example if Canada refuses to lift restrictions on non-essential travel if and when the President decides that time is up.

This Ramadan, in solitude, will be more meaningful than ever

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Fatima Al Fahim: But the pandemic need not dampen Ramadan spirits. Physical distancing gives us a reminder of the true meaning of the holy month.

The world has a big China problem now

Campbell Clark: We dont know precisely what happened in China in the early days of COVID-19, but we know some whistle-blowers were stifled and, for whatever reason, officials waited for days to tell the world after learning they faced a serious epidemic.

By Brian Gable

Brian Gable/The Globe and Mail

What you really need is a room edit, not a reno

Especially while in isolation, you may be looking for curatorial guidance, but are keen to avoid the expense of a full interiors overhaul. Some people would rather rip out a wall or buy a bigger house, when all it often takes is reimaging and reworking what you already have, says Joanna Teplin, the Nashville co-founder of the Home Edit. If you want to remodel, read about how you might be able to make the change with what you already have.

Snuppy, right, the first male dog cloned from adult cells by somatic nuclear cell transfer, and the male Afghan hound from which an adult skin cell was taken to clone Snuppy, are seen in this handout photo released in Seoul on Aug. 3, 2005.

Seoul National University via Reuters

Snuppy worlds first cloned dog is born

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If he were born today, Snuppy would be dubbed, in internet lingo, a very good pupper or an excellent doggo. Instead, Snuppy, the first successful clone of a dog, had to settle for merely being hailed as a breakthrough in biotechnology. A team of 45 South Korean researchers, led by stem-cell researcher Hwang Woo-suk, produced the pup using a process called somatic cell nuclear transfer with a cell from the ear of a male Afghan dog, Tai. Snuppy was named for Seoul National University (SNU) and puppy. While other mammals had been cloned successfully starting with Dolly the sheep in 1996 cloning mans best friend proved more challenging. The achievement suggested that, given time and expertise, almost any mammal could be reproduced. Defying concerns that clones would be rife with ailments, Snuppy was generally healthy. He fathered 10 pups by artificial insemination and produced, by stem-cell clone, a litter with three surviving pups. Snuppy died of cancer, a common fate in dogs, just days after his 10th birthday in 2015. Jessie Willms

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Morning Update: Canadas data gaps are hurting our ability to fight the pandemic - The Globe and Mail

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SAN DIEGO, April 24, 2020 (GLOBE NEWSWIRE) -- Pfenex Inc. (NYSE American: PFNX) announced today that it will report its financial results for the first quarter ended March 31, 2020, after the market close on Thursday, May 7, 2020. Pfenex will host a conference call and webcast to discuss its financial results and provide a company update that day at 1:30 PM Pacific Time (4:30 PM Eastern Time).

About Pfenex Inc.

Pfenex is a development and licensing biotechnology company focused on leveraging its Pfenex Expression Technology to develop and improve protein therapies for unmet patient needs. Using the patented Pfenex Expression Technology platform, Pfenex has created an advanced pipeline of potential therapeutic equivalents and novel and next generation therapeutics. Pfenexs lead product candidate is PF708, a therapeutic equivalent candidate to Forteo (teriparatide injection). PF708 has been approved in the U.S. for the treatment of osteoporosis in certain patients at high risk for fracture, and marketing authorization applications are pending in other jurisdictions. In addition, Pfenex is developing hematologic oncology products in collaboration with Jazz Pharmaceuticals, including PF743, a recombinant crisantaspase, and PF745, a recombinant crisantaspase with half-life extension technology. Pfenex also uses its Pfenex Expression Technology platform to produce CRM197, a diphtheria toxoid carrier protein used in prophylactic and therapeutic vaccines.

Pfenex investors and others should note that Pfenex announces material information to the public about Pfenex through a variety of means, including its website (http://www.pfenex.com/), its investor relations website (http://pfenex.investorroom.com/), press releases, SEC filings, public conference calls, corporate Twitter account (https://twitter.com/pfenex), Facebook page (https://www.facebook.com/Pfenex-Inc-105908276167776/timeline/), and LinkedIn page (https://www.linkedin.com/company/pfenex-inc) in order to achieve broad, non-exclusionary distribution of information to the public and to comply with its disclosure obligations under Regulation FD. Pfenex encourages its investors and others to monitor and review the information Pfenex makes public in these locations as such information could be deemed to be material information. Please note that this list may be updated from time to time.

