Publisher Health

When a DNA test revealed a decades-old family secret, Maia’s life was turned upside down. What she learned next was even more disturbing.Maia and her sister now believe a fertility doctor used his own sperm to artificially inseminate their mother – and he may be the biological father to many others. This is how her family’s life has changed since the discovery.Video by Angélica M Casas

A 30-year-old man says he “jumped at the chance” when he was offered a Covid-19 jab earlier than expected.Lawrence Dixon, from Cardiff, said he signed up to the reserve list in the morning and received a phone call in the evening asking if he wanted to come down for a vaccine.Dr Emma Ynhell, also 30 and from Cardiff, received the jab after she spotted people “chatting about it on social media” and signed up to the reserve list.Cardiff and Vale health board said it was a mistake that people in their 30s had been offered reserve slots so soon.Although she said it was important no doses of vaccines went to waste, Ms Meredith told BBC Radio Wales that staff had been reminded to give older people the opportunity first.

Keeping the middle seats vacant during a flight could reduce passengers’ exposure to airborne coronavirus by 23 to 57 percent, researchers reported in a new study that modeled how aerosolized viral particles spread through a simulated airplane cabin.But the study may have overestimated the risks of traveling on a fully occupied plane, critics said, because it did not take into account mask-wearing by passengers.“It’s important for us to know how aerosols spread in airplanes,” said Joseph Allen, a ventilation expert at Harvard T.H. Chan School of Public Health who was not involved in the study. But he added, “I’m surprised to see this analysis come out now, making a big statement that middle seats should stay open as a risk-reduction approach, when the model didn’t include the impact of masking. We know that masking is the single most effective measure at reducing emissions of respiratory aerosols.”Although scientists have documented several cases of coronavirus transmission on planes, airplane cabins are generally low-risk environments because they tend to have excellent air ventilation and filtration.Still, concern has swirled around the risk of airplane travel since the pandemic began. Planes are confined environments, and full flights make social distancing impossible. Some airlines began keeping middle seats vacant as a precaution.The new paper, published Wednesday in the Morbidity and Mortality Weekly Report, is based on data collected at Kansas State University in 2017. In that study, the researchers sprayed a harmless aerosolized virus through two mock airplane cabins. (One was a five-row section of an actual single-aisle plane; the other was a mock-up of a double-aisle wide-bodied plane.) The researchers then monitored how the virus dispersed through each cabin.For the new study, researchers from Kansas State and the Centers for Disease Control and Prevention used the 2017 data to model how passengers’ exposure to an airborne virus would change if every middle seat remained open in a 20-row single-aisle cabin.Depending on the specific modeling approach and parameters they used, keeping the middle seats vacant reduced the total exposure passengers experienced in the simulation by 23 to 57 percent, compared with a fully occupied flight.This reduction in risk stemmed from increasing the distance between an infectious passenger and others as well as from reducing the total number of people in the cabin, which lowers the odds that an infectious passenger would be aboard in the first place.The laboratory experiments on virus dispersal in aircraft cabins were conducted several years before the current pandemic began, and did not account for any protection that wearing masks could provide.Masking would reduce the amount of virus that infectious passengers emit into the cabin air and would likely lower the relative benefit of keeping middle seats open, Dr. Allen said.The researchers acknowledge that the study has limitations, but they say that their results suggest that “physical distancing of aircraft passengers, including through policies such as middle-seat vacancy,” could be one of several strategies for reducing air passengers’ exposure to the virus.The cost-benefit analysis is tricky for airlines. But purely from a health perspective, keeping middle seats open would be helpful, providing a buffer between an infectious person and others nearby, according to Alex Huffman, an aerosol scientist at Denver University who was not involved in the study. “Distance matters, for both aerosols and droplets,” he said.

