Publisher Health

Researchers at CÚRAM have this week published an interdisciplinary framework that enables the development of extracellular matrix-inspired hydrogels for biomedical applications.
An extracellular matrix (ECM) is a three-dimensional cementing material that gives structural support to our cells. Hydrogels mimicking this extracellular matrix (ECM) have become increasingly attractive in biomedical science research due to their tunability and biocompatibility. However, hydrogel development and characterisation require an interdisciplinary approach that is seldom fully achieved as it needs an extraordinary degree of researcher skill.
This review is a first-of-its-kind approach that will provide information on available tools for properly characterising ECM-based hydrogels and interpreting the resulting data. It also provides an accurate roadmap that can be used by biomedical researchers when attempting to bridge the gap between material science and biomedicine.
The review paper was published by Matter, a sister journal to Cell and home for multi-disciplinary, transformative materials science and impactful research.
Lead author and Director of CÚRAM Professor Abhay Pandit said: “With this proposed review, we aim to combine the knowledge of chemistry, material science, and biology by critically discussing the available tools to properly characterise ECM-based hydrogels and interpreting the resulting data, leading to an accurate roadmap to be applied in this exciting field.”
ECM hydrogel development and characterisation involve a wide array of interdisciplinary tools; this review will appeal to chemists, material scientists, engineers, and biologists working in the field. This review provides a concise, complete, and easy-to-follow guide for advanced undergraduates, early postgraduate researchers, industry (MedTech, Pharmaceutical, and BioTech), and experts in this interdisciplinary field.
Professor Pandit further explains: “The impact of this review is an attempt to facilitate further interdisciplinary work to create solutions for chronic illnesses in the future aligning with CÚRAMs mission of improving quality of life for people living with chronic illness.
It will be a go-to resource for researchers in academia and industry and a source of inspiration for the next generation of materials scientists and engineers.”
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Materials provided by National University of Ireland Galway. Note: Content may be edited for style and length.

Schizophrenia patients have fewer connections between nerve cells. This is believed to be caused by genetic risk variants leading to an excessive elimination of nerve cell connections by the immune cells of the brain. Researchers at Karolinska Institutet now report in Nature Communications that the levels of protein from the relevant risk gene are elevated in first-episode patients and that inflammation further increases the expression of the risk gene. 
In the late-teenage brain, a normal elimination of less desirable connections between nerve cells takes place. The pruning of these connections, so-called synapses, is of great importance for the development of functional neural networks. However, patients with schizophrenia have fewer synapses. A few years ago, researchers at Karolinska Institutet could show in an experimental model that the elimination of synapses is increased in schizophrenia patients and can be linked to the gene coding for complement component 4A (C4A), a protein involved in immune signalling. 
The same team has now developed a method to measure C4A levels in cerebrospinal fluid. In two independent cohorts, they observed elevated C4A levels in first-episode psychosis patients that a few years later would develop schizophrenia. 
“After checking for genetic risk variants, we still observed elevated levels of C4A,” says Jessica Gracias Lekander, a doctoral student at the Department of Physiology and Pharmacology, Karolinska Institutet, and first author of the study. 
The pro-inflammatory cytokines IL-1beta and IL-6 have previously been shown to be elevated in schizophrenia, and the researchers performed new experiments in which they could show that these cytokines stimulate the expression of the C4A gene, while patients with high C4A levels also displayed high levels of IL-1beta in cerebrospinal fluid. C4A levels also correlated with markers of synapse density. 
“This indicates that the effect we see in the laboratory is also relevant in the brain, and that the inflammation enhances the effect of the genetic riskvariant,” says senior author Carl Sellgren Majkowitz at the Department of Physiology and Pharmacology, Karolinska Institutet, and Psykiatri Nordväst, Region Stockholm. 
The researchers hope that their findings will lead to more effective and personalized treatment strategies and be part of the emerging precision psychiatry. 
“Existing treatments are non-personalized and focus on reducing psychotic symptoms in patients that have developed the disorder,” says Carl Sellgren Majkowitz. 
The study was primarily funded by the Swedish Research Council, One Mind Foundation/Kaiser Permanente, Erling Persson Foundation, and the Swedish Federal Government under the ALF agreement.
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Materials provided by Karolinska Institutet. Note: Content may be edited for style and length.

Sport and exercise experts are calling for better education around periods and pregnancy in women’s football.
New research carried out at women’s football clubs across six European countries shows that education around the menstrual cycle, hormonal contraception and pregnancy is severely lacking.
