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June 6, 2023

Stem Cells Fast Facts | CNN

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CNN
—

Here is some background information about stem cells.

Scientists believe that stem cell research can be used to treat medical conditions including Parkinson’s disease, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis and rheumatoid arthritis.

Sources: National Institutes of Health, Mayo Clinic

Stem cell research focuses on embryonic stem cells and adult stem cells.

Stem cells have two characteristics that differentiate them from other types of cells:

– They are unspecialized cells that can replicate themselves through cell division over long periods of time.

– Stem cells can be manipulated, under certain conditions, to become mature cells with special functions, such as the beating cells of the heart muscle or insulin-producing cells of the pancreas.

There are many different types of stem cells, including: pluripotent stem cells and adult stem cells.
– Pluripotent stem cells (ex: embryonic stem cells) can give rise to any type of cell in the body. These cells are like blank slates, and they have the potential to turn into any type of cell.
– Adult stem cells can give rise to multiple types of cells, but are more limited compared with embryonic stem cells. They are more likely to generate within a particular tissue, organ or physiological system. (Ex: blood-forming stem cells/bone marrow cells, sometimes referred to as multipotent stem cells)

Embryonic stem cells are harvested from four to six-day-old embryos. These embryos are either leftover embryos in fertility clinics or embryos created specifically for harvesting stem cells by therapeutic cloning. Only South Korean scientists claim to have successfully created human embryos via therapeutic cloning and have harvested stem cells from them.

Adult stem cells are already designated for a certain organ or tissue. Some adult stem cells can be coaxed into or be reprogrammed into turning into a different type of specialized cell within the tissue type – for example, a heart stem cell can give rise to a functional heart muscle cell, but it is still unclear whether they can give rise to all different cell types of the body.

The primary role of adult stem cells is to maintain and repair the tissue in which they are found.

Regenerative medicine uses cell-based therapies to treat disease.

Scientists who research stem cells are trying to identify how undifferentiated stem cells become differentiated as serious medical conditions, such as cancer and birth defects, are due to abnormal cell division and differentiation.

Scientists believe stem cells can be used to generate cells and tissues that could be used for cell-based therapies as the need for donated organs and tissues outweighs the supply.

Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases, including Alzheimer’s diseases.

Cloning human embryos for stem cells is very controversial.

The goal of therapeutic cloning research is not to make babies, but to make embryonic stem cells, which can be harvested and used for cell-based therapies.

Using fertilized eggs left over at fertility clinics is also controversial because removing the stem cells destroys them.

Questions of ethics arise because embryos are destroyed as the cells are extracted, such as: When does human life begin? What is the moral status of the human embryo?

1998 – President Bill Clinton requests a National Bioethics Advisory Commission to study the question of stem cell research.

1999 – The National Bioethics Advisory Commission recommends that the government allow federal funds to be used to support research on human embryonic stem cells.

2000 – During his campaign, George W. Bush says he opposes any research that involves the destruction of embryos.

2000 – The National Institutes of Health (NIH) issues guidelines for the use of embryonic stem cells in research, specifying that scientists receiving federal funds can use only extra embryos that would otherwise be discarded. President Clinton approves federal funding for stem cell research but Congress does not fund it.

August 9, 2001 – President Bush announces he will allow federal funding for about 60 existing stem cell lines created before this date.

January 18, 2002 – A panel of experts at the National Academy of Sciences (NAS) recommends a complete ban on human reproductive cloning, but supports so-called therapeutic cloning for medical purposes.

February 27, 2002 – For the second time in two years, the House passes a ban on all cloning of human embryos.

July 11, 2002 – The President’s Council on Bioethics recommends a four-year ban on cloning for medical research to allow time for debate.

February 2005 – South Korean scientist Hwang Woo Suk publishes a study in Science announcing he has successfully created stem cell lines using therapeutic cloning.

December 2005 – Experts from Seoul National University accuse Hwang of faking some of his research. Hwang asks to have his paper withdrawn while his work is being investigated and resigns his post.

January 10, 2006 – An investigative panel from Seoul National University accuses Hwang of faking his research.

July 18, 2006 – The Senate votes 63-37 to loosen President Bush’s limits on federal funding for embryonic stem-cell research.

July 19, 2006 – President Bush vetoes the embryonic stem-cell research bill passed by the Senate (the Stem Cell Research Enhancement Act of 2005), his first veto since taking office.

June 20, 2007 – President Bush vetoes the Stem Cell Research Enhancement Act of 2007.

January 23, 2009 – The FDA approves a request from Geron Corp. to test embryonic stem cells on eight to 10 patients with severe spinal cord injuries. This will be the world’s first test in humans of a therapy derived from human embryonic stem cells. The tests will use stem cells cultured from embryos left over in fertility clinics.

March 9, 2009 – President Barack Obama signs an executive order overturning an order signed by President Bush in August 2001 that barred the NIH from funding research on embryonic stem cells beyond using 60 cell lines that existed at that time.

August 23, 2010 – US District Judge Royce C. Lamberth issues a preliminary injunction that prohibits the federal funding of embryonic stem cell research.

September 9, 2010 – A three-judge panel of the US Court of Appeals for the District of Columbia Circuit grants a request from the Justice Department to lift a temporary injunction that blocked federal funding of stem cell research.

September 28, 2010 – The US Court of Appeals for the DC Circuit lifts an injunction imposed by a federal judge, thereby allowing federally funded embryonic stem-cell research to continue while the Obama Administration appeals the judge’s original ruling against use of public funds in such research.

October 8, 2010 – The first human is injected with cells from human embryonic stem cells in a clinical trial sponsored by Geron Corp.

November 22, 2010 – William Caldwell, CEO of Advanced Cell Technology, tells CNN that the FDA has granted approval for his company to start a clinical trial using cells grown from human embryonic stem cells. The treatment will be for an inherited degenerative eye disease.

April 29, 2011 – The US Court of Appeals for the District of Columbia lifts an injunction, imposed last year, banning the Obama administration from funding embryonic stem-cell research.

May 11, 2011 – Stem cell therapy in sports medicine is spotlighted after New York Yankees pitcher Bartolo Colon is revealed to have had fat and bone marrow stem cells injected into his injured elbow and shoulder while in the Dominican Republic.

July 27, 2011 – Judge Lamberth dismisses a lawsuit that tried to block funding of stem cell research on human embryos.

February 13, 2012 – Early research published by scientists at Cedars-Sinai Medical Center and Johns Hopkins University shows that a patient’s own stem cells can be used to regenerate heart tissue and help undo damage caused by a heart attack. It is the first instance of therapeutic regeneration.

May 2013 – Scientists make the first embryonic stem cell from human skin cells by reprogramming human skin cells back to their embryonic state, according to a study published in the journal, Cell.

April 2014 – For the first time scientists are able to use cloning technologies to generate stem cells that are genetically matched to adult patients,according to a study published in the journal, Cell Stem Cell.

October 2014 – Researchers say that human embryonic stem cells have restored the sight of several nearly blind patients – and that their latest study shows the cells are safe to use long-term. According to a report published in The Lancet, the researchers transplanted stem cells into 18 patients with severe vision loss as a result of two types of macular degeneration.

May 2, 2018 – The science journal Nature reports that scientists have created a structure like a blastocyst – an early embryo – using mouse stem cells instead of the usual sperm and egg.

June 4, 2018 – The University of California reports that the first in utero stem cell transplant trial has led to the live birth of an infant that had been diagnosed in utero with alpha thalassemia, a blood disorder that is usually fatal for fetuses.

January 13, 2020 – In a study published in the Proceedings of the National Academy of Sciences, researchers announce they have created the world’s first living, self-healing robots using stem cells from frogs. Named xenobots after the African clawed frog (Xenopus laevis), the machines are less than a millimeter (0.04 inches) wide, small enough to travel inside human bodies. Less than two years later, scientists announce that these robots can now reproduce.

February 15, 2022 – A US woman becomes the third known person to go into HIV remission, and the first mixed-race woman, thanks to a transplant of stem cells from umbilical cord blood, according to research presented at a scientific conference on Retroviruses and Opportunistic Infections.

