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Published14 minutes agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesBy George WrightBBC NewsEurope saw a 14% drop in its birth rate in January 2021 compared to previous years – a decline probably triggered by the first wave of the Covid-19 pandemic, research suggests.January 2021 was nine to 10 months after the imposition of Covid-related lockdowns.Longer lockdowns led to fewer pregnancies, the research suggests.The decline was more common in countries where health systems struggled.Lithuania and Romania saw the biggest drops – at 28% and 23% respectively – while Sweden, which had no lockdown, saw normal birth rates, according to findings published in the journal Human Reproduction.Researchers say the findings may lead to “long-term consequences on demographics particularly in western Europe where there are aging populations”.”The longer the lockdowns the fewer pregnancies occurred in this period, even in countries not severely affected by the pandemic,” said Dr Leo Pomar, a midwife sonographer at Lausanne University Hospital, who wrote the study. “We think that couples’ fears of a health and social crisis at the time of the first wave of Covid-19 contributed to the decrease in live births nine months later.”Social distancing measures, fears related to the virus, and the social and economic crisis caused as a result may be “indirect factors that played a role in the decision of couples to postpone pregnancies”, the report states. England and Wales saw a 13% drop in January 2021, compared with January 2018 and 2019 – while the number of babies born in Scotland decreased by 14%.France and Spain saw a 14% and 23% drop respectively. In March 2021, births returned to a similar rate to the pre-pandemic level, corresponding to a rebound nine to 10 months after the end of lockdowns, the study says. But researchers say that this rebound does not appear to have compensated for the drop in birth rates two months before. “The fact that the rebound in births does not seem to compensate for the decrease in January 2021 could have long-term consequences on demographics, particularly in western Europe where there are aging populations,” Dr Pomar said.More on this story’Jaw-dropping’ world fertility rate crash expected15 July 2020US birth rate falls during pandemic4 March 2021

“Metabolism” describes the body’s chemical changes that create the necessary materials for growth and overall health. Metabolites are the substances made and used during these metabolic processes — or, as a new discovery out of Scripps Research and its drug development arm, Calibr, indicates, they could also be potent molecules for treating severe diseases.
In a study from Metabolites published in August 2022, the researchers used novel drug discovery technologies to uncover a metabolite that converts white fat cells (“bad” fat) to brown fat (“good” fat) cells. This discovery offers a potential way of addressing metabolic conditions like obesity, type 2 diabetes and cardiovascular disease. Even more, it speaks to the promise of using this creative drug discovery method to identify countless other potential therapeutics.
“The reason many types of molecules don’t go to market is because of toxicity,” says co-senior author Gary Siuzdak, PhD, the senior director of the Scripps Center for Metabolomics and professor of Chemistry, Molecular and Computational Biology at Scripps Research. “With our technology, we can pull out endogenous metabolites — meaning the ones that the body makes on its own — that can have the same impact as a drug with less side effects. The potential of this approach is even evidenced by the FDA’s recent approval of Relyvrio, the combination of two endogenous metabolites for the treatment of amyotrophic lateral sclerosis (ALS).”
Metabolic diseases are often caused by an imbalance in energy homeostasis — in other words, when the body takes in more energy than it expends. This is why certain therapeutic approaches have centered around converting white fat cells (known as adipocytes) into brown fat cells. White adipocytes store excess energy and can eventually result in metabolic diseases like obesity, while brown adipocytes dissolve this stored energy into heat — ultimately increasing the body’s energy expenditure and helping bring it back into balance.
To uncover a therapy that could stimulate the production of brown adipocytes, the researchers searched through Calibr’s ReFRAME drug-repurposing collection — a library of 14,000 known drug compounds that have been approved by the FDA for other diseases or have been extensively tested for human safety. Using high-throughput screening — an automated drug discovery method for searching through large pools of information — the scientists scanned ReFRAME for a drug with these specific capabilities.
This is how they uncovered zafirlukast, an FDA-approved drug used for treating asthma. Through a set of cell culture experiments, they found zafirlukast could turn adipocyte precursor cells (known as preadipocytes) into predominantly brown adipocytes, as well as convert white adipocytes into brown adipocytes.

People with HIV who have moderate immune suppression appear to be at greater risk of severe COVID-19 “breakthrough” infection after vaccination, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
These findings suggest that this group should be considered for additional vaccine dosages and other risk-reduction measures.