The study, led by academics from Staffordshire University, involved more than 1,100 players, coaches and managers from grassroots to elite level clubs in Bulgaria, England, Finland, France, Poland and Spain. It investigated policies, perceptions and understanding through an online survey and a series of focus groups.
Dr Jacky Forsyth, Associate Professor of Exercise Physiology, explained: “The topic of ovarian hormones and their effects on training and performance, in addition to pregnancy and postpartum, seems to have received scant consideration within any formal coach education courses.
“In sport, these topics also come with varying degrees of stigma and silence, as well as being a barrier to gender equality. To address this, we wanted to collect best practice across Europe to learn what clubs are doing well, what is effective and what can be improved.
“Despite some good practices in individual clubs across different countries, there was limited knowledge and understanding of how training, performance and health are affected. Knowledge was generally left up to the individual without support from governing bodies or coach education providers.”
69% of all participants said that educational provision on menstrual cycle was ‘not at all’ provided at their clubs and while some clubs tracked players’ menstrual cycle this was varied and inconsistent.

Parents can transmit a genetic risk for alcohol problems to their children not only directly, but also indirectly via genetically influenced aspects of the home environment, such as marital discord or divorce, according to a Rutgers researcher.
The study, published in Molecular Psychiatry, found that children’s exposure to parents’ relationship discord or divorce is associated with the potential for alcohol use disorder as adults.
“Previous research has shown that genes that predispose people to alcohol use disorder also predispose them to experience more conflict in their close romantic relationships,” said Jessica Salvatore, coauthor of the study and an associate professor and director of the Genes, Environments and Neurodevelopment in Addictions Program at Rutgers Robert Wood Johnson Medical School. “Based on this, we hypothesized that children who are exposed to divorce or parental relationship discord also inherit a genetic predisposition toward alcohol problems — and that experiencing these family adversities might be one pathway through which genetic risk for alcohol problems is passed from parents to their children.”
The researchers used The Collaborative Study on the Genetics of Alcoholism — a large-scale family study designed to identify genes that affect the risk for alcohol use disorder and alcohol-related behaviors — and analyzed data from 4,846 people of European ancestry and 2,005 people of African ancestry who were interviewed when they were approximately age 30. They assessed whether participants had any symptoms of DSM-5 Alcohol Use Disorder and studied predictors in their parents, including relationship discord, divorce and alcohol use disorder symptoms as well as a measure of their genetic predispositions for alcohol problems.
“The conventional understanding is that genetic risk for alcohol problems is passed in families from parents to children through the sharing of alleles, or variations of genes, from across the genome. What we found is that parents with more alleles for alcohol problems were also more likely to divorce or experience relationship discord, which in turn was associated with greater alcohol use disorder symptoms in their adult children,” Salvatore said. “Genes can shape our environment: Parents’ genes contribute to the types of environment that they create for us. Thus, one of the ways that genetic inheritance works is through our home environment. And these family adversities can turn the dial on our risk of experiencing alcohol use disorder symptoms later on. In other words, it’s not ‘nature’ or ‘nurture,’ but rather nature [genes] contributing to nurture [family experiences].”
In families of European descent, researchers found evidence that parental alleles associated with increased risk of alcohol problems also increased the likelihood that children in those families would experience parental relationship discord and divorce, which were in turn associated with riskier alcohol behaviors from drinking at earlier ages to greater lifetime maximum drinks to a greater likelihood of developing alcohol use disorder symptoms. Importantly, these effects were observed even when parents’ own alcohol use behaviors were statistically controlled for in the model.
The study did not find this evidence in people with African ancestry, and Salvatore said further research is needed to determine why.
Salvatore said the findings can lead to new avenues for treatment beyond medication. “One implication of our study findings is that even if someone’s risk for alcohol problems is, in part, grounded in their genetic makeup, the intervention could be environmental and not necessarily pharmaceutical,” she said.
Salvatore shared first authorship on this study with Nathaniel Thomas, Virginia Commonwealth University. Other Rutgers co-authors included Sally Kuo, Fazil Aliev, Sarah Brislin and Danielle Dick. COGA is a multisite study, and this study included additional co-authors from Washington University School of Medicine, State University of New York Health Sciences University, the University of Connecticut, the University of Iowa, Indiana University, and the University of California San Diego.
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Materials provided by Rutgers University. Original written by Patti Zielinski. Note: Content may be edited for style and length.

