Publisher Health

The new air-powered hand provides a lightweight, low-maintenance and easy-to-use body-powered prosthetic option particularly well suited for children and those in low and middle-income countries.
A revolutionary new hand prosthesis powered and controlled by the user’s breathing has been developed by researchers at the University of Oxford.
The simple lightweight device offers an alternative to Bowden cable-driven body-powered prosthetics initially developed in the early 19th century — particularly for those too young or anatomically unsuited to an uncomfortable harness and cable system.
Senior author Professor Jeroen Bergmann, Department of Engineering Science, University of Oxford said: ‘Our breathing-powered device provides a novel prosthetic option that can be used without limiting any of the user’s body movements. It is one of the first truly new design approaches for power and control of a body-powered prosthetic since the emergence of the cable-driven system over two centuries ago.’
Although several different prosthetic options exist (suitability dependent on the level of upper limb difference amongst other factors) little progress has been made in developing new approaches to power and control of body-powered devices compared to sophisticated externally powered prosthetics.
The most widely used functional upper-limb prosthesis remains the cable-driven body-powered system — which can be prohibitively expensive to own and maintain in low-resource settings because of the costs associated with the necessary professional fitting and maintenance.

Located between and above your eyebrows, the frontal sinuses develop in shapes that are as unique to each person as a fingerprint. Since 1925, they’ve been used by forensic anthropologists to help identify human remains when dental or other medical records were missing.
Boston University School of Medicine (BUSM) researchers have found the development of the frontal sinus was affected more by sexual dimorphism than the ancestry of the individual and that it was the interplay between those two factors that produced the most significant variation.
“It is a common drive of people to be curious about ourselves, our backgrounds and our bodies. This study takes a fascinating structure that is as unique to an individual as their fingerprint and starts to shed light on what causes this feature to be so special to each person,” said corresponding author Sean Tallman, PhD, assistant professor of anatomy & neurobiology. Former graduate student Austin Shamlou, MS, now a research technician at Massachusetts General Hospital, is a co-author in the study.
The researchers analyzed computed tomography (CT) images of more than 300 individuals designated as assigned male or assigned female at birth. Individuals also were classified by ancestral backgrounds of African-derived, Asian-derived, European-derived, or Latin American-derived. The authors used Photoshop to create an outline of the frontal sinus layer-by-layer and took measurements of maximum height, width and depth. These frontal sinus outlines were categorized into three groups and compared against variables. The study concluded that when considered separately neither assigned sex nor ancestry significantly affected sinus shape, but there was significant variation in maximum height and maximum depth when the two factors were looked at together.
“Interestingly, the interactive effects of sexual dimorphism and adaptive population histories influence the dimensions of the frontal sinus,” said Tallman, who added that a clear pattern had not yet been found.
Tallman said further research was needed to address the question of why the frontal sinus forms unique structures for every individual. He cautioned that in the U.S. sinus variation did not fall along ancestral lines, suggesting that there was significant overlap in ancestral climates or that climate adaptations no longer impacted variation in the U.S.
These findings appear online in the journal Biology.
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Materials provided by Boston University School of Medicine. Note: Content may be edited for style and length.

Alzheimer’s disease can begin almost imperceptibly, often masquerading in the early months or years as forgetfulness that is common in older age. What causes the disease remains largely a mystery.
But researchers at Tufts University and the University of Oxford, using a three-dimensional human tissue culture model mimicking the brain, have shown that varicella zoster virus (VZV), which commonly causes chickenpox and shingles, may activate herpes simplex (HSV), another common virus, to set in motion the early stages of Alzheimer’s disease.
Normally HSV-1 — one of the main variants of the virus — lies dormant within the neurons of the brain, but when it is activated it leads to accumulation of tau and amyloid beta proteins, and loss of neuronal function — signature features found in patients with Alzheimer’s.
“Our results suggest one pathway to Alzheimer’s disease, caused by a VZV infection which creates inflammatory triggers that awaken HSV in the brain,” said Dana Cairns, GBS12, a research associate in the Biomedical Engineering Department. “While we demonstrated a link between VZV and HSV-1 activation, it’s possible that other inflammatory events in the brain could also awaken HSV-1 and lead to Alzheimer’s disease.”