For the study, researchers analyzed data from the electronic health records of people with and without HIV. Of these, 3,649 people had breakthrough COVID-19 infection in the second half of 2021. The researchers found that people with HIV did not have a significantly higher rate of severe COVID-19 breakthrough infection. Among the group with HIV, the researchers found that those who had CD4 counts lower than 350 cells/cubic millimeter of blood, were 59 percent more likely to have severe breakthrough infections compared to people without HIV.
The study was published online October 13 in JAMA Network Open.
Currently, the CDC recommends people who are moderately or severely immunocompromised take additional precautions to protect themselves from COVID-19, including additional doses of vaccine.
“People with HIV and CD4 counts between 200 and 350 cells/mm3 are not included in the current CDC recommendations,” says study senior author Keri Althoff, PhD, MPH, associate professor in the Department of Epidemiology at the Bloomberg School. “Our findings suggest people with HIV who have CD4 counts less than 350 cells/mm3 should be consideredmoderately or severely immunocompromised by the CDC, and encouraged to take additional precautions to protect themselves from severe COVID-19.”
The Centers for Disease Control and Prevention recommends additional vaccine dosing and regular vaccine boosters for people who are moderately or severely immunocompromised. Although people do not need to prove their immunocompromised status to obtain extra vaccinations per the CDC’s guidelines, this category includes people with advanced or untreated HIV infection, defined as a CD4 T-cell count below 200 cells per microliter and an unsuppressed HIV viral load.

People who suffer from inflammatory bowel disease may soon have access to personalized dietary guidelines to keep them feeling well, thanks to new research on how dietary fibre affects the disease.
The research team discovered that certain types of dietary fibre cause an inflammatory response in some patients, causing symptoms to worsen.
They are now working to develop a stool test to examine the microbes found in each patient’s gut in order to predict who will have the negative response, so they can tailor dietary recommendations and treatment for individual patients.
Approximately 0.7 per cent of Canada’s population, or one in 150 people, has IBD, including Crohn’s disease and ulcerative colitis, and that is predicted to grow to one per cent by 2030.
IBD symptoms may include abdominal pain, diarrhea, bloody stools, weight loss, late puberty, and a long-term risk of colorectal cancer. The exact cause is unknown, but some risk factors include genetics, diet, environmental factors and changes in the gut microbes.
“We know there are health benefits to consuming dietary fibres and they promote good gut health in healthy individuals, but IBD patients quite frequently complain about a sensitivity when they consume dietary fibres,” says Heather Armstrong, who started the research as a postdoctoral researcher at the U of A and is now an assistant professor of internal medicine at the University of Manitoba and Canada Research Chair in Integrative Bioscience. “We really wanted to understand the mechanisms behind this.”
“By creating this stool test, we are hoping to be able to tell you how to adjust your diet to prevent flares or further worsening,” says Eytan Wine, a professor in the U of A’s Faculty of Medicine & Dentistry. “It’s a dynamic situation so it’s possible that a certain food you should avoid now, in a few months you’ll be okay to eat that again.”
The researchers have identified that specific types of fibres found in foods such as artichoke, chicory roots, garlic, asparagus, and bananas, are especially hard to ferment if certain microbes are missing or malfunctioning, as is often the case for IBD patients.
Fibre has a beneficial anti-inflammatory effect in most healthy people and aids with digestion, but the researchers have found that select unfermented fibres actually increases inflammation and worsens symptoms in some IBD patients.
“We want to start uncovering why it is that 20 to 40 per cent of patients experience sensitivity,” says Armstrong, “while in the other portion of patients these dietary fibres can actually benefit health and protect against the disease and have very positive effects.”
Wine and Armstrong both warn that the new dietary guidelines will not replace drug treatments, but should complement them so patients can avoid flares and get back into remission more quickly when they do experience inflammation.
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Materials provided by University of Alberta. Original written by Gillian Rutherford. Note: Content may be edited for style and length.

If Russia’s invasion and the ensuing war significantly reduce Ukrainian grain exports, surging prices could increase food insecurity and carbon dioxide emissions, as marginal land is pushed into crop production.
That’s the chain reaction predicted by modeling from a research team that includes Amani Elobeid, a teaching professor of economics at Iowa State University. An article about their projections was published recently in Nature Food, an academic journal.
