Health24.com | From China to Vietnam: Highlighting how the coronavirus spreads from person to person

A man from Wuhan, the Chinese city that’s the epicenter of the coronavirus outbreak, apparently transmitted the infection to his son living in Vietnam, a new case report shows.

The report, published on January 28 in the New England Journal of Medicine, highlights how the respiratory illness can spread person-to-person, experts say.

More than 6 000 cases of the coronavirus, dubbed 2019-nCoV, have been reported in China, while the death toll has climbed to more than 130. Only five cases – all brought back from China by people traveling there – have been reported in the United States, and patients are thought to be in good condition.

But researchers now believe that 2019-nCoV can be spread even when an infected person doesn’t show symptoms. That could make the virus much harder to contain, experts say.

In the new case report, physicians led by Dr Thuong Nguyen at the Pasteur Institute in Ho Chi Minh City in southern Vietnam said that a 65-year-old man from Wuhan appears to have transmitted the coronavirus to his 27-year-old son living just outside of Ho Chi Minh City.

The father, along with his wife, had flown from Wuhan to the northern Vietnamese city of Hanoi on January 13. But four days later, after travelling southward in Vietnam, he developed a fever. On January 22, he arrived at an emergency department in Ho Chi Minh City.

Tests showed that the man was ill with 2019-nCoV, and so he was put in isolation in the hospital and treated with a variety of antimicrobial drugs.

Some good news

Though he has a number of chronic conditions – high blood pressure, type 2 diabetes, lung cancer, and heart disease requiring a stent – the man did recover from coronavirus. By January 26 his “condition had improved”, doctors said. His wife is healthy and appears to have never become infected.

However, the couple’s otherwise healthy son met his father upon the latter’s arrival in central Vietnam on January 17 – the son shared an air-conditioned hotel room with his parents for three days.

By January 20, the son had developed a cough, vomiting and loose stools, and went to the hospital in Ho Chi Minh City on January 22. All of that suggests that “the incubation period for 2019-nCoV may have been three days or less in this case,” the doctors noted.

Because the son had no history of travel to a 2019-nCoV-endemic region, at this point “his father was thought to be the source of infection,” Nguyen’s team said.

As has happened in the vast majority of cases of 2019-nCoV infection, the son’s condition has improved and is now “stable”, doctors said.

There was some good news from the report: “The family had travelled to four cities across Vietnam using various forms of transportation, including planes, trains and taxis. A total of 28 close contacts had been identified, and symptoms of an upper respiratory infection have not developed in any of them,” the Vietnamese team noted.

Very concerning

Still, person-to-person transmission outside of China is occurring in other places. According to The New York Times, such cases have also now been recorded in Germany, Japan and Taiwan.

“These reports are concerning, if they stand up to scrutiny, which they certainly sound credible,” Dr Arthur Reingold, a professor of epidemiology at the University of California, Berkeley, told The Times.

Sometimes the illness has been transmitted between family members, but in Japan a tour bus driver came down with coronavirus after driving two different groups from Wuhan, the newspaper noted.

“I think what that says is, if we can get transmission in such a setting, then we can certainly get it in the waiting room of a clinic or a hospital,” Reingold said. “That’s very concerning.”

For now, no cases of person-to-person transmission within the United States have been reported.

Dr Len Horovitz is a pulmonary disease specialist at Lenox Hill Hospital in New York City. Reading over the Vietnamese report, he said that “the novel coronavirus that is causing global concern appears to have an incubation of anywhere from three days to two weeks. Symptoms are similar to influenza symptoms – aches, fever, dry cough, sweats – but may include gastrointestinal symptoms such as vomiting and diarrhea.”

Still, Horovitz said, most people recover from their illness – the death rate is 3%, “not that much more than [the] influenza death rate of about 2%.”

In fact, he said, flu remains a bigger threat to Americans at this time than 2019-nCoV. Up to “40 000 people die annually from influenza in this country in an average year – and yet many people still refuse the flu shot,” Horovitz noted.

Image credit: Getty Images

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Health24.com | What are ‘farmacy’ prescriptions?

Doctors are used to writing prescriptions for medicine. But three Boston-area cardiologists are working on a federal programme that would focus on writing prescriptions for food.

