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Holly Elgison and Len Schillaci are a mixed vaxxed couple, and they are far from alone.“I was always going to get the vaccine, 100 percent,” said Ms. Elgison, a medical claims auditor in Valrico, Fla.Her husband, a disaster insurance adjuster, said he will pass. “To be honest with you, I think that the worst of Covid is behind us,” Mr. Schillaci said. “I’m good.”As the Biden administration seeks to get 80 percent of adult Americans immunized by summer, the continuing reluctance of men to get a shot could impede that goal.Women are getting vaccinated at a far higher rate — about 10 percentage points — than men, even though the male-female divide is roughly even in the nation’s overall population. The trend is worrisome to many, especially as vaccination rates have dipped a bit recently.The reasons for the U.S. gender gap are many, reflecting the role of women in specific occupations that received early vaccine priority, political and cultural differences and long standing patterns of women embracing preventive care more often generally than men.The gap exists even as Covid-19 deaths worldwide have been about 2.4 times higher for men than among women. And the division elucidates the reality of women’s disproportionate role in caring for others in American society.“It could matter to localized herd immunity,” said Alison Buttenheim, an associate professor of nursing at the University of Pennsylvania and expert on vaccine hesitancy. “While most experts are fretting about larger gaps by race, political party, religion and occupational group,” she said, many of which overlap with the gender disparities, “I haven’t heard of any specific initiatives to target men.”In Los Angeles County, where 44 percent of women over 16 have gotten their first shot — compared with 30 percent of men — officials are scrambling to figure out how to do just that.“We are very concerned about it and are planning to embark on some targeted outreach among men,” said Dr. Paul Simon, the chief science officer at the Los Angeles County Department of Public Health, who said that the disparities are of particular concern for Black and Latino men. Only 19 percent of Black males in Los Angeles County and 17 percent of Latino males have received at least one dose of the vaccine, compared with 35 percent of Asian men and 32 percent of white men, according to the most recent data available from early this month.“We don’t fully understand it,” Dr. Simon said. “One of our messaging strategies will be that the vaccine is not only important for you but, in addition, is a means of protecting others in your family.”In Los Angeles County, 44 percent of women over 16 had gotten their first shot — compared with about 30 percent of men.Frederic J. Brown/Agence France-Presse — Getty ImagesThe early divisions in vaccine rates by gender could largely be explained by demographics. Americans over 70 got the first sets of doses, and women make up a larger proportion of that age group. In many states, health care workers and schoolteachers were also given vaccine priority: Women account for three-quarters of full-time health care workers and over 75 percent of public schoolteachers in the United States are female.The disparities show both where women do the paid and unpaid labor of life. For instance, women lost the majority of the earliest jobs in food services, retail businesses, health care and government jobs. The mothers among them have done most of the work in the shift to remote schooling and caring for parents and sick relatives.The combination may have increased their vaccine motivation in two ways: They are seeking to protect the rest of their family and they are desperate to get back in the work force. Indeed, just as women drove the job losses last year, they are leading the economic recovery now; roughly half a million women joined the labor force in March, in part because in-person schooling has resumed across much of the country.“In addition to women being disproportionately represented in several essential jobs,” said Pilar Gonalons-Pons, an assistant professor of sociology at the University of Pennsylvania who specializes in gender issues, “they are also disproportionately represented as unpaid caregivers for older adults in their families and communities, and this can also be an additional motivation for getting the vaccine.”In many ways, the pattern with vaccines reflects longstanding gender differences when it comes to preventive health care. Women are on average more likely to get annual physicals than men, even when adjusted for pre-existing health conditions and other factors, and are more likely than men to get preventive care.Men are more likely than women to engage in behaviors that hurt their health — like heavy drinking, smoking and illicit drug use — and are more overweight compared to women. Men are less likely to visit doctors regularly and go to the emergency room in a crisis and to get basic dental care, according to federal data. Vaccines are no exception: Historically, influenza vaccination is much higher among females — about 63 percent compared to 53 percent — though the gap narrows in Americans over 75 years old.The coronavirus vaccine “is the latest expression of the tried-and-true gender gap we’ve long witnessed in preventive health care seeking patterns,” said Lindsey Leininger, a health policy researcher and clinical professor at Tuck School of Business at Dartmouth College.But experts say that even in the context of general male health care recalcitrance, there may be some factors that are specific to this vaccine that are preventing more male shots in arms. Because the sign up has been cumbersome and confusing, men may have had less patience in navigating the system, which has largely taken place online, a process that women might find easier since they tend to get more of their health care information online.