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A fundamental mystery of the human cortex is how its 16 billion neurons integrate or bind the many different kinds of information they encode into a single coherent unified experience or memory.
Scientists have hypothesized that such binding involves high-frequency oscillations or “ripples” that promote neural interactions, much like rhythm does in music or dance. In a paper published July 7, 2022 in PNAS, researchers at University of California San Diego School of Medicine provide some of the first empirical evidence that such ripples do, in fact, occur in people.
“Think about the experience of petting your cat: its form, location, surroundings, color, feel, movement and sound, plus your own responding emotions and actions. They are all bound together in a coherent whole,” said senior author Eric Halgren, PhD, professor of radiology at UC San Diego School of Medicine.
“These different aspects of the experience are encoded in locations distributed across the cortical surface of the brain, and the experience is sub-served by their spatiotemporal firing pattern. The mystery has been how activities in those different locations get connected.”
Previous studies, mainly in rodents, had found that ripples in a different structure, the hippocampus, organize the replay of these spatiotemporal patterns during sleep, and this is essential for making memories permanent.
The UC San Diego team, led by Halgren, found that ripples also occur in all areas of the human cortex, in waking as well as sleep. The ripples were brief, lasting roughly one-tenth of a second, and had a consistent narrow frequency close to 90 cycles per second. The authors calculated that a typical brief ripple event may involve approximately 5,000 small modules becoming active simultaneously, distributed across the cortical surface.

Microglia, a type of central nervous system cell, is primarily responsible for neuronal death in Leigh Syndrome and the neurological symptoms related to this mitochondrial disease. This is the conclusion of a research group from the Institut de Neurociències of the Universitat Autònoma de Barcelona (INc-UAB) in a new study carried out on a mouse model of the disease. The study was coordinated by Juan Hidalgo, researcher at the INc and the Department of Cell Biology, Physiology and Immunology of the UAB, and published in the journal GLIA.
Leigh Syndrome is the most common form of mitochondrial disease. The cause of this group of diseases is a malfunction of the mitochondria — the organelles responsible for generating energy for the cell to function properly — caused by mutations in mitochondrial RNA or cellular DNA. In Leigh Syndrome, organs and tissues that need more energy, such as muscles or the brain, cannot function normally, causing very serious motor and respiratory problems in people who suffer from it.
Previous studies had described high neuroinflammation in the brains of Leigh Syndrome mouse models, but its effect on the development of the disease was unknown: protective, harmless, or harmful. In the present study, researchers found that inflammation causes neuronal death and that the main element responsible for this process is microglia cells. These cells, which under normal conditions defend the nervous system from external or internal aggression, attack neurons with mitochondrial dysfunction, causing their death.
In the study, researchers analyzed the effect of suppressing microglial cells using a drug, Pexidartinib (PLX-3397). “With the removal of microglia, it took longer for motor problems to appear, and life expectancy was higher. In addition, when studying their brains, we found that there was much less neuronal loss,” says Kevin Aguilar, first author of the article. “This drug, although it is not a good candidate for treating the disease, has been a key tool in identifying the effect of the neuroinflammation process and understanding how neuronal loss occurs,” he adds.
The study also looked at the role of IL-6, a protein that modulates inflammatory activity and guides the activity of microglia. “We suspected that this protein would also play a key role in the symptoms of the syndrome. That’s why we wanted to analyze what happened when there was a deficiency. However, contrary to what we expected, although respiratory problems were reduced, the effects were very moderate. This makes us think that there are other proteins involved,” explains Aguilar. “Our next goal will be to describe the specific process by which microglia cells attack neurons and thus be able to develop more specific and selective treatments in the future,” he concludes.
The study, which is a collaboration between the Neuroinflammation and Oxidative Stress research group and the Mitochondrial Neuropathology laboratory, both at the INC-UAB, is fundamental to understanding Leigh Syndrome and finding a therapy for mitochondrial diseases, which affect 1 in every 5,000 newborns.
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Using a state-of-the-art method, researchers at DZNE and the University of Texas have succeeded for the first time at unraveling the effects of autoimmune antibodies, that are directed against the brain, in detail at the atomic level. To this end, they studied two antibodies that dock to so-called GABAA receptors in one variant of autoimmune encephalitis. Their findings on the structural mechanisms, which they have now published in the journal Cell are an important step towards the development of effective therapies — and they also pave the way for further promising investigations using the new method.
