Publisher Health

People who have headaches after experiencing concussions may also be more likely to have higher levels of iron in areas of the brain, which is a sign of injury to brain cells, according to a preliminary study released today, March 5, 2024, that will be presented at the American Academy of Neurology’s 76th Annual Meeting taking place April 13-18, 2024, in person in Denver and online.
“These results suggest that iron accumulation in the brain can be used as a biomarker for concussion and post-traumatic headache, which could potentially help us understand the underlying processes that occur with these conditions,” said study author Simona Nikolova, PhD, of the Mayo Clinic in Phoenix, Arizona, and a member of the American Academy of Neurology.
The study involved 60 people who had post-traumatic headache due to mild traumatic brain injury, or concussion. The injuries were due to a fall for 45% of the people, 30% were due to a motor vehicle accident and 12% were due to a fight. Other causes were the head hitting against or by an object and sports injuries. A total of 46% of the people had one mild traumatic brain injury in their lifetime, 17% had two, 16% had three, 5% had four and 16% had five or more mild traumatic brain injuries.
The people with mild traumatic brain injuries were matched with 60 people who had not had concussions or post-traumatic headache.
All the participants had brain scans to look at iron levels in various areas of the brain, using an indirect measure for iron burden. For those with mild traumatic brain injuries, the scans were taken an average of 25 days after the injury.
The study found that compared to the people without concussion, those with a history of concussion and headaches had higher levels of iron accumulation in several areas of the brain, including the left occipital area, right cerebellum and right temporal lobe. For example, in the left occipital area, those with concussion and headaches had more iron accumulation than those with no concussion or headaches.
Researchers also found that the more concussions people had over their lifetime and the more frequent their headaches were, the more likely they were to have higher levels of iron accumulation in certain areas of the brain. They also found that the more time that had passed since the concussion occurred, the more likely people were to have higher levels of iron accumulation in areas of the brain.
“Previous studies have shown that iron accumulation can affect how areas of the brain interact with each other,” Nikolova said. “This research may help us better understand how the brain responds and recovers from concussion.”
Nikolova said that since the study used an indirect measure of iron burden, it’s possible that the change in that measure could be due to other factors such as hemorrhage or changes in tissue water rather than iron accumulation.
The study was supported by the U.S. Department of Defense and the National Institutes of Health.

Four children have remained free of detectable HIV for more than one year after their antiretroviral therapy (ART) was paused to see if they could achieve HIV remission, according to a presentation today at the 2024 Conference on Retroviruses and Opportunistic Infections (CROI) in Denver. The children, who acquired HIV before birth, were enrolled in a clinical trial funded by the National Institutes of Health in which an ART regimen was started within 48 hours of birth and then closely monitored for drug safety and HIV viral suppression. The outcomes reported today follow planned ART interruptions once the children met predefined virological and immunological criteria.
“These findings are clear evidence that very early treatment enables unique features of the neonatal immune system to limit HIV reservoir development, which increases the prospect of HIV remission,” said NIAID Director Jeanne Marrazzo, M.D., M.P.H. “The promising signals from this study are a beacon for future HIV remission science and underscore the indispensable roles of the global network of clinicians and study staff who implement pediatric HIV research with the utmost care.”
Advances in ART have significantly reduced perinatal HIV transmission, when a child acquires HIV while in the uterus, during birth, or through consumption of milk from a lactating person. If transmission does occur, children must take lifelong ART to control replication of the virus and protect their immune systems from life-threatening complications. Typically, interruption in treatment will lead to rapid resumption of HIV replication and detectable virus in the blood within weeks. However, in 2013, a case report described an infant born with HIV in Mississippi who initiated treatment at 30 hours of life, was taken off their ART at 18 months of age and remained in remission with no evidence of detectable HIV for 27 months.
Building on the observation that very early ART initiation may limit HIV’s ability to establish reservoirs of dormant virus in infants researchers began an early-stage proof-of-concept study of very early ART in infants conducted in Brazil, Haiti, Kenya, Malawi, South Africa, Tanzania, Thailand, Uganda, the United States, Zambia, and Zimbabwe. Previous publications from the clinical study showed that ART initiated within hours of birth was safe and effective at achieving and maintaining HIV suppression. A small subset of children achieved sustained HIV suppression and met other predefined study criteria for interrupting ART. These criteria include a durable absence of HIV replication from 48 weeks of ART initiation onward, no detectable antibodies near the time of ART interruption, and having a CD4+ T-cell count (the main immune cell target of HIV) similar to those of a child without HIV. Children who met these criteria, were older than 2 years and had stopped consuming human milk were eligible to interrupt ART.
