New research led by a professor at NUI Galway is set to change how doctors treat some patients with high blood pressure — a condition that affects more than one in four men and one in five women.
The study by researchers at NUI Galway, Johns Hopkins University and Harvard Medical School found no evidence that diastolic blood pressure — the bottom reading on a blood pressure test — can be harmful to patients when reduced to levels that were previously considered to be too low.
Lead researcher Bill McEvoy, Professor of Preventive Cardiology at NUI Galway and a Consultant Cardiologist at University Hospital Galway, said the findings have the potential to immediately influence the clinical care of patients.
Professor McEvoy said: “We now have detailed research based on genetics that provides doctors with much-needed clarity on how to treat patients who have a pattern of high systolic values — the top reading for blood pressure — but low values for the diastolic, or bottom, reading.
“This type of blood pressure pattern is often seen in older adults. Old studies using less reliable research methods suggested that the risk for a heart attack began to increase when diastolic blood pressure was below 70 or above 90. Therefore, it was presumed there was a sweet-spot for the diastolic reading.”
High blood pressure is a major cause of premature death worldwide, with more than 1 billion people having the condition. It is linked with brain, kidney and other diseases, but it is best known as a risk factor for heart attack. More recently, high blood pressure has emerged as one of the major underlying conditions that increase the risk of poor outcomes for people who become infected with Covid-19.
Professor McEvoy and the international research team analysed genetic and survival data from more than 47,000 patients worldwide. The study, published in the medical journal Circulation, showed: There appears to be no lower limit of normal for diastolic blood pressure and no evidence in this genetic analysis that diastolic blood pressure can be too low. There was no genetic evidence of increased risk of heart disease when a patient’s diastolic blood pressure reading is as low as 50. The authors also confirmed that values of the top, systolic, blood pressure reading above 120 increased the risk of heart disease and stroke.Blood pressure medications reduce both systolic and diastolic values.
Professor McEvoy added: “Because doctors often focus on keeping the bottom blood pressure reading in the 70-90 range, they may have been undertreating some adults with persistently high systolic blood pressure.
“The findings of this study free up doctors to treat the systolic value when it is elevated and to not worry about the diastolic blood pressure falling too low.
“My advice now to GPs is to treat their patients with high blood pressure to a systolic level of between 100-130mmHg, where possible and without side effects, and to not worry about the diastolic blood pressure value.” Dr Joe Gallagher, Irish College of General Practioners’ Lead, National Heart Programme, said: “This data helps remove uncertainty about how to treat people who have an elevated systolic blood pressure but low diastolic blood pressure. This is a common clinical problem which causes much debate. It will help impact clinical practice internationally and shows the importance of Irish researchers in clinical research.”
The research team used new technologies to take into account genetic information that is unbiased, which was not the case with prior observational studies. They assessed data from 47,407 patients in five groups with a median age of 60.
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Studies show wearing masks and social distancing can contain the spread of the COVID-19 virus, but their combined effectiveness is not precisely known.
In Chaos, by AIP Publishing, researchers at New York University and Politecnico di Torino in Italy developed a network model to study the effects of these two measures on the spread of airborne diseases like COVID-19. The model shows viral outbreaks can be prevented if at least 60% of a population complies with both measures.
“Neither social distancing nor mask wearing alone are likely sufficient to halt the spread of COVID-19, unless almost the entire population adheres to the single measure,” author Maurizio Porfiri said. “But if a significant fraction of the population adheres to both measures, viral spreading can be prevented without mass vaccination.”
A network model encompasses nodes, or data points, and edges, or links between nodes. Such models are used in applications ranging from marketing to tracking bird migration. In the researchers’ model, based on a susceptible, exposed, infected, or removed (recovered or has died) framework, each node represents a person’s health status. The edges represent potential contacts between pairs of individuals.
The model accounts for activity variability, meaning a few highly active nodes are responsible for much of the network’s contacts. This mirrors the validated assumption that most people have few interactions and only a few interact with many others. Scenarios involving social distancing without mask wearing and vice versa were also tested by setting up the measures as separate variables.
