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Published1 hour agoShareclose panelShare pageCopy linkAbout sharingImage source, EPABy Cecilia MacaulayBBC NewsA Sudanese doctor has told the BBC that he and his colleagues are “expecting… to get shot [at] any time” while working in a Khartoum hospital.The doctor, who we are not naming, has been volunteering to treat sick people, most of whom have been shot.He said he felt “helpless” and that it was “difficult” to “see people in front of you… dying”.Both staff and patients at the hospital have been hit by stray bullets, he said.He will no longer return to that hospital because it is not safe, but instead will treat patients at a different medical facility.The Central Committee of Sudanese Doctors (CCSD) says 39 out of 59 hospitals in the capital, Khartoum, and nearby states are “out of service”, highlighting the worsening humanitarian situation in the country.”Among the hospitals that have stopped working, there are nine hospitals that were bombed, and 16 hospitals that were subjected to forced evacuation,” the CCSD said.Fighting between the Sudanese army and the rival paramilitary Rapid Support Forces (RSF) group is now in its fifth day, amid a power struggle in the country.The doctor confirmed to the BBC that patients and doctors in at least 16 hospitals had been forcibly evacuated from hospitals by the RSF, although the BBC is not able to independently verify this report. Patients are stranded in some hospitals with no clean water or food, and it is difficult to evacuate them because of “lack of transportation, the lack of safe passages and the lack of gasoline”.He also said that several corpses had been left in hospitals that cannot be accessed.Live updates on the Sudan crisisResidents flee Sudan capital as fighting continuesThe two generals fighting over Sudan’s futureWhat is going on in Sudan? A simple guideA second medic, Dr Ahmed Abbas who is a coordinator for the Sudan Doctors’ Union, told the BBC’s Newshour radio programme that the “situation is bad” and that very few Khartoum hospitals were functioning.Those hospitals are struggling and “running short of oxygen” and life-saving drugs, while doctors have been working “round the clock” and are exhausted to the “point of collapse”.Image source, Getty ImagesDr Abbas also warned that “people are dying from lack of staff” and blood supplies, while others were dying because of a “long wait” to get to the operating rooms, adding that the heath service was “beyond collapse”.Both Dr Abbas and the unnamed Khartoum doctor told the BBC that some hospitals had been used by the factions as a refuge for their fighters. Dr Abbas said five major Khartoum hospitals had been almost totally destroyed by “crossfire fighting”. Speaking on Tuesday, World Health Organization director-general Tedros Adhanom Ghebreyesus called for immediate action to help civilians caught in the crossfire, and to ensure protection for health workers.”Healthcare facilities and workers must never be a target, especially in a situation like this, where there are thousands of civilians who need access to emergency care,” Dr Tedros said. About 270 civilians have been killed since fighting broke out on Saturday, according to a statement from Western diplomats based in Khartoum.Large numbers of Khartoum residents have been fleeing, whilst others are trapped in their homes seeking shelter as a fresh wave of explosions erupted in the capital this morning. Sudan: The basicsSudan is in north-east Africa and has a history of instability: The military toppled long-time leader Omar al-Bashir in 2019 after mass protestsIt then overthrew a power-sharing government in 2021, putting two men at the helm: The head of the army and his deputy, who is also the head of a paramilitary group called the RSFThey disagree on how to restore civilian rule to Sudan: The RSF leader claims to represent marginalised groups against the country’s elites but his forces were accused of ethnic cleansing Are you in the affected areas? If it is safe to do so 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 storyResidents flee Sudan capital as fighting continues25 minutes agoThe two generals fighting over Sudan’s future1 day agoThe Khartoum residents under attack – videos and witnesses23 hours ago’I thought we’d die’ – Sudan patients cry for help1 day agoWhat is going on in Sudan? A simple guide2 days agoAround the BBCAfrica Today podcasts

LOGANVILLE, Wis. — Brenda Statz remembers the rain on the day they lost Leon, her husband of 34 years. The deluge had fallen for weeks, flooding their fields, delaying the harvest, pounding the roof of the barn where Mr. Statz finished his morning chores, then ended his life.It was Oct. 8, 2018, a Monday. Mr. Statz, father of three, grandfather of one, was 57. A note in the pocket of his work pants described how depression had robbed him of the hope and pride he had in running a third-generation dairy farm.Most families Mrs. Statz knew suffered such losses in isolation, silenced by the stigma surrounding mental illness. “But I was compelled to talk about it,” Mrs. Statz said. Soon after her husband’s death she and several friends founded the Farmer Angel Network, connecting struggling farmers and their families with help, and with each other.The rate of suicide among farmers is three and a half times higher than among the general population, according to the National Rural Health Association. Suicide rates in rural communities increased by 48 percent between 2000 and 2018, compared with 34 percent in urban areas.