Varanda, which stands for Veterans Administration Repurposing Agriculture for Nutrition and Diet Awareness, would create a network of sustainable food gardens at veterans’ hospitals to provide fresh food – for free – to vets and their families.

Farm operation in a hospital

The work is inspired by the rooftop farm at Boston Medical Center. The farm, in place since 2017, harvests more than two tons of fresh vegetables yearly and distributes them to their preventive food pantry and hospital kitchen.

“The rooftop farm is this amazing farm operation in a hospital,” said Dr Stephanie Moore, an assistant professor at Harvard Medical School and VA staff cardiologist.

“The doctors could write prescriptions for fresh vegetables and healthy foods that the patients could pick up at the on-site pantry. They would go onto their computers and, much like I would write a prescription for a medication, they would write a prescription for food. And it’s free.”

Moore, who first learned about the farm, told two colleagues. Dr Aruna Pradhan, a cardiologist and epidemiologist works in preventive medicine at the Brigham and Women’s Hospital and in cardiovascular medicine at the VA Hospital’s West Roxbury Campus. Dr Pei-Chun (Cheri) McGregor directs the ambulatory cardiology outpatient clinics for Boston Virginia. McGregor is a lieutenant colonel in the Air Force Reserves and a former 11-year active duty officer.

“We as cardiologists see a lot of diseases where we give medication instead of getting to the root of the problem, when a lot of the issues are actually lifestyle and nutrition-related,” McGregor said.

Sustainable produce garden

The programme is slated to start this year in the Boston suburbs Brockton and Bedford. Funding will come from private donations, federal and foundation grants and existing VA reimbursement mechanisms.

The doctors envision Varanda as a preventive health initiative that includes a food pantry, sustainable produce garden and a farmers market for veterans and their families.

The pantry and farm will provide food to veterans in need, and the vegetables will be grown on farms at the two VA hospitals, where thousands of veterans annually receive health care. The goal is to supply over 5 000 pounds of fresh produce from April to November and be supplemented by food from the Greater Boston Food Bank for year-round distribution. Farm output will stock the in-hospital preventive health pantry, an on-campus farmers market and hospital cafeteria.

“We’ll be a health care facility with a pharmacy and a ‘farmacy’,” said Moore. “Access to Varanda by prescription means access not only to free and nutritious and healthy protein sources, but to a host of educational resources and activities, like cooking classes.”

While the three women kicked off the idea on their own, they quickly received buy-in from several VA departments, including nutritional services, social work, homelessness and more. They now have a core group of more than 60 people. Varanda also coincides with the VA’s rollout of Whole Health, a plan focusing on nutritional and cultural transformation of systems of health care. VA Boston is one of 18 flagship VA sites for Whole Health.

Nutrition awareness and practice

“As a huge national single payer system, the VA has enormous potential for successful local programmes to spread more widely,” Moore said.

“We’re trying to write the playbook for this, not just make it a one-off. Each aspect of planning and implementation will be framed by the idea of scalability to VA medical centres nationwide.”

An education imperative also drives Varanda.

“Unfortunately, nutrition is not well-taught or well-received in medical schools,” Moore said.

Because training at VA medical centres is a core component of medical education for thousands of medical students yearly, Moore hopes Varanda will be an opportunity to give those trainees the needed nutrition awareness and practice.

“We strongly believe that future and current physicians should learn how to integrate lifestyle choices into their practice in a real and tangible way.”

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Researchers discover how cellular senescence leads to neurodegeneration

Although a link has been established between chronic inflammation and neurodegenerative diseases, there have been many open questions regarding how cellular senescence, a process whereby cells that stop dividing under stress spew out a mix of inflammatory proteins, affects these pathologies. Publishing in PLOS ONE, researchers at the Buck Institute report that senescence in astrocytes, the most abundant cell type in the brain, leads to damaging “excitotoxicity” in cortical neurons that are involved in memory.

This research, led by research scientist Chandani Limbad, PhD, found that cellular senescence in astrocytes downregulates the glutamate transporters, which are vital for glutamate homeostasis in the brain. Glutamate is one of the most important neurotransmitters in the brain; an excess of it causes neurons to repeatedly fire leading to their eventual death. Memantine, an FDA-approved drug for Alzheimer’s disease, reduces glutamate toxicity in patients suffering from moderate to severe disease for up to a year, but evidence that the drug might slow pathology is weak. “This study gets to the underlying mechanisms that drive the toxicity,” said senior author and Buck professor Judith Campisi, PhD. “We have identified targets that may be of more use in drug development.”