November 7, 2022 – Scientists announce they have transfused lab-made red blood cells grown from stem cells into a human volunteer in a world-first trial that experts say has major potential for people with hard-to-match blood types or conditions such as sickle cell disease.

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June 5, 2023

Using melatonin for sleep is on the rise, study says, despite potential health harms | CNN

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Editor’s Note: Sign up for the Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep.

CNN
—

More and more adults are taking over-the-counter melatonin to get to sleep, and some may be using it at dangerously high levels, a study has found.

The overall use among the US adult population is still “relatively low,” but the study does “document a significant many-fold increase in melatonin use in the past few years,” said sleep specialist Rebecca Robbins, an instructor in the division of sleep medicine for Harvard Medical School. She was not involved in the study.

The study, published in the medical journal JAMA, found that by 2018 Americans were taking more than twice the amount of melatonin than a decade earlier.

Melatonin has been linked to headaches, dizziness, nausea, stomach cramps, drowsiness, confusion or disorientation, irritability and mild anxiety, depression and tremors as well as abnormally low blood pressure. It can also interact with common medications and trigger allergies.

While short-term use for people with jet lag, shift workers and those who have trouble falling asleep appears to be safe, long-term safety is unknown, according to the National Center for Complementary and Integrative Health at the National Institutes of Health.

“In an associational study we found that older adults who reported frequent use — every night or most nights — of a sleep aid (over the counter or prescription) had a higher risk of incident dementia and early mortality,” Robbins said.

However, researchers could not determine which type of sleep aid — over-the-counter medications, such as melatonin, or prescription medications — was responsible for the findings.

Since 2006, a small but growing subset of adults are taking amounts of melatonin that far exceed the dosage of 5 milligrams a day typically used as a short-term treatment, the study found.

However, pills for sale may contain levels of melatonin much higher than what is advertised on the label. Unlike drugs and food, melatonin is not fully regulated by the US Food and Drug Administration, so there are no federal requirements that companies test pills to ensure they contain the amount of advertised melatonin.

“Previous research has found that that melatonin content in these unregulated, commercially available melatonin supplements ranged from — 83% to +478% of the labeled content,” said Robbins, who coauthored the book “Sleep for Success! Everything You Must Know About Sleep But are Too Tired to Ask.”

Nor are there any requirements that companies test their products for harmful hidden additives in melatonin supplements sold in stores and online. Previous studies also found 26% of the melatonin supplements contained serotonin, “a hormone that can have harmful effects even at relatively low levels,” according to the National Center for Complementary and Integrative Health.

“We cannot be certain of the purity of melatonin that is available over the counter,” Robbins said.

Taking too much serotonin by combining medications such as antidepressants, migraine medications and melatonin can lead to a serious drug reaction. Mild symptoms include shivering and diarrhea, while a more severe reaction can lead to muscle rigidity, fever, seizures and even death if not treated.

Because it is purchased over the counter, experts say many people view melatonin as an herbal supplement or vitamin. In reality, melatonin is a hormone made by the pineal gland, located deep within the brain, and released into the bloodstream to regulate the body’s sleep cycles.

“There is a view that if it’s natural, then it can’t hurt,” Robbins told CNN in an earlier interview on the impact of melatonin on children. “The truth is, we just really don’t know the implications of melatonin in the longer term, for adults or kids.”

Another reality: Studies have found that while using melatonin can be helpful in inducing sleep if used correctly — taking it at least two hours before bed — but the actual benefit is small.

“When adults took melatonin, it decreased the amount of time it took them to fall asleep by four to eight minutes,” Dr. Cora Collette Breuner, a professor in the department of pediatrics at Seattle Children’s Hospital at the University of Washington, told CNN in 2021.

“So for someone who takes hours to fall asleep, probably the better thing for them to do is turn off their screens, or get 20 to 40 minutes of exercise each day, or don’t drink any caffeinated products at all,” Breuner said.

“These are all sleep hygiene tools that work, but people are very reticent to do them. They rather just take a pill, right?”

There are other proven sleep tips that work just as well, if not better than sleeping aids, experts say. The body begins secreting melatonin at dark. What do we do in our modern culture? Use artificial light to keep us awake, often long past the body’s normal bedtime.

Research has found that the body will slow or stop melatonin production if exposed to light, including the blue light from our smartphones, laptops and the like.

“Any LED spectrum light source may further suppress melatonin levels,” said Dr. Vsevolod Polotsky, who directs sleep basic research in the division of pulmonary and critical care medicine at Johns Hopkins University School of Medicine, in an earlier CNN interview.

So ban those devices at least an hour before you want to fall asleep. Like to read yourself to sleep? That’s fine, experts say, just read in a dim light from a book or use an e-reader in night mode.

“Digital light will suppress the circadian drive,” Polotsky said, while a “dim reading light will not.”

Other tips include keeping your bedroom temperature at cooler temperatures — about 60 to 67 degrees Fahrenheit (15 to 20 degrees Celsius). We sleep better if we’re a bit chilly, experts say.

Set up a bedtime ritual by taking a warm bath or shower, reading a book or listening to soothing music. Or you can try deep breathing, yoga, meditation or light stretches. Go to bed and get up at the same time each day, even on weekends or your days off, experts say. The body likes routine.

If your doctor does prescribe melatonin to help with jet lag or other minor sleep issues, keep the use “short term,” Robbins said.

If you are planning to use melatonin for a short-term sleep aid, try to purchase pharmaceutical grade melatonin, she advised. To find it, look for a stamp showing that the independent, nonprofit US Pharmacopoeial Convention Dietary Supplement Verification Program has tested the product.

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June 5, 2023

Spanish scientist helps free Australia’s ‘worst female killer’

Post By zittrexstore World Australia, genetics, murder, science, Spain No Comments

Kathleen Folbigg spent twenty years in prison being demonised for killing her four children, until a Spanish scientist helped to free her, and expose one of Australia’s biggest injustices.

An Australian woman who spent 20 years in prison for killing her four children was pardoned and released on Monday following an inquest into her guilt.

Kathleen Folbigg, now 55, was dubbed “Australia’s worst serial killer” after being convicted in 2003 of murdering three of her children, and convicted of manslaughter in the death of the fourth.

According to prosecutors, her children, aged between nine weeks and three years, had been suffocated to death by Folbigg, who has always rejected these accusations, claiming that each of their deaths was linked to a natural cause.

A pardon on the grounds of reasonable doubt was seen as the quickest way to secure her release from prison — a subsequent inquiry could see her convictions quashed completely.

Kathleen Folbigg spent her two decades in prison being demonised.

Once the most reviled name in Australia, Folbigg has been cleared thanks in part to a Spanish scientist Carola García Vinuesa, who, along with other colleagues, has managed to show the children could have died of natural causes.

“The theory that she had killed her children had no evidence. The only evidence was circumstantial, because she was the one finding them dead,” García Vinuesa told Euronews.

“Folbigg is very grateful, not only to us – the scientists – but also to her lawyers, who have done most of the work for free,” she adds.

Australia’s ‘most notorious killer’

The first to die was her son Caleb, aged 19 days. One night, Kathleen woke up because she needed to go to the toilet. She checked on her baby and realised he wasn’t breathing.

“There’s something wrong with my baby,” she shrieked. Her husband came running, and they tried to resuscitate the child, but by the time the ambulance arrived he was dead.

After this she lost Patrick when the baby was just eight months old. Ten-month-old Sarah and 18-month-old Laura died later. Two of the children had died of sudden infant death syndrome. The trauma was huge so Folbigg and her husband’s relationship deteriorated and the couple decided to get a divorce.

Years later, her former husband found Folbigg’s personal diary. Some of the lines his ex-wife had written set alarm bells ringing, like when she wrote that her daughter Sarah had “gone away with a little help”. He was so shocked he gave the diaries to the police.

Although there was no evidence against her, at the time, there was a lot of weight put placed on the ‘Meadow’s Law’ theory about sudden infant deaths, which has now been discredited.

British pediatrician Roy Meadow believed that one sudden death is a tragedy, two are suspicious and three is considered murder until proven otherwise. His theories have since been largely debunked, and he was struck off the UK medical register for a number of years.

How did a Spanish scientist get involved in the case?

In Australia, the jury convicted Folbigg accusing her of suffocating her four children, but she always maintained her innocence.