“We have to figure out if disparities are about access, if men are having more difficulty navigating the appointment systems,” Mr. Simon of Los Angeles said.Further, when it comes to the coronavirus — which has been the subject of rampant misinformation, evolving medical advice and politicization — other dynamics may be at work.“Some men have a sense that they are not necessarily susceptible,” Mr. Simon said health care workers have told officials. “They have weathered this for more than a year and have a sense of omnipotence.”Public health and academic experts have been long concerned with the “macho” effect that prevents men from getting all sorts of health care, and fear that it might be exacerbated with this vaccine. (Notably, in the most male service branch of the military, the Marines, about 40 percent of those who were offered the vaccine by the Defense Department have turned it down.)A selfie after receiving a Covid shot at the First Baptist Church of Glenarden in Upper Marlboro, Md., last month.Erin Schaff/The New York Times“This avoidance has been linked to masculinity ideals of men being strong, invincible and not asking for help,” said Kristen W. Springer, an associate professor in the Department of Sociology at Rutgers University in New Jersey who has done research on this trait.“In other words, these cultural ideals lead men to avoid important health care in order to act masculine,” she said. “Now that the vaccine is available to everyone, it will be interesting to watch male-female differences in vaccine uptake, because these will more likely reflect social and cultural ideas about gender and health, such as the cultural idea that ‘real men’ don’t need preventive health care.”At this stage, U.S. health authorities have not released data on nonbinary adults and vaccination.There may also be political connections. Women are far more likely than men to register as Democrats, and polls demonstrate that Republicans across the country have been far less likely than Democrats to embrace the vaccine.So who will men listen to? Not their wives and female friends or doctors, it seems. For their recent preprint study, Leah Witus and Erik Larson, professors at Macalester College in Saint Paul, Minn., watched videos with men and women that featured identical information about the vaccine. Among the 1,184 Americans who watched them, most were positively influenced by the male narrator while the female narrator got a far more mixed response.“The male-narrated version of the video increased vaccination intention in viewers,” said Ms. Witus, “but the female-narrated had mixed associations with vaccine propensity, and in some viewers, those that identified as conservative, actually decreased vaccination intention.”This may spell victory for Mr. Schillaci as he and his wife subtly joust for influence over their 20-year-old son’s vaccination decision. Mr. Schillaci has been sharing his views with his son, whom his wife is prodding to take a shot.“I would rather he got the shot, and I hope that he’ll consider it,” said Ms. Elgison.But Ms. Elgison’s own decision may benefit her son, even if he decides against the vaccine.As often happens in life, men may find their gaps covered by women. “To the extent most people live and socialize in a mixed-gender setting, the men will benefit from the higher coverage among women,” Ms. Buttenheim said.Ms. Elgison, however, still has a trump card she hopes might work. “I would like my son to get it so we can all travel together,” she said. “I explained to him that it’s possible that we could protect his dad.”

Note: Figures reflect weekly totals of positive flu tests, from public and clinical laboratories.·Source: Centers for Disease Control and Prevention […]

A synthetic DNA vaccine candidate for Middle East respiratory syndrome coronavirus (MERS-CoV) developed at The Wistar Institute induced potent immune responses and afforded protective efficacy in non-human primate (NHP) models when given intradermally in abbreviated, low-dose immunization regimen. A similar vaccine candidate was previously shown to be safe and tolerable with a three-dose intramuscular injection regimen in a recently completed human phase 1 study and is currently in expanded studies of phase 1/2a trial.
New results were published today in JCI Insight.
“While several vaccine products are being advanced against MERS and other coronaviruses, low-dose delivery and shortened regimes are crucial to rapidly induce protective immunity, particularly during emerging outbreaks, as the current SARS-CoV-2 pandemic has emphasized,” said David B. Weiner, Ph.D., Wistar executive vice president, director of the Vaccine & Immunotherapy Center (VIC) and W.W. Smith Charitable Trust Professor in Cancer Research, who led the study.