Vanessa Kirby’s Oscar-nominated performance involves an extended sequence that these experts say gets some things right — and a few wrong.In the movies, birth is usually an emergency. It begins with the woman’s water breaking, at the worst possible moment. She appears to be barely in labor, and yet she is rushed, through gridlock traffic, to the hospital. There she becomes angry, and the pain is her husband’s fault. She yells at him, perhaps even injures him, and orders him to get a vasectomy. Then she begs for an epidural, but for some reason, she can’t have it. After four minutes of intense screaming, she’s handed something that looks like the Gerber baby.The recent Netflix film “Pieces of a Woman,” featuring an Oscar-nominated performance by Vanessa Kirby, tries to subvert this narrative, with a naturalistic home birth scene that occupies almost a quarter of the movie. The extended sequence, which ultimately has a tragic outcome, has gotten midwives talking, especially because film and television can deeply influence the expectations of couples who have never had a baby. In a handful of interviews, midwives across the country applauded the naturalistic birth as a new frontier in screen depictions, even as they argued that several details fell short of a fully empowered experience.As the labor scene begins, Martha (Kirby) is leaning against a stove, her contractions intensifying. Her partner, Sean, played by Shia LaBeouf, rushes around her, asking repeatedly if she wants water. They eventually move to the living room, where he cradles her in his lap. “I think I might throw up,” she says, burping and gagging.Hannah Epstein, a midwife nurse practitioner in San Francisco, said that what struck her about the scene is what many other movies leave out: “You never see labor, only birth.” She said that some patients worry they might not know when they’re in labor, and others think labor is entirely pushing. “Pieces of a Woman” helped correct those misconceptions. “It was a good early-labor depiction of that uncomfortable, icky” feeling, she said, noting that nausea and vomiting in labor are also extremely common.After offering words of encouragement, Martha’s midwife (played by Molly Parker) suggests that they move to the tub. Angelina Ruffin-Alexander, a midwife in Atlanta, was pleased to see water included in the labor, a technique that reduces the stress of labor pain. “You’re trying to create a sense of calm and a sense of peace,” she said.In the tub, Martha asks Sean for music and explains how she wants the lights dimmed. Stephanie Tillman, a midwife nurse practitioner and clinical medical ethics fellow in Chicago, applauded this exchange. “There’s not always a positive depiction of how parents interact with each other,” she said. “I appreciated seeing how the partner supported her, especially moving around the space with her.”Showing labor in a bathtub was important to one midwife, who said water can help reduce the stress of pain.Benjamin Loeb/NetflixWith ambient music in the background, Martha pushes her forehead against Sean’s, and they speak in hushed voices. According to Epstein, this quiet tone is more accurate than the chaos she’s used to seeing onscreen. She described the labor and birth process as “whispery, soft, breathy, and not a ton of words” as women try to conserve their energy.After about three minutes in the tub, Martha begins to shake, and a low groan evolves into a deep, animalistic grunt. The midwife asks her, “Are you feeling like you want to push?”To Tillman, “this was a really good portrayal of the physiology.” She added, “People will go from nauseous to body shaking, legs shaking. That’s the result of a natural change in hormones.” Martha moves to the bed, but before the pushing phase begins, the midwife does a pelvic exam. “I’m just going to check your cervix and see where you’re at, OK?” she asks, but proceeds without receiving an answer. “Ow!” Martha responds, to which the midwife says “I know, I know, sorry babe,” and continues. Later, the midwife tells her “Just rest, honey,” and while she’s pushing repeatedly encourages her by saying “Attagirl!”Tillman, who studies consent in intimate health care, said she found this exchange “very disheartening,” as well as a missed opportunity to show a properly conducted pelvic exam. “It’s exactly what I try to unteach physicians,” she said. Consent in pelvic exams should work similarly to consent during sex, Tillman explained: Providers should get a clear yes before beginning an exam. If a patient expresses pain, she said, they should stop and investigate.Tillman also found the midwife’s terms of endearment “patronizing, belittling and misogynistic,” though common. “It reinforces a power dynamic between patients and providers,” she said. “It implies ‘I have knowledge or social status or power over you,’ rather than ‘You and I are working together.’” To Epstein, this language was “very cringey.”A “Grey’s Anatomy” episode