Publisher Health

As theatres reopen, actors like Stephen Beckett have been swapping their lockdown jobs for their place on the stage once more. His first thoughts when the lockdown first shut down his show were ‘I’m an actor, what can I do’. Then, he worked with a care agency, looking after elderly people. Beckett plays one of the dads in the long running musical Mamma Mia, which is now re-opening in the West End.

One of the leading producers of rapid tests purged supplies and laid off workers as sales dwindled. Weeks later, the U.S. is facing a surge in infections with diminished capacity.For weeks in June and July, workers at a Maine factory making one of America’s most popular rapid tests for Covid-19 were given a task that shocked them: take apart millions of the products they had worked so hard to create and stuff them into garbage bags.Soon afterward, Andy Wilkinson, a site manager for Abbott Laboratories, the manufacturer, stood before rows of employees to announce layoffs. The company canceled contracts with suppliers and shuttered the only other plant making the test, in Illinois, dismissing a work force of 2,000. “The numbers are going down,” he told the workers of the demand for testing, saying it wasn’t their fault. “This is all about money.”As virus cases in the U.S. plummeted this spring, so did Abbott’s Covid-testing sales. But now, amid a new surge in infections, steps the company took to eliminate stock and wind down manufacturing are proving untimely — hobbling efforts to expand screening as the highly contagious Delta strain rages across the country.Demand for the 15-minute antigen test, BinaxNOW, is soaring again as people return to schools and offices. Yet Abbott has reportedly told thousands of newly interested companies that it cannot equip their testing programs in the near future. CVS, Rite Aid and Walgreens locations have been selling out of the at-home version, and Amazon shows shipping delays of up to three weeks. Abbott is scrambling to hire back hundreds of workers.America was notoriously slow in rolling out testing in the early days of the pandemic, and the story of the Abbott tests is a microcosm of the larger challenges of ensuring that the private sector can deliver the tools needed to fight public health crises, both before they happen and during the twists and turns of an actual event.BinaxNOW, a rapid antigen test made by Abbott, can provide results in 15 minutes.Abbott, via Agence France-Presse — Getty Images“Businesses crave certainty, and pandemics don’t lend certainty to demand,” said Stephen S. Tang, chief executive of OraSure Technologies, which in the midst of the testing slump in June received emergency F.D.A. authorization for its own rapid test, InteliSwab, long in development. But the company is not yet supplying retail stores.Meanwhile, Dr. Sean Parsons, chief executive of Ellume, the Australian manufacturer of a competitor rapid test, said this week that demand was 1,000 times greater than forecast and the company was racing to set up a U.S. plant. Abbott’s decisions have ramifications even beyond the United States. Employees in Maine, many of them immigrants from African countries, were upset at having to discard what might have been donated. Other countries probably could have used the materials, according to Dr. Sergio Carmona, chief medical officer of FIND, a nonprofit that promotes access to diagnostics.“This makes me feel sick,” he said of the destruction, noting that more than a dozen African nations have no domestic funds to buy Covid tests.In an interview, Robert B. Ford, Abbott’s chief executive, argued that the discarded materials — finished test cards — should not be viewed as tests. Kits for sale also include swabs, liquid buffer and instructions. “I would just caution in terms of using the word ‘destroy’ because it kind of gives a sense here that we’ve got all these tests that were in packages and we threw them away,” he added.Asked why the materials needed to be thrown away, Mr. Ford cited a limited shelf life. But photographs of some of the estimated 8.6 million Abbott test cards that employees said were shredded show expiration dates that were more than seven months away.Workers had their own conjectures. Some figured layoffs were imminent and there would be no employees left to dispose of the excess, while others thought the company did not want to flood the market and decrease the value of its product: A box of two home tests carries a retail price of $20 to $24.As for donating BinaxNOW, it is a U.S. product that is not registered internationally, Mr. Ford said. “We couldn’t just ship it there.” But he acknowledged that the company did in fact send a million tests to India in May, paid for by the U.S. government.Dr. Mariangela Batista Galvao Simao, an assistant director general at the W.H.O., said the agency was not made aware of the BinaxNOW surplus. While some countries might have had regulatory barriers, the W.H.O. “would have worked to facilitate whatever is needed.” Donating tests would probably have required considerable extra work for Abbott, she added.Addressing the challenges