Mammography can miss tumors in women with dense breasts, so their doctors often include ultrasound or M.R.I. scans. Patients often wind up paying the bill. Mammograms can miss tumors in women with dense breast tissue. So for these patients, doctors often include a second scan — ultrasound, for example, or an M.R.I. — which are more likely to turn up cancers at early stages. But some older patients are running into an unexpected twist. Though many women see the extra scan as a routine form of prevention, Medicare won’t pay for it, and some patients are left to pick up a hefty tab. Joellen Sommer, 66, who lives in Manhattan, went for her annual breast cancer screening in March. But the clinic’s staff said that while her mammogram would be fully covered by Medicare, a so-called supplemental ultrasound was not.Ms. Sommer has dense breasts, and a family history of breast cancer. She said she has received mammograms and ultrasound imaging throughout her adult life. “I just don’t understand how something that has been the recommended diagnostic test for years is suddenly not covered by Medicare,” she said.“My mother had breast cancer, my aunt had breast cancer — I guess that’s not enough,” she added. “I wonder if it was a test for men, if the same issue would arise.”Lenox Hill Radiology in New York City has started warning patients that if they are insured by Medicare, they may be on the hook for up to $450 if they receive a breast ultrasound, even if breast tissue is known to be dense and the extra scan is performed on the same day as a screening mammogram. 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.

Published21 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, PA MediaBy James GregoryBBC NewsPrime Minister Rishi Sunak will call for an end to the UK’s “sick note culture” in a speech on welfare reform.Mr Sunak is considering moving responsibility for assessing fitness to work away from GPs to “specialist work and health professionals” in England.A record high of 2.8m people are out of work as of February 2024, according to the Office for National Statistics.Labour says the government has “run out of ideas” and has failed to deliver a healthy nation or economy.In a speech announcing plans to overhaul the benefits system on Friday, the prime minister is expected to say the focus must shift away from what people cannot do to what work people might be able to do. “We don’t just need to change the sick note, we need to change the sick note culture so the default becomes what work you can do – not what you can’t,” Mr Sunak is expected to say. He will also warn against “over-medicalising the everyday challenges and worries of life”. Opposition parties say changes to sick notes – officially known as fit notes – have been announced previously by the government.A call for evidence will be published on Friday seeking responses from healthcare professionals, employers, and those with lived experiences asking how the current process works and how it can be improved.Who are the millions of Britons not working?Mr Sunak is expected to refer to challenges presented since the pandemic, with the government saying a “significant number of working aged people have become inactive due to long-term sickness which has in large part been driven by mental health conditions”.The government said NHS data showed almost 11m fit notes were issued last year in England, with 94% of those signed “not fit for work”. It also said a large proportion of these were repeat fit notes issued without any advice.But Prof Kamila Hawthorne, chair of the Royal College of GPs, told BBC Radio 4’s Today programme it was standard practice for surgeries to check in and provide advice for their patients before giving repeat fit notes.She added that as a profession, GPs were “not against the idea” of moving responsibility for issuing notes to other professionals, but she said the practice was quite often part of a “normal consultation” with a patient. The prime minister’s speech comes a month after Work and Pensions Secretary Mel Stride faced criticism for an interview in which he said there was “a real risk” that “the normal ups and downs of human life” were being labelled as medical conditions which then held people back from working.Those comments were described as “disappointing” by the president of the Royal College of Psychiatrists, while the Centre for Mental Health charity said they risked “belittling people’s struggles”.Ahead of Mr Sunak’s speech on Friday, Alison McGovern, Labour’s acting shadow work and pensions secretary, said: “A healthy nation is critical to a healthy economy, but the Tories have completely failed on both.”She claimed 14 years of Conservative government had resulted in a record number of people “locked out of work because they are sick – at terrible cost to them, to business and to the taxpayer paying billions more in spiralling benefits bills.”Today’s announcement proves that this failed government has run out of ideas, announcing the same minor alternation to fit notes that we’ve heard them try before.”The Lib Dem Work and Pensions spokesperson Wendy Chamberlain said: “These reheated announcements will do nothing to help the millions languishing in pain on waiting lists.”This is a prime minister and a Conservative government that has overseen nothing but stagnant economic growth and forced families to choose between heating and eating.”Green Party co-leader Carla Denyer said: “The prime minister should be fixing the NHS so that people can get well, not blaming people who are ill.”We would invest in mending the health and social care system, not denying people the right to see a GP when they need it.”More on this storyWho are the millions of Britons not working?Published2 days ago

