Publisher Health

Mopping up free radicals with antioxidants was the rage in the 1970’s; people were taking large, sometimes massive doses of various general antioxidants, including vitamins and minerals, to try to remove harmful byproducts of energy metabolism. The method was supposed to blunt the effects of aging and stave off chronic disease. The strategy didn’t work, and in some cases, it caused harm because untargeted antioxidants also compromised beneficial cellular signaling pathways. Over time, this area of research went on the shelf as mitochondrial theories of disease and aging fell into disfavor.
But research at the Buck offers a new way to deal with free radicals: rather than mop them up, take a pill that selectively keeps them from being produced in the first place. Building on this work, collaborative research between the Buck and Calico Labs, recently published in Free Radical Biology and Medicine shows that specifically inhibiting free radical production at a particular mitochondrial site prevents and treats metabolic syndrome in mice, by preventing and reversing insulin resistance.
“We think that mitochondrial radical production drives many chronic diseases of aging, and that blocking the production of free radicals is a viable disease-treating and anti-aging intervention,” said Martin Brand, Ph.D., Buck Professor Emeritus and senior investigator of the study. “We’ve found a way to selectively keep problematic free radicals in check without compromising normal energy production in the mitochondria. These compounds act like a cork in a wine bottle. They plug a specific site so that it doesn’t produce free radicals, without hindering the mitochondria’s critical function of energy metabolism. We look forward to continuing this groundbreaking area of research.”
The orally bioavailable compound that has been developed, S1QEL1.719 (a new “S1QEL” — Suppressor of site IQ Electron Leak), was given both prophylactically and therapeutically to mice fed a high-fat diet that causes metabolic syndrome. Treatment decreased fat accumulation, strongly protected against decreased glucose tolerance and prevented or reversed the increase in fasting insulin levels by protecting against the development of insulin resistance.
Acting on mitochondrial complex I highlights potential interventions for other conditions
S1QEL1s act on site IQin mitochondrial complex I. (The mitochondrial electron transport chain consists of four protein complexes integrated into the inner mitochondrial membrane. Together they carry out a multi-step process, oxidative phosphorylation, through which cells derive 90% of their energy.)
First author and Buck staff scientist Mark Watson, Ph.D., says current literature strongly implicates complex I in a number of different diseases, from metabolic syndrome to Alzheimer’s, fatty liver disease, and noise-induced hearing loss, as well as the underlying aging process itself.
“S1QELs don’t sequester oxidants or radicals. Rather, they specifically inhibit radical production at the IQ site on complex I without interfering with other sites,” Watson said. “So the normal redox signaling that we require in our cells will continue. S1QELs just modulate that one site. They are very clean, very specific, and do not disrupt mitochondrial functioning like inhibitors of mitochondria do.”
Brand says the data shows that free radical production from complex I is an essential driver of insulin resistance and metabolic syndrome, a major disease of poor lifestyle choices and of aging. He says this feature is a strong reason to revisit the mitochondrial theory of aging. “These compounds fine-tune mitochondrial production of free radicals,” he said. “And it’s really interesting; just inhibiting this specific site improves the whole redox environment and prevents metabolic disease, and that is amazing.”

The recent progress in the field of robotics and artificial intelligence (AI) promises a future where these technologies would play a more prominent role in society. Current developments, such as the introduction of autonomous vehicles, the ability to generate original artwork, and the creation of chatbots capable of engaging in human-like conversations, highlight the immense possibilities held by these technologies. While these advancements offer numerous benefits, they also pose some fundamental questions. The characteristics such as creativity, communication, critical thinking, and learning — once considered to be unique to humans — are now being replicated by AI. So, can intelligent machines be considered ‘human’?
In a step toward answering this question, Associate Professor Tomohide Ibuki from Tokyo University of Science, in collaboration with medical ethics researcher Dr. Eisuke Nakazawa from The University of Tokyo and nursing researcher Dr. Ai Ibuki from Kyoritsu Women’s University, recently explored whether robots and AI can be entrusted with nursing, a highly humane practice. Their work was made available online on 12 June 2023 and published in the journal Nursing Ethics on 12 June 2023.
“This study in applied ethics examines whether robotics, human engineering, and human intelligence technologies can and should replace humans in nursing tasks,” says Dr. Ibuki.
Nurses demonstrate empathy and establish meaningful connections with their patients. This human touch is essential in fostering a sense of understanding, trust, and emotional support. The researchers examined whether the current advancements in robotics and AI can implement these human qualities by replicating the ethical concepts attributed to human nurses, including advocacy, accountability, cooperation, and caring.
Advocacy in nursing involves speaking on behalf of patients to ensure that they receive the best possible medical care. This encompasses safeguarding patients from medical errors, providing treatment information, acknowledging the preferences of a patient, and acting as mediators between the hospital and the patient. In this regard, the researchers noted that while AI can inform patients about medical errors and present treatment options, they questioned its ability to truly understand and empathize with patients’ values and to effectively navigate human relationships as mediators.
The researchers also expressed concerns about holding robots accountable for their actions. They suggested the development of explainable AI, which would provide insights into the decision-making process of AI systems, improving accountability.
The study further highlights that nurses are required to collaborate effectively with their colleagues and other healthcare professionals to ensure the best possible care for patients. As humans rely on visual cues to build trust and establish relationships, unfamiliarity with robots might lead to suboptimal interactions. Recognizing this issue, the researchers emphasized the importance of conducting further investigations to determine the appropriate appearance of robots for facilitating efficient cooperation with human medical staff.
Lastly, while robots and AI have the potential to understand a patient’s emotions and provide appropriate care, the patient must also be willing to accept robots as care providers.
Having considered the above four ethical concepts in nursing, the researchers acknowledge that while robots may not fully replace human nurses anytime soon, they do not dismiss the possibility. While robots and AI can potentially reduce the shortage of nurses and improve treatment outcomes for patients, their deployment requires careful weighing of the ethical implications and impact on nursing practice.
“While the present analysis does not preclude the possibility of implementing the ethical concepts of nursing in robots and AI in the future, it points out that there are several ethical questions. Further research could not only help solve them but also lead to new discoveries in ethics,” concludes Dr. Ibuki.
Here’s hoping for such novel applications of robotics and AI to emerge soon!