Researchers evaluated the immunogenicity and protective efficacy of their MERS synthetic vaccine when delivered intradermally using a shortened two-dose immunization schedule compared with intramuscular delivery of higher doses in NHP.
“Given that human efficacy trials for MERS vaccines may be challenging due to the low number of yearly cases, animal models such as our NHP model are valuable as a bridge with human data coming from early-phase clinical trials,” said Weiner.
In this study, Weiner and team report robust antibody neutralizing antibodies and cellular immune responses in all conditions tested. A rigorous virus challenge experiment showed that all vaccination groups were protected against MERS-CoV compared to unvaccinated control animals. However, the low-dose regimen with intradermal delivery was more impactful in controlling disease and symptoms than the higher dose delivered intramuscularly in NHP models.
“To our knowledge, this is the first demonstration of protection with an intradermally delivered coronavirus vaccine,” said Ami Patel, Ph.D., Caspar Wistar Fellow at the Vaccine & Immunotherapy Center and one of the lead authors of the paper. “Intradermal delivery of synthetic DNA vaccines has significant advantages for rapid clinical development. It can be dose sparing and has higher tolerability in people compared with intramuscular injection. The positive results of this study are important not only for the advancement of this MERS vaccine but also for development of other vaccines.”
“Our team is also advancing a COVID-19 vaccine through clinical trials, and we were able to do so in a very short time thanks to our previous experience developing the MERS vaccine,” added Weiner.
Importantly, no evidence of adverse effects on the lungs was observed in any of the dosing groups compared to unimmunized control animals. Through the assessment of a large panel of blood cytokines, researchers showed significant decrease in all mediators of inflammation, which further suggests the vaccine prevents the destructive inflammation induced by coronaviruses.
“In the past twenty years, three new coronaviruses have emerged and caused human outbreaks. The current SARS-CoV-2 pandemic has further emphasized the importance of rapid infection control for coronaviruses and other emerging infectious diseases,” said Emma L. Reuschel, Ph.D., a staff scientist in the Weiner lab and co-first author on the study. “Vaccine candidates that are simple to deliver, well tolerated, and can be readily deployed in resource-limited settings will be important to achieve control of infection.”
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Research has identified critical factors that enable dangerous bacteria to spread disease by surviving on surfaces in hospitals and kitchens.
The study into the mechanisms which enable the opportunistic human pathogen Pseudomonas aeruginosa to survive on surfaces, could lead to new ways of targeting harmful bacteria.
To survive outside their host, pathogenic bacteria must withstand various environmental stresses. One mechanism is the sugar molecule, trehalose, which is associated with a range of external stresses, particularly osmotic shock — sudden changes to the salt concentration surrounding cells.
Researchers at the John Innes Centre analysed how trehalose is metabolised by P. aeruginosa to define its role in protection against external stresses.
Combining analytical biochemistry and reverse genetics — using mutated bacteria lacking key functions — they show that trehalose metabolism in P. aeruginosa is connected to biosynthesis of the carbon storage molecule glycogen.
Experiments showed that disruption of either trehalose or glycogen pathways significantly reduced the ability of P. aeruginosa to survive on human-made surfaces such as kitchen or hospital counters.
The study found that while both trehalose and glycogen are important for stress tolerance in P. aeruginosa they counter distinct stresses: trehalose helps the bacteria to survive in conditions of elevated salt; glycogen contributes to survival in dry (desiccated) environments.
The findings raise the possibility of targeting the trehalose and glycogen pathways to limit pathogen survival on human-made surfaces.
“We have shown how a dangerous human pathogen Pseudomonas aeruginosa responds to environmental challenges, such as salt stress or drying out. Disrupting the production of certain stress-tolerance sugars in this bug significantly reduces its ability to survive on kitchen and hospital worksurfaces,” said corresponding author of the study Dr Jacob Malone.
An unexpected finding was how the bacteria operates different pathways for different stresses, said Dr Malone: “Conventional wisdom says that trehalose was responsible for both phenotypes, but we have shown that trehalose only protects against osmo-stress and glycogen is needed to protect against desiccation. We were also surprised to see such a marked drop in surface survival when we disrupted the pathways in the bugs.”