The model drew on cellphone mobility data and Facebook surveys obtained from the Institute for Health Metrics and Evaluation at the University of Washington. The data showed people who wear masks are also those who tend to reduce their mobility. Based on this premise, nodes were split into individuals who regularly wear masks and socially distance and those whose behavior remains largely unchanged by an epidemic or pandemic.
Using data collected by The New York Times to gauge the model’s effectiveness, the researchers analyzed the cumulative cases per capita in all 50 states and the District of Columbia between July 14, 2020, when the Centers for Disease Control and Prevention officially recommended mask wearing, through Dec. 10.
In addition to showing the effects of combining mask wearing and social distancing, the model shows the critical need for widespread adherence to public health measures.
“U.S. states suffering the most from the largest number of infections last fall were also those where people complied less with public health guidelines, thereby falling well above the epidemic threshold predicted by our model,” Porfiri said.
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Evolutionary anthropologists from the University of Vienna and colleagues now present evidence for a different explanation, published in PNAS. A larger bony pelvic canal is disadvantageous for the pelvic floor’s ability to support the fetus and the inner organs and predisposes one to incontinence.
The human pelvis is simultaneously subject to obstetric selection, favoring a more spacious birth canal, and an opposing selective force that favors a smaller pelvic canal. Previous work of scientists from the University of Vienna has already led to a relatively good understanding of this evolutionary “trade-off” and how it results in the high rates of obstructed labor in modern humans. However, it has remained unclear what the advantage of a narrow birth canal is, given its disadvantage for childbirth. It has long been thought that a smaller birth canal is advantageous for bipedal locomotor performance. A different, less prominent explanation is that it enhances pelvic floor functionality. The muscles of the human pelvic floor play a vital role in supporting our inner organs and a heavy fetus, and in maintaining continence. A larger pelvic canal would increase the downward deformation of the pelvic floor, increasing the risk of pelvic floor disorders, such as pelvic organ prolapse and incontinence. However, this “pelvic floor hypothesis” has been challenging to prove.
A team of evolutionary anthropologists and engineers from the University of Vienna, the Konrad Lorenz Institute for Evolution and Cognition Research, and the University of Texas at Austin (USA) used a new approach to test this hypothesis. The researchers, led by Katya Stansfield and Nicole Grunstra from the Department of Evolutionary Biology, simulated a Finite Element model of a human pelvic floor across a range of different surface areas and thicknesses and investigated the deformation in response to pressure. “Finite Element analysis allowed us to isolate the effect of pelvic floor geometry by controlling for other risk factors, such as age, number of births, and tissue weakness,” says Stansfield. This approach also enabled the team to model pelvic floor size across a broader range of variation than can be observed in the human population, “because natural selection may prevent the occurrence of such ‘extreme’ sizes precisely because of the disadvantages for pelvic floor functionality,” explains Grunstra.
As predicted by the pelvic floor hypothesis, larger pelvic floors deformed disproportionately more than smaller pelvic floors. “Our results support the notion that smaller pelvic floors — and thus smaller birth canals — are biomechanically advantageous for organ and fetal support despite their disadvantage for childbirth,” says Stansfield.
The researchers also found that thicker pelvic floors were more resistant to bending and stretching, which partly compensated for the increase in pelvic floor deformation as a result of increased surface area. So why did natural selection not result in a larger birth canal that eases childbirth, along with a disproportionately thicker pelvic floor that compensates for the extra deformation? “We found that thicker pelvic floors require quite a bit higher intra-abdominal pressures in order to undergo stretching, which is actually necessary during childbirth,” says Grunstra. The pressures generated by women in labor are among the highest recorded intra-abdominal pressures and they may be difficult to increase further. “Being unable to push the baby through a resistant pelvic floor would equally complicate childbirth, and so we think we have identified a second evolutionary trade-off, this time in the thickness of the pelvic floor,” concludes Grunstra. “Both the size of the birth canal and the thickness of the pelvic floor appear to be evolutionary ‘compromises’ enforced by multiple opposing selective pressures,” says co-author Philipp Mitteroecker.
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Altering a mosquito’s gut genes to make them spread antimalarial genes to the next generation of their species shows promise as an approach to curb malaria, suggests a preliminary study published today in eLife.
