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Published9 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, PA MediaScientists have grown “mini-placentas” in a laboratory to help them better understand pre-eclampsia.Pre-eclampsia occurs in about six in 100 first pregnancies. It can put at risk both the mother and baby’s health.The international study shows it is possible to experiment on a developing human placenta.Cambridge University’s Prof Ashley Moffett said most “major disorders of pregnancy” depend on “difficult to study” early placenta development. She worked with colleagues from the Friedrich Miescher Institute, Basel, Switzerland, and the Wellcome Sanger Institute, Cambridge.Image source, Friedrich Miescher Institute/University of CambridThey used the “mini-placenta” – a cellular model of the early stages of the placenta – to provide a window into early pregnancy and “help improve our understanding of reproductive disorders”.Successful pregnancy depends on the development of the placenta in the first few weeks of gestation.During this period, the placenta implants itself into the endometrium – the mucosal lining of the mother’s uterus.Two babies in two days for mum with double wombWoman helps others after crippling pregnancy painThousands of first time mums in pre-eclampsia studyProf Moffett, from the university’s department of pathology, said: “Most of the major disorders of pregnancy – pre-eclampsia, still birth, growth restriction, for example – depend on failings in the way the placenta develops in the first few weeks.”This is a process that is incredibly difficult to study – the period after implantation, when the placenta embeds itself into the endometrium, is often described as a ‘black box of human development’.”Yet “we understand so little about the interactions between the placenta and the uterus”, she said. ‘Millions affected worldwide’Interactions between the cells of the endometrium and the cells of the placenta are critical to whether a pregnancy is successful. In particular, these interactions are essential to increase the maternal blood supply to the placenta, necessary for foetal growth and development.When these interactions do not work properly, they can lead to complications, such as pre-eclampsia, a condition that causes high blood pressure during pregnancy, typically after 20 weeks.Dr Margherita Turcom, from the Friedrich Miescher Institute, said: “Despite affecting millions of women a year worldwide, we still understand very little about pre-eclampsia. “[To] really to understand it – to predict it and prevent it – we have to look at what’s happening in the first few weeks.”The study, published in the scientific journal Cell Stem Cell, was supported by Wellcome, the Royal Society, European Research Council and Medical Research Council.Follow East of England news on Facebook, Instagram and X. Got a story? Email eastofenglandnews@bbc.co.uk or WhatsApp 0800 169 183More on this storyTwo babies in two days for mum with double wombPublished23 December 2023Ethnicity affects pregnancy healthcare, study findsPublished17 December 2023Woman helps others after crippling pregnancy painPublished15 November 2023Mothers warn of disorder that can cause stillbirthPublished29 September 2023Thousands of first time mums in pre-eclampsia studyPublished19 July 2023Related Internet LinksUniversity of CambridgeWellcome Sanger InstituteFMI – Friedrich Miescher Institute for Biomedical ResearchMedical Research Council (MRC) – UKRIThe BBC is not responsible for the content of external sites.

Published1 hour agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Andy GiddingsBBC News, West MidlandsMeasles outbreaks are rising across England, with areas including the West Midlands seeing their highest number of cases since the 1990s.It has prompted health officials to encourage people to get vaccinated, with official figures showing uptake of the measles, mumps and rubella (MMR) vaccine is at its lowest point in more than a decade.Here the BBC answers some of the questions people have been searching for. What is measles?Measles is a highly contagious disease which is spread by coughs and sneezes. In most cases it can be unpleasant, but will usually pass between seven and 10 days without causing any further problems.However, it can lead to serious problems for some if it spreads to other parts of the body, such as the lungs or brain. It can cause serious problems such as pneumonia, meningitis, blindness, and fits, with certain groups such as babies and small children, pregnant women and those with a weakened immune system more at risk. It can cause death, but this is rare. Government figures from 2022 show since 2000, there were eight deaths in children or adults that could have been prevented by having the vaccine.What are the symptoms?High fever, sore, red and watery eyes, coughing, sneezing, aching and feeling generally unwell are all common signs of measles. A blotchy red/brown rash usually appears after the initial symptoms.People with measles remain infectious until at least four days after the onset of the rash, so they should stay away from nursery, school, university, work and other group activities until then.Image source, NHSThe NHS says the best way to prevent measles is by getting both doses of the MMR vaccine.For people who do not consume pork products, there is a version of the vaccine called Priorix which has no pork ingredients which can be requested from a GP.How is measles spread?The virus is contained in tiny droplets that come