Chapter 16. None

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By Katie Engelhart The doctors told Naomi that she could not leave the hospital. She was lying in a narrow bed at Denver Health Medical Center. Someone said something about a judge and a court order. Someone used the phrase “gravely disabled.” Naomi did not think she was gravely disabled. Still, she decided not to fight it. She could deny that she was mentally incompetent — but this would probably just be taken as proof of her mental incompetence. Of her lack of insight. She would, instead, “succumb to it.” It was early 2018. She had come to the hospital voluntarily, because she was getting so thin. In the days before, she had felt her electrolyte levels dip toward the danger zone — and she had decided that, even after everything, she did not want to be dead. By then, Naomi was 37 and had been starving herself for 26 years, and she was exquisitely attuned to her body’s corrupted chemistry. At the hospital, she was admitted to the ACUTE Center for Eating Disorders & Severe Malnutrition for medical stabilization. There, doctors began what was once called refeeding but is now more commonly called nutritional rehabilitation, using an intravenous line that fed into her neck. Reintroducing food to an emaciated body can be dangerous and even lethal if done too quickly. Physicians identified this phenomenon in the aftermath of World War II, when they observed skeletal concentration-camp survivors and longtime prisoners of war eat high-caloric foods and then drop dead of cardiac failure. “Well, here I am,” Naomi said in a video message that she recorded for her parents. “I am alive, but am I happy? I don’t know. … It’s pretty pathetic. I don’t know how I feel about the fact that I would have died had I not come.” In the video, she was wearing a hot pink tank top, even though it was cool in the hospital room, because she wanted to shiver, because shivering burned calories. A few days later, when she was not imminently dying anymore, Naomi announced that she was going home — and the hospital responded by placing her on a 72-hour mental-health hold. Clinicians then obtained what Colorado calls a short-term certification, which required, by judicial order, that Naomi be detained and treated, in her case until she reached what physicians determined to be 80 percent of her “ideal body weight.” In Colorado, as in most states, a patient can be treated against her will if she is mentally ill and found incapable of making informed decisions. That day, Naomi was transferred to a residential program at Denver’s Eating Recovery Center (E.R.C.) © 2024 The New York Times Company

Keyword: Anorexia & Bulimia
Link ID: 29075 - Posted: 01.03.2024

By Regina G. Barber Human brains aren't built to comprehend large numbers, like the national debt or how much to save for retirement. But with a few tools — analogies, metaphors and visualizations — we can get better at it. erhui1979/Getty Images Imagine a horizontal line. The very left is marked one thousand and the very right is marked one billion. On this line, where would you add a marker to represent one million? If you said somewhere in the middle, you answered the same as the roughly 50 percent of people who have done this exercise in a number line study. But the answer is actually much closer to one thousand since there are one thousand millions in one billion. This error makes sense because "our human brains are pretty bad at comprehending large numbers," says Elizabeth Toomarian, an educational neuroscientist at Stanford University. She studies how the brain makes sense of numbers. Or doesn't. "Our brains are evolutionarily very old and we are pushing them to do things that we've only just recently conceptualized," says Toomarian. Instead, the human brain is built to understand how much of something is in its environment. For example, which bush has more berries or how many predators are in that clearing? But comprehending the national debt or imagining the size of our universe? "We certainly can use our brains in that way, but we're recycling these sort of evolutionarily old brain architectures to do something really new," she says. In other words, it's not our fault that we have trouble wrapping our heads around big numbers. © 2024 npr