Published4 hours agoShareclose panelShare pageCopy linkAbout sharingBy Rachel StonehouseBBC West InvestigationsExperts are warning of an alarming increase in bladder issues among young people due to chronic ketamine use.People as young as 21 are having major, risky surgery to treat problems caused by addiction, doctors say.Beth, an addict in her 20s, told the BBC: “I can’t walk 50 metres without either needing to sit down or needing to run to the toilet.”Latest government figures estimate ketamine use in England and Wales has more than doubled since 2016.It has more than tripled in the under-25 age group in the same period.Chronic ketamine usage affects the lining of the bladder, and can shrink it. As a result, some urology departments have set up specialist clinics to help the increasing number of young people with bladder issues.Southmead Hospital in Bristol is currently helping around 60 patients from across the West – some as young as 19.”If we are offering major surgery to a person who’s 21, then the likelihood of having any sort of complications after that surgery [in the rest of their lives] – it’s enormous,” said consultant urologist Dr Carolina Ochoa.Beth is currently addicted to the drug after trying it as a teenager, “in the classroom at school”.Ketamine ‘visible in my urine’She says she now uses ketamine as a way of coping with past traumatic events.”It’s just that little bit of escapism. Unfortunately, having had a few things that have gone on in my life that have led me to make these decisions and post-traumatic stress disorder, I do suffer [with my] mental health as well. “And so that’s [ketamine] kind of been my turn-to.”Beth is now struggling with the physical impact of prolonged use as well.Her ketamine use caused a big growth in her bladder, which had to be burnt away, and she also says the drug could be seen floating in her urine on a hospital camera screen, when she was seen by urologists.What is ketamine?Ketamine is widely used in the NHS as an anaesthetic, sedative and pain reliever, and is also commonly used on animals.Because of its hallucinogenic effects, it is also thought of as a “party drug”.It was the main reason cited in the accidental death of Friends star Matthew PerryKnown on the street as Special K, it usually comes as a crystalline powder or liquid.Image source, Getty ImagesKetamine is classed by the government as a Class-B drug, which means it is illegal to take, carry, make or sell.Tolerance is known to build quickly, so users increasingly need more and more to feel an effect.Chronic usage affects the lining of the bladder, and can shrink it.This can lead to frequency in needing to urinate, infections, bleeding, blockages and incontinence.’Very serious consequences’Dr Mohammed Belal is from the British Association of Urological Surgeons, which is now putting together a document to help other health professionals spot the signs of ‘ketamine bladder’.”I think we’ve seen a huge explosion of young people taking ketamine throughout the country, and that means that they come to see us with a significant urinary symptoms and these symptoms can include going to the toilet every hour or even every half an hour,” he said.”Ketamine destroys the lining of the bladder, and that can have very serious consequences.”We’ve noticed lots of young patients with severe bladder problems that we would not expect to see until patients are much older.”Pagan, from Oxfordshire, has now recovered from a 12-year addiction to ketamine, and is using her experience to try and help others get clean.At her worst point she said she was taking more than 10 grams a day.’I wanted to die'”I wanted to die, yeah, I just didn’t want to be alive anymore,” she said.”I didn’t want to be in the world in that pain – completely reliant on ketamine.”As a result of her addiction Pagan’s daughter was adopted, she had bladder surgery and ended up going to rehab for the third time in 2022.”I spent eight weeks in hospital and I kind of felt like I tempted fate too many times, so I needed to give it up, otherwise I would have would have ended up dead.”She says her journey to recovery was “really, really difficult” at first, and she couldn’t have done it without the support of drug and alcohol charity Turning Point, where she now volunteers as a peer mentor.’It’s never too late’In a statement the UK government told the BBC it is committed to offering support and tackling the supply of illegal drugs. Jasmine King is a specialist urologist nurse at Southmead Hospital, working to help people struggling with the impacts of chronic ketamine use.She describes the increase in patients as “very concerning” and urges people to seek support through drug charities, mental health services and hospitals if needed.”One thing I want to make people aware of is if they do come and see us, we are not judging them,” she said.”We’re here to support them and help them with their problems. We just want to help.”As for Pagan, she says: “No matter how much you think it’s taken your life, it’s never too late to reach out for help.”You can watch ‘Young and addicted: Generation Ketamine” on BBC iPlayer now.If you have been affected by any of the issues raised in this article, you can find advice here.Follow BBC West on Facebook, X and Instagram. Send your story ideas to: westinvestigations@bbc.co.ukMore on this storyPerry death an accident caused by ketamine – coronerPublished15 December 2023Matthew Perry ‘felt like he was beating’ addictionPublished13 MarchFunding cuts blamed for spike in ketamine usePublished18 JanuaryCall for ketamine to treat depressionPublished24 July 2023Warning after rise in ketamine hospitalisationsPublished24 June 2023’I thought my bladder would explode’Published29 October 2014