Elobeid said she and her colleagues — Jerome Dumortier of Indiana University-Purdue University Indianapolis and Miguel Carriquiry of the University of the Republic in Uruguay — ran their models shortly after the start of the invasion in February in hopes of estimating the impact on global grain markets and the subsequent climate implications.
“We’re trying to present a more complete picture of what this war is costing the world,” she said.
Ukraine, sometimes called the “bread basket of Europe,” is a major exporter of wheat and corn. A deal struck with Russia in July aims to allow Ukrainian grain shipments, but it’s unclear how effective it will be at limiting the war’s impact on exports. For the study, researchers examined four potential outcomes: a 50% drop in Ukrainian exports and three scenarios assuming no Ukrainian exports in combination with other related situations or responses, such as a reduction in biofuel production in the U.S. and Europe or a 50% drop in Russian grain exports.
Their models estimate how changes in global agricultural markets impact production, trade, food consumption and prices — which in turn affect what land is used for crops. When the price of corn goes up due to a shortage, for instance, dense Brazilian forests are likelier to be razed for farming because there’s an incentive to expand production.
Depending on the scenario, the cost of wheat would rise up to 7.2%, while the price hike for corn could reach 4.6%. Elobeid said those spikes would be on top of already rising food costs and would disproportionally worsen hunger in poorer countries in Africa and the Middle East, regions which rely heavily on grain imports from Ukraine.
“In the U.S., an additional 5% increase in food prices might not be that alarming. But in countries that are extremely poor and have high levels of food insecurity, even a 1% increase is very significant,” she said.
Globally, the amount of new land used for growing crops under the scenarios studied would range from 16.3 million to 45 million acres, causing an average estimated increase in carbon emissions between 527 million and 1.6 billion metric tons of carbon dioxide equivalent, according to the study.
In wealthier countries, increased subsidies for lower-income households would help counteract higher food prices, but that’s not an option in poorer nations, Elobeid said. Removing trade restrictions and implementing policies such as temporarily reducing biofuel mandates would help reduce grain prices worldwide and limit land-use changes that drive up carbon emissions. The most effective policy response, however, is clear yet elusive.
“The obvious solution is for the conflict to end,” she said.
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Watch any episode of “CSI,” and a character will use forensic DNA profiling to identify a criminal. A new study from San Francisco State University suggests that these forensic profiles may indirectly reveal medical information — perhaps even those of crime victims — contrary to what the legal field has believed for nearly 30 years. The findings could have ethical and legal implications.
“The central assumption when choosing those [forensic] markers was that there wouldn’t be any information about the individuals whatsoever aside from identification. Our paper challenges that assumption,” said first author Mayra Bañuelos (B.S., ’19), who started working on the project as a San Francisco State undergraduate and is now a Ph.D. student at Brown University.
Law enforcement uses the Combined DNA Index System (CODIS), a system organizing criminal justice DNA databases that uses specific genetic markers to identify individuals. Crime labs from national, state and local levels contribute to these databases and provide profiles from samples collected from crime scene evidence, convicted offenders, felony arrestees, missing persons and more. Law officials can use the database to try to match samples found in an investigation to profiles already stored in the database.
CODIS profiles consist of an individual’s genetic variants as a set of short tandem repeats (STRs), sequences of DNA that repeat at various frequencies among individuals. Since the ’90s, 20 STRs have been chosen for forensic CODIS profiling specifically because it was believed they did not relay medical information. If these profiles contained any trait information, then there could be issues about medical privacy.
“But that assumption hasn’t had much investigation in a long time, and we know a lot more about the genome now than we did back then,” explained SF State Associate Professor of Biology Rori Rohlfs, who led this project.
The assumption that only criminals are sampled is also not completely accurate. “It actually also includes victims of crime and people that may have been at crime scenes. You have these huge databases including a lot of people that are not necessarily criminals,” Bañuelos said. “I believe also that accessibility to these databases varies a lot according to a jurisdiction.”
The researchers explained that other papers have found associations between other (non-CODIS) STRs and disease or gene expression. With that in mind, the SF State team wanted to understand the relationship between the CODIS STR markers and gene expression.