“Our producers are constantly expected to do more with less, innovate and improve, raise a family, preserve a legacy — and let’s not forget feeding and clothing the world while we’re at it,” Zach Ducheneaux, the administrator of the Farm Service Agency, the federal government’s main conduit for financial support to agriculture, wrote last summer.The average farmer in America is male and around 57 years of age, as Mr. Statz was, although more women and younger people have entered farming over the past decade. Men in general are more likely to die by suicide, and full-time farmers face intense financial pressure, their livelihoods affected by global forces outside their control like trade wars and livestock pandemics.Raised to value stoicism and self-determination, they often avoid seeking mental health treatment out of shame, and the erroneous notion that depression is not an illness but a state of mind fixable through attitude, faith or hard work.Leon Statz was 57 years old when he died.Alyssa Schukar for The New York TimesMr. Statz was a father of three, with one grandchild.Alyssa Schukar for The New York TimesSenator Tammy Baldwin, Democrat of Wisconsin, is seeking $10 million in the 2023 farm bill — the same level as authorized in the 2018 farm bill — for an Agriculture Department stress assistance network that helps fund behavioral health services for rural Americans. Ms. Baldwin was the lead sponsor of legislation to create a 988 number to reach the Suicide & Crisis Lifeline, which last year replaced the decades-old 10-digit number, and she helped secure $3.1 million from the government to support the 988 line’s rollout in her state.“We can and must do more,” Ms. Baldwin said in a statement.The National Rural Health Association agrees. Last month the association, whose 21,000 members include rural hospitals and clinics, wrote to leaders of the House and Senate agricultural committees demanding greater attention to what its chief executive, Alan Morgan, called “a deep-seated and longstanding problem.”The association wants Congress to increase the stress assistance network’s funding to $15 million annually in the farm bill, and make it permanent. The group is also calling for a national crisis line tailored to agricultural workers, separate from the 988 number.“It’s impossible to overstate the rural and urban difference when it comes to seeking behavioral health care,” Mr. Morgan said.‘He Thought He Failed’The Statz family farm is in the Driftless Area, a fertile, rolling swath of Wisconsin, Illinois, Minnesota and Iowa untouched by ice age glaciers and the rocky “drift” they left as they retreated. A sign out front proudly announces years of awards for dairy production.Mr. Statz’s life revolved around the 200-acre farm, an operation kept small enough so that the family could work it without outside help. Mr. Statz’s parents had lived and worked on the farm. The couple’s sons, Tom and Ethan, farmed with their father part-time, as did Mrs. Statz, who also works in a Lands’ End distribution center in nearby Reedsburg.Mr. Statz’s life revolved around family and the 200-acre farm.Alyssa Schukar for The New York TimesEvery day, Mrs. Statz feeds and cares for the family’s cattle in the barn where her husband died.Alyssa Schukar for The New York Times“I didn’t know if I could speak his name,” Mrs. Statz said at the first group meeting three months after her husband’s death.Alyssa Schukar for The New York TimesMr. Statz was sociable and adventurous. He used to ride a motorcycle when he and Mrs. Statz were dating, and when he turned 50 he bought two of them, including a vivid green Harley-Davidson. On weekends the couple sometimes rode up to Wildcat Mountain State Park, which overlooks the Kickapoo River valley. In summer they invited relatives and friends over for Mr. Statz’s grilled onion burgers and beer, and in winter they threw parties whose price of admission was a donation to their church food pantry. Their farm was a home away from home for friends of their sons and daughter, Sarah.“You never knew on a Friday night who would be sleeping here, on the couches, chairs or wherever,” Mrs. Statz recalled.Unknown to most in their orbit, Mr. Statz had bouts of depression for three decades. Their children were infants when he first sought help from the family’s doctor.“He basically told Leon to ‘chin up and face it like a man — in a year, you’ll laugh at it,’” Mrs. Statz recalled. “I will never forget that. Because then Leon’s like, ‘Now it falls back on me again. It’s my fault I can’t get out of this.’”Mrs. Statz said her husband took medication for his depression periodically, and had done well for years on it. “But any time there was a major change, that’s when I could see it coming,” she said.Mr. and Mrs. Statz were married in 1984 and raised three children together.Alyssa Schukar for The New York TimesPictures of the Statz family over the years are displayed in their home.Alyssa Schukar for The New York TimesIn late 2017 the family sold their prized Holstein cattle. As part of a plan to bring the couple’s two sons more fully into the business, they went into grain and beef farming, which is less labor-intensive than milking cows twice daily. It allowed their sons to keep part-time jobs off the farm, but it was a riskier endeavor than milk production because it involves heavy upfront costs for seed and fertilizer, with a paycheck dependent on a distant, uncertain harvest.The transition plunged Mr. Statz into paralyzing anxiety. He grew convinced the farm was going under. No amount of reassurance from his family or their bankers, Mrs. Statz said, could convince him that the farm was in fact prospering.Mr. Statz sought part-time work off the farm to help tide the family over before the harvest. Offered good-paying jobs at a local valve company and as a forklift operator, he instead signed on as a meat cutter in a local supermarket. It was low-paid, dangerous work. “He finally admitted why he took that job,” Mrs. Statz recalled. “Because he thought he failed, and he needed to punish himself.”Four months after selling the cows, Mr. Statz made his first suicide attempt. He called his children to say goodbye, swallowed a handful of pills and sealed himself into a shed, with farm equipment running inside.