Published9 hours agoShareclose panelShare pageCopy linkAbout sharingBy Chris Vallance & Philippa WainTechnology reportersNearly a quarter of UK five-to-seven-year-olds now have their own smartphone, Ofcom research suggests.Social media use also rose in the age group over last year with nearly two in five using messaging service WhatsApp, despite its minimum age of 13.The communications regulator warned parental enforcement of rules “appeared to be diminishing.”It also said the figures should be a “wake up call” for the industry to do more to protect children.In its annual study of children’s relationship with the media and online worlds, Ofcom said the percentage of children aged between five and seven who used messaging services had risen from 59% to 65%.The number on social media went up from 30% to 38%, while for livestreams it increased from 39% to 50%. Just over 40% are reported to be gaming online – up from 34% the year before.Over half of children under 13 used social media, contrary to most of the big platforms’ rules, and many admitted to lying to gain access to new apps and services.”I think this is a wake up call for industry. They have to take account of the users they have, not the users that their terms and conditions say they have,” Mark Bunting, from Ofcom’s Online Safety Group told BBC News.”We’ve known for a long time that children, under the age limit on a lot of the most popular apps, are widely using those apps, and companies are now under a legal obligation to take steps to keep those children safe,” he added. Some campaigners want age limits to be introduced for smartphone use, and existing ones raised for social media.However it is already the case that most phones possessed by children are likely to have been provided by parents – under-18’s cannot sign contracts, and most big operators say they do not sell pay-as-you-go phones to under-16’s.Many parents give children phones because they want to be able to contact them or to track them via their mobile.How can you keep children safe online?Parents who spoke to the BBC also cited peer pressure, saying it was a struggle to keep children off social media when all their friends were a using an app. One parent said she felt “pushed into a corner”.Closely watchedHeather Bryson who is 11 won wide recognition for her online exercise videos designed to help people in care homes during the pandemic, particularly those suffering dementia.She’s had a smartphone since she was eight-years-old.Her parents feel she’s benefited socially from being online, but what she does and who she communicates with are closely supervised.”I think it’s become an important tool for anyone growing up these days”, her father, Gary Bryson says.”Being able to monitor exactly what she’s doing is paramount”.Heather says it lets her talk with friends on social media and through message apps, but there are negatives.”Sometimes I get boys swearing at me online in chats which is not nice, but the good things there are loads of nice people out there too”. “It’s just something that you get used to after a while but you shouldn’t have to”, she says.’Resigned’ parentsOnly a third of parents know the correct minimum age requirement for most social media platforms Ofcom suggestsBut the regulator said parents were also less willing to enforce the rules they knew about.Three in ten parents were willing to let a child aged 5-7 have a social media profile even if it was under the minimum age permitted for the apps, an increase compared to last year. Parents may be “resigned” to not being able to control children’s online lives the new report notes.Mr Bunting said he had “a lot of sympathy” for parents on this issue: “It may not be about preventing use entirely for children under 13, which I think is very difficult in today’s society. But parents can talk to their children about using those services safely. And we’d encourage them to do that,” he said.Phone freeSome say investigations like that carried out by the BBC this month – which found that children as young as nine were added to a malicious WhatsApp group – mean further action is needed.Mark Zuckerberg, the chief executive of Meta which owns WhatsApp and Instagram, has previously suggested that he favours requiring app-stores to check the ages of users.Responding to the Ofcom report, Clare Fernyhough, of the Smartphone Free Childhood campaign, told the BBC that society had sleep-walked into “just assuming that we all need a smartphone – and now we’re beginning to see the huge impact that that’s having”But Professor Sonia Livingstone, Director of the Digital Futures for Children centre, said it was wrong to protect children by restricting their access to technology.”This is the first generation with access to a powerful personal computer, it could be so amazing for them, and that’s what children want too,” she told the BBC.”But the companies are risky by design, and what we need is child rights by design”, she said.Ofcom said new age limits for smartphones would be a matter for government. In May it will be consulting on the steps it expects tech firms to take to ensure children have safer experiences online, and later on new uses of AI to combat harmful content online.Does your young child have a smartphone? Share your experiences by emailing haveyoursay@bbc.co.uk.Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways:WhatsApp: +44 7756 165803Tweet: @BBC_HaveYourSayUpload pictures or videoPlease read our terms & conditions and privacy policy

If you are reading this page and can’t see the form you will need to visit the mobile version of the BBC website to submit your question or comment or you can email us at HaveYourSay@bbc.co.uk. Please include your name, age and location with any submission. More on this storyHow can you keep children safe online?Published9 FebruaryBrianna’s mum: Ban under 16s from social media on phonesPublished4 FebruaryMum begins anti-smartphone campaign by mistakePublished15 February

A heart attack will leave a permanent scar on a human heart, yet other animals, including some fish and amphibians, can clear cardiac scar tissue and regrow damaged muscle as adults.
Scientists have sought to figure out how special power works in hopes of advancing medical treatments for human cardiac patients, but the great physiological differences between fish and mammals make such inquiries difficult.
So University of Utah biologists, led by assistant professor Jamie Gagnon, tackled the problem by comparing two fish species: zebrafish, which can regenerate its heart, and medaka, which cannot.
A tale of two fish
The team identified a few possible explanations, mostly associated with the immune system, for how zebrafish fix cardiac tissue, according to newly published research.
“We thought by comparing these two fish that have similar heart morphology and live in similar habitats, we could have a better chance of actually finding what the main differences are,” said Clayton Carey, a postdoctoral researcher in the Gagnon lab and lead author on the new study.
Gagnon’s team wasn’t able to solve the mystery — yet — but their study shed new light on the molecular and cellular mechanisms at play in zebrafish’s heart regeneration.