Nobody believed her story, until García Vinuesa decided to help her.

The Spanish scientist had never heard of Folbigg’s case, until one afternoon when she received a call from a former student.

David Wallace, who did his dissertation with García Vinuesa’s research group, was watching a television programme when Folbigg popped up on screen.

Wallace, who had also studied law, had his doubts and wanted the scientist’s opinion.

“He called more researchers, but the rest must not have been interested. I was really surprised when I heard about the case,” says the Spaniard, whose team had pioneered the sequencing of the human genome.

“Two of Folbigg’s children had been very ill before dying and this really made me question the case, so I contacted Folbigg’s lawyers to tell them it was worth doing genetic research,” she adds.

Genetic research

The researcher knew that up to 35% of cases of sudden death can be explained by genetic factors, and with this in mind, García Vinuesa called her colleague, geneticist Todor Arsov.

They decided to draw up a list of genes that can cause sudden death.

The next step in their scientific investigation was to visit Folbigg in prison and sequence her genome.

“We discovered that there was a mutation in a gene that encodes calmodulin, and this is one of the most well-known causes of sudden death in infancy,” García Vinuesa tells Euronews.

“I wrote to Kathleen’s lawyers and told them we had found this mutation. We wanted to do a full cardiovascular work-up. We also needed to sequence the childrens’ and father’s genome,” she adds.

In 2018, a petition raising doubts over some of the evidence presented at Folbigg’s trial led to the first of two inquiries into Folbigg’s case. Two teams of immunologist-geneticists were called.

García Vinuesa’s team found a gene mutation in two of Folbigg’s daughters, while the other two children had severe epilepsy and respiratory distress.

They contacted Peter Schwartz, one of the most famous geneticists in the world, working at the Auxological Institute in Milan. He had just studied a similar case and, after analysing the information, agreed that it was the most likely cause of the children’s deaths.

“We sent it to the judge and thought that would be enough, but the judge decided that he preferred the evidence of the diaries”, she says. The judge stated he didn’t need a psychiatrist to explain the mother’s diary entries.

He also sided with arguments presented by the prosecution’s team of immunologists who disagreed with García Vinuesa.

At the original trial, the jury never had access to Folbigg’s full diaries, only excerpts taken out of context in the aftermath of the deaths of her children.

“Those notes were not a confession, she only said she felt guilty. In this last inquiry into Folbigg’s case, nine experts – forensic experts, psychiatrists, linguists – analysed it and agreed that they were expressions of a grieving mother and did not contain an admission of criminal guilt,” says García Vinuesa.

Fighting for Folbigg’s release

When talking about the personal toll, García Vinuesa says she had to face the frustration felt when the court did not understand science and decided not to call in the necessary experts to analyse her findings.

Instead of calling in more experts, the judge said he preferred the expertise of the other team of immunologists and the evidence of Folbigg’s diary which, to Carola García Vinuesa, seemed very subjective.

Despite the judge’s verdict, García Vinuesa and her colleagues published their findings and asked the Australian Academy of Science to support the science. “Since all legal pathways had been exhausted, they made a petition to the governor of New South Wales. They asked for her pardon”.

This petition was signed by 90 scientists and medical experts from around the world, among them were two Nobel laureates.

Folbigg’s freedom wasn’t an option at first, but this letter changed the social climate and improved her life in prison. “Her colleagues, who mistreated her because she was a child murderer, changed their attitude and helped her,” she says.

In May 2022, the governor had his decision made: there would not be a pardon for Folbigg, but he announced a new review of the case.

This time round they had more support. “The Australian Academy of Science got legal representation and had a team of lawyers who were able to advise who were the best experts in the world in each field. Also what kind of questions they should be asking these experts.”

“It’s making sure that the system is fair and can be assessed transparently.”

After Folbigg’s legal pardon, García Vinuesa feels satisfied at last, but looks back with a bittersweet feeling.

“Scientifically it has been a challenge. It has been a very hard, intense and sometimes a painful process”.

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May 27, 2023

HIV/AIDS Fast Facts | CNN

Post By zittrexstore Health Africa, aids and hiv, biology, Biotechnology, brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, cnn fast facts, continents and regions, diseases and disorders, domestic alerts, domestic-health and science, domestic-international news, economy and trade, health and medical, iab-biological sciences, iab-biotech and biomedical industry, iab-business and finance, iab-diseases and conditions, iab-industries, iab-infectious diseases, iab-medical health, iab-pharmaceutical drugs, iab-pharmaceutical industry, iab-science, immune system disorders, Infectious Diseases, international alerts, international-health and science, life forms, medical biotechnology, medical fields and specialties, medical research, medical treatments and procedures, microscopic life, North America, pharmaceutical industry, pharmaceuticals, pharmaceuticals and prescription drugs, science, stem cells, the americas, United States, viruses, western africa No Comments

CNN
—

Here’s a look at the origins, treatments and global response to HIV and AIDS.

HIV stands for human immunodeficiency virus.

AIDS stands for acquired immunodeficiency syndrome.

HIV/AIDS is spread through sexual contact with an infected person, sharing needles with an infected person, through transfusions of infected blood or through an infected mother.

People infected with HIV go through three stages of infection:

Acute infection, or acute retroviral syndrome, which can produce flu-like symptoms in the first month after infection.
Clinical latency, or asymptomatic HIV infection, in which HIV reproduces at lower levels.
AIDS, in which the amount of CD4 cells fall below 200 cells per cubic millimeter of blood (as opposed to the normal level of 500-1,500).

HIV-1 and HIV-2 can both cause AIDS. HIV-1 is the most common human immunodeficiency virus; HIV-2 is found mostly in western Africa.

Antiretroviral therapy (ART) involves taking a cocktail of HIV medications used to treat the virus. In 1987, Azidothymidine (AZT) became the first FDA-approved drug used to attempt to treat HIV/AIDS.

from UNAIDS:

38.4 million – Number of people living with HIV/AIDS worldwide in 2021.

5.9 million – Approximate number of people living with HIV globally that are unaware of their HIV-positive status in 2021.

160,000 – Newly infected children worldwide in 2021.

1.5 million – New infections worldwide in 2021.

650,000 – Approximate number of AIDS-related deaths worldwide in 2021.

Of the 4,500 new infections each day in 2019, 59% are in sub-Saharan Africa.

40.1 million – Approximate number of AIDS-related deaths worldwide since the start of the epidemic.

Sub-Saharan Africa is comprised of the following countries: Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Democratic Republic of the Congo, Ivory Coast, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Republic of the Congo, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, Sudan, South Sudan, Swaziland, Tanzania, Togo, Uganda, Zambia and Zimbabwe.

1981 – The Centers for Disease Control and Prevention (CDC) publish the first reports of men in Los Angeles, New York and San Francisco who were previously healthy and are suffering from rare forms of cancer and pneumonia, accompanied by “opportunistic infections.”

1982 – The CDC refer to the disease as AIDS for the first time.

1983 – French and American researchers determine that AIDS is caused by HIV.

1985 – Blood tests to detect HIV are developed.

December 1, 1988 – First World AIDS Day.

1999 – Researchers in the United States find evidence that HIV-1 most likely originated in a population of chimpanzees in West Africa. The virus appears to have been transmitted to people who hunted, butchered and consumed the chimpanzees for food.

January 29, 2003 – In his State of the Union speech, US President George W. Bush promises to dramatically increase funding to fight HIV/AIDS in Africa.

May 27, 2003 – Bush signs H.R. 1298, the US Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, also known as PEPFAR (US President’s Emergency Plan for AIDS Relief), that provides $15 billion over the next five years to fight HIV/AIDS, tuberculosis and malaria abroad, particularly in Africa.

July 30, 2008 – H.R. 5501, The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, becomes law and authorizes up to $48 billion to combat global HIV/AIDS, tuberculosis and malaria. Through 2013, PEPFAR plans to work in partnership with host nations to support treatment for at least four million people, prevention of 12 million new infections and care for 12 million people.

October 2011 – In his book, “The Origins of AIDS,” Dr. Jacques Pepin traces the emergence and subsequent development of HIV/AIDS to suggest that initial AIDS outbreaks began earlier than previously believed.

