Food manufacturers are recalling a small number of products – believed to be pre-packed sandwiches containing salad leaves – as a precaution following a recent outbreak of E. coli in the UK.

21 minutes agoBy 

As a boy, Les Milne carried an air of triumph about him, and an air of sorrow. Les was a particularly promising and energetic young man, an all-Scottish swim champion, head boy at his academy in Dundee, a top student bound for medical school. But when he was young, his father died; his mother was institutionalized with a diagnosis of manic depression, and he and his younger brother were effectively left to fend for themselves. His high school girlfriend, Joy, was drawn to him as much by his sadness as his talents, by his yearning for her care. “We were very, very much in love,” Joy, now a flaxen-haired 72-year-old grandmother, told me recently. In a somewhat less conventional way, she also adored the way Les smelled, and this aroma of salt and musk, accented with a suggestion of leather from the carbolic soap he used at the pool, formed for her a lasting sense of who he was. “It was just him,” Joy said, a steadfast marker of his identity, no less distinctive than his face, his voice, his particular quality of mind.Listen to this article, read by Robert PetkoffJoy’s had always been an unusually sensitive nose, the inheritance, she believes, of her maternal line. Her grandmother was a “hyperosmic,” and she encouraged Joy, as a child, to make the most of her abilities, quizzing her on different varieties of rose, teaching her to distinguish the scent of the petals from the scent of the leaves from the scent of the pistils and stamens. Still, her grandmother did not think odor of any kind to be a polite topic of conversation, and however rich and enjoyable and dense with information the olfactory world might be, she urged her granddaughter to keep her experience of it to herself. Les only learned of Joy’s peculiar nose well after their relationship began, on a trip to the Scandinavian far north. Joy would not stop going on about the creamy odor of the tundra, or what she insisted was the aroma of the cold itself.Joy planned to go off to university in Paris or Rome. Faced with the prospect of tending to his mother alone, however, Les begged her to stay in Scotland. He trained as a doctor, she as a nurse; they married during his residency. He was soon the sort of capable young physician one might hope to meet, a practitioner of uncommon enthusiasm, and shortly after his 30th birthday, he was appointed consultant anesthesiologist at Macclesfield District General Hospital, outside Manchester, in England, the first in his graduating class to make consultant.The Milnes installed themselves in an ancient stone farmhouse high on a country hill in Cheshire. By then they had three young sons, and the edifice, which was old enough to be listed in the Domesday Book of 1086, was a happy, never-ending project. They threw elaborate, boozy dinner parties; they kept geese and hens and took in stray cats, dogs, a duck. “We just seemed to get on and do things,” Joy told me. Friends still liken her to Mary Poppins, part twinkly magic, part no frills practicality. She considers herself to be a “never-stop person,” she said. Her husband was the same.Les spent long hours in the surgical theater, which in Macclesfield had little in the way of ventilation, and Joy typically found that he came home smelling of anesthetics, antiseptics and blood. But he returned one August evening in 1982, shortly after his 32nd birthday, smelling of something new and distinctly unsavory, of some thick must. From then on, the odor never ceased, though neither Les nor almost anyone but his wife could detect it. For Joy, even a small shift in her husband’s aroma might have been cause for distress, but his scent now seemed to have changed fundamentally, as if replaced by that of someone else. She thought he smelled vaguely of his mother.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

2 hours agoBy 

Excess sodium intake and a lack of potassium are major contributing factors towards high blood pressure in Indonesia, prompting calls for low-sodium potassium-rich salt substitutes (LSSS) to be readily available to improve health and curb health costs.
New Griffith University research has looked at the impact of switching out current table salt (100 per cent sodium chloride) with a low-sodium alternative in Indonesia.
Lead author Dr Leopold Aminde from the School of Medicine and Dentistry said the World Health Organisation has recommended a population-wide reduction in sodium consumption to tackle the burden of high blood pressure and non-communicable diseases.
“LSSS look similar to table salt and research shows they have a similar taste with some consumers unable to differentiate between the two options,” Dr Aminde said.
“The research shows that making LSSS available would have a positive impact on the Indonesian health system by reducing blood pressure, and preventing heart attacks, strokes, and kidney disease.
“Ultimately it would reduce health expenditure by up to US$2 billion [IDR 27.7 trillion] over 10 years, providing a much-needed cost-saving measure.”
Dr. Wahyu Nugraheni, co-author and Head of the Research Centre for Public Health and Nutrition at the National Research and Innovation Agency in Jakarta said: “Indonesians consume more sodium than is physiologically required.”
“LSSS are an excellent option to help people effortlessly reduce the sodium in their diet,” Dr Nugraheni said.