The study is the latest in a series of steps toward using CRISPR-Cas9 gene-editing technology to make changes in mosquito genes that could reduce their ability to spread malaria. If further studies support this approach, it could provide a new way to reduce illnesses and deaths caused by malaria.
Growing mosquito resistance to pesticides, as well as malaria parasite resistance to antimalarial drugs, has created an urgent need for new ways to fight the disease. Gene drives are being tested as a new approach. They work by creating genetically modified mosquitoes that, when released into the environment, would spread genes that either reduce mosquito populations or make the insects less likely to spread the malaria parasite. But scientists must prove that this approach is safe and effective before releasing genetically modified mosquitoes into the wild.
“Gene drives are promising tools for malaria control,” says first author Astrid Hoermann, Research Associate at Imperial College London, UK. “But we wanted a clear pathway for safely testing such tools in countries where the disease most commonly occurs.”
In the study, Hoermann and colleagues genetically modified the malaria-transmitting mosquito Anopheles gambiae. They used the CRISPR-Cas9 technology to insert a gene that encodes an antimalarial protein amidst genes that are turned on after the mosquito eats a blood meal. The team did this in a manner that allowed the whole section of DNA to also function as a gene drive that could be passed on to most of the mosquitoes’ offspring. They initially inserted the gene along with a fluorescent marker to help them track it in three different spots in the DNA, and then later removed the marker, leaving only a minor genetic modification behind.
Next, the team bred the mosquitoes to see if they were able to successfully reproduce and remain healthy. They also tested how well the malaria parasite developed in the mosquitoes’ guts. Their experiments provide preliminary evidence that this approach to genetic modifications could create successful gene drives.
“These genetic modifications are passive, and could be tested in the field and undergo a stringent regulatory process to ensure they are safe and effective in blocking the parasite without raising concerns of accidental spread in the environment,” explains senior author Nikolai Windbichler, Senior Lecturer at the Department of Life Sciences, Imperial College London. “However, once we combine them with other mosquitoes with an active gene drive, they turn into gene drives themselves without the need for any further changes. Our approach thus brings gene drives one step closer to being tested in the field as a malaria elimination strategy.”
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SARS-CoV-2 is the virus responsible for the COVID-19 pandemic. We know that mutations in the genome of SARS-CoV-2 have occurred and spread, but what effect do those mutations have? Current methods for studying mutations in the SARS-CoV-2 genome are very complicated and time-consuming because coronaviruses have large genomes, but now a team from Osaka University and Hokkaido University have developed a quick, PCR-based reverse genetics system for analyzing SARS-CoV-2 mutations.
This system uses the polymerase chain reaction (PCR) and a circular polymerase extension reaction (CPER) to reconstruct the full-length cDNA of viral genome. This process does not involve the use of bacteria, which can introduce further unwanted mutations, and takes only two weeks using simple steps to generate infectious virus particles. Previous methods took a couple of months and were very complicated procedures.
“This method allows us to quickly examine the biological features of mutations in the SARS-CoV-2,” says lead author of the study Shiho Torii. “We can use the CPER technique to create recombinant viruses with each mutation and examine their biological features in comparison with the parental virus.” The large circular genome of SARS-CoV-2 can be constructed from smaller DNA fragments that can then be made into a viable viral genome with CPER, and used to infect suitable host cells. A large amount of infectious virus particles can be recovered nine days later.
“We believe that our CPER method will contribute to the understanding of the mechanisms underlying propagation and pathogenesis of SARS-CoV-2, as well as help determine the biological significance of emerging mutations,” explains corresponding author Yoshiharu Matsuura. “This could accelerate the development of novel therapeutics and preventative measures for COVID-19.” The team also suggest that the use of the CPER method will allow researchers to insert “reporter genes” into the SARS-CoV-2 genome to “tag” genes or proteins of interest. This will enable a greater understanding of how SARS-CoV-2 infects cells and causes COVID-19, assisting with the development of therapies. The CPER method could even allow a recombinant virus that is unable to cause disease to be generated, which could be used as a safe and effective vaccine for SARS-CoV-2.
Mutations are arising in the SARS-CoV-2 population all the time, as well as questions as to what those mutations do and whether they could affect the efficacy of vaccines. “Our simple and rapid method allows scientists around the globe to characterize the mutants, which is a vital step forward in our fight against the SARS-CoV-2,” says Takasuke Fukuhara of the research group.