July 24, 2012 – Doctors announce during the 19th International AIDS Conference that Timothy Ray Brown, known as the “Berlin patient,” has been clinically “cured” of HIV. Brown, diagnosed with leukemia, underwent a bone marrow transplant in 2007 using marrow from a donor with an HIV-resistant mutation. He no longer has detectable HIV.

March 3, 2013 – Researchers announce that a baby born infected with HIV has been “functionally cured.” The child, born in Mississippi, was given high doses of antiretroviral drugs within 30 hours of being born. A year later, the child now has detectable levels of the virus in her blood, 27 months after being taken off antiretroviral drugs, according to scientists involved with her case.

June 18, 2013 – Marking the 10th anniversary of PEPFAR, Secretary of State John Kerry announces that the millionth child has been born HIV-free due to prevention of mother-to-child transmission programs (PMTCT).

March 14, 2014 – The CDC reports on a case of likely female-to-female HIV transmission. Unlike previous announcements of other cases involving female-to-female transmission, this case excludes additional risk factors for HIV transmission.

July 24, 2017 – A 9-year-old child from South Africa is reported to have been in remission for over eight years without treatment, according to Dr. Avy Violari, who spoke at the 9th International AIDS Society Conference on HIV Science in Paris.

November 2018 – According to PEPFAR’s website, they have “supported life-saving antiretroviral treatment (ART) for more than 14.6 million men, women and children” since 2003.

March 5, 2019 – According to a case study published in the journal Nature, a second person has sustained remission from HIV-1. The “London patient” was treated with stem cell transplants from donors with an HIV-resistant mutation. The London patient has been in remission for 18 months since he stopped taking antiretroviral drugs. The study also includes a possible third remission after stem cell transplantation, this person is referred to as the “Düsseldorf patient.”

May 2, 2019 – A study of nearly 1,000 gay male couples, where one partner with HIV took antiretroviral therapy (ART), found no new cases of transmission to the HIV-negative partner during sex without a condom. The landmark, eight-year study, published in the Lancet medical journal shows that the risk of passing on the HIV virus is eliminated with effective drugs treatment.

October 7, 2019 – Governor Gavin Newsom signs a bill making HIV prevention drugs available without a prescription in California starting on January 1, 2020. The medications covered by the new legislation are pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), which both help prevent HIV infections. California becomes the first state in the country to allow pharmacists to provide the drugs without a physician’s prescription.

November 6, 2019 – According to a study published in the Journal of Acquired Immune Deficiency Syndromes, a team of scientists has detected a new strain of HIV. The strain is a part of the Group M version of HIV-1, the same family of virus subtypes to blame for the global HIV pandemic, according to Abbott Laboratories, which conducted the research along with the University of Missouri, Kansas City.

June 15, 2020 – A study is published in the journal JAMA Network Open showing that the life expectancy of people with HIV approaches that of people without the virus, when antiviral therapy is started early in infection. However, disparities still remain in the number of chronic health problems that people with HIV endure.

July 7, 2020 – Scientists presenting at the 23rd International AIDS Conference announce a new study that found an injection of the investigational drug cabotegravir every eight weeks was more effective at preventing HIV than daily oral pills. It is also announced that a Brazilian man might be the first person to experience long-term HIV remission after being treated with only an antiviral drug regimen – not stem cell transplantation.

November 16, 2021 – A new study finds a second patient whose body has seemingly rid itself of HIV. The international team of scientists reports in the Annals of Internal Medicine that the patient, originally from the city of Esperanza, Argentina, showed no evidence of intact HIV in large numbers of her cells, suggesting that she may have naturally achieved what they describe as a “sterilizing cure” of HIV infection. The 30-year-old woman in the new study is only the second patient who has been described as achieving this sterilizing cure without help from stem cell transplantation or other treatment.

December 20, 2021 – The US Food and Drug Administration announces that it has approved the first injectable medication for pre-exposure prophylaxis (PrEP) to lower the risk of getting HIV through sex.

February 15, 2022 – A US woman becomes the third known person to go into HIV remission, and the first mixed-race woman, thanks to a transplant of stem cells from umbilical cord blood, according to research presented at a conference on Retroviruses and Opportunistic Infections.

December 1, 2022 – An experimental HIV vaccine, called eOD-GT8 60mer, has been found to induce broadly neutralizing antibody precursors among a small group of volunteers in a Phase 1 study. The clinical trial results, published in the journal Science, suggest that a two-dose regimen of the vaccine, given eight weeks apart, can elicit immune responses against the human immunodeficiency virus.

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May 24, 2023

Sleep apnea raises risk of long Covid by up to 75% for some, study says | CNN

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CNN
—

Adults who have obstructive sleep apnea have up to an 75% increased risk, on average, of developing long Covid after a SARS-CoV-2 infection compared with people without sleep apnea, a new study found.

Women with obstructive sleep apnea had up to an 89% increased risk, while men had a 59% higher risk, according to the analysis of electronic health data on nearly 1.8 million people.

Obstructive sleep apnea is a potentially dangerous disorder in which breathing stops for about 10 seconds multiple times during the night due to a blockage of the airways by heavy or relaxed soft tissues in the mouth and throat.

A second analysis of medical records of a smaller group of 330,000 adults found the risk to be only 12%, according to the study, which is part of RECOVER, or Researching Covid to Enhance Recovery. RECOVER is a National Institutes of Health initiative dedicated to understanding why some people develop long Covid and how best to detect, treat, and prevent the condition.

Why the huge difference in numbers? People in the larger study had additional health concerns, or comorbidities, such as obesity, diabetes, high blood pressure and heart disease, said senior study author Lorna Thorpe, co-lead of the RECOVER Clinical Science Core at NYU Langone Health.

“The range of 12% to 75% is likely due to a combination of different study populations and different levels of comorbidities, but also different definitions of long Covid,” she said. “We didn’t even have a diagnostic code for long Covid until October 2021.

“I believe the risk is likely to be in the middle, but we will need additional studies to tease that out,” added Thorpe, a professor and director of the division of epidemiology at NYU Grossman School of Medicine.

A third analysis of medical records of 102,000 children with sleep apnea found no correlation between sleep apnea and long Covid after the various confounding health conditions were factored out, “which, of course, is great news,” Thorpe said.

“By using three very large networks of electronic health records, we were able to do this study three times, which is one of the strengths of the research,” she added. “This study is the first collaboration of this focus and scale to find that adults with sleep apnea are at greater risk for long Covid.”

This is an “important study” on long Covid, said Dr. Sairam Parthasarathy, a principal investigator of the University of Arizona Health Sciences RECOVER Adult Study and professor of medicine.

“Research needs to be done in a prospective study to verify this association, and if found to be true these findings have implications for treatment of long Covid,” said Parthasarathy, who was not involved in the study.

“It is important to note that some of the symptoms of long Covid such as fatigue may be related to obstructive sleep apnea, and that the treatment of obstructive sleep apnea may improve such long Covid-related symptoms,” he added.

The study, published Thursday in the journal Sleep, is one of a several studies released since Congress allocated $1.15 billion to NIH in January 2021, to study the long-term effects of Covid over a four-year period. To date, the agency says it has used about $811 million to fund research.

Researchers wanted to investigate the role of sleep apnea in long Covid due to the well-known association between the condition and poorer outcomes after a Covid infection.

“People with sleep apnea are at higher risk for a more severe case of Covid-19, admission to intensive care at the hospital and for mortality,” Thorpe said.

“Obstructive sleep apnea can result in increased inflammation, potentially disrupted sleep leading to an increased propensity to develop infections and reduced immunity,” said Dr. Bhanu Prakash Kolla, a sleep medicine specialist in the Center for Sleep Medicine at the Mayo Clinic in Rochester, Minnesota.

“This could potentially explain the pathway by which obstructive sleep apnea leads to an increased risk of having Covid and also … (long Covid),” said Kolla, who was not involved in the study.

Sleep apnea is an underdiagnosed condition regardless of gender, said the University of Arizona’s Parthasarathy.

“It is conservatively estimated that 80% of patients with obstructive sleep apnea (OSA) are not diagnosed,” he said. In addition, “an assumption with these analyses is that patients with OSA are likely to be treated. However, nearly half of them are not using the treatment.”