The study is published in the Journal of Alzheimer’s Disease.
Viruses Lying in Wait
“We have been working off a lot of established evidence that HSV has been linked to increased risk of Alzheimer’s disease in patients,” said David Kaplan, Stern Family Professor of Engineering and chair of the Department of Biomedical Engineering at Tufts’ School of Engineering. One of the first to hypothesize a connection between herpes virus and Alzheimer’s disease is Ruth Itzhaki of the University of Oxford, who collaborated with the Kaplan lab on this study.

Neanderthals are the closest relatives to modern humans. Comparisons with them can therefore provide fascinating insights into what makes present-day humans unique, for example regarding the development of the brain. The neocortex, the largest part of the outer layer of the brain, is unique to mammals and crucial for many cognitive capacities. It expanded dramatically during human evolution in species ancestral to both Neanderthals and modern humans, resulting that both Neanderthals and modern humans having brains of similar sizes. However, almost nothing is known about how modern human and Neanderthal brains may have differed in terms of their development and function.
Researchers from the Max Planck Institute of Molecular Cell Biology and Genetics (MPI-CBG) in Dresden and the Max Planck Institute for Evolutionary Anthropology (MPI-EVA) in Leipzig have now discovered that neural stem cells — the cells from which neurons in the developing neocortex derive — spend more time preparing their chromosomes for division in modern humans than in Neanderthals. This results in fewer errors when chromosomes are distributed to the daughter cells in modern humans than in Neanderthals or chimpanzees, and could have consequences for how the brain develops and functions. This study shows cellular differences in the development of the brain between modern humans and Neanderthals.
After the ancestors of modern humans split from those of Neanderthals and Denisovans, their Asian relatives, about one hundred amino acids, the building blocks of proteins in cells and tissues, changed in modern humans and spread to almost all modern humans. The biological significance of these changes is largely unknown. However, six of those amino acid changes occurred in three proteins that play key roles in the distribution of chromosomes, the carriers of genetic information, to the two daughter cells during cell division.
The effects of the modern human variants on brain development
To investigate the significance of these six changes for neocortex development, the scientists first introduced the modern human variants in mice. Mice are identical to Neanderthals at those six amino acid positions, so these changes made them a model for the developing modern human brain. Felipe Mora-Bermúdez, the lead author of the study, describes the discovery: “We found that three modern human amino acids in two of the proteins cause a longer metaphase, a phase where chromosomes are prepared for cell division, and this results in fewer errors when the chromosomes are distributed to the daughter cells of the neural stem cells, just like in modern humans.” To check if the Neanderthal set of amino acids have the opposite effect, the researchers then introduced the ancestral amino acids in human brain organoids — miniature organ-like structures that can be grown from human stem cells in cell culture dishes in the lab and that mimic aspects of early human brain development. “In this case, metaphase became shorter and we found more chromosome distribution errors.” According to Mora-Bermúdez, this shows that those three modern human amino acid changes in the proteins known as KIF18a and KNL1 are responsible for the fewer chromosome distribution mistakes seen in modern humans as compared to Neanderthal models and chimpanzees. He adds that “having mistakes in the number of chromosomes is usually not a good idea for cells, as can be seen in disorders like trisomies and cancer.”
“Our study implies that some aspects of modern human brain evolution and function may be independent of brain size since Neanderthals and modern humans have similar-sized brains. The findings also suggest that brain function in Neanderthals may have been more affected by chromosome errors than that of modern humans,” summarizes Wieland Huttner, who co-supervised the study. Svante Pääbo, who also co-supervised the study, adds that “future studies are needed to investigate whether the decreased error rate affects modern human traits related to brain function.”
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Materials provided by Max Planck Institute of Molecular Cell Biology and Genetics (MPI-CBG). Note: Content may be edited for style and length.

Cells in the gut send secret messages to the immune system. Thanks to new research from La Jolla Institute for Immunology (LJI) scientists, we can finally get a look at what they’re saying.
A new study in Science Immunology reveals how the barrier cells that line the intestines send messages to the patrolling T cells that reside there. These cells communicate by expressing a protein called HVEM, which prompts T cells to survive longer and move more to stop potential infections.