Over the first 10 years of implementation, LSSS could prevent up to 1.5 million non-fatal cardiovascular disease events and more than 640,000 new cases of chronic kidney disease.
“The greatest health benefits will likely be seen in the low-income bracket of the population,” Dr Aminde said.
The research team is hoping the findings will prompt the government in Indonesia, and other countries globally, to consider reformulation of regular salt to LSSS alternatives, or facilitate supply chains to expand their availability and affordability.
The research findings will inform the upcoming WHO guidelines on the evidence gaps related to implementation costs, cost-effectiveness, and the possible impacts on health inequalities.
The paper ‘Cost-effectiveness analysis of low-sodium potassium-rich salt substitutes in Indonesia: an equity modelling study’ has been published in The Lancet Regional Health — Southeast Asia.

Deploying and evaluating a machine learning intervention to improve clinical care and patient outcomes is a key step in moving clinical deterioration models from byte to bedside, according to a June 13 editorial in Critical Care Medicine that comments on a Mount Sinai study published in the same issue. The main study found that hospitalized patients were 43 percent more likely to have their care escalated and significantly less likely to die if their care team received AI-generated alerts signaling adverse changes in their health.
“We wanted to see if quick alerts made by AI and machine learning, trained on many different types of patient data, could help reduce both how often patients need intensive care and their chances of dying in the hospital,” says lead study author Matthew A. Levin, MD, Professor of Anesthesiology, Perioperative and Pain Medicine, and Genetics and Genomic Sciences, at Icahn Mount Sinai, and Director of Clinical Data Science at The Mount Sinai Hospital. “Traditionally, we have relied on older manual methods such as the Modified Early Warning Score (MEWS) to predict clinical deterioration. However, our study shows automated machine learning algorithm scores that trigger evaluation by the provider can outperform these earlier methods in accurately predicting this decline. Importantly, it allows for earlier intervention, which could save more lives.”
The non-randomized, prospective study looked at 2,740 adult patients who were admitted to four medical-surgical units at The Mount Sinai Hospital in New York. The patients were split into two groups: one that received real-time alerts based on the predicted likelihood of deterioration, sent directly to their nurses and physicians or a “rapid response team” of intensive care physicians, and another group where alerts were created but not sent. In the units where the alerts were suppressed, patients who met standard deterioration criteria received urgent interventions from the rapid response team.
Additional findings in the intervention group demonstrated that patients: were more likely to get medications to support the heart and circulation, indicating that doctors were taking early action; and were less likely to die within 30 days”Our research shows that real-time alerts using machine learning can substantially improve patient outcomes,” says senior study author David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens, the Horace W. Goldsmith Professor of Anesthesiology, and Professor of Artificial Intelligence and Human Health at Icahn Mount Sinai. “These models are accurate and timely aids to clinical decision-making that help us bring the right team to the right patient at the right time. We think of these as ‘augmented intelligence’ tools that speed in-person clinical evaluations by our physicians and nurses and prompt the treatments that keep our patients safer. These are key steps toward the goal of becoming a learning health system.”
The study was terminated early due to the COVID-19 pandemic. The algorithm has been deployed on all stepdown units within The Mount Sinai Hospital, using a simplified workflow. A stepdown unit is a specialized area in the hospital where patients who are stable but still require close monitoring and care are placed. It’s a step between the intensive care unit (ICU) and a general hospital area, ensuring that patients receive the right level of attention as they recover.
A team of intensive care physicians visits the 15 patients with the highest prediction scores every day and makes treatment recommendations to the doctors and nurses caring for the patient. As the algorithm is continually retrained on larger numbers of patients over time, the assessments by the intensive care physicians serve as the gold standard of correctness, and the algorithm becomes more accurate through reinforcement learning.
In addition to this clinical deterioration algorithm, the researchers have developed and deployed 15 additional AI-based clinical decision support tools throughout the Mount Sinai Health System.
The Mount Sinai paper is titled “Real-Time Machine Learning Alerts to Prevent Escalation of Care: A Nonrandomized Clustered Pragmatic Clinical Trial.” The remaining authors of the paper, all with Icahn Mount Sinai except where indicated, are Arash Kia, MD, MSc; Prem Timsina, PhD; Fu-yuan Cheng, MS; Kim-Anh-Nhi Nguyen, MS; Roopa Kohli-Seth, MD; Hung-Mo Lin, ScD (Yale University); Yuxia Ouyang, PhD; and Robert Freeman, RN, MSN, NE-BC.