Why would women have up to an 89% higher risk compared with 59% in men? The study did not address that issue.

However, “one can postulate this difference may be based on what we know about sex differences in sleep and immune responses,” said Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine in Chicago.

Zee, who was not involved with the new research, coauthored one of the first published studies on the link between sleep apnea and serious Covid infection.

“Women typically have stronger immune responses to viral infections, and thus also vulnerability for post-infection inflammation,” Zee said. “Women in general have more insomnia and with long Covid tend to present with fatigue and insomnia symptoms, which are also common symptoms of long Covid.”

Another reason could be that sleep apnea has historically been considered a male disease, Thorpe said, which could mean that by the time a woman is diagnosed her apnea is more advanced.

“It could be that the women who are documented in electronic health records have more severe sleep apnea because physicians more often look for sleep apnea among men,” she said.

As scientists continue to learn more about long Covid, further information will become available, Thorpe said. In the meantime, people who have sleep apnea — or who snore, snort and stop breathing at night, which are all signs of the condition — should be exceedingly careful when they contact Covid.

“People with sleep apnea who get infected with Covid should seek early treatment and consider getting Paxlovid, the oral medication prescribed to reduce risk of severe outcomes,” Thorpe said. “They should also keep up with their vaccinations to lower the risk of infection in the first place.”

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May 23, 2023

What happens if you wake up before your alarm? Tips from sleep experts | CNN

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Sign up for CNN’s Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep.

CNN
—

Many people dread the blaring sound of an alarm clock, signaling the start of a busy workday. Others wish they weren’t already awake and that the sound had actually woken them up.

Waking up many minutes or even hours before the alarm is not a new phenomenon, sleep experts tell CNN, but it can cause people discomfort.

More than a third of Americans get fewer hours of sleep a night than the minimum recommendation of seven hours, according to the US Centers for Disease Control and Prevention. According to the National Institutes of Health, studies across the globe show anywhere from 10% to 30% of the population struggles with insomnia, defined as the consistent difficulty falling asleep and the inability to return to sleep after going to bed.

Those experiencing insomnia can have a combination of “nocturnal awakenings” and what’s categorized as “early morning awakenings,” according to a 2009 study from the Stanford Sleep Epidemiology Research Center and other universities. The study finds that some people may experience early awakenings without other insomnia symptoms such as “difficulty initiating sleep,” “nocturnal awakenings” and “non-restorative sleep,” meaning sleep that isn’t substantial even with the recommended hours.

While insomnia treatments include cognitive behavioral therapy and medication, other daily tips can have an impact on early morning awakenings. An acute sleep disorder could be at play for someone not experiencing chronic insomnia but waking up early.

The constant waking up before that daily sound is coupled with an immense frustration about not falling back asleep. The stress can feel isolating and all-consuming, taking more precedence than the initial sleep problem.

“You start ruminating about it, and then you start doing things that make insomnia worse,” said Dr. Rajkumar Dasgupta, associate professor of clinical medicine at the University of Southern California Keck School of Medicine in Los Angeles.

“Don’t start telling yourself … ‘I’m going to make myself stay in bed until I fall asleep,’ ” he said.

So, what can you do about it?

If you wake up suddenly — in what feels like the early morning hours — resist checking the clock. Finding out it’s 3 a.m. when you set the alarm for 7 a.m. can cause increased worry about the hours of sleep you hoped to attain.

“The anxiety and the frustration build,” said sleep specialist Wendy Troxel, a senior behavioral scientist at Rand Corp. “Clock watching becomes habitual, and that habitual response of frustration and anxiety also causes a stress response in the body.”

When anxiety and worry take precedence, cortisol levels increase, and the body becomes alert. This process is counterproductive for maintaining drowsiness, as the brain becomes hyper-engaged.

“You look at the clock. It’s 3 o’clock in the morning like clockwork, and immediately might grit your teeth. You think of all the demands … how awful it is going to be when you’re sleep-deprived,” Troxel said. “All of this mental processing and agitation is antithetical to the sleep state. It’s making you more alert and aroused … versus sending the signal to the brain that it’s OK to drift.”

If your alarm is on the phone, checking the clock can pose an even more significant trigger. Consider getting an alarm that isn’t attached to your phone.

“Our phone is our strongest signal to our waking lives,” Troxel said. “You’re getting the light exposure from your phone, which can directly stimulate your circadian signal for alertness. The content of what we are consuming on our phones can be very activating, whether it’s scrolling through social media or reading the news. These can all stimulate emotional states that are more activating rather than relaxing.”

Paradoxically, experts say to get out of bed. Yes, even at 3 a.m.

“Abandon the idea of getting back to sleep,” Troxel said. “When you do that, when you let the pressure go that sleep isn’t so effortful, sleep is more likely to come back.”

In a stimulus control technique, you can distract your brain with a mundane task to help bring back drowsiness faster than staying frustrated in bed.

Mentally assigning the bed with sleeping helps people associate positive sleep thoughts with their space. Leaving the room when agitation sets in can separate the frustration from the bed.

Anything from reading a book to knitting or listening to soft music (but not using a phone) can positively distract the brain. Once drowsiness sets in again, head back to bed.

Dasgupta recommends keeping track not only of when you went to bed and woke up on a given night, but also the calming techniques, environmental factors — and even nutrition and exercise routines that seemed to help you sleep that day.

“Perfect sleep is like having a puzzle, and you need all the right pieces,” Dasgupta said. “People who have insomnia, they’re missing one of those sleep hygiene pieces. When you make your recommendation, like a muscle relaxation, maybe that’s not the thing that they were missing. Maybe sound wasn’t the key part. Maybe you need more of that weighted blanket.”

It also depends on our given circadian rhythm, or the 24-hour solar cycle the body runs on that alerts us when sleepiness sets at night. If any environmental factors change — such as travel, work schedule or lighting — the body’s circadian rhythm may be thrown off, signaling an uncomfortable early wake-up before the alarm, Dasgupta said. In this case, changing the lighting in a given room or getting alternative lighting could help.

Progressive muscle relaxation may work — start at the toes, clench the given muscles for three seconds and release. Breathe through this process. The 4-7-8 breathing exercise coupled with muscle relaxation can be successful, Dasgupta said. Breathe in for 4 seconds, hold it for 7 seconds and breathe out for 8 seconds.

Relaxing breath

Follow along as Dr. Ellen Vora guides you through the 4-7-8 breathing technique.

Source: Courtesy Dr. Ellen Vora

Others may find that yoga, meditation or reading can help when they wake up before their alarm. The same techniques don’t work for everyone, but practicing various strategies that may affect sleep is critical, ultimately building a well-followed routine.

If the problem continues beyond three times a week for three months, experts recommend talking to a sleep specialist. It may require more than a simple habit change.

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May 18, 2023

When older parents resist help or advice, use these tips to cope | CNN

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KFF Health News
—

It was a regrettable mistake. But Kim Sylvester thought she was doing the right thing at the time.

Her 80-year-old mother, Harriet Burkel, had fallen at her home in Raleigh, North Carolina, fractured her pelvis and gone to a rehabilitation center to recover. It was only days after the death of Burkel’s husband, 82, who had moved into a memory care facility three years earlier.

With growing distress, Sylvester had watched her mother, who had emphysema and peripheral artery disease, become increasingly frail and isolated. “I would say, ‘Can I help you?’ And my mother would say, ‘No, I can do this myself. I don’t need anything. I can handle it,’ ” Sylvester told me.

Now, Sylvester had a chance to get some more information. She let herself into her mother’s home and went through all the paperwork she could find. “It was a shambles — completely disorganized, bills everywhere,” she said. “It was clear things were out of control.”

Sylvester sprang into action, terminating her mother’s orders for anti-aging supplements, canceling two car warranty insurance policies (Burkel wasn’t driving at that point), ending a yearlong contract for knee injections with a chiropractor and throwing out donation requests from dozens of organizations. When her mother found out, she was furious.

“I was trying to save my mother, but I became someone she couldn’t trust — the enemy,” Sylvester said. “I really messed up.”

Dealing with an older parent who stubbornly resists offers of help isn’t easy. But the solution isn’t to make an older person feel like you’re steamrolling them and taking over their affairs. What’s needed instead are respect, empathy and appreciation of the older person’s autonomy.

