Anabolic androgenic steroids (AAS), a synthetic version of the male sex hormone testosterone, are sometimes used as a medical treatment for hormone imbalance. But the vast majority of AAS is used to enhance athletic performance or build muscle because when paired with strength training. AAS use increases muscle mass and strength, and its use is known to have many side effects, ranging from acne to heart problems to increased aggression. A new study now suggests that AAS can also have deleterious effects on the brain, causing it to age prematurely.
The report appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.
“Anabolic steroid use has been associated with a range of medical and psychological side effects,” said lead author, Astrid Bjørnebekk, PhD, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. “However, since anabolic steroids have only been in the public domain for about 35 years, we are still in the early phase of appreciating the full scope of effects after prolonged use. The least studied effects are those that relate to the brain.”
Steroid hormones readily enter the brain, and receptors for sex hormones are found throughout the brain. Because AAS are administered at much higher doses than those naturally found in the body, they could have a harmful impact on the brain, particularly over a long period of use. Previous studies have shown that AAS users performed worse on cognitive tests than non-users.
Dr. Bjørnebekk and colleagues performed magnetic resonance imaging (MRI) of the brains of 130 male weightlifters with a history of prolonged AAS use and of 99 weightlifters who had never used AAS. Using a set of data compiled from nearly 2,000 healthy males from age 18 to 92 years of age. The researchers used machine learning to determine the predicted brain age of each of their participants and then determined the brain age gap: the difference between each participant’s chronological age and their predicted brain age. Advanced brain age is associated with impaired cognitive performance and increased risk for neurodegenerative diseases.
Not surprisingly, AAS users had a bigger brain age gap compared to non-users. Those with dependence on AAS, or with a longer history of use, showed accelerated brain aging. The researchers accounted for use of other substances and for depression in the men, which did not explain the difference between the groups.
“This important study shows in a large sample that use is associated with deviant brain aging, with a potential impact on quality of life in older age. The findings could be directly useful for health care professionals, and may potentially have preventive implications, where brain effects are also included into the risk assessment for young men wondering whether to use anabolic steroids,” added Dr. Bjørnebekk.
Cameron Carter, MD, editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said of the study: “The results of this brain imaging study should be of concern for athletes using anabolic steroids for performance enhancement and suggest that the adverse effects on behavior and cognition previously shown to be associated with long-term use are the result of effects on the brain in the form of accelerated brain aging.”
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SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesGerman Chancellor Angela Merkel has defended the EU’s decision to procure coronavirus vaccines jointly as the bloc struggles with delays in rollout.EU leaders are to hold virtual talks shortly to discuss ways of boosting vaccine supplies and improving distribution across the 27 nations.Pressure is mounting upon them to deliver after other countries, like the UK, achieved much faster vaccination.The European Commission is seeking added controls on vaccine exports.Such controls could affect supply to the UK, where Prime Minister Boris Johnson has warned against imposing “blockades”.The virtual summit comes as a third wave of coronavirus infections sweeps across much of mainland Europe.EU states have seen some of the deadliest outbreaks of the pandemic, with Italy recording more than 106,000 deaths, France 93,000, Germany 75,000 and Spain 73,000.Yet recent figures show just 12.9 doses of vaccine have been administered per 100 people in the EU compared with 44.7 in the UK and 37.2 in the US.Why is the EU having vaccine problems?Where is the Oxford-AstraZeneca vaccine made?EU tussle with UK over AstraZeneca jabs escalatesThe European Commission has blamed pharmaceutical companies – primarily AstraZeneca – for not delivering the promised doses to the EU. A site in Belgium produces the Oxford-AstraZeneca vaccine, and another in the Netherlands is expected to increase supplies of the jab in the EU.Brussels has said that of the more than 40 million doses exported from the EU over the past two months, a quarter were sent to the UK.The UK and the EU said on Wednesday they wanted to “create a win-win situation and expand vaccine supply for