“For the first time, we have exploited the interface between two fields that have developed strongly in recent times: on the one hand, cryo-electron microscopy, which manages to image individual atoms, and on the other hand, research on clinically relevant autoantibodies, that we isolate from patients with neurological and psychiatric diseases. The expertise from both fields has merged here,” says Prof. Harald Prüß, a DZNE scientist and also director of the Department of Experimental Neurology at Charité — Universitätsmedizin Berlin. The GABAA receptors are among the most important inhibitory receptors in the central nervous system.
Blockade of the GABAA Receptors
Normally, GABAA receptors bind to the neurotransmitter γ-aminobutyric acid (GABA). However, the antibodies that the scientists studied, inhibit GABA receptors. Until now, it was assumed that the misdirected human antibodies are internalized, i.e. taken up together with the receptor, after binding to the receptor. But this is not the case, as has now been shown. These two antibodies are not internalized, but inhibit the function of GABA receptors by different mechanisms: For example, by preventing the actual transmitter — GABA — from docking. This results in hyperexcitability of the nervous system, which can lead to twitching of the body, psychotic symptoms and epileptic seizures.
Autoimmune Encephalopathies
Autoimmune encephalopathies are brain inflammations not caused by bacteria or viruses, but by antibodies from the immune system that mistakenly attack the patient’s own body. There are numerous types of these encephalopathies that differ primarily in the specific structures which the aberrant antibodies attack. Receptors in the human brain are frequently affected, but often this involves other molecules, ion channels or other targets in the brain. “It has been a mystery why people with very different levels of these antibodies can develop the same symptoms of autoimmune encephalitis. Due to the high resolution of the investigation, we have now discovered another mechanism. Depending on the location of the binding site on the receptor, the antibodies can have very different effects,” explains Harald Prüß.
Paving the Way for Research of Other Diseases
While GABAA receptor encephalopathy is extremely rare, similar anti-brain antibodies play an increasing role in many neurological disorders, from epilectic seizures to dementia. “The gained information will inspire future research. We have paved the way to elucidating the mechanisms of human autoantibodies at the atomic level, which can now also be pursued in numerous other diseases,” says Harald Prüß. The methodology could now lead to a new standard for how deeply scientists can study and understand such modes of action in the future.
DZNE scientists Harald Prüß and Dr. Jakob Kreye contributed their expertise on antibodies and autoimmune encephalitis to the now published study. The researchers at the University of Texas Southwestern Medical Center, on the other hand, are experts in the field of structure analysis.

Students should not wait until they are on campus to begin thinking about how to protect their emotional well-being, experts say.As fall approaches, new students will arrive on college campuses toting all kinds of things: luggage and school supplies, mini fridges and sports equipment. But in the midst of the preparation for move-in day, many have not considered what tools they will need to support themselves emotionally.In other words, what can they do to protect their mental health?In a 2017 survey of more than 700 parents and guardians, over 40 percent said they did not discuss the potential for either anxiety or depression when helping their teenagers prepare for college or postsecondary school. In addition, most of the caregivers said mental health services on campus were not a priority when choosing a school.But a large number of teenagers are struggling. According to the Centers for Disease Control and Prevention, more than 1 in 3 high school students experienced persistent feelings of sadness or hopelessness in 2019, representing a 40 percent increase since 2009.Once they arrive on campus, these problems don’t go away. A survey conducted in March by Inside Higher Ed and College Pulse found that undergraduate students were more than twice as likely to rate their overall mental health as “poor” (22 percent) versus “excellent” (9 percent).And a new study using eight years of data from more than 350,000 students at nearly 400 campuses found that the mental health of college students across the United States has been on the decline. More than 60 percent of students surveyed during the 2020-2021 academic year met criteria for one or more mental health problems, a nearly 50 percent increase from 2013.Experts suggest that parents and teenagers take proactive steps now to help plan for and preserve mental well-being during the big transition to college.Vanessa Leroy for The New York TimesConnect early with the counseling centerConsider contacting the college’s counseling center before you arrive on campus. This is particularly important for those who already have an emotional disorder or other mental health concern.At SUNY Broome Community College in Binghamton, N.Y., the counseling center begins seeing registered students as early as Aug. 1, one month before classes begin.