“It told us these two hearts that look very similar are actually very different,” Gagnon said.
Both members of the teleost family of ray-finned fish, zebrafish (Danio rerio) and medaka (Oryzias latipes) descended from a common ancestor that lived millions of years ago. Both are about 1.5 inches long, inhabit freshwater and are equipped with two-chamber hearts. Medaka are native to Japan and zebrafish are native to the Ganges River basin.
According to the study, the existence of non-regenerating fish presents an opportunity to contrast the differing responses to injury to identify the cellular features unique to regenerating species. Gagnon suspects heart regeneration is an ancestral trait common to all teleosts.
Understanding the evolutionary path that led to the loss of this ability in some teleost species could offer parallel insights into why mammals cannot regenerate as adults.
With their distinctive horizontal stripes, zebrafish have long been popular as pets in the United States. In the 1970s zebrafish were embraced by biologists as a model organism for studying embryonic development of vertebrates.
Scientists like zebrafish because they can be propagated by the thousands quickly in labs, are easy to study and proved to be extremely hardy.

Cold shock to the heart
To conduct their experiments, the Gagnon lab used a device called a cryoprobe to injure the fish hearts in ways that mimic heart attacks in humans, then extracted the hearts after certain time frames to learn how the two species responded differently.
Carey made the cryoprobe from a piece of copper wire, which was cooled in liquid nitrogen to about minus 170 degrees Celsius. Team members cut tiny incisions in the fish’s bellies to expose their hearts, then applied the probe for 23 seconds to the edge of the heart.
In 95% of the cases, the fish survived the procedure, although not for long. After three days or 14 days, their hearts were extracted and dissolved into a single-cell solution, which was then subjected to RNA sequencing in search of markers indicating how the fish responded to the injury.
“Zebrafish have this immune response that is typical of what you might see during a viral infection, called an interferon response,” Carey said. “That response is completely absent in medaka.”
The study documented differences in immune cell recruitment and behavior, epicardial and endothelial cell signaling, and alterations in the structure and makeup of the heart. For example, medaka lack a certain type of muscle cells that are present in zebrafish.
How zebrafish heal damaged cardiac tissue
“My hunch is the ancestor of all animals could regenerate its heart after an injury, and then that’s been repeatedly lost in different types of animals,” Gagnon said. “I would like to understand why. Why would you lose this great feature that allows you to regenerate your heart after an injury?”
The study indicates the zebrafish’s ability to regenerate has something to do with its immune system, but understanding exactly how would take more research. For example, far more macrophages, specialized immune cells, migrated into the wound site in zebrafish than in medaka.
Unlike medaka, the zebrafish form a transient scar that doesn’t calcify into rigid tissue.
“What you do with that scar is what matters,” Gagnon said. “We think that the interferon response causes these specialized macrophage cells to come into that wound site and start to promote the growth of new blood vessels.”
Over time new muscle replaces the damaged cardiac tissue and the heart heals.
“The more we learn about how animals can regenerate tissues, how those features have been lost in us and other animals, that’s going to help us think about our limitations and how we might engineer strategies to help us overcome those,” Gagnon said. “Our hope is that we build this knowledge base in animals that are really accessible and can be studied in incredible detail, then use that knowledge to generate more focused experiments in mammals, and then maybe someday in human patients.”