all”.What did Merkel say?Speaking to German MPs, the German chancellor said that if some members had had vaccine supplies and other had not, it would have shaken the EU’s internal market to its core.But some EU states, led by Austria, are calling for a revision in the distribution method after failing to obtain enough doses earlier this year.”We are in a situation where some member states will have vaccinated their population by the beginning or middle of May while for others, it will take six, eight or ten weeks longer,” Austrian Chancellor Sebastian Kurz said last week. “We believe that’s a problem.”Mrs Merkel warned that the impact of the pandemic could go beyond the current year.”We have to assume that the virus, with its mutations, may be occupying us for a long time to come so the question goes far beyond this year,” she said.The EU, she said, relied on what vaccines it could make locally because “British production sites are manufacturing for Britain and the United States is not exporting”.At the same time, more had to be done to ensure the rest of the world was supplied with vaccines, since otherwise new mutations would keep emerging, Mrs Merkel said.EU leaders had planned to meet face to face in Brussels but a third wave of the pandemic is sweeping across much of mainland Europe. So, a summit by video-conference was deemed safer. EU politicians are under increasing public pressure. Many voters blame their governments and Brussels for a vaccine rollout that lags far behind the UK. The European Commission blames pharmaceutical companies – primarily AstraZeneca – for not delivering jabs promised to the EU. But leaders are divided over proposals for new restrictions on vaccine exports out of the bloc to boost domestic supply. Some fear that would disrupt global supply chains needed to manufacture vaccines and damage already strained relations with the UK after Brexit. While there have been suggestions that the proposals being put before EU leaders on Thursday will be focused on the UK and US in particular, EU Health Commissioner Stella Kyriakides said that this was not the case. “We’re dealing with a pandemic and this is not seeking to punish any countries,” he said.What is the EU planning?The tougher export controls are most likely to affect vaccine-exporting countries that have higher vaccination rates than the EU, such as the UK and US. The key criteria for the proposed regulations are “reciprocity” and “proportionality”:The EU says there is no reciprocity if a country importing vaccines from the EU restricts exports itself – so it may review exports to this country Member states and the Commission will also consider the state of the pandemic in that country, its vaccination rate and vaccine supplies There will be no outright export bans, which are opposed by countries such as the Netherlands and Belgium. Vaccine manufacturers would be assessed to see if they were fulfilling their contract with the EU, although no specific algorithm is planned.In an interview with the BBC, the EU’s Internal Market Commissioner Thierry Breton insisted the bloc’s issues were with AstraZeneca and not the UK government. “I know that there’s some tension… but as long as we have transparency, I think [relations] will be able to be normalised,” he said.But he said that if AstraZeneca had provided the agreed 120 million doses to the EU, member states would have been at the same rate of vaccination as the UK: “We have been heavily penalised and we just want to understand why.”AstraZeneca denies that it is failing to honour its contract with the EU.

Behind the Byline • APOORVA MANDAVILLIMaking the Science of Covid ClearerBehind some of The Times’s vital journalism on the coronavirus is a reporter who speaks seven languages, holds a master’s degree in biochemistry and, OK, has a weakness for “Bridgerton.”March 25, 2021Times Insider explains who we are and what we do, and delivers behind-the-scenes insights into how our journalism comes together.As a science reporter for The New York Times, Apoorva Mandavilli knows the world of research, labs and technical papers. It’s helpful that she’s trained in science, with a master’s degree in biochemistry. She brings that knowledge to her current beat: Covid-19, including the immune response to the coronavirus and the variants that have emerged.Here, she talks about when she realized she didn’t want to be a research scientist, what it’s like to send her own kids back to school and her favorite lowbrow television.How did you start working as a science reporter?I went to graduate school for biochemistry at the University of Wisconsin, at Madison. I was there for four years, and I would have gotten a Ph.D. if I’d stayed one more year. But I realized that being a lab scientist was just a little too slow, a little too specific and a little too antisocial for me. I went to journalism school at N.Y.U.’s science journalism program, and I’ve been a reporter ever since. My mom is a writer. She’s a