ahead in the U.S., Abbott’s public affairs director, Aly Morici, said in an email that it was “difficult to scale up on a dime, but we’re doing so again.” She acknowledged that “there will be some supply constraints over the coming weeks.”Abbott invited workers back to the plant in Maine this month to meet what it described in a letter as “unexpected manufacturing needs.” But it is unclear how many employees will return. They would forgo weeks of being paid for doing no work, as provided for in their severance packages, with only a two-week “thank you” pay extension and no guarantee that their jobs will last.The company was not in this position in early 2020. Anticipating the need for quick, reliable tests that required no specialized equipment, Abbott assembled a team of about 100 scientists, supply-chain experts and engineers to design BinaxNOW in a highly compressed time frame. “Everybody was working nonstop,” Mr. Ford said. “This is ultimately what Abbott was built for.” The test strip, resembling the one on a pregnancy stick, is less sensitive than PCR but delivers results on the spot, allowing a company or school to take immediate action.The F.D.A. granted BinaxNOW emergency authorization last August. A day later, the U.S. government announced plans to buy 150 million of the tests for $760 million — $5 a test, plus shipping — to be used in settings including nursing homes and schools.Friendship Public Charter School in Washington received 20,000 government-purchased BinaxNOW tests free of charge as part of a pilot program supported by the Rockefeller Foundation. Patricia A. Brantley, the school’s chief executive, said that 70 percent of students’ parents opted in for them to undergo weekly testing. Children as young as 3 submitted to a swipe in the nose in exchange for a sticker. “Testing is still an important part of the strategy not only to reopen schools but to keep them open,” Ms. Brantley said.Northwestern University also adopted BinaxNOW early, testing students twice a week. The university performed up to 5,000 rapid tests a day, according to Luke Figora, the school’s vice president for operations.After the F.D.A. authorized BinaxNOW for at-home use, Northwestern bought 150,000 kits, handing them out to students, faculty and staff. “We wanted to give them one more tool to stay safe,” Mr. Figora said. Abbott met its initial production goals by keeping manufacturing lines running 24 hours a day and emphasizing speed to an extent that some employees said made them uncomfortable.On a January conference call, investors learned the hard work was paying off: Abbott had sold $2.4 billion in coronavirus tests, mostly rapid ones, in the final quarter of 2020. “I expect testing demand is still going to remain high, even as the vaccines roll out,” Mr. Ford said on the call.“The big point here is the sustainability of this.”For a while, it appeared he would be right. In March, the federal government announced $10 billion to support testing in schools. By April, Abbott had reaped another $2.2 billion in testing sales. The same month, the F.D.A. extended BinaxNOW’s shelf life, originally six months, to a year.But then the C.D.C. came out with a game-changing announcement: Vaccinated people without symptoms no longer needed to be tested, even after exposure.“We couldn’t have anticipated what has occurred over the past several weeks,” Mr. Ford told investors on another call, describing “a sharp and rapid decline in demand,” particularly for rapid tests, and dropping the company’s earnings forecast.“Are you not thinking that there’s going to be any kind of, you know, resurgence or ramp-up of screening testing in the fall?” Matt Taylor, a managing director at UBS, asked on the call. “What are you to do with all the capacity that you’ve built up?”The destruction that followed lasted about a month. A list of “lots to be destroyed” appeared on a white board at the plant in Westbrook, Maine, and some of those batches had recently been labeled with new expiration dates.Boxes of BinaxNOW test cards that employees said they were told to destroy. A board indicating lots to be purged.An expiration date in February next year. Several employees, not authorized to speak on behalf of the company, said they were told to eliminate 25 lots of about 345,000 test cards each at the Westbrook factory. Mr. Ford would not confirm that number.Test pouches were dumped onto tables, one former employee, Steven Hall, recalled. “Some people ripped them open singly, and some people used the scissors and did four or five at a time,” he said. They stuffed foil wrappers and desiccant packets into trash bags and boxed the test cards for shredding.Test cards in Maine that were to be put through a shredder.As the Delta variant drives a new appreciation for screening programs, and the C.D.C. again recommends testing vaccinated people who are exposed, Abbott’s inability to meet demand is causing pain in the business world.The U.S. Rapid Action Consortium, which buys BinaxNOW on behalf of more than a dozen workplace testing programs, including Air Canada and Scotiabank, has seen increased