“A lot of times the students who come to us early, they have a lot that they need to unpack,” said Melissa Martin, a licensed social worker and the chairwoman of counseling services at the school.The Jed Foundation, a suicide prevention organization that aims to protect the emotional health of teenagers and young adults, suggests asking the following of the school’s counseling center:What services are provided?Are there a maximum number of sessions allowed per year?Is there a counselor on call 24 hours a day? If not, what after-hours emergency services are available?What accommodations are available through disability services for students with emotional disorders?What is the school’s policy on taking leaves of absence?Are there other types of support available, like text lines or resident advisers?Check to see if the counseling center provides off-campus referrals, and assemble a short list of potential providers to have in your back pocket ahead of arriving at school. This is a good practice for any student, as it may be necessary to seek outside support if the school’s counseling center develops a waiting list. It also helps to familiarize yourself with your insurance plan to see what type of coverage it provides. If you won’t be using your parents’ plan, compare the campus health insurance to other available options like those provided by the Affordable Care Act.“I think it’s never too early to say, ‘Hey, I need help,’” Ms. Martin said. “You might not see anyone else reaching out for help, but they might not be talking about it.”Vanessa Leroy for The New York TimesStudies have found that students of color are less likely than white students to use mental health services offered on campus, in part because of the stigma associated with mental health care but also because of a lack of diversity among counseling staff.Those seeking a provider of color may have to take on the extra burden of trying to find a therapist off campus, said Ebony O. McGee, a professor of diversity and STEM education at Vanderbilt University’s Peabody College.“That student might actually not do it, which opens the possibility of turning to unhealthy things,” she said.Embrace other types of supportThere are many resources available to students besides the counseling center. Tutoring, academic and peer advising, education coaching, student activities and career services can all help support a student’s emotional well-being.Connecting with other students is especially important, the experts said.“College students report that loneliness and isolation and feeling like they don’t fit in — those kinds of emotions are very common and challenging in first year of college,” said John MacPhee, chief executive of The Jed Foundation.Spend some time looking at the school’s extracurricular activities and clubs, and thinking about how to engage with others while on campus. And consider having a roommate even if you have the option of living alone, Mr. MacPhee added — it can broaden your social network and help buffer stressors.Don’t count out high school friends or anyone back home — a sibling, parent or religious leader, for example — who has been especially helpful.“I often recommend making a list of your three to five biggest supporting people in your life,” Ms. Martin said. “And when you’re not feeling the best at school, you know you can reach out to one of them.”One way that students of color can protect their mental health is by taking an African American history or ethnic studies class and exploring some of the structural problems that contribute to stress, anxiety and depression, said Dr. McGee, who has studied the emotional struggles experienced by high-achieving Black students.“When many Black and brown students have mental health situations, it is often because of racialized or gendered racialized experiences,” she said. “It is about that environment that breeds alienation.”Dr. McGee recommended seeking out spaces of comfort and understanding. “Go to places and spaces where you are affirmed and celebrated, and not simply tolerated,” she said. It could be an extracurricular activity or a religious organization — anywhere you might find other marginalized students of color.Vanessa Leroy for The New York TimesPractice basic wellness habitsIn the summer before college, teenagers should take stock of how they’re eating, sleeping and socializing, the experts said, especially given that they may have formed some unhealthy habits during the pandemic. If a student’s basic needs are neglected, it becomes more difficult to cultivate a healthier mental state.Learning how to support yourself and taking steps to become more independent can also make the college transition less jarring. Before arriving on campus, practice managing a budget; advocating for yourself with a teacher, doctor or coach; or spending time outside of your childhood home — perhaps with a relative, or at summer camp.Senior year can be “a rollicking ride” especially during the age of Covid, said Dave Anderson, a clinical psychologist at the Child Mind Institute, a nonprofit that provides therapy and other services to children and families with mental health and learning disorders. “It’s just ups and downs, and disappointment and hopes, and trying to figure out where they’re supposed to be.”He advised one teenage client (who had slept an average of five hours a night during his senior year) to begin getting eight hours of sleep each night this summer, and to be aware of how much time he was spending on screens. His client also began eating a healthier diet that included more vegetables, and started working out first thing in the morning because he knows his college classes will start later in the day.Drinking is “another thing that we’ll discuss very openly with teenagers during the summer before college,” Dr. Anderson said. Many high school students are already drinking alcohol socially with friends, he added, and in college they may feel pressure to binge drink or “pre-game.” But teenagers can prepare mentally for this and other types of circumstances — including drug use and sexual situations — by setting boundaries now.“How can we make sure that this summer you’re setting intentional goals related to your limits and what you feel like is safe for you?” he asks college-bound teens. That conversation can sometimes make parents nervous, Dr. Anderson added.“But if we can speak honestly to kids about that, they will be more likely to set those limits when they get to college because they’ve practiced.”

New research shows that fatty foods may not only be adding to your waistline but also playing havoc with your brain.
