Publisher Health

The proposal would ban all single-use, disposable vapes, halt the importation of nonprescription vapes and restrict certain flavors, colors and ingredients.The Australian government said it wanted to crack down on the use of e-cigarettes in an effort to “reduce smoking and stamp out vaping” in one of the most sweeping tobacco regulatory moves in the country in years.The proposal, announced on Tuesday, would ban all single-use, disposable vapes; stop the importation of nonprescription vapes; require “pharmaceutical-like packaging”; reduce nicotine concentrations and amounts; and restrict certain flavors, colors and ingredients.The federal government would also work with states and territories to end the sale of vapes in convenience stores and other retail settings “while also making it easier to get a prescription for legitimate therapeutic use,” the Department of Health and Aged Care said in a statement.Nicotine vapes are currently available only with a prescription in Australia, but they thrive on the black market, especially among young people. While the contours of the proposal are still tentative, Mark Butler, the health minister, said its long-term intentions were clear.“I want vaping to return to the purpose that we were told it was invented for, that is a therapeutic product to help long-term smokers quit,” Mr. Butler said in a speech at the National Press Club of Australia on Tuesday. “We were promised this was a pathway out of smoking, not a pathway into smoking. That is what it has become. That is what it has been sold as so shamelessly and presented as.”In particular, Mr. Butler said, the government wants “to stamp out the idea that this is a recreational product at all, but particularly a recreational product for our kids.”“Knocking that market out is what I am aiming for,” he said.Many health regulators, including the Food and Drug Administration in the United States, consider e-cigarettes to be generally beneficial because they provide an alternative to adult smokers of traditional cigarettes, which coat the lungs in tar. But regulators did not account for young people becoming addicted to nicotine after getting hooked on the fruity flavors of vapes, nor for the mysterious and life-threatening vaping-related illnesses afflicting many young users. The F.D.A. began its own crackdown in recent years.Mr. Butler said the Australian government had no plans to ban smoking or to phase out smoking by birth year, as New Zealand did recently when it placed a lifetime prohibition on cigarette sales to everyone born after 2008.In its statement, the government called the strategy a “new national framework” to reduce daily smoking rates across Australia.Australia’s treasurer, Jim Chalmers, will deliver the federal government’s annual operating budget to Parliament on May 9. It will include 737 million Australian dollars, or nearly $492 million, in funding for the initiative.The budget will call for a 5 percent annual increase in the tobacco tax, effective Sept. 1, generating an additional 3.3 billion Australian dollars, or about $2.2 billion, in revenue over four years. Mr. Butler said on Tuesday that the government would largely invest that money in the nation’s health system, including a new national lung cancer screening program, cancer care services for Indigenous groups and programs to reduce vaping and smoking among First Nations Australians.But the focus of the initiative, Mr. Butler said, was to “shut down a major health risk to the youngest generation of Australians.”“We all know this as we interact as parents or uncles and aunties with young school students — it is just flourishing, particularly over the course of Covid,” he said. “We are going to have to shut down an industry, a market that has been allowed to grow up, in spite of the fact that it wasn’t really supposed to.”But Nicole Lee, an adjunct professor at the National Drug Research Institute at Curtin University, said she was skeptical that this kind of approach would have the effect on the black market that regulators hoped it would. A shortage of primary care doctors means that those seeking prescriptions for vapes are less likely to get them, putting more stress on an already explosive black market.“We want to see reduced access and we want to see people able to use it for quitting smoking,” she said. “Quasi banning it means the black market will flourish and young people have more access, not less access.”Yan Zhuang

