A hibernating species of North American squirrel might provide vital insights for tackling one of the most persistent and lethal heart diseases globally.
California’s biotechnology firm fauna ecology has created a novel drug based on the genetic insights of hibernating mammals.
The small molecule drug, referred to as Faun 1083, targets heart failure with preserved ejection fraction (HFpEF)—a form of heart failure impacting millions and lacking effective treatments.
Fauna’s strategy draws inspiration from the natural world, as noted by CEO Dr. Ashley Zehnder: “We’re investigating where biological evidence exists for disease resistance or recovery,” as mentioned in BBC Science Focus.
“Years of physiological research indicate that ground squirrels can safeguard their hearts from harm during hibernation. Additionally, heart failure ranks as one of the top causes of death worldwide.”
By examining how the adorable American line squirrel protects its organs while hibernating, Dr. Fauna discovered a gene that aids the animal in averting tissue damage and scarring—critical factors in heart failure among humans.
“What is elevated in the ground squirrel’s system, which shields the heart from harm, may be diminished in humans suffering from heart failure,” Zehnder explains. “This informs our focus on the pathways that are crucial for human health issues.”
Currently, there are limited effective treatments for heart failure with preserved ejection fraction (HFpEF) beyond merely alleviating symptoms – Photo credit: Getty
Fauna’s AI-enhanced discovery platform analyzes these protective traits across animal genomes and human genetic data to identify potential drug targets.
According to Zehnder, the resultant compound Faun 1083 stems directly from research into the cardiac biology of ground squirrels. The new treatment has already shown potential during preclinical trials and is set to undergo animal safety assessments prior to commencing human trials next year.
Fauna Bio’s research is part of a burgeoning field known as ‘comparative genomics,’ which seeks evolutionary insights to enhance human health.
The company is part of the Zoonomia Consortium, which unveils adaptations that enable animals to resist disease and recover from tissue damage.
“Our goal is to leverage evolutionary adaptations,” Zehnder asserts. “Humans rarely cure diseases naturally, but many mammals worldwide do so regularly… Why not utilize the full spectrum of nature’s experiments?”
Do you often feel anxious? Struggling to concentrate at work? Do you wake up drenched in sweat? Welcome to a phase that is frequently overlooked and often chaotic.
This transitional stage, marked by menopause symptoms but not yet completed, was once brushed off as a fleeting hormonal shift. Today, it’s increasingly acknowledged as a challenging and disruptive decade during which significant changes occur within the body and mind.
Emotional ups and downs, migraines, fluctuations in heart rhythms, urinary tract infections—an array of symptoms can leave many feeling unacknowledged. Fortunately, as our grasp of hormonal health evolves, emerging treatments are providing essential relief.
Nonetheless, there’s no shortage of noise. Social media is awash with advice on remedies, ranging from dietary supplements to intricate exercise routines. What genuinely benefits you, and what is merely a waste of time and money?
The answer depends on your personal experience of the perimenopause phase. During this time, estrogen levels fluctuate unpredictably, accompanied by declines in progesterone and testosterone, impacting everything from bone density and muscle strength to cognitive function and cardiovascular health.
Despite the fact that half the population goes through this transition, its significance is often underestimated. “Menopause marks a pivotal moment in a woman’s life—physically, emotionally, and socially,” states Christina del Toro Badsa, a physician and expert in hormonal health based in Atlanta, Georgia. “However, many women belong to the ‘sandwich generation,’ caring for both children and aging parents while their own well-being is often neglected.”
These symptoms go beyond personal struggles; they can have far-reaching social implications. According to a survey by British charities regarding welfare, one in four women considers leaving their job due to menopausal symptoms. In the U.S., a 2025 study estimates that the costs associated with reduced working hours or premature retirement due to menopause amount to $1.8 billion annually.
Many individuals experiencing perimenopausal symptoms opt for HRT
Elena Popova/Getty Images
In terms of solutions, the UK’s National Institutes of Health (Nice) identifies hormone replacement therapy (HRT) as the first-line treatment for those over the age of 40. However, despite its efficacy, the adoption remains inconsistent, and its use in the U.S. has dramatically fallen over the last quarter-century. This decline is partly due to long-standing fears surrounding side effects revealed in two studies. A significant HRT trial in 2002 was halted after early results suggested an increased risk of breast cancer, heart attacks, and strokes. A follow-up in 2003 estimated that HRT was linked to 20,000 breast cancer cases in the following decade.
While these trial findings were not incorrect, they had limitations and were misunderstood. Media reports, for instance, focused on women over 60. Later trials indicate that the age at which women start HRT significantly influences their breast cancer risk. For example, five years after stopping HRT, women who have taken HRT for less than 5 years show no increased risk of breast cancer.
Context is key. According to the British Menopause Society, women aged 50-59 using HRT (both estrogen and progestogen) for up to 14 years may see an additional 10 breast cancer diagnoses per 1,000. However, this “minor risk” must be evaluated against the substantial reduction in endometrial cancer risk provided by HRT. This risk is comparable to several lifestyle factors, such as obesity, which adds 10 additional breast cancer diagnoses per 1,000 women in the same age group, while consuming 4-6 units of alcohol daily increases cases by eight. In short, while HRT slightly raises the likelihood of breast cancer diagnosis, it is not substantial compared to various other lifestyle choices.
Advantages of HRT
Furthermore, HRT offers several benefits, including lowering the risk of cardiovascular diseases and reducing fracture rates. Initial research suggests that estrogens may be crucial in assisting the brain with glucose metabolism regulation, potentially explaining fatigue and memory lapses during perimenopause due to estrogen depletion affecting glucose processing. Additionally, studies by Roberta Brinton from the University of Arizona indicate that HRT may provide some protection against Alzheimer’s disease—a notion that remains controversial.
“All menopause guidelines indicate that hormone replacement therapy is the most evidence-based treatment for perimenopausal symptoms,” asserts Louise Newson, a physician and member of the UK government’s menopause task force.
Still, HRT isn’t suitable for everyone. Some women may have additional risk factors that prevent their use of HRT, such as prior history of lupus or blood clots, while others may hesitate due to perceived associated risks. For instance, researchers like Karyn Flick from the University of Wisconsin-Milwaukee are studying highly selective estrogen receptor drugs. Unlike current HRTs, which activate a broad range of estrogen receptors, these drugs target only those linked to protective effects, such as inhibiting the growth of breast and ovarian cancer. Initial studies suggest this method could be more effective than existing treatments.
Nice also recommends cognitive-behavioral therapy (CBT) as a frontline strategy during the perimenopausal phase. Clinical trials indicate that CBT can effectively diminish hot flashes and night sweats.
On the topic of hot flashes, drug developers are making strides. In 2023, the FDA approved Fezolinetant, the first non-hormonal medication designed for this issue. It operates by blocking NK3 receptors in the brain that control the body’s internal thermostat in low estrogen conditions. “This medication works quickly and effectively,” explains Alyssa Dweck, a consultant gynecologist and chief medical officer at Bonafide Health, a US-based company specializing in menopause products. The downside is the high cost, unsure insurance coverage in the U.S., and the necessity for regular liver monitoring due to potential side effects.