Cancer cells have a series of features that allow the immune system to identify and attack them. However, these same cells create an environment that blocks immune cells and protects the tumour. This means that immune cells cannot reach the cancer cells to remove them. The scientific community has been working for years to increase the effectiveness of the immune system against cancer by using vaccines based on dead tumour cells.
Scientists at IRB Barcelona, led by ICREA researcher Dr. Manuel Serrano, and Dr. Federico Pietrocola, now at the Karolinska Institutet, in Sweden, have studied how inducing senescence in cancer cells improves the effectiveness of the immune response to a greater degree than the dead cancer cells. After vaccinating healthy mice with senescent cancer cells and then stimulating the formation of tumours, the researchers observed that the animals did not develop cancer or that the number that do is significantly reduced. They also analysed the efficacy of vaccination in animals that had already developed tumours. In this setting, although the results were more moderate due to the protective barrier of the tumour, improvements were also observed.
“Our results indicate that senescent cells are a preferred option when it comes to stimulating the immune system against cancer, and they pave the way to considering vaccination with these cells as a possible therapy,” explains Dr. Serrano, head of the Cellular Plasticity and Disease lab at IRB Barcelona.
The researchers tested the technique in animal models of melanoma, a type of cancer characterised by high activation of the immune system, and also in pancreatic cancer models, which present strong barriers against immune cells. Prophylactic vaccination therapy with senescent cancer cells was effective against both types of tumors. They also complemented the study with tumour samples from cancer patients and confirmed that human cancer cells also have a greater capacity to activate the immune system when they are previously rendered senescent.
The group is now studying the combined efficacy of vaccination with senescent cells and immunotherapy treatments.
Senescence and its capacity to activate the immune system
Senescence is a state of latency reached by damaged or aged cells in which they do not reproduce but do not disappear either. Senescent cells emit information signals into their environment, which warn of their presence, stimulating an inflammatory response and tissue regeneration.

Deaths from contaminated cough syrups in Gambia have brought attention to loose regulations in India and a lack of testing capacity in poor importing nations.They had fevers, aches, runny noses, the normal stuff of childhood. The kind of illnesses for which a doctor would prescribe cough syrup.But the children’s condition only worsened. They developed persistent diarrhea, then could no longer urinate, as their kidneys failed. The very medicines that were supposed to make them better, simple cough syrups imported from India, were instead killing them, because they turned out to be poison.In all, 70 children in the tiny West African nation of Gambia are suspected to have died in recent months from contaminated Indian-made cough syrups. Among them was 2-year-old Muhammad Lamin Kijera, who died on Aug. 4.“He was lively and likable — he was everybody’s friend,” said his father, Alieu Kijera, who works as a nurse at an eye clinic in Banjul, the Gambian capital. “How can they allow something like this into the country, destroying lives?”India has taken to calling itself “the world’s pharmacy” as its drug industry has expanded rapidly, providing a lifeline to the developing world by selling medicines, many of them generics, for an array of illnesses like malaria and AIDS at prices lower than those of American or European drugs.But the deaths in Gambia have raised alarm over what one expert called a “dangerous cocktail”: on one side, a $50 billion Indian pharmaceutical industry whose regulation has remained loose and chaotic despite repeated calamities, and on the other, poor nations with little or no way to test the quality of the medicines they import.India’s drug industry, experts say, is rife with data fraud, inadequate testing and substandard manufacturing practices. While people around the world take Indian medicines every day without incident, the regulatory weaknesses give the country’s drug makers openings to cut corners and increase profits, experts say.That has created a hazardous reality far more widespread than the occasional tragic cases of mass poisonings, and could shake faith in Indian medicines in the places that need them most.Cough syrups collected for disposal in Banjul, Gambia, in October.Milan Berckmans/Agence France-Presse — Getty Images“What happened in Gambia is happening in other African countries without us even knowing,” said Michel Sidibé, the African Union special envoy for the African Medicines Agency, a new body aimed at harmonizing drug regulation across the continent.