The mother of a disabled boy has said she believes he is being failed by the social care system.Zach, 10, from Mansfield, has multiple life-limiting conditions, including learning disabilities, sensory processing disorder and intestinal failure.He also has a central line – a tube connected to a large vein near his heart – which provides him with vital fluids and medication.Despite having continuous care needs, Zach faces a wait of up to a year for essential new equipment, according to his mum Tricy.”His bed isn’t suitable. He’s damaged his central line three times,” she said.Together For Shorter Lives, a charity which supports seriously ill children and their families, said it has seen an increase in the number of calls from parents who are struggling to access continuing health care, while children’s services in England have been described as being “woefully underfunded” by the Association of Directors of Children’s Services.Laurence Jones, service director, commissioning and resources in children and family services at Nottinghamshire County Council, said the authority was “sympathetic” towards Zach’s situation.”We strive to ensure that children and young people receive the support they need. We are providing ongoing social care support for which the county council is responsible and regularly assess to ensure this is reviewed as the child’s needs change,” he added.A spokesperson for NHS Nottingham and Nottinghamshire Clinical Commissioning Group (CCG) said: “We cannot comment on a patient’s individual case. However, the CCG always works in partnership with colleagues across the system in education and social care to ensure that the needs of children with complex conditions are met.”On 6 May across England millions of people will be voting for new councillors, mayors and police and crime commissioners. Register to vote here.Video journalist: Alex ThorpFollow BBC East Midlands on Facebook, Twitter, or Instagram. Send your story ideas to eastmidsnews@bbc.co.uk.

She won three gold medals in the 1960s but was the focus of speculation about her gender. She retired after pulling out of a track meet that would have required a sex test.Tamara Press, a dominant Soviet shot-putter and discus thrower who won three Olympic gold medals in the 1960s but was the focus of speculation about her gender because of her physique, died on April 26. She was 83.Her death was announced by the Russian Ministry of Sport, which did not specify where she died or cite the cause.Press, who was 5-foot-11 and 225 pounds, began to attract international notice in 1958, when she won the gold medal in the discus and the bronze in the shot-put at the European Athletic Championships in Stockholm.More success followed. At the 1960 Summer Olympics in Rome, she won a gold medal in the shot-put and a silver in the discus. Four years later, at the Summer Olympics in Tokyo, she set Olympic records while winning gold medals in both events.But Press and her sister, Irina — who won gold medals in the 80-meter hurdles in Rome and in the pentathlon in Tokyo — received more than glory from their athletic careers.They heard cruel taunts about their size, some of it from sportswriters who compared Tamara to a defensive tackle. She and Irina were sometimes called the “Press brothers.”“I’m a champion, but you can see I’m a woman,” Tamara Press told The Associated Press in 1964. “The fact that a girl is a sportswoman has nothing to do with femininity.”Press throwing the discus at the 1964 Summer Olympics in Tokyo. She won gold medals that year in both the discus and the shot-put. Rolls Press/Popperfoto, via Popperfoto, via Getty ImagesSeven decades later, a contentious debate continues in track and field regarding the eligibility of intersex athletes — those born with sex characteristics that do not conform to binary descriptions of male and female.Caster Semenya, a two-time Olympic champion at 800 meters, has been challenging, so far without success, the rules of World Athletics, track and field’s governing body, which require intersex athletes who identify as female to suppress their natural testosterone levels below that of men before being able to compete in women’s races from a quarter-mile to a mile.World Athletics has acknowledged that the restrictions are discriminatory, but nonetheless said they’re necessary to provide a level playing field during competition. Critics, including the World Medical Association and the United Nations High Commissioner for Human Rights, have called the rules unnecessary and humiliating.In 1966, when Press was 29, her career (as well as her sister’s) came to a near-total end when they decided to withdraw from the European Athletics Championships in Budapest.It is not clear why Press decided to withdraw. Had she taken anabolic steroids to gain strength, endurance and bulk, she might have aroused suspicion, but she would not have faced little risk of being detected, because drug testing was in its infancy in those days.If she was intersex, Press might have feared failing a new test instituted at the athletics championships: the so-called nude parade, which required women athletes to appear before a medical panel that would determine their eligibility.