from the nose and mouth when an infected person coughs or sneezes.Measles is caught by breathing these in or touching the droplets and then placing your hand near your nose or mouth.The virus can survive on surfaces for a few hours.People with measles become infectious from when the symptoms develop until about four days after the rash first appears.Ruth Tennant, the director of public health for Solihull, in the West Midlands, said: “I think we’d forgotten quite how infectious and nasty measles can be.”Why is there an outbreak now?It is unclear where the current outbreak originated, but official figures show uptake of the MMR vaccine is at its lowest point in more than a decade.In 2022/23, some 84.5% of youngsters in England had received both doses of the jab by the time they were five years old – the lowest level since 2010/11. Image source, Getty ImagesUp to 92.5% had received one dose, the figures show.Where are the worst affected areas?The majority of measles cases in the West Midlands – 80% – have been found in Birmingham, while 8% were identified in Coventry, with the rest spread across surrounding areas.Ms Tennant said since the beginning of October, there had been more than 250 confirmed cases in the region and numbers had picked up since Christmas.Letters have been sent to all schools in Birmingham to warn parents if their child is not immunised from measles they could be made to isolate for three weeks, if exposed.Pop-up vaccination clinics have been set up in the Black Country to help ensure children aged 12 to 16 are up to date with their MMR jab.How do I protect myself and my family?John Denley, Wolverhampton’s director of public health, said: “The best way to prevent measles in the first place is by getting both doses of the MMR vaccine, which is both safe and effective.”The two-part MMR vaccine is given as part of the childhood vaccination programme.However, patients can be vaccinated at any age if they have not been fully vaccinated before.Image source, Getty ImagesThere is an alternative for those not suited to the MMR vaccine, called human normal immunoglobulin (HNIG). This can be used at for people at risk of catching measles.People who develop the symptoms of measles are advised to stay at home and phone their GP or call the NHS on 111 for advice.Those with symptoms are asked not to visit their GP surgery or hospital because of the risk of passing it on.The NHS says it is important to seek medical advice if pregnant women or anyone with a weakened immune system has been in contact with someone with measles.Does the vaccine have side effects?Most side effects are mild and do not last long.The area where the needle goes in can be red, sore and swollen for up to three days and babies and young children may feel unwell or develop a high temperature for up to three days.There is no evidence of any link between the MMR vaccine and autism.The NHS says: “There are many studies that have investigated this.”A purported link was made in one discredited study in 1998, causing vaccination rates to drop. The research was later dismissed and its author struck off by the General Medical Council. What should I do if I get measles?The NHS advises patients to take paracetamol or ibuprofen to relieve fever, aches and pains, but aspirin should not be given to children under 16 years old.It says people with measles should drink plenty of water to avoid dehydration and close the curtains to help reduce light sensitivity.Image source, NHSIt also advises using damp cotton wool to clean the eyes.Because measles can spread easily, people with symptoms are asked to stay off school or work for at least four days from when the rash first appears.It is advised that people regularly wash their hands with soap, use and dispose of tissues when they sneeze and avoid close contact with anyone who is not fully vaccinated.Can you get measles twice?Once you have had measles, your body builds up resistance to the virus. The NHS says it is highly unlikely you will get it a second time.Follow BBC West Midlands on Facebook, X and Instagram. Send your story ideas to: newsonline.westmidlands@bbc.co.ukMore on this storyWarning of further measles outbreaks as cases risePublished1 day agoChildren’s hospital inundated with measles casesPublished5 days agoMeasles cases highest since 1990sPublished6 days agoRelated Internet LinksMeasles, mumps and rubella vaccineThe BBC is not responsible for the content of external sites.

Migraine can impact many aspects of a person’s life, but less is known about how feelings of stigma about the disease affect quality of life. For people with migraine, these feelings of stigma were linked to more disability, increased disease burden and reduced quality of life, according to new research published in the January 17, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“Stigma is common where the disease is not readily apparent to others, and there is indication that it could be especially relevant for those living with migraine,” said study author Robert Evan Shapiro, MD, PhD, of the University of Vermont and Fellow of the American Academy of Neurology. “This stigma may arise when a person with migraine recognizes negative stereotypes about the disease and experiences shame for having the disease, fear of experiencing stigma from others, or other negative emotions.”
For the study, researchers looked at 59,001 people with migraine with an average age of 41. Among all participants, 41% reported experiencing four or more headache days per month on average.