“Most African countries don’t have testing capacities nor well-trained regulatory bodies,” Mr. Sidibé said. “The African market is very fragmented, but because of poor regulations, drugs move from one country to another.”More on IndiaCoal Baron or Climate Warrior?: The business decisions of Gautam Adani, Asia’s richest man, could go a long way in determining whether India helps the world avert a climate catastrophe.Straining Democracy: As India rises on the global stage, Prime Minister Narendra Modi has faced little pushback from Western allies as he weaponizes institutions to consolidate power.Taking a Stand: The website Alt News, a leading debunker of misinformation, has been calling out hate speech against minorities. That has put it on a collision course with the Indian government.Woven Reusable Bags: When shoppers choose them over plastic alternatives, they aren’t just helping the planet. They are reviving India’s deep-rooted jute industry.India is the world’s third-largest drug manufacturer by volume, producing 60 percent of global vaccines and 20 percent of generic medicines. In a sign of the world’s reliance on Indian drugs, the country’s pharmaceutical exports increased nearly 20 percent during the first year of the pandemic, reaching $24 billion, despite lockdowns that disrupted global supply chains.As a stamp of approval for the quality of Indian medicines, officials point out that more than half of the drugs manufactured in India go to highly regulated markets — “every third pill in the U.S. and every fourth pill in Europe is sold from India,” according to the Indian Pharmaceutical Alliance.It is the other half where the danger may lie.Dinesh Thakur, a public health activist and industry whistle blower who pulled the curtain on some of its perilous practices, and Prashant Reddy, a lawyer and researcher, chronicled India’s regulatory gaps in a recent book, “The Truth Pill.”Mr. Thakur, Mr. Reddy and other experts have long suspected that Indian manufacturers may be taking shortcuts with some medicines bound for export to markets with poorer quality controls. Some of the evidence is anecdotal, but they point to a limited study in which the quality of Indian drugs was tested across multiple importing nations, as well as Indian drug products that have drawn complaints and blacklisting in other countries.They also note that regulatory bodies of Western nations, such as the Food and Drug Administration in the United States, carry out regular inspections of Indian factories that manufacture drugs for their markets. But poorer nations do not have the resources to do the same, leaving the products shipped to their countries at the mercy of loose Indian regulation.“Drugs they export to Africa tend to be of lower quality than the other markets,” Mr. Reddy said, “because they know they are more likely to get away with substandard drugs.”The problem with cough syrups is an old one, so old that similar contamination issues helped lead to the United States’ strict drug regulations and the creation of the F.D.A. nearly a century ago.In recent decades, several cases of mass deaths from drugs made in China, a big producer of medicines and pharmaceutical raw materials, have been traced to cough syrups. In those cases, counterfeiters were found to have used diethylene glycol and ethylene glycol, which break down into toxic compounds in the body, instead of more expensive nontoxic solvents.In India, at least five mass-death episodes caused by diethylene glycol contamination have been recorded since the 1970s. The Indian-made syrups exported to Gambia were also found to have high amounts of diethylene glycol and ethylene glycol. But they were produced by a licensed manufacturer, not counterfeiters, as in China.India has an antiquated model of regulation that focuses on checking the end product. The F.D.A., by contrast, has a “process-oriented” regulatory framework, which focuses on quality and safety checks during the manufacturing of a drug.The process falls short in India, Mr. Thakur and Mr. Reddy said, because of a lack of resources in conducting the product checks, as well as widespread corruption.Manufacturers take advantage of loopholes in a layered system of regulation in India’s federal system. The central government is charged with ensuring the quality of imported drugs and approves new drugs. But state governments are largely responsible for enforcing drug regulations, both for domestic use as well as manufacturing for export.A member of the Gambian Red Cross looking through sacks of collected cough syrups in Banjul in October. Milan Berckmans/Agence France-Presse — Getty ImagesMr. Thakur said that state governments often had budgets much too small to continuously purchase drugs from the markets for testing. Even when a drug in one state is found to be hazardous, jurisdiction issues and weak legal frameworks prevent swift recalls.“For the state governments, state capacity is very low, and drug regulation is an extremely low priority for them,” Mr. Reddy said.Only recently have there been efforts in India to create a consolidated central database where test results from one state can be easily shared with others. Partial data uploaded from three states alone showed about 7,500 failures — because of problems like insufficient active ingredients, difficulties with metabolism or bacterial contamination — of drugs on the market that those states had tested over the past decade.The four syrups linked to the deaths in Gambia were produced by Maiden Pharmaceuticals. The three-decade-old firm manufactures drugs in the state of Haryana. Maiden’s website, which says one of the company’s principles is “at any cost don’t compromise on quality,” shows that its exports reach four dozen countries.Maiden, in a statement, said that it had “valid drug approvals for the export of the products in question” and that the raw material for the drugs had come from “certified and reputable companies.”But Maiden had been flagged before for substandard products. The database shows that in the state of Kerala, five of its products failed tests in 2021. Eight years earlier, the consul general of India in Ho Chi Minh City named Maiden among 46 Indian companies that Vietnamese drug controllers had “blacklisted for quality violation,” asking for action against them “for bringing bad name to the Indian pharma industries abroad.”In the Gambia case, the country’s Medicines Control Agency, working with the W.H.O., alerted the Indian government to the problems with the syrups on Sept. 29 and ordered a recall on Oct. 4, nearly three months after the doctors in the Banjul hospital had begun seeing a pattern.A day later, the W.H.O., which had sent samples