Women are about twice as likely as men to be diagnosed with Alzheimer’s disease. Some of that is age; in the U.S., women outlive men by five to six years, and advanced age is the strongest risk factor for Alzheimer’s. But there’s more to it than that, so Alzheimer’s researchers continue to look for other reasons why women have an elevated risk of the deadly neurodegenerative disease.
Stress may be one such reason. A study by researchers at Washington University School of Medicine in St. Louis shows that the effect stress has on the brain differs by sex, at least in mice. In stressful situations, levels of the Alzheimer’s protein amyloid beta rises sharply in the brains of females but not males. In addition, the researchers identified a molecular pathway that is active in brain cells from female mice but not male mice, and showed that it accounts for the divergent responses to stress.
The findings, published May 2 in Brain, add to a growing collection of evidence that sex matters in health and disease. From cancer to heart disease to arthritis, scientists have found differences between males and females that could potentially affect how men and women respond to efforts to prevent or treat chronic diseases.
“How women respond to stress versus how men respond to stress is an important area of research that has implications for not just Alzheimer’s disease but other conditions, too,” said co-corresponding author Carla M. Yuede, PhD, an associate professor of psychiatry. “In recent years, the National Institutes of Health (NIH) has prioritized understanding sex differences in medicine. Stress is one area in which you can clearly see a difference between males and females. This study shows that reducing stress may be more beneficial for women than men, in terms of lowering the risk of Alzheimer’s disease.”
Stress falls into the category of socioeconomic risk factors, along with factors such as depression and social isolation, that together account for an estimated 8% of the risk of developing Alzheimer’s. That risk calculation, however, doesn’t take gender into account. Women consistently report higher levels of stress than men, and stress affects women’s bodies differently than men’s in many ways, such as cardiovascular health, immune responses and other issues.
Corresponding author John Cirrito, PhD, an associate professor of neurology; Yuede; and first author Hannah Edwards, a graduate student in Cirrito’s lab, reasoned that stress also may affect women’s brains differently than men’s, and these differences may help explain the sex imbalance in Alzheimer’s disease.
To find out, they measured levels of amyloid beta — a key Alzheimer’s protein — in the brains of mice every hour for 22 hours, beginning eight hours before the mice experienced stress. The experience was equally stressful for male and female mice, as measured by the levels of stress hormones in their blood. But the responses in their brains were not the same.
In female mice, amyloid beta levels rose significantly within the first two hours and stayed elevated through the end of the monitoring period. In male mice, brain amyloid levels did not change overall, although about 20% of them did show a delayed and weak rise in amyloid levels.
Further experiments revealed that the difference comes down to a cellular stress response pathway in brain cells. Stress causes the release of a hormone known as corticotropin releasing factor. Neurons from female rodents take up the stress hormone, triggering a cascade of events that results in increasing levels of amyloid beta in the brain. In contrast, neurons from male rodents lack the ability to take up the stress hormone. It is not known whether there are similar sex differences in how human neurons take up stress hormones.
“There’s a fundamental biological difference between males and females in how they respond to stress at the cellular level, in both mice and people,” Cirrito said. “We don’t think that stress is the sole factor driving the sex difference in Alzheimer’s disease. There are many other differences between men and women — in hormones, lifestyle, other diseases they have — that undoubtedly contribute in some way. But that stress is driving one aspect of this sex difference I think is very likely.”

A new WCS-led study that analyzed 17 years of migratory bird-nesting data in Prudhoe Bay, Alaska, revealed that nest survival decreased significantly near high-use oil and gas infrastructure and its related noise, dust, traffic, air pollution, and other disturbances. Prudhoe Bay is the site of intensive energy development and is located on the Arctic Coastal Plain, one of the most important avian breeding grounds in the world. Millions of birds nest here, with some then migrating through every state in the nation to wintering grounds in Central and South America, even Africa, with others crossing the Pacific Ocean to Russia, China, Japan, Australia, New Zealand, and Antarctica.
The findings, described in the journal Avian Biology, come as the U.S. recently approved the $8 billion Willow oil project — a controversial, long-term effort to drill in Alaska’s largest remaining untouched wilderness in the U.S., the 36,875 square mile National Petroleum Reserve (NPR-A) west of Prudhoe Bay. Willow’s planned infrastructure borders the Teshekpuk Lake Special Area, one of five regions within the NPR-A that have been set aside from production due to significant ecological importance or subsistence value — in this case nesting waterfowl and shorebirds, as well as caribou.
Said Martin Robards, Regional Director of WCS’s Arctic Beringia Program and an author of the study: “tundra-breeding birds contend with short breeding seasons, harsh climatic conditions, and now, rapidly changing, variable, and unpredictable environmental conditions caused by climate change. Additionally, as we demonstrate here, those breeding in industrial areas are impacted by human activities too. The urgency to better understand these relationships and mitigate impacts cannot be expressed strongly enough, given widely acknowledged declines in these species, our national and global obligations to protect migratory birds, and that the potential impacts that are large.”
The research team evaluated factors influencing reproductive parameters of breeding birds at Prudhoe Bay between 2003-2019. They monitored 1265 shorebird nests, 378 passerine (songbird) nests, and 231 waterfowl nests. They found that nest survival decreased significantly nearer high-use infrastructure, which has not previously been detected in earlier short-term studies. The authors note that long-term datasets are rare in the Arctic, but they are crucial for understanding impacts to breeding birds from both climate change and increasing anthropogenic activities.
Factors associated with industrial development that may directly or indirectly affect nesting include: habitat degradation via hydrology alteration and road dust, vehicle and aircraft traffic, noise, air pollution, and increased nest predator populations associated with development, including glaucous gulls, ravens, Arctic fox, and other species.
Said John Calvelli, WCS Executive Vice President for Public Affairs: “In the face of current uncertainty, to protect migratory birds, the U.S. Government should ensure the most important bird areas continue to be set aside, as has been done through the NPR-A’s Special Areas.”