“The research shows how barrier cells in the intestine, structural elements of the tissue, and resident immune cells communicate to provide host defense,” says LJI Professor and Chief Scientific Officer Mitchell Kronenberg, Ph.D., senior author of the new study.
Barrier cells, or “epithelial” cells, form a one-cell thick layer that lines the gut. One can picture these cells lining up like a busy queue outside a nightclub. The epithelial cells squish together. They jostle each other and chat. Meanwhile, T cell security guards circulate around the line, looking up and down the block for signs of trouble. “These T cells move around the epithelial cells as if they are truly patrolling,” says Kronenberg.
But what keeps these T cells in the epithelium to do their job?
“We’ve got some insight on what gets T cells to the gut, but we need to understand what keeps them there,” says Kronenberg. In fact, a lot of immune cells reside long-term in specific tissues. By understanding the signals that keep T cells in certain tissues, Kronenberg hopes to shed light on conditions like inflammatory bowel disease, where far too many inflammatory T cells gather in the bowel.

Containing the outbreak, scientists say, will depend on better understanding the virus’s transmission and how well available tools work.Monkeypox, once a relatively obscure virus endemic to Africa, has bloomed into a global threat, infecting more than 20,000 people in 75 countries and forcing the World Health Organization to declare a worldwide health emergency.On Thursday, New York State and San Francisco declared emergencies of their own. But even as the national tally nears 5,000 cases and experts warn that containment is slipping away, federal health officials have not followed suit.One reason: This virus — unlike the coronavirus — is a known enemy, officials say. Doctors understand how it spreads, and there already are tests, vaccines and treatments.But to scientists, the accumulating research presents a more complicated, and challenging, picture. The virus remains a mystery in some important ways, not exactly behaving in ways that researchers saw during sporadic outbreaks in African countries.Scientists are racing to answer three questions in particular that will determine how quickly monkeypox can be stopped — if it can be stopped at all.A scan showing monkeypox viruses obtained from a sample of human skin.CDC, via Associated PressExactly how is the virus spreading?At the beginning of the outbreak, health officials asserted that the virus spread through respiratory droplets emitted when an infected person coughed or sneezed, and through close contact with pus-filled skin lesions or bedding and other contaminated materials.All of that was true. But it may not be the whole picture.More than 99 percent of the people infected so far are men who acquired the virus through intimate contact with other men, according to the Centers for Disease Control and Prevention. Only 13 women and two young children had been diagnosed with monkeypox as of July 25.Researchers have found the virus in saliva, urine, feces and semen. It is unclear whether those fluids can be infectious and, in particular, whether the virus can be transmitted during sex by means other than close skin-to-skin contact. But the pattern of spread so far, along sexual networks, has left researchers wondering.It is clear, however, that monkeypox does not spread easily and has not yet spilled into the rest of the population. The average person is not at risk from store-bought clothes, for example, or from a fleeting interaction with an infected person, as some social media posts have suggested.What to Know About the Monkeypox VirusCard 1 of 7What is monkeypox?

The common pathogen frequently produces the mild symptoms of a cold, but it can cause severe illness and death in babies under 3 months old, health officials say, warning doctors to be vigilant.Over six weeks this spring, 23 children were admitted to a Tennessee hospital for treatment of parechovirus, a common virus that in rare cases can a pose a lethal threat to infants, according to a report released this week by the Centers for Disease Control and Prevention.Twenty-one of the children have recovered without complications, but one was at risk for hearing loss and blood clots, the C.D.C. said, while another child experienced persistent seizures and was expected to suffer from severe developmental delay.The children admitted to the Nashville hospital — Monroe Carell Jr. Children’s Hospital at Vanderbilt University — were between 5 days and 3 months old, and their illnesses were detected from April 12 to May 24, the C.D.C. said. The report described the infections as an “unusually large cluster.” Six more cases have been identified at the hospital at other times this year, a “peak in infections” compared with recent years, according to the report.Thirteen of the patients were girls and 10 were boys, and all of them were previously healthy, the C.D.C. said.Not long after this cluster, the C.D.C. alerted doctors this month that the type of parechovirus most associated with serious illness had been circulating nationally since May. It suggested parechovirus as a diagnosis to consider for babies with an unexplained fever or seizures.Parechovirus is so common that most children have been infected with it by the time they reach kindergarten age, and its symptoms include a runny nose and sneezing — what we normally associate with the common cold.But infants under 3 months, and particularly those less than a month old, are at greater risk for severe illness, according to the C.D.C.There is no cure for parechovirus, but diagnoses can still govern how doctors manage the illness.Experts say it is possible that the rise in cases comes from increased socializing after a period of lockdowns during which people were not exposed to common pathogens, which might have weakened their immune systems. But it is also possible that babies are simply being tested for parechovirus more often.“Our ‘eyes’ have gotten better, therefore we are seeing more,” Dr. Kenneth Alexander, chief of infectious diseases at Nemours Children’s Hospital in Florida, told The New York Times this month.