A more promising alternative may be Elinzanetant, a similar drug that received approval in July from the UK’s regulatory agency. It targets both NK1 and NK3 receptors, and early trials suggest it not only reduces moderate to severe hot flashes, but also alleviates sleep disorders without inducing liver toxicity.
Is Increasing Protein Intake Necessary During Menopausal Transition?
Medical intervention is just one component of the solution. Dietary changes can also be beneficial. Many influencers advocate for “increased protein intake,” which may hold some truth during the perimenopause. Although most individuals meet their protein requirements with a balanced diet, hormonal shifts during perimenopause can lead to bone and muscle loss, causing some women to gain weight for unclear reasons.
Arthur Conigrave from the University of Sydney suggests that the disparity between the body’s protein needs and actual intake could be a contributing factor. In a 2022 study, he and his colleagues found that as muscle protein breaks down, the brain compels a person to eat more to restore protein levels. However, without dietary adjustments to boost protein percentage, many end up eating more carbs and gaining weight.
The Conigrave research team posits that during the perimenopausal phase, women might need to boost their daily protein intake by approximately 0.1 to 0.2 grams per kilogram of body weight. For a person weighing 70 kg (about 155 lbs), that’s an extra 7g to 14g of protein each day—equivalent to a large egg or a cup of edamame.
Do Supplements for Perimenopause Actually Deliver Results?
Despite the hype, scientific evidence supporting supplements for perimenopausal symptom relief is sparse. A 2021 review identified only one extract, Cimicifuga racemosa, or Black Cohosh, as having considerable evidence for effectiveness; research suggests it may alleviate anxiety, irritability, and hot flashes. This might be due to increased serotonin levels, but results vary widely. Safety remains uncertain. Vitamin B6 may lessen hot flashes and protect against cognitive decline, while maintaining optimal vitamin D levels can bolster mood and immune function. Nevertheless, these supplements may not yield transformative effects.
Weightlifting during perimenopause can positively influence bone density.
Elena Popova/Getty Images
“Certain vitamins and supplements can alleviate some symptoms, but they cannot replace missing hormones or provide the long-term health benefits that HRT offers,” notes Newson. Multiple studies have indicated that HRT reduces the long-term risk of heart disease and diabetes.
Moreover, there’s an increasing interest in the microbiome and its alterations during menopause. A recent review of current research demonstrated that while probiotics show beneficial effects on perimenopause-related bone health, hot flashes, psychological symptoms, and vaginal dryness, many studies still require more robust design to minimize bias.
Should I Focus on Weights or Cardio?
Finally, there’s the question of the most effective exercise regimen to combat the effects of perimenopause. Is it necessary to hit the pavement, or is strength training the better approach? A review of studies from 2015 to 2022 confirmed that weight training during perimenopause enhances strength, bone density, and metabolic health, but it’s still uncertain if this method outperforms other forms of exercise.
In terms of social media “advice,” proceed with caution. Regulators are tightening restrictions on misleading claims, but this area still possesses a Wild West atmosphere. Significant attention and funding are necessary to further understand the conditions affecting women.
Cats that exhibit dementia-like symptoms in their senior years undergo changes analogous to those seen in humans with Alzheimer’s disease, as highlighted in a study I found. This finding may open pathways for new research and help in discovering treatments for these challenging and notorious diseases.
“Our advancements in treating Alzheimer’s disease have been relatively limited compared to other illnesses,” stated Dr. Robert McGeechan, the study’s lead author, in an interview with BBC Science Focus.
“Cats are experiencing similar neurological changes, making them potentially more relevant models for understanding the disease. By investigating Alzheimer’s in cats, we can develop treatments that might be more effective for humans.”
Alzheimer’s disease is the most prevalent form of dementia, encompassing a range of neurodegenerative conditions that impair memory, problem-solving, language, and behavior. Approximately one in nine individuals over 65 are affected by Alzheimer’s, and with an aging global population, over 150 million people could be diagnosed by 2050.
Yet, despite decades of investigation and billions spent, only a handful of effective treatments exist today.
How Cats Develop Dementia
The understanding that cats can show dementia-like symptoms with age is not new. According to some research, nearly one-third of cats aged 11 to 14 exhibit at least one sign of cognitive dysfunction syndrome (CDS), the veterinary term for dementia in felines. For cats older than 15, this figure increases to over half.
CD symptoms in cats, which resemble those in humans with Alzheimer’s, include changes in sleep patterns and disorientation. Many cats also become more vocal and often seek additional comfort and attention from their owners.
It is also known that, similar to humans, older cats typically develop an accumulation of amyloid beta plaques in their brains, which are suspected to play a role in the onset of Alzheimer’s.
“As we age, humans develop these protein plaques in our brains. However, not everyone with these plaques develops Alzheimer’s, and the reasons for this remain unclear,” McGeechan explained.
“We were similarly situated with cats, knowing they could develop dementia and that some produce these proteins as they grow older, but we lacked clarity on whether this was solely age-related or if it contributed to dementia.”
To delve deeper, McGeechan’s team examined the brains of 25 cats of varying ages post-mortem, including those with CDS symptoms.
They discovered that amyloid beta plaques were not just passively situated in the brain but were also linked to detrimental changes. Notably, they observed increased inflammation and signs of glial cells, the immune cells of the brain, “enveloping” the synapses surrounding these protein plaques.
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Synapses are tiny junctions enabling brain cells to communicate, and their progressive loss is believed to underlie many memory and behavioral symptoms associated with dementia.
The findings imply that a similar toxic chain reaction may also occur in feline brains. As amyloid beta accumulates, it activates glial cells, leading to the degradation of healthy synapses. While this broader pattern was evident, the finer details proved to be more intricate.
Upon comparing the brains across different age groups, subtle differences emerged. Cats with dementia appeared significantly different from younger cats, exhibiting greater amyloid plaque accumulation, inflammation, and synaptic loss. However, they did not starkly differ from older, yet otherwise healthy cats.
This observation indicates that researchers might struggle to draw a clear line between aging and dementia.
Yet, the team noted an important distinction concerning the relationship between amyloid plaques and synaptic damage. In older, healthy cats, increased amyloid did not equate to more harm. However, in cats with dementia, higher plaque levels correlated with increased inflammation and greater brain cell loss.
McGeechan posits that this mirrors human scenarios. Numerous older adults accumulate amyloid plaques in their brains without developing Alzheimer’s, while others experience significant cognitive decline.
“Amyloid may have a more toxic impact on cats experiencing CDS,” he noted. “This correlation suggests amyloid plays a role in inflammation and synaptic loss in the dementia group, unlike in the aging group.”
Thus, while amyloid accumulation may contribute to feline dementia, it likely does not tell the full story. Much like Alzheimer’s in humans, a complex interplay of various factors may also be at play.
MRI image of a cat’s brain exhibiting signs of cognitive dysfunction. The lighter areas on the edges illustrate regions of tissue loss.