Published37 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Kathryn ArmstrongBBC NewsA top US health official has warned the country is facing an epidemic of loneliness that is as dangerous to health as smoking 15 cigarettes a day.The Surgeon General, Vivek Murthy, has released an advisory calling for social isolation to be treated as seriously as obesity or drug abuse. It warns that almost half of all Americans from all walks of life are thought to have been affected. Mr Murthy has also unveiled a national framework to rebuild social connection. Loneliness is reported to increase the risk of premature death by almost 30% – through health conditions including diabetes, heart attacks, insomnia and dementia. Lack of social connection is also linked to lower academic achievement and worse performance at work, according to the advisory. The issue has been exacerbated by the Covid pandemic, which led many people to reduce the size of their social circles.One study quoted in the report found a 16% decrease on average in the social network size of participants from June 2019 to June 2020.In order to tackle this, Mr Murthy has called for a collective effort to “to mend the social fabric of our nation” in order to “destigmatise loneliness and change our cultural and policy response to it”. His strategy has six pillars that include efforts to strengthen social infrastructure in communities, in part by utilising public health systems. The advisory calls for more “pro-connection public policies” that are developed with the help of a research agenda to help address gaps in the data surrounding the effects of social isolation. It also highlights the need for more data transparency from tech firms and a reform of digital environments. The advisory is part of the Biden administration’s broader efforts to address mental health, White House press secretary Karine Jean-Pierre said on Monday. May is Mental Health Awareness Month in the US. While the declaration is intended to increase awareness, no new promises of federal funding to combat the issue have so far been made. More on this storyThe ‘girl gang’ tackling loneliness in young women22 MarchUni students lonelier than other adults – study9 June 2022Black people more lonely than general population13 May 2022Over-60s with only virtual contact ‘more lonely’26 July 2021

Published2 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, AFPBy Grace TsoiBBC NewsFang Bin, who documented the initial Covid outbreak in the Chinese city of Wuhan, has been freed from jail after three years, sources told the BBC. Mr Fang is one of several so-called citizen journalists who disappeared after sharing videos of scenes in Wuhan, the epicentre of the pandemic. After disappearing in February 2020, he was sentenced to three years in jail at a secret trial in Wuhan, sources said.He was released on Sunday and is in good health, they added.Mr Fang is now back home in Wuhan. The BBC could not reach his family for comment. The video that caught the attention of the outside world was one where he counted eight body bags outside a Covid hospital in the space of five minutes. He said he was detained that night but released. Then came a video with the message: “All people revolt – hand the power of the government back to the people”. That was the last video he shared.Although activists have welcomed his release, they are concerned about the fate of another whistleblower – Zhang Zhan, a 39-year-old former lawyer, was detained in May 2020 and jailed for four years in December 2020. Like Mr Fang, she too was convicted for “picking quarrels and provoking trouble”, according to activists who say the vague offence has often been used against critics of China’s government. Two other citizen reporters Chen Qiushi and Li Zehua also disappeared in Wuhan in February 2020, but surfaced months later.Their videos provided a rare glimpse into Wuhan in the early months of 2020. Cases were climbing and lockdowns had come into force, but information from officials remained scarce. Wuhan’s 76-day lockdown – which inspired the country’s harsh zero-Covid strategy – put the city under severe strain.Ms Zhang, who lived in Shanghai, travelled to Wuhan in February 2020 to report on the outbreak after reading about a resident’s experience. She was active on YouTube and Twitter, both of which are banned in mainland China, and continued sharing videos despite reportedly being threatened by local authorities. “Maybe I have a rebellious soul… I’m just documenting the truth. Why can’t I show the truth?” she said in an interview with an independent filmmaker that was obtained by the BBC.The politics driving China’s hellish lockdownsWhy have two reporters in Wuhan disappeared?Grieving a daughter in Wuhan – while being surveilledShortly after the arrest, she began a hunger strike and was sometimes force-fed as her weight plummeted to under 40kg (88lb), according to the Free Zhang Zhan group. It’s unclear if she is still on a hunger strike. Her family knows little about her condition.Last December, her brother uploaded photos of a letter written by Ms Zhang in now-deleted tweets. She drew flowers on the envelope to reassure their mother, he said. In the letter, Ms Zhang mostly asked after her mother, who had recently undergone surgery and chemotherapy. She added that she was being treated well by the authorities.Image source, Twitter / Jeffreychang81Mr Fang’s release came quietly and with no warning as China tries to move on from the pandemic. Years of gruelling lockdowns and unyielding Covid rules took a huge toll, but their abrupt end late in 2022 brought on a devastating Covid wave. The country has reported 120,000 deaths since the start of the pandemic, according to the World Health Organization (WHO). Nearly half of those were recorded between 8 December 2022 and 12 January 2023. But the numbers don’t represent the true toll. In February, the Chinese Communist Party’s top leaders declared a “decisive victory” over Covid, boasting the lowest fatality rate in the world. They also said the country’s Covid exit was a “miracle”. A new history textbook talks of how the government “achieved major achievements in co-ordinating the prevention and control of the pandemic”. And China’s swift and effective censorship machine also means that the videos and accounts shared by those such as Mr Fang or Ms Zhang will likely fade from memory, if they haven’t already. “I visited China in March, and my observation is that people there want to move on and leave the past behind,” says Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations. “They had to endure the draconian zero-Covid for a prolonged period, and now they yearn for a return to a more normal way of life.” But, he adds, that this desire to move on is also driven by the lack of public discussion or debate. Not everyone in Wuhan has forgotten what life was like in early 2020. One 31-year-old resident, who did not wish to reveal his full name, said he had not heard of Fang Bin but does remembers Li Wenliang, a doctor who tried to warn the world about the coronavirus and died after contracting it. Mr Li was investigated for “spreading rumours”, although local authorities later apologised to him.Image source, EPAHe says he often talks about the pandemic with his friends, even though he admits they might be a minority. “Society is revising the memory of this period,” he says. He said he lived with his parents throughout the lockdown. His mother would be so anxious and wash her hands so often that her hands cracked because of it. “My mum still doesn’t really understand the virus. If the media start reporting about virus again, she will wear a mask. She is really frightened.”And there are others like Yang Min, who lost her only child to Covid in January 2020. She believes an early warning from officials would have saved her daughter. Now, three years on, she is still fighting to hold officials accountable and trying to file a lawsuit against the local government. She is under surveillance but, she told the BBC earlier this year, she was not afraid. “I have already lost the most precious thing in life. What else can they take away from me?”Additional reporting by Lok Lee, BBC ChineseMore on this storyChina history book’s ‘Covid war’ sparks discussion5 days ago