Data presented at CROI summarized the experience of six children, all aged 5 years, who were eligible for ART interruption with close health and safety monitoring. Four of the six children experienced HIV remission, defined as the absence of replicating virus for at least 48 weeks off ART. One of them experienced remission for 80 weeks, but then their HIV rebounded to detectable levels. Three others have been and remain in remission for 48, 52 and 64 weeks, respectively. However, two children did not experience remission, and their HIV became detectable within three and eight weeks after ART interruption, respectively. The two children whose HIV returned at eight and 80 weeks experienced mild acute retroviral syndrome (ARS) with symptoms including headache, fever, rash, swollen lymph nodes, tonsillitis, diarrhea, nausea and vomiting. One child had markedly low white blood cells, which are a type of immune cell. Both the ARS and white blood deficiency resolved either prior to or soon after restarting ART. The three children who experienced viral rebound resumed HIV suppression within six, eight and 20 weeks of restarting ART.
“This is the first study to rigorously replicate and expand upon the outcomes observed in the Mississippi case report,” said lead study virologist Deborah Persaud, M.D., professor of pediatrics at the Johns Hopkins University School of Medicine, and director of the Division of Pediatric Infectious Diseases at Johns Hopkins Children’s Center, Baltimore. “These results are groundbreaking for HIV remission and cure research, and they also point to the necessity of immediate neonatal testing and treatment initiation in health care settings for all infants potentially exposed to HIV in utero.”
The latest findings show that very early ART initiation has varying but favorable outcomes on control of HIV. While ARS was generally mild and resolved in both cases, the authors cautioned that close monitoring for this potential event is needed in ongoing and future HIV remission research involving ART interruption. The children participating in this study took ART regimens with medicines that have been part of standard first-line therapy for decades. Further research is planned or underway to understand how these observations could differ in children receiving newer, more potent generations of antiretroviral drugs, and to identify biomarkers to predict the likelihood of HIV remission or rebound following ART interruption. Additional studies are also needed to understand the mechanisms by which neonatal immunity and very early ART initiation limited the formation of HIV reservoirs and contributed to the remission observed in this study.
“ART shifted the HIV care paradigm, but treatment is a long road, especially for children as lifetime HIV survivors” said Adeodata Kekitiinwa, MBChB, MMed, emeritus clinical associate professor in the Department of Pediatrics at Baylor College of Medicine, study investigator of record and clinical research site leader in Kampala, Uganda. “This trial takes us a step closer to realizing another paradigm shift in which our approach to ART could be so effective that it might be used for a season of life, rather than its entirety.”
This ongoing research is being conducted by the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Network, which is funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Institute of Mental Health (NIMH).
The research was led by study co-chairs Ellen Chadwick, M.D., professor of pediatrics at Northwestern University Feinberg School of Medicine, and Yvonne Bryson, M.D., professor of pediatrics at the David Geffen School of Medicine and Mattel Children’s Hospital at UCLA, and director of the Los Angeles Brazil AIDS Consortium. Dr. Kekitiinwa, Boniface Njau, M.S., study coordinator at Kilimanjaro Christian Medical Centre in Tanzania and Teacler Nematadzira, MBChB, site investigator at the University of Zimbabwe-University of California San Francisco Collaborative Research Program continue to lead the study teams overseeing care of children who experienced HIV remission. Jennifer Jao, M.D., M.P.H., professor of pediatrics at Northwestern University Feinberg School of Medicine has since assumed a study co-chair role with Dr. Chadwick. The full IMPAACT P1115 study team consists of hundreds of staff across 30 NIAID- and NICHD-supported sites in the 11 study countries.

A research team led by Professor Yuanliang ZHAI at the School of Biological Sciences, The University of Hong Kong (HKU) collaborating with Professor Ning GAO and Professor Qing LI from Peking University (PKU), as well as Professor Bik-Kwoon TYE from Cornell University, has recently made a significant breakthrough in understanding how the DNA copying machine helps pass on epigenetic information to maintain gene traits at each cell division. Understanding how this coupled mechanism could lead to new treatments for cancer and other epigenetic diseases by targeting specific changes in gene activity. Their findings have recently been published in Nature.