poet and a short-story writer, and I’ve been around literature my whole life. So my job has married two very different parts of my brain — science and writing.How do you think your science training influences your work?It’s very helpful in a lot of ways. I’m not writing about biochemistry, so the exact subject matter doesn’t help, but I understand the basics of biology. Much of my career, I’ve actually written for scientists, who can be exacting readers. They want things to be clear, but they never want things dumbed down. That has pushed me to always be accurate.I also think it is helpful to understand the business of science, like how universities operate and how the tenure system works and why scientists are so desperate to publish. All those things help anchor my understanding of where researchers are coming from and what sort of critical lens to have when looking at a paper.Where do your story ideas come from?Every day, I look at all of the research papers and preprints — studies that are released before undergoing the standard peer review process — that have to do with Covid. I scan the long list. Often, I see trends, something that’s emerging that more people are talking about, either on social media or because these papers are coming out.Sometimes, an idea can come from a sentence in somebody else’s article. Sometimes, it can come from reading anything that stirs a question in my mind. For example, my article about whether you still need to wear a mask after you’re vaccinated came about because I wondered that in early December, a few weeks before it became the national obsession.What is the biggest challenge in doing the job?I never have enough time. I have worked mostly as an editor, assigning stories to reporters, so I find it easy to spot stories that I want to write. I’m trying to write as many of them as I can.You previously worked on a website that focused on the autism spectrum. How did that inform your work?That was a site that was intended for scientists, but it was read by a lot of nonscientists as well. I think that’s one of the places where I learned to hone this fine balance of being technically accurate and being clear and simple at the same time. Also, I learned the skill of identifying stories and seeing trends. Autism is a pretty small niche, and we had to be able to spot small and interesting things and be able to develop them into full stories. So I’ve had a lot of practice doing that.You frequently write about the science around the decision to send kids back to school. How are you navigating that in your own life?I have two kids. My son is in middle school, and my daughter is 8. My kids are in school two days a week. Now they do this hybrid schedule, but I know how much they miss being in school full time. I know how much they miss the company of their friends, and I worry for their physical safety, and I worry for their mental health. I understand the parents all over the world who are desperate to have their kids in school.How do you disconnect when your beat is Covid?When I get away from the computer, my kids are right there, demanding my attention, wanting to be read to, fighting, yelling, being annoying and loving. They take up a lot of time. I also watch TV. I am extremely forgiving of my lowbrow tastes. I used to read a lot, and I have not been reading novels at all, which is kind of sad, but I just don’t have the attention span right now. I do a lot of crosswords, and I’m addicted to The Times’s Spelling Bee game.What is your favorite lowbrow television?Well, I really enjoyed “Bridgerton.” There was a period of time last spring when I even watched “The O.C.” for a couple of months.What would readers be surprised to learn about you?Maybe that I speak multiple languages — I’m fluent in four Indian languages, plus English, and can speak conversational French and Japanese. I grew up in India until I was 17, so English is not my first language.If you were to choose another job, not in journalism, what would it be?Somebody asked this question on Twitter, and I said I would still be a journalist. I can’t imagine not being one, because I have so many questions about how things work. I can’t imagine being able to ask those questions, and holding governments and institutions accountable, in any other role.What keeps you coming back to the job?I’ve never stopped learning. I’ve learned so much this year. Covering Covid, I’ve had to learn viral evolution and deep immunology and epidemiology. It’s just endlessly interesting.The Times has reported on the challenges faced by working moms during the pandemic. How have you managed child care when you’re reporting as much as you are?I have an extremely supportive husband. He is a squash pro, so he’s not working at the moment. He has taken over the caregiver roles quite a bit in our house. There are some things, of course, for which the kids still want me, but he does a lot. He takes care of all of the food, for example, which is a huge help.