Published10 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Allan ArchiveBy Chloe Hayward and Hugh PymHealth producer and health editor, BBC NewsThe true scale of the number of medical trials using infected blood products on children in the 1970s and 80s has been revealed by documents seen by BBC News.They reveal a secret world of unsafe clinical testing involving children in the UK, as doctors placed research goals ahead of patients’ needs.They continued for more than 15 years, involved hundreds of people, and infected most with hepatitis C and HIV.One surviving patient told the BBC he was treated like a “guinea pig”.The trials involved children with blood clotting disorders, when families had often not consented to them taking part. The majority of the children who enrolled are now dead. Documents also show that doctors in haemophilia centres across the country used blood products, even though they were widely known as likely to be contaminated.A shortage of blood products in the UK in the 1970s and 80s meant they were imported from the US. High-risk donors such as prisoners and drug addicts provided the plasma for the treatments that were infected with potentially fatal viruses including hepatitis C – which attacks the liver resulting in cirrhosis and cancer – and HIV. One blood product, known as Factor VIII, was seen to be highly effective for stopping bleeding but also widely known to be contaminated with viruses. A public inquiry is under way into the scandal. The final report is due in May. ‘Guinea pig’Luke O’Shea-Phillips, 42, has mild haemophilia – a blood clotting disorder that means he bruises and bleeds more easily than most. He caught the potentially lethal viral infection hepatitis C while being treated at the Middlesex Hospital, in central London, which was administered because of a small cut to his mouth, aged three, in 1985.Documents seen by the BBC suggest he was deliberately given the blood product – which his doctor knew might have been infected – so he could be enrolled in a clinical trial.The doctor wanted to find out how likely patients were to catch diseases from a new version of heat-treated Factor VIII. Though he had never been treated for his condition before, Luke was given heat-treated Factor VIII to stop his mouth bleeding.A letter from Luke’s doctor, Samuel Machin, to another expert in haemophilia, was submitted in evidence to the public inquiry into the infected blood scandal.Writing to Peter Kernoff, at London’s Royal Free Hospital, Dr Machin detailed the treatment of Luke and another boy, asking: “I hope they will be suitable for your heat-treated trial.”Months earlier, Dr Kernoff had called on fellow doctors in the field to identify patients suitable for clinical trials. Specifically, he said, they had to be “previously untreated patients”, known as “PUPs” in the medical community. They were also nicknamed “virgin haemophiliacs” – a term written on Luke’s medical record by Dr Machin.”I was a guinea pig in clinical trials that could have killed me,” Luke told the BBC. “There is no other way to explain it – my treatment was changed so I could be enrolled in clinical trials. This change in medication gave me a fatal disease – hepatitis C – yet my mother was never even told.””To the scientific world, it was an incredible benefit being a virgin haemophiliac,” he added. “To be a clean petri dish to understand science through, I was without question a part of that.”What is the infected blood scandal?Parents and pupils kept in the dark at blood scandal schoolInfected blood scandal: Boy, 7, died from Aids after doctor ignored rules In the following years, as the medical trial reached its conclusions, Luke had many blood tests. Doctors said they were monitoring him and, at the time, his mother, Shelagh O’Shea, was grateful. In their findings, published in 1987, Dr Kernoff and Dr Machin concluded heat treatment had “little or no effect” in reducing the risk of hepatitis C. Both Dr Kernoff and Dr Machin are now dead.Before he died, Dr Machin gave evidence to the public inquiry, when he confirmed that Luke had been recruited to Dr Kernoff’s study.He denied this had been done without Luke’s mother’s knowledge. “This would have been discussed with his mother, although I acknowledge that standards of consent in the 1980’s was quite different to what it is now,” Dr Machin said.However, Mrs O’Shea told the inquiry she was “absolutely not” told about the trial. “With an innocent child of three and a half I would not have considered such an action. I would never ever have allowed my child to be part of a trial – never,” she added.Documents reveal doctors knew Luke had contracted hepatitis C as early as 1993, but he was not told until 1997. One medical record states a positive test result and says: “Have not discussed with patient or family.”Luke is now clear of the infection after successful treatment.’Laboratory rats’However, evidence of the clinical trials have raised wider concerns. “A patient should always be given the best possible treatment and they should always have given informed consent – if those two factors haven’t been achieved then a trial would be seen as very problematic,” says Professor Emma Cave, Professor of Healthcare Law at Durham University.Professor Edward Tuddenham, who was a haemophilia doctor at the Royal Free Hospital in the 1980s, confirmed these fears. When asked if he thought ethical standards had been met during clinical trials in the 1980s, he simply answered: “No.”The BBC’s investigation has revealed that Dr Machin and Dr Kernoff were among a community of doctors with similar research ambitions.A specialist school near Alton, in Hampshire, was attended by a large cohort of haemophiliac boys. The school for disabled children had an NHS haemophilia unit on site, so boys who had bleeds could be treated quickly and then return to lessons. Their doctor, Dr Anthony Aronstam – who has also since died – used his “unique” cohort of boys for extensive clinical trials. One series of experiments considered whether using three to four times more Factor VIII than normally required by a child would help to reduce the number of bleeds he had. This was preventative treatment, know as prophylaxis, and involved repeated injections with infected Factor VIII products and follow-up blood tests. The high concentrations of infected blood products were administered to the boys without their – or their parents’ – consent. Of the122 pupils attending Treloar’s College between 1974-1987, 75 have so far died of HIV and hepatitis C infections.”Despite knowing the product was riddled with hepatitis, they started a trial that required us to have way more of it than we needed,” says Gary Webster, who was unknowingly enrolled.Ade Goodyear, a pupil at Treloar’s from 1980 to 1989, added: “We were treated like lab rats. There was a plethora of studies that we were all enrolled on for the decade we were at the school.”Image source, Lee StayControversially, another trial involved placebo treatments. This meant that some boys, who thought they had been given Factor VIII to prevent bleeds, had in fact been given a saline solution.”When you think you’ve been given a treatment, this changes your behaviour,” Gary said. “You run more, you play more rough in football. For a haemophiliac, you feel a bit invincible for a short window after a jab. But with a placebo you are just risking your life by changing your behaviour.”He told the BBC he was punished at school if he missed injections. “It would have meant their trials would have been flawed and so we, us kids, were made to toe the line.”Dr Kernoff’s pursuit of clinical advancement through research was rigorous, as was his hunt for suitable subjects for trials – PUPs and virgin haemophiliacs – which led to those involved getting young and younger. A four-month-old baby was involved in a trial. Among his studies was one that compared the infectiousness of another blood plasma product – Cryoprecipitate (Cryo) – to Factor VIII concentrates.Cryo was used for treating mild blood clotting conditions. It contained the Factor VIII protein, but at lower concentrations and from fewer donors and was therefore thought to be less risky.Dr Kernoff’s search for suitable subjects led him to Mark Stewart, his brother, and his father, who all had very mild cases of von Willebrand’s disease – another type of blood clotting disorder. Their usual treatment was cryo.Image source, Mark Stewart As part of his test, Dr Kernoff gave them all Factor VIII concentrates instead.”Until we were given concentrates it would be once a month you’d have a little nose bleed, and you’d go up and have cryo and that was that.” All three contracted hepatitis C.Mark’s brother and father have both died of liver cancer after the infection attacked the organ. Neither were told they had contracted the disease until it was too late for treatment.”Angry is an understatement,” Mark said. “Your dad is in the front carriage, your brother is in the second carriage and you are in the third carriage – so you know what is coming. It won’t veer off that track. This is how hep C works. It will get you.”​A statement from Treloar’s said: “We await the publication of the infected blood inquiry, which we hope will provide our former pupils with the answers they have been waiting for.”The inquiry into the wider infected blood scandal will conclude on 20 May.More on this storyWhat is the infected blood scandal and how many people died?Published2 AprilBoy, 7, died from Aids after doctor ignored rulesPublished5 days agoInfected blood inquiry report delayed until MayPublished17 JanuaryAction lodged against school over infected bloodPublished24 January 2022Parents and pupils kept in dark at infected blood schoolPublished26 June 2021The school where dozens died in NHS blood scandalPublished21 June 2021Related Internet LinksInfected Blood InquiryThe BBC is not responsible for the content of external sites.