Background of the Research
Our bodies are composed of many differentiated cell types. Genetic information is stored within our DNA which serves as a blueprint guiding the functions and development of our cells. However, not all parts of our DNA are active at all times. In fact, every cell type in our body contains the same DNA, but only specific portions are active, leading to distinct cellular functions. For example, identical twins share nearly identical genetic material but exhibit variations in physical characteristics, behaviours and disease susceptibility due to the influence of epigenetics. Epigenetics functions as a set of molecular switches that can turn genes on or off without altering the DNA sequence. These switches are influenced by various environmental factors, such as nutrition, stress, lifestyle, and environmental exposures.
In our cells, DNA is organised into chromatin. The nucleosome forms a fundamental repeating unit of chromatin. Each nucleosome consists of approximately 147 base pairs of DNA wrapped around a histone octamer which is composed of two H2A-H2B dimers and one H3-H4 tetramer. During DNA replication, parental nucleosomes carrying the epigenetic tags, also known as histone modifications, are dismantled and recycled, ensuring the accurate transfer of epigenetic information to new cells during cell division. Errors in this process can alter the epigenetic landscape, gene expression and cell identity, with potential implications for cancer and ageing. Despite extensive research, the molecular mechanism by which epigenetic information is passed down through the DNA copying machine, called the replisome, remains unclear. This knowledge gap is primarily due to the absence of detailed structures that capture the replisome in action when transferring parental histones with epigenetic tags. Studying the process is challenging because of the fast-paced nature of chromatin replication, as it involves rapid disruption and restoration of nucleosomes to keep up with the swift DNA synthesis.
In previous studies, the research team made significant progress in understanding the DNA copying mechanism, including determining the structures of various replication complexes. These findings laid a solid foundation for the current research on the dynamic process of chromatin duplication.
Summary of Research Findings
This time, the team achieved another breakthrough by successfully capturing a key snapshot of parental histone transfer at the replication fork. They purified endogenous replisome complexes from early-S-phase yeast cells on a large scale and utilised cryo-electron microscopy (cryo-EM) for visualisation.
They found that a chaperone complex FACT (consisting of Spt16 and Pob3) interacts with parental histones at the front of the replisome during the replication process. Notably, they observed that Spt16, a component of FACT, captures the histones that have been completely stripped off the duplex DNA from the parental nucleosome. The evicted histones are preserved as a hexamer, with one H2A-H2B dimer missing. Another protein that involved in DNA replication, Mcm2, takes the place of the missing H2A-H2B dimer on the vacant site of the parental histones, placing the FACT-histone complex onto the front bumper of the replisome engine, called Tof1. This strategic positioning of histone hexamer on Tof1 by Mcm2 facilitates the subsequent transfer of parental histones to the newly synthesised DNA strands. These findings provide crucial insights into the mechanism that regulates parental histone recycling by the replisome to ensure the faithful propagation of epigenetic information at each cell division.
This study, led by Professor Zhai, involved a collaborative effort that spanned nearly eight years, starting at HKUST and concluding at HKU. He expressed his excitement about the findings, ‘It only took us less than four months from submission to Nature magazine to the acceptance of our manuscript. The results are incredibly beautiful. Our cryo-EM structures offer the first visual glimpse into how the DNA copying machine and FACT collaborate to transfer parental histone at the replication fork during DNA replication. This knowledge is crucial for elucidating how epigenetic information is faithfully maintained and passed on to subsequent generations. But, there is still much to learn. As we venture into uncharted territory, each new development in this field will represent a big step forward for the study of epigenetic inheritance.’
The implications of this research extend beyond understanding epigenetic inheritance. Scientists can now explore gene expression regulation, development, and disease with greater depth. Moreover, this breakthrough opens up possibilities for targeted therapeutic interventions and innovative strategies to modulate epigenetic modifications for cancer treatment. As the scientific community delves deeper into the world of epigenetics, this study represents a major step towards unravelling the complexities of replication-coupled histone recycling.

For the first time, neuroscientists have established a link between shifts in our visual perception and the cadence of our steps while walking.
The research, published in Nature Communications, shows that the brain processes vision in a rhythmic manner, rising and falling in sensitivity in a cycle that corresponds to the rhythm of our steps. When swinging from one step to the next, human perception is good and reactions fast.
During footfall, however, our vision is not as sharp and reactions are slowed.