“There was something different about the Press sisters,” said John Hoberman, a historian of doping in sports and the author of “Testosterone Dreams: Rejuvenation, Aphrodisia, Doping” (2005). He added that it was “not out of the question” that both things were true — that the sisters were intersex and that they also used steroids.All Soviet officials would say about the sisters’ absence from the meet is that they had to stay at home to care for their sick mother.Tamara Natanovna Press was born on May 10, 1937, in Kharkov, Ukraine, and lived there until her family was evacuated to Samarkand, Uzbekistan, early in World War II. Her father was in the Soviet military and died in battle in 1942. At 18, Tamara moved to Leningrad to train under Viktor Aleksyev, a renowned track and field coach.From 1959 to 1965, Press set 11 world records, including her personal bests: 18.59 meters (or 60.9 feet) in the shot-put and 59.70 meters (195.9 feet) in the discus.Press, lying down, with her sister, Irina, in an undated photo. Irina Press won gold medals in the 80-meter hurdles at the 1960 Rome Olympics and the pentathlon in Tokyo in 1964.Ullstein Bild/ullstein bild, via Getty ImagesFollowing the Press sisters’ decision not to compete in Budapest, Tamara Press stayed active until 1967. At one of her last meets, the Moskow Spartakiad, an all-Soviet event that did not require gender testing, she won the shot-put. She retired later that year.In the years after she stopped competing, Press worked as an engineer and a coach. In 1996 she worked to help re-elect Boris Yeltsin as Russia’s president. She was also the vice president of the Physical Culture and Health Fund, a charity that helps promising Russian athletes, and the author of several books, including “The Price of Victory.”In 2012, President Vladimir Putin wished Press a happy 75th birthday, saying in a statement, “You earned the respect of opponents and the love of millions of fans.”Information about her survivors was not immediately available. Her sister died in 2004.In 1996, as the Summer Olympics were taking place in Atlanta, Press told The Christian Science Monitor that her success in the 1960 and 1964 Games “was a victory for our country,” adding, “Communism — that’s another question.”And she recalled that she was so focused at the Tokyo Olympics that at some point she was unaware that one of her competitors had dropped the shot on her thigh.“There was so much tension that I didn’t even notice,” she said. “After the competition I saw a black mark on my leg and thought, ‘What’s this?’”

A team of University of Alberta researchers has discovered a way to use 3-D bioprinting technology to create custom-shaped cartilage for use in surgical procedures. The work aims to make it easier for surgeons to safely restore the features of skin cancer patients living with nasal cartilage defects after surgery.
The researchers used a specially designed hydrogel — a material similar to Jell-O — that could be mixed with cells harvested from a patient and then printed in a specific shape captured through 3-D imaging. Over a matter of weeks, the material is cultured in a lab to become functional cartilage.
“It takes a lifetime to make cartilage in an individual, while this method takes about four weeks. So you still expect that there will be some degree of maturity that it has to go through, especially when implanted in the body. But functionally it’s able to do the things that cartilage does,” said Adetola Adesida, a professor of surgery in the Faculty of Medicine & Dentistry.
“It has to have certain mechanical properties and it has to have strength. This meets those requirements with a material that (at the outset) is 92 per cent water,” added Yaman Boluk, a professor in the Faculty of Engineering.
Adesida, Boluk and graduate student Xiaoyi Lan led the project to create the 3-D printed cartilage in hopes of providing a better solution for a clinical problem facing many patients with skin cancer.
Each year upwards of three million people in North America are diagnosed with non-melanoma skin cancer. Of those, 40 per cent will have lesions on their noses, with many requiring surgery to remove them. As part of the procedure, many patients may have cartilage removed, leaving facial disfiguration.

Scientists believe a stomach-specific protein plays a major role in the progression of obesity, according to new research in Scientific Reports. The study co-authored by an Indiana University School of Medicine researcher, could help with development of therapeutics that would help individuals struggling with achieving and maintaining weight loss.