The next step for the research is to understand how trehalose and glycogen metabolic pathways are regulated in P. aeruginosa and closely related species. The group also wants to understand how glycogen accumulation allows the bacteria to survive in dry environments and provide more explanation of how and when different parts of the pathways are turned on and off.
P. aeruginosa is a significant pathogen in animals as well as humans. In humans it primarily affects immunocompromised individuals, where it is a major cause of pneumonia and hospital-acquired infections. Chronic P. aeruginosa infections occur in 80% of adult cystic fibrosis patients, where it is the primary cause of morbidity and mortality.
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Engineers have developed a new material that mimics human cartilage — the body’s shock absorbing and lubrication system, and it could herald the development of a new generation of lightweight bearings.
Cartilage is a soft fibrous tissue found around joints which provides protection from the compressive loading generated by walking, running or lifting. It also provides a protective, lubricating layer allowing bones to pass over one another in a frictionless way. For years, scientists have been trying to create a synthetic material with the properties of cartilage.
To date, they have had mixed results.
But in a paper published in the journal Applied Polymer Materials, researchers at the University of Leeds and Imperial College London have announced that they have created a material that functions like cartilage.
The research team believes a cartilage-like material would have a wide-range of uses in engineering.
Cartilage is a bi-phasic porous material, meaning it exists in solid and fluid phases. It switches to its fluid phase by absorbing a viscous substance produced in the joints called synovial fluid. This fluid not only lubricates the joints but when held in the porous matrix of the cartilage, it provides a hydroelastic cushion against compressive forces.

In rare cases, people who have been fully vaccinated against COVID and are immune to the virus can nevertheless develop the disease. New findings from The Rockefeller University now suggest that these so-called breakthrough cases may be driven by rapid evolution of the virus, and that ongoing testing of immunized individuals will be important to help mitigate future outbreaks.
The research, published this week in the New England Journal of Medicine, reports results from ongoing monitoring within the Rockefeller University community where two fully vaccinated individuals tested positive for the coronavirus. Both had received two doses of either the Moderna or the Pfizer vaccine, with the second dose occurring more than two weeks before the positive test. One person was initially asymptomatic and then developed typical COVID-19 symptoms; the other developed symptoms prior to testing. Both individuals recovered at home, an outcome consistent with evidence suggesting vaccination is effective in preventing severe disease.
Genome sequencing revealed multiple mutations in both viral samples, including the E484K variant in one individual, first identified in South Africa and Brazil, and the S477N variant in the other individual, which has been spreading in New York since November.
“These patients got vaccinated, had great immune responses, and nonetheless broke through with a clinical infection,” says Robert B. Darnell, The Robert and Harriet Heilbrunn Professor, who led the research with immunologist Michel C. Nussenzweig, virologist Paul Bieniasz, and geneticist Richard P. Lifton. The researchers were able to discern a quantifiable amount of virus in saliva samples from routine testing ongoing at Rockefeller, and sequence the viral RNA using a new coronavirus testing method developed in Darnell’s lab by postdoctoral associate Ezgi Hacisuleyman with help from senior research associate Nathalie Blachere. Since January, the university has required all employees working on-site to be tested weekly using this saliva-based PCR assay.
The observations suggest what is likely a small but ongoing risk among vaccinated individuals, and the possibility that they may continue to spread the virus.
“The idea that we could be entirely done with testing in the post-vaccine world is probably not a good one right now; for example, even fully vaccinated people who develop respiratory symptoms should consider getting tested for COVID-19,” says Darnell. “Conversely, exposure to individuals with known infection, even if fully vaccinated, should be taken seriously and again individuals should consider getting tested.”
“Given the scope of the pandemic, there’s a huge amount of virus in the world right now, meaning a huge opportunity for mutations to develop and spread,” he adds. “That is going to be a challenge for the developers of vaccines over the next months and years.”
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In the arms race “humankind against bacteria,” bacteria are currently ahead of us. Our former miracle weapons, antibiotics, are failing more and more frequently when germs use tricky maneuvers to protect themselves from the effects of these drugs. Some species even retreat into the inside of human cells, where they remain “invisible” to the immune system. These particularly dreaded pathogens include multi-resistant staphylococci (MRSA), which can cause life-threatening diseases such as sepsis or pneumonia.