If finalized, the agreement, along with a companion deal reached by Teva earlier this week, would send as much as $6.6 billion to communities harmed by the opioid epidemic.A bipartisan group of state attorneys general announced Friday morning that it had struck an agreement in principle with the pharmaceutical company Allergan for $2.37 billion to resolve more than 2,500 opioid-related lawsuits brought by states, local governments and tribes nationwide who have suffered during the ongoing opioid epidemic.The company did not immediately respond to requests for comment, but a quarterly earnings report on Friday by Allergan’s parent company, AbbVie, characterized the amount as “a charge related to a potential settlement of litigation involving Allergan’s past sales of opioid products.”The proposed settlement is a companion agreement to a $4.25 billion deal in principle announced earlier in the week from Teva Pharmaceuticals. If a significant majority of states and communities sign on, the combined deal, when finalized, could be worth $6.6 billion, said lawyers familiar with the negotiations. That is higher than a nationwide settlement struck with Johnson & Johnson or an offer from Purdue Pharma, opioid manufacturers with much higher public profiles.The deals are linked largely because, in 2016, Teva bought Allergan’s generic drug portfolio, including its substantial opioid business. Teva made this week’s settlement contingent in part on Allergan reaching its own deal for opioid liability.“We’ve worked hard to get the best result for Americans harmed by the opioid crisis, and it’s rewarding to take another step in the right direction,” said Tom Miller, the attorney general for Iowa, whose office led the bipartisan group in the negotiations with Allergan and Teva. “We continue to make it a priority to hold manufacturers responsible, while ensuring victims of this epidemic receive the help they need.”Unlike Teva’s deal, under which plaintiffs can elect to receive a portion of the payout in overdose drug reversal and addiction treatment medication rather than cash, Allergan’s offer is all cash with no product, lawyers familiar with the negotiations said. Teva’s payments to states and communities would be disbursed over 13 years, while Allergan’s would be over six years. The amounts of both pharmaceutical companies presumably include the settlement figures that were already struck over the past year with a handful of states and counties.Both Allergan and Teva sold branded as well as generic opioid painkillers. Lawyers for thousands of entities asserted that these manufacturers, like so many others, exaggerated the benefits of opioids to doctors and the public and downplayed the drugs’ addictive properties. In addition, although the companies are required to report suspicious orders to authorities, both failed to do so, lawyers said.Teva had said that the potential agreement was not an admission of wrongdoing.The deals still have a ways to go before money actually starts flowing to communities. Issues such as allocation of funds, tighter monitoring of suspicious orders and the creation of a public repository of internal documents have yet to be resolved.Josh Stein, the North Carolina attorney general, commented on the arc of the opioid epidemic and the litigation to emerge from it. “In 2020, nine North Carolinians died each day from opioid overdose,” he said. “There is no amount of money that could ever repair that kind of loss. But there is hope in recovery, and, thanks to our ongoing work to hold these companies accountable, people across this state are getting the treatment and support they need to get healthy. And we’re still not done.”

People who live in socioeconomically deprived neighborhoods are about 20% less likely to conceive in any given menstrual cycle compared with people living in neighborhoods with more resources, a recent Oregon State University study found.
The study measured “fecundability,” which is the monthly probability of getting pregnant, among couples attempting conception without the use of fertility treatments.