I still remember the torturous feeling of hanging from the pull-up bars in elementary school gym class, struggling with all my meager might to lift myself up. While other kids seemed naturally gifted with physical power, I came to believe my arms were best used for answering a question in class.And yet, I have tasted physical strength since then. I took a weight lifting course in college and loved how the boost in muscle made me feel. Before my wedding, I got hooked on barre workouts, and discovered the satisfaction of being able to carry groceries for more than two minutes without resting.Beyond the visceral joys of feeling strong, I am also aware of the health benefits of building muscle. A recent study published in the British Journal of Sports Medicine found that combining aerobics with one to two weekly strength sessions not only lengthens life span but improves people’s quality of life and well-being. Numerous studies have found that resistance training is good for mental health: It has been shown to positively influence cognition and to decrease depression and anxiety. Evidence also suggests it allows us to simply feel better in our bodies.But every time I’ve done enough strength training to see progress, my commitment has ultimately petered out, mostly because of the demands of daily life. Consumed by cycles of work, child care and utter exhaustion, I’ve pursued the path of least resistance — literally and figuratively. The majority of Americans struggle to carve out time for strength training, too. While the U.S. Centers for Disease Control and Prevention recommends that adults do two muscle-building workouts a week, only 31 percent of us hit this benchmark.So I asked exercise psychologists, scientists, trainers and muscle evangelists for their best advice on launching a lasting strength-training routine. Here’s what I learned.Start small.For those of us who haven’t done much strength training — or if it’s been a while — experts suggest starting with short but consistent strength sessions. “Set some small goals for yourself,” said Mary Winfrey-Kovell, a lecturer in exercise science at Ball State University. “Some movement is better than no movement.”How small? Depending on one’s schedule, needs and desires, exercise scientists suggest devoting 20 minutes twice a week to strength training, or perhaps 10 to 15 minutes three times a week.If you miss a workout, go easy on yourself. The goal is to build long term habits.Ryan Frigillana for The New York TimesCan’t leave the couch after a long day? Couches can also make useful workout tools.Ryan Frigillana for The New York TimesThis is backed up by another recent study in the British Journal of Sports Medicine, which found that just 30 to 60 minutes a week of strength training can bring significant long-term rewards, including a 10 to 20 percent reduction in one’s risk of mortality, cardiovascular disease and cancer. (Notably, the benefits plateaued after an hour and decreased after two hours per week.)Start simple.Fitness marketing often tries to convince us that any routine worth doing must involve fancy devices or specialized gear, but in fact you need very little. “Strength training does not have to mean barbells and super heavy weights and lots of equipment,” said Anne Brady, a professor of kinesiology at the University of North Carolina-Greensboro.Muscle-building exercises that rely on your own body weight — think push-ups, planks and sit-to-stands (sometimes called chair rises) — can be incredibly effective when done correctly and consistently, she said. You can always incorporate equipment as you progress in strength and knowledge.Embrace being a novice.Kicking off a strength-training routine when you have little or no experience can feel daunting — particularly if you work out in a gym or public space, in view of more experienced exercisers.Many of us “hold ourselves to a standard that we need to look like we already know what we’re doing,” said Casey Johnston, author of the popular lifting newsletter “She’s a Beast” and the book “Liftoff: Couch to Barbell.” “It’s OK to make mistakes. It’s OK to ask questions.”More than anything, learning proper form — and which movements are safest for your body — can help to avoid injury and promote a lasting routine. If you’re able to afford it, consider hiring a certified personal trainer for a few sessions, either virtual or in person, who will create a training plan and guide you through the exercises. And if you work out in a gym, don’t be afraid to ask staff for guidance.One upside to starting from scratch? Your strength will improve exponentially at first. “I think most people would be surprised by how quickly they can get a lot stronger than they are,” said Ms. Johnston. After a few sessions, she said, “you really will feel the difference in functionality in your body.”Do it early in