“It’s hard when you see an older person making poor choices and decisions. But if that person is cognitively intact, you can’t force them to do what you think they should do,” said Anne Sansevero, president of the board of directors of the Aging Life Care Association, a national organization of care managers who work with older adults and their families. “They have a right to make choices for themselves.”

That doesn’t mean adult children concerned about an older parent should step aside or agree to everything the parent proposes. Rather, a different set of skills is needed.

Cheryl Woodson, an author and retired physician based in the Chicago area, learned this firsthand when her mother — whom Woodson described as a “very powerful” woman — developed mild cognitive impairment. She started getting lost while driving and would buy things she didn’t need, then give them away.

Chastising her mother wasn’t going to work. “You can’t push people like my mother or try to take control,” Woodson said. “You don’t tell them, ‘No, you’re wrong,’ because they changed your diapers and they’ll always be your mom.”

Instead, Woodson learned to appeal to her mother’s pride in being the family matriarch. “Whenever she got upset, I’d ask her, ‘Mother, what year was it that Aunt Terri got married?’ or ‘Mother, I don’t remember how to make macaroni. How much cheese do you put in?’ And she’d forget what she was worked up about, and we’d just go on from there.”

Woodson, author of “To Survive Caregiving: A Daughter’s Experience, a Doctor’s Advice,” also learned to apply a “does it really matter to safety or health?” standard to her mother’s behavior. It helped Woodson let go of her sometimes unreasonable expectations.

One example she related: “My mother used to shake hot sauce on pancakes. It would drive my brother nuts, but she was eating, and that was good.”

“You don’t want to rub their nose into their incapacity,” said Woodson, whose mother died in 2003.

Barry Jacobs, a clinical psychologist and family therapist, sounded similar themes in describing a psychiatrist in his late 70s who didn’t like to bend to authority. After his wife died, the older man stopped shaving and changing his clothes regularly. Though he had diabetes, he didn’t want to see a physician and instead prescribed medicine for himself. Even after several strokes compromised his vision, he insisted on driving.

An adult child needs to show empathy and respect for the autonomy of an aging parent.

Jacobs’ take: “You don’t want to go toe-to-toe with someone like this, because you will lose. They’re almost daring you to tell them what to do so they can show you they won’t follow your advice.”

What’s the alternative? “I would employ empathy and appeal to this person’s pride as a basis for handling adversity or change,” Jacobs said. “I might say something along the lines of, ‘I know you don’t want to stop driving and that this will be very painful for you. But I know you have faced difficult, painful changes before and you’ll find your way through this.’ “

“You’re appealing to their ideal self rather than treating them as if they don’t have the right to make their own decisions anymore,” he said. In the older psychiatrist’s case, conflict with his four children was constant, but he eventually stopped driving.

Another strategy that can be useful: “Show up, but do it in a way that’s face-saving,” Jacobs said. Instead of asking your father if you can check in on him, “Go to his house and say, ‘The kids really wanted to see you. I hope you don’t mind.’ Or ‘We made too much food. I hope you don’t mind my bringing it over.’ Or ‘I wanted to stop by. I hope you can give me some advice about this issue that’s on my mind.’ “

This psychiatrist didn’t have any cognitive problems, though he wasn’t as sharp as he used to be. But encroaching cognitive impairment often colors difficult family interactions.

If you think this might be a factor with your parents, instead of trying to persuade them to accept more help at home, try to get them medically evaluated, said Leslie Kernisan, author of “When Your Aging Parent Needs Help: A Geriatrician’s Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, and More.”

“Decreased brain function can affect an older adult’s insight and judgment and ability to understand the risks of certain actions or situations while also making people suspicious and defensive,” she noted.

This doesn’t mean you should give up on talking to an older parent with mild cognitive impairment or early-stage dementia, however. “You always want to give the older adult a chance to weigh in and talk about what’s important to them and their feelings and concerns,” Kernisan said.

“If you frame your suggestions as a way of helping your parent achieve a goal they’ve said was important, they tend to be much more receptive to it,” she said.

A turning point for Sylvester and her mother came when the older woman, who developed dementia, went to a nursing home at the end of 2021. Her mother, who at first didn’t realize the move was permanent, was furious, and Sylvester waited two months before visiting. When she finally walked into Burkel’s room, bearing a Valentine’s Day wreath, Burkel hugged her and said, “I’m so glad to see you,” before pulling away. “But I’m so mad at my other daughter.”

Sylvester, who doesn’t have a sister, responded, “I know, Mom. She meant well, but she didn’t handle things properly.” She learned the value of what she calls a “therapeutic fiblet” from Kernisan, who ran a family caregiver group Sylvester attended between 2019 and 2021.

After that visit, Sylvester saw her mother often, and all was well between the two women up until Burkel’s death. “If something was upsetting my mother, I would just go, ‘Interesting,’ or ‘That’s a thought.’ You have to give yourself time to remember this is not the person you used to know and create the person you need to be your parent, who’s changed so much.”

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May 17, 2023

Older dogs who sleep badly may have dementia, study says | CNN

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CNN
—

In a veterinary lab in North Carolina, Woofus, a 15-year-old basset hound mix, is allowing researchers to attach an electroencephalogram, or EEG, electrodes to his head before padding off to a dark, cozy room for an afternoon nap.

During his snooze, the study team will analyze Woofus’ brain waves to judge the quality of his sleep. Woofus has canine cognitive dysfunction syndrome, or CCDS, the doggie disorder that’s similar to Alzheimer’s disease in people. The elderly dog’s owners say he is struggling to get enough rest at night.

“Just like humans with Alzheimer’s disease, dogs with CCDS experience sleep disruptions, such as insomnia and sleep fragmentation,” said veterinarian Dr. Natasha Olby, a professor of neurology, neurosurgery and gerontology at North Carolina State College of Veterinary Medicine in Raleigh.

Woofus isn’t the only sleep-deprived dog in this study. On other days in the clinic, Jake, a 13-year-old pointer, and Coco, a 12-year-old dachshund, among others, might be taking a siesta while researchers peer inside their brains.

“Owners of dogs with CCDS report their dogs suffer from difficulty sleeping at night, increased sleeping during the day or both, as well as pacing and vocalizations at night,” Olby said. “This can be very hard on the dog’s owners — not only are they worried for their pet, their sleep is also significantly disrupted.”

To find out whether sleep problems in dogs indicate early signs of dementia as they do in people, Olby and her team turned to a group of senior dogs enrolled in an ongoing study testing antiaging supplements. The dogs visit twice a year “and do all kinds of really fun cognitive testing,” she said. “They really enjoy it and like the handlers they work with.”

To be considered for the antiaging study, the dog must have lived more than 75% of the expected life span for their breed or mix of breeds. A dog also could not be crippled by arthritis or going blind, as the pet needed to be able to perform tasks designed to test their cognitive capabilities.

A dog might be asked, for example, to find a treat hidden under a cup or a snack inside a cylinder in which one end had been closed by a researcher. By repeating the tasks at the clinic every six months, any decline in the dog’s mental agility or performance can be tracked.

Woofus, 15-year-old basset hound mix, plays

For the new study measuring a dog’s brain waves during sleep, researchers used a form of electroencephalogram called polysomnography, used in sleep clinics to diagnose sleep problems in people.

“It’s the gold standard method to look at what the brain is doing during sleep,” Olby said, adding this is the first canine study to apply the same technology used on humans.

“We glue these electrodes on with a really great conductive glue that’s water soluble. Then we just wash it off afterwards,” she said. “We don’t use anywhere near as many electrodes as you see on people in a sleep lab, because dogs have far less cortex and surface area to cover.”

Already at ease with the staff, it wasn’t too difficult to train 28 senior dogs to wear electrodes and walk around with dangling wires without complaint, she said.

Jake, a 13-year-old pointer, was one of 28 dogs trained to sleep with EEG electrodes.

To make the dogs more comfortable during their siestas, owners bring their dogs’ beds from home, which are placed in a protected room with white noise.

“Staff sit with them while they nap to make sure that they’re not trying to pull out or eat the electrodes or do anything that might hurt them,” Olby said.