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Asthma afflicts more than 300 million people worldwide. The most severe manifestation, known as non-Th2, or non-atopic childhood asthma, represents the majority of the cases, greater than 85%, particularly in low-income countries, according to Hyunok Choi, an associate professor at the Lehigh University College of Health. Yet, whether non-Th2 is a distinct disease (or endotype) or simply a unique set of symptoms (or phenotype) remains unknown.
“Non-Th2 asthma is associated with very poor prognosis in children and great, life-long suffering due to the absence of effective therapies,” says Choi. “There is an urgent need to better understand its mechanistic origin to enable early diagnosis and to stop the progression of the disease before it becomes severe.”
Studies show that nearly 50% of the children whose asthma is poorly controlled are expected to emerge as severe adult cases. Yet, a one-size-fits-all treatment approach, currently the norm for asthma, is ineffective and, says Choi, and partially responsible for asthma’s growing economic burden.
“The primary reason for lack of therapeutic and preventive measures is that no etiologic, or causal, driver has ever been identified for the non-Th2 asthma,” says Choi.
Now, for the first time, an epidemiological study, led by Choi, has shown that not only is non-Th2 a distinct disease, its likely inducer is early childhood exposure to airborne Benzo[a]pyrene, a byproduct of fossil fuel combustion. Choi and her colleagues are the first to demonstrate air pollution as a driver of the most challenging type of asthma, the severe subtype which is non-responsive to current therapies.
The team describes their results in an article recently published online in Environmental Health Journal called “Airborne Benzo[a]Pyrene May Contribute to Divergent Pheno-Endotypes in Children.”
What is termed asthma is an umbrella word for multiple diseases with common symptoms. Asthma has been broadly classified as two major sets of symptoms: T helper cell high (Th2-high) and T helper cell low (non-Th2). Th2-high is associated with early-childhood allergies to common pollutants such as pet dander, tree pollens, or mold. In contrast, non-TH2 is not related to an allergic response. The non-Th2 type, marked explicitly by being non-allergy-related, is far less understood than the TH-2 type and could transform into severe or difficult to treat type.
“The identification of non-Th2 asthma as a distinct disease, with early exposure to Benzo[a]pyrene as a driver, has the potential to impact tens of millions of sufferers, since this would make it possible to intervene before the onset of irreversible respiratory injuries,” says Choi.
The team tested two comparable groups of children from an industrial city, Ostrava, and the surrounding semi-rural area of Southern Bohemia, in the Czech Republic: 194 children with asthma and a control group consisting of 191 children. According to the study, Ostrava is an industrial city with a high level of coal mining activities, coal processing, and metallurgical refinement. The district-level ambient mean for Benzo[a]pyrene at the time of their investigation November 2008) was 11-times higher than the recommended outdoor and indoor air quality standard.
Not only was elevated exposure to Benzo[a]pyrene associated with correspondingly elevated odds of non-Th2 asthma, it was also associated with depressed systemic oxidant levels.
“Contrary to the current body of evidence supporting adult onset of non-atopic asthma, our data suggest for the first time that the lung function deficit and suppressed oxidative stress levels during early childhood are critical sentinel events preceding non-atopic asthma,” says Choi.
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Materials provided by Lehigh University. Original written by Lori Friedman. Note: Content may be edited for style and length.

A large study of children has uncovered evidence that behavioral problems in children who snore may be associated with changes in the structure of their brain’s frontal lobe. The findings support early evaluation of children with habitual snoring (snoring three or more nights a week). The research, published in Nature Communications, was supported by the National Institute on Drug Abuse (NIDA) and nine other Institutes, Centers, and Offices of the National Institutes of Health.
Large, population-based studies have established a clear link between snoring and behavioral problems, such as inattention or hyperactivity, but the exact nature of this relationship is not fully understood. While a few small studies have reported a correlation between sleep apnea — when pauses in breathing are prolonged — and certain brain changes, little is known about whether these changes contribute to the behaviors seen in some children with obstructive sleep-disordered breathing (oSDB), a group of conditions commonly associated with snoring that are characterized by resistance to breathing during sleep.
