Category Archives: Nutrition

Post-COVID syndrome severely damages children’s hearts

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Multisystem inflammatory syndrome in children (MIS-C), believed to be linked to COVID-19, damages the heart to such an extent that some children will need lifelong monitoring and interventions, said the senior author of a medical literature review published Sept. 4 in EClinicalMedicine, a journal of The Lancet.

Case studies also show MIS-C can strike seemingly healthy children without warning three or four weeks after asymptomatic infections, said Alvaro Moreira, MD, MSc, of The University of Texas Health Science Center at San Antonio. Dr. Moreira, a neonatologist, is an assistant professor of pediatrics in the university’s Joe R. and Teresa Lozano Long School of Medicine.

“According to the literature, children did not need to exhibit the classic upper respiratory symptoms of COVID-19 to develop MIS-C, which is frightening,” Dr. Moreira said. “Children might have no symptoms, no one knew they had the disease, and a few weeks later, they may develop this exaggerated inflammation in the body.”

Results

The team reviewed 662 MIS-C cases reported worldwide between Jan. 1 and July 25. Among the findings:

  • 71% of the children were admitted to the intensive care unit (ICU).
  • 60% presented with shock.
  • Average length of stay in the hospital was 7.9 days.
  • 100% had fever, 73.7% had abdominal pain or diarrhea, and 68.3% suffered vomiting.
  • 90% had an echocardiogram (EKG) test and 54% of the results were abnormal.
  • 22.2% of the children required mechanical ventilation.
  • 4.4% required extracorporeal membrane oxygenation (ECMO).
  • 11 children died.

“This is a new childhood disease that is believed to be associated with SARS-CoV-2,” Dr. Moreira said. “It can be lethal because it affects multiple organ systems. Whether it be the heart and the lungs, the gastrointestinal system or the neurologic system, it has so many different faces that initially it was challenging for clinicians to understand.”

The amount of inflammation in MIS-C surpasses two similar pediatric conditions, Kawasaki disease and toxic shock syndrome. “The saving grace is that treating these patients with therapies commonly used for Kawasaki — immunoglobulin and glucocorticosteroids — has been effective,” Dr. Moreira said.

Cardiac abnormalities

Most of the 662 children suffered cardiac involvement as indicated by markers such as troponin, which is used with great accuracy in adults to diagnose heart attacks.

“Almost 90% of the children (581) underwent an echocardiogram because they had such a significant cardiac manifestation of the disease,” Dr. Moreira said.

The damage included:

  • Dilation of coronary blood vessels, a phenomenon also seen in Kawasaki disease.
  • Depressed ejection fraction, indicating a reduced ability for the heart to pump oxygenated blood to the tissues of the body.
  • Almost 10% of children had an aneurysm of a coronary vessel. “This is a localized stretching or ballooning of the blood vessel that can be measured on an ultrasound of the heart,” Dr. Moreira said.

Children with an aneurysm are at the most risk of a future event. “These are children who are going to require significant observation and follow-up with multiple ultrasounds to see if this is going to resolve or if this is something they will have for the rest of their lives,” Dr. Moreira said.

“And that’s catastrophic to a parent who had a previously healthy child and then he/she is in the very small percentage of individuals who developed MIS-C after COVID-19 infection,” he said.

Another finding from the case studies: Almost half of patients who had MIS-C had an underlying medical condition, and of those, half of the individuals were obese or overweight.

“Generally, in both adults and children, we are seeing that patients who are obese will have a worse outcome,” Dr. Moreira said.

When compared to the initial COVID-19 infection, inflammatory markers in MIS-C were far more abnormal. For instance, troponin, the marker used in adults to diagnose heart attacks, was 50 times its normal level in children with MIS-C.

“Evidence suggests that children with MIS-C have immense inflammation and potential tissue injury to the heart, and we will need to follow these children closely to understand what implications they may have in the long term,” Dr. Moreira said.

Researchers at Texas Children’s Hospital in Houston, Georgetown University, the National Institutes of Health and the University of Pennsylvania joined Dr. Moreira in conducting this literature review.

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Unexpected electrical current that could stabilize fusion reactions

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Electric current is everywhere, from powering homes to controlling the plasma that fuels fusion reactions to possibly giving rise to vast cosmic magnetic fields. Now, scientists at the U.S. Department of Energy’s (DOE) Princeton Plasma Physics Laboratory (PPPL) have found that electrical currents can form in ways not known before. The novel findings could give researchers greater ability to bring the fusion energy that drives the sun and stars to Earth.