to Switzerland and Senegal for testing, announced that lab tests had confirmed the presence of “unacceptable amounts” of diethylene glycol and ethylene glycol in the syrups.Hundreds of Red Cross volunteers raced to intercept the contaminated syrups in Gambia, one household and pharmacy at a time. Out of 50,000 bottles of contaminated syrup, the Gambian police said that 41,500 had been recalled, but that the rest remained unaccounted for.Many children who took the syrups are still fighting for their lives, as doctors in Gambia had continued prescribing them as late as mid-September.The alarm has spread beyond Gambia. While the syrups are not registered for sale in most other West African countries, once a product is in the region, “it’s very difficult to control its circulation due to porous borders,” said Arnaud Pourredon, the founder of Meditect, an Ivory Coast-based company that helps pharmacists digitize their stocks and track fake medicines.In India, officials raided the production site in Haryana two days after they were alerted by the Gambian government. On Oct. 11, they ordered Maiden’s production facility to close.Legal notices on the front gate of a manufacturing unit of Maiden Pharmaceuticals.Xavier Galiana/Agence France-Presse — Getty ImagesHaryana and national regulatory bodies said in a joint statement that “the firm has been manufacturing and testing drugs without adhering to and in contravention” of accepted manufacturing practices and that Maiden “has not maintained and not produced complete records of manufacturing and testing as per rules.”But the central government tried to shift responsibility, saying the burden for ensuring quality rested on Gambia as the importing country.Gambia’s health minister acknowledged that the country did not have labs to test imported medicines. The nation’s pharmaceutical regulatory body, established in 2014, relies on certificates provided by manufacturers, said Salieu Taal, a lawyer and the president of the Gambia Bar Association.He said that the loose regulations in some exporting countries and the lack of resources for testing in recipient nations had left many African countries facing “a very dangerous cocktail.”“There may be more deaths than we have recorded,” Mr. Taal said.Mady Camara

The report points to widespread misbehavior by the plans and the marketing firms they hire.Companies selling private Medicare plans to older adults have posed as the Internal Revenue Service and other government agencies, misled customers about the size of their networks and preyed on vulnerable people with dementia and cognitive impairment, according to a new investigation of deceptive marketing practices in the industry released Thursday by the Senate Finance Committee.Many individuals say they were enrolled in plans without realizing it.The report catalogs complaints from 14 states, and a multitude of marketing materials generated by the insurers and the companies they hire to help sell the private plans.The plans are part of a program called Medicare Advantage that now enrolls nearly half of all Medicare beneficiaries. The committee says people both in traditional Medicare and those already in a private plan have been inappropriately switched.“It is unacceptable for this magnitude of fraudsters and scam artists to be running amok in Medicare, and I will be working closely with C.M.S. to ensure this dramatic increase in marketing complaints is addressed,” said Ron Wyden, a Democratic senator from Oregon and the committee’s chairman, referring to the Centers for Medicare and Medicaid Services, the agency that oversees Medicare. “Medicare Advantage offers valuable plan options and extra benefits to many seniors but it is critical to stop any tactics or actors that harm seniors or undermine their confidence in the program.”Medicare Advantage has become a highly lucrative market for health insurers. But many of the insurers selling such plans have been accused of overstating how sick their customers are, according to a New York Times review last month that found four of the five largest insurers have faced federal lawsuits accusing them of fraud.“Because it’s such a profitable line of business, they have an incentive to do more marketing,” said Tricia Neuman, a senior vice president at the Kaiser Family Foundation, who is working on a review of television advertisements by the plans. “And they have more money to do marketing, which increases revenue.”Most of the behavior documented in the report came from insurance brokers or third-party marketing firms hired by the companies, not the insurers themselves.The Senate report did not say which insurers benefited from the behaviors described. But it identified similar misleading behavior across multiple states, and an escalating number of complaints, suggesting that the tactics were not limited to a small group of bad actors.Industry trade groups denounced the practices.“America’s seniors and people with disabilities deserve Medicare Advantage (MA) plans that continue to deliver better services, better access to care, and better value,” Kristine Grow, a spokeswoman for AHIP, an industry trade group, said in a statement. “Health insurance providers are clear: Americans should be protected from bad actors who engage in misleading advertising and marketing tactics.”She emphasized the federal government’s strict oversight of the industry’s marketing, including new rules that will require brokers to record their calls with potential customers and offer greater supervision of the third-party marketing groups enrolling new customers.The Senate report pointed to several aggressive practices that it said amounted to fraud.Five states said they were aware of brokers that had targeted people with cognitive impairment, and six states indicated people were signed up for a Medicare Advantage plan without even