To address this knowledge gap, researchers led by Amal Isaiah, M.D., D.Phil., of the University of Maryland School of Medicine, capitalized on the large and diverse dataset provided by the Adolescent Brain Cognitive Development (ABCD) Study, a long-term study of child health and brain development in the United States. The team of researchers mined this wealth of data from more than 11,000 9- and 10-year-old children to examine the relationships among snoring, brain structure, and behavioral problems.
Confirming the results of previous work, their statistical analysis revealed a positive correlation between habitual snoring and behavioral problems, with the children who most frequently snored generally exhibiting worse behavior according to an assessment completed by parents. The findings further showed that snoring is linked to smaller volumes of multiple regions of the brain’s frontal lobe, an area involved in cognitive functions such as problem solving, impulse control, and social interactions. The statistical analysis also suggested that the brain differences seen in children who snore may contribute to behavioral problems, but additional work on how snoring, brain structure, and behavioral problems change over time is needed to confirm a causal link.
This study’s findings point to oSDB as a potential reversible cause of behavioral problems, suggesting that children routinely be screened for snoring. Children who habitually snore may then be referred for follow-up care. Such care may include assessment and treatment for conditions that contribute to oSDB, such as obesity, or evaluation for surgical removal of the adenoids and tonsils.
The ABCD Study, the largest of its kind in the United States, is tracking nearly 12,000 youth as they grow into young adults. Investigators regularly measure participants’ brain structure and activity using magnetic resonance imaging (MRI) machines, and collect psychological, environmental, and cognitive information, as well as biological samples. The goal of the study is to define standards for normal brain and cognitive development and to identify factors that can enhance or disrupt a young person’s life trajectory.
The Adolescent Brain Cognitive Development Study and ABCD Study are service marks and registered trademarks, respectively, of the U.S. Department of Health and Human Services.
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SharecloseShare pageCopy linkAbout sharingimage copyrightReutersUS health authorities are calling for a pause in the use of the Johnson & Johnson Covid-19 vaccine, after reports of extremely rare blood clotting cases.The Food and Drug Administration (FDA) said it was acting “out of an abundance of caution”.It said six cases of severe blood clotting had been detected in more than 6.8 million doses of the vaccine.The recommendation follows similar rare cases in the AstraZeneca vaccine, which has prompted some curbs in its use.In a series of tweets, the FDA said it and the Centers for Disease Control and Prevention (CDC) were reviewing “six reported US cases of a rare & severe type of blood clot in individuals after receiving the vaccine. Right now, these adverse events appear to be extremely rare”.”We are recommending a pause in the use of this vaccine out of an abundance of caution,” it said.This was to “ensure that the health care provider community is aware of the potential for these adverse events”.A joint statement from the FDA and CDC clarified that the blood clotting was cerebral venous sinus thrombosis (CVST).It said that this type of blood clot needed a different treatment than usual.The common treatment – an anticoagulant drug called heparin – “may be dangerous”, it said and an alternative was required.All six cases were in women aged between 18 and 48, with symptoms six to 13 days after vaccination.The New York Times quoted officials as saying one woman had died and a second, in Nebraska, was in a critical condition.Johnson & Johnson statementThe joint statement said that “people who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider”.Johnson & Johnson, a US health care company, issued a statement saying that safety was its “number one priority” and that it shared “all adverse event reports” with the health authorities.It added: “We are aware that thromboembolic events including those with thrombocytopenia have been reported with Covid-19 vaccines. At present, no clear causal relationship has been established between these rare events and the Janssen (J&J) Covid-19 vaccine.”It said it would continue to work closely with the regulators.AstraZeneca vaccinationsThe Oxford-AstraZeneca vaccine, which has been given safely to tens of millions of people, has also seen some extremely rare blood clotting cases.The reports led some nations to suspend its use but most have now resumed, although in a number of cases with a recommended minimum age, for example 60 and over in Germany.In the UK, authorities advised that those under 30 should be offered an alternative.