Lead author Dr Matthew Davidson from the School of Psychology at the University of Sydney said: “This work reveals a previously unknown relationship between perception and movement. It bridges a gap between experimental psychology and our natural, everyday behaviour.”
The study also confirms our understanding of the visual brain sensing the environment in a strobe-like way; our perception takes regular samples of the world before stitching them together to create our seamless experience.
However, the new finding that reveals shifts in our visual perception has important implications for understanding human behaviour, how we interact with our environment and make decisions.
The work was conducted by Dr Matthew Davidson with colleagues Professor David Alais and Professor Frans Verstraten in the School of Psychology, University of Sydney.

Dr Davidson said: “We are consciously aware of a seamless stream of vision but this is deceptive. I use the analogy of a duck swimming on a pond. Beneath the smooth motion on the surface there is a lot cycling activity beneath.”
This study extends earlier work from the same lab showing that perception of vision and sound is cyclic, with our brain taking around eight samples per second.
Professor Alais said: “The critical new finding in this study is that these oscillations in the brain’s sampling of the world slow down when walking to match the step cycle.
“Humans take about two steps per second when walking and generally keep to a consistent rhythm. The reported oscillations in visual sensitivity also occur at about two cycles per second and are locked to the step cycle. In some participants these rhythmic oscillations occur at four cycles per second but these were also locked to the step cycle.”
This work is the first time that visual perception has been finely and continuously sampled during walking. Without virtual reality headsets and motion tracking it would not be possible.
Dr Davidson said: “Thanks to VR technology we have discovered that our vision moves through a good and a bad phase on every step.”
It is unclear why our brain’s perceptual processes are so closely linked to walking.

Professor Alais said: “One possible explanation is that vision becomes secondary to motor control while your foot is grounded and the next step is planned. Once you are in the swing phase between footfalls, the brain switches back to prioritising perceptual sampling of the world, creating an ongoing perceptual rhythm that harmonises with your step rate.”
The findings open questions that the research team will pursue in further studies. For example, does perception of sound and touch also modulate as we walk? And what about neural activity?
The research team plans to follow up these questions to further understand the implications.
Dr Davidson said: “An obvious question is whether these oscillations in perception are more pronounced in the elderly given difficulties with balance and coordination as we age.
“It also raises the exciting possibility that we could develop cheap and easy diagnostic tests using VR headsets, or use this information to develop tests for early onset of neuro-muscular disorders or some psychiatric illnesses, which can manifest in abnormal gaits.”
He said it could also be applied to further research in sports science to see if the findings could be applied to optimise decision-making and reaction times in athletes.
Underlying all this research remains a persistent mystery. If the world is sampled by our brains rhythmic pulses, why is our conscious perception so seamlessly smooth?
Professor Verstraten said: “This was once a question for philosophers, but with access to technology neuroscientists have been able to shed light on how the gaps get filled in. The current view is that the brain is a predictive machine that actively constructs perception and predicts what ought to be there and fills in the blanks. But clearly, we need more research to deepen our understanding.”
Methods
Researchers tracked the walking of 45 subjects walking back and forth along a 10-metre path in a virtual environment. During each walk (lasting about 9 seconds), subjects were required to respond to between zero and eight random visual stimuli. The same stimuli were also presented in stationary trials. Eye and head movement was tracked along with gait and walking information.
Of the 45 subjects, insufficient data was collected for seven subjects. In the datasets for 38 subjects, reduced perception at footfall was recorded 83 percent of the time.

Antimicrobial resistance is a story of constantly moving parts and players. With every new or tweaked antibiotic or antimicrobial drug, the targeted pathogens begin the evolutionary dance of acquiring resistance, prompting researchers to constantly develop workarounds or entirely new classes of medicine.
Understanding the underlying mechanisms of acquired antimicrobial resistance is critical to the fight, a case of knowing one’s enemy. In a new paper published March 2, 2024 in npj Antimicrobials and Resistance, part of the Nature Portfolio, researchers at Sanford Burnham Prebys, working with Roche Pharma Research and Early Development, describe how two notable pathogens — Escherichia coli and Acinetobacter baumannii — employ distinctly different tools to fend off antibiotic attack.
“This work was conceived as a comparative study of the mechanisms and dynamics of resistance acquisition for two drugs and two bugs,” said senior author Andrei L. Osterman, Ph.D., at Sanford Burnham Prebys.