“I wish I never sold (our, my) cows! I’m a dairy farmer,” Mr. Statz wrote in a note to his family. “I want my old life back, but I can’t get it anymore. Every thing I do fails. I didn’t plan ahead for this … I really screwed up! I have everything that’s worth nothing!”Mrs. Statz heard the equipment from the house. She tangled with Mr. Statz while trying to shut it down and open the shed’s overhead doors, to let air inside. She summoned the police and their pastor. Mr. Statz was involuntarily hospitalized for three days in Winnebago, more than two hours away.He returned home still anxious, and with an extensive medication regime. Mrs. Statz, deeply shaken, was uncertain about how to care for him, what to watch for or what to say. She recalled sitting with him in the car outside their church, St. Peter’s Lutheran in Loganville, on a Sunday soon after his hospitalization. Her husband was ashamed to go inside.Their pastor, the Rev. Donald Glanzer Jr., had just lost a close friend to depression. “We were all pulling for Leon,” he said. But Mr. Statz was reluctant to share his struggles. “If a couple hundred acres need combining, farmers will ask for help,” Pastor Glanzer said. “But anything to do with their emotional makeup or personal psychology, they usually don’t.”In the summer of 2018, Mr. Statz’s son Ethan found him in the haymow, fashioning a noose. Hospitalized this time in the state capital of Madison, 60 miles away, Mr. Statz underwent electroconvulsive therapy. Halfway through, “he came home and he was like himself — he was old Leon,” Mrs. Statz recalled. “And I’m like, wow. This is working. He’s maybe going to pull out of it now.”Mrs. Statz playing with her granddaughter, Raelynn Rose, on the farm.Alyssa Schukar for The New York TimesMr. Statz’s old Chevrolet Chevelle is stored in the now-empty dairy parlor.Alyssa Schukar for The New York Times“We were back to square one,” Mrs. Statz said about her husband canceling his therapy sessions.Alyssa Schukar for The New York TimesMr. Statz’s doctors canceled the rest of the therapy, but two weeks later “we were back to square one,” Mrs. Statz said. They restarted the treatments, but his condition did not improve.Mr. Statz described to his wife how he felt: “Like you’re in the bottom of this hole, this pit, and you can see the top and you’re climbing, climbing, and struggling your way to the top. And just when you get to the top, it goes higher, and you keep climbing, and pretty soon you get tired and you can’t climb anymore.”On that October morning in 2018, Ethan found his father dead in the heifer shed, his raincoat draped neatly over a door nearby.‘Come and Talk’Mr. Statz was buried in jeans and his favorite Harley Davidson shirt and belt. In his obituary, the Statz family departed from convention. They did not write that he died “tragically” or “suddenly,” but “after a long-fought battle with depression.” They included a phone number for the county crisis line. “We needed to get the word out,” Mrs. Statz said. “He wasn’t weak or a failure. He was sick.”In his sermon, Pastor Glanzer called on the congregation to acknowledge the illness that led to Mr. Statz’s death, and to recognize it among others.“Leon’s life was a wonderful tapestry, every thread in place. But if you turn the tapestry to the backside, it was a frightening array of thread and knots and frayed ends and stray threads,” the pastor recalled saying. “Even though that’s not as good, it’s as equal a part of our life as the beautiful tapestry that everyone else sees.”“If a couple hundred acres need combining, farmers will ask for help. But anything to do with their emotional makeup or personal psychology, they usually don’t,” said the Rev. Don Glanzer Jr., the family’s former pastor.Alyssa Schukar for The New York TimesThe rate of suicide among farmers is three and a half times higher than among the general population, or more than 43 deaths per 100,000, according to the National Rural Health Association.Alyssa Schukar for The New York TimesAt a lunch after the service, friends of Mr. Statz approached Pastor Glanzer about doing something to help others, “so it doesn’t happen again,” he recalled.They decided to hold Wednesday meetings once a month in the church hall — “a place to come in and be among other farmers, if you just want to come and talk, listen, whatever,” Mrs. Statz said. They enlisted Pam Jahnke, the “Fabulous Farm Babe” on a regional farm radio station, to spread the word on her popular morning report.Church volunteers set out free soup and sandwiches. Mrs. Statz expected 15 people to show up. Instead 40 came. A woman whose brother died by suicide talked about the warning signs. Frank Friar from the Wisconsin Farm Center offered free counseling vouchers and financial planning for farmers in stress. A man from the region’s Amish community offered free bookkeeping for farmers in trouble. Others rose to offer help with milking, planting and harvesting for neighbors who need a break.That first meeting was only three months after Mr. Statz’s death, and “I didn’t know if I could speak his name,” Mrs. Statz said. But she did speak, and has done so nearly every day since. The meetings grew into the Farmer Angel Network, funded through donations from individuals, local businesses and groups.“You can’t always be the tough guy and get it done yourself,” Mrs. Statz said. “Sometimes you say, ‘You know what? Yeah, I could use some help.’”The meetings Mrs. Statz started at St. Peter’s Church grew into the Farmer Angel Network.Alyssa Schukar for The New York TimesMrs. Statz recruits volunteers and spreads the word at pasture walks, county fairs and “wherever the farmers are,” she said.Alyssa Schukar for The New York TimesMs. Statz spends most Thursday nights with friends in Downtown Loganville.Alyssa Schukar for The New York TimesIf you are having thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline, or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Even as biomedical engineer Anirban Sen Gupta refines artificial platelets to stem traumatic bleeding, he and his colleagues are seeking new uses for their synthetic solution.