An international study led by UniSA neuroscientists Professor Xin-Fu Zhou and Associate Professor Larisa Bobrovskaya has established a clear link between mice fed a high-fat diet for 30 weeks, resulting in diabetes, and a subsequent deterioration in their cognitive abilities, including developing anxiety, depression and worsening Alzheimer’s disease.
Mice with impaired cognitive function were also more likely to gain excessive weight due to poor metabolism caused by brain changes.
Researchers from Australia and China have published their findings in Metabolic Brain Disease.
UniSA neuroscientist and biochemist Associate Professor Larisa Bobrovskaya says the research adds to the growing body of evidence linking chronic obesity and diabetes with Alzheimer’s disease, predicted to reach 100 million cases by 2050.
“Obesity and diabetes impair the central nervous system, exacerbating psychiatric disorders and cognitive decline. We demonstrated this in our study with mice,” Assoc Prof Bobrovskaya says.
In the study, mice were randomly allocated to a standard diet or a high-fat diet for 30 weeks, starting at eight weeks of age. Food intake, body weight and glucose levels were monitored at different intervals, along with glucose and insulin tolerance tests and cognitive dysfunction.
The mice on the high-fat diet gained a lot of weight, developed insulin resistance and started behaving abnormally compared to those fed a standard diet.
Genetically modified Alzheimer’s disease mice showed a significant deterioration of cognition and pathological changes in the brain while fed the high fat diet.
“Obese individuals have about a 55 per cent increased risk of developing depression, and diabetes will double that risk,” Assoc Prof Bobrovskaya says.
“Our findings underline the importance of addressing the global obesity epidemic. A combination of obesity, age and diabetes is very likely to lead to a decline in cognitive abilities, Alzheimer’s disease and other mental health disorders.”
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Published6 hours agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesParts of the UK are predicted to experience a heatwave over the next few days, the Met Office has said.Southern and eastern areas will see consistently high temperatures over the next week.On Friday, parts of the country are predicted to hit 28C (82.4F) – beginning the run of hot days.The forecaster and the UK Health Security Agency (UKHSA) has issued a level 2 heat-health alert warning ahead of the hot weather.It will come into force from Monday 11 July until Friday 15 July, and covers the east of England, south-east and London.The heat-health alert scale is designed to help healthcare workers manage through periods of extreme temperatures and has four levels. Level 2, called alert and readiness, is triggered as soon as there is a 60% risk that temperature thresholds will be reached in one or more regions on at least two consecutive days and the night in between.The Met Office declares a heatwave when it records at least three days in a row with maximum temperatures exceeding a set temperature – which varies in different areas of the country. The UK previously experienced a heatwave three weeks ago, with 17 June marking the hottest day of the year so far.Northern Ireland had its hottest day of 2022 so far on Thursday, with highs of 23.5C.Is the UK getting hotter?Check the weather forecast where you are10 tips for sleeping in hot weatherWhat do heatwaves do to the body?Temperatures in the mid to high 20s are expected in some areas over the weekend before they reach the low 30s at the start of next week, according to the Met Office’s deputy chief meteorologist David Oliver. The north-west of England is expected to buck the trend seen elsewhere, with cloud and light rain expected over the weekend and into next week.BBC Weather presenter Nick Miller said: “Temperatures are set to rise this weekend lasting into a least the first half of next week. “Parts of England and Wales will see highs in the upper 20s and low 30s Celsius for several days and meet the criteria for an official heatwave to be declared.”Some places are likely to see their highest temperature of the year so far.” Image source, PA MediaHeatwaves are becoming more likely and more extreme because of human-induced climate change. The world has already warmed by about 1.2C since the industrial era began, and temperatures will keep rising unless governments around the world make steep cuts to emissions.In England, there were 2,500 excess deaths in the summer of 2020 as a result of hot weather, while heat-related deaths in the UK could treble in 30 years, the British Red Cross predicts. How are you preparing for the heatwave? Please get in touch by emailing haveyoursay@bbc.co.uk.Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways:WhatsApp: +44 7756 165803Tweet: @BBC_HaveYourSayUpload pictures or videoPlease read our terms & conditions and privacy policy

If you are reading this page and can’t see the form you will need to visit the mobile version of the BBC website to submit your question or comment or you can email us at HaveYourSay@bbc.co.uk. Please include your name, age and location with any submission. This video can not be playedTo play this video you need to enable JavaScript in your browser.THE FALKLANDS WAR: As told by the British troops who fought there’I FELT SO ALONE’: A shocking insight into the lives of young people in careMore on this storyIs the UK getting hotter?17 JuneHeatwaves redefined in England over climate change29 March10 tips for sleeping in hot weather15 JuneWhat does hot weather do to the body?15 JuneDogs at double risk of heatstroke in London23 MayHow do we know climate change is caused by humans?25 October 2021A really simple guide to climate change13 October 2021