“Comparing mutational landscapes triggered by the same drug in two distinct bugs allows us to deduce both shared and unique evolutionary trajectories toward resistance. A comparison of two drugs in the same bug reveals shared and unique mechanistic features of fundamental and translational importance, from drug discovery to rational optimization of treatment regimens.”
Both pathogens studied are gram-negative bacteria with shared characteristics, but also notable differences.
For the most part, E. coli is a bacterium routinely found in the guts of humans and animals, where it resides with no ill effect. Some strains, however, do cause harm, everything from mild gastroenterological distress to urinary tract infections, respiratory illness and pneumonia.
Acinetobacter baumannii is more problematic, particularly in clinical settings where it can cause severe infections, some life-threatening.

Both bacteria have developed resistance to most current antibiotic treatments.
In their paper, Osterman and colleagues combined experimental evolution in a continuous culturing device (morbidostat) with whole genome sequencing of evolving cultures to track how E. coli and A. baumannii acquired drug resistance against a pair of antibiotics that inhibit DNA gyrase, an essential enzyme in bacteria.
Inhibiting the enzyme disrupts DNA synthesis and, subsequently, causes the bacteria to die. One antibiotic — ciprofloxacin — has been in active clinical use since 1987; the other — GP6 — is experimental.
The researchers found that pathogenic bacteria with acquired resistance to ciprofloxacin remained susceptible to effective antimicrobial treatment by GP6 drug. However, the opposite was not true: evolution of resistance to GP6 also triggered resistance to ciprofloxacin.
These findings underscored that E. coli and A. baumannii employ shared and unique mechanisms to acquire resistance to these two types of drugs.
“Bacteria acquire resistance as a result of random mutational events that happen in the DNA replication as uncorrected ‘typos’,” said Osterman. “These spontaneously emerge in a handful of drug-resistant variants/strains out of godzillions of neutral mutations) under selective pressure.”
(A godzillion is a descriptive term, not a precise unit of measurement. It refers to a number of enormous size. In this case a number ranging between 108 to 109 neutral mutations.)

These harmful mutations may underlie several types of resistance mechanisms, including modifying the protein targets of a given drug, the ability of bacterial cells to expel compounds (drugs) before they cause harm (efflux) and special bacterial enzymes that inactivate active drug compounds.
Osterman said the work advances progress toward developing “resistibility profiles” of established and novel antimicrobial drugs, which would help set forth “boundaries for possible combinational treatment, including clinically relevant multidrug resistant strains. Our acquired knowledge provides crucial guidelines for all these translational activities.”
The findings are not limited to E. coli and A. baumannii. They have potential to at least partially predict resistance drivers across other closely related species posing significant health risks, including Pseudomonas, Salmonella and Klebsiella spp. all difficult-to-treat bacterial pathogens linked to serious and sometimes deadly infections.
Additional authors on the study include Semen A. Leyn, James E. Kent, Jaime E. Zlamal and Marinela L. Elane, all at Sanford Burnham Prebys; and Maarten Vercruysse, Rocha Pharma.
The study was supported by F. Hoffmann-La Roche Ltd and the National Institute of Allergy and Infectious Diseases (grant 5R01AI167977).