Keyword: Attention
Link ID: 29074 - Posted: 01.03.2024

By Catherine Pearson Dry January sounds like a simple proposition: No alcohol. For 31 days. And some enthusiasts jump in without much planning — perhaps even hungover after a rowdy New Year’s Eve. There is no data suggesting that those folks won’t be able to abstain from drinking, said Dr. David Wolinsky, an assistant professor of psychiatry and behavioral sciences with Johns Hopkins Medicine, who specializes in addiction. But starting the month with a few strategies in your back pocket — and with a clear sense of your goals — may help you get the most out of the challenge. “Most of the benefits of Dry January are probably going to be related to the intention with which you go into Dry January,” Dr. Wolinsky said. The challenge isn’t a stand-in for treatment for people with alcohol use disorder, he stressed, but those who are looking to get a fresh start to the year may benefit from the mental and physical reset it can offer, and the opportunity to adopt new habits. For instance, a 2016 study found that six months after Dry January ended, participants were drinking less than they were before. We spoke to Dr. Wolinsky and other experts about some strategies for a successful month. One of the simplest steps is to spread the word among friends and family that you intend to take the month off, said Casey McGuire Davidson, a sobriety coach and host of “The Hello Someday Podcast,” which focuses on “sober-curious” topics. Research has shown that accountability can play a critical role in helping habits stick, and you might find a friend or partner to join you, Ms. Davidson suggested. Even if you don’t, you may be surprised by how encouraging people are of your goal (though she said you should share it only with people you trust). “Dry January gives people a period of time when they can stop drinking with community and support,” she said, “without a lot of questions.” Ms. Davidson also recommended reading books that may help you evaluate your relationship with alcohol, or listening to sobriety podcasts. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 29071 - Posted: 12.31.2023

Rudi Zygadlo To celebrate our anniversary, my partner and I dine in a trendy London restaurant in Hackney with a Michelin star – my first time in such a place. A crispy little bonbon is introduced to us simply as “Pine, kvass lees and vin brûlé.” I watch my partner light up, the flickering candle in her eyes, as the waiter sets the thing down. The impact of the aroma has already registered on her face. With her first bite she is transported to her childhood in Massachusetts. “Gosh,” she gasps, closing her eyes as a New England virgin pine forest explodes in her mind. When she blinks open, returning to the here and now, she looks at me guiltily. I take a bite and wince. No coniferous wonderland for me. Just unpleasant bitterness, confined very much to the tongue. I am pleased for her, truly. I’m a magnanimous guy. But from that moment on, the whole evening is a bit of a spectator sport and, by the end of it, I have a feeling that she is even playing her enjoyment down, muting her reactions, as if to say, “You’re not missing out.” She finds some dishes prove more successful than others – the sweetness of cherry, an umami-rich mushroom – but I am missing out: on the nuances, the emotions, the memories. The smell. It’s been three years since I lost it. November 2020. I was living with three friends in a flat in Glasgow when we all caught Covid in the pre-vaccine days. Two of us lost our smell and never fully recovered it. We’re in good company. Around 700,000 people in the UK are believed to have total smell loss caused by the virus, with around six million still experiencing some olfactory dysfunction. I estimate mine has returned by about 30%, but it’s inconsistent and often distorted. To summarise my symptoms of anosmia, as total or partial loss of smell is known: some things have a faint odour, some don’t smell as they should and others don’t smell at all. For example: basil smells mild but good, ground coffee and a certain brand of toothpaste smell like fish and, mercifully, shit doesn’t stink at all. Apart from the latter, all bad news.

Keyword: Chemical Senses (Smell & Taste)
Link ID: 29070 - Posted: 12.31.2023

By Mariana Lenharo Could artificial intelligence (AI) systems become conscious? A trio of consciousness scientists says that, at the moment, no one knows — and they are expressing concern about the lack of inquiry into the question. In comments to the United Nations, three leaders of the Association for Mathematical Consciousness Science (AMCS) call for more funding to support research on consciousness and AI. They say that scientific investigations of the boundaries between conscious and unconscious systems are urgently needed, and they cite ethical, legal and safety issues that make it crucial to understand AI consciousness. For example, if AI develops consciousness, should people be allowed to simply switch it off after use? Such concerns have been mostly absent from recent discussions about AI safety, such as the high-profile AI Safety Summit in the United Kingdom, says AMCS board member Jonathan Mason, a mathematician based in Oxford, UK and one of the authors of the comments. Nor did US President Joe Biden’s executive order seeking responsible development of AI technology address issues raised by conscious AI systems, Mason notes. “With everything that’s going on in AI, inevitably there’s going to be other adjacent areas of science which are going to need to catch up,” Mason says. Consciousness is one of them. The other authors of the comments were AMCS president Lenore Blum, a theoretical computer scientist at Carnegie Mellon University in Pittsburgh, Pennsylvania, and board chair Johannes Kleiner, a mathematician studying consciousness at the Ludwig Maximilian University of Munich in Germany. © 2023 Springer Nature Limited