interest, according to Darren Saumur, chief operating officer at Genpact, a founding member. But when the group asked to bump up its purchases, an Abbott sales representative said that she could only provide what was already committed, adding that the company had been unable to fulfill 14,000 requests from new clients, Mr. Saumur said. (Abbott declined to comment on the figure.)The group’s negotiations with Abbott to lower the cost of the tests were also halted. “The price points we were talking about they definitely don’t want to talk about anymore,” Mr. Saumur said.For many Abbott employees, especially those from African countries, the most troubling aspect was the waste of it all. “I was hurting, seeing that,” said Aristoteles Landa, a worker from Angola.Abbott representatives said the company was able to meet demand for its rapid Covid tests outside the U.S. through sales of a South Korean-manufactured version called Panbio.Last fall, the W.H.O. approved that test for emergency use, and the Global Fund committed an initial $50 million to allow low- and middle-income countries to buy Panbio and another company’s test at a maximum price of $5 each (a malaria test based on similar technology sells for about $0.20). A coalition of international organizations announced a goal of securing a half-billion tests within the year.But more than 10 months after the announcement, only a fraction of that number — under 60 million — has been procured under the plan, according to the W.H.O., with cost being one constraint.Amal Barakat, a virologist at the W.H.O.’s Eastern Mediterranean regional office, shook her head when she heard about the destruction in Maine. “My heart,” she said, “it hurts.”Students at College des Saints Coeurs Ain Najm in Lebanon. The W.H.O. has had trouble buying tests for schools in the country.Mohamed Azakir/ReutersIn many countries, Dr. Barakat said, “we can’t fulfill all their demand.” Lebanon recently requested rapid tests for children in schools, she said, but her agency lacks the funds to procure them. Laboratories there were importing “whatever,” regardless of regulatory status.She dismissed the idea that the test could not go to other countries because it had not been approved. “This is just paperwork,” she said.Emily Anthes contributed reporting.

Artificial intelligence (AI) will fundamentally change medicine and healthcare: Diagnostic patient data, e.g. from ECG, EEG or X-ray images, can be analyzed with the help of machine learning, so that diseases can be detected at a very early stage based on subtle changes. However, implanting AI within the human body is still a major technical challenge. TU Dresden scientists at the Chair of Optoelectronics have now succeeded for the first time in developing a bio-compatible implantable AI platform that classifies in real time healthy and pathological patterns in biological signals such as heartbeats. It detects pathological changes even without medical supervision. The research results have now been published in the journal Science Advances.
In this work, the research team led by Prof. Karl Leo, Dr. Hans Kleemann and Matteo Cucchi demonstrates an approach for real-time classification of healthy and diseased bio-signals based on a biocompatible AI chip. They used polymer-based fiber networks that structurally resemble the human brain and enable the neuromorphic AI principle of reservoir computing. The random arrangement of polymer fibers forms a so-called “recurrent network,” which allows it to process data, analogous to the human brain. The nonlinearity of these networks enables to amplify even the smallest signal changes, which — in the case of the heartbeat, for example — are often difficult for doctors to evaluate. However, the nonlinear transformation using the polymer network makes this possible without any problems.
In trials, the AI was able to differentiate between healthy heartbeats from three common arrhythmias with an 88% accuracy rate. In the process, the polymer network consumed less energy than a pacemaker. The potential applications for implantable AI systems are manifold: For example, they could be used to monitor cardiac arrhythmias or complications after surgery and report them to both doctors and patients via smartphone, allowing for swift medical assistance.
“The vision of combining modern electronics with biology has come a long way in recent years with the development of so-called organic mixed conductors,” explains Matteo Cucchi, PhD student and first author of the paper. “So far, however, successes have been limited to simple electronic components such as individual synapses or sensors. Solving complex tasks has not been possible so far. In our research, we have now taken a crucial step toward realizing this vision. By harnessing the power of neuromorphic computing, such as reservoir computing used here, we have succeeded in not only solving complex classification tasks in real time but we will also potentially be able to do this within the human body. This approach will make it possible to develop further intelligent systems in the future that can help save human lives.”
