23 hours agoIan Aikman

A scientist finds beauty in the “visual synonyms” that exist in images seen through microscopes and telescopes.For Kimberly Arcand, a visualization scientist with NASA’s Chandra X-ray Observatory, visual symmetry reveals how basic physics and chemistry thread through everything in the universe, from the tiniest organisms to the most massive galactic clusters.Microscopes might capture more in terms of magnitude, she said, but telescopes let us travel back in time by peering into the earliest periods of our universe. Can you tell the difference between microscopic and massive?Red whirls on this rabbit’s tongue are filiform papillae, which roughen the tongue and help move food around the mouth. Along with blue connective tissue and purple muscle fibers, the striped structure brings to mind …… the gas giant Jupiter. The planet’s rotation gives rise to the Coriolis effect, which deflects air flow and determines the direction of its swirling cyclones and bands.These clumps of Raji cells, which can cause a strain of herpes in humans, look like …… the sun’s churning surface. Dark spots are cooler than the surrounding areas; they appear where the star’s magnetic field keeps heat from emerging. Purple and white “spike” proteins on this popular model of the coronavirus help it attach to and enter our cells. These might remind you of …… the clumps of cosmic debris in Tycho’s supernova, a star that may have exploded at many points simultaneously.Each color in this slice of a mouse’s eye is a different amino acid; green is glutamine, pink is taurine and blue is glutamate. Its rings resemble …… the raging vortex at Saturn’s north pole, where green, pink and blue correspond to clouds of increasing depth. Winds whip around this hexagon at 300 miles per hour, but why the region forms the shape is a mystery.The bacterium that causes tuberculosis glows yellow in this phlegm sample; in orange are possible immune cells from the lung. Together they look like … … expanding bubbles, sculpted by stellar winds and explosions, in a galaxy called the Small Magellanic Cloud. Some astronomers believe our solar system formed within a similar structure.The time-keeping cells, in green, in a mouse brain brighten and dim throughout the day, helping the body maintain its circadian rhythm. The nucleus of each cell glows blue. Compare this to …… a cluster of stars in our Milky Way emitting infrared light, in green. Diffuse X-rays, in blue, were probably created by plasma streaming from the stars and heating the surrounding gas.Produced by

At the American Psychiatric Association’s annual meeting, a patient described a restraint that haunts him, more than eight years later.The annual gathering of the American Psychiatric Association is a dignified and collegial affair, full of scholarly exchanges, polite laughter and polite applause.So it was a shock, for those who took their seats in Room 1E08 of the Jacob K. Javits Convention Center in Manhattan, to watch a powerfully built 32-year-old man choke back tears as he described being slammed to the floor and cuffed to a stretcher in a psychiatric unit.Because the man, Matthew Tuleja, had been a Division I football player, he had a certain way of describing the circle of bodies that closed around him, the grabbing and grappling and the sensation of being dominated, pinned and helpless.He was on the ground in a small room filled with pepper spray. Then his wrists and ankles were cuffed to the sides of a stretcher, and his pants were yanked down. They gave him injections of Haldol, an antipsychotic medication he had repeatedly tried to refuse, as he howled in protest.Forcible restraints are routine events in American hospitals. One recent study, using 2017 data from the Centers for Medicare and Medicaid Services, estimated the number of restraints per year at more than 44,000.But it is rare to hear a first-person account of the experience, because it tends to happen to people who do not have a platform. Researchers who surveyed patients about restraint and seclusion have found that a large portion, 25 to 47 percent , met criteria for post-traumatic stress disorder.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.