Company Contact: investorrelations@pfenex.com

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Pfenex to Announce First Quarter 2020 Financial Results on May 7 - Yahoo Finance

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An F-16 combat jet at Spangdahlem Air Base achieved a landmark 10,000 flight hours on Thursday, nearly 27 years after it rolled off the production line and began flying for the 52nd Fighter Wing.

The aircraft Tail No. 343 is the first Block 50 Fighting Falcon in Europe and only the second F-16 in the U.S. Air Forces inventory to reach the historic milestone, something maintainers hailed as a testament to its durability and their dedicated labor.

An F-16 at Misawa Air Base in northern Japan hit the mark a year ago, but that jet was delivered a year earlier than Spangdahlems, maintainers said. It also took 26 years and 11 months to reach 10,000 hours two months longer than No. 343.

It takes a lot of work and a lot of diligence and a lot of very thorough inspections to keep (the aircraft) safe and ready to fly, said Senior Master Sgt. Andrew Yates of the 480th Aircraft Maintenance Unit at Spangdahlem.

The planes been flying since before about 75% of the people in this building were even born definitely before any of us even joined the military, he said.

Both are true for 1st Lt. Christina Nunley, 25, the assistant officer in charge for the 480th AMU.

This aircraft has been at Spangdahlem longer than I have been alive, she said. Obviously, there are struggles that come with having an older aircraft, but the history behind it is a huge motivating factor and its something that we take a lot of pride in.

Chief Master Sgt. Chris Yager, 45, is part of that history. His first assignment out of tech school in 1997 was at Spangdahlem, where he worked on the jet and saw it reach 2,000 flight hours.

Back then, there were those old crusty guys that were out there training me how to work on aircraft and sometimes I wondered why they were training me the way they were, said Yager, the 52nd Maintenance Group superintendent.

With Thursdays milestone, Yager said he sees the fruits of that labor.

Keeping No. 343 airworthy involved about 190,000 hours of work by ground crews, maintainers said. The F-16 on average requires 19 hours of maintenance for every hour of flying time a figure that includes thorough inspections, refueling and basic maintenance such as changing tires and oil.

The wings vice commander, Col. Jason Hokaj, took the jet up Thursday afternoon for less than an hour to reached the milestone. Base firefighters hosed down the aircraft as it taxied down the flightline after landing.

This is such an amazing event to be part of, Hokaj said in a statement. To think about the amount of hands and minds used to get here, to keep this machine flying, its a testament to the professionalism of the 52nd Maintenance Group.

The Lockheed Martin Block 50 F-16s that the 480th Fighter Squadron flies were initially designed to last 8,000 flight hours, Yates said. But a series of upgrades has kept many of them going past that mark, he said.

Yager likened the F-16 to the Air Forces Cold War-era B-52 bomber, which is still in service after more than 50 years.

It was only designed for so many hours but it keeps going and going, he said.

Lockheed Martins F-35A Lightning II is the planned replacement for the F-16 across the service, but due to delays in the program, the F-16s are expected to receive service-life extension upgrades to keep them airworthy until 2048 and beyond.

No. 343 was part of the 480ths deployment for Operation Inherent Resolve to Iraq and Syria in 2016, when the squadron broke a record for number of munitions dropped by an F-16 unit within a six-month period.

Its just been a good, durable aircraft, Yates said. Theres a lot of superstition in the maintenance community rubbing the bellies and certain things but really, the biggest reason is making sure all the required inspections for this aircraft are complied with.

svan.jennifer@stripes.comTwitter: @stripesktown

U.S. Air Force Col. Jason Hokaj, 52nd Fighter Wing vice commander, prepares for takeoff in aircraft 343, an F-16 Fighting Falcon, at Spangdahlem Air Base, Germany, April 23, 2020. Later that day, Hokaj's aircraft passed the 10,000 flight hours milestone.KYLE COPE/U.S. AIR FORCE

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F-16 at Spangdahlem first in Europe to hit 10000 flight hours - Stars and Stripes

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Three score and ten is so 1970s. Today, the average baby born in the UK will live long enough to see the beginning of the 22nd century. Increasingly we also hear claims of longevity breakthroughs that could propel those children and maybe even their parents into triple digits and beyond. Is eternal life something we want outside of science fiction? And how will society cope if it is?