A lollipop might be a sweet reward for a kid who’s endured a trip to the doctor’s office, but now, this candy could make diagnostic testing during a visit less invasive and more enjoyable. Researchers publishing in ACS’ Analytical Chemistry have shown, for the first time, that a lollipop-based saliva collection system can capture bacteria from adults and remain shelf-stable for up to a year. Study participants also preferred the candies over conventional collection systems.
Throat swabs are commonly used to collect samples for the diagnosis of a wide variety of illnesses, including strep throat. A less-gag-inducing method is saliva sampling, in which technicians analyze a patient’s spit with methods such as quantitative polymerase chain reaction (qPCR). Because this type of sample can be collected directly by a patient, the technique is popular for at-home testing and saw expanded use during the COVID-19 pandemic. Gathering the necessary amount of saliva can be somewhat gross, though, which is why some scientists are looking to make the process more enjoyable by combining it with the equally drool-filled, yet much more pleasant, experience of enjoying a lollipop.
Previously, Sanitta Thongpang, Ashleigh Theberge, Erwin Berthier and colleagues developed their own lollipop collection device dubbed CandyCollect. At first glance, CandyCollect looks like most lollipops, except for its spoon-like stick with a spiral-shaped groove carved into the top. This flattened end is covered with isomalt candy, allowing for saliva to easily flow into the groove as the lollipop is eaten. In a past study, the researchers showed in lab tests that the device could capture the bacteria responsible for strep throat. Now, they wanted to target other, naturally occurring bacteria and see how their system compared to other commercially available, at-home saliva sampling methods with real people.
Researchers sent CandyCollect and two conventional saliva sampling kits to 28 adult volunteers, who used them, answered some survey questions, then shipped the devices back to the lab. The researchers eluted the samples and then quantified Streptococcus mutans and Staphylococcus aureus bacteria using qPCR. Whenever one or both of the conventional methods detected the target bacteria, CandyCollect also detected them 100% of the time. Additionally, the candies were the most popular method of the three among participants, who also agreed it was the “most sanitary” and “least disgusting.” The devices still produced accurate results after being stored for a year. Although the studies are still ongoing, the team says that this work shows that the system is adaptable and well liked. The researchers say it could inspire other scientists to develop more intuitive and convenient at-home testing methods.

University of Virginia School of Medicine researchers have discovered how the cells that let us hear can repair themselves after being damaged. That important insight could benefit efforts to develop new and better ways to treat and prevent hearing loss.
“Hair cells” found in the inner ear, are important both for our ability to hear and our sense of balance. They are known as hair cells because the cells are covered in hair-like structures that serve as mechanical antennas for sound detection. When auditory hair cells are killed, as we learn in school, they are gone for good. But the new UVA Health research shows these delicate cells have the ability to repair themselves from damage caused by loud noises or other forms of stress.
“For many years, auditory research has placed considerable emphasis on the regeneration of sensory hair cells. Although these efforts continue, it is equally important to enhance our comprehension of the intrinsic mechanisms that govern the repair and maintenance of these cells. By gaining a deeper understanding of these inherent repair processes, we can uncover strategies to fortify them effectively. One such approach in the future might involve the utilization of drugs that stimulate repair programs,” said researcher Jung-Bum Shin, PhD, of UVA’s Department of Neuroscience. “In essence, when replacement of hair cells proves challenging, the focus shifts towards repairing them instead. This dual strategy of regeneration and repair holds strong potential in advancing treatments for hearing loss and associated conditions.”
Hearing Repair
Hair cells are naturally fragile — they must be delicate so they can sense sound, but they also must withstand the continuous mechanical stress inherent in their jobs.
Prolonged exposure to loud noise harms hair cells in a variety of ways, and one of those is by damaging the cores of the “hairs” themselves. These hair-like structures are known as stereocilia, and Shin’s new research shows a process they use to repair themselves.