Published1 hour agoShareclose panelShare pageCopy linkAbout sharingImage source, British RowingBy Rachel Schraer & Paul GrantBBC Trending and BBC File on 4A former Team GB rower claims a treatment she underwent for long Covid leaves participants feeling “blamed” for being ill.Oonagh Cousins was offered a free place on a course run by the Lightning Process, which teaches people they can rewire their brains to stop or improve long Covid symptoms quickly. Ms Cousins, who contracted Covid in March 2020, said it “exploits” people.However, the programme’s founder denied it blames patients for their illness, saying that was completely at odds with the concepts of the programmePhysical illnessMs Cousins had reached a career goal many athletes can only dream of – being selected for the Olympics – when she developed long Covid. By the time the cancelled 2020 Olympic Games in Tokyo were rescheduled for 2021, Ms Cousins was too ill to take part.When she went public with her struggles, she was approached by the Lightning Process. It offered her a free place on a three-day course, which usually costs around £1,000.”They were trying to suggest that I could think my way out of the symptoms, basically. And I disputed that entirely,” the former rower said.”I had a very clearly physical illness. And I felt that they were blaming my negative thought processes for why I was ill.” She added: “They tried to point out that I had depression or anxiety. And I said ‘I’m not, I’m just very sick’.”What are the symptoms of long Covid?Long Covid blood clues could prompt future trialsHealth staff start court fight over long CovidThere is no official test or approved treatment for long Covid – an umbrella term to describe a range of different problems in different people. For illnesses we cannot yet directly test for, there is a history of branding them as being driven by mindset. This is an ongoing challenge for ME patients, also known as chronic fatigue syndrome.Multiple sclerosis and extreme pregnancy sickness were both, at one time, considered to be psychological. But researchers now have growing evidence of what is causing long Covid – pockets of virus hiding in organs, signs in the blood of a disrupted immune system, and other measurable changes. In secret recordings by the BBC, coaches can be heard telling patients that almost anyone can recover from long Covid by changing their thoughts, language and actions.Over three days on Zoom, the course taught the ritual that forms the basis of the programme. Every time you experience a symptom or negative thought, you say the word “stop”, make a choice to avoid these symptoms and then do a positive visualisation of a time you felt well.You do this while walking around a piece of paper printed with symbols – a ritual the BBC was told to do as many as 50 times a day.Prof Danny Altmann, a leading long Covid researcher, says such behavioural approaches disregard the “mass” of underlying damage in patients that can be measured in tests. Image source, British RowingWe’ve spoken to several people who did not get better – and even felt worse – after taking the course. There were some who said it did help them a lot, including one who said it made her feel better almost immediately.In some cases the Lightning Process has encouraged participants to increase their activity levels without medical supervision, against official advice – which could make some more unwell, according to NHS guidelines. Lightning Process founder, Dr Phil Parker, who’s not a medical doctor but has a PhD in psychology of health, told us his course was “not a mindset or positive thinking approach,” but one that uses “the brain to influence physiological changes”, backed by peer-reviewed evidence. The coach on the course we attended said “thoughts about your symptoms, your worry about whether it’s ever going to go – that’s what keeps the neurology going.””Being in those kind of thoughts is what’s maintaining your symptoms,” the coach said. “They’re not caused by a physical thing any more.”Postcode lotteryDr Camilla Nord, a neuroscientist at the University of Cambridge, disputed these claims. She said the Lightning Process was “right that the brain can create symptoms of physical ill health” but added: “I think it’s a wild claim to say there’s nothing wrong with your body.”She believes there is a place for therapies that calm the body’s stress response and adjust how people react to their symptoms. But even if some symptoms are based in the brain, she added, that didn’t mean it was “something that you can actively change”. The coach on the course stressed the importance of avoiding negative thoughts and words like “pain” and “fatigue”, claiming using them can continue symptoms. “I’m afraid now we’ve strayed very, very far from neuroscience,” Dr Nord says, calling this an “abuse” of scientific terms. When we put these specific claims to Dr Parker, he said our questions seemed to be “informed solely by the rumours and misinformation” circulated by what he called “anti-recovery activists”. Long Covid support groups told the BBC’s File on 4 programme that a lack of consistent services for patients is leaving people with nowhere to go. Of the 90 trusts running long Covid services in England, about two-thirds (58 trusts) responded to Freedom of Information requests asking for details about their provision. Of those, seven had at least one full-time doctor on staff. Eleven said they could not order tests or scans, while 24 said they could not prescribe drugs.Prof Altmann, said: “There are hundreds of thousands of dissatisfied, desperate patients who never get to meet any doctor.” He said the long Covid clinic coverage was “uneven” and had become a “postcode lottery”.Long Covid: Mind Over Matter?Rachel Schraer investigates a controversial programme that claims to retrain patients’ brains to stop or improve their symptoms.Listen on BBC Radio 4 and BBC Sounds.