A new study analyzing data on over 20,000 U.S. adults links a healthier diet and increased exercise to weight loss that reduces heart disease risk — while associating skipping meals and taking prescription diet pills with minimal weight loss, weight maintenance or weight gain.
For many in the study sample, however, losing a “clinically significant” 5% of their body weight did not eliminate their risk factors for cardiovascular disease, results showed. In fact, the average composite score on eight risk factors for heart disease was the same across the entirety of the study population — regardless of reported weight changes, up or down.
The study is the first to compare weight-loss strategies and results in the context of the American Heart Association’s “Life’s Essential 8,” a checklist promoting heart disease risk reduction through the pursuit of recommended metrics for body weight, blood pressure, cholesterol, blood sugar, smoking, physical activity, diet and sleep. The AHA first defined a construct of cardiovascular health with “Life’s Simple 7” metrics in 2010, and updated the recommendations to the “Life’s Essential 8” in June 2022.
The Ohio State University researchers found that overall, U.S. adults had an average score of 60 out of 100 on the eight measures — suggesting there is plenty of room for improvement even among those whose diet and exercise behaviors helped move the needle on some metrics.
“The Life’s Essential 8 is a valuable tool that provides the core components for cardiovascular health, many of which are modifiable through behavior change,” said senior study author Colleen Spees, associate professor of medical dietetics in the School of Health and Rehabilitation Sciences at Ohio State.
“Based on the findings in this study, we have a lot of work to do as a country,” she said. “Even though there were significant differences on several parameters between the groups, the fact remains that as a whole, adults in this country are not adopting the Life’s Essential 8 behaviors that are directly correlated with heart health.”
The research was published recently in the Journal of the American Heart Association.

Data for the analysis came from 20,305 U.S. adults aged 19 or older (average age of 47) who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. Participants reported their smoking status, physical activity, average hours of sleep per night, weight history and weight loss strategy, and what they had eaten in the previous 24 hours. Health exams and lab tests measured their body mass index, blood pressure, LDL (bad) cholesterol and blood glucose.
The Ohio State researchers used the data to determine individuals’ values for Life’s Essential 8 metrics and assessed their diet quality according to the Healthy Eating Index, which gauges adherence to U.S. Dietary Guidelines for Americans.
Within the sample, 17,465 individuals had lost less than 5% of their body weight, maintained their weight or gained weight in the past year. The other 2,840 reported intentional loss of at least 5% of their body weight in the same time frame.
“Clinically significant weight loss results in improvements in some health indices,” Spees said. “People should feel hopeful in knowing that losing just 5% of their body weight is meaningful in terms of clinical improvements. This is not a huge weight loss. It’s achievable for most, and I would hope that incentives people instead of being paralyzed with a fear of failure.”
In this study, adults with clinically significant weight loss reported higher diet quality, particularly with better scores on intakes of protein, refined grains and added sugar, as well as more moderate and vigorous physical activity and lower LDL cholesterol than the group without clinically significant weight loss. On the other hand, the weight-loss group also had a higher average BMI and HbA1c blood sugar measure and fewer hours of sleep — all metrics that would bring down their composite Life’s Essential 8 score.