Researchers focused on Gastrokine-1 (GKN1) — a protein produced exclusively and abundantly in the stomach. Previous research has suggested GKN1 is resistant to digestion, allowing it to pass into the intestine and interact with microbes in the gut.
In the Scientific Reports study, researchers show that inhibiting GKN1 produced significant differences in weight and levels of body fat in comparison to when the protein was expressed.
“While diet and exercise are critical to maintaining a healthy weight, some individuals struggle with weight loss — even in cases of bariatric surgery, maintaining weight loss can be a challenge,” said David Boone, PhD, associate professor of microbiology and immunology at IU School of Medicine, an adjunct professor in the Department of Biology at the University of Notre Dame and a co-author of the study. “These results are an example of how a better understanding of the gut microbiome and the physiological aspects of obesity — how our bodies regulate metabolism and accumulate body fat — could help inform new therapies.”
Data from the Centers for Disease Control show adult obesity rates have increased to 42.4 percent in the United States. In addition to increasing an individual’s risk of stroke, diabetes, certain cancers and other health issues, obesity can also increase the risk of severe illness due to COVID-19.
Boone and his team conducted a microbiome analysis of mouse models with and without the GKN1 protein expressed. Researchers measured food intake, caloric extraction, blood sugar, insulin and triglyceride levels. They used magnetic resonance imagining to monitor body composition. The team also calculated energy expenditure and observed inflammation levels.
Models without GKN1 weighed less and had lower levels of total body fat and higher percentages of lean mass — despite consuming the same amount of food. When put on a high-fat diet, models without GKN1 showed a resistance to weight gain, increased body fat and hepatic inflammation, which can lead to liver disease. Researchers also found no evidence of adverse effects such as cancer, diabetes, loss of appetite, malabsorption or inflammation — and results were consistent in male and female models.
While more research is needed to determine the efficacy of blocking GKN1 to prevent obesity, researchers said if proved as a viable solution, such therapies could reduce the burden on health care systems and help improve quality of life for patients.
Story Source:
Materials provided by Indiana University School of Medicine. Note: Content may be edited for style and length.

While most of the United States has seen a steady decline in new coronavirus cases recently, Arizona has been an outlier.The state has not been swamped with another virus wave, but public health experts are worried about a steady increase in cases and hospitalizations. As of Monday, Arizona’s daily average had climbed 21 percent in the last two weeks, tying it with Wyoming for the largest rise in the nation over that period. Only three other states reported increases of more than 10 percent in that time: Washington, Oregon and Missouri.Arizona’s daily new case load, at 10 per 100,000 people, is still below the national average of 15 per 100,000. Over the last 14 days, as federal health officials have suggested that the virus’s trajectory is improving, the country has seen a 26 percent decrease in new coronavirus cases, and 28 states have seen declines of 15 percent or more, according to a New York Times database.Will Humble, the former state health director who now heads the Arizona Public Health Association, said the increase in new cases could be attributed to several factors, including a spring influx of travelers and the prevalence of a virus variant first detected in Britain. The variant, B.1.1.7., has been associated with increased transmissibility.Mr. Humble said the rise in Arizona was not likely to yield a substantial rise in deaths, which have been declining in the state. Most older adults and other people in the state who are at elevated risk of severe illness have already been vaccinated, he said, while the new cases are predominantly people in their 20s, 30s and 40s who are more likely to have milder cases.Mr. Humble said the rise in cases has “totally different public health implications” now than it would have several months ago, when far fewer people were vaccinated.“We’re not going to experience the type of lethal experiences that we would have in December, January or February,” Mr. Humble said. Even so, he said, there had been “a notable upward movement in general ward beds and also I.C.U.”Arizona was slow to put restrictions in place and quick to remove them last summer as cases skyrocketed and intensive-care beds filled to near capacity. For more than a month, from early June until mid-July, the state reported new cases at the highest rate in the country, relative to its size, reaching a peak of 3,800 a day.In January, Arizona again had the highest rate of daily new cases for a time. At one point, it averaged more than 8,000 a day, more than double the summer peak.Gov. Doug Ducey signed an executive order in March that lifted all Covid-19 restrictions in the state and barred local governments from imposing mask mandates.Mr. Humble said that policy might have left Arizona more vulnerable.“There’s no mitigation at all here, and there hasn’t been for months,” he said.About 41 percent of Arizonans have received a first dose of the vaccine, and 30 percent have been fully vaccinated, just below the national average. But the picture varies considerably from one part of the state to another. Three of Arizona’s 15 counties have vaccinated more than 40 percent of residents, but six have vaccinated fewer than 30 percent, as of Monday.Dr. Cara Christ, the director of the Arizona Department of Health Services, told reporters last month that the initial rush for vaccines had slowed considerably. “Vaccine appointments used to be snapped up almost as soon as they were made available,” she said. “Now it’s to a point where it’s possible to get a same-day appointment at virtually any state site.”