Some genes are known to drive cancer, and astonishing new research shows why: Mutations in the noncoding regions become functional, altering the abundance of messenger RNA, or mRNA, and potentially facilitating cell proliferation. Even more surprising, the number of mutations in these regions can predict patient survival time for certain types of cancer.
Most genes are a sequence of DNA that holds the recipes for producing proteins. Proteins, in turn, are chains of amino acids that the body uses to send signals between cells, build and repair tissues, and for countless other functions necessary for life. Within these genes, certain areas are directly translated into proteins, whereas others, referred to as noncoding regions, do not directly contribute to protein production.
But these silent, noncoding regions are far from lazy. They act much like a basketball coach during a game, directing the active regions of the gene to either enhance or suppress their expression, thus playing a crucial regulatory role.
Mutations in these noncoding areas are relatively common, yet they were once thought to have minimal impact on an organism’s functions because they don’t alter a protein’s recipe. But what happens to their regulatory duties when a mutation occurs?
Researchers at UCLA now have an answer. Mutations in these noncoding areas are relatively common, yet they were once thought to have minimal impact on an organism’s functions because they don’t alter a protein’s recipe. But researchers at UCLA made an important discovery: These mutations lead to production of abnormal amounts of mRNA. mRNA serves as the DNA’s courier, carrying the blueprint for protein production from the cell nucleus to the cytoplasm, where proteins are synthesized.
When mutations cause changes in mRNA levels, it can lead to either an excess or deficit in protein production, akin to the culinary disaster of mistaking a teaspoon for a cup of salt in a recipe. Because cancer involves the unchecked growth of cells, the abundance of mRNA might activate — or fail to inhibit — proliferation of cells, ultimately leading to tumors and cancer.
The researchers made this discovery by synthesizing thousands of mutations into fully functioning DNA reporters — a kind of gene that helps scientists study what a gene expresses — which they put into cells, then analyzed the resulting alterations in mRNA abundance. The findings were published in the journal Nature Communications.

“Predicting the outcomes of mutations in protein-coding regions is relatively straightforward, but understanding the functions of mutations in noncoding regions presents a significant challenge,” said corresponding author Xinshu “Grace” Xiao, a UCLA professor of integrative biology and physiology. “We designed a high throughput experiment capable of simultaneously assessing a vast array of mutations.”
Some noncoding mutations are so rare they occur in only a few individuals. Plus, every person has their own unique mutations. Rare mutations are challenging to study because their scarcity means they are hard to obtain in statistically meaningful quantities.
“We focused on these poorly understood rare mutations because with our method, we could generate any number of them, offering an unprecedented opportunity to figure out what they do,” Xiao said.
This exploration led to a completely unforeseen discovery: Many of the rare, functional mutations were associated with genes linked to cancer pathways.
This finding shifted the research to the singling out of genes known to drive cancer. These notorious cancer driver genes have many somatic mutations — acquired over the course of the individual’s life rather than through inheritance — in noncoding regions that aren’t understood. The team repeated their experiments, this time testing 11,929 somatic mutations in 166 cancer driver genes.
They discovered that a large fraction — 33% — of somatic mutations in noncoding regions of 155 of the 166 tested cancer driver genes can change mRNA abundance. But Xiao’s group didn’t stop there. They combed a cancer database to find patients who had these mRNA-modulating rare mutations and found many. Turning over this stone revealed an even bigger surprise.