The first ten million years were the worst, said Marvin. The second ten million years, they were the worst, too. The third ten million years I didnt enjoy at all. After that I went into a bit of a decline.

So opines Marvin, Douglas Adams paranoid android, who follows the protagonists of The Hitchhikers Guide to the Galaxy around like a bumbling, grumbling storm cloud. Functionally immortal (and cursed with a brain the size of a planet), Marvin is the hubristic dream of eternal life printed and stamped in circuitry. While his human shipmates stumble from one disaster to another, devoting their limited talents to avoiding death at all costs, Marvin plods glumly along, bemoaning the pointlessness of an infinite existence in which there is nothing new to learn, no challenge to his intellect and in which everyone even his closest friend, a rat that nested for a time in his foot dies. Except him.

Marvin is archetypical of immortals. Our stories are not kind to them. The Ancient Greek gods were positively psychopathic in doling out eternal damnation as punishment for everything from stealing fire (the titan Prometheus, who was lashed to a rock and whose liver was pecked out by an eagle, every day, forever) to winning a sewing contest (Arachne, who with perhaps limited foresight challenged Athena to a weave-off and was transformed into a forever-spinning spider when she won). For centuries since, thats more or less been the lot of would-be immortals: vampires are stuck in castles, the future rich keep their youth (but lose their humanity), and seekers of life-giving plants, elixirs and artefacts end up eaten, cursed or crushed under collapsing temples. If ever you are invited on a quest to find the... well, anything of eternal life, the entirety of our literary canon says: dont go.

Yet at the same time life extension is, almost by definition, what we expect of medicine. Its feels odd to frame chemotherapy or cardiovascular treatments as life-extension technologies, but for cancer and heart disease patients thats exactly what they are. More generally, we expect some small increase in life expectancy for each new generation. Every ten years, the Office for National Statistics releases data on how long the populations of England and Wales are living, and for the last five decades, life expectancy at birth has risen by around two-to-three years per decade. And when that increase stalls (as it did in the late 2010s), scientists are rounded up for television interviews and grilled over what or who is toblame.

This is a paradox of human life extension: we expect our kids to live longer than we do, but not much longer. An extra half-decade sounds about right. An extra half-century does not. The latter would seem outrageous and unfair if it werent so fanciful. And yet, serious people are treating the postponement of ageing increasingly seriously. The UKs Nuffield Council on Bioethics, by way of example, published a paper titled The Search for a Treatment for Ageing in 2018, listing eight avenues of current life-extension research. In 2013, Google a company associated with many things, but not life extension funded Calico, a company which specialises in exactly that.

Various studies in mice and rats have shown what well-publicised studies in mouse and rat populations often do: that a thing (in this case, a potential anti-ageing treatment) has done something miraculous (slowed down ageing) for the mice and rats (who have since been dissected) from which we can extrapolate a comparable result for humans (who will live longer and healthier lives and not be dissected). Theres no one clear indicator that radical life extension is around the corner but this rise in funding, debate and vivisected mouse carcasses suggests that our everyday assumption that there is a right amount of life for people may be rooted more in experience than in rational thought.

I havent really, fully absorbed how deep-seated the irrationality is, says Dr Aubrey de Grey, biogerontologist and co-founder of the SENS (Strategies for Engineered Negligible Senescence) Research Foundation. De Grey has been both researching and campaigning for what he calls radical life extension for nearly two decades. His two most recognisable features are the long grey beard that reaches almost to his waist, and his utter impatience with what he has called The Global Trance: the cross-cultural acceptance that one day, in the not-so-far-future, all of us must necessarily stop existing. De Greys view that functional immortality may not only be possible, but that its disparate foundations have already been laid in laboratories around the world, is highly controversial.

Scathing appraisals of his proposals have been made by experts across the biological sciences, who argue that the technologies he presents as joint candidates for life extension are too early in their development to be useful for decades, if ever. But taking this macro view of deGreys ideas feels like missing the point. SENS is far from the only organisation with the goal of increasing lifespan and it is far from the largest. But deGrey is a powerful orator, cowing audiences into listening with the air of an otherwise jovial science teacher who cant quite believe how badly his class has done in their mock exam.