Participants answered 12 questions to assess two types of stigma: whether they felt others viewed migraine being used for secondary gain and whether they felt others were minimizing the burden of migraine. Questions included “How often have you felt that others viewed your migraine as a way to get attention?” “… as something that made things difficult for your co-workers or supervisor?” and “…with a lack of understanding of the pain and other symptoms?”
Researchers found that 32% of the participants experienced migraine-related stigma often or very often.
To assess migraine-related disability, participants reported the number of days they missed or had reduced productivity at work, home or social events over the previous three months. High scores on migraine-related stigma were linked with moderate to severe disability. Three-quarters of those who experienced stigma often or very often had moderate to severe disability, compared to 19% of those who never experienced stigma.
They also took a test assessing migraine-specific quality of life, which looked at the impact of migraine on social and work-related activities over the previous four weeks. Scores ranged from zero to 100 with higher scores meaning higher quality of life. Researchers found that those who experienced the highest rates of migraine-related stigma scored far lower in these tests, with an average score of 35 compared to those who did not experience stigma with an average score of 69.

The results remained the same after researchers adjusted for other factors that could affect disability and quality of life, such as age, employment status, other medical conditions and frequency of migraines.
They also found that the amount of stigma experienced increased with migraine severity. Those with 8-14 headache days or more than 15 monthly headache days were far more likely to report at least one form of stigma with 42% and 48%, respectively, compared to those with less than four monthly headache days with 26%.
“The social context of migraine may have a greater impact on quality of life than the number of monthly headache days,” said Shapiro. “However, it is possible that connecting with others with migraine may help decrease migraine-related stigma and stereotypes. More studies are needed to explore the mechanisms that link stigma to health outcomes.”
A limitation of the study was that participants self-reported their migraines, based on a questionnaire or a diagnosis from a health care provider, and they may not have remembered all the information accurately.
The study was funded by Eli Lilly & Company, the maker of medications to treat migraine. Dr. Shapiro serves as a consultant for Eli Lilly.

Three different HIV antibodies each independently protected monkeys from acquiring simian-HIV (SHIV) in a placebo-controlled proof-of-concept study intended to inform development of a preventive HIV vaccine for people. The antibodies — a human broadly neutralizing antibody and two antibodies isolated from previously vaccinated monkeys — target the fusion peptide, a site on an HIV surface protein that helps the virus fuse with and enter cells. The study, published in Science Translational Medicine, was led by the Vaccine Research Center (VRC) at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
Antibodies that target the fusion peptide can neutralize diverse strains of HIV in vitro, that is, in a test tube or culture dish outside of a living organism. The NIAID VRC isolated a fusion peptide-directed human antibody, called VRC34.01, from a person living with HIV who donated blood samples for research. They also isolated two antibodies from rhesus macaques — a species of monkey with immune systems like humans’ — who previously had received a vaccine regimen designed to generate fusion peptide-directed antibodies. Demonstrating that these antibodies protect animals would validate the fusion peptide as a target for human vaccine design. SHIV challenge — administering an infective dose of SHIV — to rhesus macaques is a widely used animal model for assessing the performance of HIV antibodies and vaccines.
In this study, rhesus macaques in each of four groups received a single intravenous infusion of one type of antibody — a 2.5 or 10 mg/kg of bodyweight dose of VRC34.01, or one of the two vaccine-elicited rhesus macaque antibodies — and other monkeys received a placebo infusion. To determine the protective effect of the antibodies, each monkey was challenged five days after infusion with a strain of SHIV known to be sensitive to fusion peptide-directed antibodies.
All monkeys that received a placebo infusion acquired SHIV following the challenge. Among monkeys that received VRC34.01 infusions, none receiving the 10 mg/kg dose and 25% of those receiving the 2.5 mg/kg dose acquired SHIV. Of those that received the vaccine-elicited rhesus macaque antibodies, no monkeys receiving the antibody called DFPH-a.15 acquired SHIV, and 25% of those receiving the antibody called DF1W-a.01 acquired SHIV. Over time, the concentration of antibodies in the blood of animals that received DFPH-a.15 declined. Those animals were re-challenged 30 days later to see if the lower concentration of antibodies had a decreased protective effect, and half of them acquired SHIV.
The three antibodies studied each provided statistically significant protection from SHIV, and the effect was dose dependent, that is, highest in monkeys with greater antibody concentrations in their blood.