Cellular senescence is one of the hottest topics in research on aging. Success in the Campisi lab and others around the world has given rise to companies and research projects aimed at developing either senolytics, drugs that clear senescent cells, or senomorphics, drugs that suppress the senescence-associated inflammation. Earlier work in the Campisi lab in collaboration with the Buck Institute’s Andersen lab showed that clearing senescent cells prevented Parkinson’s in a mouse model of the disease.

Campisi says that most of the research aimed at understanding the characteristics of cellular senescence involves human fibroblasts, cells in connective tissue which produce collagen and other fibers. She says this work in astrocytes should be a wake-up call to those studying Alzheimer’s disease, arguing that, “What is commonly termed non-familial Alzheimer’s disease should probably more accurately be termed age-related dementia. If you see five spontaneous Alzheimer’s patients, all of them present differently. Some have personality changes, others don’t. Memory is affected differently in each patient; some people lose motor control, others don’t. These findings highlight aging as the biggest risk factor for almost all neurodegeneration and that is where the research should be focused.”

Co-author Pierre-Yves Desprez, PhD, a scientific consultant in the Campisi lab, who also runs a lab at the California Pacific Medical Center Research Institute, says the research also has implications for those studying glioblastoma, a particularly aggressive form of brain cancer which happens in astrocytes. “Cellular senescence is a double-edged sword and the current state of senescence-associated research is messy. While senescence leads to chronic inflammation which promotes cancer and neurodegeneration, it also acts as a tumor suppressor. There are many factors secreted by senescent astrocytes, we think some of them could be exploited as a way to treat glioblastoma.”

The research, which involved unbiased RNA sequencing of transcripts expressed by senescent and non-senescent astrocytes, found changes in the expression of more than 5,000 genes whose functions are important in cancer, infectious diseases, and neurological diseases. Results are available to the research community.

Story Source:

Materials provided by Buck Institute for Research on Aging. Note: Content may be edited for style and length.

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Prescribed burns benefit bees

Freshly burned longleaf pine forests have more than double the total number of bees and bee species than similar forests that have not burned in over 50 years, according to new research from North Carolina State University.

For many forests, fire is as essential as rainfall. But while several studies have outlined the benefits of human-controlled prescribed burns on forest ecosystems, little was understood about how prescribed burns, or fires in general, may impact pollinators.

“There is global concern about the decline of insects in general, and pollinators in particular, so it’s really important for land managers to understand how prescribed fire affects insect communities,” says Elsa Youngsteadt, co-author of a paper on the work and an assistant professor in NC State’s Department of Applied Ecology.

“Given the importance of fire in maintaining longleaf pine ecosystems overall, you would expect it to be good for the region’s native bees. But it’s also easy to imagine small bees and their nests, especially nests in twigs and stems, just getting incinerated. We weren’t sure where we would find the most robust pollinator community.”

NC State researchers worked with the Walthour-Moss Foundation’s longleaf pine savannah reserve, which was established to protect this endangered pine. The reserve regularly burns 90% of its plots in 3-year cycles, while the remaining 10% of plots have not been burned for at least 50 years. This provided an ideal opportunity to compare bee abundance and diversity between unmanaged and managed ecosystems.

“The southeastern U.S. has some of the highest lightning strike rates in the world, which used to contribute to low-intensity fires passing through the longleaf pine savannas every 2 or 3 years,” Youngsteadt says. “But agriculture, development, and logging fragmented this landscape and blocked the movement of fire.”

For this study, researchers placed bee “traps” at 16 sites: four that had been burned the year of sampling, four that had been burned one year before sampling, four that had been burned two years before sampling, and four unburned control sites.

The researchers found that burned sites supported 2.3 times more total pollinators than plots that had not burned in 50 years. Burned sites also had 2.1 times as many different bee species as unburned sites. Within those burned areas, bee abundance and diversity tended to be greatest at sites that were most recently burned, and this abundance and diversity decreased with time since the last fire.