Pfizer expects to apply to the Food and Drug Administration in September for emergency authorization to administer its coronavirus vaccine to children between the ages of 2 and 11, the company told Wall Street analysts and reporters on Tuesday during its quarterly earnings call.The company said it also plans to apply this month for full approval of the vaccine for use in people from ages 16 to 85. And it said it expected to have clinical trial data on the safety of its vaccine in pregnant women by early August.The Pfizer-BioNTech vaccine is being given to adults under an emergency use authorization that the companies received in December. Obtaining full F.D.A. approval would, among other things, allow the companies to market the vaccine directly to consumers. The approval process is expected to take months.“Full approval is a welcome indicator of the continued safety and efficacy of the Pfizer vaccine,” Saskia Popescu, an infectious disease epidemiologist at George Mason University, said in an email. It could also “build further confidence in the importance of vaccination,” she said.The Pfizer-BioNTech coronavirus vaccine was the first to receive emergency authorization in the United States. Emergency authorizations are meant to be temporary, and can be revoked when a public health emergency is over.Full approval would allow the vaccine to remain on the market as the pandemic fades. It may also make it easier for companies, government agencies, schools and other entities to require vaccination. The University of California and California State University school systems, for instance, have announced that once coronavirus vaccines receive full F.D.A. approval, they will require students, faculty and staff members to be vaccinated. The U.S. military, which has seen many troops decline coronavirus vaccines, has said that it would not make them mandatory as long as they have only emergency authorization.The F.D.A. is expected to issue an emergency use authorization early next week allowing the vaccine to be used in children 12 to 15 years old.Jen Psaki, the White House press secretary, said at a news conference on Tuesday that she did not want to get ahead of the F.D.A.’s authorization process, but that if a vaccine were to be approved, the administration was preparing to “make that accessible to additional, younger populations.”Dr. Popescu said the possibility of opening up use of the vaccine to children in the United States was both exciting and frustrating. “We have essential workers around the world unable to get vaccines, and countries that may not have access for a year or more, so this conversation needs to be broadened to include global access,” she said.As of Tuesday, more than 131 million doses of the Pfizer-BioNTech vaccine had been administered in the United States, according to the Centers for Disease Control and Prevention. They make up a bit more than half of all doses administered in the country so far.Pfizer’s chief executive, Dr. Albert Bourla, said the company approached the F.D.A. on Friday with new data that it hopes will persuade the agency to allow its vaccine to be kept at refrigerator temperatures, rather than frozen, for up to four weeks. Currently, the limit is five days. He said the company is working on an updated version of the vaccine that could potentially be kept in refrigerators for up to 10 weeks, and hopes to have supporting data for that in August.Rebecca Robbins

“I’m honoured I got to say goodbye to him, as there’s lots of families that didn’t get that opportunity and he wasn’t on his own.”Father-of-three Eric Ohene-Adjei died in his wife’s arms on 17 April after being treated for coronavirus in the intensive care unit at the University Hospital of Wales, in Cardiff.His widow, Rachel, said he had not wanted to go into hospital with the virus as “he knew he wasn’t going to come out”.Rachel said their three children, Isaac, 12, Jacob, nine, and Ebony, eight, had been asking for their father “every day”.She praised the care he had received in hospital.