“The number of functional mutations in untranslated regions can predict patient survival for certain cancer types,” said Ting Fu, the first author of the article and a postdoctoral scholar in Xiao’s lab. “We called this metric ‘untranslated tumor mutation burden’ or uTMB and found particularly striking the association between uTMB and lung squamous cell carcinoma as well as head and neck squamous cell carcinoma.”
This insight opens up new avenues for the development of prognostic testing tools. By calculating uTMB for individual patients, health care professionals could gain valuable predictions regarding survival outcomes to guide selection of the most effective treatment options.
The findings also signal a promising new direction for research into the gene regulation mechanisms implicated in cancer. Understanding how these mutations influence mRNA abundance — and by extension, protein production — could shed light on the intricate processes that drive cancer progression.
“Our next objective is to unravel the precise regulatory mechanisms by which these mutations function in cancer cells. Given their impact on mRNA levels, the underlying mechanisms could hold critical importance for the advancement of cancer treatment,” Xiao said.
This work was supported by grants from the National Institutes of Health.

Trains carrying loads of coal bring with them higher rates of asthma, heart disease, hospitalization and death for residents living nearest the rail lines, according to a new study from the University of California, Davis.
The study, published online today in the journal Environmental Research, focuses on the San Francisco Bay Area and is the first health impact assessment of coal train pollution in the world.
It found that coal train pollution has significant health effects that disproportionately impact communities of color and people who are young, old, or have low incomes.
While centered on East Bay neighborhoods, the study carries implications for communities worldwide living alongside passing coal trains. At least 80 countries use coal power, which generates about 40% of the world’s electricity.
“These trains run all over the world, exposing the poorest populations who often live close to the train tracks,” said lead author Bart Ostro, a scientist with the UC Davis Air Quality Research Center. “As a result, these impacts have local and global implications.”
Coal, and more coal
The study includes parts of Oakland, Berkeley, Martinez and Richmond, where coal is already being transported from Utah mines by rail. The assessment specifically centers on the potential health impacts of a proposed coal terminal under review, which could bring an additional 7.4 million tons of coal per year by rail to the Port of Oakland.

“That translates to about 10 trains per week potentially passing through a densely populated urban area,” Ostro said. “The trains continuously generate microscopic particles — — called PM2.5, or fine particles, which are regulated by the U.S. EPA. This results in chronic exposures. The particles can infiltrate the lungs and bloodstream and pose serious health risks.”
Health impacts of coal trains
To quantify the health impacts of PM2.5 emitted from passing coal trains, the study authors integrated air quality data with medical and demographic information using software mapping and analysis programs. They ran different scenarios for increases in PM2.5 for the roughly 262,000 people who would be exposed.
They found that, under the most severe scenario — an increase in annual fine particulates of 2.1 micrograms per cubic meter of air — six additional people would be expected to die each year among this population.
When the authors adjusted the analysis to incorporate the higher risks for people of color, an estimated 15 total deaths were possible.
The study results also suggested: 28 additional hospital admissions for heart disease. 22 new cases of asthma. 17 additional cases of pneumonia. 58,000 additional days of asthma attributable to coal train transit.Several of these outcomes represent a 3 to 6% increase over current levels.

Under a less severe scenario (1 microgram per cubic meter of air), additional yearly health impacts would be about 50% lower.
Race-specific estimates
The study also provided race-specific estimates, finding that Hispanic and Black residents have 41% and 29% higher levels of PM25.5 exposure, respectively, relative to White residents.
“Our study is a microcosm of what likely affects millions of city residents throughout the world living near passing, uncovered coal trains that deliver coal to power plants and export terminals,” said Ostro.
Additional co-authoring institutions include UC Irvine and the California Office of Environmental Health Hazard Assessment.
The research was supported by the California Air Resources Board Community Air Monitoring Grant Program and the UC Davis Environmental Health Science Center.