Keyword: Consciousness; Robotics
Link ID: 29065 - Posted: 12.27.2023

By Elise Cutts On a summer night in the Bay of Naples, hordes of worms swam upward from the seagrass toward the water’s surface under the light of a waning moon. Not long before, the creatures began a gruesome sexual metamorphosis: Their digestive systems withered, and their swimming muscles grew, while their bodies filled with eggs or sperm. The finger-length creatures, now little more than muscular bags of sex cells, fluttered to the surface in unison and, over a few hours, circled each other in a frantic nuptial dance. They released countless eggs and sperm into the bay — and then the moonlit waltz ended in the worms’ deaths. The marine bristle worm Platynereis dumerilii gets only one chance to mate, so its final dance had better not be a solo. To ensure that many worms congregate at the same time, the species synchronizes its reproductive timing with the cycles of the moon. How can an undersea worm tell when the moon is at its brightest? Evolution’s answer is a precise celestial clock wound by a molecule that can sense moonbeams and sync the worms’ reproductive lives to lunar phases. No one had ever seen how one of these moonlight molecules worked. Recently, however, in a study published in Nature Communications, researchers in Germany determined the different structures that one such protein in bristle worms takes in darkness and in sunlight. They also uncovered biochemical details that help explain how the protein distinguishes between brighter sunbeams and softer moonglow. It’s the first time that scientists have determined the molecular structure of any protein responsible for syncing a biological clock to the phases of the moon. “I’m not aware of another system that has been looked at with this degree of sophistication,” said the biochemist Brian Crane of Cornell University, who was not involved in the new study. © 2023 An editorially independent publication supported by the Simons Foundation.

Keyword: Biological Rhythms; Evolution
Link ID: 29062 - Posted: 12.22.2023

Emily Baumgaertner This is not a work of art. It’s an image of microscopic blood flow in a rat’s brain, taken with one of many new tools that are yielding higher levels of detail in brain imaging. Here are seven more glorious images from neuroscience research → © 2023 The New York Times Company

Keyword: Brain imaging
Link ID: 29059 - Posted: 12.22.2023

By Ann Gibbons Louise hadn’t seen her sister or nephew for 26 years. Yet the moment she spotted them on a computer screen, she recognized them, staring hard at their faces. The feat might have been impressive enough for a human, but Louise is a bonobo—one who had spent most of her life at a separate sanctuary from these relatives. The discovery, published today in the Proceedings of the National Academy of Sciences, reveals that our closest primate cousins can remember the faces of friends and family for years, and sometimes even decades. The study, experts say, shows that the capability for long-term social memory is not unique to people, as was long believed. “It’s a remarkable finding,” says Frans de Waal, a primatologist at Emory University who was not involved with the work. “I’m not even sure we humans remember most individuals we haven’t seen for 2 decades.” The research, he says, raises the possibility that other animals can also do this and may remember far more than we give them credit for. Trying to figure out whether nonhuman primates remember a face isn’t simple. You can’t just ask them. So in the new study, comparative psychologist Christopher Krupenye at Johns Hopkins University and colleagues used eye trackers, infrared cameras that noninvasively map a subject’s gaze as they look at images of people or objects. The scientists worked with 26 chimpanzees and bonobos living in three zoos or sanctuaries in Europe and Japan. The team showed the animals photos of the faces of two apes placed side by side on the screen at the same time for 3 seconds. Some images were of complete strangers; some were of close friends, foes, or family members who had once lived in their same social groups, but whom they hadn’t seen in years.