The hair cells do this by deploying a protein called XIRP2, which has the ability to sense damage to the cores, which are made of a substance called actin. Shin and his team found that XIRP2 first senses damage, then migrates to the damage site and repairs the cores by filling in new actin.
“We are especially excited to have identified a novel mechanism by which XIRP2 can sense damage-associated distortions of the actin backbone,” Shin said. “This is of relevance not only for hair cell research, but the broader cell biology discipline.”
The pioneering work has netted Shin and his colleagues more than $2.3 million from the National Institutes of Health, grant R01DC021176, to fund additional research into how the cores are repaired. By understanding this, scientists will be better positioned to develop new ways to battle hearing loss — even the kind that comes from aging, the researchers say.
“Age-related hearing loss affects at least a third of all older adults,” Shin said. “Understanding and harnessing internal mechanisms by which hair cells counteract wear and tear will be crucial in identifying ways to prevent age-related hearing loss. Furthermore, this knowledge holds potential implications for associated conditions such as Alzheimer’s disease and other dementia conditions.”
Findings Published
The researchers have published their findings in the scientific journal eLife. The article is open access, meaning it is free to read.
The research team consisted of Elizabeth L. Wagner, Jun-Sub Im, Stefano Sala, Maura I. Nakahata, Terence E. Imbery, Sihan Li, Daniel Chen, Katherine Nimchuk, Yael Noy, David W. Archer, Wenhao Xu, George Hashisaki, Karen B. Avraham, Patrick W. Oakes and Shin. The researchers have no financial interest in the work.
The research was supported by the National Institutes of Health’s National Institute on Deafness and Other Communication Disorders, grants R01DC014254, R56DC017724, R01DC018842, R01DC011835 and 1F31DC017370-01. Additional support was provided by the Owens Family Foundation, the Virginia Lions Hearing Foundation, and a National Science Foundation CAREER Award.

A team of scientists led by Nanyang Technological University, Singapore (NTU Singapore) has found that an existing cancer drug could be repurposed to target a subset of cancers that currently lack targeted treatment options and is often associated with poor outcomes.
This subset of cancers makes up 15 per cent of all cancers and is especially prevalent in aggressive tumours such as osteosarcoma (bone tumour) and glioblastoma (brain tumour).
These cancerous cells ‘stay immortal’ using a mechanism called the alternative lengthening of telomeres (ALT), but the team has demonstrated that ponatinib, a cancer drug approved by the US Food and Drug Administration, blocks key steps in the ALT mechanism that leads it to fail.
Reporting their findings based on laboratory experiments and preclinical animal studies, the scientists found that ponatinib helped to shrink bone tumours (a type of ALT cancer) without causing weight loss, a common side effect associated with cancer drugs. In mice with tumours treated with ponatinib, they found a reduction in a biomarker for ALT cancer as compared to untreated mice. The findings are published in the scientific journal Nature Communications.
The researchers say that the findings move them a step closer to developing a targeted therapeutic option for ALT cancers, which lack clinically approved targeted treatments to date.
Dr Maya Jeitany and a team of researchers from the NTU School of Biological Sciences, together with collaborators from the Cancer Science Institute of Singapore and the Yong Loo Lin School of Medicine, both at the National University of Singapore (NUS), and the Genome Institute of Singapore at the Agency for Science, Technology and Research (A*STAR), are seeking to address this unmet need.

Dr Jeitany, study lead and senior research fellow at NTU’s School of Biological Sciences, said: “A prominent feature of cancer is its ability to evade cell death and acquire indefinite replication — to stay immortal, in other words — which it can do through the alternative lengthening of telomeres (ALT) mechanism. While a sizeable portion of cancer cells depend on this mechanism, there is no clinically approved targeted therapy available.
“Through our study, we identified a novel signalling pathway in the ALT mechanism and showed that the FDA-approved drug ponatinib inhibits this pathway and holds exceptional promise in stopping the growth of ALT cancer cells. Our findings may provide a new direction for the treatment of ALT cancers by repurposing an FDA-approved drug for these types of tumours.”
Commenting as an independent expert, Assistant Professor Valerie Yang, medical oncologist with the Department of Lymphoma and Sarcoma at the National Cancer Centre Singapore, said: “Sarcomas and glioblastomas are both highly complex cancers that are more prevalent in young people and currently have limited treatment options. The identification of a drug that is FDA-approved which can be repurposed to target ALT, an Achilles heel in these cancers, is very exciting.”
The study aligns with NTU 2025, the University’s five-year strategic plan, which aims to address humanity’s grand challenges by responding to the needs and challenges of healthy living.
How cancer cells replicate and grow
Telomeres are protective “caps” at the tips of every chromosome, which carries our DNA. With each cell division, a bit of the telomeres is naturally snipped off, until they become too short, leading to cell death.

Most cancer cells bypass this process by activating an enzyme called telomerase, which lengthens the telomeres so that the cells can replicate indefinitely. However, about 15 per cent of cancers lengthen their telomeres through alternative pathways, rather than activating telomerase. This mechanism is known as the alternative lengthening of telomeres (ALT).
To date, there is no clinically approved targeted treatment for ALT cancers. Furthermore, many ALT cancers, such as osteosarcoma and glioblastoma, show resistance to chemotherapy, highlighting the need for a more targeted form of treatment.
Drug affects telomeres in ALT cancer cells
Through high-throughput drug screening — a process of screening large numbers of relevant biological or pharmacological compounds — and subsequent testing of shortlisted compounds, the scientists discovered that ponatinib, a drug approved by the US Food and Drug Administration for a type of bone marrow cancer, can kill ALT cancer cells effectively.
When osteosarcoma and liposarcoma (a tumour that grows in fatty tissues) cells were treated with ponatinib, the scientists found that the drug led to DNA damage, dysfunctional telomeres, and triggered senescence, a process in which the cell stops dividing. Importantly, the synthesis of telomeres in the cells also dropped after 18 to 20 hours of treatment with the drug.
Pre-clinical studies conducted on mice that had received transplants of human bone cancer cells further validated the potential of ponatinib. The drug reduced the tumour sizes without affecting the mice’s body weight, a common side effect associated with cancer treatments.
In mice with tumours treated with ponatinib, there was also a reduction in a biomarker for ALT cancer as compared to untreated mice — an indicator that the drug was effective in inhibiting ALT cancer growth.
The scientists ran further tests to identify ponatinib’s mode of action on telomeres in ALT cancer cells and identified a signalling pathway (a series of chemical reactions in which a group of molecules in a cell work together to control a cell function) that could be responsible for the drug’s effect on ALT.
The researchers are now studying further how ponatinib affects telomeres to understand in more detail the signalling pathway they have identified. They are also assessing potential ponatinib-based combinatorial drug treatments for ALT cancers.