the day.If you’re like me and frequently plan to strength train at night but find that, come 5 o’clock or later, you feel unable to will your weary self off the couch, experts advise making time early in the morning.There is a reason for this. Research suggests that the more self-control we expend throughout the day, the less we have to give at night. “So if you’ve sprinkled out self-control for various things, and your plan was to work out in the evening,” it’s not surprising if you give into a desire to veg out in front of your phone or TV instead of breaking a sweat, said Elizabeth Hathaway, a professor of exercise psychology and health behavior change at the University of Tennessee at Chattanooga. “Self-control is not an infinite resource.”Getting started, scientists suggest devoting 20 minutes twice a week, or perhaps 10 to 15 minutes three times a week, to strength training.Ryan Frigillana for The New York TimesTry “temptation bundling.”Need an extra push? Kelly Strohacker, a professor of exercise physiology at the University of Tennessee-Knoxville who researches health behavior change, suggests a behavioral economics hack called “temptation bundling.”It works like this: By “bundling” something we love and look forward to — for example, a favorite podcast or TV show, gripping audiobook or playlist — with an activity we find challenging, we can boost our chances of doing the latter. “Simply pairing those together can help ease a little bit of that initial, ‘I don’t really want to do it, but I know I should,’” said Dr. Strohacker. They key, however, is to only allow yourself to indulge in that particular pleasure while doing the workout.Wear (pretty much) whatever you want.If the thought of changing into specific “exercise clothes” presents a barrier to strength training, don’t bother!“Wear anything that you’re comfortable in,” said Dr. Brady. “The most important thing is to be able to move freely through different ranges of motion.” You might also benefit if your clothes “breathe” so you don’t become overheated, but no need to buy special moisture-wicking athletic gear if you’re more comfortable moving in your pajamas.Wear something comfortable. Buy some fancy workout clothes, if it puts you in the mood. Or else just wear pajamas.Ryan Frigillana for The New York TimesIf you have trouble getting excited to workout, “bundle” it with something you like — a podcast or show — that you only consume while exercising.Ryan Frigillana for The New York TimesRemember that the goal is forward progress.If you find that you need to miss sessions, show self-compassion, said Dr. Strohacker. Strength-training, like all exercise, is a long game, and the ultimate goal is to simply keep at it throughout our lives, despite setbacks along the way.“Our culture really pushes this narrative of ‘you can do it if you really want to,’” she said. “This is very oversimplifying.” Life happens. Research suggests the true path to longevity and consistency in any activity are “enjoying it and feeling accomplished,” she added. This becomes easier when we celebrate our progress, no matter how incremental, and find our way back when we stray off course.Consider a couch workout!If the desire to spend time on your couch feels overpowering, make your couch work for you: Use it as a piece of equipment to facilitate your workout.With a couch, you can do sit-to-stand exercises, said Dr. Brady. You can turn around and do push-ups or planks.And if you want to watch TV during your couch work, choose programs with commercials and try the “commercial challenge,” Ms. Winfrey-Kovell suggests. During these breaks, do leg marches or leg lifts, or keep hand weights next to you and lift until the program returns. Just make sure you can maintain good posture and form.“We don’t want to exercise with our back in a shrimp position,” she said. But “if the hips are in the proper position, the spine is in alignment, the shoulders are back, and your feet can touch the ground,” there’s a lot you can do on a couch.Try this 20-minute starter routine.Ready to get started? Dr. Brady recommends beginning with this basic strength-building routine. The only equipment you’ll need is your own body and a set of resistance bands, which you can purchase for under $20 online. (See Wirecutter’s list of the best options.)Complete each exercise, in order, 10 to 15 times, then go back and do it again for a second set. The exercises alternate muscle groups, and should be performed with a moderate level of intensity — whatever that feels like for you.1. Push-ups (or modified push-ups)2. Squats3. Seated rows with resistance band4. Glute bridges5. Overhead presses with resistance band6. Bird dogs7. Pulldowns with resistance bandDanielle Friedman is a journalist in New York City and author of “Let’s Get Physical: How Women Discovered Exercise and Reshaped the World.”