SharecloseShare pageCopy linkAbout sharingimage copyrightReutersPeople aged 45 or over in England can now get a Covid jab, as the vaccination programme enters the next phase.Appointments can be booked on the NHS England website, which temporarily crashed on Tuesday morning when it opened up to the new age group. It comes after all over-50s and those in high-risk groups in the UK were offered a first dose of the vaccine.Prime Minister Boris Johnson said he could not see any reason to change England’s roadmap out of lockdown.However, he warned that infections and deaths would start to rise again as restrictions were eased.He said that although the vaccination programme had helped reduce the numbers, “the bulk of the work in reducing the disease has been done by the lockdown” and he urged people to be “cautious”.Mr Johnson added that he was “very confident” about the UK’s vaccine supplies. The government is aiming to offer a first dose to all adults by the end of July.When will over-40s get the jab?How many people have been vaccinated so far?UK sets new record for Covid jab second dosesMinisters have met their target of offering a first dose to the top nine priority groups by 15 April. Its has now moved onto “phase 2” of the vaccination programme – which involves offering vaccines to healthy adults under the age of 50. There are an estimated 3.7 million people in England aged 45 to 49.In Northern Ireland, people aged 40-45 are now eligible to get a Covid vaccine, while in some areas in Wales 40-49 year-olds are being invited.More than 32 million people in the UK have had their first vaccine dose.On Saturday a record 475,230 second doses were given out, with more than 7.6 million people now fully vaccinated.’Supply is a key variable for what happens next’Given how quickly the vaccination programme has been rolled out in the UK, hitting the target of all priority groups by mid-April is not unexpected. And remember, there is no published data on the number of people offered jabs, as opposed to those who have actually been vaccinated. However, NHS England has made clear that across the nine groups, 95% have actually had their first doses – that is an average, with take-up rates varying in different groups.Online bookings for the next age group, those aged 45 and over, have opened in England. Text messages to 48 and 49-year-olds from local vaccination centres are set to go out soon. But what’s not known is to what extent supplies of Pfizer and Moderna vaccines will fill the gap caused this month by supply problems with the AstraZeneca doses. The government is sticking to the line that the programme is on track to offer every adult a first dose by late July. But officials qualify it by saying this is “subject to supply” – and that is a key variable.England has joined Wales and Scotland in giving out its first doses of the Moderna jab, the third Covid-19 vaccine to be administered in the UK.Meanwhile, Prof Jeremy Brown, a member of the Joint Committee of Vaccination and Immunisation (JCVI), said people will eventually “have to” mix Covid jabs.He told BBC Radio 4’s Today programme: “It’s practically going to have to be that way because, once you’ve completed a course of, say, the Moderna or Pfizer or the AstraZeneca with two doses, in the future it’s going to be quite difficult to guarantee you get the same type of vaccine again.”So there will be a mix-and-match occurring just by the sort of practicalities of doing a third or fourth vaccination over the next few years.”He added that trials involving mixed vaccine combinations were ongoing.Another member of the JCVI, Prof Adam Finn, welcomed the news that the UK had completed the first phase of its vaccination programme but added: “We’re only halfway up the hill.”He told BBC Breakfast: “We mustn’t take our eye off the task and we’ve got to keep working to get to the top.”Prof Finn said people over 50 who have not been invited for a first dose of the vaccine should make a “gentle enquiry” with their GP.On Monday, the UK recorded 3,568 new coronavirus cases and 13 deaths within 28 days of a positive test. It comes after pub gardens, non-essential shops and hairdressers reopened in England. Northern Ireland’s “stay at home” order also ended on Monday, while in Wales non-essential shops and close-contact services reopened. In Scotland, non-essential shops and hospitality are not due to open until 26 April. Meanwhile, surge testing has been implemented in the Wandsworth and Lambeth areas of south London after a cluster of the South African Covid-19 variant was found. The Department of Health and Social Care called it the “largest surge testing operation to date” following the identification of 44 confirmed and 30 probable cases.LOOK-UP TOOL: How many cases in your area?LOCKDOWN RULES: What are they and when will they end?SOCIAL DISTANCING: How can I meet my friend safely? OXFORD JAB: What is the Oxford-AstraZeneca vaccine?A LIFE CHANGED IN SECONDS: “I’d been living my perfect life”EXTRA-TERRESTRIAL LIFE: Is suggesting evidence of aliens worth jeopardising a career?