relied on tropes like a woman yelling at her partner and the health-care provider. Jessica Brooks/ABC, via Getty ImagesSeveral midwives were critical of showing Martha delivering on her back in bed, when in reality women may give birth squatting, on their hands and knees, on their side, in water, or even holding onto a pole. Roberto Caldeyro-Barcia, a pioneering doctor in the field of childbirth, once wrote that “except for being hanged by the feet, the supine position is the worst for delivery.”Vicki Elson, a childbirth anthropologist and educator who studies depictions of birth in the media, said that she first became interested in the topic when a 1995 episode of “E.R.” about a mother’s death in labor led to a surge in calls to midwives from worried parents. “My job is to undo the fear that people have learned from the culture,” she said in an interview.“The mass media is quite dangerous,” she added. “It sets up expectant parents to think they’re going to experience something dangerous and harrowing. And that can have a physical effect on you in labor. When you’re afraid, your body tenses up, and doesn’t work as well with natural hormones.”Such portrayals, as well as scenes that show mothers’ lack of agency, show up onscreen regularly, whether in “Mother!” (2017), in which Jennifer Lawrence labors in the midst of a nightmarish mob, or a 2019 episode of “Grey’s Anatomy” in which a woman arrives at the hospital in a police car and screams at both her partner and the health-care provider during delivery.So how can filmmakers depict a natural, healthy and focused birth, while also maintaining tension and drama? “It’s dramatic to follow someone flipping their body around in 10 directions,” Tillman said. “It’s dramatic to help a partner or family member catch their own family member.”Other midwives described a range of birth scenarios they would like to see depicted, like women giving birth surrounded by family members, or laboring alone. Epstein also pointed out that while “Pieces of a Woman” depicts a white woman’s dehumanizing experience, when it comes to births that result in tragedy, “it’s striking how much more common that is for people of color.” Epstein and other midwives called for more depictions of women of color giving birth.The midwives interviewed were hopeful that future films and television would portray women as having agency, rather than being out of control and dependent on others.In the end, Sander said, what makes an empowering birth scene is actually quite simple: It’s people in the room “listening to women and what they want.”

Amid a deep residue of mistrust, Western cautions on the AstraZeneca and Johnson & Johnson vaccines risk igniting an explosion of damaging anti-vaccine fervor in the global south.Far beyond the United States and Europe, the safety scares engulfing the AstraZeneca and Johnson & Johnson vaccines have jeopardized campaigns to inoculate the world, undercutting faith in two sorely needed shots and threatening to prolong the coronavirus pandemic in countries that can ill afford to be choosy about vaccines.With new infections surging on nearly every continent, signs that the vaccination drive is in peril are emerging, most disconcertingly in Africa.In Malawi, people are asking doctors how to expunge the AstraZeneca vaccine from their bodies.In South Africa, health officials have paused giving the Johnson & Johnson shot, the only one they have, a repeat blow after dropping AstraZeneca from their arsenal in February.And in the Democratic Republic of Congo, not a single person has been vaccinated, despite 1.7 million doses of the AstraZeneca shot languishing in the country since March 2.In those countries and others, Western colonialism and unethical medical practices have left a residue of mistrust in vaccines, which could harden if the perception takes hold that rich countries are dumping second-rate shots on the global south.Already, doctors say, the recent pauses have vindicated vaccine skeptics and made many others feel duped.“People, especially those who were vaccinated, felt like they had been tricked in a way — they were asking, ‘How do we get rid of the vaccine in our body?’” said Precious Makiyi, a doctor and behavioral scientist in Malawi, where health workers have been racing to empty their shelves of nearly expired AstraZeneca doses. “We fought so hard with vaccine messaging, but what has happened this past week has brought us back to square zero.”Police officers guarding AstraZeneca vaccines after a shipment arrived last month in Lilongwe, the capital of Malawi.Thoko Chikondi/Associated PressAfrican health officials have reacted with fury at the breezy reassurances of American and European lawmakers that people denied the AstraZeneca or Johnson & Johnson shots could be given another vaccine. In much of the world, there are no other vaccines.And even as American health officials stressed that they paused use of the Johnson & Johnson vaccine on Tuesday in “an abundance of caution,” they forced global health officials to begin crafting the difficult case that shots unsafe for the world’s rich were still suited to its poor. “It’s sending vaccine confidence into a crater,” Ayoade Alakija, co-chair of the African Union’s Africa Vaccine Delivery Alliance, said of rich countries’ actions. “It’s irresponsible messaging, and it speaks to the selfishness of the moment that there wouldn’t be more consultation and communication.”What rich countries call caution, poorer nations will experience as a devastating gamble with the survival of their citizens against Covid-19. “Out of an abundance of caution, let us not destroy vaccine confidence in places that only have access to one type of vaccine,” Dr. Alakija said.The AstraZeneca and Johnson & Johnson vaccines, cheaper and easier to store than the alternatives, are mainstays of global inoculations. AstraZeneca’s shot is being used in at least 118 countries. Lately, amid shortages of that vaccine, some regions have pivoted to Johnson & Johnson’s: Two weeks ago, the African Union acquired 400 million doses.Together, the two vaccines account for a third of the portfolio of Covax, the international effort to procure and distribute vaccines.But it is becoming more apparent by the day that those shots, built on a relatively rugged vaccine platform, are becoming afterthoughts in wealthy nations. After canceling Johnson & Johnson appointments over concerns about rare blood clots, American states offered people the pricier Pfizer or Moderna vaccines instead. The European Union said on Wednesday that it had acquired another 50 million doses of the Pfizer vaccine, allowing it to curb use of AstraZeneca’s vaccine and phase it out altogether next year.Those decisions, intended for domestic audiences, have nevertheless reverberated in countries where variants are spreading, physical distancing is a luxury and there is no choice of shots. Health officials fear that any setbacks in vaccinations could sow the seeds of the next calamitous outbreak, one that deluges hospitals and exports new mutations around the world. In those places, doctors said, the math is obvious: Many more people will die without the AstraZeneca and Johnson & Johnson vaccines than with them.Amid the clotting concerns, the World Health Organization and African Union have not wavered in recommending the use of the AstraZeneca and Johnson & Johnson’s vaccines. In Britain, AstraZeneca’s vaccine remains the backbone of the country’s speedy inoculation campaign, despite people under 30 being offered alternatives. Congo, after spurning the AstraZeneca shot in light of unease in Europe, said on Tuesday that it would launch the much-delayed inoculations next week.A vaccination center inside Salisbury Cathedral, in Salisbury, England, in January. Britain has forged ahead with the AstraZeneca vaccine, though restricting its use to people aged 30 and above.Andrew Testa for The New York TimesAnd in Dakar, the capital of Senegal, people continued to line up on wooden benches on Wednesday for the AstraZeneca shot as they watched their children run through the corridors of a medical center.“We don’t have a choice,” said Alioune Badara Diagne, 34, who lives in the city’s lively Ouakam neighborhood. Despite talk of vaccination pauses in wealthy nations and rumors of vaccine makers using Africans as “guinea pigs,” he said, Westerners themselves were continuing to be injected. He added, “The vaccine is our only hope.”But in much of the world, the American regulators who endorsed Tuesday’s pause on Johnson & Johnson vaccinations act as sort of surrogate decision makers on drugs and vaccines, giving their hesitation extra weight in African nations.“I became even more skeptical when I heard that the United States suspended Johnson & Johnson,” said Lawmond Lawse Nwehla, 32, an engineer in Dakar. “They said it was effective and then they stopped it. So I wonder why.”In immediately pausing the use of Johnson & Johnson’s shot, American regulators reacted more aggressively than did their British counterparts, who backed the AstraZeneca vaccine even as they investigated clotting cases..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-rqynmc{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.9375rem;line-height:1.25rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-rqynmc{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-rqynmc strong{font-weight:600;}.css-rqynmc em{font-style:italic;}.css-yoay6m{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}@media (min-width:740px){.css-yoay6m{font-size:1.25rem;line-height:1.4375rem;}}.css-1dg6kl4{margin-top:5px;margin-bottom:15px;}.css-16ed7iq{width:100%;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;-webkit-box-pack:center;-webkit-justify-content:center;-ms-flex-pack:center;justify-content:center;padding:10px 0;background-color:white;}.css-pmm6ed{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;}.css-pmm6ed > :not(:first-child){margin-left:5px;}.css-5gimkt{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.8125rem;font-weight:700;-webkit-letter-spacing:0.03em;-moz-letter-spacing:0.03em;-ms-letter-spacing:0.03em;letter-spacing:0.03em;text-transform:uppercase;color:#333;}.css-5gimkt:after{content:’Collapse’;}.css-rdoyk0{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-eb027h{max-height:5000px;-webkit-transition:max-height 0.5s ease;transition:max-height 0.5s ease;}.css-6mllg9{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;position:relative;opacity:0;}.css-6mllg9:before{content:”;background-image:linear-gradient(180deg,transparent,#ffffff);background-image:-webkit-linear-gradient(270deg,rgba(255,255,255,0),#ffffff);height:80px;width:100%;position:absolute;bottom:0px;pointer-events:none;}#masthead-bar-one{display:none;}#masthead-bar-one{display:none;}.css-1pd7fgo{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-1pd7fgo{padding:20px;width:100%;}}.css-1pd7fgo:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-1pd7fgo{border:none;padding:20px 0 0;border-top:1px solid #121212;}.css-1pd7fgo[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-1pd7fgo[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-1pd7fgo[data-truncated] .css-5gimkt:after{content:’See more’;}.css-1pd7fgo[data-truncated] .css-6mllg9{opacity:1;}.css-1rh1sk1{margin:0 auto;overflow:hidden;}.css-1rh1sk1 strong{font-weight:700;}.css-1rh1sk1 em{font-style:italic;}.css-1rh1sk1 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#ccd9e3;text-decoration-color:#ccd9e3;}.css-1rh1sk1 a:visited{color:#333;-webkit-text-decoration-color:#ccc;text-decoration-color:#ccc;}.css-1rh1sk1 a:hover{-webkit-text-decoration:none;text-decoration:none;}The costs of the American approach were already evident in Europe, where many nations stopped and then restarted AstraZeneca vaccinations, only to find that it had become a pariah. Most people in France, Germany and Spain distrusted the vaccine.“Once you take the cork out of the bottle, I’m not sure you can get it back in particularly easily,” said Anthony Cox, a vaccines safety expert at the University of Birmingham in England. South Africa immediately copied the American pause on Johnson & Johnson vaccinations, infuriating doctors who are still clamoring for shots, especially in remote parts of the country. In February, health officials dropped the AstraZeneca vaccine over its limited efficacy against a dangerous variant there.To date, only half of 1 percent of the population is vaccinated, and a mere 10,000 shots are being given each day. At that rate, it could take weeks, if not longer, for a single rare blood clotting case to emerge, said Jeremy Nel, an infectious disease doctor in Johannesburg. He was dismayed by the decision to pause shots, given the risk to vaccine confidence in a country where two-fifths of the people say they have no intention of being vaccinated.“The slower you go, that failure is measured in death,” Dr. Nel said. “Even if you delay for a week, there is a non-trivial chance that will cost lives.”The solution in many European countries — to stop using seemingly riskier vaccines in younger people, who are at lower risk from Covid-19 — would be unworkable in Africa, where the median age in many countries is below 20.And any further restrictions would compound the hurdles facing Covax, among them a paucity of funding for every part of inoculation programs beyond the touchdown of doses at airports.Mali, in western Africa, has administered 7 percent of the AstraZeneca doses that Covax has delivered. Sudan, in eastern Africa, has given 8 percent of the doses it has received.Skittishness over the AstraZeneca and Johnson & Johnson vaccines, analysts fear, could stoke demand for Russian- and Chinese-made shots about which far less is known. As it is, some global health officials have turned their attention to the Novavax vaccine, which is not yet authorized but makes up a third of Covax’s portfolio.“Even at this stage of the pandemic, we have our fingers crossed that some vaccine will work to help vaccinate developing countries, instead of ramping up production of vaccines we know work,” said Zain Rizvi, an expert on medicines access at Public Citizen, an advocacy group.In Kenya, where enthusiasm for vaccines is high in cities but perilously low in rural areas, “the story about blood clots from Europe could not have come at a worse time,” said Catherine Kyobutungi, the director of the African Population and Health Research Center there. “Even those who were perhaps on the fence, and leaning toward getting vaccinated, all of a sudden had second thoughts,” she said.The American pause on Johnson & Johnson shots promised a second media furor.“When the F.D.A. suspends, it makes headlines for days,” she said. “When it lifts the suspension, it doesn’t make as many headlines.”Mady Camara contributed reporting from Dakar, Senegal.