According to the authors, these findings represent the proof-of-concept that fusion peptide-directed antibodies can provide protection against SHIV and help determine the concentration of antibodies a vaccine would need to generate to be protective. They suggest that their findings on vaccine-elicited antibodies in some animals support further work to design preventive HIV vaccine concepts targeting the fusion peptide. They conclude that an effective HIV vaccine targeting the HIV fusion peptide likely will need to expand upon the concepts used in this study, by generating multiple varieties of fusion peptide-directed antibodies. This would increase the likelihood that the vaccine could maintain a preventive effect across the vastly diverse HIV variants in circulation.

An innovative study at Marshall University published in ArthroplastyToday explores the use of robotic-assisted joint replacement in revision knee scenarios, comparing the pre- and post-revision implant positions in a series of revision total knee arthroplasties (TKA) using a state-of-the-art robotic arm system.
In this retrospective study, the orthopaedic team at the Marshall University Joan C. Edwards School of Medicine and Marshall Health performed 25 revision knee replacements with a robotic assisted computer system. The procedure involved placing new implants at the end of the thighbone and top of the shinbone with the computer’s aid to ensure the knee was stable and balanced throughout the range of motion. Researchers then carefully compared the initial positions of the primary implants with the final planned positions of the robotic revision implants for each patient, assessing the differences in millimeters and degrees.
The analysis found that exceedingly small changes in implant position significantly influence the function of the knee replacement. Robotic assistance during revision surgery has the potential to measure these slight differences. In addition, the computer system can help the surgeon predict what size implant to use as well as help to balance the knee for stability.
“Robotic-assisted surgery has the potential to change the way surgeons think about revision knee replacement,” said Matthew Bullock, D.O., associate professor of orthopaedic surgery and co-author on the study. “The precision offered by robotic-assisted surgery not only enhances the surgical process but also holds promise for improved patient outcomes. Besides infection, knee replacements usually fail because they become loose from the bone or because they are unbalanced leading to pain and instability. When this happens patients can have difficulty with activities of daily living such as walking long distances or negotiating stairs.”
The study underscores the importance of aligning the prosthesis during revision surgery. The research also suggests potential advantages, including appropriately sized implants that can impact the ligament tension which is crucial for functional knee revisions.
“These findings open new doors in the realm of revision knee arthroplasty,” said Alexander Caughran, M.D., assistant professor of orthopaedic surgery and co-author on the study. “We continue to collect more data for future studies on patient outcomes after robotic revision knee replacement. We anticipate that further research and technological advancements in the realm of artificial intelligence will continue to shape the landscape of orthopaedic surgery.”
In addition to Bullock and Caughran, co-authors from Marshall University include Micah MacAskill, M.D., resident physician; Richard Peluso, M.D., resident physician; Jonathan Lash, M.D., resident physician; and Timothy Hewett, Ph.D., professor.

After COVID vaccination, it usually takes weeks for our bodies to develop protective antibody responses. Imagine, however, a vaccine that speeds up the production of antibodies against SARS-CoV-2, the virus that spreads COVID-19.
A research team led by Rong Hai, an associate professor of microbiology and plant pathology at the University of California, Riverside, has developed such a vaccine by using preexisting immunity to a separate virus (the influenza virus) to help kickstart the process of making antibodies against SARS-CoV-2.
“Any delay in the immune response to SARS-CoV-2 means there is some time when people are left poorly protected against the virus,” Hai said. “Our vaccine is designed to get people those protective antibody responses faster, so they are not vulnerable to the coronavirus. This is better protection for everyone. It could be especially valuable for people who still lack immunity to SARS-CoV-2, such as children.”
Study results appear in the Journal of Virology.
To develop the new design, Hai and his colleagues targeted SARS-CoV-2 as a representative pandemic virus and generated a “fusion protein” vaccine that combines the nucleoprotein from influenza A virus and the receptor-binding domain, or RBD, of the SARS-CoV-2 spike protein. The SARS-CoV-2 virus uses the spike protein to attach to a receptor on the surface of cells — the first step in the infection of the cell by the virus. Antibodies against RBD block the interaction of the spike protein with the receptor, thereby preventing the virus from infecting the cell.
The new vaccine design addresses a long-standing challenge in the field of virology: the delay in developing protective adaptive immunity for emerging viral pathogens. Hai explained that in any infection antibodies are made by a type of cell called the B cell. Each B cell produces one antibody against one specific target; only a small subset of B cells, however, can produce antibodies against RBD.