A greater proportion of people who did not lose at least 5% of their weight reported skipping meals or using prescription diet pills as weight-loss strategies. Additional strategies reported by this group included low-carb and liquid diets, taking laxatives or vomiting, and smoking.
“We saw that people are still gravitating to non-evidence-based approaches for weight loss, which are not sustainable. What is sustainable is changing behaviors and eating patterns,” Spees said.
With federal data estimating that more than 85% of the adult U.S. population will be overweight or obese by 2030 (compared to the current rate of 73%), Spees said that to fend off related increases in heart disease and other health problems, a paradigm shift toward prevention is in order.
“We absolutely need to be moving toward prevention of disease versus waiting until people are diagnosed with a disease. This becomes quite overwhelming, and individuals may feel it’s too late at that point,” she said.
One idea to consider, she said, would be prescriptions for regular visits with registered dietitians trained in behavior change, complete with insurance reimbursement — similar to physical therapy.
“We have fantastic research, we have incredible educators,” she said. “What we don’t have is policy that promotes optimal health across the lifespan, from pregnancy through older adulthood.”
Co-authors of the study included first author Emily Hill (supported by a National Center for Advancing Clinical Sciences fellowship), Lauren Cubellis, Randell Wexler and Christopher Taylor.

In recent years, experts have debated whether most birthing individuals would benefit from labor induction once they reach a certain stage of pregnancy.
But a new statewide study in Michigan suggests that inducing labor at the 39th week of pregnancy for people having their first births with a single baby that is in a head down position, or low risk, doesn’t necessarily reduce the risk of caesarian births. In fact, for some birthing individuals, it may even have the opposite effect if hospitals don’t take a thoughtful approach to induction policies.
“Some people in the field have suggested that after 39 weeks of gestation, medical induction should be standard practice,” said lead author Elizabeth Langen, M.D., a high-risk maternal fetal medicine physician and researcher at University of Michigan Health Von Voigtlander Women’s Hospital, of Michigan Medicine.
“We collaborated with peer hospitals to better understand how labor induction may influence cesarean birth outcomes in real world maternity units outside of a clinical trial. In our study sample, we found inducing labor in this population of women and birthing people did not reduce their risk of cesarean birth.”
The new research, published in the American Journal of Perinatology, was based on more than 14,135 deliveries in 2020 analyzed through a statewide maternity care quality collaborative registry. The collaborative, known as the Obstetrics Initiative and which began in 2018, includes at least 74 birthing hospitals and centers on reducing primary cesarean birth rates in low-risk pregnancies.
Results conflict with national trial findings
The study was conducted in response to published research in 2018 from a multicenter trial known as “ARRIVE” (A Randomized Trial of Induction Versus Expectant Management.)

Findings from ARRIVE indicated that medical induction at 39 weeks gestation in first time low risk pregnancies resulted in a lower rate of cesarean deliveries compared to expectant management — or waiting for labor to occur on its own or for a medical need for labor induction.
Michigan researchers mimicked the same framework used in the national trial and analyzed data from the collaborative’s data registry, comparing 1,558 patients who underwent a proactively induced labor versus 12,577 who experienced expectant management.
“We designed an analytic framework mirroring the previous trial’s protocol using retrospective data, but our results didn’t reinforce a link between elective induced labor in late pregnancy and a reduction in caesarian births,” said senior author and U-M professor of nursing Lisa Kane Low, Ph.D., C.N.M., a midwife and researcher at Michigan Medicine and the U-M School of Nursing.
In fact, results from the general Michigan sample were contradictory to the ARRIVE trial: Women who underwent elective induction were more likely to have a cesarean birth compared with those who underwent expectant management (30% versus 24%.)
In a subset of the sample, matching patient characteristics for a more refined analysis, there were no differences in c-section rates. Authors noted that time between admission and delivery was also longer for those induced.

Expectantly managed women were also less likely to have a postpartum hemorrhage (8 % versus 10 %) or operative vaginal delivery (9 % versus 11 %), whereas women who underwent induction were less likely to have a hypertensive disorder of pregnancy (6 % versus 9%.) There were no other differences in neonatal outcomes.
Authors point to several possible explanations for why the two studies had conflicting results. One key difference was that the Michigan study collected data after births for the purpose of quality improvement in a general population of low-risk births. The ARRIVE trial, however, used data collected in real time as part of a research study.
A significant difference between individuals in a clinical trial and the general birthing population, Low says, may revolve around shared decision-making. Before trial enrollment, participants undergo a thorough informed consent process from trained study team members.
For the ARRIVE trial, this meant 72% of women approached to be in the study declined participation. Meanwhile, previous research has indicated that women in the general U.S. population often may feel pressured into agreeing to have their labor induced.
“Better outcomes may have occurred in the trial because the participants were fully accepting of this process,” Low said.
“Further research is needed to identify best practices to support people undergoing labor induction,” she added. “Prior to initiating an elective induction of labor policy, clinicians should also ensure resources and a process to fully support shared decision-making.”
Inequities impacting likelihood of induced labor
Michigan researchers also found that the practice of inducing labor at 39 weeks was not applied equally across demographic groups, with those being induced more likely to be birthing people who are at least 35 years old, identify as White non-Hispanic and who are privately insured.
The racial disparity in the data is consistent with the Centers for Disease Control and Prevention (CDC) data that shows more white women undergo induced labor than birthing individuals of any other racial or ethnic group.
“These findings suggest that the practice of elective induction of labor may not be equitably applied across birthing people,” Langen said. “We can only speculate about the reasons for these differences, but it’s important that we pursue equitable application of evidence-based practices for all who would benefit.”
Hospitals across the Michigan collaborative varied in size, teaching status and location but the sample size for induced deliveries was not adequate to analyze the impact of specific hospital factors on outcomes, authors note.
However, the team’s additional analysis found cesarean birth rate after induced delivery did not differ between large hospitals and the rest of the collaborative.
“Inductions of labor for both medical indications and individual preferences will continue to be part of modern obstetrics, making it important to pursue strategies that optimize the induction process and outcomes,” Langen said. “Future work should include a health equity approach and include the voices of pregnant people and their experiences of changes in care management.”