Bruising caused by physical abuse is the most common injury to be overlooked or misdiagnosed as non-abusive before an abuse-related fatality or near-fatality in a young child. A refined and validated bruising clinical decision rule (BCDR), called TEN-4-FACESp, which specifies body regions on which bruising is likely due to abuse for infants and young children, may improve earlier recognition of cases that should be further evaluated for child abuse. Findings were published in the journal JAMA Network Open.
“Bruising on a young child is often dismissed as a minor injury, but depending on where the bruise appears, it can be an early sign of child abuse,” said lead author Mary Clyde Pierce, MD, a pediatric emergency medicine physician and the Research Director for the Division of Child Abuse Pediatrics at Ann & Robert H. Lurie Children’s Hospital of Chicago, and Professor of Pediatrics and Preventive Medicine at Northwestern University Feinberg School of Medicine. “We need to look at bruising in terms of risk. Our new screening tool helps clinicians identify high-risk cases that warrant evaluation for child abuse. This is critical, since abuse tends to escalate and earlier recognition can save children’s lives.”
According to the study findings, the bruising screening tool TEN-4-FACESp reliably signals high risk for abuse when bruising appears on any of the following regions. “TEN” stands for torso, ear, and neck. “FACES” specifies facial features — frenulum (skin between upper lip and the gum, lower lip and the gum, and under the tongue), angle of jaw, cheeks (fleshy), eyelids, and subconjunctivae (red bruise on white part of the eye). The “p” is for patterned bruising, when, for example, bite marks or the shape of the hand is visible on the child’s skin. The “4” represents any bruising anywhere to an infant 4.99 months of age or younger. Importantly, the rule only applies to children with bruising who are younger than 4 years of age. This screening tool is a refined version of TEN-4, previously developed by Dr. Pierce.
This multi-center study was made possible through a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). In the study, Dr. Pierce and colleagues screened for bruising in over 21,000 children younger than 4 years of age at five pediatric emergency departments. They enrolled 2,161 patients with bruising. Researchers found that the TEN-4-FACESp screening tool had a sensitivity of 95 percent and specificity of 87 percent, which means that it distinguished potential abuse from non-abuse with high level of accuracy.
“It was very important to us to make sure that the screening tool captures potential abuse without over-capturing innocent cases of children with bruising caused by accidental or incidental injury,” said Dr. Pierce. “We are excited that it proved to be highly reliable, and it is simple enough to be applied during any clinical encounter. A skin exam in infants and young children is essential.”
The evidence behind the TEN-4-FACESp BCDR will soon be available as an app developed by Dr. Pierce and co-author Kim Kaczor, expected to launch by October 2021. The app will present a rotatable 3-D image of a child’s body. When a clinician clicks on an area of a patient’s bruise, a summary of study results will appear that allows comparison of the clinicians patient with the actual data from this large scale study with the goal of helping the user decide whether the bruise is a red flag for abuse. The app is in no way meant to supplant judgment but to provide evidence-based guidance to inform decision making.
Dr. Pierce cautions that TEN-4-FACESp is not negative for abuse in children without bruising. It is simply not relevant in those circumstances and other methods of identifying abuse would be needed.
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A new state-by-state analysis shows a statistical association between high adherence to mask wearing and reduced rates of COVID-19 in the U.S. Charlie Fischer and colleagues at the Boston University School of Public Health in Massachusetts present these findings in the open-access journal PLOS ONE on April 14.