In order to track down the germs in their hidouts and eliminate them, a team of researchers from Empa and ETH Zurich is now developing nanoparticles that use a completely different mode of action from conventional antibiotics: While antibiotics have difficulty in penetrating human cells, these nanoparticles, due to their small size and structure, can penetrate the membrane of affected cells. Once there, they can fight the bacteria.
Bioglass and metal
The team of Inge Herrmann and Tino Matter has used cerium oxide, a material with antibacterial and anti-inflammatory properties in its nanoparticle form. The researchers combined the nanoparticles with a bioactive ceramic material known as bioglass. Bioglass is of interest in the medical field because it has versatile regenerative properties and is used, for example, for the reconstruction of bones and soft tissues.
They then synthesized flame-made nanoparticle hybrids made of cerium oxide and bioglass. The particles have already been successfully used as wound adhesives, whereby several interesting properties can be utilized simultaneously: Thanks to the nanoparticles, bleeding can be stopped, inflammation can be dampened and wound healing can be accelerated. In addition, the novel particles show a significant effectiveness against bacteria, while the treatment is well tolerated by human cells.
Recently, the new technology was successfully patented. The team has now published its results in the scientific journal Nanoscale in the “Emerging Investigator Collection 2021.”
Destruction of germs

As the COVID-19 pandemic has progressed, it has become clear that many survivors — even those who had mild cases — continue to manage a variety of health problems long after the initial infection should have resolved. In what is believed to be the largest comprehensive study of long COVID-19 to date, researchers at Washington University School of Medicine in St. Louis showed that COVID-19 survivors — including those not sick enough to be hospitalized — have an increased risk of death in the six months following diagnosis with the virus.
The researchers also have catalogued the numerous diseases associated with COVID-19, providing a big-picture overview of the long-term complications of COVID-19 and revealing the massive burden this disease is likely to place on the world’s population in the coming years.
The study, involving more than 87,000 COVID-19 patients and nearly 5 million control patients in a federal database, appears online April 22 in the journal Nature.
“Our study demonstrates that up to six months after diagnosis, the risk of death following even a mild case of COVID-19 is not trivial and increases with disease severity,” said senior author Ziyad Al-Aly, MD, an assistant professor of medicine. “It is not an exaggeration to say that long COVID-19 — the long-term health consequences of COVID-19 — is America’s next big health crisis. Given that more than 30 million Americans have been infected with this virus, and given that the burden of long COVID-19 is substantial, the lingering effects of this disease will reverberate for many years and even decades. Physicians must be vigilant in evaluating people who have had COVID-19. These patients will need integrated, multidisciplinary care.”
In the new study, the researchers were able to calculate the potential scale of the problems first glimpsed from anecdotal accounts and smaller studies that hinted at the wide-ranging side effects of surviving COVID-19, from breathing problems and irregular heart rhythms to mental health issues and hair loss.
“This study differs from others that have looked at long COVID-19 because, rather than focusing on just the neurologic or cardiovascular complications, for example, we took a broad view and used the vast databases of the Veterans Health Administration (VHA) to comprehensively catalog all diseases that may be attributable to COVID-19,” said Al-Aly, also director of the Clinical Epidemiology Center and chief of the Research and Education Service at the Veterans Affairs St. Louis Health Care System.