“For more B cells to become activated and start producing antibodies against RBD, two steps are needed,” said Harrison Dulin, the first author of the paper and a former graduate student in Hai’s lab. “First, the B cell needs to encounter the RBD protein, and second, the B cell needs to be activated by another cell called a helper T cell. At the start of an immune response against SARS-CoV-2, there are only a few helper T cells around that can help activate the RBD-specific B cells. This causes a delay in mounting the antibody response against the pathogen.”
According to Hai, the new vaccine design has the advantage of allowing the RBD-specific B cells to derive help from a pool of readily available helper T cells generated in response to a flu infection.

“The flu helper T cells are harnessed to activate the RBD-specific B cells, speeding up the process of antibody production,” he said.
Encouragingly, the new design can be used even in countries with limited financial resources.
“Given the simplicity of our new design, it would not require these countries to acquire any additional complicated or expensive equipment,” Hai said. “We designed the vaccine so that it could be administered the same way as currently available vaccines.”
The new design stemmed from another project led by Hai, which aimed to design a dual vaccine platform for both influenza and SARS-CoV-2 virus. Although the research team only tested the vaccine against SARS-CoV-2, in principle the new design can be used to speed up antibody responses against other emerging pathogens.
“It could be especially useful if we ever have to deal with SARS-CoV-3 or some other novel pandemic virus,” said coauthor Emma H. Wilson, a professor of biomedical sciences in the UCR School of Medicine.
Hai cautioned more work needs to be done in the lab before the newly designed vaccine is made available to people.

“So far, we have only tested the vaccine in mice,” Hai said. “We need to explore through clinical trials if this vaccine is safe for humans. It’s a long process. Further, preexisting immunity to influenza can vary from person to person, and we know that immune responses can wane over time. We need to test this vaccine in a range of immune backgrounds to see how widely applicable our strategy is.”
The research project made use of the newly established biosafety level 3, or BSL-3, lab at UCR.
“We needed to show that the antibody responses produced by our vaccine could effectively neutralize live SARS-CoV-2,” Hai said. “Because SARS-CoV-2 is a dangerous and highly contagious virus, working with live versions of the virus can only be done in BSL-3 labs.”
Hai, Wilson and Dulin were joined in the research by Duo Xu, Arrmund Neal, Edward Vizcarra, Jerald Chavez, Arzu Ulu, Keidy Wuang, Nikhil Bhakta, and Chanvoraboth Chea of UCR; and Ramya S. Barre, Myeon-Sik Yang, Siddiqur Rahman Khan, and Luis Martinez-Sobrido of the Texas Biomedical Research Institute in San Antonio. Dulin is now a postdoctoral researcher at the Fred Hutchinson Cancer Research Center, which focuses on infectious diseases.
The research was funded by a grant to Hai from the National Institute of Allergy and Infectious Diseases of the National Institutes of Health.

When medicine does not ease an enlarged prostate, known also as BPH, a common surgery with few risks is often used.King Charles III will have a procedure to address an enlarged prostate at a hospital next week. The 75-year-old British monarch’s diagnosis is common among men his age, and experts say that typical treatments are not dangerous.An enlarged prostate, known also as benign prostatic hyperplasia, or BPH, is a noncancerous condition that occurs frequently among older men. By age 60, more than half of men have at least mild BPH symptoms, which include difficulty urinating and a sense of urgency to urinate. But often the symptoms are not severe enough to require treatment.The condition is analogous to menopause in women, said Dr. Peter Albertsen, a urologist and prostate specialist at the University of Connecticut. Menopause usually begins around age 50 when levels of testosterone and estrogen start changing. The same thing happens in men, Dr. Albertsen said, and at the same age.“We think it’s the changing ratio of testosterone to estrogen,” he said. “The way the male responds is that the prostate enlarges. It’s a normal process of aging.”The prostate is shaped like a doughnut surrounding the urethra, the tube that carries urine from the bladder to the penis. When the prostate grows, the tube gets squeezed, said Dr. Judd W. Moul, a urologist and prostate specialist at Duke University.Most men notice symptoms, he added. They urinate more often, they get up at night to urinate. Their urine stream is more feeble.If symptoms get more severe, men usually are treated with medications to relax the prostate. Dr. Albertsen said that doctors typically start by prescribing an alpha blocker, like terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral) or silodosin (Rapaflo).Another choice is finasteride (Proscar or Propecia), which blocks the conversion of testosterone to dihydrotestosterone, the hormone that causes the prostate to enlarge.If the prostate continues to grow despite medical treatment — which can happen when men reach Charles’s age — some may need surgery.Buckingham Palace did not describe on Wednesday the procedure Charles would undergo. But experts say that the most common and appropriate treatment is a transurethral resection of the prostate, or TURP. A surgeon scrapes out the inside of the prostate gland, giving the urethra more space. The operation has been used for 100 years, Dr. Moul said.Men who have a TURP usually go home that day or the next, and have a catheter to drain urine for the next day or two.More recently, new surgical treatments have been introduced, including an electrical cutting loop to destroy prostate tissue, steam to vaporize prostate tissue and a system that uses implants to hold the prostate away from the urethra.Although the techniques vary, all the operations have the same goal — making the prostate smaller.“The best operation,” Dr. Moul said, “is the one the most experienced surgeon does expertly.”None of the operations is debilitating, Dr. Albertsen added.Surgery for benign prostatic hypertrophy “is no big deal,” he said.