When sleeping brain waves were compared with a dog’s cognitive testing, researchers found that dogs with greater dementia spent less time in deep and REM sleep, just as people do. The study was recently published in the journal Frontiers in Veterinary Science.

“Dogs that did worse on our memory tests had levels of REM sleep which were not as deep as they should be,” Olby said. “We found the same when it came to deep sleep.”

While no one knows the exact mechanism at work — either in people or in dogs — research like this study may help scientists better understand the process and find ways to treat it, Olby said.

“There’s a possibility we might be able to identify an early signature of change on the EEG that can tell us, ‘Hey, things are starting to slide.’ Because with a chronic neurodegenerative process, of course we’d love to be able to intervene sooner rather than later.”

In the meantime, there are medications for anxiety and melatonin for sleep that veterinarians can prescribe as a dog ages, Olby said. And as with people, diet and exercise appears to be a factor.

“There’s been some very nice studies showing diets that are enriched in flavonoids and antioxidants and medium-chain fatty acids could possibly slow the development of dementia in dogs,” she said. “It’s just like people — if you can eat a Mediterranean diet and do your exercise, you’re going to do better.”

Doggie dementia is a worrisome reality for many senior dogs. Research has found that by 11 or 12 years of age, 28% of dogs had mild and 10% had severe cognitive impairment. By the time the dogs reached age 15, the risk had risen to 68% for mild and 35% for severe cognitive impairment. A 2022 study found the odds of canine cognitive dysfunction increased by 52% with each year of age, Olby said.

Pet owners can look for signs that their dog’s mental functions are declining. According to Olby, vets use an acronym called DISHA-AL, which stands for disorientation, interaction changes, sleep/wake cycle alterations, house soiling; activity changes (increased or decreased); and anxiety and learning & memory.

“One of the earliest signs is you’ll start to see a little confusion just like you do with people, they suddenly start to make some mistakes and things you wouldn’t expect them to do. Very similar to us,” Olby said.

Dogs and cats who share their human's bed tend to have a

A dog who sleeps at the end of the bed with their face toward the door might have a more protective personality, Varble said.</p><p>

Is sleeping with your pets good for them?

Dogs may also lose learned behaviors, or forget their house training and begin to have unintentional accidents around the house, she added.

“A classic problem is wandering around and getting lost under the table or something — they just can’t process the information and figure out where they are. Changes in sleep cycle, increased anxiety, all of these things are classic signs of dementia,” she said.

Don’t assume that is what is wrong with your dog, however. Just like in people, other health problems such as metabolic disease, urinary tract infections or even brain tumors can mimic classic signs of dementia.

“High blood pressure can make dogs anxious, for example,” Olby said, “so a vet needs to thoroughly check the dog to rule out disease.”

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May 14, 2023

Sleeping will be one of the challenges for astronauts on Mars missions | CNN

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CNN
—

Astronauts have been adjusting to the challenges of sleeping in space for years — and the lessons learned from their zero gravity slumbers will ensure that one day the first crewed missions to Mars will have gotten enough rest before exploring the red planet.

Rotating crews have spent an average of six months living and working aboard the International Space Station for nearly 23 years, and they struggle with sleep issues just like people on Earth. Some of the challenges are similar to those of shift workers or people with abnormal schedules, but others are more unique to the space environment.

NASA astronaut Josh Cassada is bundled up in his crew quarters on the International Space Station on March 2.

For example, most people don’t have to worry about floating away from their beds due to zero gravity. Don’t worry — astronauts use special restraints to keep them from floating through the space station while asleep.

Two of the biggest challenges for astronauts include their sleep environment and the establishment of a natural sleep cycle.

Astronauts have dark, quiet and private crew quarters on the space station conducive to good sleep — but that won’t always be the case on other space missions, said Dr. Erin Flynn-Evans, director of the Fatigue Countermeasures Laboratory at NASA’s Ames Research Center in Mountain View, California.

Like their historic Apollo predecessors, the Orion capsules that will be used during future Artemis missions to the moon are small vehicles with limited space for crews and sleeping bags for rest periods.

“I think of it like camping,” Flynn-Evans said. “If it’s for a couple days, probably no big deal. But the longer you’re in close quarters with someone, the more disruptive that can be.”

While the space station affords incredible views of Earth, the 16 sunrises an astronaut witnesses a day can wreak havoc on circadian rhythm, the body’s natural clock for sleeping and waking.

On Earth, disruptions to circadian rhythm occur for people who work overnight shifts or experience jet lag while traveling across time zones.

“Light is what resets our circadian rhythm and keeps us organized to that day-night cycle, but in space we have several challenges,” Flynn-Evans said.

The space station orbits around Earth every 90 minutes, creating alternating cycles of darkness and light. Rather than force the astronauts to adapt to such a strange cycle, experts at NASA have added lighting to the interior of the space station that mimics what people experience during a normal day on Earth.

“We have to try to block out the light from windows during the night,” she said, “and we have to really try to maximize the light either through windows or with internal lighting to make sure the crew are getting that synchronizing stimulus so that they’re able to stay awake and asleep at the right time.”

Jet lag begins before astronauts ever arrive at the space station, and their sleep schedules are shifted for days before liftoff based on the time of day and time zone from which they will launch. Once they reach the space station, each astronaut is shifted to Greenwich Mean Time, “a nice middle ground between all of the countries that participate,” Flynn-Evans said.

At the Fatigue Countermeasures Laboratory, Flynn-Evans and her colleagues develop tools to help astronauts overcome sleep challenges. Some of the strategies involve managing when the astronauts are exposed to blue light, the primary synchronizing wavelength for the circadian system, and when to reduce blue light to help them sleep.

Astronauts have regimented schedules, but the arrival of resupply missions or new crews sometimes interrupt those. Flynn-Evans and other researchers develop approaches to shifting sleep safely for the astronauts, such as determining when to take naps or stay up later to accommodate schedule changes.

The same tips that help astronauts sleep also apply on Earth, including following a regular schedule with waking and falling asleep at the same time as much as possible and limiting exposure to blue light before going to bed, which is emitted by LED TVs, smartphones, computers and tablets.

Although scientists have sleep data from years of spaceflight, conducting simulated missions on Earth allow for more control.

“We do fake space missions all the time,” Flynn-Evans said. “We have what we call an analog space environment at Johnson Space Center called the Human Exploration Research Analog or HERA, and that’s basically a small habitat.”

The CHAPEA crew will live in a habitat with individual quarters at NASA's Johnson Space Center in Houston.

The habitat mimics the size of a lunar base or small spacecraft and can house crews of four people for long periods of time. Flynn-Evans was involved in a study in which crews spent 45 days in the habitat and were restricted to five hours of sleep on weeknights and eight hours on weekends. The participants were tested for alertness and performance.

Findings from the experiment showed that if crew members only got five hours of sleep one night, they needed more opportunities to catch up on sleep on subsequent nights to prevent the ill effects of sleep deprivation. The current requirement is that crew members get 8½ hours of sleep per night on missions to avoid long-term sleep loss, fatigue-induced errors and health complications, according to NASA.

In June, NASA will begin the first experiment in a new 3D-printed Martian habitat at Johnson Space Center called the Crew Health and Performance Exploration Analog, or CHAPEA.

Over the course of one year, a four-person crew will live and work inside a 1,700-square-foot (158-square-meter) space to simulate living on Mars. The focus for the first experiment is nutrition, but Flynn-Evans and her fellow researchers will also monitor how well the crew sleeps.

Habitats such as HERA and CHAPEA allow scientists to simulate surprises that may happen on a real mission to the moon or Mars, such as limited resources, failing equipment, communication issues and other stressors of small habitats.

An unexpectedly rich source of sleep data has proven to be studying the Earth-bound scientists and engineers who work on Mars missions such as the Perseverance rover.

A day on Mars lasts about 39 minutes longer than one on Earth, but it’s just enough that the members of Mars mission control have to adjust their schedules constantly to stay on Perseverance’s timetable.

“If you’re shifting 39 minutes a day, that means that you’re basically going to bed 39 minutes later every day,” Flynn-Evans said. “It doesn’t seem that bad on a single night. But after five days, it’s like you’ve crossed like six time zones. It’s a real stressor on the body.”

Many unknowns still exist about being on “Mars time,” such as how the time shift affects the human body’s metabolism.