Published4 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, PrimeBy Annabelle LiangBusiness reporterUS Senate Majority Leader Chuck Schumer has called on regulators to investigate an energy drink promoted by high-profile YouTubers KSI and Logan Paul.Mr Schumer alleges the drink is being targeted at children despite its high caffeine content.Prime Energy contains 200mg of caffeine per can, which is almost twice the amount in rival energy drink Red Bull.Each drink carries a warning stating that it is not recommended for children under the age of 18.However, Mr Schumer alleged that Prime Energy was packaged and marketed “in near identical form” as a caffeine-free drink from the brand.As a result, some parents had unknowingly bought the caffeinated drink for their children, he told reporters in New York on Sunday.”The FDA [Food and Drug Administration] must investigate PRIME for its absurd caffeine content and its marketing targeting kids on social media,” he later said on Twitter.Prime did not immediately respond to a BBC request for comment.Image source, Getty ImagesIn 2022, Logan Paul and KSI – who have around 48 million YouTube followers between them – launched the caffeine-free Prime Hydration drink.It quickly became an online sensation, sparking long queues and even headfirst dives into shelves at stores.The caffeinated Prime Energy drink was launched in January this year. It is promoted by the company as being sugar-free and vegan.A warning on each can of the drink states that it is not recommended for children under the age of 18, people who are sensitive to caffeine, pregnant women or women who are breastfeeding.Some schools around the world have sent out warnings about Prime drinks or banned them altogether.Earlier this year, the Milton Primary School in Newport, Wales sent a message to parents warning them not to confuse the caffeinated and non-caffeinated versions of the drink after a pupil fell ill outside of school hours.Meanwhile, the Maryborough State High School in Queensland, Australia issued a ban on energy drinks.”There are some new energy or hydration drinks that have recently hit the market… some of which have 4 TIMES the caffeine or stimulant as ‘regular’ energy drinks,” the school said in a post on Facebook.”These can cause significant concerns in students with (potentially unidentified) health issues,” it added.This video can not be playedTo play this video you need to enable JavaScript in your browser.More on this storyIs Prime causing problems in playgrounds?Published5 JunePrime Energy prompts caffeine warning concernsPublished22 MayHow KSI and Logan Paul made people crazy for PrimePublished18 April

Published6 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Michelle RobertsDigital health editorEurope’s drugs regulator has told BBC News it is conducting a review of some weight-loss jabs after being alerted to a possible link to thoughts of suicide and self-harm among users. Member state Iceland notified the European Medicines Agency after seeing three cases. The safety assessment will look at Wegovy, Saxenda and similar drugs, such as Ozempic, that help curb appetite. Product leaflets already list suicidal thoughts as a possible side effect.Suicidal behaviour is not currently listed for these prescription drugs.Celebrity weight loss jab to be sold by chemistsGPs to offer Wegovy on NHSAre weight loss jabs the answer to tackling obesity?The EMA’s Pharmacovigilance Risk Assessment Committee (PRAC), which is conducting the review, will consider whether other treatments in same broader category of medicines, glucagon-like peptide-1 (GLP-1) receptor agonists, also need assessing.But initially, it will assess only the risks of using weight-loss medication that contains either semaglutide or liraglutide. An EMA official said: “The review is being carried out in the context of a signal procedure raised by the Icelandic Medicines Agency, following three case reports. “A signal is information on a new or known adverse event that is potentially caused by a medicine and that warrants further investigation. “The case reports included two cases of suicidal thoughts – one following the use of Saxenda and one after Ozempic. “One additional case reported thoughts of self-injury with Saxenda.”The EMA will communicate further when more information becomes available.”Global shortagesSocial media posts about people, often celebrities, shedding large amounts of weight has led to big demand for these types of treatment.Saxenda and Wegovy are approved and licensed for weight loss. Wegovy is not yet available in the UK – but the prime minister has said GPs in England may soon start offering it to some patients, as well as specialist weight-management clinics.Ozempic is for people with diabetes to help control blood sugar as well as weight but contains a lower dose of the same medicine, semaglutide, as Wegovy. And with some people without diabetes buying the pre-filled pens to lose weight, there have been continuing global shortages.All medicines have potential side effects. For weight-loss drugs, which should be used alongside a healthy diet and exercise, more common ones include:nauseavomitingheadachesdiarrhoeaconstipationstomach achetirednessDepression or thoughts of suicide is listed in the product-information leaflet, which advises users: “You should pay attention to any mental changes, especially sudden changes in your mood, behaviours, thoughts, or feelings. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.”Prescribers are also advised to monitor for this. Manufacturer Novo Nordisk is working with the EMA and says patient safety is a top priority. A representative said: “GLP-1 receptor agonists have been used to treat type-2 diabetes for more than 15 years and for treatment of obesity for eight years, including Novo Nordisk products such as semaglutide and liraglutide that have been in the UK market since 2018 and 2009 respectively. “The safety data collected from large clinical-trial programmes and post-marketing surveillance have not demonstrated a causal association between semaglutide or liraglutide and suicidal and self-harming thoughts. “Novo Nordisk is continuously performing surveillance of the data from ongoing clinical trials and real-world use of its products and collaborates closely with the authorities to ensure patient safety and adequate information to healthcare professionals. “EMA continuously monitors for safety signals and so does Novo Nordisk. “Novo Nordisk remains committed to ensuring patient safety.”The UK’s drug regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), said it was monitoring the situation.Dr Alison Cave, MHRA Chief Safety Officer, said: “As part of our close monitoring, any emerging evidence is routinely considered alongside other sources of information, including suspected adverse drug reactions. We will communicate any new advice to healthcare professionals and patients if appropriate.”If you are experiencing suicidal thoughts or thoughts of self-harm, please seek immediate medical assistance.”We ask everyone to report any suspected side effects using our Yellow Card scheme website.”If you have been affected by any of these issues, visit BBC Action Line, where you can find support.More on this storyGPs set to offer weight-loss jab to reduce obesityPublished7 JuneCelebrity weight loss jab to be sold by chemistsPublished13 FebruaryAre weight-loss injections the answer to obesity?Published19 MarchRelated Internet LinksEuropean Medicines AgencyThe BBC is not responsible for the content of external sites.