A pair of Mayo Clinic studies shed light on something that is typically difficult to see with the eye: respiratory aerosols. Such aerosol particles of varying sizes are a common component of breath, and they are a typical mode of transmission for respiratory viruses like COVID-19 to spread to other people and surfaces.
Researchers who conduct exercise stress tests for heart patients at Mayo Clinic found that exercising at increasing levels of exertion increased the aerosol concentration in the surrounding room. Then also found that a high-efficiency particulate air (HEPA) device effectively filtered out the aerosols and decreased the time needed to clear the air between patients.
“Our work was conducted with the support of Mayo Cardiovascular Medicine leadership who recognized right at the start of the pandemic that special measures would be required to protect patients and staff from COVID-19 while continuing to provide quality cardiovascular care to all who needed it,” says Thomas Allison, Ph.D., director of Cardiopulmonary Exercise Testing at Mayo Clinic in Rochester. “Since there was no reliable guidance on how to do this, we put a research team together to find answers through scientific testing and data. We are happy to now share our findings with everyone around the world.” Dr. Allison is senior author of both studies.
To characterize the aerosols generated during various intensities of exercise in the first study, Dr. Allison’s team set up a special aerosol laboratory in a plastic tent with controlled airflow. Two types of laser beam particle counters were used to measure aerosol concentration at the front, back and sides of a person riding an exercise bike. Eight exercise volunteers wore equipment to measure their oxygen consumption, ventilation and heart rate.
During testing, a volunteer first had five minutes of resting breathing, followed by four bouts of three-minute exercise staged ? with monitoring and coaching ? to work at 25%, 50%, 75% and 100% of their age-predicted heart rate. This effort was followed by three minutes of cooldown. The findings are published online in CHEST.
The aerosol concentrations increased exponentially throughout the test. Specifically, exercise at or above 50% of resting heart rate showed significant increases in aerosol concentration.
“In a real sense, I think we have proven dramatically what many suspected ? that is why gyms were shut down and most exercise testing laboratories closed their practices. Exercise testing was not listed as an aerosol-generating procedure prior to our studies because no one had specifically studied it before. Exercise generates millions of respiratory aerosols during a test, many of a size reported to have virus-carrying potential. The higher the exercise intensity, the more aerosols are produced,” says Dr. Allison.
The follow-up study led by Dr. Allison focused on how to mitigate the aerosols generated during exercise testing by filtering them out of the air immediately after they came out of the subject’s mouth. Researchers used a similar setup with the controlled airflow exercise tent, particle counter and stationary bike, but added a portable HEPA filter with a flume hood.
Six healthy volunteers completed the same 20-minute exercise test as the previous study, first without the mitigation and then with the portable HEPA filter running.
Also, a separate experiment tested aerosol clearance time in the clinical exercise testing laboratories by using artificially generated aerosols to test how long it took for 99.9% of aerosols to be removed. Researchers performed the test first with only existing heating, ventilation and air conditioning, and then with the addition of the portable HEPA filter running.
“Studying clearance time informed us of how soon we could safely bring a new patient into the laboratory after finishing the test on the previous patient. HEPA filters cut this time by 50%, allowing the higher volume of testing necessary to meet the clinical demands of our Cardiovascular Medicine practice,” says Dr. Allison.
“We translated CDC (Centers for Disease Control and Prevention) guidelines for aerosol mitigation with enhanced airflow through HEPA filters and showed that it worked amazingly well for exercise testing. We found that 96% plus or minus 2% of aerosols of all sizes generated during heavy exercise were removed from the air by the HEPA filter. As a result, we have been able to return to our practice of performing up to 100 stress tests per day without any recorded transmission of COVID in our exercise testing laboratories,” says Dr. Allison.
Story Source:
Materials provided by Mayo Clinic. Original written by Terri Malloy. Note: Content may be edited for style and length.

Next-generation gene sequencing (NGS) technologies — in which millions of DNA molecules are simultaneously but individually analyzed — theoretically provides researchers and clinicians the ability to noninvasively identify mutations in the blood stream. Identifying such mutations enables earlier diagnosis of cancer and can inform treatment decisions. Johns Hopkins Kimmel Cancer Center researchers developed a new technology to overcome the inefficiencies and high error rates common among next-generation sequencing techniques that have previously limited their clinical application.