After the death of his son, a police detective, was linked to toxins at the World Trade Center site, he helped win federal benefits for other emergency responders.Joseph C. Zadroga, whose lobbying helped deliver health benefits to thousands of emergency workers whose health was impaired by inhaling dust and debris at ground zero after the 2001 terrorist attack on the World Trade Center — although his efforts came too late for his own son, a New York City detective — died on Saturday after being hit by a car in Pomona, N.J. He was 76.His death was confirmed by his son Joseph F. Zadroga.Early Saturday afternoon, the elder Mr. Zadroga was visiting his wife at the Bacharach Institute for Rehabilitation. According to the Galloway Township police, he was standing outside his parked car when he was struck by an SUV that apparently accelerated accidentally and pinned him under it. He was pronounced dead at AtlantiCare Regional Medical Center.A retired North Arlington, N.J., police chief, Mr. Zadroga was instrumental in the passage by Congress in 2010 of the James Zadroga 9/11 Health and Compensation Act, which provides federal medical benefits, including monitoring and treatment, to police officers, firefighters and emergency medical workers who became ill as a result of their exposure to the contaminants in the aftermath of the 2001 devastation in Lower Manhattan. Mr. Zadroga and others successfully pushed Congress to reauthorize the legislation in 2015.The death of his son James was the first death of a public employee that was officially linked by an autopsy to time spent by an emergency worker at ground zero.James Zadroga, Mr. Zadroga’s son, with his daughter, Tyler Ann. She was orphaned after he died in 2006, and the elder Mr. Zadroga, along with other members of the family, raised her.FAMILY PHOTO VIA NEW YORK DAILY NEWS, via Associated PressJames Zadroga died in 2006, at 34, after spending some 500 hours engaged in recovery efforts at what became known as the Pile. By the following May, after sifting the rubble for human remains, workers had removed 1.8 million tons of tangled wreckage. He eventually qualified for disability pension benefits.His death came a year after his wife, Rhonda, died of a heart attack, which left him to raise their 4-year-old daughter, Tyler Ann. She was orphaned when he died bringing her a baby bottle, and she was brought up by his parents, his brother and his sister-in-law.“I just want everybody out there, the victims who got sick, to have the health care that they deserve, because Jimmy didn’t get it,” Joseph Zadroga said at a rally in 2014.Patrick Hendry, the president of the Police Benevolent Association, New York City’s largest police officers’ union, said in a statement: “Joseph Zadroga took on a fight that no father should have to face. But he fought for his hero son with incredible courage and helped every single 9/11 responder in the process.”After his son died, Mr. Zadroga was invited by Representative Carolyn Maloney, a Manhattan Democrat, to testify before Congress, and he helped mount a nationwide campaign for the health care legislation that was supported by the comedian and talk show host Jon Stewart and other celebrities.In his testimony, Ms. Zadroga quoted from a letter written by his son: “Everyone praises the dead as heroes, as they should, but there are more living suffering than dead.”The Ocean County coroner had originally found that James Zadroga died of “respiratory failure” resulting from a “history of exposure to toxic fumes and dusts.”But about a year and a half later, New York City’s chief medical examiner, Charles S. Hirsch, concluded that the particles in his lungs were from the abuse of prescription drugs. (His family said that if he had taken painkillers, it was because he found it increasingly painful to breathe.) A third opinion, by Dr. Michael Baden, who had been the city’s chief medical examiner in the late 1970s, supported the coroner’s original finding.The conflicting opinions entangled Mayor Michael R. Bloomberg, who endorsed Dr. Hirsch’s conclusion and said: “We wanted to have a hero, and there are plenty of heroes. It’s just in this case, science says this was not a hero.” The mayor later apologized, saying, “I believe that James Zadroga was a hero for the way he lived, regardless of the way that he died.”James Zadroga is not listed on the 9/11 memorial.Mr. Zadroga with the comedian and talk show host Jon Stewart in Washington in 2019. Mr. Stewart was among the celebrities who supported Mr. Zadroga’s campaign for what became the James Zadroga 9/11 Health and Compensation Act.Jim Watson/Agence France-Presse — Getty ImagesJoseph Charles Zadroga was born on April 2, 1947, in Newark. His