The Significance of Cats in Research
Alzheimer’s disease research has historically depended on rodents, where diseases are artificially induced by genetic manipulation.
While these models aid in exploring molecular mechanisms, they often fall short of encapsulating the intricacies of naturally occurring diseases that unfold over time. Consequently, numerous promising drugs that succeed in mice fail when tested on humans.
In contrast, cats naturally develop dementia as they age, mirroring the human experience. They also share the same living environments and risk factors, including diet and air quality.
This similarity renders them a more realistic model for understanding disease biology and identifying environmental triggers that might push certain individuals towards dementia.
“Cats could serve as a bridge in our pursuit of effective treatments,” McGeechan expressed.
Future Directions
At this point, the findings raise just as many inquiries as they resolve. Given that the study involved only 25 cats, a larger sample size may be necessary to clarify the precise mechanisms underlying the observed clinical outcomes, according to McGeechan.
Another area of focus is tau. Besides amyloid beta, tau is another key protein associated with Alzheimer’s disease. Unlike amyloid plaques, tau forms tangles within brain cells. Many researchers believe tau drives the most severe stages of the disease in humans, but this investigation did not address tau in cats.
Dogs may also present a valuable avenue for exploration. Like cats, they can age into a dementia-like syndrome, displaying symptoms recognizable to many owners, such as sleep disturbances, anxiety, and forgetfulness. Comparing the brains of dogs and cats might reveal shared biological processes across species.
Ultimately, this body of research holds promise not just for human health.
“Dementia in cats is a distressing condition for both the animals and their owners,” remarked Professor Danièlle Gunn-Moore, a co-author of the study and a chair in feline medicine at the Royal (Dick) School of Veterinary Medicine.
“Conducting such research aims to enhance our understanding of how best to treat these conditions. This work benefits not just cats and their owners but also individuals with Alzheimer’s disease and their loved ones. Dementia in cats serves as an ideal natural model to study Alzheimer’s disease.”
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About Our Experts
Robert McGeechan is a resident in Veterinary Neurology and Neurosurgery and serves as an ECAT Veterinary Clinical Lecturer at the University of Edinburgh, UK. His research has been published in European Journal of Neuroscience, Scientific Reports, and Nature Neuroscience.
Healthcare has witnessed remarkable advancements over the past few decades. In high-income nations, the survival rate for certain types of pediatric leukemia has increased from about 10% to over 90%. HPV vaccinations have decreased the incidence of cervical cancer, and early detection of HIV can lead to life expectancies similar to that of the general population.
In contrast, progress in mental health treatment has been less pronounced. Psychiatry often struggles with a perception of stagnation in treatment methodologies. Historically, it has heavily relied on psychopharmaceuticals developed in the mid-20th century. The field has remained largely anchored to these early drug treatments.
This stagnation is not due to a lack of effort. In the 1970s, molecular psychiatry emerged, focusing on the molecular basis of mental health conditions through proteins, genes, and signaling pathways. The goal was to anchor diagnostics and treatments to biological mechanisms instead of merely interpreting subjective symptoms. Despite advances in genetic research, including exploring the genetic links to schizophrenia, we have yet to see significant improvements in mental health treatment paralleling those in physical health.
The new approach is targeting chronic inflammation.
Given that approximately 8-16% of individuals in high-income countries like England experience anxiety and depression, a fresh perspective is crucial. Current innovative approaches focus on chronic inflammation, a phenomenon linked not just to heart disease and type 2 diabetes, but also to mental health.
For many, chronic low-grade inflammation results from the pace of modern life, often fueled by factors such as stress, obesity, and poor dietary choices. Promising developments suggest that certain anti-inflammatory medications may have potential benefits for the brain, alleviating issues associated with depression and dementia (“Chronic inflammation harms your mind. Here’s how to calm it down”).
These findings also clarify that managing mental health can be approached through actions such as regular exercise, relaxation techniques, and nutritious eating.
While this path may not work for everyone, given that antidepressants fail to help approximately 30% of those treated for depression, any progress is welcomed.
Microglia are specialized immune cells in the brain
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The process of replacing immune cells in the brain halts the advancement of a rare and terminal brain disorder known as ALSP. This also paves the way for future clinical trials targeting other neurological ailments.
Extensive research indicates that impaired microglia—specialized immune cells within the brain—play a role in various neurological disorders, including Alzheimer’s disease and schizophrenia. The term ALSP stands for adult-onset leukoencephalopathy with axonal spheroids and pigmented glia, characterized by mutations in genes responsible for the survival of these cells, resulting in a reduced number of microglia and leading to progressive cognitive decline. Currently, no effective treatment exists for this fatal illness.
To address this, Bo Peng from Fudan University in China and his team employed a novel treatment called microglia replacement therapy. Prior experiments in rodents have shown that implanted stem cells—capable of developing into different cell types—can effectively replace microglia. However, it is necessary to first eliminate existing microglia in the brain to facilitate this. This can be achieved using drugs that target protein microglia.
Pursuing this avenue, Peng and his colleagues conducted initial tests on five mice with genetic mutations analogous to those associated with ALSP. As the mutations already impacted protein microglia, the researchers did not need to deplete these proteins with medication. Subsequently, they transplanted stem cells from healthy mice into the affected mice. Fourteen months later, treated mice exhibited approximately 85% more microglia in their brains compared to six untreated mice harboring the same mutation. Notably, these treated mice also demonstrated improvements in motor function and memory.
Encouraged by these promising findings, the researchers extended the treatment to eight individuals diagnosed with ALSP, using donor stem cells without preconditions. One year post-treatment, brain scans revealed minimal changes in participants compared to scans taken before the procedure. In contrast, four untreated individuals displayed significant brain deterioration and lesions over the same period. This implies that microglial replacement therapy effectively halted the progression of the disease.
At the study’s outset, all participants underwent cognitive assessments using a 30-point scale, where a decrease in score indicated cognitive decline. Reassessments a year later showed that, on average, scores remained stable for those who received the microglia replacements.
These results point to microglial replacement therapy being a potentially effective solution for ALSP. However, since this represents the inaugural human trial, “we remain unaware of any potential side effects,” comments Peng. “Given the rapidly progressive and lethal nature of this disease, prioritizing benefits over possible side effects might be crucial.”
Chris Bennett from the University of Pennsylvania cites the historical use of stem cell transplants for treating neurological disorders. “It has demonstrated effectiveness, particularly through microglia replacement,” he states. Recent FDA approvals for two similar therapies addressing other rare brain conditions further support this. “While prior studies may not have used this exact terminology, they effectively addressed similar conditions,” Bennett elaborates. “I’d describe this as a smart and innovative application of stem cell transplants. Nonetheless, microglia replacement therapy has been evolving for decades.”
Despite this, the results underscore the broader implications of microglial replacement therapy. Experts believe this strategy could one day address more prevalent brain disorders. For example, certain genetic mutations significantly heighten Alzheimer’s disease risk and affect microglial function. Replacing these malfunctioning cells with healthy human equivalents could offer a promising avenue for treatment.