Keyword: Attention; Learning & Memory
Link ID: 29058 - Posted: 12.19.2023

By Andrew Jacobs An autopsy report released by the Los Angeles County medical examiner on Friday said the death of “Friends” actor Matthew Perry, who was found face down and unresponsive in a hot tub at his home on Oct. 28, resulted from the “acute effects” of ketamine, an anesthetic with psychedelic properties. Ketamine has become increasingly popular as a therapy for treatment-resistant depression and other mental health issues. It is also used recreationally. Mr. Perry had publicly acknowledged his long struggle with alcohol and drug use, but the report said he had been sober for 19 months and little was known about his relationship to ketamine. What is ketamine, and is it legal? Ketamine is an injectable, short-acting dissociative anesthetic that can have hallucinogenic effects at certain doses. It distorts perceptions of sight and sound and makes users feel detached from pain and their surroundings. Developed as a battlefield anesthetic in the 1960s, ketamine has been legal since 1970 for use in both people and animals. It is frequently used as an anesthetic for children, especially in the developing world. But the psychiatric use of ketamine is still unapproved and unregulated, although it is increasingly used off label for treating depression, suicidal ideation and chronic pain In 2019, the Food and Drug Administration approved a derivative of ketamine called esketamine in a nasal spray for treatment-resistant depression. Ketamine has the potential for abuse, which may lead to moderate or low physical dependence or high psychological dependence, but experts consider it a safe medication. Those who use it recreationally often snort the drug in powder form or administer it intranasally by spray. © 2023 The New York Times Company

Keyword: Drug Abuse
Link ID: 29057 - Posted: 12.19.2023

Robin McKie, Science Editor People in Britain could benefit from a key medical breakthrough next year. They may be given access to the first drugs ever developed to slow the impact of Alzheimer’s disease. The first of these medicines – lecanemab – was recently approved in the US and Japan, where treatments using it have already been launched. A second drug, donanemab, is expected to follow soon, and next year it is anticipated that the UK medical authorities will consider both of them for approval in Britain. The prospect has raised hopes that, after years of effort, scientists may be closing in on ways to directly tackle the UK’s dementia crisis. About a million people are living with the condition in this country, and this is expected to rise to about 1.7 million by 2040 – with potentially grim consequences. Last year dementia took the lives of 66,000 people in England and Wales, and it is now the leading cause of death in Britain, with Alzheimer’s accounting for two-thirds of cases. Until now doctors have only been able to prescribe medicines that help patients manage their symptoms, so the arrival of the first drugs that treat the actual cause of the condition has been welcomed – although experts have warned that their use should be treated with some caution. “The new drugs slow down the development of Alzheimer’s by six months to a year and are useful only for those in the early stages of the condition, so they are certainly not miracle medicines,” said David Thomas, head of policy at Alzheimer’s Research UK. “However, after decades of research, they are the first to improve patients’ lives directly, and that is a justifiable cause for excitement. If nothing else, they suggest we are probably on the right road to tackling Alzheimer’s.” © 2023 Guardian News & Media Limited

Keyword: Alzheimers
Link ID: 29056 - Posted: 12.19.2023

By Mark MacNamara The notion of boxing as the “sweet science” is often thought to have been coined in 1956 by the great New Yorker writer A.J. Liebling. He used the term as the title of his definitive book on the sport, but he took it—with much appreciation—from a British sportswriter, Pierce Egan. In 1813, Egan wrote about the “sweet science of bruising” in his master work, Boxiana. The book is a collection of magazine pieces set in a bloody, bare-knuckled world opposite Jane Austen’s. As for the “sweet science,” no one ever really defines it. A carefully thrown knockout punch to a sweet spot on the chin is one possible derivation. There’s also the play on a science with so little apparent sweetness. But that’s not it. The sweet science Liebling and Egan describe had more to do with British principles of “stoic virtues,” “generosity,” and “true courage”—altogether, life in a contradictory place. It’s a square ring, after all, where sometimes hope transcends the specter of an awful inevitability. Or so I’ve come to think, on a journey I’ve begun in the past year, exploring how the sweet science can be used as a treatment for Parkinson’s disease—that increasingly common degenerative disorder of the nervous system, tied to a loss of the brain chemical dopamine, which is involved in movement, memory, motivation, and cognition. Someone told her she moved like a wavy wind sock outside a used car lot. “Exactly how I feel,” she said. In October 2022, a longtime tennis partner noticed something “strange” in my stride, along with a noisy shuffle. “Fatigue,” I replied with pique. The truth is I’m 75 and had known something might not be right for years, particularly the ominous hand tremors, as well as the night-of-the-living-dead gait and a facial expression to match. Add severe anxiety in public places and bizarre nightmares, some quite disturbing. © 2023 NautilusNext Inc.,