Published10 minutes agoShareclose panelShare pageCopy linkAbout sharingThis video can not be playedTo play this video you need to enable JavaScript in your browser.By André Rhoden-PaulBBC NewsRishi Sunak has promised to pay “comprehensive compensation” to people affected by the infected blood scandal. The prime minister said the government would pay “whatever it costs” following a damning report on the scandal, which saw 30,000 people infected. A public inquiry found authorities had exposed victims to unacceptable risks and covered up the NHS’s biggest treatment disaster.The government will set out compensation details on Tuesday. Ministers have reportedly earmarked around £10bn for a compensation package. The Infected Blood Inquiry accused doctors, government and the NHS of letting patients catch HIV and hepatitis while they were receiving NHS care between the 1970s and 1990s.About 3,000 have since died and more deaths will follow.Chris Mason: Will things ever change?Infected blood report’s key findings at a glanceWhy thousands of NHS patients were given infected bloodRead more about the victims, families and what happenedMr Sunak described the release of the report as a “day of shame for the British state” and vowed to pay “comprehensive compensation” to those affected and infected by the scandal. “Whatever it costs to deliver this scheme, we will pay it,” he told the House of Commons on Monday. He said Cabinet Office minister John Glen would set out the details on compensation on Tuesday. Members of the infected blood community said that they expected the government to set out how much compensation would be paid, simplified into a few categories. This is likely to come under five main categories: injury, social impact, autonomy, care and financial loss.Sir Keir Starmer, leader of the opposition Labour party, apologised too for his party’s involvement whilst in government and welcomed the Conservative prime minister’s confirmation of financial support for victims, saying Labour would “work with him to get that done swiftly”.’Compensation must be paid now’ The inquiry looked at over 50 years of decision-making before, during and after the infection of thousands of people from contaminated blood transfusions and blood products from the 1970s onwards.The 2,527-page report found the infected blood scandal “could largely have been avoided” and there had been a cover-up to hide the truth. Deliberate attempts were made to conceal the disaster, including evidence of Whitehall officials destroying documents, the inquiry found.Inquiry chairman Sir Brian Langstaff said: “What I have found is that disaster was no accident.”People put their trust in doctors and the government to keep them safe and that trust was betrayed…”That’s why what I’m recommending is that compensation must be paid now.”Image source, PA MediaSir Brian’s two interim reports, in July 2022 and April 2023, made recommendations about compensation for victims and their families.The government has already made interim pay-outs of £100,000 each to about 4,000 survivors and bereaved partners.Two main groups were caught up in the scandal:One was people with haemophilia or similar rare genetic disorders preventing their blood properly clottingThe second group included people who had had a blood transfusion after childbirth, accidents or during medical treatment.Behind the Story: The infected blood scandalHealth editor Hugh Pym and senior producer Chloe Hayward go behind the story of the infected-blood inquiry.Available now on BBC iPlayer.

As Dr. Sreyleak Luch drove to work the morning of Feb. 8, through busy sunbaked streets in Cambodia’s Mekong river delta, she played the overnight voice messages from her team. The condition of a 9-year-old boy she had been caring for had deteriorated sharply, and he had been intubated, one doctor reported. What, she wondered, could make the child so sick, so fast?“And then I just thought: H5N1,” she recalled. “It could be bird flu.”When she arrived at the airy yellow children’s ward at the provincial hospital in Kratie, she immediately asked the child’s father if the family had had contact with any sick or dead poultry. He admitted that their rooster had been found dead a few days before and that the family had eaten it.Dr. Luch told her colleagues her theory. Their responses ranged from dubious to incredulous: A human case of avian influenza had never been reported in their part of eastern Cambodia. They warned her that if she set off the bird flu warning system, many senior government officials might get involved. She risked looking foolish, or worse.Anxious but increasingly certain, Dr. Luch phoned the local public health department, located just across the street. Within minutes, a team arrived to collect a sample from the child, Virun Roeurn, for testing in a lab.By then, Virun’s distraught parents had lost faith in the hospital. They demanded that he be sent by ambulance to the capital, Phnom Penh. His flu swab sample traveled with him.Virun died on the journey. At 8 p.m., Cambodia’s National Public Health Laboratory confirmed Dr. Luch’s suspicion: He had died of highly pathogenic avian influenza.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.