Individuals with type 1 diabetes struggle to produce sufficient insulin for blood sugar regulation
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Researchers have developed a 3D-printed device comprising insulin-producing cells, offering potential for long-term management of type 1 diabetes by enabling patients to generate their own insulin without invasive surgery.
Type 1 diabetes patients typically lack the ability to produce enough insulin to manage their blood sugar levels, necessitating regular insulin injections and dietary precautions. A common long-term approach involves transplanting clusters of insulin-producing cells from a donor’s pancreas. However, similar to organ transplants, this method requires invasive surgical procedures.
Quentin Perrier from Wake Forest Research Institute in North Carolina explains, “Currently, the procedure involves injecting human islets into the liver through the portal vein.” Unfortunately, around half of these implanted islets lose their function quickly, necessitating multiple transplants for effective treatment.
By placing islets directly beneath the skin, not only does it minimize surgical invasiveness, but it also alleviates stress and inflammation, factors that can shorten the lifespan of the cells.
Adam Feinberg from Carnegie Mellon University and Fluidform Bio states, “The greater the density, the better the outcome. This approach will reduce the size of the devices required for implantation in patients.”
To achieve this increased density, Perrier and his team utilize 3D printing to create islands from “bioinks” composed of human pancreatic tissue and alginates, a type of carbohydrate derived from seaweed. Living insulin-producing cells are incorporated into this material.
“We combine this bioink with human islets in a syringe and print specialized motifs,” Perrier elaborates. This porous design allows for the development of new blood vessels around the structure.
In laboratory settings, this technique has proven effective, with about 90% of the cells in the islet surviving and functioning for up to three weeks. “The next step is to rigorously test this finding in vivo,” Perrier added. Their research was shared at the 2025 European Organ Transplant Association (ESOT) conference in London on June 29th.
Feinberg and his team have also undertaken the 3D printing of islets themselves. Their technique involves creating a framework akin to “3D printing within a hair gel” by printing cells and collagen directly onto a hydrogel polymer. This was showcased at the International Pancreatic and Islet Transplant Association conference in Pisa, Italy, on June 16th. In diabetic laboratory mice, these islets managed to restore normal glucose control for up to six months.
While Perrier’s findings are “undoubtedly promising,” Feinberg cautions that the inherent variability of human tissues employed in creating the islands can present challenges. “It’s akin to receiving a transplanted organ,” he notes. “The material may function exceptionally well, yet its variability poses challenges and complicates the situation.”
Both Feinberg and Perrier concur that stem cell therapy may hold the key to the future of managing type 1 diabetes. By integrating stem cells into their 3D printing process, they believe this approach could address multiple challenges associated with current cell sources.
One of the most significant yet frequently overlooked success stories of this century is the increasing number of individuals who are surviving cancer.
Several of these improvements can be attributed to reduced smoking rates and the establishment of national screening programs for various types of cancer. Additionally, advancements in treatment options have introduced groundbreaking therapies, especially in immunotherapy, encompassing monoclonal antibodies, checkpoint inhibitors, and cancer vaccines.
Medications that focus on the interaction between cancer and our neurons show promising results
However, not all is positive. Despite encouraging advances, the incidence of cancer continues to rise, and there are indications that improvements in survival rates are slowing. To witness the extraordinary progress made thus far, one may need to reevaluate cancer from an entirely different perspective.
Fortunately, an emerging field known as cancer neuroscience may provide that new perspective, as detailed in a recent cover story. The realization that nerves play a crucial role in cancer proliferation and dissemination introduces a novel approach to treatment. Drugs designed to target the interaction between cancer cells and our neurons are already showing promise in clinical trials and are being hailed as potential breakthroughs in cancer therapy.
If cancer neuroscience leads to the next major breakthrough, the resulting drugs could be surprisingly affordable and accessible. For instance, some widely used beta blockers are currently under research.
This development is particularly welcome in light of the fact that many newer therapies can become prohibitively expensive, and challenges still exist in ensuring equitable, swift, and affordable access to optimal cancer treatments.
Medical professionals have created an artificial intelligence tool capable of predicting which men diagnosed with prostate cancer are likely to benefit from treatment, potentially lowering the risk of mortality.
Abiraterone is regarded as a revolutionary treatment for the condition, which is the most prevalent cancer among men in over 100 countries. It has already enabled countless individuals with advanced prostate cancer to enjoy extended lifespans.
Nonetheless, some nations, including the UK, have ceased offering this “remarkable” medication to men whose cancer has not metastasized.
Currently, teams from the US, UK, and Switzerland are developing AI assessments that determine which men are likely to gain from Abiraterone. This “promising” advancement enhances the healthcare system to allocate medications more effectively to suitable candidates while allowing others to avoid unnecessary treatments.
The AI test was unveiled in Chicago at the annual conference of the American Society of Clinical Oncology, the largest cancer conference globally.
Nick James, a professor specializing in prostate and bladder cancer research at the London Cancer Institute, serves as a consultant clinical oncologist at the Royal Marsden NHS Foundation Trust, where he leads the development team.
“Abiraterone has already greatly enhanced the prognosis for hundreds of thousands of men with advanced prostate cancer,” James stated. “We recognize that for many men whose cancer hasn’t spread yet, it can have significant implications.
“However, the treatment comes with side effects and necessitates additional monitoring for potential issues such as hypertension or liver abnormalities. It is extremely valuable to identify those most likely to truly benefit, as it may slightly elevate the risks of diabetes and heart complications.
“This research indicates that those who respond optimally to abiraterone, as well as those who fare well with standard treatments alone, can decide between hormone therapy and radiation therapy.”
The AI tool examines tumor images and identifies features that may not be discernible to the naked eye. Prostate Cancer UK, the Medical Research Council, and arterial funded teams analyzed biopsy images from over 1,000 men exhibiting high-risk prostate cancer that had not metastasized.
AI analysis pinpointed 25% of the men in the study who were most likely to gain from Abiraterone. For these individuals, the medication halved the risk of mortality.
In the study, patients received a score indicating a positive or negative biomarker. This was then compared with outcomes. Among those with biomarker-positive tumors, the risk of death was reduced from 17% to 9% after five years for one in four men.
For patients with biomarker-negative tumors, Abiraterone decreased the risk of death from 7% to 4%. The research team indicated this result was neither statistically nor clinically significant, meaning these men are better off with standard treatment alone and can avoid unnecessary therapies.
Professor Gert Attard, the research co-leader at UCL Cancer Institute, noted, “This study highlights that, within a sizable cohort of patients, new algorithms can be utilized to glean information from routinely available pathology slides to customize treatments to individual patients, thereby minimizing unnecessary interventions while maximizing the effectiveness of treatment.”
James mentioned that fewer men may require the medication than previously believed, suggesting that health services should contemplate administering it to men whose cancer hasn’t spread.
While it has been sanctioned for use within the NHS for advanced prostate cancer in England, it has yet to receive approval for newly diagnosed high-risk cases that have not metastasized. However, men with indications of high-risk cancer have had access to treatment in Scotland and Wales for two years.