Keyword: Parkinsons
Link ID: 29055 - Posted: 12.19.2023

By Sandra G. Boodman His plane was coming in for a landing at Philadelphia International Airport when Allen M. Weiss, a marketing professor at the University of Southern California, felt a spasm of pain pierce his left cheek near his nose. “It was really weird,” recalled Weiss, then director of Mindful USC, a group of meditation-based programs at the Los Angeles university. “My face froze up.” Within minutes the pain disappeared and the final leg of Weiss’s December 2015 trip home to California was uneventful. But over the next few months the sensation recurred in the same spot. At first the unpredictable pain was fairly mild and merely bothersome; later it became an excruciating daily torment. Several years after the pain first occurred Weiss, who had consulted dentists, oral pain experts and an otolaryngologist, was given a diagnosis that ended up being correct. But his complicated medical history, a radiology report that failed to describe an important finding and a cryptic warning by one of his doctors delayed effective treatment for three more years. “It was completely confusing,” Weiss said. In June 2023 he underwent surgery that has significantly reduced his pain and improved the quality of his life. N. Nicole Moayeri, the Santa Barbara, Calif., neurosurgeon who operated on Weiss, said a protracted search for a diagnosis and treatment is not unusual for those suffering from Weiss’s uncommon malady. “I commonly see people who’ve had multiple dental procedures for years” when the problem was not in their mouths, Moayeri said. “It’s really shocking to me that so many people suffer” with this for so long. After three months of intermittent pain following the flight, Weiss consulted his internist. For reasons that are unclear, the doctor told Weiss the cause was probably psychological, not physical, and that it wasn’t serious. He sent Weiss to an ear, nose and throat specialist whom he saw in March 2016. She performed an exam and ordered a CT scan that revealed a deviated septum, a typically painless condition estimated to affect up to 80 percent of the population in which the bone or cartilage that divides the nostrils is off-center. A moderate or severe deviation can contribute to the development of sinus infections, headaches and breathing problems. But Weiss had none of these. And a deviated septum didn’t explain the spasms of pain.

Keyword: Pain & Touch
Link ID: 29054 - Posted: 12.19.2023

By Carl Zimmer Neanderthals were morning people, a new study suggests. And some humans today who like getting up early might credit genes they inherited from their Neanderthal ancestors. The new study compared DNA in living humans with genetic material retrieved from Neanderthal fossils. It turns out that Neanderthals carried some of the same clock-related genetic variants as do people who report being early risers. Since the 1990s, studies of Neanderthal DNA have exposed our species’ intertwined history. About 700,000 years ago, our lineages split apart, most likely in Africa. While the ancestors of modern humans largely stayed in Africa, the Neanderthal lineage migrated into Eurasia. About 400,000 years ago, the population split in two. The hominins who spread west became Neanderthals. Their cousins to the east evolved into a group known as Denisovans. The two groups lived for hundreds of thousands of years, hunting game and gathering plants, before disappearing from the fossil record about 40,000 years ago. By then, modern humans had expanded out of Africa, sometimes interbreeding with Neanderthals and Denisovans. And today, fragments of their DNA can be found in most living humans. Research carried out over the past few years by John Capra, a geneticist at the University of California, San Francisco, and other scientists suggested that some of those genes passed on a survival advantage. Immune genes inherited from Neanderthals and Denisovans, for example, might have protected them from new pathogens they had not encountered in Africa. Dr. Capra and his colleagues were intrigued to find that some of the genes from Neanderthals and Denisovans that became more common over generations were related to sleep. For their new study, published in the journal Genome Biology and Evolution, they investigated how these genes might have influenced the daily rhythms of the extinct hominins. © 2023 The New York Times Company