“It’s very important to understand which processes produce electrical currents in plasma and which phenomena could interfere with them,” said Ian Ochs, graduate student in Princeton University’s Program in Plasma Physics and lead author of a paper selected as a featured article in Physics of Plasmas. “They are the primary tool we use to control plasma in magnetic fusion research.”

Fusion is the process that smashes together light elements in the form of plasma — the hot, charged state of matter composed of free electrons and atomic nuclei — generating massive amounts of energy. Scientists are seeking to replicate fusion for a virtually inexhaustible supply of power to generate electricity.

The unexpected currents arise in the plasma within doughnut-shaped fusion facilities known as tokamaks. The currents develop when a particular type of electromagnetic wave, such as those that radios and microwave ovens emit, forms spontaneously. These waves push some of the already-moving electrons, “which ride the wave like surfers on a surfboard,” said Ochs.

But the frequencies of these waves matter. When the frequency is high, the wave causes some electrons to move forward and others backward. The two motions cancel each other out and no current occurs.

However, when the frequency is low, the waves pushes forward on the electrons and backward on the atomic nuclei, or ions, creating a net electrical current after all. Ochs found that researchers could surprisingly create these currents when the low-frequency wave was a particular type called an “ion acoustic wave” that resembles sound waves in air.

The significance of this finding extends from the relatively small scale of the laboratory to the vast scale of the cosmos. “There are magnetic fields throughout the universe on different scales, including the size of galaxies, and we don’t really know how they got there,” Ochs said. “The mechanism we discovered could have helped seed cosmic magnetic fields, and any new mechanisms that can produce magnetic fields are interesting to the astrophysics community.”

The results from the pencil-and-paper calculations consist of mathematical expressions that give scientists the ability to calculate how these currents, which occur without electrons directly interacting, develop and grow. “The formulation of these expressions was not straightforward,” Ochs said. “We had to condense the findings so they would be sufficiently clear and use simple expressions to capture the key physics.”

The results deepen understanding of a basic physical phenomenon and were also unexpected. They appear to contradict the conventional notion that current drives require electron collisions, Ochs said.

“The question of whether waves can drive any current in plasma is actually very deep and goes to the fundamental interactions of waves in plasma,” said Nathaniel Fisch, a coauthor of the paper, professor and associate chair of the Department of Astrophysical Sciences, and director of the Program in Plasma Physics. “What Ochs derived in masterful, didactic fashion, with mathematical rigor, was not only how these effects are sometimes balanced, but also how these effects sometimes conspire to allow the formation of net electrical currents.”

These findings lay the groundwork for future research. “What especially excites me,” Fisch said, “is that the mathematical formalism that Ochs has built, together with the physical intuitions and insights that he has acquired, now put him in a position either to challenge or to put on a firm foundation even more curious behavior in the interactions of waves with resonant particles in plasma.”

Story Source:

Materials provided by DOE/Princeton Plasma Physics Laboratory. Original written by Raphael Rosen. Note: Content may be edited for style and length.

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Autophagy: the beginning of the end

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Autophagosomes first form as cup-shaped membranes in the cell, which then grow to engulf the cellular material designated for destruction. The formation of these membranes is catalyzed by a complex machinery of proteins. “We have a very good knowledge of the factors involved in autophagosomes formation,” explains group leader Sascha Martens, “but how they come together to initiate the formation of these membranes has so far been enigmatic.”

One of the factors is Atg9, a protein whose importance in the process was known, but whose role was not clear. Atg9 is found in small intracellular vesicles. Researchers Justyna Sawa-Makarska, Verena Baumann and Nicolas Coudevylle from the Martens lab now show that they form a platform on which the autophagy machinery can assemble to build the autophagosome. “Atg9 vesicles are abundant in the cell, which means they can be rapidly recruited when autophagosomes are needed,” explains group leader Sascha Martens.

Cells encapsulate cargo in vesicles, so that they can be correctly transported and degraded in a chemical environment that is different to the one normally found in cells. Autophagosomes therefore consist of a double membrane made of phospholipids. This greasy envelope creates a waterproof package that separates material from the aqueous surroundings of the cell and marks it for degradation. However, Atg9 vesicles do not supply the bulk of the lipids to the growing autophagosome.

To understand a complex machinery like the cell, it often helps to take it apart and rebuild it. The biogenesis of autophagosome involves numerous proteins. By isolating and characterizing 21 of these components, the scientists have been able to rebuild parts of the autophagy machinery in the ‘test tube’ — an arduous process that took Sascha Martens and his team almost ten years. “With this approach we could reconstitute the early steps of autophagosome biogenesis in a controlled manner,” he says. With the elaborate toolkit the Martens lab has developed, the scientists now aim to unravel the next steps in the biogene-sis of the autophagosome. The research project was a collaboration of the Martens lab with Gerhard Hummer and Soeren von Bülow from the Max Planck Institute for Biophysics in Frankfurt and Martin Graef from the Max Planck Institute for Biology of Ageing in Cologne.