Published8 hours agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesIn June, passengers on a high-speed train from China’s financial hub Shanghai to Beijing failed to reach their destination. Halfway to the capital, officials wearing protective clothing stopped the train, boarded and announced on megaphones that everyone must get off because one of the passengers had been linked to a Covid cluster. Chinese people mostly went along with such demands early in the pandemic because they believed the government knew what it was doing. Now, the authorities can’t rely on such compliance.Travellers shouted back: “No! Why should we get off? How did you let this person on the train?”But they were soon bussed off to an isolation centre hundreds of kilometres away. Such measures are part of China’s uncompromising “zero Covid” strategy. President Xi Jinping has repeatedly warned that no other path is acceptable. After the initial outbreak in Wuhan, the country has been kept inside a giant Covid protection bubble, shielding the population from the high death rates experienced elsewhere, but it has come at a cost – and growing political risk.In China, what the Communist Party fears above all else is major social unrest – and Mr Xi does not want to see this ahead of his move into a historic third term at a Party congress later this year.A cloud of uncertainty While the rest of the world is trying to live with Covid, China is the only major economy still prioritising the fight against the virus above almost everything else.So-called zero Covid measures involve mass testing, tracking and strict isolation. Just a handful of cases can spark a city-wide lockdown. Beijing has had only a few infections recently but its more than 21 million residents are required to queue for PCR tests every three days to access public buildings and even corner shops.When a Covid case is confirmed, a whole suburb can be swiftly cordoned off. It’s been especially hard for businesses – shops, bars and restaurants can be seen pulling down shutters for good.Everyone in China is living under a cloud of uncertainty. It’s difficult to make plans, and it makes one wonder how much longer people will put up with this. Image source, Getty ImagesIf the Party is not worried about all this, it should be. It’s not hard to imagine riots in Shanghai if residents were to be confined to their homes again. Yet, China has shown no signs of shifting its Covid approach. The world is looking on and asking why.In short, there are two reasons: politics and vaccines.China’s vaccine rates are still too low It’s not clear why China dropped the ball on vaccination rates, which are still seen as too low for the country to safely reopen. Officials fear that a widespread outbreak could overwhelm hospitals and cause many deaths.”Some vulnerable groups haven’t been fully vaccinated with two doses or booster shots, so we can’t just give in,” Professor Liang Wannian from China’s National Health Commission said in March.There’s been a belated move to ramp up vaccine rates – 89% of people have had two shots, but only 56% of those eligible have received a booster, according to official data. A few months ago, the situation was much worse. It’s been especially worrying among the elderly. In Hong Kong, a huge proportion of those who’ve died have been older and unvaccinated.During the Shanghai outbreak in April, city officials said that only 38% of those over 60 had received three shots, and only 15% of those over 80 had got the first two jabs.Across the country, only 19.7% of those over 80 have had a booster. Why the reluctance? For many in China, the government’s success in controlling Covid before the Omicron variant seems to have reduced the urgency for vaccination.Officials had been portraying Covid as an overseas problem, blaming passengers from abroad for bringing the virus into China and this belief took hold. People have also told the BBC that some doctors have warned those with underlying conditions of the dangers associated with vaccination – rather than of the dangers of not being vaccinated, especially for the elderly or patients in high-risk groups. Image source, Getty ImagesPensioners the BBC spoke to in a Beijing park said they weren’t too concerned by the virus.”I’m not worried about Covid. Just be careful, wear a mask,” one 85-year-old woman told us. She and her husband had just received a shot that morning, she said. A man nearby said: “Covid management in Beijing is good. Beijing people, the Chinese people, listen to the government. Unlike people overseas, when asked to stay at home, we just stay at home.”But Beijing is yet to have a full shutdown, with people restricted to their homes, to the extent that Shanghai, Wuhan, Xian, Jilin and other cities have. People in the capital often compare China’s experience with what they think has happened abroad. State-controlled media reports heavily on Covid in other countries. But it has been much less inclined to accurately cover the chaos and hardship as residents suffering food shortages battled through the lockdown in Shanghai.So why hasn’t Mr Xi’s administration pushed vaccines harder? PCR tests are required for travel – why not vaccination records? Several international business groups in China have called for some of the vast resources devoted to testing and quarantine to be reallocated to a more vigorous long-term vaccine strategy. Earlier this week, the Beijing city government announced a change: proof of vaccination would be required