An increase in nightmares and hallucinations — or ‘daymares’ — could herald the onset of autoimmune diseases such as lupus, say an international team led by researchers at the University of Cambridge and King’s College London.
The researchers argue that there needs to be greater recognition that these types of mental health and neurological symptoms can act as an early warning sign that an individual is approaching a ‘flare’, where their disease worsens for a period.
In a study published today in eClinicalMedicine, researchers surveyed 676 people living with lupus and 400 clinicians, as well as carrying out detailed interviews with 69 people living with systemic autoimmune rheumatic diseases (including lupus) and 50 clinicians. Lupus is an autoimmune inflammatory disease known for its effect on many organs including the brain.
In the study, the team also asked patients about the timing of 29 neurological and mental health symptoms (such as depression, hallucinations and loss of balance). In interviews, patients were also asked if they could list the order that symptoms usually occurred when their disease was flaring.
One of the more common symptoms reported was disrupted dream sleep, experienced by three in five patients, a third of whom reported this symptom appearing over a year before onset of lupus disease.
Just under one in four patients reported hallucinations, though for 85% of these the symptom did not appear until around the onset of disease or later. When the researchers interviewed the patients, however, they found that three in five lupus patients and one in three with other rheumatology-related conditions reported increasingly disrupted dreaming sleep — usually vivid and distressing nightmares — just before their hallucinations. These nightmares were often vivid and distressing, involving being attacked, trapped, crushed, or falling.
One patient from Ireland described their nightmares as: “Horrific, like murders, like skin coming off people, horrific…I think it’s like when I’m overwhelmed which could be the lupus being bad…So I think the more stress my body is under then the more vivid and bad the dreaming would be.”
The study interviewers found that using the term ‘daymares’ to talk about hallucinations often led to a ‘lightbulb’ moment for patients, and they felt that it was a less frightening and stigmatised word.

A patient from England said: “[When] you said that word daymare and as soon as you said that it just made sense, it’s like not necessarily scary, it’s just like you’ve had a dream and yet you’re sitting awake in the garden…I see different things, it’s like I come out of it and it’s like when you wake up and you can’t remember your dream and you’re there but you’re not there… it’s like feeling really disorientated, the nearest thing I can think of is that I feel like I’m Alice in Wonderland.”
Patients experiencing hallucinations were reluctant to share their experiences, and many specialists said they had never considered nightmares and hallucinations as being related to disease flares. Most said they would talk to their patients about nightmares and hallucinations in future, agreeing that recognising these early flare symptoms may provide an ‘early warning system’ enabling them to improve care and even reduce clinic times by averting flares at any earlier stage.
Lead author Dr Melanie Sloan from the Department of Public Health and Primary Care at the University of Cambridge said: “It’s important that clinicians talk to their patients about these types of symptoms and spend time writing down each patient’s individual progression of symptoms. Patients often know which symptoms are a bad sign that their disease is about to flare, but both patients and doctors can be reluctant to discuss mental health and neurological symptoms, particularly if they don’t realise that these can be a part of autoimmune diseases.”
Senior study author Professor David D’Cruz from Kings College London said: “For many years, I have discussed nightmares with my lupus patients and thought that there was a link with their disease activity. This research provides evidence of this, and we are strongly encouraging more doctors to ask about nightmares and other neuropsychiatric symptoms — thought to be unusual, but actually very common in systemic autoimmunity — to help us detect disease flares earlier.”
The importance of recognising these symptoms was highlighted by reports that some patients had initially been misdiagnosed or even hospitalised with a psychotic episode and/or suicidal ideation, which was only later found to be the first sign of their autoimmune disease.
One patient from Scotland said: “At 18 I was diagnosed with borderline personality disorder, and then 6 months later with lupus at 19, so it’s all very close together and it was strange that when my [borderline personality disorder] got under control and my lupus got under control was within 6 months.”
A nurse from Scotland said: “I’ve seen them admitted for an episode of psychosis and the lupus isn’t screened for until someone says ‘oh I wonder if it might be lupus’…but it was several months and very difficult… especially with young women and it’s learning more that that is how lupus affects some people and it’s not anti-psychotic drugs they needed, it’s like a lot of steroids.”