“Abiraterone costs just £77 per pack compared to thousands for new treatments,” James remarked. “We sincerely hope this new research will clarify who truly benefits from this drug, especially given NHS England’s decision not to fund it for high-risk non-metastatic prostate cancer cases.”
Dr. Matthew Hobbs, research director at Prostate Cancer UK, termed the AI test as “promising.” He further elaborated:
Philip Sunshine, a physician at Stanford University, significantly advanced neonatal theory as a medical specialty, transforming the care for premature and severely ill neonates, who previously faced little hope of survival. He passed away on April 5 at his home in Cupertino, California, at the age of 94.
His daughter, Diana Sunshine, confirmed his death.
Before Dr. Sunshine and a few other dedicated doctors took an interest in caring for infants in the late 1950s and early 1960s, more than half of these incredibly vulnerable patients died shortly after birth, often without insurance coverage for their treatment.
As a pediatric gastroenterologist, Dr. Sunshine believed that with proper attention, many premature babies could be saved. At Stanford, he assembled a multidisciplinary team to treat these infants in specialized intensive care units. Alongside his colleagues, he developed innovative feeding methods and breathing assistance techniques using ventilation.
“We managed to keep babies alive who would have otherwise not survived,” Dr. Sunshine recounted during an interview in 2000 with the Pediatric History Center at the American Academy of Pediatrics. “And now, this progress is often taken for granted.”
The early 1960s marked a pivotal moment for the care of premature babies.
As noted by the Oxford English Dictionary, the term “Neonatology” first appeared in the 1960 book “Isises of Newborn” by pediatrician Alexander J. Schaffer from Baltimore. By that time, Stanford’s Neonatology School, one of the nation’s earliest schools for this field, was already functional.
In 1963, Patrick Bouvier Kennedy, the second son of President John F. Kennedy, was born nearly six weeks prematurely and sadly passed away just 39 hours later. This tragic event captured the attention of newspapers across the nation and spurred federal health officials to begin funding research focused on newborns.
“Kennedy’s situation was a significant turning point,” Dr. Sunshine remarked in 1998 to Aha News, a publication of the American Hospital Association.
Serving as the Newborn Dean at Stanford from 1967 to 1989, Dr. Sunshine played a crucial role in training hundreds, if not thousands, of doctors who went on to work in neonatal intensive care units worldwide. Upon his retirement in 2022 at the age of 92, the survival rate for babies born at just 28 weeks had surpassed 90%.
“Phill is one of the pioneers in neonatology—an exceptional neonatologist and one of the finest in our field’s history,” stated David K. Stevenson, the head of the neonatology division at Stanford, who succeeded Dr. Sunshine, in a 2011 graduate journal.
Dr. Sunshine understood that providing care for young children involves both technical skills and personal connection. He advocated for allowing parents to visit the neonatal intensive care unit to hold their newborns, noting that skin-to-skin contact was highly beneficial.
He also encouraged nurses to exercise their judgment and express concerns when they felt something was amiss.
“Our nurses have always been invaluable caregivers,” Dr. Sunshine recounted in oral history. “Throughout my career, I collaborated with nursing staff who often recognized baby issues before the doctors did, and they continue to do so.”
A newborn nurse who worked alongside Dr. Sunshine for over 50 years shared in a blog post for Stanford Medicine, “Phil exuded a deep kindness—towards the babies, us, and everyone around him.”
“He viewed everyone as equally important,” she commented.
It was a challenging journey, and the pressure was immense.
“He had a calming, encouraging presence and was completely unflappable,” Dr. Stevenson said in an interview. “He would often say, ‘If you’re going to be up all night in the hospital, what better way to spend your time than by giving someone 80 or 90 years of life?'”
Philip Sunshine was born in Denver on June 16, 1930, to parents Samuel and Molly (Fox) Sunshine, who owned a pharmacy.
He earned his bachelor’s degree from the University of Colorado in 1952 and graduated from medical school in 1955.
After his first year of residency at Stanford, he was drafted into the US Navy, where he served as a physician. Upon returning to Stanford in 1959, he trained under pediatrician Louis Gulac, later developing a modern neonatal intensive care unit at Yale University.
“He inspired my passion for caring for newborns and made the field so fascinating,” Dr. Sunshine recalled. He stated.
Since there was no neonatal fellowship available at the time, Dr. Sunshine pursued advanced training in pediatric gastroenterology and pediatric metabolism fellowships.
“This was a really thrilling period,” he commented in a Stanford Medicine Children’s Health blog post. He remarked. “People from diverse backgrounds were contributing valuable skills for newborn care—like neonatal specialists, cardiologists, and those with interests in gastrointestinal issues with infants. I learned a wealth of information and enthusiasm from them.”
Dr. Sunshine married Sarah Elizabeth Vryland, dubbed Beth, in 1962.
He is survived by his wife, daughter Diana, four other children—Rebecca, Samuel, Michael, and Stephanie—and nine grandchildren.
In many ways, Dr. Sunshine’s surname aptly captured his essence; it resonates perfectly with his profession and approach.
“Beyond being a pioneer in neonatology, he truly brought light to every environment he entered,” Susan R. Hintz, a neonatologist at Stanford University, shared in an interview. “He was a soothing presence, especially during incredibly stressful times. Nurses frequently remarked, ‘He is someone everyone remembers.’
A spokesperson from HHS stated that the U.S. is experiencing its largest measles outbreak in 25 years, marking the latest move in a series of actions by top health officials. Experts worry that this may negatively impact public confidence in vaccines, which are crucial for public health.
This announcement comes as Kennedy faces intense criticism while managing the outbreak, which has severely affected regions in the southwest with low vaccination rates. The outbreak has led to hundreds of infections and two fatalities among young girls. As of Friday, the Centers for Disease Control and Prevention reported over 930 cases nationwide, with most linked to the southwestern outbreaks.
Critics argue that Kennedy has emphasized unproven treatments like cod liver oil supplements and provided limited support for the measles vaccine, which has a proven 97% efficacy rate in preventing infections.
Redirecting resources towards potential treatments rather than promoting vaccination can have serious consequences at the core of the outbreak.
“We’ve seen many individuals engaging with public health schools,” noted Jennifer Nuzzo, an epidemiologist at Brown University’s Faculty of Public Health.
Researchers have extensively studied various vitamins and drug therapies as potential treatments for measles, said Michael Osterholm, an epidemiologist from the University of Minnesota.
Currently, there is no effective treatment for the measles virus, which can cause pneumonia and complicate oxygen absorption in the lungs, as well as lead to brain swelling resulting in blindness, hearing loss, and cognitive impairment.
“It’s not that there is a lack of research,” he emphasized.
Patients with measles are typically given “supportive care” to ease symptoms, which may include fever reduction, supplemental oxygen, and IV fluids.
HHS spokesman Andrew Nixon mentioned that the initiative to explore new treatments is intended to assist those who have opted not to get vaccinated. He reiterated that the CDC still endorses the measles, mumps, and rubella vaccine as the most effective preventive measure against measles.