The latest application to show promise involves providing synthetic platelets to treat a genetic condition that prevents blood from clotting, Von Willebrand disease (VWD). The most common of all bleeding disorders, VWD is found in up to 1% of the U.S. population (roughly 3 million people), according to the Centers for Disease Control and Prevention.
“There simply hasn’t been any study yet using our technology for treating genetic blood disorders, although it’s something we’ve wanted to explore for some time,” said Sen Gupta, the Leonard Case Jr. Professor of Engineering at the Case School of Engineering. “Almost all our work so far has been in heavy traumatic bleeding, but we often ask ourselves, ‘Who else could we help?'”
Sen Gupta said the progress he and a global research team have made to date could someday expand to start testing for other genetic blood diseases.
“There is a lot of work ahead on this, but it’s very exciting,” Sen Gupta said. “We’ve shown that it can work, but we’ll have to continue to work it out in appropriate animal models and someday human clinical trials.”
Treating VWD requires injecting patients with a lab-created form of the protein, or a drug to stimulate the protein’s production. In healthy people, VWF allows platelets to attach to a bleeding injury site to help them clot.
Sen Gupta’s collaborators include Cécile Denis and Peter Lenting, directors of research at INSERM (Institut National de la Santé et de la Recherche Médicale) in Kremlin-Bicêtre Hospital in France; and Julie Rayes, associate professor of cardiovascular sciences at the University of Birmingham, England.
The research recently appeared in the American Society of Hematology journal Blood.
Platelet-inspired tech
For more than a decade, Sen Gupta has pioneered research in artificial platelet systems and various platelet-inspired therapeutic technologies.
Those efforts include the licensing of a synthetic platelet technology known as SynthoPlate, by Haima Therapeutics, a biotechnology company Sen Gupta co-founded in 2016.
Earlier this year, Case Western Reserve announced Sen Gupta’s role in a four-year, $46 million Defense Advanced Research Projects Agency (DARPA) project being led by the University of Maryland School of Medicine and involves multiple academic institutions and industry partners.

A nanocellulose wound dressing that can reveal early signs of infection without interfering with the healing process has been developed by researchers at Linköping University, Sweden. Their study, published in Materials Today Bio, is one further step on the road to a new type of wound care.
The skin is the largest organ of the human body. A wound disrupts the normal function of the skin and can take a long time to heal, be very painful for the patient and may, in a worst case scenario, lead to death if not treated correctly. Also, hard-to-heal wounds pose a great burden on society, representing about half of all costs in out-patient care.
In traditional wound care, dressings are changed regularly, about every two days. To check whether the wound is infected, care staff have to lift the dressing and make an assessment based on appearance and tests. This is a painful procedure that disturbs wound healing as the scab breaks repeatedly. The risk of infection also increases every time the wound is exposed.
Researchers at Linköping University, in collaboration with colleagues from Örebro and Luleå Universities, have now developed a wound dressing made of nanocellulose that can reveal early signs of infection without interfering with the healing process.
“Being able to see instantly whether a wound has become infected, without having to lift the dressing, opens up for a new type of wound care that can lead to more efficient care and improve life for patients with hard-to-heal wounds. It can also reduce unnecessary use of antibiotics,” says Daniel Aili, professor in the Division of Biophysics and Bioengineering at Linköping University.
The dressing is made of tight mesh nanocellulose, preventing bacteria and other microbes from getting in. At the same time, the material lets gases and liquid through, something that is important to wound healing. The idea is that once applied, the dressing will stay on during the entire healing process. Should the wound become infected, the dressing will show a colour shift.
Non-infected wounds have a pH value of about 5.5. When an infection occurs, the wound becomes increasingly basic and may have a pH value of 8, or even higher. This is because bacteria in the wound change their surroundings to fit their optimal growth environment. An elevated pH value in the wound can be detected long before any pus, soreness or redness, which are the most common signs of infection.
To make the wound dressing show the elevated pH value, the researchers used bromthymol blue, BTB, a dye that changes colour from yellow to blue when the pH value exceeds 7. For BTB to be used in the dressing without being compromised, it was loaded onto a silica material with pores only a few nanometres in size. The silica material could then be combined with the dressing material without compromising the nanocellulose. The result is a wound dressing that turns blue when there is an infection.