Many aging baby boomers have long histories with drugs, cannabis and alcohol. “The field wasn’t ready for that,” said one expert.When Dr. Benjamin Han, a geriatrician and addiction medicine specialist, meets new patients at the School of Medicine at the University of California, San Diego, he talks with them about the usual health issues that older adults face: chronic conditions, functional ability, medications and how they’re working. He asks, too, about their use of tobacco, alcohol, cannabis and other nonprescription drugs. “Patients tend to not want to disclose this, but I put it in a health context,” Dr. Han said.He tells them, “As you get older, there are physiological changes and your brain becomes much more sensitive. Your tolerance goes down as your body changes. It can put you at risk.”That’s how he learns that someone complaining about insomnia might be using stimulants, possibly methamphetamines, to get going in the morning. Or that a patient who has long taken an opioid for chronic pain has run into trouble with an added prescription for, say, gabapentin.When one 90-year-old patient, a woman fit enough to take the subway to his previous hospital in New York City, began reporting dizziness and falls, it took Dr. Han a while to understand why: She washed down her prescribed pills, an increasing number as she aged, with a shot of brandy.He has had older patients whose heart problems, liver disease and cognitive impairment were most likely exacerbated by substance use. Some have overdosed. Despite his best efforts, some have died.Until a few years ago, even as the opioid epidemic raged, health providers and researchers paid limited attention to drug use by older adults; concerns focused on the younger, working-age victims who were hardest hit.But as baby boomers have turned 65, the age at which they typically qualify for Medicare, substance use disorders among the older population have climbed steeply. “Cohorts have habits around drug and alcohol use that they carry through life,” said Keith Humphreys, a psychologist and addiction researcher at the Stanford University School of Medicine.Aging boomers “still use drugs far more than their parents did, and the field wasn’t ready for that.”Evidence of a growing problem has been stacking up. A study of opioid use disorder in people over 65 enrolled in traditional Medicare, for instance, showed a threefold increase in just five years — to 15.7 cases per 1,000 in 2018 from 4.6 cases per 1,000 in 2013.Tse-Chuan Yang, a co-author of the study and a sociologist and demographer at the University at Albany, said the stigma of drug use may lead people to underreport it, so the true rate of the disorder may be higher still.Fatal overdoses have also soared among seniors. From 2002 to 2021, the rate of overdose deaths quadrupled to 12 from 3 per 100,000, Dr. Humphreys and Chelsea Shover, a co-author, reported in JAMA Psychiatry in March, using data from the Centers for Disease Control and Prevention. Those deaths were both intentional, like suicides, and accidental, reflecting drug interactions and errors.Most substance use disorders among older people involve prescribed medications, not illegal drugs. And since most Medicare beneficiaries take multiple drugs, “it’s easy to get confused,” Dr. Humphreys said. “The more complicated the regimen, the easier to make mistakes. And then you have an overdose.”The numbers so far remain comparatively low — 6,700 drug overdose deaths in 2021 among people 65 and older — but the rate of increase is alarming.“In 1998, that’s what people would have said about overdose deaths in general — the absolute number was small,” Dr. Humphreys said. “When you don’t respond, you end up in a sorrowful state.” More than 100,000 Americans died of drug overdoses last year.Alcohol also plays a major role. Last year, a study of substance use disorders, based on a federal survey, analyzed which drugs older Americans were using, looking at the differences between Medicare enrollees under 65 (who may qualify because of disabilities) and those 65 and older.Of the 2 percent of beneficiaries over 65 who reported a substance use disorder or dependence in the past year — which amounts to more than 900,000 seniors nationwide — more than 87 percent abused alcohol. (Alcohol accounted for 11,616 deaths among seniors in 2020, an 18 percent increase over the previous year.)In addition, about 8.6 percent of disorders involved opioids, mostly prescription pain relievers; 4.3 percent involved marijuana; and 2 percent involved non-opioid prescription drugs, including tranquilizers and anti-anxiety medications. The categories overlap, because “people often use multiple substances,” said William Parish, the lead author and a health economist at RTI International, a nonprofit research institute.Although most people with substance use problems don’t die from overdoses, the health consequences can be severe: injuries from falls and accidents, accelerated cognitive decline, cancers, heart and liver disease and kidney failure.“It’s particularly heartbreaking to compare rates of suicidal ideation,” Dr. Parish said. Older Medicare beneficiaries with substance use disorders were more than three times as likely to report “serious psychological distress” as those without such disorders — 14 percent versus 4 percent. About 7 percent had suicidal thoughts, compared with 2 percent who didn’t report substance disorders.Yet very few of these seniors underwent treatment in the past year — just 6 percent, compared with 17 percent of younger Medicare beneficiaries — or even made an effort to seek treatment.“With these addictions, it takes a lot to get somebody ready to get into treatment,” Dr. Parish said, noting that almost half of the respondents over 65 said they lacked the motivation to begin.But they also face more barriers than younger people. “We see higher rates of stigma concerns, things like worrying about what their neighbors would think,” Dr. Parish said. “We see more logistical barriers,” he said, such as finding transportation, not knowing where to go for help and being unable to afford care.It may be “harder for older adults to try to navigate the treatment system,” Dr. Parish said.Uneven Medicare coverage also presents obstacles. Federal parity legislation, mandating the same coverage for mental health (including addiction treatment) and physical health, guarantees equal benefits in private employer insurance, state health exchanges, Affordable Care Act marketplaces and most Medicaid plans.But it has never included Medicare, said Deborah Steinberg, senior health policy attorney at the Legal Action Center, a nonprofit working to expand equitable coverage.Advocates have made some inroads. Medicare covers substance use screening and, since 2020, opioid treatment programs like methadone clinics. In January, following congressional action, it will cover treatment by a broader range of health professionals and cover “intensive outpatient treatment,” which typically provides nine to 19 hours of weekly counseling and education. Expanded telehealth benefits, prompted by the pandemic, have also helped.But more intensive treatment can be hard to access, and residential treatment isn’t covered at all. Medicare Advantage plans, with their more limited provider networks and prior authorization requirements, are even more restrictive. “We see many more complaints from Medicare Advantage beneficiaries,” Ms. Steinberg said.“We’re actually making progress,” she added. “But people are overdosing and dying because of lack of access to treatment.” Their doctors, unaccustomed to diagnosing substance abuse in older people, may also overlook the risks.In an age cohort whose youthful drinking and drug use have sometimes provided amusing anecdotes (a common refrain: “If you can remember the ’60s, you weren’t there”), it can be difficult for people to recognize how vulnerable they have become.“That person may not be able to say, I’m addicted,” Dr. Humphreys said. “It’s a Rubicon people don’t want to cross.”A joke about dropping acid at Woodstock “makes me colorful,” he added. “Crushing OxyContin and snorting it is not colorful.”