The study’s DOI is 10.1038/s44259-024-00021-y

The agency tested 75 types of cinnamon after hundreds of children were poisoned by the spice in applesauce. It found some lead in cinnamon brands sold at some dollar stores and other markets.The Food and Drug Administration is telling consumers to throw out certain brands of cinnamon that were found to have elevated levels of lead, and it urged companies to recall the products from store shelves.The agency conducted tests across the country after at least 460 children were sickened last year by illnesses linked to applesauce pouches. Those products had been contaminated with very high levels of lead from cinnamon processed in Ecuador.The F.D.A.’s latest tests, however, detected far lower levels, 2 to 3 parts per million, in the cinnamon. In contrast, the cinnamon from Ecuador that sickened children last year had 2,200 to 5,100 parts per million.“Although we have concern about these products in the safety alert, they do not present the same level of risk to human health as the cinnamon in the apple purée and applesauce products,” Conrad Choiniere, an F.D.A. food official, said in a release on Wednesday.Lead is a potent toxin that is particularly hazardous to young children and has been tied to learning and behavior challenges as well as developmental delays. The agency said no illnesses were reported in relation to the latest batches of cinnamon, which were singled out over elevated lead levels after tests of 75 samples from retail stores.The latest batches of cinnamon and the applesauce pouches were both sold at Dollar Tree stores. The company has said it is committed to the safety of the products it sells. Brands that the F.D.A. has urged companies to recall include Supreme Tradition cinnamon, sold exclusively at Dollar Tree and Family Dollar stores. Other cinnamon with elevated lead levels in the recent tests included the La Fiesta brand sold at La Superior SuperMercados and the Marcum brand sold at Save A Lot.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Published14 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Michelle RobertsDigital health editorThere is a worrying rise in whooping cough, officials warn, with 553 cases in England recorded in January alone and high numbers in Wales.They fear it could be a bumper year for the bacterial infection. The last peak year, 2016, saw 5,949 cases in England.Known as pertussis or “100-day cough”, the infection can be particularly serious for babies and infants. And The UK Health Security Agency warns of a steady decline in uptake of the vaccine in pregnant women and children.In September 2023, the number of two-year-olds who completed their routine six-in-one vaccinations, which includes protection against pertussis, was 92.9%, compared with 96.3% in March 2014. Uptake of the maternal pertussis vaccine, offered to women in every pregnancy, also dropped – from over 70% in September 2017 to about 58% in September 2023.Check if your child has whooping coughThe first signs of whooping cough are similar to a cold, with a runny nose and sore throat. But after about a week, the infection can develop into coughing bouts that last a few minutes and are typically worse at night. Young babies may also make a distinctive “whoop” or have difficulty breathing after a bout of coughing.The bacteria spread through coughs and sneezes, so experts advise members of a family in which it has been diagnosed to stay at home until three weeks after the symptoms began or 48 hours after the patient started taking antibiotics.NHS England national director for vaccinations and screening Steve Russell said: “With whooping cough on the rise, it is important that families come forward to get the protection they need. “If you are pregnant and have not been vaccinated yet or your child is not up-to-date with whooping cough or other routine vaccinations, please contact your GP as soon as possible.”And if you or your child have symptoms ask, for an urgent GP appointment or get help from NHS 111.”More on this storyWhooping cough cases show sharp risePublished23 JanuaryRelated Internet LinksNHS Whooping CoughThe BBC is not responsible for the content of external sites.

Lawmakers want shopkeepers to remove e-cigarettes that were not authorized by the F.D.A. Retailers say it is not that simple.The chairmen of five key Senate committees on Thursday warned the chief executives of major convenience stores and wholesalers to stop sales of illicit flavored vaping products that they called “widespread violations of federal law.”The senators voiced their concerns in letters to the companies, amplifying the frustration among some lawmakers in Congress over the continued availability of e-cigarettes in vivid colors and candy flavors that attract young people who could become addicted to nicotine. The unchecked sales, they wrote, “pose a tremendous public health threat.”“F.D.A. and the industry must do more to address the youth vaping epidemic and remove unauthorized vaping products from their shelves immediately,” Senator Dick Durbin of Illinois, the Democratic whip, said.The letters were addressed to retailers including 7-Eleven, Circle K, bp America, Pilot, Kwik Trip and others. The Food and Drug Administration had earlier issued warnings about sales of unauthorized brands like Elf Bar, E.B. Design and Funky Republic.The senators’ letters reminded the companies that Congress gave the F.D.A. authority over tobacco products in a landmark 2009 law. Selling unapproved items can result in fines or an order to stop selling any tobacco products, the letter notes.“Today, millions of children use unauthorized e-cigarettes, risking nicotine addiction, respiratory illness, exacerbation of depression and anxiety, and many other harms,” read the letter to Joseph DePinto, the chief executive of 7-Eleven. The company did not respond to a request for comment.