But why?

Fires maintain openings in the forest canopy, reduce ground cover and release nutrients into soils at the same time, creating the perfect environment for large blooms, increasing the flower resources pollinators rely on. The study also found that the low-intensity prescribed burns did not reduce the amount of nesting material for above-ground nesting pollinators, and the abundance of above-ground nesting pollinators was not impacted by the fires. Meanwhile, below-ground nesting species appeared to benefit from the increased access to bare soil.

“It’s great news that prescribed fire, as currently used in longleaf pine savannas, is helping to support the pollinator community,” Youngsteadt says. “But there’s still a lot to learn. For example, the fires in this study were set in the winter, but many land managers use summer burns. Knowing the effects of fire in different seasons will be an important next step, as will knowing the optimal area of land to burn at any one time.”

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Speedy recovery: New corn performs better in cold

Nearly everyone on Earth is familiar with corn. Literally.

Around the world, each person eats an average of 70 pounds of the grain each year, with even more grown for animal feed and biofuel. And as the global population continues to boom, increasing the amount of food grown on the same amount of land becomes increasingly important.

One potential solution is to develop crops that perform better in cold temperatures. Many people aren’t aware that corn is a tropical plant, which makes it extremely sensitive to cold weather. This trait is problematic in temperate climates where the growing season averages only 4 or 5 months — and where more than 60% of its 1.6 trillion pound annual production occurs.

A chilling-tolerant strain could broaden the latitudes in which the crop could be grown, as well as enable current farmers to increase productivity.

A group of researchers led by David Stern, president of the Boyce Thompson Institute, have taken a step closer to this goal by developing a new type of corn that recovers much more quickly after a cold snap. Stern is also an adjunct professor of plant biology in Cornell University’s College of Agriculture and Life Sciences.

The research is described in a paper published online in Plant Biotechnology Journal on December 20.

This work built on research published in 2018, which showed that increasing levels of an enzyme called Rubisco led to bigger and faster-maturing plants. Rubisco is essential for plants to turn atmospheric carbon dioxide into sugar, and its levels in corn leaves decrease dramatically in cold weather.

In the latest study, Stern and colleagues grew corn plants for three weeks at 25°C (77°F), lowered the temperature to 14°C (57°F) for two weeks, and then increased it back up to 25°C.

“The corn with more Rubisco performed better than regular corn before, during and after chilling,” said Coralie Salesse-Smith, the paper’s first author. “In essence, we were able to reduce the severity of chilling stress and allow for a more rapid recovery.” Salesse-Smith was a Cornell PhD candidate in Stern’s lab during the study, and she is now a postdoctoral researcher at the University of Illinois.

Indeed, compared to regular corn, the engineered corn had higher photosynthesis rates throughout the experiment, and recovered more quickly from the chilling stress with less damage to the molecules that perform the light-dependent reactions of photosynthesis.

The end result was a plant that grew taller and developed mature ears of corn more quickly following a cold spell.

Steve Reiners, a co-team leader for Cornell Cooperative Extension’s vegetable program, says that sweet corn is a major vegetable crop in New York, worth about $40-$60 million annually. He notes that many New York corn growers plant as soon as they can because an early crop commands the highest prices of the season.

Reiners, who was not involved in the study, is also a professor of horticulture at Cornell.

“The corn we developed isn’t yet completely optimized for chilling tolerance, so we are planning the next generation of modifications,” said Stern. “For example, it would be very interesting to add a chilling-tolerant version of a protein called PPDK into the corn and see if it performs even better.”

The researchers believe their approach could also be used in other crops that use the C4 photosynthetic pathway to fix carbon, such as sugar cane and sorghum.

Co-authors on the paper include researchers from The Australian National University in Canberra.

The study was supported by the U.S. Department of Agriculture’s National Institute of Food and Agriculture (2016-67013-24464) and Australian Research Council Centre of Excellence for Translational Photosynthesis (CE1401000015).

Story Source:

Materials provided by Boyce Thompson Institute. Original written by Aaron J. Bouchie. Note: Content may be edited for style and length.

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Just Deciding

If clarity won’t succumb to an information-based approach, how can we possibly make any headway here? Don’t we need reliable information in order to make good decisions about our lives?