Researchers compared neighborhoods based on their “area deprivation index” score, a measure of the socioeconomic resources in a neighborhood. They found that even among a relatively affluent, highly educated study population, people living in more deprived neighborhoods had lower fecundability rates than people living in higher-opportunity neighborhoods.
“The world of fertility research is beginning to examine factors associated with the built environment. There are dozens of studies looking at how your neighborhood environment is associated with adverse birth outcomes, but the pre-conception period is heavily under-studied from a structural standpoint,” said lead author Mary Willis, a postdoctoral scholar in OSU’s College of Public Health and Human Sciences. “Turns out, before you’re even conceived, there may be things affecting your health.”
Public health research in the last decade has highlighted the importance of social determinants of health and the idea that ZIP code is the greatest predictor for overall life expectancy, based on factors like income, health care access, employment rates, education level and access to safe water.
“But the concept that your neighborhood affects your fertility hasn’t been studied in depth,” Willis said. “In addition, the world of infertility research is largely focused on individual factors, so when I came into this study as an environmental epidemiologist, I was thinking we should look at it as a structural problem.”
The study leveraged data from an ongoing study by Boston University, the Pregnancy Study Online (PRESTO). Researchers analyzed a cohort of 6,356 individuals ranging from 21 to 45 years old, attempting to conceive without the use of fertility treatment, in data compiled from 2013 through 2019.

Experts share tips on advocating for yourself in a health care setting.Christina, who lives in Portland, Me., said she felt ignored by doctors for years. When she was 50 pounds heavier, her providers sometimes blamed her body size when she discussed her health concerns.One instance occurred weeks after she had fallen off her bike. “My elbow was still hurting,” said Christina, 39, who asked that her last name be withheld when discussing her medical history. “I went to my regular primary care doctor and she just sort of hand-waved it off as ‘Well, you’re overweight and it’s putting stress on your joints.’”Eventually, Christina visited an urgent care center where providers performed an X-ray and found she had chipped a bone in her arm.The experience of having one’s concerns dismissed by a medical provider, often referred to as medical gaslighting, can happen to anyone. A recent New York Times article on the topic received more than 2,800 comments: Some recounted misdiagnoses that nearly cost them their lives or that delayed treatment, leading to unnecessary suffering. Patients with long Covid wrote about how they felt ignored by the doctors they turned to for help.Lately, the problem has been drawing attention — in both the medical community and the general public — for disproportionately affecting women, people of color, geriatric patients and L.G.B.T.Q. people. For example, studies have found that women are more likely than men to be misdiagnosed with certain conditions — like heart disease and autoimmune disorders — and they often wait longer for a diagnosis. And one group of researchers discovered that doctors were more likely to use negative descriptors like “noncompliant” or “agitated” in Black patients’ health records than in those of white patients — a practice that could lead to health care disparities.“Gaslighting is real; it happens all the time. Patients — and especially women — need to be aware of it,” said Dr. Jennifer H. Mieres, a professor of cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and co-author of the book “Heart Smarter for Women.”Here are some tips on how to advocate for yourself in a medical setting.What are the signs of gaslighting?Gaslighting can be subtle and isn’t always easy to spot. When seeking medical care, experts recommend watching for the following red flags.Your provider continually interrupts you, doesn’t allow you to elaborate and doesn’t appear to be an engaged listener.Your provider minimizes or downplays your symptoms, for example questioning whether you have pain.Your provider refuses to discuss your symptoms.Your provider will not order key imaging or lab work to rule out or confirm a diagnosis.You feel that your provider is being rude, condescending or belittling.Your symptoms are blamed on mental illness, but you are not provided with a mental health referral or screened for such illness.