knowing it.Marketing firms in several states sent mailers to Medicare beneficiaries made to look like correspondence from the Internal Revenue Service, the Social Security Administration or Medicare itself, the report said.An example of a mailer that the report said was designed to look like a government document.Senate Finance CommitteeThe mailings are designed to generate leads for insurance brokers. Federal rules prevent cold-calling of Medicare beneficiaries. But once respondents call, click or mail back a form, the companies are allowed to call them repeatedly. The investigation found similar forms from several states that looked like tax documents, using the font and layouts of an I.R.S. form. One Utah mailing declared: “IMPORTANT-COMPLETE & RETURN POSTAGE-PAID CARD WITHIN 5 DAYS.”The report also said that a frequent refrain in television commercials and mailings was the idea that switching to Medicare Advantage would increase beneficiaries’ Social Security benefits. Some plans do charge lower premiums than traditional Medicare, but not most. Only 7 percent of beneficiaries this year were enrolled in a plan that offered such a premium discount, according to research from the Medicare Payment Advisory Committee.The report described an Oregon man who enrolled in a Medicare Advantage plan after hearing that switching would increase his Social Security check by $135 a month. It turned out that his new plan did not cover prescription drugs, and his Social Security income was unchanged because Medicaid already paid his Medicare premiums. “He was astonished and very stressed out when he went to the pharmacy,” according to a complaint cited in the Senate report. “He says he was never told that and would never have enrolled in a plan” without drug coverage.Ten of the 14 states said people were confused about whether their doctors or the drugs they were being prescribed were covered under a plan. In Oregon, a patient was switched from traditional Medicare and a Medicare supplemental policy to a Medicare Advantage plan by an agent who came to her house. The new plan did not include her mental health provider as part of its network. Her claims, previously covered, were denied.A 94-year-old woman with dementia in Missouri was sold a plan that did not include the hospital or doctors she saw in her rural area, according to another complaint. She was forced to travel significantly farther for her medical care.Soon, Half of Medicare Will be PrivatizedMedicare Advantage is on track to enroll most Medicare beneficiaries by next year.

Published7 hours agoSharecloseShare pageCopy linkAbout sharingImage source, SOCIAL MEDIABy Stephen McDonellBBC News, BeijingChina’s leader Xi Jinping insists there will be no swerving from zero-Covid – but the ongoing chaos which his government’s policy is delivering is there for all to see at the Foxconn plant in the city of Zhengzhou.What drove the mass breakout at the world’s largest assembly line for Apple computers was fear, panic and ignorance.Foxconn, the company which runs this enormous factory, must shoulder a portion of the blame for this but really the root cause is this country’s inflexible, strict, zero-Covid approach.The BBC has spoken to workers there who paint a picture of an urgent need to escape for their own safety. It may not be rational, but some say they feared for their lives.Take a 21-year-old Foxconn worker who had been hearing the rumours for a while. The more the stories and speculation continued, the more extreme they were becoming.It didn’t help that her immediate bosses at Foxconn were saying that there were no Covid infections in the factory while the company was telling the media that there were no “symptomatic” infections. And yet there were plenty of known examples of staff who had tested positive.Hundreds of thousands of staff had been ordered not to leave this huge industrial complex. After workers were confined to only the worker dormitories and other parts of the factory, the rumour mill stepped up another gear.This young factory worker heard that the army was going to come in and take control so as to enforce a type of giant “living with Covid” experiment which involved allowing everyone in that part of Zhengzhou city to get sick. Image source, Getty ImagesAccording to these rumours, the plan was to see how many of them would die. Then, if the carnage wasn’t too bad, this would provide a guide as to whether the rest of China could open up or not.Sentiments were spreading on their chat groups like: “Foxconn is going to take my life.”She clearly wasn’t the only one hearing this and workers started busting out. On Saturday night footage went round of a yellow barrier fence being pushed down to allow some to escape.By the next morning, she already had word from some of her friends that they’d made it all the way back to their hometowns.Half those in her eight-person dormitory had gone. She packed a bag but couldn’t take everything.Rapid Covid spreadAnother worker told us she too suddenly panicked before leaving. “To be honest, I did not think it would be that bad at first,” she said. “But then people around me started getting infected. Positive cases in other dorms were not being taken away to quarantine for several days. Those I know who kept working, all started confirming as positive.” Apart from the Foxconn workers, because most of Zhengzhou city is currently under some form of lockdown, phone app health codes will not permit anyone to leave, at least officially.This means that, even if public transport was operating, you would not be allowed on board and this includes taxis. The solution for workers at Foxconn – jump over the fence and simply start walking. For some, this has meant travelling on foot with whatever they can carry for more than 100km.You don’t have to search hard to see images with extended lines of mostly