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Materials provided by Technische Universität Dresden. Note: Content may be edited for style and length.

A stress signal received by the heart from fat could help protect against cardiac damage induced by obesity, a new study led by UT Southwestern researchers suggests. The finding, published online in Cell Metabolism, could help explain the “obesity paradox,” a phenomenon in which obese individuals have better short- and medium-term cardiovascular disease prognoses compared with those who are lean, but with ultimately worse long-term outcomes.
“The mechanism we have identified here could be one of many that protects the heart in obesity,” said study leader Philipp E. Scherer, Ph.D., Professor of Internal Medicine and Cell Biology at UTSW who has long studied fat metabolism.
Study co-leader Clair Crewe, Ph.D., Assistant Instructor of Internal Medicine at UTSW, explained that the metabolic stress of obesity gradually makes fat tissue dysfunctional, causing its mitochondria — the cellular organelles that generate energy — to shrink and die. Eventually, this unhealthy fat loses the ability to store lipids generated by excess calories in food, poisoning other organs through an effect called lipotoxicity. Some organs, including the heart, appear to mount a preemptive defense to protect against lipotoxicity. But how the heart senses fat’s dysfunctional state has been unknown.
In their study, Dr. Crewe, Dr. Scherer, and their colleagues used a genetic technique to speed the loss of mitochondrial mass and function in mice. When these animals ate a high-fat diet and became obese, the researchers found that the rodents’ fat cells began sending out extracellular vesicles filled with small pieces of dying mitochondria. Some of these mitochondrial snippets traveled through the bloodstream to the heart, triggering oxidative stress, a state in which cells generate harmful free radicals.
To counteract this stress, heart cells produce a flood of protective antioxidant molecules. This protective backlash was so strong that when the scientists injected mice with extracellular vesicles filled with mitochondrial snippets and later induced a heart attack, the animals had significantly less damage to their hearts compared with mice that didn’t receive an injection.
Further research using fat tissue sampled from obese patients showed that these cells also release mitochondria-filled extracellular vesicles, Dr. Crewe said, suggesting that the effects observed in mice also take place in humans.
Eventually, she explained, the heart and other organs in obese individuals become overwhelmed by lipotoxic effects, leading to many of obesity’s comorbidities. However, learning how to artificially generate the protective mechanism identified in this study could lead to new ways to buffer obesity’s negative consequences. This knowledge could even suggest strategies to protect the heart against damage in lean individuals as well.
“By better understanding the distress signal from fat,” Dr. Crewe said, “we may be able to harness the mechanism to improve heart health in obese and non-obese individuals alike.”
Other researchers who contributed to this study include Jan-Bernd Funcke, Shujuan Li, Nolwenn Joffin, Christy M. Gliniak, Alexandra L. Ghaben, Yu A. An, Hesham A. Sadek, Ruth Gordillo, Yucel Akgul, Shiuhwei Chen, and Christine M. Kusminski, all of UTSW; Dmitri Samovski and Samuel Klein of Washington University School of Medicine in St. Louis; and Pamela Fischer-Posovszky of Ulm University Medical Center in Germany.
Dr. Sadek holds the J. Fred Schoellkopf, Jr. Chair in Cardiology.Dr. Scherer is the Gifford O. Touchstone, Jr. and Randolph G. Touchstone Distinguished Chair in Diabetes Research and the Touchstone/West Distinguished Chair in Diabetes Research.
This study was supported by National Institutes of Health (NIH) grants R01-DK55758, R01-DK127274, R01-DK099110, RC2-DK118620 and P01-AG051459.

When was the last time you had your blood pressure checked? High blood pressure affects 1.13 billion people around the globe and in 2019, it accounted for 10.8 million deaths. Worldwide, it’s the leading risk factor for mortality. More than a third of the Australian population over the age of 18 has high blood pressure, yet it’s estimated 50 per cent of Australians don’t realise they’re living with it.
As high blood pressure puts you at high risk of having a heart attack or stroke (cardiovascular disease), it’s important to keep track of your blood pressure. People over the age of 18 are advised to have a blood pressure check at least every two years.