Keyword: Biological Rhythms; Evolution
Link ID: 29052 - Posted: 12.16.2023

By Joseph Howlett Garter snakes have something in common with elephants, orcas, and naked mole rats: They form social groups that center around females. The snakes have clear “communities” composed of individuals they prefer hanging out with, and females act as leaders that tie the groups together and guide their members’ movements, according to the most extensive field study of snake sociality ever carried out. “This is an important first step in understanding how a community of snakes is organized in the wild,” says Gordon Burghardt, an ecologist at the University of Tennessee, Knoxville, who was not involved in the research. Other experts agree: “This is a big deal,” says integrative biologist Robert Mason of Oregon State University. “It’s a whole new avenue of research that I don’t think people have really given any thought to.” Ecologists had long assumed snakes are antisocial loners that hang out together only for core functions such as mating and hibernation. However, in 2020, Morgan Skinner, a behavioral ecologist at Wilfrid Laurier University, and collaborators showed in laboratory experiments that captive garter snakes have “friends”—specific snakes whose company they prefer over others. Still, studies of wild snakes were lacking “because they’re so secretive and difficult to find,” Skinner says. Then he learned that the Ontario Ministry of Transportation had funded an unprecedented long-term study of a huge population of Butler’s garter snakes (Thamnophis butleri) in Windsor, Canada. Ecologists began to monitor the flute-size slitherers in 2009 to keep them safe from nearby road construction. They regularly captured snakes in the 250-hectare study area, using identifying markings to track more than 3000 individuals over a 12-year span—about the lifetime of a garter snake. “We were mainly monitoring the population after they were relocated, to make sure they were thriving,” says Megan Hazell, a biologist with the consulting firm WSP, who led the field research as a graduate student at Queen’s University.

Keyword: Evolution; Sexual Behavior
Link ID: 29050 - Posted: 12.16.2023

By Oshan Jarow Sometimes when I’m looking out across the northern meadow of Brooklyn’s Prospect Park, or even the concrete parking lot outside my office window, I wonder if someone like Shakespeare or Emily Dickinson could have taken in the same view and seen more. I don’t mean making out blurry details or more objects in the scene. But through the lens of their minds, could they encounter the exact same world as me and yet have a richer experience? One way to answer that question, at least as a thought experiment, could be to compare the electrical activity inside our brains while gazing out upon the same scene, and running some statistical analysis designed to actually tell us whose brain activity indicates more richness. But that’s just a loopy thought experiment, right? Not exactly. One of the newest frontiers in the science of the mind is the attempt to measure consciousness’s “complexity,” or how diverse and integrated electrical activity is across the brain. Philosophers and neuroscientists alike hypothesize that more complex brain activity signifies “richer” experiences. The idea of measuring complexity stems from information theory — a mathematical approach to understanding how information is stored, communicated, and processed —which doesn’t provide wonderfully intuitive examples of what more richness actually means. Unless you’re a computer person. “If you tried to upload the content onto a hard drive, it’s how much memory you’d need to be able to store the experience you’re having,” Adam Barrett, a professor of machine learning and data science at the University of Sussex, told me. Another approach to understanding richness is to look at how it changes in different mental states. Recent studies have found that measures of complexity are lowest in patients under general anesthesia, higher in ordinary wakefulness, and higher still in psychedelic trips, which can notoriously turn even the most mundane experiences — say, my view of the parking lot outside my office window — into profound and meaningful encounters.

Keyword: Consciousness
Link ID: 29049 - Posted: 12.16.2023

By Tosin Thompson Last month saw the first-ever approval of a gene therapy that uses the CRISPR–Cas9 gene-editing tool, a treatment for the blood conditions sickle-cell disease and β-thalassaemia that works by precisely cutting out a faulty gene in people’s stem cells. Now, researchers in search of new treatments for Alzheimer’s disease are hoping to deploy similar strategies against forms of the disease that are caused by genetic mutations. Although there are now some treatments that slow the progression of Alzheimer’s, these often don’t benefit people who are in the later stages or who have mutations that raise the risk of the disease. “CRISPR therapies could potentially be a one-and-done cure, which no other drug can match,” says Subhojit Roy, a neuroscientist at the University of California, San Diego. But he adds that there is a long way to go before these therapies could be deployed against such a complex condition. “Cutting and pasting a gene is much harder to do in the brain using current technology.” Alzheimer’s is the most common form of dementia, a health issue of global concern. More than 55 million people are affected by dementia, and this figure is projected to nearly triple by 2050. “We do not fully understand how the brain works, which makes the challenge of understanding and treating brain diseases like Alzheimer’s very difficult,” says Tara Spires-Jones, who studies neurodegeneration at the University of Edinburgh, UK. Much of Alzheimer’s research is driven by the amyloid hypothesis, the idea that the build-up of amyloid-β proteins in the brain, which eventually form clumps called plaques, is the main cause of the disease. Amyloid plaques trigger another brain protein, called tau, to clump together and spread inside neurons. It is usually well into this process that symptoms such as memory loss start to appear. Usually, the more tau is present, the more severe the symptoms are. © 2023 Springer Nature Limited