A new study shows that a 20-year-old drug prevents scarring in mice. If it works on humans, it could change the lives of those with disfiguring wounds.Cleft palates that close without scars. Burn wounds that recover without a trace of injury. Years-old disfiguring scars that disappear, leaving skin smooth and flawless.It sounds like science fiction, but healing without scarring may become a tantalizing possibility. In a study published Thursday in Science, two researchers at Stanford University report that they have figured out the molecular signals that make scars form and found a simple way to block them — at least in mice.A 20-year-old drug, verteporfin, already on the market as an intravenous treatment for macular degeneration, can prevent scarring if it is injected at the edge of a wound.As the verteporfin-treated wounds heal, the skin that forms looks perfectly normal, nothing like skin that heals with scars, those lumpy wound closures that are not only unsightly but also much weaker than normal skin and have no hair, or oil and sweat glands.The study involved mice, but the researchers, Dr. Michael Longaker, Stanford’s vice chair of surgery, and Geoffrey Gurtner, Stanford’s vice president of surgery for innovation, have now moved on to pigs, whose skin is closest to that of humans. With these new subjects, the surgeons made an incision as wide as a thumb and five inches long. When they sutured the cut and injected verteporfin around the edge, there was dramatically less scarring.“It’s pretty spectacular,” Dr. Longaker said.Researchers who study wounds and who were not associated with the study were enthusiastic.“It is unusual for me to read a paper and say, ‘Wow, this is really a major advance,’” said Valerie Horsley, a tissue developmental biologist at Yale who studies wound healing. “But this is a major advance.”Marjana Tomic-Canic, director of the wound healing and regenerative medicine program at the University of Miami Miller School of Medicine, said that the study is “really a leap,” adding, “everyone will get excited about this work.”Dr. Longaker said that he hoped to get permission from the Food and Drug Administration by the end of the year to test the safety and efficacy of the drug in babies with cleft lips and palates.For Dr. Longaker, speed is of the essence if the treatment works and is safe. “I don’t want this to be a 10-year journey,” he said.Stanford has filed patents for the use of verteporfin in scar formation.Although verteporfin is available, and doctors can prescribe drugs for unapproved uses, Dr. Longaker says that it’s crucial to wait for F.D.A. approval before using the drug to try to prevent scars.“Obviously we want to help patients as soon as possible,” he said. “But we’ve got to make sure this drug is tested in a way that ensures safety and efficacy.”The history of medicine, he said, offers a sobering picture of treatments that looked good in animals but failed in clinical trials.If the drug works on humans, the discovery stands to be lucrative and life transforming. Hundreds of millions of people are seriously scarred each year, and many of those scars are disfiguring — from accidents, as well as from heart bypass surgeries, mastectomies and burns.“Scars in general cause pain and itching and prevent us from moving the way we should,” said Dr. Benjamin Levi, a burn specialist who directs the Center for Organogenesis and Trauma at the University of Texas Southwestern Medical Center. The possibility of blocking the scarring process “has huge potential,” he said.Dr. Jason A. Spector, professor of plastic surgery and otolaryngology at Weill Cornell Medical College, said that when he does reconstructive surgery on patients with head and neck cancer, many “are more concerned about the scar through their lip and skin than about the cancer itself.”Dr. Longaker’s obsession with scars began with an experiment in 1987 as a new postdoctoral fellow in the lab of Dr. Michael R. Harrison at the University of California, San Francisco. Dr. Harrison, who was studying fetal surgery, suggested that Dr. Longaker operate on a fetal lamb two-thirds of the way through pregnancy and then return the fetus to its mother’s womb to continue developing.Dr. Longaker gasped when he later delivered the baby lamb. Its skin was intact. There were no scars to be seen.“I will never forget that moment,” he said.He went on to become a pediatric plastic surgeon and saw firsthand the scarring on children after they had undergone operations for cleft lips or palates. And he ran a lab devoted to figuring out how to prevent scars.He learned that for the first two trimesters of fetal life, skin is gelatinous, “like a bowl of Jell-O,” Dr. Longaker said. Then, as the fetus develops to live outside the sterile liquid world of the womb, the skin forms a barrier to prevent water loss and block the entry of microorganisms. At that point, breach of the skin barrier could be deadly, so the body switches on a system that lets it quickly seal it.But there is a trade-off for speed in healing a wound, Dr. Longaker noted. “The cost is loss of form and function.” And scar formation.Dr. Tomic-Canic described the process: When there is a wound, the strong muscle under the skin contracts and brings the edges of the wound together. A clot forms as a temporary barrier over the