Professor Guy Leschziner, a study author and neurologist at Guys’ and St Thomas’ hospital, and author of The Secret World of Sleep, said: “We have long been aware that alterations in dreaming may signify changes in physical, neurological and mental health, and can sometimes be early indicators of disease. However, this is the first evidence that nightmares may also help us monitor such a serious autoimmune condition like lupus, and is an important prompt to patients and clinicians alike that sleep symptoms may tell us about impending relapse.”
The research was funded by The Lupus Trust and is part of the INSPIRE project (Investigating Neuropsychiatric Symptom Prevalence and Impact in Rheumatology patient Experiences).

Chronic obstructive pulmonary disease patients with type 2 inflammation may soon gain access to a new drug — dupilumab — that showed rapid and sustained improvements in patients in a pivotal Phase 3 clinical trial, researchers report in the New England Journal of Medicine. This monoclonal antibody is the first biologic shown to improve clinical outcomes in COPD. The data supporting the use of dupilumab in COPD will be reviewed by the United States Food and Drug Administration in June.
The disease improvements — as measured by a significantly lower annualized rate of acute exacerbations and significantly better lung function than placebo-treated adults with COPD — were observed at 12 weeks after the initiation of dupilumab and were sustained throughout the 52-week trial period. In terms of safety, the number of adverse events was similar between placebo and treatment groups and consistent with the established profile of dupilumab.
The lung disease COPD is marked by cough and labored breathing. COPD has traditionally been thought of as an inflammatory disease predominantly driven by neutrophilic inflammation. About 20 percent to 40 percent of COPD patients have COPD with a predominant type 2 inflammation that is commonly detected by elevated blood eosinophil counts. These patients have a high risk of exacerbations.
“Dupilumab substantially decreases exacerbation frequency and improves lung function as well as symptom burden in patients with COPD with type 2 inflammation and high exacerbation risk, who are already on maximal inhaled therapy,” said Surya Bhatt, M.D., a professor of medicine and endowed professor of airways disease in the University of Alabama at Birmingham Department of Medicine Division of Pulmonary, Allergy and Critical Care Medicine.
Bhatt and Klaus Rabe, M.D., Ph.D., a professor of pulmonary medicine at the LungenClinic Grosshansdorf, Grosshansdorf, Germany, co-led the international multicenter clinical study that had 470 patients in the dupilumab group and 465 patients in the placebo group. The patients ranged in age from 40 to 85.
The just completed trial replicates an initial, nearly identical, Phase 3 clinical trial of dupilumab reported in NEJM by Bhatt and Rabe last year. The current Phase 3, randomized, double-blind, placebo-controlled trial was needed to confirm findings of that first trial for COPD patients with blood eosinophil counts of 300 cells per microliter or higher and an elevated exacerbation risk, despite being on inhaled triple therapy. Carefully designed clinical trials produce data that allows the FDA to determine whether benefits of an investigational drug outweigh any known and potential risks for its intended population.
COPD patients often have disease exacerbations that can lead to an increased risk of subsequent exacerbations, accelerated lung-function decline and an increased risk of death. Thus, says Bhatt, improving lung function and reducing exacerbations are unmet needs in patients with COPD.
“COPD is the third leading cause of death globally,” Bhatt said. “Exacerbations of COPD lead to poorer quality of life, increased hospitalizations and an increased risk of death.”