to enter cinemas, gyms, internet cafes, libraries, museums and other entertainment venues. But, within days, state media has reported officials walking this back saying that it is not compulsory.But vaccinations are only part of the issue. Zero Covid has turned into a political challengeA significant part of the problem seems to have started with officials having too much faith in the Party’s propaganda. Government representatives have openly ridiculed other countries for opening up. China would not do this, they declared.In June, Mr Xi visited Wuhan, where the pandemic first started. State media said he stressed the value of the “dynamic zero Covid” approach and told locals the government would prioritise people and prioritise life. He was quoted as saying that, if China switched to a “herd immunity” approach, the aftermath would be unimaginable.While the Omicron variant has shown how unstoppable the virus can be, the language from the top in China remains centred on “defeating” the virus and “winning the war against the pandemic”. As a result, many people here believe that, with enough effort, the virus can somehow be expunged. Image source, Getty ImagesIf this crisis had been years away from the next Communist Party congress – which will usher in Mr Xi’s third term – the mood might be different. But it is just months away.Former leader Deng Xiaoping introduced a two-term limit to prevent the rise of another figure like Mao Zedong who ruled China for nearly three decades. But that limit has now been dropped to allow Mr Xi to remain in power for as long as he chooses. It is not a small shift in the country’s political history. If there are those in the senior ranks who don’t want Chairman Xi to go the way of Chairman Mao, there are not many ways to stop it, certainly not many opportunities. What might be needed?a political vehicle (like a Party congress)an emergency (for example, an economy-smashing epidemic)the handling of that crisis to have been bungledfor enough senior Party members to decide that the risk of keeping Mr Xi in power is greater than the risk of opposing himIt is hard to imagine that the last of those pre-conditions is anywhere near in place. But China’s leader and his allies would always be considering the worst-case scenario to make sure it doesn’t happen.In May, the party’s seven-man Politburo standing committee, which sits at the top of Chinese politics, stressed the need for the “resolute struggle against all distortions, doubts and denials of our epidemic prevention policy”, according to the published highlights.They would not have been discussing “doubts” about zero Covid if such wavering didn’t exist. It must also have existed at a reasonably senior level. Covid fatigue is everywhere It would be surprising if questions were not being asked in the upper echelons of power. For generations, China’s economy has been the most important priority and Covid is wrecking it. Economists are speculating that the country’s statistics are being massaged to hide the true impact of the virus and the approach to fighting it. The World Bank predicted that China’s real GDP growth would slow to 4.3% in 2022 in its June update, largely because of Omicron outbreaks and prolonged lockdowns.But it’s too late now to drop zero Covid before the Party congress. Mr Xi has to ride it out and hope for no more city-wide lockdowns before his new term.In cities which have had multiple or long lockdowns, signs of Covid fatigue are everywhere.More social media posts openly make fun of the government. In other countries this might not be unusual – in China, it represents a real shift. When Shanghai was shut down and food deliveries were not getting through, people started posting clips of the song – Do you hear the people sing? – from Les Miserables. This video can not be playedTo play this video you need to enable JavaScript in your browser.It doesn’t mean the building of barricades is imminent, but it is a slap in the face for the government whose reputation for Covid management has gone from highly effective to bungling and inflexible.Last week, when state media quoted Beijing’s party secretary having said the zero Covid approach would remain in place for at least another five years, it prompted an instant outcry on social media. There was a quick correction. Apparently there had been a misunderstanding.An announcement followed that quarantine for international arrivals would be reduced to seven days in a hotel followed by three at home. Perhaps this was a way to ease jitters and show people the government is trying to relax restrictions. But many believe China is simply kicking the can down the road – one day it’s going to have to find a way forward. A potential off-ramp could involve redefining zero Covid and finding a way to declare that victory has been achieved.Until then, brush fires will keep appearing. The Party wouldn’t want them to get out of control.More on this storyOmicron vs Zero-Covid: How long can China hold on?21 MarchXi Jinping: From princeling to president12 May 2021

Balancing how much protein you eat with the amount your body needs could reduce nitrogen releases to aquatic systems in the U.S. by 12% and overall nitrogen losses to air and water by 4%, according to a study from the University of California, Davis.
Protein consumption in the United States, from both plant and animal sources, ranks among the highest in the world. The study, published in the journal Frontiers in Ecology and the Environment, said that if Americans ate protein at recommended amounts, projected nitrogen excretion rates in 2055 would be 27% less than they are today despite population growth.