Here’s the thing: we actually don’t. We often make decisions without perfect information, and we still get by. We don’t freeze up constantly.

Every day we drink water, we eat food, and we move around. Maybe we get some work done. Maybe we talk to people. Maybe we mess around online a bit. But we can and do make decisions. And we live with the results of those decisions. We do this repeatedly.

We don’t need 100% reliable information to make decisions. Somehow we’re able to decide and take action anyway, even when our information is full of holes.

Consider some decisions you’ve made in the past few days. Did you always carefully consider the potential upsides and downsides of each option? You’ll probably find that you made some decisions very quickly and without serious analysis.

How did you decide what to eat for each meal? How did you decide what to wear? How did you spend your leisure time? It’s doubtful that you weighed the pros and cons of every accessible option.

For many decisions you had to make, it would appear that you just decided.

How did you muster a sufficient level of clarity to do that? How did you just decide instead of thinking more deeply and analytically about each possible path?

Consider this: Making a decision can be an incredibly simple process. You can do it in a split second by just deciding.

No long-winded analysis. No resistance. No analysis paralysis. You can just decide. You already do this many times each day.

When you make decisions simply, you allow a decision to unfold without stopping yourself, and you flow into action. You don’t use blocking mechanisms to slow yourself down.

When you’re ready to eat, you decide what to eat, and you eat. When you’re ready to go to bed, you decide to go to bed, and you go to bed. When you’re ready to quit your job, you decide to quit, and you quit.

Just deciding is a simple step, often made automatically and unconsciously. It usually doesn’t take much force or pushing. You may have the sense that some part of you – your brain, your heart, your spirit, or something else – just decided for you.

Here’s a simple but important reframe to adopt. When people claim they’re making a decision, and they’re taking a while to do so, consider that they aren’t actually deciding. Deciding takes less than a second. Making a decision is as quick as pushing a button. What such people are actually doing is applying the brakes.

Researching options isn’t making a decision. Discussing possibilities isn’t making a decision. Thinking about making a decision isn’t making a decision. All of these are braking mechanisms that delay action. The button isn’t being pushed yet.

Now there may be intelligent reasons to apply the brakes. Maybe it’s important to weigh the pros and cons. Maybe your outcome would be improved by seeking more and better information. Maybe you need to consult with others who may be affected by the decision.

That’s all well and good, but I advise you not to wrap these information-gathering and analytical aspects into the simple act of making a choice. The reason is that if you wrap these into the decision itself, it’s easy to fall into the trap of claiming that you’re deciding when you’re actually delaying, and once you’re stuck in that particular frame, it can be hard to escape and move the process forward.

It’s okay to delay now and then. You may not feel ready to move forward with your decision. But when you frame your braking methods as part of your decision-making process, you can easily muddle your sense of clarity. It’s common for people to claim to be unclear about a decision and to say they need more time to decide, when what they’re really doing is applying the brakes because they don’t feel ready to deal with the decision and its challenges yet.

There’s tremendous value in saying to yourself, “I feel the need to apply the brakes and work on my readiness because I’m feeling overwhelmed by what I need to do next” instead of saying, “I’m still trying to decide.” The first statement increases your clarity. The second muddies your clarity.

It’s important to note that clarity tends to diminish when you’re standing still, and it tends to increase when you’re in motion. When you’re applying a braking mechanism, you’re slowing down or stopping, so your sense of clarity will usually decrease. It’s okay to experience that temporarily, but if you also believe that you should be feeling more clear because you’re in the “process of deciding,” you may feel frustrated and confused by your reduced sense of clarity when you’re expecting the opposite.

When you frame this process as applying the brakes, you won’t be so surprised when your sense of clarity drops because you’ll know the drop is caused by your own braking… and you’ll also know that you can raise your sense of clarity back up again by releasing the brakes and getting back into motion.

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Health24.com | WATCH | No, pasta isn’t bad for you

29 January 2020

WATCH | No, pasta isn’t bad for you

Moderation is key.

Stringr

Research reveals that pasta lovers can enjoy their favorite Italian dish as part of a healthy diet, as long as it’s eaten in moderation.

Image credit: Jorge Zapata, Unsplash

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Lungs ‘magically’ heal damage from smoking

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