young people dragging luggage along the sides of highways.Ordinary people driving through have taken pity and picked up workers, ferrying them as far as possible.In scenes reminiscent of the great depression a century ago, workers have been piling onto the backs of trucks, sometimes lighting small fires to keep warm.The footage of this has kept coming, first spreading around Henan Province then across China and around the world.This is full tilt zero-Covid economic disruption.A key problem has been widespread ignorance about the nature of the illness. In much of China, people are as terrified of catching the virus as if it were cancer.The Chinese government has done little to alter these misunderstandings and, in fact, has often made them worse.Image source, EPAThe narrative from those in charge here has been that elsewhere, Covid has been cutting a swathe through the population, but Chinese people should consider themselves lucky because they have the Communist Party to protect them with the zero-Covid approach.It is true that this strategy has stopped the country’s hospitals from being swamped and it is true that Covid has resulted in a tragic loss of lives.However, it is also true that – for the vast majority of infected people who have been vaccinated – catching the virus means a few days sick at home and nothing more.This last point is something that many in China are completely unaware of.Lockdown delayed potentially life-saving treatmentChina outcry over death of girl sent to quarantineHow zero-Covid is spoiling Xi’s partySo when the workers of Foxconn made it to their hometowns and were put into hastily constructed quarantine facilities at local high schools, for them this was not as bad as the Covid hell they imagined was descending upon them back at their factory.Staff the BBC has spoken to say they don’t know if they will be able to return to work at Foxconn; or if they will be able to even retrieve their remaining belongings in their dorms. They expect that they have lost their work attendance bonuses which boost pay after you do a certain number of days at work in a row. However, again, none of this matters as much as feeling safe.Naturally, the sight of workers fleeing their place of employment has caused an outcry and Foxconn has responded.The company announced that those who want to go will be allowed to leave on secure buses which have now been organised in coordination with other towns and which will take people directly to quarantine sites, thus ensuring a much more calm and orderly process.It has also announced the quadrupling of bonuses for staff who remain on site and don’t take leave.Image source, Getty ImagesIn an announcement, Foxconn said that this was part of an effort to “gradually resume orderly production”.As an official lockdown has been re-imposed on the entire Zhengzhou Airport Economic Zone, the exodus from the factory appears to have slowed to a trickle for the time being.One volunteer, who has been distributing food and water along the roads, told us that what looked like thousands getting away last weekend had reduced to dozens at a time and even less by the middle of this week.If Foxconn can’t properly manage this crisis, in the short term, it will hit global supply chains for Apple and other products.But, in the long run, this shows a much bigger problem for China.The government’s system of controlling Covid is not capable of operating without causing significant disruption, not only to people’s lives, but potentially to key sectors of economy.For China’s leader Xi Jinping, this may not be as important as maintaining political control. But there are only two paths ahead – alter the zero-Covid approach or see more Foxconn-style upheaval in the future.More on this storyHow zero-Covid is spoiling Xi’s party7 OctoberChina outcry over death of girl sent to quarantine20 OctoberLockdown delayed potentially life-saving treatment2 hours ago

The dual agreements would resolve thousands of lawsuits over the retailers’ role in the addiction crisis. But a large majority of state, local and tribal governments must sign on.CVS and Walgreens, two of the nation’s largest retail pharmacy chains, said on Wednesday that they had reached tentative agreements to pay about $5 billion each to settle thousands of lawsuits over their role in the opioid crisis, a development that could signal the beginning of the end of years of opioid litigation.Since 2013, a snowballing number of state, local and tribal governments have been seeking to make companies across the pharmaceutical industry pay to reduce the ongoing costs of addiction, death and crime in an epidemic that began with prescription painkillers. While most of the big opioid manufacturers and drug distributors agreed to pay billions of dollars in national settlements in recent years, the retail chains had so far resisted negotiating a broad settlement deal.Wednesday’s announcements change the narrative.“My sense is that we’re nearing the end of the saga,” said Alexandra Lahav, who teaches complex litigation at Cornell University Law School.Citing recent court decisions, she added: “Things weren’t looking super for them, so it makes sense that they were finally coming to the table. And I’m guessing the rest of the defendants are going to follow.”In a sign that others may indeed follow, a person familiar with the negotiations said that Walmart had agreed to pay $3.1 billion in its settlement negotiations. The company declined to comment.“We’re a lot closer to the end today than we were yesterday,” said Jayne Conroy, a lawyer on the negotiating committee who represents cities and counties.CVS and Walgreens disclosed the tentative agreement in government filings. Finalization is conditional on an overwhelming majority of plaintiffs signing on, they said.Fentanyl Overdoses: What to KnowCard 1 of 5Devastating losses.