The study is the first to estimate how much protein consumption contributes to excess nitrogen in the environment through human waste. It also indicates that coastal cities have the largest potential to reduce nitrogen excretions headed for their watersheds.
“It turns out that many of us don’t need as much protein as we eat, and that has repercussions for our health and aquatic ecosystems,” said lead author Maya Almaraz, a research affiliate with the UC Davis Institute of the Environment. “If we could reduce that to an amount appropriate to our health, we could better protect our environmental resources.”
Protein shake-up
The human body requires protein. But when a body takes in more protein than it needs, excess amino acids break it down into nitrogen, which is excreted mostly through urine and released through the wastewater system. This brings additional nitrogen into waterways, which can result in toxic algal blooms, oxygen-starved “dead zones” and polluted drinking water.

High dose inhaled nitric oxide gas (iNO) is a safe and effective respiratory therapy for pregnant women hospitalized with severe COVID-19 pneumonia, resulting in a more rapid weaning from supplemental oxygen and reduced length of hospital stay, according to a research team led by Massachusetts General Hospital (MGH). In a study published in Obstetrics & Gynecology, researchers from four Boston hospitals reported that the addition of twice-daily nitric oxide to standard of care oxygen therapy decreased the respiratory rate of pregnant women with low oxygenation levels of the blood without causing any side effects.
“To date, very few respiratory treatments to complement supplemental oxygenation in COVID-19 pregnant patients have been tested,” says senior author Lorenzo Berra, MD, with the Department of Anesthesia, Critical Care and Pain Medicine, MGH. “Investigators from all four medical centers that participated in our study agreed that administration of high dose nitric oxide through a snug-fitting mask has enormous potential as a new therapeutic strategy for pregnant patients with COVID-19.”
Pneumonia triggered by COVID-19 is particularly threatening to pregnant women since it may quickly progress to oxygen insufficiency in the blood and bodily tissues, a condition known as hypoxemia, requiring hospitalization and cardiopulmonary support. “Compared to non-pregnant female patients with COVID-19, pregnant women are three times more likely to need intensive care unit admission, mechanical ventilation, or advanced life support, and four times more likely to die,” notes Carlo Valsecchi, MD, lead author in the Department of Anesthesia, Critical Care and Pain Medicine, MGH. “They also face a greater risk of obstetric complications such as preeclampsia, preterm delivery, and stillbirth.”
Nitric oxide is a therapeutic gas that was initially approved by the U.S. Food and Drug Administration in 1999 for inhalation treatment of intubated and mechanically ventilated newborns with hypoxic respiratory failure. With MGH driving many early studies, iNO in high concentrations was also shown to be effective as an antimicrobial in reducing viral replication of SARS-CoV-1 and, more recently, SARS Co-V-2, the virus that causes COVID-19. During the first wave of COVID-19, MGH treated six non-intubated pregnant patients with iNO at high doses of up to 200 parts per million (ppm). Findings of a more favorable outcome with iNO led MGH clinicians to offer this treatment to other pregnant patients, and to design the current study to determine the safety and efficacy of iNO200 for COVID-19 pneumonia in pregnancy.
To that end, a collaborative network of four medical centers in the Boston area was formed. In addition to MGH, it included Tufts Medical Center, Beth Israel Deaconess Medical Center, and Boston Medical Center. Researchers and clinicians from multiple departments — including critical care medicine, respiratory care, and maternal fetal medicine — studied 71 pregnant patients with severe COVID-19 pneumonia admitted to these hospitals, 20 of whom received iNO200 twice daily. The study found that iNO therapy at this dosage, when compared to standard of care alone, resulted in reductions in the need for supplemental oxygen and in hospital and ICU lengths of stay. No adverse events related to the intervention were reported in either mothers or their babies.
“Being able to wean patients from respiratory support quicker could have other profound implications, including reducing stress on women and their families, lowering the risk of hospital-acquired infections, and relieving the burden on the health care system,” notes Berra. “Above all, our study supports the safety of high dose nitric oxide in the pregnant population, and we hope more physicians will consider incorporating it into carefully monitored treatment regimens.”
Berra is an associate professor of Anesthesia, Harvard Medical School (HMS), and medical director of Respiratory Care, MGH. Valsecchi is a post-doctoral fellow and investigator in the Department of Anesthesia, MGH. Co-authors include William Barth, Jr., MD, vice chair of Obstetrics, MGH, and an associate professor of Obstetrics, Gynecology, and Reproductive Biology, HMS; Ai-ris Collier, MD, investigator and instructor in Obstetrics, Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center; Ala Nozari, professor of Anesthesiology at Boston Medical Center; Jamel Ortoleva, MD, assistant professor of Anesthesiology at Tufts Medical School, and cardiothoracic anesthesiologist and critical care physician at Tufts Medical Center; and Anjail Kaimal, MD, chief of the Division of Maternal-Fetal Medicine, MGH, and an associate professor of Obstetrics, Gynecology, and Reproductive Biology, HMS.