Given the impact of this global health challenge, there is a clear need for strategies to reduce the prevalence and severity of high blood pressure, and exercise is one such strategy. While aerobic and dynamic resistance exercise appear effective at reducing blood pressure, a new study led by UNSW Medicine & Health researchers has revealed isometric resistance training (IRT) as an emerging mode of exercise demonstrating effectiveness in reducing office blood pressure. Office blood pressure refers to your pressure when taken during a GP visit, for example. It is taken at one time-period, usually when you’re sitting down.
What is isometric resistance training?
IRT is a type of strength training. During IRT, the muscles produce force but do not change length. For example, pushing against a wall or holding a ‘plank’. This is different to more traditional strength training like a squat or a push up or where muscles shorten and lengthen during the movement.
Currently, IRT is not recommended by several international guidelines for the management of high blood pressure. This was mostly due to concerns over its safety because the static nature of IRT causes blood pressure to increase markedly during exercise, particularly when performed using large muscle groups or at high intensity, compared to traditional strength exercise such as lifting weights or aerobic exercise such as walking or cycling.

Mammalian sperm cannot fertilize an egg from the get-go. It’s an ability acquired only after insemination, during passage through the female reproductive tract, and requires two consecutive, time-sensitive processes to provide sperm with the physical and biochemical traits necessary to complete their fundamental job.
The first process is called capacitation, which alters the physiology of each spermatozoa, changing the membrane of the head to help it penetrate the hard, outer layer of an egg — the zona pellucida — and chemistry in the tail to generate greater motility, the ability to move and swim.
The second process is acrosome reaction (AR), a chemical action that involves releasing enzymes in the spermatozoa’s head that further boost penetration of the zona pellucida.
Both processes are essential to successful fertilization of an egg, and AR is time-dependent: It cannot take place too early or too late. Indeed, premature AR has been associated with idiopathic (spontaneous) male infertility.
Neither process, however, is well understood in terms of the underlying molecular mechanisms involved. In a new paper, publishing August 19, 2021 in the journal eLife, a team of researchers at University of California San Diego School of Medicine detail how GIV/Girdin, a ubiquitous signaling molecule plays a critical role in male fertility, orchestrating capacitation and AR to promote sperm motility, survival and fertilization success.
Specifically, the research team, led by senior author Pradipta Ghosh, MD, professor in the departments of Medicine and Cellular and Molecular Medicine at UC San Diego School of Medicine, found that GIV — a member of the G protein family that serve as molecular switches inside cells, transmitting and fine-tuning signals — regulates the activity of enzymes that turn on and turn off the processes of capacitation and AR.
“The findings demonstrate how GIV orchestrates distinct signaling programs in sperm that separated by space and time, effectively supporting capacitation while inhibiting premature AR,” said Ghosh. “As a result, GIV plays an essential role in male fertility.”
Infertility affects an estimated 8 to 12 percent of couples globally, with males being a primary or contributing factor in roughly half of all cases, according to published studies. Causes of male infertility are multiple, but roughly 25 percent involve either sperm transport disorders or idiopathic factors in sperm with no apparent dysfunction.
“GIV is required for male fertility, and low levels of GIV transcripts in men is invariably associated with infertility,” said Ghosh. “We’ve found evidence that GIV may perform different roles in the capacitation of sperm, findings that shed new light on both how defective GIV-signaling might be used as a potential marker for male infertility and how inhibitors of GIV-dependent signaling inhibit fertility by reducing sperm motility and viability and by promoting premature acrosome reaction.
“The latter, ironically enough, may be a promising strategy for development of a male contraceptive pill specifically targeting sperm.”
Co-authors include: Sequoyah Reynoso, Vanessa Castillo, Gajanan D. Katkar, Inmaculada Lopez-Sanchez, Sahar Taheri, Celia R. Espinoza, Christina Rohena, Debashis Sahoo and Pascal Gagneux, all at UC San Diego.
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Materials provided by University of California – San Diego. Original written by Scott La Fee. Note: Content may be edited for style and length.

A microphysiological system (MPS), also known as an organ-on-a-chip, is a 3D organ construct using human cells that help reveal how organs respond to drugs and environmental stimuli.
Now, Tohoku University researchers have developed a new analytical method that visualizes cell functions in MPS using scanning probe microscopy (SPM).