She was a young athlete who suffered frequent head injuries. Her family assumed that was the cause of her strange symptoms — then she had a seizure.“What just happened?” The 16-year-old girl’s voice was flat and tired. “I think you had a seizure,” her mother answered. Her daughter had asked to be taken to the pediatrician’s office because she hadn’t felt right for the past several weeks — not since she had what looked like a seizure at school. And now she’d had another. “You’re OK now,” the mother continued. “It’s good news because it means that maybe we finally figured out what’s going on.”To most people, that might have been a stretch — to call having a seizure good news. But for the past several years, the young woman had been plagued by headaches, episodes of dizziness and odd bouts of profound fatigue, and her mother embraced the possibility of a treatable disorder. The specialists she had taken her daughter to see attributed her collection of symptoms to the lingering effect of the many concussions she suffered playing sports. She had at least one concussion every year since she was in the fourth grade. Because of her frequent head injuries, her parents made her drop all her sports. Even when not on the playing field, the young woman continued to fall and hit her head. The headaches and other symptoms persisted long after each injury. She saw several specialists who agreed that she had what was called persistent post-concussive syndrome — symptoms caused either by a severe brain injury or, in her case, repeated mild injuries. She should get better with time and patience, the girl and her mother were told. And yet her head pounded and she retreated to her darkened room several times a week. She did everything her doctors suggested: She got plenty of sleep, rested when she was tired and tried to be patient. But she still got headaches, still got dizzy. She found it harder and harder to pay attention. For the past couple of years, it had even started to affect her grades. Early in September, the mother got a call from her daughter’s high school. Her daughter was ill and needed to go home. “What happened?” her mother asked her later. The girl answered: “I don’t know. I was in class; it had just started. The next thing I knew, class was almost over and everyone was standing around me.” That evening one of the girl’s friends sent the mother a text. I want to tell you what I saw, he said. They were in class, and he noticed that his friend’s hand started to shake. She seemed kind of zoned out, and she was drooling. It only lasted a minute or so, but it was strange, the boy said. Fearing her daughter may have had a seizure, the mother looked for a specialist. She found one in Stamford, a half-hour south of their home in suburban Connecticut. This doctor made an odd request: Keep your daughter awake the night before the appointment. She would need an EEG, and fatigue can lower the threshold to have a seizure and make the problem easier to find, he explained. But the test was normal. She may have had a seizure, the neurologist said, but these are often isolated events. A Very Strange Night But just a few weeks later, on that visit to the pediatrician, it happened again, and right in front of the doctor. After hearing that she might have had another seizure, the young woman had another question. “Can I still go to homecoming?” she asked.“Absolutely,” the doctor answered. The mother was a little surprised, but pleased. Maybe this really was good news. That evening, after the girl left to go to the homecoming dance, the doctor called. “That wasn’t a seizure your daughter had in my office,” he told her. “I think it was a panic attack.” After a seizure, he explained, patients usually have a period of severe fatigue and confusion. “No one who’s had a seizure asks about going to homecoming,” he said. She had been breathing heavily before her strange episode in his office. He thought she was hyperventilating — something that can occur before a panic attack — and gave her a paper bag to breathe into. She had barely put the bag to her lips when she started flailing her arms and legs. Panic attacks are common, especially in this age group. She should probably see a psychiatrist, he added. Hearing this, the mother was stunned. This doctor had been the family’s pediatrician since their son, now 23, was born. He had always been great — the kind of doctor who always goes the extra mile. But this time the mother was certain he was wrong. The young woman was home that night by 8:30. She spent barely 20 minutes at the dance. The music was too loud, she told her questioning parents. The flashing lights gave her a headache. She went straight to bed. Hours later her mother eased open the door to her daughter’s room, to check on the girl before going to bed herself. As she gazed at her daughter, the young woman began to shake. It wasn’t the wild flailing she saw in the doctor’s office. It was like the kind of shaking chills you might get from a fever, but more so. The episode lasted only a few seconds. The mother, far too worried to go to her own bed, lay down next to her daughter to wait for the strange shaking to recur. She was awakened a couple of hours later. The entire bed seemed to be moving. Her daughter’s eyes were closed, and her body was shaking. Again, it lasted only seconds. Was this a seizure? She jumped out of bed and called the pediatrician. The mother didn’t know the doctor who called her back, and she wasn’t reassured by the doctor’s reminder that her daughter had a similar episode that day that was thought to be a panic attack, not a seizure. Hanging up, the mother felt terribly alone. Who would know what she should do? Suddenly she remembered the neurologist who did the EEG. He’d said that it might have been an isolated episode. But clearly it wasn’t. Who has heard of a panic attack happening in the middle of the night?That neurologist wasn’t on call, she was told by the answering service, but someone would call her back. A few minutes later, her phone rang and a lightly accented voice identified the caller as Dr. Cigdem Akman. She was a pediatric neurologist from the NewYork-Presbyterian Morgan Stanley Children’s Hospital in Manhattan. The mother