Feces from fish that are typically thought to promote healthy reefs can damage and, in some cases, kill corals, according to a recent study by Rice University marine biologists.
Until recently, fish that consume algae and detritus — grazers — were thought to keep reefs healthy, and fish that eat coral — corallivores — were thought to weaken reef structures. The researchers found high levels of coral pathogens in grazer feces and high levels of beneficial bacteria in corallivore feces, which they say could act like a “coral probiotic.”
“Corallivorous fish are generally regarded as harmful because they bite the corals,” said Carsten Grupstra, a former graduate student at Rice and lead author of the open-access study in Frontiers in Marine Science. “But it turns out that this doesn’t tell the whole story.”
Grupstra received his doctorate in 2022, and is now a postdoctoral researcher at Boston University and Woods Hole Oceanographic Institution. In 2021, he, his doctoral adviser, Adrienne Correa, and others from her Rice research group discovered that feces of coral predators are packed with living symbiotic algae that corals depend upon.
The new study builds on that with data and evidence compiled from two years of field research and laboratory experiments at Rice and theMoorea Coral Reef Long-term Ecological Research station on the South Pacific island of Moorea, French Polynesia. The research showed corallivore feces contained many bacteria that are found in healthy corals under normal conditions. Grazer feces were both found to contain pathogenic bacteria and shown to damage or kill living coral fragments in controlled laboratory experiments.
To understand why corals might benefit from their predators’ feces, Grupstra said it is important to consider that coral-eating fish do not devour their prey. Ever wary of being eaten themselves, they spend their days repeating a simple two-step process: grab a mouthful, swim to a new location. Because they relieve themselves as they go, they naturally disperse poop — and any beneficial organisms it contains — over a wide area.

Grupstra said the new study suggests corallivore feces could be an important source of beneficial microbes for corals.
“It’s analogous to fecal microbiota transplantation therapy in humans,” Grupstra said.
The study examined bacteria from both corallivore and grazer feces, and compared their effects on live corals. The researchers began by collecting fresh feces from corallivores and grazers during research dives. They both assayed bacteria in the samples and conducted controlled experiments to see how each type of feces affected coral.
They placed pieces of coral in jars with microbe-free seawater. To some jars, they added fresh feces from either corallivores or grazers. To determine whether the physical characteristics of the feces alone might harm the coral, they sterilized some fecal samples and added them to other jars. To the final group of jars, an experimental control, nothing was added. At the end of the experiment, coral fragments from all jars were examined and categorized as apparently healthy, containing lesions or dead.
The experiments showed that some feces could kill or smother corals. In most cases, the effect was localized, producing lesions on the coral fragment. In others, the entire fragment died. Feces from grazers caused lesions or death in all jars. Corallivore feces produced fewer and smaller lesions and rarely led to fragment death, and sterilized feces produced comparable damage.
“The bacterial assays from our field samples helped explain the results from the laboratory experiments,” said Correa, an assistant professor of biosciences. “We found coral pathogens were more abundant in grazer feces, and beneficial microbes were more abundant in corallivore feces.”
Grupstra said researchers need to further test how fish feces affect corals in the ocean. For example, damaging or beneficial effects could be limited if fecal pellets disintegrate or are eaten or removed by another organism. Better understanding the drivers of fecal effects could allow reef managers to implement treatments that promote beneficial effects or minimize negative impacts.
“Together, these findings result in a more nuanced understanding of the roles of fish on coral reefs and may help us better understand the interactions that are happening on reefs around the world,” he said. “Both corallivores and grazers have important ecological roles and understanding those roles can help us better manage and conserve these important ecosystems.”
The research was supported by the National Science Foundation (2145472 and 1635798), Rice University startup funds and fellowships awarded by the Wagoner Foreign Study Scholarship Program and the Kirk W. Dotson Endowed Graduate Fellowship in Ecology and Evolutionary Biology.