The city has struggled to respond to a growing monkeypox outbreak, the first major public health crisis since the Covid pandemic began.Thousands of New Yorkers spent hours refreshing a city government webpage on Wednesday, desperately seeking a monkeypox vaccine that, for now, is mostly going to the most web-savvy and connected.The rollout echoed the early days of New York City’s Covid-19 vaccine, when finding an appointment could feel like winning a radio contest. The city decided to assign appointments for the first 3,500 or so doses of the highly sought-after monkeypox vaccine via an online system, using Twitter as the main way to notify people. The appointments went within minutes.On top of that, because of a glitch, about 600 appointments went only to those who happened to store an older appointment website on their browsers, because the slots appeared there before a link on the main Department of Health website went live.“By following the Department of Health’s instructions, we had zero chance of getting the vaccine,” said Nicholas Diamond, who spent hours refreshing the city’s website. “I am really concerned that the city, state and federal government have learned nothing from the Covid response, and essentially the burden again has been left on us to figure out how to care for ourselves.”New York City is the epicenter of the nation’s monkeypox outbreak, its health commissioner said, with 141 cases recorded so far, more than any other city. The disease is mostly spreading among men who have sex with men, and experts believe there may be many more cases than have so far been detected.The spreading outbreak has not yet caused any deaths in the United States, but it can cause very painful lesions that take weeks to resolve.The health commissioner, Dr. Ashwin Vasan, apologized for the appointment glitch at a news conference Thursday and explained that the city would work harder to insure a more equitable approach as more appointments become available.“Our vendor experienced technical glitches, and New Yorkers have had to wait much longer than they should have to get this vaccine,” Dr. Vasan said. “Ultimately, they work for us and the buck stops with us. And so we apologize to New Yorkers, and we pledge to do better going forward on this issue in the days ahead.”He added: “Equity is an incredibly hard thing to preserve in an environment of scarce supply.”Cases of monkeypox have been steadily increasing in the city, despite limited testing. New York City’s public health lab, which was the only place running the test for the disease in the city until Wednesday, has only been able to test 10 people per day, city officials said. But testing will now be able to ramp up: Labcorp, the commercial testing company, also began offering the test on Wednesday.Public health officials have decided not to put up billboards warning the wider public about the disease, which spreads primarily by prolonged close contact, because they see it for now as an outbreak almost completely among the community of men who have sex with men. Instead, they say they have been mostly relying on getting the word out through smaller efforts with community partners within the L.G.B.T.Q. community.That began to change on Thursday, when officials held a news conference to announce the opening of a second clinic in New York City that will offer the vaccine by appointment only, in Harlem. The first clinic was in Chelsea, which advocates argued primarily reached a well-off patient population.Dr. Vasan said that he picked Chelsea for the first site because 75 percent of the cases so far have been in Manhattan, and one-third of known cases are in the Chelsea and Hell’s Kitchen neighborhoods.Officials acknowledged that there were high levels of anxiety among men who have sex with men and that there were still many unknowns about the disease’s spread.New York City has so far received about 7,000 doses of the Jynneos vaccine, the preferred vaccine for the monkeypox. Of those about 4,000 have already been given out or assigned to appointments. An additional several thousand are being held in reserve for distribution through community partners, Dr. Vasan said.More doses are coming, said Dr. Raj Panjabi, the coordinator of the White House Pandemic Office, who also spoke at the news conference. Another 144,000 doses will be released by the federal government within the next weeks, with some of those coming to New York. In total, four million doses have been ordered for use nationwide, with 1.5 million of those expected to go out to health departments later this summer and fall.The Jynneos vaccine requires two doses to be fully protective, according to the Food and Drug Administration, but so far, all of the doses coming to the city are being considered as first doses. As more doses arrive, there will be more available for second doses, said Dr. Mary Bassett, the state health commissioner.Paul Chaplin, the chief executive officer of Bavarian Nordic, which makes the vaccine, said Thursday that research shows that one dose offers “robust protection.” Dr. Bassett, however, said that full protection from the vaccine would only come two weeks after the second dose.What to Know About the Monkeypox VirusCard 1 of 4What is monkeypox?