recounted the long day’s events. After describing what happened at the pediatrician’s office she paused, then added, “Her doctor thought it was a panic attack, but my daughter has never been one to lose her head.” Then she described the bed shaking she saw and felt that evening. “I have no doubt that your daughter is having seizures,” the doctor told the mother. There was nothing that needed to be done right then, but her daughter should be evaluated. Akman would arrange for her to be seen in the video EEG lab. A 48-hour study could reveal what was going on. Photo illustration by Ina JangOne Visible Abnormality Mother and daughter traveled to the hospital’s epilepsy-monitoring unit two days later. In the first 24 hours she was monitored, she had eight seizures, one while awake and seven when sleeping. During the seizure when she was awake, the young woman was able to walk and talk intelligibly. The only obvious abnormality was her eyes. She blinked rapidly several times, then her chin lifted slightly and her eyes rolled back. It lasted only seconds but the EEG showed the presence of a type of generalized seizure called an “absence seizure” — characterized by a lack of attention. The strange eye movements indicated a rare type of absence-seizure disorder called Jeavons syndrome. She was immediately started on a potent antiseizure medication. Jeavons was first described in 1977. It usually starts in childhood, though is frequently not diagnosed until adolescence. It is much more common in girls than boys. Affected children have seizures that are very brief, lasting only a few seconds, but often occur many times a day. Untreated, these seizures can impact learning. And they can change from absence seizures to tonic-clonic or grand mal seizures, as this young woman’s had. It took a few months for Akman to find the right medications for her, but since starting that medication, she has had no seizures at all. Once her seizures were under control, she stopped having accidents. The headaches disappeared. So did the fatigue and dizziness. For much of her life, the young woman was known to have episodes of inattention. These had been attributed to her many concussions. Now it was clear that many, if not most, of them were actually seizures. On the antiseizure medication, the young woman’s grades went up. She is now a junior in college, majoring in neuroscience.Lisa Sanders, M.D., is a contributing writer for the magazine. Her latest book is “Diagnosis: Solving the Most Baffling Medical Mysteries.” If you have a solved case to share, write her at Lisa.Sandersmdnyt@gmail.com.

Every year around 2 million people die worldwide from hemorrhaging or blood loss. Uncontrolled hemorrhaging accounts for more than 30% of trauma deaths. To stop the bleeding, doctors often apply pressure to the wound and seal the site with medical glue. But what happens when applying pressure is difficult or could make things worse? Or the surface of the wound is too bloody for glue? Drawing inspiration from nature, researchers from McGill University have developed a medical adhesive that could save lives, modeled after structures found in marine animals like mussels and flatworms.
“When applied to the bleeding site, the new adhesive uses suction to absorb blood, clear the surface for adhesion, and bond to the tissue providing a physical seal. The entire application process is quick and pressure-free, which is suitable for non-compressible hemorrhage situations, which are often life-threatening,” says lead author Guangyu Bao, a recently graduated PhD student under the supervision of Professor Jianyu Li of Department of Mechanical Engineering.
In putting the new technology to the test, the researchers found that the adhesive promotes blood coagulation. The adhesive can also be removed without causing re-bleeding or even left inside the body to be absorbed. “Our material showed much better-improved safety and bleeding control efficiency than other commercial products. Beyond bleeding control, our material could one day replace wound sutures or deliver drugs to provide therapeutic effects,” says senior author Professor Jianyu Li.
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A new study that links the location of brain injury to levels of depression in patients following the injury has identified two distinct brain networks; one associated with increased depression symptoms and one associated with decreased depression symptoms. The large-scale study led by researchers with University of Iowa Health Care expands on previous findings and suggests that these brain networks might be potential targets for neuromodulation therapies to treat depression.
Neuromodulation therapies such as transcranial magnetic stimulation, or deep brain stimulation, are emerging as new non-pharmacological treatments for mood disorders. However, understanding which areas of the brain to target to get the best therapeutic effect is still limited.
The new findings, which are published in the journal Brain, used brain imaging scans and depression scores from 526 patients who had acquired localized areas of brain injury from a stroke or other type of traumatic brain injury. A detailed statistical analysis of the patients’ data allowed the researchers to correlate the brain lesion locations with levels of depression experienced by the patients in the months following the brain injury.
“We found some really interesting results identifying specific brain structures that were associated with higher levels of depression post lesion, and surprisingly, also found some areas that were associated with lower-than-average levels of depression post lesion.” says Nicholas Trapp, MD, UI assistant professor of psychiatry and lead author of the study.
Risk and resilience networks in depression
Using data from functional brain scans of healthy subjects to understand how these structures were interconnected, the researchers then discovered that the risk and resilience regions were not randomly scattered within the brain. Instead, regions most strongly associated with increased depression coincided with the nodes of the so-called salience network, which is involved in task reorientation, attention, and emotion processing.