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Materials provided by University of Vienna. Note: Content may be edited for style and length.

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Coronavirus case numbers ‘remain unchanged’ in England

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Despite local outbreaks, household tests suggest the level of the virus was stable during August.

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Health24.com | Just like Covid, severe flu can trigger heart crises

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  • With the focus on Covid-19, it is easy to forget that the ‘regular’ seasonal flu can also be dangerous
  • The flu can also lead to complications like pneumonia and worsen certain chronic health conditions, including heart disease
  • To help prevent the flu, experts say that getting the flu shot is more important than ever 

Amid the Covid-19 pandemic, a new US study serves as a reminder of how severe the seasonal flu can be.

Researchers found that among 90 000 Americans hospitalised with the flu, 12% had a serious heart complication, including heart attack and sudden heart failure. Many ended up in the intensive care unit, and 7% died in the hospital.

The study shows that Covid-19 isn’t alone among viruses that can up the odds for heart events.

The findings also underscore the importance of getting the flu shot – especially this year, experts said.

Flu shot always recommended

“The flu is not ‘just a cold’,” said Dr Kathryn Edwards, a professor at Vanderbilt University School of Medicine in Nashville. “People often don’t appreciate how serious it can be.”

A yearly flu shot is always recommended, she said, especially for people older than 65 and those with certain chronic conditions such as heart disease, diabetes and asthma. They are at heightened risk of flu complications.

This season, flu vaccination is particularly important because of the pandemic, Edwards said. That’s in part to avoid having hospitals overrun by both flu and Covid patients.

Edwards, who was not involved in the study, is also a spokesperson for the Infectious Diseases Society of America.

While the flu usually causes temporary miseries like fever, cough and a sore throat, it can also lead to complications such as pneumonia and other secondary infections. The infection can also worsen certain chronic health conditions, including heart disease.

Body-wide inflammation

But that is not necessarily common knowledge, said Dr Shikha Garg, the senior researcher on the new study.

“I don’t know that these cardiac complications are on people’s radar,” said Garg, of the US Centers for Disease Control and Prevention. “This study shows just how common they are.”

For the study, Garg’s team looked at 90 000 flu hospitalisations in 17 US states between 2010 and 2018. Just under 12% of those patients suffered a heart complication.

Not surprisingly, people with existing heart conditions were at greater risk: 21% of those patients had a cardiac complication – as did 19% of patients with kidney disease and 15% of those with diabetes.

Edwards said the flu may directly trigger heart complications, by spurring body-wide inflammation. If, for example, a person has artery-clogging “plaques”, that inflammation could rupture the plaque and lead to a heart attack.

Of study patients with heart complications, almost one-third landed in the ICU, and 7% died.

No guarantee against the flu

Despite the severity of the flu, Americans frequently skip the annual vaccine. During the 2018–2019 season, the CDC says, between 34% and 56% of adults got the flu shot, with variations by state.

“Everyone age six months and older should be vaccinated,” Edwards said.

The shot is no guarantee against the flu, she added, but it is typically about 50% effective. And even if it does not prevent the infection entirely, Edwards said, it may reduce the severity of the illness.

“We don’t know for sure what’s going to happen in the fall,” Garg said. But since both the new coronavirus and the flu are likely to be in circulation, she added, Americans should be prepared.

Flu vaccine safe

“Now more than ever,” Garg said, people should get the flu shot.

It is possible, Edwards noted, that the efforts in place to battle Covid – from physical distancing to hand-washing to mask-wearing – will take some of the bite out of flu season. But those things do not take the place of vaccination, she said.

Garg agreed. “The flu vaccine is safe, and it’s our most important tool for prevention.”

The findings were published in the Annals of Internal Medicine.

Image credit: iStock

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Esketamine spray for treating depression ‘not cost-effective’

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It is also not clear how well the drug works long term, the healthcare watchdog says.

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Health24.com | Flu, pneumonia vaccines save lives of heart failure patients

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  • A study found that heart failure patients who had received flu and pneumonia vaccines had a lower risk of in-hospital death 
  • It is a known fact that respiratory infections make heart failure worse 
  • Despite that, very few heart failure patients receive these immunisations

Flu and pneumonia vaccines lead to fewer hospital deaths among heart failure patients, a new study finds.

“Our study provides further impetus for annual immunisations in patients with heart failure. Despite advice to do so, uptake remains low,” said study author Dr Karthik Gonuguntla, of the University of Connecticut.