CNN
 — 

Human-caused climate change has already made heat waves around the world more frequent and intense.

Scientists who study the role of global warming on weather say that every heat wave today bears the fingerprints of the climate crisis.

Climate change, driven primarily by humans burning fossil fuels, is worsening global extreme weather in general, but much of that change is related to heat.

In the US, heat kills more Americans than any other weather-related disaster, and it will only continue to worsen as the world heats up from burning fossil fuels.

Here’s what happens to your body in extreme heat, what you need to watch out for and how to stay safe.

What happens to your body

Normally, your body is used to a certain range of temperatures, usually between 97 to 99 degrees Fahrenheit. When your brain senses a change – either lower or higher than that – it attempts to help your body cool down or heat up, according to Dr. Judith Linden, executive vice chair of the department of emergency medicine at Boston Medical Center and a professor in the emergency medicine department at Boston University’s school of medicine.

“There are a number of different ways in which (the brain) attempts to cool the body down. One way, the most common way we think of, is that you sweat,” Linden said. “The pores open, the body sweats and the sweat evaporates, that cools the body.”

The second way your body cools itself down is by dilating vessels and upping your heart rate, which helps bring heat and blood to the surface of your body and helps releases that excess heat.

When you’re exposed to high temperatures, it becomes harder for your body to try and keep up with cooling itself down. And if your environment is hot and humid, sweat doesn’t evaporate as easily – which pushes your body’s temperature even higher, according to the Mayo Clinic.

“The higher the humidity, the lower temperatures you need for extreme heat,” Linden said.

High body temperatures can lead to damage to the brain and other vital organs, the CDC says. They can also lead to several heat-related illnesses.

Mild-heat related illnesses, including heat cramps, are most common, Linden said. Heat cramps can develop in people who sweat a lot, including during exercising. The excessive sweating uses up all of the body’s salt and moisture and can lead to muscle pains or spasms, usually in the abdomen, arms or legs, according to the CDC.

A heat rash can also develop. That’s a skin irritation caused by too much sweating in hot and humid weather, and is most common in young children, the CDC says. It is usually a red cluster of pimples or blisters, and tends to be in places including the neck, upper chest or in elbow creases.

When your body’s beginning to exceed its ability to cool itself down, you can develop what’s known as heat exhaustion.

“In this case you’re going to see excessive sweating because your body is really going to try and keep up with that extra heat. You’re going to feel light-headed, you may feel dizzy, often people present with nausea, headaches and their skin often looks pale and clammy and their pulse is often fast,” Linden said.

“This is the body’s last attempt to cool itself before it really goes into a point of no return.”

A heat stroke is the most serious heat-related illness, and, if left untreated, can lead to death.