“Our commitment is to support all families in minimizing the risks of hospitalization, severe complications, and death from measles, regardless of vaccination status,” he stated.
Kennedy mentioned the example of the Mennonite community in Western Texas, which is facing significant challenges during this outbreak.
Nixon indicated that the CDC will collaborate with universities to test new treatments for “various illnesses,” including existing drug and vitamin combinations. This initiative was initially reported by CBS News.
Public health experts expressed confusion over Kennedy’s decision to seek new treatments rather than support vaccines, which possess decades of safety and efficacy data. They remarked that this approach seems to contradict a longstanding emphasis on disease prevention rather than treatment.
“This is akin to saying, ‘Please go ahead and do something; don’t exercise or smoke excessively. We will devote all resources to heart transplants,'” remarked Dr. Jonathan Temte, former chairman of the CDC’s Vaccine Advisory Committee.
Throughout the measles outbreak, Kennedy has delivered inconsistent messages regarding MMR vaccinations. At one point, he referred to the vaccine as “the most effective way to prevent the spread of measles.”
Yet, he has also raised concerns about its safety, stating, “We don’t know the risks associated with many of these products since they lack safety testing,” during a CBS News interview last month.
Healthcare professionals in western Texas report that Kennedy’s focus on treatment over vaccinations complicates their efforts.
In the early phase of the outbreak, he claimed to have heard of “almost miraculous and instantaneous recoveries” from treatments like cod liver oil.
While doctors may manage severe measles cases with high doses of vitamin A in hospitals, experts advise against its unsupervised use.
Shortly after, doctors reported encountering a measles patient who postponed critical care to self-treat with some supplements endorsed by Kennedy. They indicated that some children with measles received dangerously high levels of vitamin A.
Dr. Osterholm noted that Kennedy’s approach assumes that people’s views on the vaccine are unchangeable.
Despite Kennedy’s assertion that the Mennonite community has “religious objections” to the vaccine due to its inclusion of “fetal fragments,” community historians report no religious doctrine prohibits vaccinations. Vaccine experts confirm that MMR vaccines do not contain fetal tissue.
Instead, local doctors attribute the reluctance of Mennonite families to vaccinate their children to misinformation regarding the vaccine’s safety perpetuated by Kennedy.
When individuals develop solid tumors in the stomach, esophagus, or rectum, oncologists have established treatment strategies. Yet, these treatments can significantly affect quality of life, leading to outcomes such as stomach and bladder removal, permanent colostomy bags, radiation exposure, infertility from chemotherapy, and lasting bodily harm.
In response, a research team at Memorial Sloan Kettering Cancer Center utilized drugs from GSK to explore a novel approach.
They initiated the study with 103 participants, who represent a small fraction (2-3%) of cancer patients with tumors ideally suited for immunotherapy—drugs designed to bypass obstacles that prevent the immune system from attacking cancer cells.
Notably, clinical trials do not generally expect immunotherapy to replace standard treatments. Researchers, led by Dr. Lewis A. Diaz Jr. and Andrea Cerseck, opted to administer dostarlimab, an immunotherapeutic agent.
The outcomes were unexpected and offered hope for a select group of patients faced with these cancers.
In 49 patients with rectal cancer, tumors vanished and did not return after five years. Among 54 patients with other cancers—including esophageal, liver, endometrial, urinary tract, and prostate cancers—35 experienced total tumor disappearance.
Out of the 103 patients, only five experienced a recurrence of cancer. Three were given three doses of immunotherapy, while one was discontinued after the tumor reappeared in the lymph nodes. Currently, the four patients show no signs of disease, while the fifth received further immunotherapy to reduce the tumor size.
On Sunday, investigators presented their findings at the American Cancer Research Association’s Annual Meeting, with a paper featured in the New England Journal of Medicine.
Dr. Bert Vogelstein, an oncologist at Johns Hopkins in Baltimore, termed the results “groundbreaking.”
The drug development’s early stages were conducted in his lab, where he expressed surprise at the advancements.
“The concept of treating large tumors from various organs without surgery seemed like science fiction 20 or 30 years ago,” he noted. However, he emphasized that these discoveries stemmed from decades of foundational research.
The reason immunotherapy succeeded for these significant tumors lies in their gene incompatible repair mutations, which obstruct the correction of DNA damage. This leads to tumors accumulating abnormal proteins that signal the immune system for destruction. Nevertheless, the tumors deploy a shield to fend off immune attacks, which immunotherapy can stimulate, enabling the immune system to target the tumors effectively.
For patients like those in this study, Dr. Michael Oberman, a gastrointestinal cancer specialist at MD Anderson Cancer Center in Houston, suggests the results point towards immunotherapy as an option free of chemotherapy, radiation, or surgery.
However, obstacles remain. The drug is priced around $11,000 per dose, requiring patients to undergo nine infusions over six months. To qualify for insurance coverage, it needs inclusion in clinical guidelines established by professional organizations.
The drug is approved for treating uterine cancer with mismatch repair mutations and is also listed in clinical guidelines for rectal cancer, based on previous small-scale studies. Yet, Dr. Diaz indicated that other cancer patients may face challenges in taking the medication. Nonetheless, Memorial Sloan Kettering continues to recruit participants for clinical trials, meaning those with eligible tumors can access the drug at no cost.
For some individuals, immunotherapy is life-transforming. Side effects can occur, with the study noting fatigue, rashes, and itching as the most common. Rare side effects included pulmonary infections and encephalitis.
Maureen Sidris, a 71-year-old from Amenia, New York, discovered she had cancer after struggling to eat a burger.
“It wouldn’t go down,” she recounted, realizing there was some blockage. Ultimately, it was identified as a tumor at the junction of her stomach and esophagus.
In 2019, she visited Sloan Kettering, where her surgeon advised that surgery, chemotherapy, and radiation were mandatory and that surgery would be complex.
However, due to her tumor’s mismatch repair mutation, she was able to join a clinical trial. Her first injection occurred on October 14 of that year, and by January, her tumor had disappeared. While Sidris experienced one side effect from the treatment requiring medication to support her kidney function, she considers it worthwhile to avoid the challenging treatments initially suggested.
“It was indeed a journey,” she remarked. However, she reasoned that she had everything to gain and nothing to lose by trying immunotherapy.
“If it didn’t succeed, I still had surgery as a backup,” she concluded.
The Trump administration has cancelled funds for dozens of research seeking new vaccines and treatments for Covid-19 and other pathogens that could cause a future pandemic.
The government’s rationale is that, according to internal NIH documents viewed by the New York Times, the community’s pandemic has ended and “provides a cause for the end of COVID-related grants.”
However, the research was not merely about Covid. 9 finished Award-funded center We will conduct research on antiviral drugs to combat so-called priority pathogens that could create an entirely new pandemic.
“This includes anti-viral projects designed to cover a wide range of families that could cause outbreaks or pandemics,” said a senior NIH official who spoke on condition of anonymity for fear of retaliation.
Vaccine research also didn’t focus on Covid, but on other coronaviruses that would one day jump from animals to humans.