These days Im very strong on not only saying, Look, have a sense of proportion, boys and girls: [ageing] is by far the major cause of suffering in the world. Hands up anyone who wants to get Alzheimers? Hands up anyone who wants anyone else to get Alzheimers?, he says, contrasting his current presentational style with the impatient brusqueness of his 2005 Ted Talk. But now I also tend to spend a fair amount of my time being a little bit more sympathetic to this irrationality and acknowledging that it only became irrational very recently... 20 years ago, it made sense to trick oneself into putting ageing out of ones mind and getting on with ones miserably short life rather than being preoccupied with this terrible thing, because there was no real reason to believe that we had much chance of moving the needle of actually accelerating the arrival of therapies that really bring ageing under control. So it kind of made sense; I have some sympathy.

20 years ago, it made sense to trick oneself into putting ageing out of ones mind and getting on with ones miserably short life rather than being preoccupied with this terrible thing, because there was no real reason to believe that we had much chance of moving the needle.

De Grey and the other researchers at SENS lay out seven factors that contribute to ageing, including cell loss and tissue atrophy, cancers and mitochondrial mutations along with novel biotechnologies that may one day mitigate their deleterious effects. SENS is not alone in suggesting potential therapies to delay ageing other candidate treatments have included the diabetes drug Metformin, resveratrol (the chemical compound/viticultural PR mega-win found in red wine) and gruesomely the transfusion of the blood of young people into the elderly. Life extension, as an investment, is high-risk-enormous-reward hence the glut of proposed therapies.

De Grey stresses that any sudden and significant change in life expectancy will not be the result of one breakthrough, but of many treatments working in concert. Attacking ageing from multiple angles will lead to what he terms Longevity Escape Velocity the idea that if you can develop treatments for age-related disease more quickly than they can kill people, not only does lifespan increase exponentially, but frailty is similarly delayed. Lifespan is almost the wrong term for what life-extension proponents are seeking a better term, already in academic use, is healthspan. Living to 150 and feeling it would be nightmarish. Proposed therapies must offer something more akin to eternal youth than eternal life.

This is something that I have to spend an enormous proportion of my time on, says deGrey. Just driving [that distinction] over and over again into peoples heads that lifespan is a side-effect of healthspan. Youve got to stay healthy to stay alive, and health is the major contributor to quality of life.

This is the second challenge for advocates of life extension: because we havent evolved, literally or culturally, to view extended, healthy lives as anything but fiction, almost nobody outside of the insular debate is equipped to properly assess its risks and virtues. If you accept that a sudden jump in healthy life expectancy is coming whether thats 50 years or 500 the lack of public discourse is troubling.

Very few studies have been performed to properly assess the publics view of living dramatically longer, and those that have show little coherence among subjects. The University of Queensland performed two such studies face-to-face studies and focus groups with 57 Australians in 2009; another, larger telephone study of 605 people in 2011. In both cases, participants views ranged from being strongly in favour to strongly against, with reasons for the latter position including issues of distributive justice, overpopulation, the breakdown of the traditional family unit and religious concerns. They showed, essentially, that most people dont know what to think, but one thing that is broadly shared is a concern that radical life extension threatens a sense of fairness.

Part of our attitude to what we think of as premature death dying before your time, is that its a sort of unfairness, and that idea of unfairness absolutely permeates across society, says bioethicist Professor John Harris. Besides teaching, Harris has acted as ethical advisor to the European Parliament, the World Health Organization (WHO), and the UK Department of Health; has published or edited more than 20 books, and written over 300 academic papers on subjects from cloning to human enhancement to the ethics of ageing both in how we treat the elderly now and why we should be supportive of life extension in the future.

There are limitless examples of the unfairness of some people getting what they want and others not getting what they want not just lifespan, but money, or sex, or whatever, Harris continues. But we cant eradicate that, because to eradicate that unfairness would mean always levelling down, rather than levelling up. We dont say wed better make sure nobody goes to university, because that would give them an unfair advantage looking for a job. The alternative to living with that unfairness of accepting that some people get what others would like but cant have is not just applicable to life extension: its applicable to almost everything that is valued.