Wound infections are often treated with antibiotics that spread throughout the body. But if the infection is detected at an early stage, local treatment of the wound may suffice. This is why Daniel Aili and his colleagues at Örebro University are also developing anti-microbial substances based on so-called lipopeptides that kill off all types of bacteria.
“The use of antibiotics makes infections increasingly problematic, as multi-resistant bacteria are becoming more common. If we can combine the anti-microbial substance with the dressing, we minimise the risk of infection and reduce the overuse of antibiotics,” says Daniel Aili.
Daniel Aili says that the new wound dressing and the anti-microbial substance are part of developing a new type of wound treatment in out-patient care. But as all products to be used in medical care settings have to pass rigorous and expensive testing, he thinks that it will be five to ten years before it will be available there.
Both studies are part of the HEALiX research project financed by the Swedish Foundation for Strategic Research with the objective of developing a new type of wound treatment. Funding was also received from, among others, the Swedish Government Strategic Research Area in Materials Science on Functional Materials (AFM) at Linköping University, Vinnova, the Knut and Alice Wallenberg Foundation and the Swedish Research Council.

Several insurers will cover abortions through Hey Jane, a start-up online provider, just as courts threaten to hobble the industry.The legal effort to ban mail-order abortion pills came along just as the fledgling telehealth industry became a more accepted and entrenched part of abortion care.This week, Hey Jane, one of more than a dozen virtual abortion providers that have no physical locations, began contracting with the insurers Anthem Blue Cross Blue Shield of Connecticut, Empire Blue Cross Blue Shield of New York and Sana, which provides health plans for small businesses nationwide. Hey Jane also already accepted Aetna in eight of the nine states in which it operates.It’s unusual for insurers to cover telehealth abortions, and most virtual clinics are cash only. The clinics are new, and insurance coverage for abortion varies widely. In the year before Roe v. Wade was overturned, just a third of abortion patients used insurance. Some states require private insurers to cover abortions, while others bar it. Federal law prohibits the use of Medicaid for most abortions, though 16 states use state funds to cover them. But even plans that do cover abortion don’t generally include these new telehealth providers in their networks.Health insurers tend to cover treatments that are widely accepted by clinicians and cost-effective, and Hey Jane’s insurance partnerships are the latest sign that virtual abortion clinics are seen by the health care industry as a safe, in-demand option. They also tend to be less expensive than in-clinic procedures for both patients and insurers.“In abortion care, as in so many other areas of health care, we believe expanding telehealth’s role is a huge lever” for making care more accessible and affordable, said Will Young, chief executive of Sana.Not all insurers are ready to cover this new way of providing abortions, said Gaby Santana, head of business at Hey Jane. For example, some require live visits, over video, while Hey Jane sees most of its patients through messaging. Other insurers told Hey Jane they only contracted with clinics with a physical location. “Our goal is to make this as big and accessible as possible,” Ms. Santana said. “That’s why we want to bring on more states and more payers.”The abortion pills mifepristone and misoprostol are packaged at Dr. Kaul’s clinic, Maitri Wellness, to be mailed to patients. Jackie Molloy for The New York TimesNew data shows telehealth accounts for a rapidly growing share of abortions, and Honeybee, the largest online pharmacy supplying mail-order abortion pills, said it was filling more than 10,000 prescriptions a month.Yet these clinics could also be hobbled just as they are starting to grow. The Fifth Circuit ruled last week that the Food and Drug Administration should ban telemedicine prescriptions and delivery by mail for mifepristone, the first of two drugs typically prescribed to induce abortions. It’s a temporary order while a Texas court considers whether to overturn the drug’s approval altogether. The Supreme Court ruled Friday that mifepristone would remain available until Wednesday at midnight while it had time to review the case.The F.D.A. first allowed telemedicine abortion in 2020, following an emergency court decision made early in the pandemic and after extensive data demonstrated that it was a safe and effective way to offer abortion pills to patients. It made the policy permanent in 2021. Pharmacists must get a special certification to dispense mifepristone, and report data about each prescription, said Jessica Nouhavandi, co-founder of Honeybee. “I had to literally create protocols and train pharmacists,” she said. “Most don’t even learn about this in school.”Most of the start-up clinics operate in only a few states; they must have a clinician licensed in each state in which they see patients. Some are financed by investors or grant makers as they figure out how to build a profitable business. Few have lawyers on staff to help them navigate the recent legal challenges.They have formed an unofficial network to help one another, with group chats about electronic medical records or legal questions. A nonprofit called Plan C provides consulting and sometimes small grants, and a database of providers.They have begun discussing what they will do if the court case prompts the F.D.A. to take mifepristone off the market. Many are preparing to offer just the second medicine, misoprostol, which is effective when used alone to end a pregnancy, but can bring more side effects.Dr. Rachna Kaul runs Maitri Wellness, a solo primary care practice in New Jersey. But she started offering telemedicine abortions during the pandemic, and now her office mails dozens of pill packs a day into three states where she is licensed. She charges cash prices for patients who can afford the service, and uses grants to cover the costs for patients who cannot. Dr. Kaul said adding the service was easier for her than many of her peers because she was self-employed. “In the beginning, we didn’t have any funding, so we took it all out of our own pockets,” she said. “I could do any other work and make so much more money. This is such a huge need.”Juniper Midwifery, which provides 175 medication abortions a month to women in six states, is run by two midwives with day jobs at a New York City hospital and clinic. They operate out of their homes or on the go.