Understanding how people on Earth adapt to live on Mars time is one way of preparing for future missions to the red planet. Flynn-Evans and her team are working closely with those planning the Artemis lunar missions to optimize the astronauts’ schedules and ensure that the lighting is sufficient and the noise is dampened inside Orion when they need to sleep.

Researchers also want to study how much caffeine astronauts require for alertness to make sure crews don’t run out of coffee in a spacecraft with limited storage.

“Sleep is intimately tied with performance, alertness, interpersonal communication and relationships,” Flynn-Evans said, “so we want to make sure that the crews are set up for success and getting that sleep they need.”

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May 13, 2023

FDA advisers narrowly vote in favor of experimental gene therapy for rare muscle disease | CNN

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—

Most parents wouldn’t be thrilled with the idea of their kids getting hooked up to an IV bag filled with trillions of viruses.

But for Melanie Hennick, whose son, Connor, has Duchenne muscular dystrophy, it was an opportunity she hoped would change his life.

“We knew this wasn’t a cure,” Hennick said. “But it was a chance.”

Connor is one of just dozens of kids to have received SRP-9001, an experimental gene therapy that aims to slow or stop the progression of Duchenne muscular dystrophy, or DMD. Current treatments for the disease – which primarily affects boys because of the way it’s inherited – include steroids and, later, heart drugs. But none stop it.

SRP-9001 uses viruses to ferry a copy of a gene to muscles to help make up for one that’s causing the disease. Hennick and many other parents like her advocated for the treatment’s accelerated approval Friday in a meeting of outside advisers to the US Food and Drug Administration.

The advisers voted 8-6 in favor of approving the treatment, and the FDA will now decide whether to follow their advice.

“The decision the FDA has to make doesn’t just affect the patients in study 301 [an ongoing confirmatory trial that Sarepta is running]; it affects the entire field of drug development for Duchenne,” said Dr. Caleb Alexander, a professor of epidemiology and medicine in the Bloomberg School of Public Health at Johns Hopkins University, who voted against recommending approval. “The totality of evidence … simply doesn’t rise to the threshold that’s required for accelerated approval.”

Dr. Raymond Roos, a neurology professor at the University of Chicago Medical Center, voted in favor. “The downside of the gene therapy here is relatively small compared to whether it really helps the patient, and for this reason, I voted yes,” he said.

Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said his agency will take the recommendation and “do something that we have to do every day at FDA. … We have to manage through the uncertainty here.”

The FDA’s decision, expected by the end of the month, will have implications not just for families like Connor’s but for how the agency regulateths treatments like this one more broadly: It would be the first of its kind of medicine – one-time treatments delivering a gene to try to fix a disease – to get accelerated approval, a faster track through the regulatory process. Its approval would set a precedent for other drugs like this based on so-called surrogate endpoints, a measure of what the drug does in the body, before further clinical evidence is available.

“Approval of a gene therapy for Duchenne muscular dystrophy will be huge,” said Jeffrey Chamberlain, a professor at the University of Washington School of Medicine who helped pioneer gene therapy approaches for the disease. “This, I think, will spur further research and further development of gene therapies for other diseases.”

DMD patients don’t have a lot of time to wait. Kids with Duchenne typically lose the ability to walk before they’re teenagers and often don’t live well into their 30s, Chamberlain said. He’s not directly involved with SRP-9001, which is being developed by Sarepta Therapeutics, and is on the scientific advisory board for another company working on DMD gene therapies, Solid Biosciences.

“Gene therapy appears to be a really good approach to try to treat this disease, because it’s a genetic disease,” Chamberlain said. “The cause of the disease is a mutation in a single gene.”

That gene is responsible for the production of dystrophin, a protein key to the structure of muscle cells.

“It’s kind of like the two-by-fours that make up your house,” Chamberlain said. “It’s really important for just holding everything together.”

SRP-9001, invented at Nationwide Children’s Hospital in Columbus, Ohio, before being licensed for development by Sarepta, delivers a miniaturized version of the dystrophin gene to cells, aiming to help them make a version of the muscle-preserving protein.

In a key clinical trial, the therapy appeared to do that. But it didn’t meet another main goal: showing a benefit on a measure of muscle function, complicating SRP-9001’s path through the FDA.

Sarepta blamed the outcome on an imbalance in how the trial separated patients into the placebo and treatment groups. But key FDA reviewers appear unconvinced.

“The clinical studies conducted to date do not provide unambiguous evidence that SRP-9001 is likely beneficial for ambulatory patients with DMD,” agency reviewers wrote in briefing documents released ahead of Friday’s meeting, referring to patients who can still walk – the group who will initially be eligible for the treatment if it gets approved.

Family after family who participated in Sarepta’s trials, like the Hennicks, disagree with the reviewers. They say they believe that the treatment has helped keep their kids walking and running in ways they never would have without it.

“It’s really miraculous,” said Nate Plasman, whose son Andrew got SRP-9001 as part of the trial in January 2019, at age 4.

Sara, left, Andrew and Nate Plasman on the day he was dosed in the trial in January 2019.

Andrew was away from school for more than two months when he got the experimental therapy, Plasman said, and when he returned, “his teachers at the preschool were blown away,” he recalled. “They’re like, ‘Who is this kid?’ He’s running. He’s jumping. He’s pedaling the tricycle. He’s getting up and down off the ground” – all things he couldn’t do as well before the therapy.

Marit Sivertson, mom to 9-year-old Brecken, agrees.

“We’ve seen the incredible changes with our son,” she said. “He’s not just walking around. He’s running; he’s swimming; he’s diving. He’s truly living the life that every 9-year-old boy ought to be living.”

Dr. Jerry Mendell of Nationwide Children's Hospital in Ohio, who developed the gene therapy, left, with Brecken Kinney.

Sivertson and Plasman also spoke at Friday’s meeting. Their goal isn’t to secure the therapy for their own kids; because it’s designed as a one-time treatment, they wouldn’t take it again. They say they’re speaking up on behalf of children who are still waiting.

That wait is especially painful for Daniel and Lindsey Flessner, who have two sons with DMD. Their 5-year-old son, Mason, is in the SRP-9001 clinical trial. Their 2-year-old, Dawson, is still too young.

“With every trip, every fall, every time he stands up by walking up his legs using his hands to help stabilize him, it just keeps chipping away at us,” Flessner said. “It’s very painful as the parents watching your children struggling knowing all you can do is wait, when waiting is what you don’t have time for.”

Lindsey and Daniel Flessner's sons, Mason and Dawson, both have DMD.

In addition to questions about how well the treatment works, the FDA reviewers raised concerns about safety, particularly “related to the possibility of administering an ineffective gene therapy.”

The reviewers focused on opportunity cost: Because of the viruses used to deliver the gene, patients can develop an immune response that could render future doses ineffective.

Chamberlain said work is underway to find ways to be able to administer more doses, if needed, but it’s currently a one-and-done treatment.

For now, he thinks this approach is the best hope for DMD patients.

“It’s not perfect,” he acknowledged. “It’s not a complete cure, but from what I can gauge from the clinical results that have been released by Sarepta and some of the other companies, I think the micro-dystrophin gene therapy is working better than any other drug that’s been tried for Duchenne muscular dystrophy.”

It’s unclear how long the effects will last; Sarepta is continuing trials, and a confirmatory study would be required as part of accelerated approval. Sarepta has proposed a trial that it’s already running to satisfy that requirement, with results expected later this year.

For families facing DMD, there’s an opportunity cost to waiting, too. In its briefing documents for the FDA meeting, Sarepta estimated that accelerated approval would speed up broad access to SRP-9001 by at least a year, a time in which about 400 boys could lose the ability to walk and another 400, whose disease is more advanced, would die.

Melanie Hennick said Connor was admitted to the trial just weeks before he’d have aged out, at 8 years old. She said she believes the therapy is the reason Connor’s doing so well.

“We had the opportunity to see Connor grow as an 8-, 9-, 10-, 11- and 12-year-old with more capacity than we ever dreamed,” she said. “He climbs stairs unaided; he runs around; he plays football; he plays hockey; he plays on a baseball team. … Those are things that we never thought we would be able to see him do, especially at 12.”

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