“I always tell my patients that they are the expert of their body,” said Dr. Nicole Mitchell, the director of diversity, equity and inclusion for the obstetrics and gynecology department at the Keck School of Medicine of the University of Southern California. “We work together to figure out what’s happening and what we can do about it. It really should be a shared decision making.”What can you do to advocate for yourself?Keep detailed notes and records. Dr. Mitchell recommended keeping a journal where you log as many details as possible about your symptoms. Her suggested prompts include: “What are your symptoms? When do you feel those symptoms? Do you notice any triggers? If you have pain, what does it feel like? Does it wax and wane, or is it constant? What days do you notice this pain?”In addition to your notes, keep records of all of your lab results, imaging, medications and family medical history.It is analogous to seeing your accountant at tax time, Dr. Mieres said: “You certainly do not show up without receipts.”Ask questions. Then ask some more. Prepare a list of questions that you would like to ask ahead of your appointment, and be prepared to ask other questions as new information is presented. If you aren’t sure where to start, Dr. Mitchell recommended asking your doctor this: “If you were me, what questions would you ask right now?”Bring a support person. Sometimes it can help to have a trusted friend or relative accompany you, particularly when discussing a treatment plan or difficult medical issue.When people are ill, scared or anxious, it can facilitate “brain freeze,” Dr. Mieres said. “We stop thinking, we don’t hear adequately, we don’t process information.”Speak with your support person to clarify their role and discuss your expectations, she added. Do you want them to take notes and be a second set of ears? Or do you primarily need them there for emotional support? Are there times where you might prefer that your friend or relative leave the room so that you can discuss private matters?Focus on your most pressing issue. Providers are often short on time, and the average primary care exam is only 18 minutes long, according to a study published in 2021. Dr. Mieres recommended taking 10 minutes before your appointment to jot down bullet points that concisely outline the reason for your visit so that you can communicate with your doctor efficiently.Pin down next steps. Ideally, you should leave your appointment feeling reassured. Tell your provider that you would like to understand three things: the best guess as to what is happening; plans for diagnosing or ruling out different possibilities; and treatment options, depending on what is found.If you’re still being ignored, what are your options?Switch providers. A study using data from 2006 and 2007 estimated that approximately 12 million adults were misdiagnosed in the United States every year and about half of those errors could be harmful. If you are concerned that your symptoms are not being addressed, you are entitled to seek a second opinion, a third or even a fourth.But in many cases that may be easier said than done. It’s not always quick or simple to find another specialist who takes your insurance and has immediate appointments available. If possible, try to get an in-network referral from your current doctor. For example, you can say: “Thank you for your time, but I would really like to seek another opinion on this. Could you refer me to another specialist in your area?”If you don’t feel comfortable asking your doctor for a referral, you can also speak with a patient liaison or nurse manager. Alternatively, you can ask friends and family, or call your insurance company to find someone in-network.Reframe the conversation. If you decide to stick with your current provider, but that person doesn’t appear to be listening, Dr. Mieres recommended that patients try redirecting the conversation by saying something like: “Let’s hit the pause button here, because we have a disconnect. You’re not hearing what I’m saying. Let me start again.”Or, alternatively: “I’ve been having these symptoms for three months. Can you help me find what is wrong? What can we do to figure this out together?”Look to support groups. There are support groups for a multitude of conditions that may provide useful resources and information.Tami Burdick, who was diagnosed in 2017 with granulomatous mastitis, a rare, chronic, inflammatory breast disease, found help from an online support group for women with the same condition.Initially, she was referred to an infectious disease specialist who dismissed a breast biopsy found to contain bacteria.“I developed horrible, painful abscesses that would open and drain on their own,” Ms. Burdick, 44, said.In her search for answers she conducted extensive research on the disease. And from the support group she learned of a gene sequencing test that could identify potential pathogens. Ms. Burdick asked her surgical oncologist to order the test and discovered she had been infected with a specific microorganism associated with granulomatous mastitis and recurrent breast abscesses. It took seven months of investigating, but she finally had an answer. To help other women, she self-published a book about her experience in collaboration with her oncologist.“If the infectious disease specialist had looked further into it,” she continued, “perhaps I could have started antibiotics right away, then and there, and never have required surgery.”Appeal to a higher authority. If you are being treated in a hospital setting, you can contact the patient advocacy staff, who may be able to assist. You might also address the problem with your doctor’s supervisor.Finally, if you are dissatisfied with the care that you’re receiving, Dr. Mitchell said, you may consider reporting your experience to the Federation of State Medical Boards.“Any instances of abuse, manipulation, gaslighting, delaying diagnoses — those are reportable events that providers need to know about,” Dr. Mitchell said. “Doctors need to be held accountable.”