SharecloseShare pageCopy linkAbout sharingimage copyrightEPAEU leaders are to hold virtual talks to discuss ways of boosting Covid vaccine supplies and improving the rollout of doses across the 27-nation bloc.The European Commission will on Thursday ask leaders to support plans for added controls on vaccine exports, which could affect supply to the UK.UK Prime Minister Boris Johnson earlier warned against imposing “blockades”.The virtual summit comes as a third wave of coronavirus infections sweeps across much of mainland Europe.US President Joe Biden will also dial in to the talks later on Thursday to discuss EU-US relations.Why is the EU having vaccine problems?Where is the Oxford-AstraZeneca vaccine made?EU tussle with UK over AstraZeneca jabs escalatesThe European Union’s vaccine rollout campaign has been slower than that of the UK. The European Commission has blamed pharmaceutical companies – primarily AstraZeneca – for not delivering the promised doses to the EU. However, leaders are divided over proposals for new restrictions on vaccine exports out of the bloc, which would aim to boost supplies within the EU. A site in Belgium produces the Oxford-AstraZeneca vaccine, and another in the Netherlands is expected to increase supplies of the jab in the EU.Brussels has said that of the more than 40 million doses exported from the EU over the past two months, a quarter were sent to the UK.In a joint statement on Wednesday, the UK and the EU said they wanted to “create a win-win situation and expand vaccine supply for all”.”We are all facing the same pandemic and the third wave makes co-operation between the EU and UK even more important,” the statement added.The tone of Wednesday’s EU-UK statement was positive, but actual progress between the two sides was described to me by an EU diplomat as “slow, cumbersome and difficult”. On both sides. That doesn’t mean impossible, but at their summit on Thursday, some EU leaders – along with the European Commission – will still be pushing for tougher controls on vaccine exports. And they could hit the UK. EU insiders say they had hoped never to use the controls. They say they want them as a means of exerting pressure on vaccine companies and on countries with vaccine production sites that are not exporting to the EU. Meanwhile, leaders are coming under increasing pressure to show voters they are taking action to ramp up both the supply of jabs and their vaccine rollout, on both of which they are trailing behind the UK.While there have been suggestions that the proposals being put before EU leaders on Thursday would be focused on the UK and US in particular, EU Health Commissioner Stella Kyriakides said that this was not the case. “We’re dealing with a pandemic and this is not seeking to punish any countries,” he said.Asked whether the UK might retaliate, Mr Johnson told MPs he did not believe “that blockades of either vaccines or of medicines, of ingredients for vaccines” would be “sensible”. Companies might draw conclusions about future investments “in countries where arbitrary blockades are imposed”, he added.What is the EU planning?The tougher export controls are most likely to affect vaccine-exporting countries that have higher vaccination rates than the EU, such as the UK and US. The key criteria for the proposed regulations are “reciprocity” and “proportionality”:The EU says there is no reciprocity if a country importing vaccines from the EU restricts exports itself – so it may review exports to this country Member states and the Commission will also consider the state of the pandemic in that country, its vaccination rate and vaccine supplies There will be no outright export bans, which are opposed by countries such as the Netherlands and Belgium. Vaccine manufacturers would be assessed to see if they were fulfilling their contract with the EU, although no specific algorithm is planned.Is the UK being targeted?In an interview with the BBC, the EU’s Internal Market Commissioner Thierry Breton insisted the bloc’s issues were with AstraZeneca and not the UK government. “I know that there’s some tension… but as long as we have transparency, I think [relations] will be able to be normalised,” he said.He said if AstraZeneca had provided the agreed 120 million doses to the EU, member states would have been at the same rate of vaccination as the UK: “We have been heavily penalised and we just want to understand why”. AstraZeneca denies that it is failing to honour its contract with the EU.A UK government spokesperson said: “We are all fighting the same pandemic. Vaccines are an international operation; they are produced by collaboration by great scientists around the world. And we will continue to work with our European partners to deliver the vaccine rollout.”Last week, European Commission President Ursula von der Leyen complained that the EU had exported more than 10 million doses to the UK, but the UK had so far exported none in return.Her colleagues added that this had to be seen in the context of the EU being both a global Covid hotspot and also the biggest exporter of vaccines. Since the end of January, EU countries have exported 43 million doses of vaccine to 33 countries not subject to export authorisation, they say.UK sources insist vital components are being sent to the continent, for example for the Pfizer vaccine, and they have emphasised the UK’s role in investing early in vaccine development, BBC correspondent Nick Beake reports.