During the COVID-19 pandemic, different states have enacted different policies on mask wearing, with some states having no mask requirements and others requiring masks in all public spaces. Understanding the link between mask wearing and COVID-19 rates could help inform policies to mitigate stress on healthcare systems, economic instability, and death.
To help clarify the effects of mask wearing, Fischer and colleagues examined publicly available data on mask-wearing policies, people’s self-reported habits on mask wearing in public, and COVID-19 rates for all 50 U.S. states and Washington, D.C. They accounted for a one-month delay between mask wearing and its subsequent potential impact on COVID-19 rates from May through October 2020. For this analysis, they considered rates of more than 200 cases per 100,000 residents to be high.
The analysis showed that, out of 15 states that did not require people to wear masks in public, 14 had high COVID-19 rates. Meanwhile, eight states had self-reported adherence rates of 75 percent of greater, and none of these states had a high COVID-19 rate. States with the lowest adherence rates had the greatest likelihood of high COVID-19 rates in the subsequent month.
The eight states with at least 75-percent adherence to mask wearing had a mean COVID-19 rate of 109.26 per 100,000 residents in the subsequent month, while the mean COVID-19 rate was 239.99 for states with less than 75 percent adherence.
These findings provide new evidence in support of mask-wearing as a major factor that contributes to reduced COVID-19 rates. They suggest that policies and public health efforts to reduce the spread of COVID-19 should include a focus on improved mask adherence throughout the U.S.
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The extent to which the composition of the microbiome of apples and oil pumpkins depends on the geographical location and what insights can be derived from this for breeding, health and shelf life of the fruits is shown in two recent publications by researchers at TU Graz.
We refer to the microbiome as the community of microorganisms that exist in or on all organisms, including bacteria and fungi. A team from the Institute of Environmental Biotechnology at Graz University of Technology (TU Graz) led by Institute head Gabriele Berg has now investigated the microbiomes of apples and oil pumpkins in two independent studies. The researchers have found that bacteria useful to plants are largely “inherited,” i.e., passed on to the next generation, while the community of fungi in the microbiome is highly dependent on the particular soil microbiome and thus on the locality.
Microbiome-guided breeding of oil pumpkins
The breeding of the Styrian oil pumpkin is relatively recent — it started about 150 years ago and is well documented. Through selective breeding of resistant, increasingly tasty and high-yielding pumpkins, the seed microbiome of the oil pumpkin has changed over the generations. Using a well-documented breeding line, the environmental biotechnologists at TU Graz were able to demonstrate for the first time that the microorganisms on the seeds of the pumpkin are inherited and probably crucial for certain plant traits. Peter Kusstatscher, one of the study authors, explains: “We studied bacteria and fungi on oil pumpkin seeds and found that the plant passes on much of its bacteria on the seed — up to 60 percent, in fact — to the next generation, while fungal diversity on the seed depends largely on the local soil microbiome.” Kusstatscher continues, “It’s mainly microorganisms that are useful for the plants that are inherited. In this respect, the plant behaves in a similar way to humans: babies also get their microbiome from their mothers.”
The results published in Frontiers in Plant Science pave the way towards a microbiome-controlled breeding of oil pumpkins. Selective breeding of a beneficial seed microbiome results in plant traits that have a positive impact on yield, health and storability of oil pumpkins.
On the tracks of the universal apple microbiome
Apples are among the most popular and widely consumed fruits in the world. Fruit quality, yield, and storability are important factors for fruit growers, fruit trade, and consumers. In a worldwide study, the apple of the variety “Royal Gala” was examined for the first time with regard to the composition and possible local differences of its microbiome. An international team was able to show that the nature and structure of the fungal and bacterial communities of the apple at the time of harvest vary from region to region, i.e. they are strongly dependent on the geographical location and thus on the prevailing climatic conditions and management practices. In particular, the fungal diversity of the fruit is significantly dependent on the locality and suggests a relationship to the type and frequency of post-harvest diseases. On the other hand, a continental pattern can be drawn especially for the bacterial community which indicates adaptation of the apple microbiome to local environments.