Describing all studies as COVID-related is “completely inaccurate and merely a way to reduce infectious disease research,” officials said. Health Secretary Robert F. Kennedy Jr. said the NIH is focusing too much on infections, officials noted.
The funding suspension was first reported Science and Nature. The cancellation surprised scientists who relied on government support.
“The idea that there’s no need for further research to learn how to treat health issues caused by the coronavirus and prevent future pandemics is because “Covid-19 is over” is ridiculous,” says Pamela Bjorkman, a structural biologist at Caltech, who was studying the new vaccine.
The goal of the project was to prepare vaccines and drugs if a new pandemic hits it, rather than developing valuable months from scratch.
“In the last pandemic, we were really knocking down our pants,” said Paul Vienias, a virologist at Rockefeller University, working with Dr. Bjorkman.
“And unless you learn that lesson and prepare better for the next pandemic, you’ll rarely do better than last time.”
Dr. Beanius, Dr. Bjorkman and his colleagues were developing a vaccine that could protect them from a wide range of coronavirus species.
Researchers have discovered new strategies for caxing the immune system and learned how to recognize molecular features common to one or more viruses. The results of animal experiments were promising.
But now, their funds have been cut suddenly, and scientists say they doubted they could build on those outcomes. Dr. Vienias said the fire made him “angry, disappointed and frustrated.”
Other scientists were working on antiviral therapy, part of a program launched in 2021.
$577 million With support from the NIH, the lab’s nationwide network was studying how the virus was replicated and searching for drugs that could block them.
The researchers focused on the Viridae family, which contains the most worrying known pathogens, such as Ebola and Nipah virus. Scientists discovered many promising molecules and were moving forward towards clinical trials.
Reuben Harris, a molecular virologist at UT Health San Antonio, said the promising compounds revealed by the program include antiviral drugs that stop Ebola-related viruses from entering cells.
“We can deploy to help a lot of people quickly,” Dr. Harris said.
Several compounds appeared to work against many viral families. “We’ve seen a lot of experience in the world,” said Nevan Krogan, a systems biologist at the University of California, San Francisco.
On Wednesday morning, Dr. Krogan and dozens of colleagues gathered in the campus meeting room to confirm their results. And they also discussed what they could now, if any.
“One student asked me, ‘Well, I booked an experiment with this microscope tomorrow – can I do that?” “And I’m like, ‘Well, I don’t know.’ ”
Dr. Harris said that without ongoing support, the promising drugs he and others have discovered will not move into clinical trials. “It’s tragic – I don’t have too many words to explain it now,” he said.
In 2023, Kennedy said he wanted to take it. “break” From infectious disease research, instead focuses on chronic diseases.
Jason McClellan, a virologist at the University of Texas at Austin, was working on an antiviral drug program, but saw cancellations of pandemic research follow that promise.
Dr. McClellan, whose previous research was based on the creation of the 2020 Covid vaccine, said this week’s cuts made him wonder whether he could continue to study the pandemic in the United States.
“We’re starting to have conversations and plan to gather more information,” he said, noting the possibility of moving abroad.
“My lab is a structural virology lab focused on structural-based vaccine design,” he added. “If the focus is on chronic diseases, it doesn’t leave us much of a funding.”
When my daughter was little, she would wash her hands a lot. We might have lightly teased her, saying she was a bit OCD. Then she started to reveal “bad thoughts” that I thought were typical of a child's imagination. I told her that everyone has these thoughts and that they will go away if she ignores them.
That wasn't the case with her. At 21, her emotions were out of control and completely out of proportion to reality. She was diagnosed with OCD, and I finally realized there was nothing “a little” about this condition.
OCD is complex, widely misunderstood, and treatment options are limited. But in recent years, the brain and body mechanisms that cause OCD have finally been uncovered, revealing a complex picture that involves genetics, various brain networks, the immune system, and even gut bacteria. The resulting improved understanding is opening up new possibilities for tackling this life-destroying condition.
Around the world, It is estimated that 1-3% of people suffer from OCD.Obsessional thoughts typically begin during adolescence or early adulthood. As its name suggests, it is characterized by obsessions, or intrusive thoughts, and compulsions, which are habits that cannot be stopped. “Obsessive thoughts capture and dominate our attention because they have become obsessive habits,” says Barbara Sahakian At Cambridge University…
serial Wide range of weekly episodes available The OG of podcasting returns for an amazing Season 4 with Sarah Koenig and Dana Chivis’ History of Guantanamo. This is a story they’ve wanted to tell for years, but haven’t been able to move much beyond the official boundaries until now. Today, staff and detainees are ready to talk. While the former report partying “pissed off,” the latter, whose response costs each $13 million a year, discuss their fears. Hannah Verdier
die for Widely available, all episodes now available Seduction and “sexual exploitation” may sound like the stuff of male fantasy, but Neil Strauss gives a Russian woman a chance to talk about the trappings of surveillance and love. First, he has to figure out if she’s the real deal, since she claims to be a “victim who was brainwashed into thinking I’m a hero.” HV
hidden heroes of history Wide range of weekly episodes available There’s nothing better than hearing Helena Bonham Carter (pictured below) tell the story of Ida and Louise Cook. In an archival interview with Sue McGregor, Mills & Boon novelist Ida talks about romance, then Bonham Carter talks about the pair’s relationship with opera stars and helping Jews escape from Nazi Germany. Explore the lives of the sisters. HV
Helena Bonham Carter. Photo: Theo Wargo/FilmMagic
It’s like a joke Wide range of weekly episodes available Hearing Katie Kershaw, Tien Tran, and ER Fightmaster talk about “all things queer, trans, and pro-women in sports” is a workout for your gossip muscles. The trio of friends talk about bad coaches, being called dykes by rival teams, and sports moments that made them gay, and they say some funny and outrageous things. HV
murder in hollywood hills Wide range of weekly episodes available Christy Johnson was 21 when a man made a charming advances on her at a Los Angeles shopping mall, saying he was a film producer looking for the next Bond girl. He took her to a photo shoot in his sports car, but his girlfriend was never seen alive again. The series, hosted by NBC’s Keith Morrison, tells the story of women who band together to find and trap a smooth-talking predator. Holly Richardson
There’s a podcast for that
Quest love. Photo: Eugene Gologursky/Getty Images for Empire State Realty Trust
this week, Ammar Kalia Our picks for the 5 best podcasts on hip hopfrom The Roots founder’s interviews with rap stars to Romesh Ranganathan’s ode to the genre.
questlove supreme Questlove, the Oscar-winning director and founder of the hip-hop group The Roots, has become something of a rap authority. His Instagram profile includes a treasure trove of tributes to lesser-known and recently deceased artists, while his series of podcasts asks living greats to share the highs and lows of their careers. I’m interviewing you about time. Eschewing the aimless chatter of other hip-hop celebrity podcasts, Questlove Supreme always brings selected anecdotes from his guests, keeping the content scholarly without losing its enthusiastic flair. Highlights include a deep dive into LL Cool J’s superstardom, the genius of producer J Dilla by writer Dan His Charnas, DJ Marley’s commentary on his ’80s hip-hop with Mar, and more. included.