“That’s where your body’s temperature goes above 104 to 105 degrees or so, and this is where your mechanisms are starting to fail,” Linden said.

Warning signs may include extremely high body temperatures, red and dry skin, a rapid pulse, headache, dizziness, nausea or loss of consciousness, according to the CDC.

The hallmark of a heat stroke is confusion and agitation, Linden said.

“So when somebody’s in the heat and they become confused and agitated, that’s heat stroke until proven otherwise and you need to call 911 for that or get help immediately and get the person out of the heat.”

Who is most at risk

Elderly, people with chronic medical conditions as well as children are at higher risk for severe heat-related illnesses.

The elderly and people with chronic medical conditions may be less likely to sense and respond to temperature changes and may be taking medication that make the heat effects worse, the CDC said.

“Very young (people) as well, because they’re less likely to recognize heat-related illness and they’re less likely to get out of the heat if they’re starting to feel overheated,” Linden said.

Student-athletes and pets are also at higher risk, she added.

“In this weather, you must never, ever, ever leave a child or a pet in the car for even a minute,” Linden added.

How to stay safe

When your community is facing extreme heat, there are several things you can do to keep yourself and others safe.

First, keep an eye out for symptoms of heat exhaustion or other illnesses. “If somebody starts feeling light-headed, dizzy, nausea or headache, that is the time to act immediately,” Linden said. “That means getting them out of the heat and into a cool environment.”

Putting water on someone who may be experiencing symptoms and giving them fluids can help cool them down. If someone is starting to lose consciousness or has nausea or vomiting, call 911.

“If you see anybody with any type of confusion, that’s an immediate red flag,” Linden added.

When it’s hot outside, try to avoid outdoor activities – especially between the hours of 11 a.m. and 3 p.m., according to Linden. If you have to go outside, wear light-colored clothing, cover your head and drink plenty of fluids.

Don’t wait until you’re thirsty to drink water – as that can be a sign of dehydration. Linden recommends drinking at least one glass of water – or more – an hour.

“If you do start to feel light-headed, dizzy, sweating, fast pulse, get out of the heat immediately,” Linden said.

Try to find air conditioning, or places in your area where you can go to stay cool, according to Ready.gov. Even spending a few hours in a shopping mall or public library can help.

When you’re home, fans can help, but don’t rely on them as your only way of cooling down – while it may feel more comfortable, they won’t help prevent heat-related illness.

“If you’re in a super hot room, if you’ve got a fan, is it helpful? No. I think, if you’ve got a fan, and you’re able to mist yourself … then fans can be helpful,” Linden said. “Fans are not foolproof.”

Finally, make sure you’re checking on your neighbors, parents and friends – especially older individuals who may be living alone or are isolated, Linden said.