In heart failure, your heart can’t pump blood as well as it should. This leads to fluid buildup in the lungs that causes shortness of breath, coughing and reduced quality of life.

Lower in-hospital death rate

Respiratory infections like pneumonia and the flu make heart failure worse, so annual vaccinations are recommended for patients. However, few studies have compared outcomes among heart failure patients who have and haven’t received these vaccinations.

In this study, the researchers looked at nearly three million heart failure patients, average age 70, in the United States who were hospitalised between 2010 and 2014. Only 1.4% of the patients had received the flu vaccine and just 1.4% had received the pneumonia vaccine.

Rates of in-hospital death were much lower among patients who received the flu and pneumonia vaccines (just over 1% for each) than among those who didn’t receive either vaccine (almost 4%), the researchers found.

The study findings were released on Friday and scheduled for presentation at the European Society of Cardiology virtual annual meeting.

Pandemic changed perceptions

“Pneumonia and flu vaccines are vital to preventing these respiratory infections and protecting patients with heart failure. Although many people have rejected common and safe vaccines before Covid-19, I am optimistic that the pandemic has changed perceptions about the role of immunisations in safeguarding our health,” Gonuguntla said in a society news release.

Serious reactions to flu and pneumonia vaccinations are rare, occur within a few hours and can be treated, he said.

Studies presented at meetings should be considered preliminary until peer-reviewed for publication in a medical journal.

Image credit: iStock

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Health24.com | Being a jerk not a recipe for getting ahead at work

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  • A study found that disagreeableness did not give people an advantage in the competition for power
  • Organisations may allow ‘jerks’ to gain power at the same rate as anyone else
  • However, selfish, deceitful and aggressive people tend to be held back by poor relationships with others

Being a selfish jerk won’t pave a path to success, new research suggests.

The study involved hundreds of participants who completed personality assessments when they were undergraduates or MBA students at three universities.

The researchers checked in with the same people about 14 years later to find out how well they’d done in their careers, and their co-workers were asked about the participants’ workplace behaviour.

In general, people who were selfish, deceitful and aggressive weren’t more likely to have attained positions of authority than those who were generous, trustworthy and pleasant, according to the study published on 31 August in the Proceedings of the National Academy of Sciences.

Poor relationships with others

“I was surprised by the consistency of the findings. No matter the individual or the context, disagreeableness did not give people an advantage in the competition for power – even in more cutthroat, ‘dog-eat-dog’ organisational cultures,” said study co-author Cameron Anderson, a professor at the University of California, Berkeley’s School of Business.

The findings don’t mean that jerks don’t attain high positions, but rather that they don’t get there faster than others, Anderson said.

Any advantage that someone may get from being selfish, deceitful and aggressive is offset by their poor relationships with others, according to the study authors.

The researchers also found that extroverts were the most likely to have advanced in their organisations due to their sociability, energy and assertiveness, something found in previous research.

“The bad news here is that organisations do place disagreeable individuals in charge just as often as agreeable people. In other words, they allow jerks to gain power at the same rate as anyone else, even though jerks in power can do serious damage to the organisation,” Anderson explained.

A strong set of alliances

“My advice to managers would be to pay attention to agreeableness as an important qualification for positions of power and leadership,” he said in a university news release. “Prior research is clear: agreeable people in power produce better outcomes.”

Anderson noted that the findings don’t shed light on whether being a jerk helps or hurts in politics, because the power dynamics are different than in business. However, there are some likely parallels.

“Having a strong set of alliances is generally important to power in all areas of life,” Anderson said. “Disagreeable politicians might have more difficulty maintaining necessary alliances because of their toxic behaviour.”

Image credit: Shutterstock

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Gene-edited babies: Current techniques not safe, say experts

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A committee to look into the issue was set up after the first gene-edited babies were born in 2018.

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Fragile Objections

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Suppose you’re sitting in a Toastmasters meeting where members are practicing their speaking skills. Suppose there are about 20 members in the room, which would be pretty typical for a Toastmasters club.

Now suppose you hear a fellow member give a speech that you find objectionable, and it bothers you to hear such words spoken within your club. The topic is permitted within the club though.

What do you do?

Do you stay quiet and keep your thoughts and feelings to yourself?

Do you voice your objections to the speaker privately?

Do you privately share your concerns with some other members about the speech or the speaker?

Do you stand up during the meeting and voice your objections in front of all the members, including the speaker?

Do you sign up to give a speech, so you can disagree with the first speech?

Do you call for a vote to kick the member out?

Do you switch to a different Toastmasters club?

Do you quit Toastmasters altogether?