The measure, believed to be among the first in the world, would apply to couples who lose a pregnancy at any point.AUCKLAND, New Zealand — New Zealand’s Parliament on Wednesday unanimously approved legislation that would give couples who suffer a miscarriage or stillbirth three days’ paid leave, putting the country in the vanguard of those providing such benefits.Ginny Andersen, the Labour member of Parliament who drafted the bill, said she had not been able to find comparable legislation anywhere in the world. “We may well be the first country,” she said, adding, “But all the countries that New Zealand is usually compared to legislate for the 20-week mark.”Employers in New Zealand, as in some other countries, had already been required to provide paid leave in the event of a stillbirth, when a fetus is lost after a gestation of 20 weeks or more. The new legislation will expand that leave to anyone who loses a pregnancy at any point, removing any ambiguity. The measure is expected to become law in the coming weeks.“I felt that it would give women the confidence to be able to request that leave if it was required, as opposed to just being stoic and getting on with life, when they knew that they needed time, physically or psychologically, to get over the grief,” Ms. Andersen said.The new law does not apply to those who terminate pregnancies, Ms. Andersen added. New Zealand decriminalized abortion last year, ending the country’s status as one of the few wealthy nations to limit the grounds for ending a pregnancy in the first half.In Australia, people who miscarry are entitled to unpaid leave if they lose a fetus after 12 weeks, while in Britain, would-be parents who experience a stillbirth after 24 weeks are eligible for paid leave. The United States does not require employers to provide leave for anyone who suffers a miscarriage.Up to 20 percent of all known pregnancies in the United States end in miscarriage, according to the Mayo Clinic. In New Zealand, whose population is five million, the Ministry of Health estimates that one to two pregnancies in 10 will end in miscarriage. The charity Sands New Zealand, which supports parents who have lost a pregnancy, says 5,900 to 11,800 miscarriages or stillbirths occur each year. More than 95 percent of the miscarriages occur in the first 12 to 14 weeks of pregnancy, according to data from the New Zealand College of Midwives.A miscarriage or stillbirth remains a fraught and painful topic, one that is difficult to talk about publicly or seek support for, health advocates say.“If you ring the hospital saying, ‘I think I’m miscarrying my baby,’ so many women will say, ‘I felt like I was the first person in the world to be miscarrying,’” said Vicki Culling, an educator about baby loss who has pushed for better support for bereaved parents in New Zealand.“The foundations of your world just crumble, because you expect to have this beautiful baby, and when that baby dies, whether it’s in utero or soon after birth, everything is shattered.”Ms. Culling applauded the New Zealand legislation as a first step but said there was more to be done.“You get three days’ paid leave, maybe you bury your baby or you have a service, and then you go back to work, and you carry on — and then what? That’s my concern,” she said.“I’m celebrating it, but I want to see us keeping this compassion going, and looking further into the needs of these parents.”

Coronavirus vaccines help protect people from getting seriously ill if they come into contact with the disease. But how do they work? And will a vaccine make you feel unwell? The BBC’s CrowdScience presenter Marnie Chesterton explains why a Covid vaccine can’t give you the virus, and why it’s normal to experience some mild side effects, such as a headache or a raised temperature. Voice: Marnie ChestertonVideo journalist: Jennifer GreenGraphics: We Are Covert With thanks to virologist Prof Jonathan Ball, University of Nottingham

Non-drug therapies as good as or better than drugs for treating depression in people with dementia
Doctors should consider more “social” prescribing of non-drug approaches for depression and loneliness, say researchers
Non-drug therapies, such as exercise, appear to be as, or more, effective than drugs for reducing symptoms of depression in people with dementia, suggests research published online in The BMJ.
The findings suggest that people with dementia will derive a clinically meaningful benefit from non-drug interventions, and the researchers say doctors should consider more “social” prescribing of non-drug approaches to treat symptoms of depression and loneliness.
Fifty million people worldwide have a diagnosis of dementia. About 16% of these people also have a diagnosed major depressive disorder, and 32% will experience symptoms of depression without a formal diagnosis.
Previous trials have shown that non-drug approaches, such as exercise, alleviate symptoms of depression in people with dementia, but it’s not clear how effective they are compared with drugs to reduce symptoms of depression.

Women who experience a miscarriage appear to be more likely to die prematurely (before age 70), particularly from cardiovascular disease, than women with all other pregnancy outcomes, suggests research published by The BMJ today.
The association between miscarriage and premature death was particularly strong for women who had miscarriages early in their reproductive life or who had recurrent miscarriages, prompting the researchers to suggest that miscarriage could be “an “early marker of future health risk in women.”