The question of who would have access to life-extension therapies might be the biggest concern in the debate. The refugee crisis and the post-2008 focus on the widening gap between rich and poor in the UK often viewed through the lens of an overstretched NHS have raised disturbing questions about how human life is valued. The spread of Covid-19 has further highlighted how closely intertwined money and life expectancy have become, with millions of people around the world simply unable to afford to heed governments advice to self-isolate and miss work. Recent science-fiction has mined this inequality to great effect, perhaps most successfully in Netflixs Altered Carbon (based on the novels by Richard K Morgan), in which the super-rich have literally ascended to a place where they will never die, leaving the rest of humanity to exist in violence, criminality and squalor. The idea of billionaires escaping not only taxes but death as well is becoming an increasingly popular dystopia.

We dont know how this would play out, Harris continues. There are ways [we could distribute treatments]: some would be fair and some would be unfair, like not funding them through national health services. Those arent arguments against life extension per se, but they may be arguments about how certain societies choose to deal with the desirability of longer life. There would be many strategies open and hopefully in democratic societies they would be debated democratically.

That distinction between life extension and what creates inequality is important. As Harris explains, the availability of life-extending therapies tells us nothing about how they should be used.

We are very familiar with life extension, but mostly it has appeared in the guise of life-saving strategies, like vaccination, he says. The vaccinations for polio and smallpox have saved hundreds of millions of lives, or to put it another way, have enabled hundreds of millions of people to live who otherwise would have died. Vaccination is an exercise in life extension but nobody throws up their hands in horror about its huge effect on life expectancy.

De Greys first answer not just to the concern of fair distribution, but also to fears of seismic societal and institutional change that may follow major breakthroughs in healthy life extension is also political: in functioning democracies, we have term limits on governments, and in his view any government that did not make life extension for all a priority as it became feasible would collapse in popularity with voters. His second answer is that whatever possible negatives we can imagine, its difficult to imagine a dystopian setting so bad that death would be preferable.

Which is not to advocate complacency: part of deGreys frustration with the lack of public debate is precisely that he sees these advances in increased longevity as potential flashpoints that a revolution in healthcare poorly handled could devolve into an actual revolution. Its not just a matter of when [these therapies] are ready: its the lead-up to it, he explains. One thing that Ive been putting more and more energy into is getting policymakers to understand that the planning needs to happen now, before the therapies are ready... At some point, public opinion is going to undergo a very sudden sea change.

Handled competently, what could radical life extension offer, beyond the obvious benefits of extra time enjoying the people and things that we value? One possibility is that, in the same way that we tend to value life more the longer it has to go (people die tragically young nobody dies tragically old), adding decades of healthy living onto the national or global average might raise the value we place on life in general. De Grey sees evidence of this over the past century.

[The world] has become, both at the individual societal level and also at the global international level, a much, much less violent place, he says. And a huge part of why [thats happened] is that there is greater value given to life. If we look, for example, within the USA at the areas that have the greatest amount of violence, they are the areas that have the lowest life expectancy. But thats not because a lot of people are dying from violence: its because a lot of people are dying from poor nutrition, lack of access to medical treatment and so life is valued less.

As a species weve become increasingly familiar with the clash between our biology and the mutagenic effects of technology upon it, but we have survived through adaptation. We think in tribes but thrive in cities. We cross the world without losing our roots. We marry our Tinder matches. If the next technological shift in our stars is the collapse of the milestoned life birth, work, family, frailty, death it will be because we see more opportunities than costs. We arent Marvins: were good, as individuals and as a species, at finding new things to do when the world changes around us.

The great thing about longevity is that you wouldnt have to choose just one career, Harris reflects. If I had my time again, I would probably have liked to be a biologist. And then once I had my 70-odd years as a biologist I might want to do something else. Nobody wants to just go on doing the same old stuff, but if we have the time and ability we can change. Its one of my regrets now, at the age that I am, that while I do go on doing philosophy and writing about the things I like writing about, I would like to learn about new things and do other things.

There are people who say, Oh, youd just get bored if you had all that time. But I dont think I would. I would gladly sample a few million years and see how it goes.