SPM differs from optical microscopy since it employs fine probe scanning over a sample surface and then exploits the local interactions between the probe and the surface. The biggest advantage of SPM over conventional microscopy is that physical and chemical conditions can be acquired rapidly and as a high-resolution image.
In this study, SPMs evaluated a vascular model (vasculature-on-a-chip) by scanning electrochemical microscopy (SECM) and scanning ion conductance microscopy (SICM). Using these SPMs, the researchers quantified the permeability and topographical information of the vasculature-on-a-chip.
“MPS shows potential to recapitulate the physiology and functions of their counterparts in the human body. Most research on this topic has focused on the construction of biomimetic organ models. Today, there is an increasing interest in developing sensing systems for MPS” said first author Yuji Nashimoto.
Some have touted electrochemical sensors to monitor MPS. However, most electrochemical sensors cannot acquire the spatial information of cell functions in MPS because they have only one sensor per one analyte. In contrast, SPM provides spatial information about cell functions rapidly.
“Our research group has developed various electrochemical imaging tools, SPMs and electrochemical arrays,” explained corresponding author Hitoshi Shiku.
“These devices will help usher in next-generation sensors in MPS.”
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Materials provided by Tohoku University. Note: Content may be edited for style and length.

Millions of people across the African continent are at risk of contracting COVID-19 because of a lack of the most basic public health tools to protect themselves — including the essentials of soap and water.
These measures — known as non-pharmacological public health interventions (NPIs), and including physical distancing or isolation at home to prevent transmission — are among the simplest and least expensive methods to slow the spread of SARS-CoV-2, the virus that causes COVID-19. Yet huge numbers of Africa’s roughly 1.4 billion people do not have access to these tools, researchers said.
“Hundreds of millions of people across Africa simply lack means for implementing NPIs to prevent SARS-CoV-2 transmission,” said Dr. Timothy Brewer, UCLA Fielding School of Public Health professor of epidemiology and professor of medicine, and a member of the Division of Infectious Diseases, at the David Geffen School of Medicine at UCLA. “These populations urgently need to be prioritized for vaccination to prevent disease and to contain the global pandemic.”
The findings — published this month in the peer-reviewed journal Epidemiology & Infection, as “Housing, sanitation and living conditions affecting SARS-CoV-2 prevention interventions in 54 African countries” -are from an international team, led by Brewer and colleagues at the University of Bristol, and including researchers in China, Ethiopia, Mexico, South Africa, Spain, Sweden, the United Kingdom, and the U.S.
As of now, COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in some 7.3 million cases and 185,505 deaths across the continent. Globally, nearly 210 million cases and 4.4 million deaths have been reported in more than 200 countries, although total mortality due to COVID-19 may be as high as 7 million deaths. The global COVID-19 case fatality ratio approximates that of the 1918 H1N1 Influenza pandemic.
“SARS-CoV-2 spreads primarily by respiratory droplets generated by coughing, sneezing or talking,” Brewer said. “Until effective vaccines are universally available, NPIs are the principal means by which governments prevent SARS-CoV-2 transmission in their populations.”
In addition to isolation of those infected and contact tracing and quarantine for those exposed, the World Health Organization (WHO) recommends physical distancing, masking in public places and hand washing as important NPIs that countries should employ for COVID-19 prevention and control. Laboratory-based and observational studies suggest that physical distancing and the wearing of face masks may reduce SARS-CoV-2 transmission by at least 80%.
“These findings illustrate the substantial barriers many African households face in keeping safe from SARS-CoV-2 infection because of living conditions that preclude their ability to quarantine, isolate or maintain physical distancing and because of substantial obstacles to handwashing,” said Dr. Jody Heymann, a UCLA distinguished professor of public health, public policy, and medicine who serves as director of the Fielding School’s WORLD Policy Analysis Center (WORLD). “Crucially, the findings raise the urgency of getting vaccines rapidly to all countries in Africa, which lag far behind, and for addressing the underlying conditions of poverty that place populations at increased risk from respiratory virus outbreaks and pandemics.”
Across the 54 countries, approximately 718 million people live in households with more than six individuals at home. Approximately 283 million people live in households where more than three people slept in a single room. An estimated 890 million Africans lack on-site water, while 700 million lack in-home soap/washing facilities.