wound, and under it, the body makes thick coils of collagen rope that form a bridge so skin cells can migrate across the gap and fill in the opening. Those collagen ropes remain — they are the scar.As molecular biology and molecular genetics advanced, Dr. Longaker seized on the new tools to probe the molecular pathways needed to form scars. The key starting point for scarring is mechanical tension when a wound tears skin that should be taut. (Older people with loose skin are less likely to scar because their skin is under less tension.) The tear in the layers of skin prompts a type of skin cell — fibroblasts — to create collagen ropes and initiates a chain reaction of molecular events inside the skin cells. The reactions culminate in the activation of a protein called YAP, for Yes-associated protein. YAP then binds to DNA, and scarring begins.Dr. Longaker and Dr. Gurtner bred mice without the YAP protein. Because mice have loose skin, the two had to hold the wounds open with a ring, like an embroidery hoop, to mimic the tension in human skin. The wounds healed. No scars.They then asked: Could verteporfin have the same effect as the absence of YAP? So in another experiment, they wounded mice that could make YAP and once again held the loose skin taut with rings. They injected verteporfin around the wound. They waited to see what would happen.Dr. Longaker remembers the moment. “Holy guacamole,” he said. The healed wounds looked just like normal skin. They were the same under the microscope. They grew hair. They had oil glands.His imagination soared. He might be able to prevent scars with a few quick injections of verteporfin. And there was no reason to think he couldn’t go even farther. A patient who had a disabling and disfiguring scar could go to a surgeon who could dab the scar with lidocaine to numb the skin, cut open the scar, inject verteporfin around the edges, and close the wound. Would it reheal without the scar?“That could change their lives,” Dr. Longaker said.Dr. Spector said he doubted all doctors would wait until F.D.A. approval if early clinical data supported the laboratory studies. Some are sure to jump ahead and try it because there is nothing now to stop scarring.Dr. Longaker hopes doctors hold off. Clinical trials must come first, he stressed, and safety must be assured.“I get it,” he said. “No one is more excited than me.”“To be honest,” he added, “I’ve been waiting for 34 years. I would love to use it. This is a big deal. But that doesn’t mean we shortcut the process.”

How to cope with a less cautious world as pandemic restrictions loosen.Amy Beigel, a fifth-grade teacher in Charlotte, N.C., has already had Covid-19. Her husband did, too. And now both of them have received their first dose of the vaccine. But when she thinks about gathering with other people outdoors this summer, she hesitates.The desire to see friends and extended family is definitely there, said Ms. Beigel, 40, a mother of four. “But then we shoot the idea down.”There are the weighty questions: “What if people came and did get sick?” she asked. The social awkwardness: “You don’t want to put undue pressure on someone.” And the logistical details: “Do you serve food?”“I don’t know,” she said. “Maybe it’s too complicated.”For the last year, public health experts have told us time and again that if you don’t socially distance and wear a mask, you could die. So, as more people get vaccinated and we accelerate toward a new normal, is it any wonder that some people are feeling hesitant to let go of those precautions?The official recommendations have already started to change. The Centers for Disease Control and Prevention now says that fully vaccinated people can travel safely in the United States; and that people in a fully vaccinated household can visit an unvaccinated household indoors without masks or social distancing, provided that they are at low risk for severe Covid-19. As we approach summer, the agency may further loosen guidelines if coronavirus cases plummet.We asked experts how best to ease back into society as our worlds broaden beyond life at home.If you don’t want to jump into the pool, dip your toe in first.For those who have remained cautious throughout the pandemic, it’s normal to feel unmoored by fewer safety precautions.“It would be disingenuous for us to say, ‘Eh, you’re fine. Go for it, it’s all good now,’” said Dr. Joshua Barocas, an infectious diseases physician at Boston Medical Center.Instead, find incremental ways of phasing back into interactions with people, he recommended.Dr. Barocas likened it to jumping into a cold swimming pool. If you can’t bring yourself to do a cannonball, first you dip one toe in and enter gradually.Sharrona Pearl, 43, who lives in Philadelphia and is fully vaccinated, said she recently decided that it felt OK to have a cup of tea indoors with a vaccinated friend.