father, Charles, worked for RCA. His mother, Ann (Czyc) Zadroga, ran the household.After graduating from North Arlington High School, Joseph earned a bachelor’s degree in criminal justice from William Paterson College (now William Paterson University) in Wayne, N.J., and a master’s in emergency management from Fairleigh Dickinson University. He served in the Army in Vietnam from 1966 to 1968.In addition to his wife, Linda (Baczewski) Zadroga, and his son, Mr. Zadroga is survived by his sister, Paula Bates, and two grandchildren.Joseph Zadroga worked for the North Arlington Police Department from 1970 until 1997, when he retired as chief. He later taught at the Bergen County Police Academy. Tattooed on his forearm were a crucifix, his son’s name and the words “Not Forgotten.”“Joe turned his son’s tragedy into something that really helped so many people,” Michael Barasch, who was James Zadroga’s lawyer, told northjersey.com, adding that James “didn’t die in vain, because of the autopsy his parents ordered.”“Without that,” he said, “we would have never had the evidence to get Congress to act.”

Scientists have grown ‘mini-placentas’ in the lab and used them to shed light on how the placenta develops and interacts with the inner lining of the womb — findings that could help scientists better understand and, in future, potentially treat pre-eclampsia.
The study, published today in Cell Stem Cell, shows that it is possible to experiment on a developing human placenta, rather than merely observe specimens, in order to study major disorders of pregnancy.
Successful pregnancy depends on the development of the placenta in the first few weeks of gestation. During this period, the placenta implants itself into the endometrium — the mucosal lining of the mother’s uterus.
Interactions between the cells of the endometrium and the cells of the placenta are critical to whether a pregnancy is successful. In particular, these interactions are essential to increase the maternal blood supply to the placenta, necessary for fetal growth and development.
When these interactions do not work properly, they can lead to complications, such as pre-eclampsia, a condition that causes high blood pressure during pregnancy. Pre-eclampsia occurs in around six in 100 first pregnancies and can put at risk the health of both the mother and the baby.
Professor Ashley Moffett from the Department of Pathology at the University of Cambridge said: “Most of the major disorders of pregnancy — pre-eclampsia, still birth, growth restriction, for example — depend on failings in the way the placenta develops in the first few weeks. This is a process that is incredibly difficult to study — the period after implantation, when the placenta embeds itself into the endometrium, is often described as a ‘black box of human development’.
“Over the past few years, many scientists — including several at Cambridge — have developed embryo-like models to help us understand early pre-implantation development. But further development is impeded because we understand so little about the interactions between the placenta and the uterus.”
Professor Moffett and colleagues at the Friedrich Miescher Institute, Switzerland, and the Wellcome Sanger Institute, Cambridge, have used ‘mini-placentas’ — a cellular model of the early stages of the placenta — to provide a window into early pregnancy and help improve our understanding of reproductive disorders. Known as ‘trophoblast organoids’, these are grown from placenta cells and model the early placenta so closely that they have previously been shown to record a positive response on an over-the-counter pregnancy test.

In previous work, Professor Moffett and colleagues identified genes that increase the risk of or protect against conditions such as pre-eclampsia. These highlighted the important role of immune cells uniquely found in the uterus, known as ‘uterine natural killer cells’, which cluster in the lining of the womb at the site where the placenta implants. These cells mediate the interactions between the endometrium and the cells of the placenta.
In their new study, her team applied proteins secreted by the uterine natural killer cells to the trophoblast organoids so that they could mimic the conditions where the placenta implants itself. They identified particular proteins that were crucial to helping the organoids develop. These proteins will contribute to successful implantation, allowing the placenta to invade the uterus and transform the mother’s arteries.
“This is the only time that we know of where a normal cell invades and transforms an artery, and these cells are coming from another individual, the baby,” said Professor Moffett, who is also a Fellow at King’s College, Cambridge.