Replacing diesel school buses with electric school buses may yield up to $247,600 in climate and health benefits per individual bus, according to a new study by researchers at Harvard T.H. Chan School of Public Health. The researchers found that these benefits — including fewer greenhouse gas emissions and reduced rates of adult mortality and childhood asthma — and their associated savings are strongest in large cities and among fleets of old (2005 and before) buses.
The study will be published in The Proceedings of the National Academy of Sciences on May 20, 2024.
While the health and climate benefits of switching from diesel vehicles to electric ones are well established, this is the first study to specifically quantify how electric school buses can improve human and planetary health.
“Research on air pollution and climate change should strive to quantify health benefits,” said senior author Kari Nadeau, John Rock Professor of Climate and Population Studies and chair of the Department of Environmental Health. “Our findings can inform policymakers that greenhouse gas emissions and air pollution are reduced by implementing solutions like electric vehicle use. Our data offer strong evidence that accelerating the ongoing transition to electric school buses will benefit individual, public, and planetary health.”
There are about half a million school buses in use in the U.S. and a substantial portion are older, highly polluting diesel buses. Switching to electric buses is a difficult decision for local, state, and federal officials as they are expensive and the health benefits are not well known.
To quantify how diesel and electric school buses impact the climate, the researchers compared the amounts of carbon dioxide emitted from diesel school bus tailpipes and from electric school buses’ electricity generation and battery production. To assess the buses’ health impacts, the researchers compared how their respective emissions contribute to fine particulate air pollution (PM2.5), which is linked to adult mortality and the onset of childhood asthma.
The study found that replacing an average diesel school bus in the U.S. fleet in 2017 with an electric one resulted in $84,200 in total benefits per individual bus. Each electric school bus emitted 181 fewer metric tons of carbon dioxide than its diesel counterpart, amounting to $40,400 worth of climate benefits. Meanwhile, each electric school bus was associated with $43,800 in health savings, from less air pollution and reduced rates of mortality and childhood asthma.

The study also found that electric school buses’ health benefits vary depending on location and the age of the diesel bus being replaced. Large metropolitan areas — defined as those with a population of more than one million — derive the most significant health benefits from electrifying fleets of school buses, given the larger number of people whose air quality is improved. The researchers calculated that, in a large city, replacing a 2005 diesel school bus with an electric bus would achieve $207,200 in health benefits per bus.
“In a dense urban setting where old diesel buses still comprise most school bus fleets, the savings incurred from electrifying these buses outweigh the costs of replacement,” Nadeau said. “Not to mention how the tangible benefits of electric school buses can improve lives — especially for racial minorities and those living in low-income communities who are disproportionately impacted by the everyday health risks of air pollution.”
Nadeau and her co-authors noted that the study did not tackle one important question: how electric school buses impact children’s exposure to in-cabin air pollution while riding the bus. Additional research into this topic could further inform policy decisions.
Ernani Choma, research associate in the Department of Environmental Health, and Lisa Robinson, senior research scientist and deputy director of the Center for Health Decision Science, were co-authors.

The dramatic decline in childhood mortality during the 20th century has added a full year to women’s lives, according to a new study.
“The picture I was building in my mind was to think about what the population of mothers in the U.S. looked like in 1900,” said Matthew Zipple, a Klarman Postdoctoral Fellow in neurobiology and behavior at Cornell University and author of “Reducing Childhood Mortality Extends Mothers’ Lives,” which published May 9 in Scientific Reports.
“It was a population made up of two approximately equal-sized groups: One was mothers who had lost children, and one was mothers who had not,” Zipple said. “If we compare that to today, when child loss is mercifully so much less common, nearly all those women who had lost children are shifted into the non-bereaved category.”
Using mathematical modeling based on Centers for Disease Control and Prevention (CDC) data, he calculated how the absence of bereavement affects the lifespans of present-day mothers in the United States. He estimates that the reduction in maternal bereavement adds, on average, a year to women’s lives.
In the paper, Zipple cites several studies that causally link child death with increased risk of maternal death. The most comprehensive is a study of mothers in Iceland over a 200-year period, spanning a range of health care access and industrialization.
Life expectancy for women after age 15 increased by about 16 years between 1900 and 2000, Zipple found from the CDC data he used in the study. His calculation attributes one year, or about 6% of this increase, to the dramatic drop in childhood mortality over the course of the 20th century.
The study also helps set priorities for progress going forward, Zipple said. In many countries, child mortality rates today are similar to those in the U.S. in 1900. Investing in reducing childhood mortality everywhere helps not only the children, but whole communities.
“The child is the core of the community,” Zipple said. “Protecting children from mortality has branching positive impacts that start with mothers but probably don’t stop there.”