CNN’s Rachel Ramirez contributed to this report

Thirty years of progress in decreasing drowning deaths in the United States appears to have plateaued, and disparities in deaths among some racial groups have worsened.Yadira Salcedo was born in Mexico to parents who did not know how to swim. As a child, she nearly drowned when she waded too deep in a backyard pool.Now a mother of two in Santa Ana, Calif., Ms. Salcedo is “breaking the cycle,” she said, making sure Ezra, 3, and Ian, 1, never experience such terror. The family has qualified for Red Cross scholarships to a new program that teaches children who might not have other chances to learn how to swim.On a recent day, Ms. Salcedo and her children climbed together into the Salgado Community Center pool, using kickboards and blowing bubbles with an instructor, Josue, who uses a mix of English and Spanish.Drowning is the leading cause of death for children ages 1 to 4, according to the Centers for Disease Control and Prevention. Deaths are likely to surge this month, as they do every July, with children drowning just feet from their parents without a scream, struggle or splash. A 4-year-old at a Texas hotel pool, a 5-year-old in a California river, a 6-year-old at a Missouri lake and a 10-year-old at an Indiana public pool all drowned just this past week.And yet, despite calls from the United Nations, the United States is one of the only developed countries without a federal plan to address the crisis. Thirty years of progress in decreasing the number of drowning deaths in the country appears to have plateaued, and disparities in deaths among some racial groups have worsened.“It’s hard to imagine a more preventable cause of death. No one is going to say, ‘Oh, well, some people just drown,’” said William Ramos, an associate professor at Indiana University School of Public Health-Bloomington and the director of the school’s Aquatics Institute.“It’s time to go deeper than the sad statistics and answer the ‘why’ and the ‘how,’” he said.A parent who has never learned to swim yields an 87 percent chance that a child won’t, either, said Dr. Sadiqa A.I. Kendi, the division chief of pediatric emergency medicine at Boston Medical Center, who studies the cyclical nature of injury and inequity.“This is anthropology,” said Mr. Ramos. “To start a new narrative around water is not an easy task.”From left, Berenice Gonzalez, with her daughter Luna Romero, 1, and Yadira Salcedo with her son Ian, 1, in the Salgado Community Center pool during a Parent and Me class.Gabriella Angotti-Jones for The New York TimesKendra Lubin, 16, an instructor in the Splash Camp swim program, helped guide Daymian Espinoza, 9, to the pool wall.Gabriella Angotti-Jones for The New York TimesThe National Institutes of Health recently published a call for research proposals to examine drowning prevention, writing that “little is known” about what intervention strategies work. The C.D.C. said it planned to do an in-depth analysis of childhood drownings in several states to better understand the contributing factors.But epidemiologists point to an array of factors that could make it increasingly difficult to close the gap, including shrinking recreation department budgets, a national lifeguard shortage and an era of distraction on pool decks, as parents juggle child supervision with laptops and cellphones when they work from home.In the longer term, the figures are likely to be exacerbated by climate change, said Deborah Girasek, a drownings researcher at the Uniformed Services University of the Health Sciences. More children are likely to drown in hurricane floodwater in Florida, fall through thin ice in Wisconsin or climb into restricted reservoirs in Yosemite for a reprieve from the increasing heat. (Research shows that drownings rise with every degree on a thermometer.)Though overall drowning deaths have decreased by one-third since 1990, they have risen by 16.8 percent in 2020 alone, according to the C.D.C. There are still over 4,000 of them in the United States annually, and about a quarter of the deaths are of children. An analysis by the C.D.C. shows that Black children between ages 5 and 9 are 2.6 times more likely to drown in swimming pools than white children, and those between ages 10 and 14 are 3.6 times more likely to drown. Disparities are also present in most age groups for Asian and Pacific Islander, Hispanic, and Native American and Alaska Native children.Socioeconomic factors are at play as well. A study of drownings in Harris County, Texas, for example, showed that they were almost three times more likely for a child in a multifamily home than in a single-family residence, and that drownings in multifamily swimming pools — like the one at the Salcedos’ apartment — were 28 times more likely than in single-family pools.Ms. Salcedo said she often saw children swimming in the pool of her apartment complex unsupervised, the gate propped ajar with a water bottle or a shoe.Apropos Parent and Me class signage at the Salgado Community Center.Gabriella Angotti-Jones for The New York TimesKendra learned to swim in her school principal’s backyard in Phoenix, where she grew up. Santa Ana paid for her training to become a lifeguard this summer.Gabriella Angotti-Jones for The New York TimesThe leading theory to explain the inequities traces back half a century to the proliferation of municipal pools after World War II. When those gave way to suburban swim clubs and middle-class backyard pools, the historian Jeff Wiltse wrote in his book on pool history, white children began learning to swim in private lessons, while children in minority families saw public pools become dilapidated and aquatics budgets be slashed. Many of the facilities and education programs have never recovered.Black adults in particular report having had negative experiences around water, with familial anecdotes of being banned from public beaches during Jim Crow-era segregation and brutalized during the integration of public pools.A U.N. resolution issued in 2021 and a World Health Assembly decision this year to accelerate action urged every member nation to prioritize the fight against childhood drownings. Both the W.H.O. and the American Academy of Pediatrics have implored the United States government to catch up.“Canada, U.K., Australia, New Zealand, South Africa — they all have a plan. We don’t,” said Mr. Ramos. “The message to Congress is: We need to fix this, and we can. But look at seatbelts, fire safety, smoking cessation. Legislation is what’s going to move the needle.”Officials could add aquatics to gym class curriculums or mandate four-sided pool fences in backyards (since many victims still wander into pools from the exposed side facing the house). Ms. Girasek said she was eager to see legislation because “we see very clearly that it works.”After former Secretary of State James Baker’s 7-year-old granddaughter Virginia Graeme Baker was trapped by the suction of a hot tub drain and drowned, a federal law was named in her honor that required public pools and spas to be equipped with drain covers that meet certain standards. It seemed to all but eradicate such deaths.The U.S. National Water Safety Action Plan, launched by a group of nonprofits last week, is the country’s first-ever attempt to construct a road map to address the crisis. Its 99 recommendations for the next decade serve as a sobering guide through the country’s various gaps in research, funding, surveillance and parental education, compiled by earnest advocacy groups on shoestring budgets that aren’t equipped to fill them alone.Though overall drowning deaths have decreased by one-third since 1990, there remain over 4,000 in the United States annually.Gabriella Angotti-Jones for The New York TimesMs. Gonzalez, blowing bubbles for Luna.Gabriella Angotti-Jones for The New York TimesConnie Harvey, the director of the Aquatics Centennial Campaign at the American Red Cross, held a Capitol Hill briefing recently alongside other experts, she said, “to let our leaders know that there is a plan — that this plan exists.”Representative Debbie Wasserman Schultz, Democrat of Florida and a longtime advocate for drowning prevention, was the only member of Congress to attend.In the meantime, some local governments have adopted their own interventions. This summer, Seattle is piloting a new initiative based on the nonprofit No More Under, which connects hundreds of low-income and foster children with swim lessons. Broward County, Fla., which has some of the highest drowning rates in the state, is offering free vouchers. And Santa Ana plans to pull more than $800,000 from its Cannabis Public Benefit Fund this year to bring its aquatics program back under its domain.The city, with a population that is nearly 80 percent Hispanic nestled between wealthier Orange County suburbs, has historically epitomized racial and economic health disparities. One of its public pools is 63 years old. But its Parks and Recreation Department recently hired an aquatics supervisor and 36 new life guards — several of whom the supervisor needed to first teach to swim.Under the new Santa Ana program, Ms. Salcedo, a waitress, and her husband, a post office employee, who live in a three-generation household, secured scholarships that brought the cost of swim lessons down to $15 per child every two weeks. They plan to attend all summer.Ezra, who is 3, cried on the first day of lessons. Now he shares facts about hammerheads between strokes during the “Baby Shark” singalong. Ian, the 1-year-old, has not yet mastered walking on land. Still, he paddled after an orange rubber duck, with his mother — now a proficient swimmer — keeping him afloat.