“If the cells aren’t able to invade properly, the arteries in the womb don’t open up and so the placenta — and therefore the baby — are starved of nutrients and oxygen. That’s why you get problems later on in pregnancy, when there just isn’t enough blood to feed the baby and it either dies or is very tiny.”
The researchers also found several genes that regulate blood flow and help with this implantation, which Professor Moffett says provide pointers for future research to better understand pre-eclampsia and similar disorders.
Dr Margherita Turco, from the Friedrich Miescher Institute in Switzerland and co-lead of this work, added: “Despite affecting millions of women a year worldwide, we still understand very little about pre-eclampsia. Women usually present with pre-eclampsia at the end of pregnancy, but really to understand it — to predict it and prevent it — we have to look at what’s happening in the first few weeks.
“Using ‘mini-placentas’, we can do just that, providing clues as to how and why pre-eclampsia occurs. This has helped us unpick some of the key processes that we should now focus on far more. It shows the power of basic science in helping us understand our fundamental biology, something that we hope will one day make a major difference to the health of mothers and their babies.”
The research was supported by Wellcome, the Royal Society, European Research Council and Medical Research Council.

New research by investigators from the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai shows that behavioral activation therapy is as effective as antidepressant medications in treating symptoms of depression in patients with heart failure.
Heart failure affects nearly 6 million adults in the United States, and approximately 50% of heart failure patients experience symptoms of depression along with their condition. Past studies show patients with heart failure and depression have lower cardiac function, more emergency department visits and hospital admissions, higher caregiver burden, and poorer quality of life compared with patients with heart failure who are not depressed.
“The most important finding here is that patients experiencing depression have a choice in terms of their treatment between therapy or medications,” said Waguih W. IsHak, MD, vice chair of Education and Research in the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai and first author of the study. “Patients who prefer not to be on medication can do behavioral activation therapy with similar results.”
The study, which was published in the peer-reviewed journal JAMA Network Open, followed more than 400 patients over the course of a year. Half of the study participants received antidepressant medication management to treat depression symptoms while the other half participated in behavioral activation psychotherapy, an evidence-based treatment for depression that promotes engagement in activities a patient finds enjoyable.
Investigators say there was no statistically significant difference between the effectiveness of the two methods, with each patient group experiencing a more than 50% reduction in the severity of depressive symptoms.
Study participants randomized to receive behavioral activation therapy worked with a therapist to develop a personalized list of activities that bring them joy and fulfillment, including having lunch with a friend, taking a walk, volunteering, listening to their favorite music — among other options — on a regularly scheduled basis. The treatment focused on increasing the level of enjoyable and rewarding activities the patient was doing every week for 12 weeks, and then incorporating them into their regular activity schedule.
Patients who received psychotherapy intervention showed a slight improvement in their physical and mental health-related quality of life, a secondary outcome monitored by the study. They also had fewer emergency department visits and spent fewer days hospitalized during the course of the study compared with the patients who were randomized to receive antidepressant medications.
“This study, which was conducted in a real-world setting, demonstrates that it is entirely feasible to incorporate psychiatric treatment into specialty medical care. Integrating psychiatric treatment into medical care is an effective way to reduce stigma, increase access and improve outcomes for people who struggle with mental health problems alongside their chronic medical conditions,” said Itai Danovitch, MD, MBA, chair of the Department of Psychiatry and Behavioral Neurosciences and a study co-author. “Most people who suffer from depression do not receive effective treatment. It is critical that we increase screening for psychiatric conditions and ensure that patients have access to high-quality and effective mental health care.”
Other Cedars-Sinai authors involved in the study are Michele A. Hamilton, MD; Samuel Korouri, BA; Marcio A. Diniz, PhD; James Mirocha, MS; Rebecca Hedrick, MD; Robert Chernoff, PhD; Jeanne T. Black, PhD; Harriet Aronow, PhD; Brigitte Vanle, MD, PhD; Jonathan Dang, MD; Gabriel Edwards, MD; Tarneem Darwish, MD; Gabrielle Messineo, LCSW; Stacy Collier, RN; Mia Pasini, RN; John G. Harold, MD; and Brennan Spiegel, MD, MSHS. Additional authors include Kaleab K. Tessema, MD, PhD; Michael K. Ong, MD; and Kenneth Wells, MD.
Funding: The study by was funded by the Patient-Centered Outcome Research Institute (PCORI) (award No.: 2017C2-7716; paid to Cedars-Sinai Medical Center).