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The 70-year-old man rapidly went from walking 10 to 15 miles a day to being nearly helpless. His wife wondered if he’d had a stroke. Surrounded by the detritus of a Thanksgiving dinner, the woman was loading the dishwasher when a loud thump thundered through the house. She hurried out of the kitchen to find her husband of 37 years sitting on the second-floor landing. Her son and son-in-law, an emergency-room doctor, crouched at his side. Her husband protested that he was fine, then began to scooch himself on his bottom into the bedroom. The two young men helped him to his feet. The man’s body shook with a wild tremor that nearly knocked him down again. “I was getting into bed and fell,” he explained — though the bed was too far away to make this at all likely. “Get some sleep,” the woman said gently once her husband was settled in the bed. “We’ll go to the hospital in the morning.”Her daughter and son-in-law had arrived that morning and already mentioned the change they noticed in the 70-year-old senior. The normally gregarious man was oddly quiet. And the tremor he had for as long as they could remember was much more prominent. His hands shook so much he had trouble using his fork and ended up eating much of his Thanksgiving dinner with his fingers. And now this fall, this confusion — they were worried.His wife was also worried. Just after Halloween, she traveled for business, and when she came back, her husband was much quieter than usual. Even more concerning: When he spoke, he didn’t always make sense. “Have you had a stroke?” she asked her first day home. He was fine, he insisted. But a few days later she came home from work to find his face covered with cuts. He was shaving, he said, but his hand shook so much that he kept cutting himself. “There is something wrong with me,” he acknowledged. It was Thanksgiving week, but she was able to get him an appointment at his doctor’s office the next day. They were seen by the physician assistant (P.A.). She was kind, careful and thorough. After hearing of his confusion, she asked the man what day it was. “Friday?” he offered uncertainly. It was Wednesday. Could he touch his finger to his nose and then to her finger, held an arm’s length away? He could not. His index finger carved jagged teeth in the air as he sought his own nose then stretched to touch her finger. And when she asked him to stand, his entire body wobbled dangerously. “It’s all happened so quickly,” the man’s wife said. The P.A. reviewed his lab tests. They were all normal. She then ordered an M.R.I. of the brain. That, she explained, should give them a better idea of what direction to take. But, she added, if he falls or seems unsafe at any point, you should take him to the emergency room. And so, early that Friday, the woman drove her husband to Danbury Hospital, the emergency room closest to the couple’s small Connecticut town. He walked in on his own. It was the last time he would walk without help for weeks. Many Pink PillsHe was admitted to the hospital. Neurology was consulted and did an extensive work-up: blood tests, CT scans, an M.R.I., an EEG, a spinal tap. While there were some abnormalities, nothing explained his rapid mental and physical decline. There was no sign of infection or tumor. No evidence of seizures. His vitamin levels were normal. And the gastritis he had earlier that spring was responding well to a daily acid-reducing medication, pantoprazole.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Published11 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Bernd Debusmann JrBBC News, WashingtonAlabama lawmakers have passed a bill to protect in-vitro fertilisation (IVF) clinics and doctors from lawsuits and criminal prosecution. Last month, the state’s supreme court ruled that frozen embryos had the same rights as children, and people could be held liable for destroying them.At least three IVF clinics paused treatments in the wake of the ruling, which divided Alabama’s conservatives. The new law will allow the clinics to resume services. The Alabama bill had overwhelming bipartisan support on Wednesday. It passed by a vote of 81-12 in the state’s House and 29-1 in the Senate. Governor Kay Ivey, a Republican, quickly signed it into law.The measures are designed to shield IVF providers from legal action and prosecution for “damage or death of an embryo” during services. Proponents of the bill said they hoped this would allow IVF providers to re-start services. “The problem we are trying to solve right now is to get those families back on track to be moving forward as they try to have children,” state legislator Terri Collins told CBS News, the BBC’s US partner. While the measure offers limited legal immunity to medical providers, it still allows – in some cases – for lawsuits to be filed against manufacturers of IVF equipment if they damage or destroy an embryo during the treatment process. ‘Fewer children will be born’: Alabama embryo ruling divides devout ChristiansWhat does Alabama ruling mean for fertility patients?The bill also did not weigh in on whether embryos can be legally classified as children. Alabama Democratic House minority leader Anthony Daniels told AL.com earlier on Wednesday that the bill did not sufficiently answer the question of whether embryos outside the womb are children. “Until that issue is addressed, it’s just putting a Band-Aid over something that requires stitches and surgery,” Mr Daniels said.The decision two weeks ago from the Supreme Court of Alabama stemmed from wrongful death lawsuits filed on behalf of three couples whose frozen embryos were accidentally destroyed at a clinic in 2020. The ruling sparked an immediate backlash, both in the southern state and nationally.With eight months to go until the US presidential election, President Joe Biden’s campaign has seized on the controversy. A Pew survey released last year found that 42% of Americans have either used IVF treatments or know someone who did. That percentage rises to 45% among middle-income Americans and 59% for those with high-incomes. More on this storyAlabama lawmakers race to protect providers of IVFPublished6 days agoAlabama’s legislature pushes to protect IVFPublished27 February’Fewer children will be born’: Alabama embryo ruling divides devout ChristiansPublished25 February