How you handle this depends on your personality and how you frame the situation. Your response depends on the meaning you assign.

Some assignments of meaning will cause you to have a more fragile relationship with your club, with its members, or with Toastmasters. Other meanings will give you enough resilience to maintain a long-term connection to your club or the organization.

Here’s a very fragile assignment of meaning:

What that speaker shared is totally out of line and should never be heard in this or any other Toastmasters club. If I stay in this club (or in Toastmasters), it means I’m personally condoning what this speaker said. I cannot stomach that.

That framing is pretty inflexible. It frames you into a corner, giving you few options. This sort of framing is incongruent with a long-term membership in Toastmasters.

Here’s a more resilient and flexible assignment of meaning:

A Toastmasters meeting is a growth-oriented practice space. Toastmasters is where members go to learn and build their skills. We don’t expect perfection there. We expect and even encourage mistakes. It’s expected that some members will share disagreeable ideas. It can even be good to have our viewpoints challenged sometimes. Variety can be nice.

If you’re in Toastmasters long enough, there’s a good chance you’ll encounter an objectionable speech or speaker. If you want a more resilient relationship with Toastmasters, it’s important to take these situations in stride. If you get worked up over them, you’ll have a more fragile relationship with Toastmasters, and sooner or later you’ll find a reason to ring the bell and quit.

From the outside looking in, the difference between these frames is pretty striking. You may look at the first frame and think that of course it’s not going to work long-term if someone adopts that frame. The second frame provides way more flexibility.

Here’s a key point: You always have a choice of framing. You can lean towards resilient frames, or you can choose fragile frames. By choosing a fragile frame, you increase the likelihood that you’re going to have to ring the bell and quit eventually. With the first framing above, quitting Toastmasters becomes pretty much inevitable; it’s just a matter of time.

So consider that by adopting such a fragile frame, you’re really choosing ring the bell and quit as well. Using a fragile frame is a way of inviting the final straw moment to present itself, often before you can identify a viable final straw event.

Why do this fragility dance then? Why pick a fragile meaning when it leads to such a predictable outcome?

One reason is that people often prefer a final straw objection. It provides a neat and tidy justification for a sometimes complex decision.

Like any growth-oriented space, Toastmasters is uncomfortable at times. You invite some risk when you show up. You may feel anxious at a meeting. You may face embarrassment. Now and then you may leave a meeting not feeling good about how you did. You may feel envious of peers who seem to be progressing faster than you.

It’s hard to keep showing up and facing that discomfort. It’s also hard to say that you’re leaving because you no longer want to deal with that discomfort.

Truthfully there are lots of reasons that people may choose a fragile frame. A common reason is to speed up the arrival of a final straw moment, so quitting can be justified without having to offer up a reason like, “It’s too uncomfortable” or “I felt too anxious” or even “My heart is calling me in a different direction.”

The downside of using fragile objections is that other people often won’t buy into them. While you may feel they’re solid enough reasons to explain your bell ringing, it’s fairly easy for many people to see them as self-created justifications, just as easily as you can spot the fragility of the first frame above. People will generally let you off the hook when you produce your fragile objection, but they’ll also likely conclude that it wasn’t your real reason for ringing the bell.

Ultimately fragile objections are a crutch. This crutch begins with the adoption of a fragile frame. A key personal growth challenge is to graduate from needing to use fragile frames that inevitably lead to fragile objections. If you’re going to ring the bell, can you learn to do that without needing to engineer any justification for it.

In any area of life, you can ring the bell and quit without having to explain or justify your actions. You can quit Toastmasters at any time and for any reason, for instance. You can quit your job today just because you decide it’s time.

I think another reason people use fragile objections is that it’s a less scary way to transition. Some decisions involve a lot of uncertainty, and it isn’t perfectly clear which way to go. To decide without a fragile objection, you need to trust reality or your intuition a lot more. You also have to accept that a big decision involves risk. If it feels like you have little or no choice in the matter, it takes some of the pressure off and makes you feel less responsible for the choice and its outcome.

So one solution I’ll provide is this: Be willing to be wrong. Be willing to make mistakes. Be willing to sit in the muck of bad outcomes that resulted from your decisions.

Consider that this life is much like a Toastmasters meeting. It’s a growth-oriented space where you learn by doing. You will make mistakes. You will make some decisions that leave you shaking your head afterwards. And that’s okay. It’s part of the reason you’re here.

You do not need to engineer fragile objections to ease the burden of those decisions by artificially narrowing your options. You can choose flexible frames that give you lots of options, and you can still make decisions even when facing a minefield of risk. Now and then you’ll choose wrong. Celebrate that you’re free to do that because that is an incredible gift.

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