Finance

Postponing ageing isnt just a natural extension of what our healthcare system does (which, at its core, is stop people from dying) theres also a strong economic argument to pursue life-extension research.

According to the most recent available figures from the Office for National Statistics, the UK spent 197.4bn on healthcare in 2017 just under 10 per cent of GDP. As life expectancy rises, so does the length of time the average person can expect to require care or live in poor health. The number of chronic conditions linked to ageing is rising (dementia, for example, currently affects an estimated 850,000 people in the UK, with that number expected to grow to one million by 2025).

The cost of fighting these age-related conditions is astronomical: according to the Institute for Fiscal Studies, the NHS spends more than twice as much on the average 65-year-old as on the average 30-year-old. Patients aged 85 and over require, on average, five times as much spending as 30-year-olds.

All of which sounds like a pretty good argument against life-extension if we struggle to treat the elderly now, it follows that dramatically extending life should be disastrous. But there are two problems with this line of reasoning. First, it ignores the fact that life-extension is something that happens albeit slowly already. A child born today is predicted to live, on average, a little over eighty years or about five years longer than a child born in 1980. An increase in age-related diseases is a crisis were living already.

The second problem is that the financial argument conflates age and health. No-one who advocates radical life-extension is suggesting the goal should be an extra 50 years in a nursing home. A treatment for ageing isnt the same as a cure for death: the proposal is to extend healthy life.

The humanitarian benefits of longer and healthier lives aside, extending life while reversing the current trend (in which longer life correlates with a longer period of physical and mental decline) would not only reduce the burden on the healthcare service, but also mean that fewer people would be forced into retirement due to poor health.

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Alexey Turchin, 47, from Moscow has been researching the topic for years. According to him, going digital is our best chance to live forever.

Stuck in self-isolation, like many of us these days, Alexey Turchin isnt sitting idly. He is not only working on his new book entitled Immortality, but is regularly collecting vast amounts of data about himself - from DNA in his toenail clippings and details about his dreams to sound recordings and things he does everyday. Why?

A dedicated life extensionist and advocate for digital immortality, he believes that one day humanity will see the emergence of artificial intelligence so strong that it could download this personal data into its system, thus, allowing a person to live forever.

As he says, accumulating such data is only one of at least three options available to us right now.

The second option is simply to survive until the creation of strong AI. The main cause of death in humans so far has been aging and if we could learn how to counter it we could live up to 3,000 years, he says. Countering aging is just a first step to achieving immortality in this scenario. If we die, we dont live long to see the creation of technologies that will allow humans to transform our bodies into cyborgs, for example, and ultimately download ourselves into a supercomputer.

Alexey and his roadmap to personal immortality

Then there is a third option - cryonics, i.e. preserving the body and/or the brain in low-temperature liquid nitrogen in the hopes that one day humanity will be able to resurrect them and somehow scan the brain to create a digital copy in a supercomputer.

But when exactly such AI will come to being? Not sooner than in 500 years, Russian researcher says.

The development of AI is going rather fast, but we are still far away from being able to download a human into a computer. If we want to do it with a good probability of success, then count on [the year] 2600, to be sure, he notes, adding that simpler and imperfect versions of such AI might even emerge in the next two decades.

As he thinks, the ongoing coronavirus outbreak might even play a role in the development of research in this respect. The pandemic will increase the public interest in biology, virology and life extension, because Covid-19 has a tendency to strike older people more often. Hence, well see that we need a more efficient healthcare system to deal with such threats. This might potentially lead to medics getting more power in determining our research priorities and bring humanity closer to extending average life expectancy, Alexey argues.

Humanity will inevitably see the emergence of digital immortality in some form, but what we are currently seeing in movies and TV shows like Transcendence or Black Mirror is not something well see in reality, the researcher says. I enjoy Westworld, but its not 100% correct. Every TV show must have a conflict to be entertaining, but in real life its not always the case, he explains. There, super AI is often portrayed as soulless or imperfect, but its not necessarily going to be that way.

In his view, the ideal situation will be when humanity invents an AI that will be a friend to humanity: It will be interested in preserving human values and will be able to create a complete model of our history and recreate each individual as part of this simulation. Thus, allowing us to live only twice.

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