Keyword: Alzheimers; Genes & Behavior
Link ID: 29046 - Posted: 12.13.2023

By Gina Kolata Dr. Edward Lewis, a pediatrician in Rochester, N.Y., has seen hundreds of children with obesity over the years in his medical practice. He finally may have a treatment for their medical condition — the powerful weight loss drug Wegovy. But that does not mean Dr. Lewis is prescribing it. Nor are most other pediatricians. “I am reluctant to prescribe medications we don’t use on a day-to-day basis,” Dr. Lewis said. And, he added, he is disinclined to use “a medicine that is a relative newcomer to the scene in kids.” Regulators and medical groups have all said that these drugs are appropriate for children as young as 12. But like Dr. Lewis, many pediatricians hesitate to prescribe Wegovy to young people, fearful that too little is known about long term effects, and mindful of past cases when problems emerged years after a drug was approved. Twenty-two percent of adolescents age 12 to 19 have obesity. Research shows that most are unlikely to ever overcome the condition — advice to diet and exercise usually has not helped. The reason, obesity researchers say, is that obesity is not caused by a lack of will power. Instead, it is a chronic disease characterized by an overwhelming desire to eat. Of particular concern to doctors are the 6 percent of children and adolescents with severe obesity, which is defined as having a body mass index at or above 120 percent of the 95th percentile for height and weight. “We are not talking about kids who are mildly overweight,” said Susan Yanovski, co-director of the office of obesity research at the National Institute of Diabetes and Digestive and Kidney Diseases. Such extreme obesity in adolescents, she said, often has “a really severe course.” These teenagers develop diabetes, heart disease, high blood pressure, kidney failure and eye damage much earlier than adults with obesity. “It is terrifying,” Dr. Yanovski added. The seriousness of health outcomes for obese teenagers motivated the American Academy of Pediatrics to recommend weight loss drugs like Wegovy for adolescents in January, after the Food and Drug Administration approved it for people age 12 and older. When that happened, experts in obesity medicine were elated, knowing full well the scope of the problem. “We said, Wow, we finally have something we can offer,” Dr. Yanovski said. Still, drugs like Wegovy are new, and the impediments to using them are snowballing. Doctors also worry about the dearth of data on long-term safety. And those who want to prescribe Wegovy say that they are beset by roadblocks put up by health insurers along with severe and continuing drug shortages. © 2023 The New York Times Company

Keyword: Obesity
Link ID: 29044 - Posted: 12.13.2023

By Yasemin Saplakoglu Erin Calipari comes from a basketball family. Her father, John Calipari, has coached college and professional basketball since 1998, leading six teams to the NCAA Final Four, and her brother coaches men’s basketball at Vanderbilt University in Nashville, Tennessee, where she now works. But when she joined her college team as an undergraduate, she realized her strengths lay elsewhere. “I was fine. I wasn’t great,” she said. “It was pretty clear to me a couple years in that it was not a career path.” Off the court, as a biology major she gravitated toward hormones and neurotransmitters. She grew fascinated with the neurobiology of how and why drugs such as cocaine and opioids are addictive, as she learned about the effects of ecstasy on the serotonin system. “I thought drugs were so cool because they hijack the brain,” she said. “Drugs essentially take the normal systems we have in our body and drive them in a way that makes you want to take drugs again.” After pursuing graduate work in neuroscience, in 2017 Calipari set up her lab at Vanderbilt to explore how addiction is connected to the ways the brain learns and makes decisions. “Deciding what to do and what not to do is really fundamental to everything we do,” Calipari said. “You put your hand on a hot stove, you learn really quickly not to do that again.” Addiction can diminish a person’s ability to learn that drug use is hurting them, and also their ability to learn anything at all. Her world still collides with sports, for instance when she gives talks to athletes about the dangers of substance use. Athletes can be vulnerable to addiction when they are prescribed pain medicines, such as opioids, for injuries. There is a risk of dependence if opioids are taken for long periods of time, even when patients follow doctors’ orders — a fact that has led to a nationwide public health emergency. Tennessee is an epicenter of the opioid epidemic. In 2022, Nashville had the second-highest rate of overdose deaths in the country. All Rights Reserved © 2023