Tiny pores in the cell nucleus play an essential role for healthy aging by protecting and preserving the genetic material. A team in Germany from the Department of Theoretical Biophysics at the Max Planck Institute of Biophysics in Frankfurt am Main and the Synthetic Biophysics of Protein Disorder Group at Johannes Gutenberg University Mainz has literally filled a hole in the understanding of the structure and function of these nuclear pores. The scientists found out how intrinsically disordered proteins in the center of the pore can form a spaghetti-like mobile barrier that is permeable for important cellular factors but blocks viruses or other pathogens.
Human cells shield their genetic material inside the cell nucleus, protected by the nuclear membrane. As the control center of the cell, the nucleus must be able to exchange important messenger molecules, metabolites or proteins with the rest of the cell. About 2000 pores are therefore built into the nuclear membrane, each consisting of about 1000 proteins.
For decades, researchers have been fascinated by the three-dimensional structure and function of these nuclear pores, which act as guardians of the genome: substances that are required for controlling the cell are allowed to pass, while pathogens or other DNA-damaging substances are blocked from entry. The nuclear pores can therefore be thought of as molecular bouncers, each checking many thousands of visitors per second. Only those who have an entrance ticket are allowed to pass.
How do the nuclear pores manage this enormous task? About 300 proteins attached to the pore scaffold protrude deep into the central opening like tentacles. Until now, researchers did not know how these tentacles are arranged and how they repel intruders. This is because these proteins are intrinsically disordered and lack a defined three-dimensional structure. They are flexible and continuously moving — like spaghetti in boiling water.
Combination of microscopy and computer simulations
As these intrinsically disordered proteins (IDPs) are constantly changing their structure, it is difficult for scientists to decipher their three-dimensional architecture and their function. Most experimental techniques that researchers use to image proteins only work with a defined 3D structure. So far, the central region of the nuclear pore has been represented as a hole because it was not possible to determine the organization of the IDPs in the opening.
The team led by Gerhard Hummer, Director at the Max Planck Institute of Biophysics, and Edward Lemke, Professor for Synthetic Biophysics at Johannes Gutenberg University Mainz, and Adjunct Director at the Institute of Molecular Biology Mainz has now used a novel combination of synthetic biology, multidimensional fluorescence microscopy and computer-based simulations to study nuclear pore IDPs in living cells.
“We used modern precision tools to mark several points of the spaghetti-like proteins with fluorescent dyes that we excite by light and visualize in the microscope,” Lemke explains. “Based on the glow patterns and duration, we were able to deduce how the proteins must be arranged.” Hummer adds, “We then used molecular dynamics simulations to calculate how the IDPs are spatially organized in the pore, how they interact with each other and how they move. For the first time, we could visualize the gate to the control center of human cells.”
Dynamic protein network as transport barrier
The tentacles in the transport pore take on a completely different behavior compared to what we knew before, because they interact with each other and with the cargo. They move permanently like the aforementioned spaghetti in boiling water. So, in the center of the pore there is no hole, but a shield of wiggly, spaghetti-like molecules. Viruses or bacteria are too big to get through this sieve. However, other large cellular molecules needed in the nucleus can pass as they carry very specific signals. Such molecules have an entry ticket, whereas pathogens usually do not. “By disentangling the pore filling, we enter a new phase in nuclear transport research,” adds Martin Beck, collaborator and colleague at the Max Planck Institute of Biophysics.
“Understanding how the pores transport or block cargo will help us identify errors. After all, some viruses manage to enter the cell nucleus despite the barrier,” Hummer sums up. “With our combination of methods, we can now study IDPs in more detail to find why they are indispensable for certain cellular functions, despite being error-prone. In fact, IDPs are found in almost all species, although they carry the risk of forming aggregates during the aging process which can lead to neurodegenerative diseases such as Alzheimer’s,” Lemke says. By learning how IDPs function, researchers aim to develop new drugs or vaccines that prevent viral infections and help healthy aging.