Ahmed Abdelfattah, Marie Curie post-doctoral fellow at the Institute of Environmental Biotechnology at TU Graz and lead author of the study explains: “Despite the variations we observed in the apple microbiome, we were still able to identify a so-called ‘core’ microbiome i.e. members of the microbiome that are shared globally among the apples. This global ‘core’ microbiome is represented by several beneficial microbial indicators and makes up a large portion of the fruit’s microbial community.”
Similar to the study results on oil pumpkin, this study lays another foundation for new approaches to improving fruit quality and health, in this case of apples. Furthermore, the results form the basis for investigations of complex microbial interactions on the surface of apple fruits. The study results were published in Environmental Microbiology.
Both studies highlight the importance of the microbiome for health issues from the crop in the agro-ecosystem to humans who consume the food. At the same time, new avenues for microbiome management are opening up for environmentally friendly pest control.
Story Source:
Materials provided by Graz University of Technology. Original written by Barbara Gigler. Note: Content may be edited for style and length.

Supplementation of cocoa powder in the diet of high-fat-fed mice with liver disease markedly reduced the severity of their condition, according to a new study by Penn State researchers, who suggest the results have implications for people.
Cocoa powder, a popular food ingredient most commonly used in the production of chocolate, is rich in fiber, iron and phytochemicals reported to have positive health benefits, including antioxidant polyphenols and methylxanthines, noted study leader Joshua Lambert, professor of food science in the College of Agricultural Sciences.
“While it is typically considered an indulgence food because of its high sugar and fat content, epidemiological and human-intervention studies have suggested that chocolate consumption is associated with reduced risk of cardio-metabolic diseases including stroke, coronary heart disease and Type 2 diabetes,” Lambert said. “So, it made sense to investigate whether cocoa consumption had an effect on non-alcohol-related fatty liver disease, which is commonly associated with human obesity.”
This study has several strengths, Lambert explained. It used a commercially available cocoa product at a “physiologically achievable dose” — meaning its equivalent could be duplicated by humans. “Doing the calculations, for people it works out to about 10 tablespoons of cocoa powder a day,” he said. “Or, if you follow the directions on the Hershey’s box of cocoa powder, that’s about five cups of hot cocoa a day.”
The high-fat-fed mouse is a well-established, diet-induced model of obesity, Lambert added. By waiting until mice were already obese before beginning cocoa treatment, researchers were able to test the protective effects of cocoa in a model that better simulates the current public health situation related to non-alcohol-related fatty liver disease.
That’s important, Lambert pointed out, because a significant proportion of the world’s population has preexisting obesity and non-alcohol-related fatty liver disease. “Given the high proportion of people in the United States and other parts of the world with obesity, there is a need to develop potentially effective dietary interventions rather than just preventive agents,” he said.

Eating red meat may have a bad reputation for being bad for the heart, but new research found that lean beef may have a place in healthy diets, after all.
In a randomized controlled study, researchers found that a Mediterranean diet combined with small portions of lean beef helped lower risk factors for developing heart disease, such as LDL cholesterol.
Jennifer Fleming, assistant teaching professor of nutrition at Penn State, said the study suggests that healthy diets can include a wide variety of foods, such as red meat, and still be heart friendly.
“When you create a healthy diet built on fruits, vegetables, and other plant-based foods, it leaves room for moderate amounts of other foods like lean beef,” Fleming said. “There are still important nutrients in beef that you can benefit from by eating lean cuts like the loin or round, or 93% lean ground beef.”
David J. Baer, research leader at the United States Department of Agriculture — Agricultural Research Service, and study co-principal investigator, added, “This study highlights the importance of including lean beef in a Mediterranean dietary pattern that can yield heart-healthy benefits.”
According to the researchers, red meat such as beef has been associated with an increased risk for cardiovascular disease in previous studies. But it has remained unclear whether red meat actually causes these effects or if they actually are caused by other diet and lifestyle choices that people engage in alongside red meat consumption.