Spontaneous abortion (the official term for a miscarriage) is one of the most common adverse outcomes of pregnancy, affecting an estimated 12-24% of known pregnancies.
Substantial evidence indicates that women with a history of miscarriage have a greater risk of high blood pressure, cardiovascular diseases, and type 2 diabetes, but evidence relating miscarriage to risk of early death is scant and inconsistent.
To explore this further, a team of US researchers set out to investigate the associations between miscarriage and risk of all cause and cause specific premature death.
Their findings are based on data for 101,681 female nurses taking part in the Nurses’ Health Study II — an ongoing study of US women of reproductive age at the beginning of the study (25-42 years) — whose pregnancies and health were followed over a 24-year period between 1993 and 2017.

Even small increases in nitrogen dioxide levels in the air may be linked to increases in cardiovascular and respiratory deaths, according to research published by The BMJ today.
The findings suggest a need to revise and tighten the current air quality guidelines, and to consider stricter regulatory limits for nitrogen dioxide concentrations.
Nitrogen dioxide (NO2) is a common air pollutant formed by burning fuel for things like transport, power and industrial processes.
It is measured in micrograms (one-millionth of a gram) per cubic meter of air or µg/m3. World Health Organization (WHO) air quality guidelines currently recommend that nitrogen dioxide levels should not exceed an annual average of 40 40 µg/m3.
Many studies have reported the effects of short term exposure to NO2 on health, but most have been based on small samples, covered limited geographical areas, or used different study designs, so results are inconsistent.
To address this uncertainty, a team of international researchers set out to investigate the short term associations between NO2 and total, cardiovascular, and respiratory deaths across multiple countries/regions worldwide.

When clinical trials were conducted to determine the immunogenicity — the ability to elicit an immune response — for the first two vaccines marshaled against SARS-CoV-2the virus that causes COVID-19, one group was not among those included: people who have received solid organ transplants and others (such as those with autoimmune disorders) who are immunocompromised.
Now, Johns Hopkins Medicine researchers have tried to rectify that inequity, taking one of the first looks at how people who are immunocompromised respond to their first dose of one of the two mRNA vaccines — Moderna and Pfizer-BioNTech — currently being administered worldwide. Their findings, as published March 15, 2021, in a research letter in the Journal of the American Medical Association, disappointingly show that only 17% produced detectable antibodies against the SARS-CoV-2 virus.
“This is in stark contrast to people with healthy immune systems who are vaccinated, nearly all of whom mount a sufficient antibody defense against COVID-19,” says study lead author Brian Boyarsky, M.D., a surgery resident at the Johns Hopkins University School of Medicine.
The study evaluated the vaccine immunogenic response for 436 transplant recipients, none of whom had a prior diagnosis of COVID-19 or tested positively for SARS-CoV-2 antibodies. The median age was 55.9 years and 61% were women. Fifty-two percent were administered a single dose of the Pfizer-BioNTech vaccine and 48% received one shot of the Moderna vaccine. The median time since transplant for the participants was 6.2 years.
At a median time of 20 days after the first dose of vaccine, the researchers report that only 76 of the 436 participants (17%) had detectable antibodies to the SARS-CoV-2 virus. The researchers also found that among the 76 transplant recipients, the most likely to develop an antibody response were those younger than age 60 who did not take anti-metabolites for immunosuppression and who received the Moderna vaccine.
“Given these observations, we feel that the U.S. Centers for Disease Control and Prevention should update their new guidelines for vaccinated individuals to warn immunocompromised people that they still may be susceptible to COVID-19 after vaccination,” says study senior author Dorry Segev, M.D., Ph.D., the Marjory K. and Thomas Pozefsky Professor of Surgery and Epidemiology and director of the Epidemiology Research Group in Organ Transplantation at the Johns Hopkins University School of Medicine. “As the guidelines are currently written, people assume that vaccination means immunity.”
Segev says that upcoming studies will define the immunogenic response of organ transplant recipients and other immunocompromised patients after a second vaccine dose. Other studies will look at the impact of more extensive immune system profiling — including characterizing the immune cells that remember SARS-CoV-2 after vaccination and produce antibodies, or directly attack the virus in response to the presence of the virus — to help guide vaccination strategies for this population.
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