Keyword: Drug Abuse
Link ID: 29039 - Posted: 12.09.2023

By Amitha Kalaichandran In May, I was invited to take part in a survey by the National Academies of Sciences, Engineering, and Medicine to better delineate how long Covid is described and diagnosed as part of The National Research Action Plan on Long Covid. The survey had several questions around definitions and criteria to include, such as “brain fog” often experienced by those with long Covid. My intuition piqued, and I began to wonder about the similarities between these neurological symptoms and those experienced by people with attention-deficit/hyperactivity disorder, or ADHD. As a medical journalist with clinical and epidemiological experience, I found the possible connection and its implications impossible to ignore. We know that three years of potential exposure to SARS-CoV-2, in combination with the shift in social patterns (including work-from-home and social isolation), has impacted several aspects of neurocognition, as detailed in a recent report from the Substance Abuse and Mental Health Services Administration. A 2021 systematic review found persistent neuropsychiatric symptoms in Covid-19 survivors, and a 2021 paper in the journal JAMA Network Open found that executive functioning, processing speed, memory, and recall were impacted in patients hospitalized with Covid-19. Long Covid may indeed be linked to developing chronic neurocognitive issues, and even dementia may be accelerated. The virus might impact the frontal lobe, the area that governs executive function — which involves how we make decisions and plan, use our working memory, and control impulses. In October, a paper in Cell reported that long Covid brain fog could be traced to serotonin depletion driven by immune system proteins called viral-associated interferons. Similarly, the symptoms of attention-deficit/hyperactivity disorder, or ADHD, are believed to be rooted structurally in the frontal lobe and possibly from a naturally low level of the neurotransmitter dopamine, with contributions from norepinephrine, serotonin, and GABA. This helps explain why people with ADHD, who experience inattention, hyperactivity, and impulsivity, among other symptoms, may seek higher levels of stimulation: to activate the release of dopamine. However, a deficit in serotonin can also trigger ADHD. The same neurotransmitter, when depleted, may be responsible for brain fog in long Covid.

Keyword: ADHD
Link ID: 29038 - Posted: 12.09.2023

By Amanda Gefter On a February morning in 1935, a disoriented homing pigeon flew into the open window of an unoccupied room at the Hotel New Yorker. It had a band around its leg, but where it came from, or was meant to be headed, no one could say. While management debated what to do, a maid rushed to the 33rd floor and knocked at the door of the hotel’s most infamous denizen: Nikola Tesla. The 78-year-old inventor quickly volunteered to take in the homeless pigeon. “Dr. Tesla … dropped work on a new electrical project, lest his charge require some little attention,” reported The New York Times. “The man who recently announced the discovery of an electrical death-beam, powerful enough to destroy 10,000 airplanes at a swoop, carefully spread towels on his window ledge and set down a little cup of seed.” Nikola Tesla—the Serbian-American scientist famous for designing the alternating current motor and the Tesla coil—had, for years, regularly been spotted skulking through the nighttime streets of midtown Manhattan, feeding the birds at all hours. In the dark, he’d sound a low whistle, and from the gloom, hordes of pigeons would flock to the old man, perching on his outstretched arms. He was known to keep baskets in his room as nests, along with caches of homemade seed mix, and to leave his windows perpetually open so the birds could come and go. Once, he was arrested for trying to lasso an injured homing pigeon in the plaza of St. Patrick’s Cathedral, and, from his holding cell in the 34th Street precinct, had to convince the officers that he was—or had been—one of the most famous inventors in the world. It had been years since he’d produced a successful invention. He was gaunt and broke—living off of debt and good graces—having been kicked out of a string of hotels, a trail of pigeon droppings and unpaid rent in his wake. He had no family or close friends, except for the birds. © 2023 NautilusNext Inc.,

Keyword: Consciousness
Link ID: 29034 - Posted: 12.09.2023