Health practitioners and fitness buffs have long known that regular physical activity offers numerous health benefits, including the prevention of chronic conditions such as cardiovascular disease, diabetes, some cancers and osteoporosis.
In addition, exercise enhances immune function and pain control, reduces fall risk and extends life expectancy. Mental health benefits include improved mood, reduced anxiety and decreased risk of dementia and depression.
Despite all these benefits, more than three out of four adults in the United States get far less exercise than the recommended 150 to 300 minutes a week of moderate physical activity or 75 to 150 minutes a week of vigorous physical activity.
Studies have also found that outdoor places such as parks and trails are effective settings for physical activity. The COVID-19 pandemic made this especially clear. Moreover, being in nature provides physical and mental health benefits similar to those of physical activity.
To date, little has been known about any potential additive benefits of engaging in physical activity in natural settings. Could being outdoors increase the effects of exercise while also encouraging more people to exercise? And if so, how could health professionals promote this behavior?
To answer these questions and more, Jay Maddock, Regents Professor with the School of Public Health at Texas A&M University and director of the university-led, collaborative Center for Health & Nature, along with Howard Frumkin, Hagler Fellow and senior vice president and director of the Land and People Lab, assessed the current scientific evidence regarding physical activity in natural settings and developed strategies for promoting these activities.
Their study, published in the American Journal of Lifestyle Medicine, identified several factors that affect how often people visit parks and natural settings, the extent to which they engage in physical activities once there and the benefits they get from this activity.

Maddock and Frumkin found that research suggests exercising in a park or other natural setting is more beneficial than exercising indoors. These studies focused on short-term outcomes of less than one year, however, and whether these benefits occur over the long term remains to be seen.
“Despite this, the research is clear that natural settings could be an effective venue for promoting physical activity,” Maddock said. “People generally enjoy being outdoors, with parks, trails and community gardens being the most popular venues.”
Factors that make these venues more attractive to visitors include physical features such as community centers, playgrounds, lighting and clear signage, as well natural features such as tree canopy and bodies of water that are well maintained. Activities such as classes and festivals also contribute to their popularity, as do a welcoming environment, a perception of safety, and visitors’ strong feeling of connectedness to nature and belief that spending time in these spaces is important.
“Parks and trails are particularly important due to their accessibility and widespread availability, but access varies significantly by geography, and rural areas often have less access to natural spaces because they have more privately held land,” Maddock said. “For example, nearly 98 percent of Illinois residents live within half a mile of a park, compared to only 29 percent in Mississippi.”
Maddock and Frumkin also found that use of parks and greenspaces for physical activity varies across demographic groups, with men more likely than women to use these spaces for physical activity. In addition, a study of parks in Los Angeles found that Black adults are less likely than white adults to engage in physical activity in parks, while English-speaking Latinos are equally likely and Asian/Pacific Islanders are more likely.
“Some groups — Black, Indigenous, and other people of color and immigrant and refugee populations, for example — often have experienced historic or current discrimination that hinders their use of natural spaces, and they routinely have less access to high-quality parks,” Frumkin said. “In addition, children, the elderly and people with disabilities face challenges in accessing natural spaces. Ensuring that these spaces are safe and easy to navigate, with appropriate programming, could help increase their use of parks and other natural settings.”
With these complexities in mind, Maddock and Frumkin offer four options that health care professionals could implement to encourage the use of parks and other natural settings by their patients.

One is simply to “prescribe” nature contact to patients.
“Recommending that patients spend more time in these settings is known as nature prescriptions or ‘ParkRx,’ and while more research is needed, the studies to date suggest that this approach is effective,” Maddock said.
Another is for health professionals to model this behavior by engaging in it themselves. This modeling has been found to be effective in promoting healthy behaviors while also enhancing the well-being of the health professionals.
A third approach is for health professionals to engage in community efforts that promote the use of outdoor spaces, such as Houston’s Be Well Communities initiative, which is supported by the M.D. Anderson Cancer Center.
Finally, health professionals could help create and maintain parks and greenspaces by steering funds into these efforts through Community Health Needs Assessments, Medicaid funds and funds from health care conversion foundations.
“It is clear that the use of parks and natural settings for physical activities could be a potentially powerful tool for promoting two important health behaviors simultaneously,” Maddock said. “This could be especially important given that the majority of Americans do not get enough exercise or spend enough time outdoors.”