To correct for these sequencing errors, the research team from the Ludwig Center and Lustgarten Laboratory at the Johns Hopkins Kimmel Cancer Center developed SaferSeqS (Safer Sequencing System), a major improvement to widely used technologies based on a previous technology called SafeSeqS (Safe Sequencing System) that Hopkins investigators invented a decade ago. The new SaferSeqS technology detects rare mutations in blood in a highly efficient manner and reduces the error rate of commonly used technologies for evaluating mutations in the blood more than 100-fold.
Their findings were reported May 3 in Nature Biotechnology.
The presence of a mutation in a clinical sample could be an early indicator that a person has developed cancer, says study lead author and M.D./Ph.D. candidate Joshua Cohen. Cancer is a genetic disease, driven by oncogenes and tumor suppressor genes. A small portion of cancer cells shed their DNA into the bloodstream, allowing their mutations to be detected via blood sample. Detecting such mutations in blood rather through surgical biopsy of a cancerous tissue is called “a liquid biopsy.” Such blood-based tests have the potential to detect cancer at an earlier stage, when it can be put into remission by surgery and/or chemotherapy. The challenge, Cohen explains, is that the vast majority of DNA present in the blood sample is shed by noncancer cells, and only a tiny fraction of the DNA is derived from the tumor. In patients with relatively early-stage cancers, a 10 mL blood sample will only contain a handful of molecules with a mutation.
“To detect cancers when they have the best chance of being cured requires a detection method that will pick up cancer signals that are present at extremely low frequencies,” says Cohen. “The technical challenge in detecting these mutations is akin to finding a needle in a haystack.”
The researchers addressed this challenge, with SaferSeqS, by efficiently tagging both strands of each original molecule present in an individual’s blood with a unique barcode. It required new biochemical approaches to do this in an efficient manner with the small number of degraded DNA molecules that are usually present in blood. The investigators use the structural redundancy of the double-stranded DNA molecule to distinguish real mutations from errors, an approach called duplex sequencing. If both strands of a DNA molecule contain the identical mutation, it is far more likely that it is a real mutation and not an error.

Repetitive transcranial magnetic stimulation, or rTMS, was FDA approved in 2008 as a safe and effective noninvasive treatment for severe depression resistant to antidepressant medications. A small coil positioned near the scalp generates repetitive, pulsed magnetic waves that pass through the skull and stimulate brain cells to relieve symptoms of depression. The procedure has few side effects and is typically prescribed as an alternative or supplemental therapy when multiple antidepressant medications and/or psychotherapy do not work.
Despite increased use of rTMS in psychiatry, the rates at which patients respond to therapy and experience remission of often-disabling symptoms have been modest at best.
Now, for the first time, a team of University of South Florida psychiatrists and biomedical engineers applied an emerging functional neuroimaging technology, known as diffuse optical tomography (DOT), to better understand how rTMS works so they can begin to improve the technique’s effectiveness in treating depression. DOT uses near-infrared light waves and sophisticated algorithms (computer instructions) to produce three-dimensional images of soft tissue, including brain tissue.
Comparing depressed and healthy individuals, the USF researchers demonstrated that this newer optical imaging technique can safely and reliably measure changes in brain activity induced during rTMS in a targeted region of the brain implicated in mood regulation. Their findings were published April 1 in the Nature journal Scientific Reports.
“This study is a good example of how collaboration between disciplines can advance our overall understanding of how a treatment like TMS works,” said study lead author Shixie Jiang, MD, a third-year psychiatry resident at the USF Health Morsani College of Medicine. “We want to use what we learned from the application of the diffuse optical tomography device to optimize TMS, so that the treatments become more personalized and lead to more remission of depression.”
DOT has been used clinically for imaging epilepsy, breast cancer, and osteoarthritis and to visualize activation of cortical brain regions, but the USF team is the first to introduce the technology to psychiatry to study brain stimulation with TMS.