Louder Than riot Hip-hop has existed for the past 50 years as an important means of social and political expression, alongside a reputation for excess and controversy. Louder Than a Riot explores how this vibrant artistry born in some of America’s most neglected communities is being policed, coinciding with the rise of mass incarceration and… is examining in detail whether they have expressed prejudice within their own ranks. Hosts Rodney Carmichael and Sidney Madden combine fascinating reporting and interviews to explore how rappers have often run afoul of the criminal justice system, before dissecting misogyny and homophobia within hip-hop. I’ll explore.
blog era Brothers Jeff and Eric Rosenthal host this fascinating series that dissects a niche but pivotal year in hip-hop history. After the birth of the Internet, but before the streaming era took off, blogs could make or break a rap artist, and the frenzied writing of blogs began to influence the very type of music that was made. Some people do. In “The Blog Era,” the Rosenthal brothers cover the music he made between 2007 and 2012 (after which SoundCloud became a dominant force), featuring appearances from J. Cole to Kid Cudi. It features people and depicts the fate of the editor who ran the site. .
dissect This long-running series from host Cole Cucina takes a break from the genre’s larger history and focuses on hip-hop one album at a time. In each series, by revealing the lyrics, music, and contextual information of a different record, Cucina draws on her songwriting training to explore how artists like Kendrick Lamar and Kanye West work on beats. It explores the details of the flow and explains the intent of the lyrics. Dissect has already covered everything from Lamar’s “To Pimp a Butterfly” to West’s “My Beautiful Dark Twisted Fantasy” to Tyler, the Creator’s “Igor.” , an exhaustive but essential listening experience for existing fans, and an ideal entry point for casual listeners as well.
hip hop saved my life Hip-hop may have started out as a distinctly American genre, but 50 years after its creation, it now has a legacy that spans the globe. The series by comic Romesh Ranganathan takes a tongue-in-cheek yet encyclopedic approach to hip-hop fandom, exploring his love for hip-hop while interviewing British celebrities and artists. Masu. Grime star Kano talks about her uniquely British spin on the genre, Mercury Prize winner Little Simz talks about her rise as a woman in hip-hop, and the late Jamal Edwards talks about pioneering grime. He talked about the establishment of the platform SBTV.
Why not try it…
Chameleon: Gallery of Lies is a six-episode tale into a world of deceit, deceit, and the possibility of redemption.
The Mediator actor James Buckley and his wife Claire discuss the nitty-gritty details of marriage and non-negotiable relationships Both when sick and when healthy.
Professional wrestler Ashley Massaro died by suicide in 2019. Ashley vs WWE, Tracing the events leading up to her death and investigating allegations of abuse during her time at the company.
A new study concludes that a combination of saline injection and ultrasound-guided irrigation in the treatment of shoulder calcific tendinopathy is no more effective than a placebo treatment, calling into question current treatments and calling for further treatment. The need for research and alternative approaches is emphasized.
Results from recent trials suggest that the use of this therapy should be reevaluated.
Recently published clinical trials BMJ A saline injection treatment commonly employed to treat calcific tendinopathy, a painful condition caused by calcium buildup in the rotator cuff tendons of the shoulder, has a significant It turns out that there is no advantage.
The study found that the perceived benefits of ultrasound-guided irrigation (a procedure in which calcium deposits are injected with saline to dissolve them), even when combined with steroid injections, are no greater than those gained from sham (placebo) treatment. It has been demonstrated that it is equivalent to
Researchers say the findings call into question the use of ultrasound-guided irrigation for this condition and should lead to a “significant reconsideration” of existing treatment guidelines.
Research background and methodology
Despite its widespread use, ultrasound-guided irrigation has never been compared to sham treatment, and it remains unclear whether the reported improvements are due to the treatment itself, natural recovery over time, or It is unclear whether this is due to a placebo effect.
To fill this important evidence gap, researchers from Norway and Sweden are the first to test the true effectiveness of ultrasound-guided irrigation with steroid injections in patients with shoulder calcific tendinopathy. A sham control study was conducted.
Their findings show that between April 2015 and March 2020, 218 adults (average age 50 years old, approximately 65% female).
At the beginning of the trial, patients provided information about various health and lifestyle factors, and X-rays were taken to assess the size of their calcium deposits.
Patients were then randomly divided into three treatment groups. Washing and steroid injection (73 participants), sham washing and steroid injection (74 participants), and sham only (71 participants). After treatment, all patients were asked to complete a home exercise program.
Evaluation and results
The primary measures of interest were pain intensity and functional disability on the Oxford Shoulder Score (0-48 point scale) reported by the patient at 2 weeks, 6 weeks, and 4, 8, 12, and 24 months. was.
At 4 months, there were no significant differences in pain and functional limitations between the three groups. At subsequent evaluations, scores remained similar even in patients whose calcium deposits had disappeared, which the researchers say casts doubt on the notion that lysis of periarticular calcium resolves symptoms. Says.
The steroid injection group reported better pain relief than the sham group at 2 and 6 weeks post-treatment, but of note, after 4 months the improvement was no different than the sham group. did not.
Findings and recommendations
Although the researchers acknowledge some limitations, including the lack of an untreated group to assess the natural course of symptoms, the double-blind, three-group design, including a sham group, They stated that they were able to evaluate the true clinical efficacy. Active treatment.
Therefore, they wrote, “Our results question existing recommendations for the treatment of calcific tendinopathy and may require a critical reexamination of established treatment concepts for these patients.” ” concludes.
Future studies should investigate alternative treatments, such as defined physical therapy programs, and should also include no treatment groups to assess the impact of the natural history of calcific tendinopathy on outcomes. the researchers added.
In a linked editorial, US researchers say that cleaning appears to be overused and may not be as effective as we think. However, it would be premature to conclude that ultrasound-guided irrigation or subacromial corticosteroid injections no longer have a role in the treatment of shoulder calcific tendinopathy.
These new findings should inform discussions with patients suffering from similar long-term symptom courses in which time resolves and corticosteroids may promote short-term pain relief. may provide some reassurance to the population,” the researchers added.
And they say future studies should include sham control groups, assess treatment response earlier in the course of symptoms, and investigate whether ultrasound classification systems can better predict treatment response. suggests.
Reference: “Ultrasound-guided lavage with corticosteroid injection versus sham lavage with corticosteroid injection for calcific tendinopathy of the shoulder: a randomized double-blind multi-arm study” Stefan Moosmayer, Ole Marius Ekeberg, Hanna Björnsson Hallgren, Ingar Heier, Synnove Kvalheim, Niels Gunnar Jewell, Jesper Blomquist, Hugo Ripp, Jens Ivor Brox, October 11, 2023, BMJ. DOI: 10.1136/bmj-2023-076447
This study was funded by the Bergersen Foundation, the Aase Bye and Trygve J.B. Hoffs Foundation, Smith and Nephew, and the Medical Research Council of South East Sweden.
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