“The pandemic has exposed structural inequalities in almost all spheres, from health to the economy, security to social protection,” said study co-author Yehualashet Mekonen, director of the African Child Observatory Program at the African Child Policy Forum (ACPF). “Girls in the continent have particularly felt its impact with far reaching consequences on their life trajectories including higher risks for early marriage, drop out from school and reduced access to reproductive health services.”
The researchers also made the point that despite the structural and resource issues faced by governments in Africa, some nation’s responses to COVID have been among the best in the world.
“Unfortunately, impoverished living conditions mean that it is almost impossible for many people in African countries to follow public health advice and protect themselves from the virus,” said co-author Dr. David Gordon, with the University of Bristol in the United Kingdom. “European and North American countries need to stop hoarding millions of doses of vaccines that they will never be able to use and make them available to people in Africa.”

Some evidence suggests it might help soothe a sunburn, but the research is thin, and there’s not always a guarantee that what you’re buying is real.As ongoing heat waves extend beach weather for many in the United States, you may find yourself sporting a bad sunburn. And perhaps, you might head to your local drugstore to pick up a bottle of aloe to soothe it.The aloe vera plant (also called Aloe barbadensis) is a cactus-like succulent that grows in hot, dry places. For thousands of years, people have been extracting the gel from its long, spiky leaves and using it as a salve for a variety of ailments, such as burns, abrasions, skin sores and more. The gel, which is mainly water, contains dozens of vitamins, enzymes, amino acids and other compounds that may have various medicinal effects.But while the global aloe vera gel market reached about $625 million in 2020 and is expected to grow in the coming years, the potions found in drugstores have had their fair share of controversy. In July, testing revealed that some CVS-brand aloe products were contaminated with benzene, a carcinogenic substance. And earlier testing found that some aloe products, found in retail stores and online, didn’t contain any aloe at all. That, paired with little solid data on how well aloe works to soothe a bad burn, as well as limited federal regulation on what’s in over-the-counter products, has led some to wonder if they should seek it out.Here’s what we know.Will aloe help a sunburn?It might, but the evidence is spotty. In 2012, Oliver Grundmann, a pharmaceutical chemist at the University of Florida’s College of Pharmacy, conducted a review of 18 clinical trials on the use of aloe for a variety of conditions — burns, genital herpes, dandruff, psoriasis — and found some evidence that it might have anti-inflammatory effects when used on a sunburn.In one randomized trial of 40 people published in 2008, for example, researchers exposed the lower backs of participants with ultraviolet rays and treated the resulting redness with four different substances — a 97.5-percent aloe vera gel, a 1-percent hydrocortisone gel, a 1-percent hydrocortisone cream and a placebo gel (with nothing in it). After 48 hours under a bandage, the aloe gel seemed to be more effective at reducing skin redness than the hydrocortisone gel, but less effective than the hydrocortisone cream (which stays on the skin longer and is easier to absorb than a gel).Other studies have found that people with first- and second-degree burns may heal faster with aloe than they would with other types of treatments like topical antibiotics. And though animals aren’t humans, some rodent studies have found promising results. In one published in June, researchers used a hot iron bar to induce second-degree burns on a small area on the backs of anesthetized rats and found that, compared with stem-cell injections, aloe gel shortened the time it took for the burns to heal. Another rat study from 2014 showed reduced inflammation with aloe treatment on induced UV burns.Not all studies have shown benefits, though. One small one from 2005, for example, found that applying aloe vera cream to the UV-induced burns of 20 people twice a day for three weeks was not effective at healing the burn.Aloe falls into the category of treatments that has some evidence to back it up, but not a ton, said Dr. Laura Ferris, a dermatologist at the University of Pittsburgh and a fellow of the American Academy of Dermatology. “I think it is fair to recommend with the caveat that it will help cool the skin and there is a chance it may expedite healing,” she said. “But we don’t have the type of large, rigorous studies we rely upon in medicine to be able to quantify the benefit or to recommend a specific product.”What does this mean for the aloe products I find in drugstores?In research studies, scientists typically use gels and creams that have precise concentrations of aloe, Dr. Ferris said. But because over-the-counter aloe products are considered cosmetics, they aren’t strictly regulated by the Food and Drug Administration and are not standardized in this way. So the quality of what you get can vary, and the benefits found in research studies may not directly apply to the aloe products you can find online or in drugstores.And, the