Published10 hours agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesBy Philippa RoxbyHealth reporterA drug based on a compound in hallucinogenic mushrooms can improve the symptoms of severe depression for up to 12 weeks, a trial shows.A 25mg tablet of psilocybin puts patients in a dreamlike state, making psychological therapy more likely to succeed.But the short-term side-effects could be frightening and support must always be on hand, the researchers said.Experts say larger studies with a much longer follow-up are still needed.An estimated 100 million people worldwide have serious clinical depression that does not respond to any available treatments – 30% attempt suicide.Scientists have been studying the effects of psilocybin on mental-health disorders for years.Recent studies have been promising but too short to assess lasting effects.Psychedelic frees up depressed brain, study showsHow psychedelic drugs might treat depression – BBC FutureMagic mushroom compound ‘promising’ for depressionIn this latest trial, published in the New England Journal of Medicine, 1mg, 10mg and 25mg doses were tested on a total of 233 people from 10 countries in Europe and North America, with 25mg giving the best results.’Waking dream’Most had been severely depressed for more than a year and were aged around 40, the researchers, from the Institute of Psychiatry, Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, said.After one 25mg dose of Comp360 psilocybin, alongside psychotherapy:one in three were no longer diagnosed as depressed at three weeksone in five saw a significant improvement at 12 weeks Study author and consultant psychiatrist Dr James Rucker said the drug was thought to have “a direct action on the brain, putting it into a more flexible state and providing an window of opportunity for therapy”.The patients, lying on a bed in a calm room, experienced a psychedelic “trip” – which one described as “a waking dream” – for six to eight hours. “It can be very positive but it can also be negative,” Dr Rucker told BBC News.”Difficult memories from the past can come up, for example, at the same time as feeling a reconnection with yourself and your feelings.” A therapist was on hand to provide support. Safety concernThe following day and a week later, the patients were given psychological support to talk through their experience.”Patients go from ‘What is wrong with me?’ to ‘What happened to me?'” psychotherapist Nadav Liam Modlin said. Some patients in all groups experienced side-effects, such as headaches, nausea, extreme tiredness as well as thoughts about suicide. This was not unusual, the researchers said – but other experts say it could be a safety concern.’Long-lasting problem’University of Edinburgh head of psychiatry Prof Andrew McIntosh said the trial provided “the strongest evidence so far to suggest that further, larger and longer randomised trials of psychedelics are justified”.”Psilocybin may [one day] provide a potential alternative to antidepressants that have been prescribed for decades,” he added.But other experts point out the effects were starting to wear off after 12 weeks.”Depression can be a long-lasting problem and much longer follow-up periods than 12 weeks should be used,” Dr Ravi Das, from University College London, said.A larger trial due to start soon will study how many doses are needed to prevent depression returning.It could be three years before the drug is close to being authorised, researchers say.More on this storyPsychedelic frees up depressed brain, study shows11 AprilPsychedelic therapy could ‘reset’ depressed brain15 March 2021Magic mushroom compound ‘promising’ for depression15 April 2021Ketamine may reduce heavy drinkers’ craving26 November 2019Ketamine’s ‘rapid help’ for depression16 April 2018Can psychedelics transform mental health?1 July 2018Around the BBCHow psychedelic drugs might treat depression – BBC Future