“I have three kids who are not vaccinated,” she said. “It’s really hard because they can’t have friends over for play dates, right? They just can’t. It’s not OK. So here I am doing it — that’s sort of frustrating for them.”Hosting a friend indoors is just one of “dozens of points of re-entry,” said Ellen Hendriksen, a clinical psychologist in Boston and the author of “How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety.”You might start out by taking public transportation once a week, for example, or visiting the grocery store more often. Eventually, you might gradually work your way up to something like a wedding or a graduation.This is assuming, of course, that you want to do these things.If you don’t yet, that’s OK. But it’s best to address your worries if they are preventing you from living the way that you want to live, or keeping you from activities that give your life meaning and purpose.Anxiety is maintained by avoidance and driven by uncertainty, Dr. Hendriksen said.Don’t wait for the anxiety to go away.As long as things you want to do are considered safe or very low risk, don’t wait until the day when you have zero anxiety about doing them.“Feeling anxious doesn’t mean you’re in danger, doesn’t mean something is wrong,” Dr. Hendriksen said. In fact, she added, it is a normal part of entering post-pandemic life.It can be helpful to engage in calming, validating self-talk, suggested Lina Perl, a clinical psychologist in New York City. Speak to yourself in a safe, reassuring voice, much like an encouraging parent might do with their child on the first day of school.Ask yourself, “What kind of world do I want to live in? Have I done all the things I have to do to make me safe?” Dr. Perl said. Then think about the tough things you’ve done before and how you pushed through them.“In order to live in the world, you need to be able to tolerate a certain amount of uncertainty and a certain amount of risk,” she said. When you start doing something new, “It can be uncomfortable, but the more you do it, the less power it has over you.”“Think of your nervous system like a pet,” she added. Train your nervous system to recognize that you are not in danger by doing the very activities that might make you a little anxious. Once you’re in that situation, try to stay there until the anxiety starts to fade, she said.But if your anxiety is bringing disproportionate distress or your life is impaired in some way, the experts said you may want to speak with a therapist or other trusted support person like a religious leader, who can guide and nudge you in a positive direction.You do not have to replicate what you did in the ‘before times.’One positive aspect of the pandemic is that it has made us question the things in our lives that were draining, such as overbooking our social calendar or commuting to work five days a week, and embrace positive things like spending more time with family. It also led to new habits that help us avoid disease, such as mask-wearing, which wasn’t typically done in the United States.Even after coronavirus cases and death rates plummet, you can choose to hold on to some of the current public health recommendations if it helps ease your fears. Frequent hand-washing? Great, that’s beneficial against a host of pathogens. Wearing face masks during the winter? It’s not only reasonable but prudent if you take public transportation regularly or live in a place with high population density. Some people might also choose to continue to wear masks in any situation where they are surrounded by large groups of people. Others might forgo handshakes in favor of elbow taps or a hand-over-heart gesture.Don’t compare yourself to what other people are doing or look to others for the right answer. “That, I think, actually creates more of an anxious churn,” Dr. Perl said.Let go of resentment.As the adage goes, you cannot control other people, only yourself. Anger, frustration and resentment toward people who either ignore public health guidelines or behave differently than you do will only raise your stress level.Instead of thinking, “Those people should be wearing a mask right now,” try thinking, “I wish those people were wearing a mask.” The two statements are similar, but the latter can help temper our emotional reaction, Dr. Hendriksen said.The C.D.C. continues to recommend masks and distancing in most situations. But when you’re outside and at least six feet from other people, the risks of contracting Covid-19 are very low even if nobody is wearing a mask, experts say. That’s especially true if you are vaccinated.Prioritize activities that help reduce anxiety.If you developed a love affair with processed foods and neglected fruits and vegetables during lockdown, start incorporating healthy foods back into your diet. And if you stopped exercising during the pandemic, start moving again. By taking care of your body you are also taking care of your mind.Dr. John Ratey, an associate clinical professor of psychiatry at Harvard Medical School who studies the effects of exercise on the brain, said aerobic exercise like a simple bike ride or brisk walk can help people with chronic anxiety or even those who are nervous about an upcoming test or an important meeting.Exercise elevates brain activity, he said: “With that, you elevate the concentration of all these good neurotransmitters and neurohormones that we have that help us feel better, feel calmer, feel less anxious.”See how you feel after putting in a half-hour of yoga or 15 minutes of aerobic exercise, Dr. Ratey said. Eventually, “you will increase your resilience and your ability to take challenges like going out without a mask or visiting your kids or your grandkids when everybody has the vaccine,” he said. “But it’s going to be a transition period, for sure.”