The capacity to adjust beliefs about one’s actions and their consequences in a constantly changing environment is a defining characteristic of advanced cognition. Disruptions to this ability, however, can negatively affect cognition and behavior, leading to such states of mind as paranoia, or the belief that others intend to harm us.
In a new study, Yale scientists uncover how one specific region of the brain might causally provoke these feelings of paranoia.
Their novel approach — which involved aligning data collected from monkeys with human data — also offers a new cross-species framework through which scientists might better understand human cognition through the study of other species.
Their findings, and the approach they used, are described June 13 in the journal Cell Reports.
While past studies have implicated some brain regions in paranoia, the understanding of paranoia’s neural underpinnings remains limited.
For the new study, the Yale researchers analyzed existing data from previous studies, conducted by multiple labs, on both humans and monkeys.
In all of the previous studies, humans and monkeys performed the same task, which captures how volatile, or how unstable, a participant believes their environment to be. Participants in each study were given three options on a screen, which were associated with different probabilities of receiving a reward.

If the participants selected the option with the highest probability of reward, they would get a reward with fewer clicks across trials. The option with the lowest probability required more clicks to receive a reward. The third option, meanwhile, was somewhere in the middle. Participants did not have information on the reward probability and had to uncover their best option by trial and error.
After a set number of trials and without warning, the highest and lowest reward probability options flip.
“So participants have to figure out what’s the best target, and when there’s a perceived change in the environment, the participant then has to find the new best target,” said Steve Chang, associate professor of psychology and of neuroscience in Yale’s Faculty of Arts and Sciences and co-senior author of the study.
Participants’ clicking behavior before and after the flip could reveal information about how volatile they view their environment to be and how adaptive their behavior is within that changing environment. “Not only did we use data in which monkeys and humans performed the same task, we also applied the same computational analysis to both datasets,” said Philip Corlett, an associate professor of psychiatry at Yale School of Medicine and co-senior author of the study. “The computational model is essentially a series of equations that we can use to try to explain the behavior, and here it serves as the common language between the human and monkey data and allows us to compare the two and see how the monkey data relates to the human data.”
In the previous studies, some of the monkeys had small but specific lesions in one of two brain regions of interest: the orbitofrontal cortex, which has been associated with reward-related decision-making, or the mediodorsal thalamus, which sends environmental information to the decision-making control centers of the brain. Among human participants, some had reported high paranoia and some did not.
The researchers found that the presence of lesions in both brain regions negatively affected the behavior of the monkeys, but in different ways.

Monkeys with lesions in the orbitofrontal cortex more often stuck with the same options even after not receiving a reward. Those with lesions in the mediodorsal thalamus, on the other hand, displayed erratic switching behavior, even after receiving reward. They appeared to perceive their environments as especially volatile, which was similar to what the researchers observed in the human participants with high paranoia.
The findings offer new information about what is happening in the human brain — and the role the mediodorsal thalamus might play — when people experience paranoia, say the researchers. And they provide a pathway for how to study complex human behaviors in simpler animals.
“It allows us to ask how we can translate what we learn in simpler species — like rats, mice, maybe even invertebrates — to understand human cognition,” said Corlett, who, along with Chang, is a member of Yale’s Wu Tsai Institute, which aims to accelerate understanding of human cognition.
This approach will also allow researchers to assess how pharmaceutical treatments that affect states like paranoia actually work in the brain.
“And maybe down the road we can use it to find new ways to reduce paranoia in humans,” said Chang.
The work was led by co-first authors Praveen Suthaharan, a graduate student in Corlett’s lab, and Summer Thompson, an associate research scientist in Yale’s Department of Psychiatry. It was done in collaboration with Jane Taylor, the Charles B.G. Murphy Professor of Psychiatry at Yale School of Medicine.

21 minutes agoBy 

Loaded guns often are not locked, even in homes where there are children, federal researchers reported.Many firearm owners in the United States do not securely store their guns, even when the weapon is kept loaded and there are children in the home, according to a report released on Thursday by the Centers for Disease Control and Prevention.The report, which relied on data from 2021 and 2022 from eight states, found that many gun owners kept weapons unlocked and loaded in their homes despite rising rates of suicides involving guns and firearm fatalities among children. Gun storage practices varied across the eight states: Alaska, California, Minnesota, Nevada, New Mexico, North Carolina, Ohio and Oklahoma.Of those surveyed in Ohio who had both children and a loaded gun in the house, about a quarter said that the weapon was kept unlocked; it was the smallest percentage among the seven states with available data for that metric. In Alaska, more than 40 percent respondents fell into that category.In all eight states, about half of respondents who reported having loaded firearms in their homes said that at least one loaded gun was kept unlocked, a finding consistent with similar studies about firearm storage behavior.The number of children who die by suicide has been trending up for more than a decade. In 2022, firearm suicides among children reached the highest rate in more than 20 years, which public health experts and advocacy groups largely attributed to the Covid-19 pandemic and rising gun sales.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.