“It’s just the two of us,” said Marisa Poverman, who started Juniper with Jillian Barovick. “We’re still in a grass-roots phase of things. So this week has felt a little bit tenuous. Are we going to be able to keep doing this and providing access to people in this way?”Juniper saw its first patients in August. Ms. Poverman built the website using WordPress, and their husbands took their headshots. They raised money from friends and family to get it off the ground, and now have a grant from New York State. They accept cash only, and use the grant to subsidize prices or provide free care to patients who need it.Hey Jane, by contrast, is among the most established of the providers, with $9.6 million in venture capital investment and 40 employees. Abortion on Demand and Aid Access operate in the largest number of states. (A separate branch of Aid Access also operates in states where abortion is illegal by connecting women with doctors and pharmacies abroad.)Carafem is another larger operation, a provider that offers telehealth abortions in 16 states and also has a few physical clinics. Melissa Grant, the chief operating officer, said one of the hardest parts of her operation had been learning the varying rules in each state.Questions about insurance coverage reflect these complications — and often amplify them. Ms. Grant said her providers work hard to help patients figure out what their insurance covers, and are trying to persuade more health plans to work with the company.“Not everyone’s plan covers abortion,” she said. “When you put telehealth on top of it, unfortunately there’s a lot more carriers that deny care.”Even if they do have coverage, not all patients want to use it, said Dr. Stephanie Colantonio, a primary care physician who offers telemedicine abortion in California through Luna Flow Health. “Some patients are so nervous about privacy and security that they prefer to pay out of pocket,” she said.

The NewsThe Food and Drug Administration on Tuesday authorized an additional round of bivalent booster shots for adults who are 65 and over as well as people with compromised immune systems. The effort is to ensure ongoing protection against Covid, which is still claiming more than 1,300 lives each week.The bivalent shots target Omicron variants of the coronavirus. The agency said people who are 65 and older who have not had a bivalent booster shot in at least four months may get another one. For those who are immunocompromised, additional doses of the bivalent vaccine can be given two months after the last shot. Those who are unvaccinated can get a single dose of the bivalent booster, the agency said.“Covid-19 continues to be a very real risk for many people,” Dr. Peter Marks, the F.D.A. vaccine chief, said. “The available data continue to demonstrate that vaccines prevent the most serious outcomes of Covid-19, which are severe illness, hospitalization and death.”The Food and Drug Administration on Tuesday approved an additional round of bivalent booster shots to ensure ongoing protection against Covid. Rosem Morton for The New York TimesWhy It MattersAlthough levels of the virus are dipping as the summer months approach, it is still being linked to 1,300 deaths each week, according to data from the Centers for Disease Control and Prevention.C.D.C. data also show that only 43 percent of people over 65 have received an Omicron booster shot, and just 20 percent of those 18 and older.BackgroundThe spring booster approval was for the same formula that was released to protect people from the Omicron variant of the virus. An updated vaccine is expected later this year. (The agency on Tuesday also rescinded authorization for the original monovalent vaccines that Americans received in the first mass-vaccination campaign.)The decision to offer the booster to the most vulnerable this spring is sound for two reasons, said Dr. Daniel Griffin, an infectious disease specialist at Columbia University.“One is the traditional reason — it protects people from severe disease,” he said. “But there is what I call the superpower where for a matter of three or four months, you get an extra benefit of reducing your risk of even getting infected.”What’s NextThe C.D.C. typically endorses updated vaccine schedules after F.D.A. authorizations.The F.D.A. said it intended to make decisions about the recommended vaccine schedule for people younger than 65 after a June advisory meeting. The agency said its advisers would make their recommendations based on whatever strain of the virus is circulating at that time.The F.D.A. said it expected to make updated formulations of the vaccines for this fall “once the specific strains are selected for the Covid-19 vaccines.”

Added-sugar warning labels reduced the likelihood that consumers would order items containing high amounts of added sugar in an online experiment led by University of California, Davis, researchers. Menu labels can help inform consumers about the surprisingly high amount of added sugar in even the smallest sizes of soda or in unexpected items like salad dressings and sauces.
In a randomized controlled trial, researchers found that warning labels reduced the probability of ordering a high-added-sugar item by 2.2%. However, only 21% of the consumers exposed to the added-sugar warning labels noticed them. Among those who noticed the labels, there was a reduction of 4.9 grams of added sugar ordered, compared to the control group.
“Given the frequency of restaurant food consumption, these modest effects could lead to meaningful changes in sugar intake at the population level, and the labels should motivate restaurants to reduce the added-sugar content of their menus,” said Jennifer Falbe, a researcher in the Department of Human Ecology and lead author. Notably, it is estimated that 21% of calories consumed in the United States come from restaurants.