products you buy are not guaranteed to contain any aloe at all. In 2016, for instance, Bloomberg published the findings of an investigation into four store-brand aloe gels sold by Walmart, Target, CVS and Walgreens. After laboratory tests looked for three chemical markers of aloe — acemannan, malic acid and glucose — they found that three of the four products tested (from Walmart, Target and CVS) contained no evidence of aloe. One product, sold by Walgreens, had a single marker for aloe, malic acid, but experts said it wasn’t enough to prove aloe’s presence. The testing did identify an ingredient called maltodextrin, a moisturizing plant-based sugar that is sometimes used as a cheaper alternative to aloe, in the Walmart, Target and CVS products.Similarly, a 2015 study commissioned by ConsumerLab.com, found aloe in only half of 10 aloe pills, gels and drinks that it tested (You can find the full list of products tested here). “Some were very good, and some had virtually none of the aloe compounds,” said Dr. Tod Cooperman, the president and founder of ConsumerLab.com.Recent testing has also found that some aloe products were contaminated with harmful substances. In July, CVS paused the sale of two aloe vera products (the CVS Health After Sun Aloe Vera and the CVS Health After Sun Aloe Vera Spray) after testing revealed low levels of benzene, a known carcinogen that has recently also been found in some spray sunscreens. When inhaled, benzene has been found to cause leukemia and other types of cancers, though few studies have examined exactly how harmful it is when applied to the skin.“We are committed to ensuring the products we offer are safe, work as intended, comply with regulations and satisfy customers,” a spokesman for CVS said via email.Is This A Scam?

Cardiovascular genetic testing in children presents unique challenges, requiring pre- and post-test counseling with an individualized approach for families, ideally with the involvement of a specialized interdisciplinary team, according to a new American Heart Association scientific statement published today in the Association’s journal Circulation: Genomic and Precision Medicine. Scientific statements represent the synthesis of data and a consensus of the leading experts, designed to address gaps in guidelines.
This is the first American Heart Association scientific statement providing guidance specifically about genetic testing of cardiovascular diseases in children. In addition to previous statements issued by the Association on genetic testing mostly focused on adults, it was important to issue a pediatric-focused statement with the recognition that children and their families face unique challenges specific to pediatric gene testing, according to the statement writing group.
“There is growing recognition that a genetic test is not a simple blood test where you get a yes or no answer. With this statement, we illustrate some of that complexity, particularly as it relates to cardiovascular diseases passed from parents to children,” said Andrew P. Landstrom, M.D., Ph.D., FAHA, chair of the statement writing group, a pediatric cardiologist, a cardiovascular geneticist and an assistant professor of pediatrics and cell biology at Duke University School of Medicine in Durham, North Carolina. “We provide consensus-based recommendations for best practices and principles to assist health care professionals in determining when cardiovascular gene testing is appropriate in children, highlighting the need for a multi-disciplinary approach to family counseling before and after testing, and we raise the importance of appropriate follow-up.”
The statement writing group noted that pre-test counseling is essential in genetic testing of children. Before a decision is made about genetic testing, counseling should be held with the parents and with the child, if the child is old enough to fully comprehend and able to contribute to the decisions. Counseling should cover the possible benefits of genetic testing and the limits of the test’s ability to help with diagnosis and management, along with the possible outcomes of testing, including the potential impact on care. Pre-test counseling should address the possibility that the genetic results may be inconclusive since there is still much to be discovered about the genetic components of many diseases of the heart. Clinicians must collaborate with the family to be prepared for all scenarios, before testing is conducted — including a positive genetic test, a negative test or whether the test is inconclusive.
Pre-test counseling is also the time to address family concerns about possible medical costs or the possibility that genetic test results could lead to discrimination or an inability to obtain health insurance in the future. The statement details federal laws families should know about that can help to alleviate some of these concerns.
Post-test counseling and follow-up are also essential, according to the statement. After genetic test results are in, post-test counseling can be a time to explain the findings and plan how the information can be used in caring for the person affected, as well as proceeding with testing or treatment for other members of the family. Ongoing follow-up, possibly over the course of a lifetime, is also important because, in the rapidly evolving field of genetics, the understanding of a specific gene’s significance may change over time.