The case against her was weak enough. Did her defense have to mock the very idea of invisible injuries?In March, on Day 7 of the Gwyneth Paltrow ski trial, after the court spectacle had already been branded everything from a “meme machine” to “the whitest trial of all time,” the retired optometrist Terry Sanderson sat in the witness box, somewhat deflated already. By that point, he probably knew that his pursuit of Paltrow for damages connected to a ski collision he said was her fault was a pretty bad idea. Sanderson claimed that injuries he sustained during the 2016 ski crash (including, notably, a concussion) changed his life, turning him into “a different person,” and “a crippled vet.” Paltrow’s lawyer, the languid, unflappably stone-eyed Stephen Owens, stood before him, presenting Facebook posts — a lot of Facebook posts, some taken months after the collision — as evidence of robust health.“This is a picture of you and your girlfriend, smiling big, right?”“Smile, camera, yup,” Sanderson replied.And then, the deluge:Was this, Owens asked, Sanderson hiking with his girlfriend? Was this him taking a picture of a moose? Was this him, looking happy? Was this him hiking again, and smiling? With a cool backpack containing water? Scuba diving? At an auto show in Germany? A shooting range? BMX bike show? Was this Sanderson on a boat ride along canals in the Netherlands? Did he do bus tours? Or go to Morocco? Twice? Did he go to the this museum in Marrakesh? Was this him at a rock concert? At a ski resort? Out with drinking buddies? At an exhibit? Feeling happy? Looking fit and happy? Was this him “doing yoga, or momba, or what?”“It’s Zumba,” Sanderson corrected. And yes.As far as controversies go, the trial was as Diamond Life as you can get. For about a week, it lived in the media as a jaunty low-stakes holiday from the high-stakes everything of our ongoing decennium horribile. Amid a news cycle of war and school shootings, recession and an indicted former president, it was an almost-delightful diversion to have this little legal whodunit, this simple question of who crashed into whom on a resort ski slope so luxurious it might as well be covered in cashmere.As much of a trifle as the trial was for viewers, it seemed to be a real inconvenience for Paltrow, who said she was injured by Sanderson and infamously claimed to have “lost half a day of skiing” as a result of the crash. Sanderson seems to me like an opportunist with an appetite for attention, or at the very least a schlemiel, possibly a little vain. The retired optometrist, the jury made clear, crashed into Paltrow, making him the offender. Unsurprisingly, she won the case.But what frustrated me in this trial, particularly in the questioning above, was that Sanderson’s claim that his life was changed by the concussion was over and over again challenged or dismissed. Part of the reason for this assertion seemed to stem from the fact that, well, he seemed to still have a life. Owens heavily implied that a man truly affected by a mild traumatic brain injury like a concussion couldn’t or wouldn’t go hiking, or travel, or make it look on Facebook as if he were living the dream. Or maybe the frame of reasoning was more that somebody living with illness — in Sanderson’s case an invisible illness — shouldn’t be doing those things. He should be in bed, in the land of the sick, no visa, no passport.The category of invisible illness — which means exactly what it sounds like: an illness or disability not immediately apparent — is growing sharply in America. Through the wonders of medicine we’ve become great at turning life-or-death illnesses, like diabetes, heart conditions or certain forms of cancer, into chronic conditions that can often be lived with. At the same time, diagnoses of hidden diseases like Crohn’s or fibromyalgia are becoming increasingly common — as is long Covid, which on its own might have affected as many as 23 million Americans.The sociologist Arthur W. Frank has called this cohort ‘remission society.’ But I prefer to think of it as a society of walking wounded.Sanderson is really not a representative whom anybody living with invisible illness wants: a person who could very likely be exaggerating or appropriating symptoms for gain; a man who identifies as a victim diminished by injury and then goes scuba-diving and sits beaming like a prince on a Moroccan camel. As far as advocacy goes, it’s not the best look.Yet as someone who has, for nearly the past 20 years, lived with invisible illness, I can tell you that it is a legitimate look. My personal complex of illness stems from an unusual neurological condition called spontaneous cerebrospinal fluid leak syndrome, which leads to a brain with an insufficient cushion around it. I also have post-concussion syndrome. In my own decades with sickness as a varyingly close companion, there have been many points at which my life was truly defined by pain and disability on the inside, but still looked pretty nice and zippy on paper (or Facebook). I had two kids, I moved cities, I traveled, I hosted events, I wrote books and articles, I got out of a marriage that wasn’t working, I had boyfriends. Sometimes I did some of these things very slowly, as if from the middle of a lake of glue. Sometimes I did them white-knuckled, with a brain that felt like a fat, broiling whale bladder. Other times I was more fine — like now — and if someone were to encounter me on the street, they might assume I was 100 percent cured.What I am describing here is the between-space spectrum of functional illness, a zone occupied by many with invisible illnesses — with feet both in the world of the well and in the universe of the sick. The sociologist Arthur W. Frank has called this cohort “remission society.” But I prefer to think of it as a society of walking wounded, because the term better includes people affected by illnesses including lupus, Lyme disease, migraine, endometriosis and, yes, the stubborn remnants of concussion — all of which are more chronically pooh-poohed, disbelieved or gaslighted, not least by the medical community.Oddly, it’s a realm Paltrow says she herself inhabits. Just a few days before the trial began, the actor and Goop founder was lambasted for a podcast interview in which she seemed to suggest that her normal daily food intake was composed of coffee, bone broth and vegetables — a therapeutic diet she says has been helping her get over her own symptoms of long Covid and other health issues. (Paltrow later clarified that she eats “full meals.”) But the interview, which might have been strategically given to position Paltrow as a sick person who got uncomplainingly ill and then took care of her own business through an anti-inflammatory diet and a stiff upper lip (rather than blame and the courts), backfired: ​Not only did it make Paltrow look disordered and out of touch; it also put her own health issues into the same quotation marks as Sanderson’s. An illness invisible, and thus relentlessly questioned.So, I don’t believe that Sanderson is a victim of reckless Hollywood royalty on skis. But I do believe his brain injury. Because I know, intimately, what a brain injury can do. And I know that between illness and health, there really is no zero-​sum game. A man can have a life forever altered by a concussion. And he can also Zumba.Source photographs: mbbirdy/E+/Getty Images; screen grab from YouTube.