However, given that most participants did not notice the added-sugar labels, Falbe added, “our findings also indicate that menu labels should be designed for higher visibility.”
First look at behavioral outcomes
The study, published online this week in the American Journal of Preventive Medicine, looked at people’s behavior as they simulated ordering from menus for fast-food and full-service chain restaurants. Co-authors include researchers from other universities and the Center for Science in the Public Interest.

Falbe said this study is the first to test a restaurant menu added-sugar warning label on behavioral outcomes. In the study, consumers selected menu items they would want to order for dinner from online menus that included common foods like hamburgers, salads, French fries, beverages (with sugar and sugar-free), sodas, cookies, sundaes and smoothies.
More than 15,000 participants were recruited to match the U.S. population in terms of age, gender, race and ethnicity, and education. Half of them were randomized to select from online menus with added-sugar warning labels while the other half selected from menus without added-sugar labels (the control group). In the intervention group, warning labels had been added to items containing over 50% of the recommended daily limit for added sugar. Researchers were able to record all participants’ behavior as they simulated ordering dinner from those menus in 2021.
Major findings include: Added-sugar warning labels reduced the likelihood that consumers would order an item high in added sugar. The warning labels helped consumers understand whether menu items were high in added sugar. A large majority, or 72%, of consumers in the study indicated that they supported a law requiring chain restaurants to post these warning labels on their menus.Falbe and colleagues had conducted previous studies on developing such warning labels, including one that designed added-sugar menu labels based on the design of existing sodium warning labels present on menus in New York and Philadelphia.
While the United States Food and Drug Administration requires large chain restaurants to make some nutrition information available in restaurants, there is currently no requirement for added sugar to be publicly disclosed for restaurant foods, researchers said.
“This gap in information leaves consumers in the dark about how much added sugar is contained in the foods and drinks that they consume,” said DeAnna Nara, a senior policy associate at Center for Science in the Public Interest and co-author. “We know that chain restaurants serve up foods and beverages packed with added sugars and are especially hard places for consumers to navigate and make healthy choices for themselves and their families, especially those managing chronic diseases.”
“Warning icons provide easily interpretable information to consumers and equip them with the information they need to make informed decisions,” said Nara. “They also have the potential to encourage restaurants to rethink their recipes, spurring reformulation to cut back on added sugars.”
Co-authors of the study include researchers from UC Davis, Harvard T.H. Chan School of Public Health, Perelman School of Medicine at the University of Pennsylvania, Center for Science in the Public Interest in Washington D.C., and the University of North Carolina at Chapel Hill.
Funding was provided by Bloomberg Philanthropies to CSPI. Bloomberg Philanthropies and CSPI played no role in the data collection, experimental design or analysis of the data. Researchers were also supported by career development and training grants from the NIH.

The program, which will include a partnership with pharmacy chains, will cover the administrative costs of giving doses to patients when the shots move to the commercial market later this year.WASHINGTON — The Biden administration plans to spend more than $1 billion on a new program to offer free coronavirus shots to uninsured Americans later this year after the vaccines move to the commercial market, administration officials said.The program for the uninsured, which will be modeled partly on an existing childhood vaccination program, will include a first-of-its-kind partnership with pharmacy chains that will cover the administrative costs of giving the doses to patients. Pfizer and Moderna have pledged to offer the shots at no cost to those who lack insurance.The administration’s move partly resolves a critical loophole in the nation’s coronavirus vaccination strategy ahead of a new booster campaign that is likely to begin as soon as late summer. Federal officials have said that they no longer plan to mass-purchase doses for Americans as they have in prior coronavirus vaccination campaigns, allowing the vaccines to be sold commercially and ceding power to manufacturers to set their own prices.In June, federal regulators are expected to choose a new formulation of the shots that will target versions of the virus they expect to circulate broadly later in the year. Those shots would most likely roll out around September, similar to the timing of last year’s booster campaign.The administration is also planning to buy discounted doses for community health clinics and federal and state vaccination programs that traditionally deliver vaccines to the uninsured. The program will be called the Bridge Access Program for Covid-19 Vaccines and Treatment, according to an administration fact sheet obtained by The New York Times.This is a developing story. Check back for updates.