Mount Sinai researchers, in collaboration with scientists at The Rockefeller University, have uncovered a mechanism in the brain that allows cocaine and morphine to take over natural reward processing systems. Published online in Science on April 18, these findings shed new light on the neural underpinnings of drug addiction and could offer new mechanistic insights to inform basic research, clinical practice, and potential therapeutic solutions.
“While this field has been explored for decades, our study is the first to demonstrate that psychostimulants and opioidsengage and alter functioning of the same brain cells that are responsible for processing natural rewards,” explains senior author Eric J. Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, and Dean for Academic Affairs of the Icahn School of Medicine at Mount Sinai, and Chief Scientific Officer of the Mount Sinai Health System. “These findings provide an explanation for how these drugs can interfere with normal brain function and how that interference becomes magnified with increasing drug exposure to ultimately redirect behavior compulsively towards drugs — a hallmark of addiction pathology.”
The study focused on identifying convergent mechanisms of addiction in mouse models across two different classes of drugs: cocaine, a psychostimulant, and morphine, an opioid. This groundbreaking work required the amalgamation of a highly interdisciplinary team, organized by Dr. Nestler and long-time collaborator Jeffrey M. Friedman, MD, PhD, Marilyn M. Simpson Professor at The Rockefeller University, Investigator of the Howard Hughes Medical Institute, and co-senior author of the study. Among its members were two biophysicists: Alipasha Vaziri, PhD, Professor of Neuroscience and Behavior at The Rockefeller University and a co-senior author of the study, and Tobias Nöbauer, PhD, Assistant Research Professor at The Rockefeller University and a co-first author of the study. Working closely together, the team employed a suite of cutting-edge tools and methodologies spanning behavioral, circuit, cellular, and molecular domains of neuroscience.
Through these innovative efforts, researchers were able to track how individual neurons in a forebrain region called the nucleus accumbens respond to natural rewards like food and water, as well as to acute and repeated exposure to cocaine and morphine in a cell-type-specific manner. They discovered a largely overlapping population of cells that respond to both addictive drugs and natural rewards, and demonstrated that repeated exposure to the drugs progressively disrupts the cells’ ability to function normally, resulting in behavior being directed toward drug-seeking and away from natural rewards.
“By tracking these cells, we show that not only are similar cells activated across reward classes, but also that cocaine and morphine elicit initially stronger responses than food or water, and this actually magnifies with increasing exposure,” notes co-first author Caleb Browne, PhD, a former Instructor in Dr. Nestler’s lab who is now a Scientist in the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH) in Toronto. “After withdrawal from the drugs, these same cells exhibit disorganized responses to natural rewards in a manner that may resemble some of the negative affective states seen in withdrawal in substance use disorder.”
Moreover, the research team identified a well-established intracellular signaling pathway — mTORC1 — that facilitates the disruption of natural reward processing by the drugs. As part of that discovery, investigators found a gene (Rheb) that encodes an activator of the mTORC1 pathway that may mediate this relationship, potentially providing a novel therapeutic target for future discovery in a field of medicine that currently offers few effective treatments.
To that end, the research team plans to dig deeper into the cellular biology behind addiction neuroscience to better characterize molecular pathways that could be critical to basic research and, eventually, clinical practice.
“Through our work we have also established a landmark dataset that integrates drug-induced brain-wide neural activation with input circuit mapping from the nucleus accumbens, which could be useful to the broad scientific community conducting substance use disorder research,” says Bowen Tan, the other co-first author of the study, and a graduate student in the laboratory of Dr. Friedman.
“We’ve known for decades that natural rewards, like food, and addictive drugs can activate the same brain region,” says Dr. Friedman. “But what we’ve just learned is that they impact neural activity in strikingly different ways. One of the big takeways here is that addictive drugs have pathologic effects on these neural pathways, that are distinct from, say, the physiologic response to eating a meal when you are hungry or drinking a glass of water when you are thirsty.”
“A major part of our ongoing research will be directed to defining how the flow of multimodal information is incorporated into value computations in brain cells and how that crucial mechanism enables drugs to overtake the processing of natural rewards, leading to addiction,” says Dr. Nestler.

The NewsThe rate of emergency room visits caused by heat illness increased significantly last year in large swaths of the country compared with the previous five years, according to a study published on Thursday by the Centers for Disease Control and Prevention.The research, which analyzed visits during the warmer months of the year, offers new insight into the medical consequences of the record-breaking heat recorded across the country in 2023 as sweltering temperatures stretched late into the year.The sun setting in July over Phoenix. Last year was the warmest on Earth in a century and a half, with the hottest summer on record.Matt York/Associated PressWhat the Numbers Say: People in the South were especially affected by serious heat illness.The researchers used data on emergency room visits from an electronic surveillance program used by states and the federal government to detect the spread of diseases. They compiled the number of heat-related emergency room visits in different regions of the country and compared them to data from the previous five years.Nearly 120,000 heat-related emergency room visits were recorded in the surveillance program last year, with more than 90 percent of them occurring between May and September, the researchers found.The highest rate of visits occurred in a region encompassing Arkansas, Louisiana, New Mexico, Oklahoma and Texas. Overall, the study also found that men and people between the ages of 18 and 64 had higher rates of visits.How It Happens: Heat can be a silent killer, experts and health providers say.Last year was the warmest on Earth in a century and a half, with the hottest summer on record. Climate scientists have attributed the trend in part to greenhouse gas emissions and their effects on global warming, and they have warned that the timing of a shift in tropical weather patterns last year could foreshadow an even hotter 2024.Heat illness often occurs gradually over the course of hours, and it can cause major damage to the body’s organs. Early symptoms of heat illness can include fatigue, dehydration, nausea, headache, increased heart rate and muscle spasms.Trying to cool off on a day of heat above 110 degrees in Phoenix last summer.Ross D. Franklin/Associated PressWe 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.