Men and people with severe illnesses were more likely to develop the condition within a year. But the data does not prove that the coronavirus causes diabetes.People infected with the coronavirus were significantly more likely to be diagnosed with Type 2 diabetes within a year of their infection, compared with those who had not been exposed to the virus, researchers in Canada reported on Tuesday.Men were more likely to develop diabetes than women, the scientists found. People who were so sick that they were hospitalized were more than twice as likely to go on to a diabetes diagnosis, compared with those who were not infected.People who were admitted to intensive care were more than three times as likely to develop diabetes, the researchers also found. The findings add to a growing body of evidence about Covid’s long-term effects.“This is definitely a concern in terms of long-term outcomes,” said Dr. Naveed Z. Janjua, the paper’s senior author and a professor at the School of Population and Public Health at University of British Columbia.“With a respiratory infection, you usually think, ‘Seven or eight days and I’m done with it, that’s it,’” he added. “Here we’re seeing lingering effects that are lifelong.”The study, published in JAMA Network Open, used a large data set from British Columbia to compare diabetes diagnoses among more than 125,000 individuals who had tested positive for Covid in 2020 and 2021 with those of over 500,000 unexposed individuals during the same period.Covid vaccines became available in December 2020, and a majority of participants in both the exposed and unexposed groups had not been fully vaccinated.More than a dozen studies have looked at the link between Covid and diabetes, and a majority have reported an increase in diagnosis following infection, as well as higher risks for men and those with severe disease.The findings do not prove that the infection causes diabetes, however. Experts said it was possible, for instance, that patients recovering from Covid were more likely to be diagnosed with diabetes simply because they were receiving more regular care.Still, there are plausible biological explanations for a link between the two conditions, said Dr. Pamela Davis, a professor of medicine at Case Western Reserve University in Cleveland, who co-wrote a commentary accompanying the study.“It’s reasonable to ask, ‘Is this an actual increase, or is this just something that accelerated diabetes that was coming anyway in people, but they got it earlier?’” Dr. Davis said in an interview.“But even if it’s just an acceleration, this is going to be costly,” she added. “The human suffering, the risk of complications in the eyes, the blood vessels, the heart, the kidneys, the days of productivity and work lost — all those things will be accelerated. I’m worried about this.”The coronavirus infects beta cells in the pancreas that make insulin, Dr. Davis said, and cause cell death. These cells are dotted with the ACE2 receptors that the virus uses as an entryway.“If you put the beta cells of the pancreas in a culture dish, the virus will avidly infect these cells and destroy them,” she said.Stress also plays a role in the development of diabetes, and the inflammatory response that accompanies Covid has been linked to the destruction of beta cells. People with severe Covid may also produce antibodies that attack the patient’s own body.Other viral infections have also been associated with the development of diabetes, according to Dr. Janjua, whose research before the pandemic focused on hepatitis.“With hepatitis C, we have strong evidence that the infection is associated with an increased risk of diabetes as well as cardiovascular outcomes and many other systemic outcomes outside the liver as well,” Dr. Janjua said.The new study found that adults who had tested positive for the virus were 17 percent more likely to develop diabetes within a year of the positive test. Men were 22 percent more likely to develop diabetes, compared with unexposed individuals. The elevated risk for women was not statistically significant overall unless they were hospitalized or admitted to an intensive care unit.The researchers matched infected and unexposed people by age and sex, and made adjustments to account for differences in underlying health conditions, socioeconomic status, vaccination status and other factors.They calculated that of all new cases of diabetes, some 3.4 percent could be attributed to a Covid infection. For men, 4.75 percent of new cases were attributed to Covid.

The idea of wirelessly gathering electrical information from the body through the skin is not new. However, the ideal electrode material must fulfill a significant list of criteria to be a realistic candidate for use on patients. Researchers from Osaka University have designed an electrode substrate derived from wood that appears to tick all the boxes and their findings have recently been published in Advanced Materials Interfaces.
The electrodes needed for on-skin electronics are supported by a substrate material that makes effective contact with the skin. Choosing a substrate requires the consideration of numerous factors: Is it flexible and comfortable to wear, but still durable? Can the substrate be sterilized so that it can be reused? Does it stick well to the skin and allow the skin to breathe? Is the substrate environmentally sustainable to produce and dispose of?
Finding a candidate is therefore tricky, but the Osaka researchers believe they have designed the most promising one to date. Their cellulose-based material is essentially paper made up of tiny nanofibers, giving it the name nanopaper e-skin, and it is the gaps between the fibers, whose size can be controlled, that give their substrate the edge.
“To get the best possible electrical signal it is important for a substrate to make good contact with the skin, which means it must be smooth. However, many examples of smooth materials are also very dense which severely reduces their breathability and results in user discomfort,” says study author Teppei Araki. “Because our nanopaper is a mesh of very fine fibers, it maintains good contact with the skin, but also has pores meaning that water vapor can pass through, reducing inflammation and making it comfortable to wear.” explains study first author Yintong Huang.
Once wet, the nanopaper could stick to skin because of the action of the water in the pores and was able to withstand 100 cycles of deformation on the forehead while maintaining function. The nanopaper could also be sterilized at high temperature.
“We believe that our nanopaper offers compatibility with both the body and the environment,” says senior author Hirotaka Koga. “The availability, flexibility, skin-conformability and -breathability, thermal stability, toughness, biocompatibility, and environmental sustainability of our substrate all combine to make it a highly promising candidate for electrophysiological monitoring that we expect to easily translate into the clinic for the measurement of data such as ECGs.” These results provide a very promising step forward in the field of on-skin electronics and may be the jump needed for explosive developments when we combine techniques of flexible and sustainable electronics that we have developed (see below resent works).