Medicine

Where Did Ivermectin Come From and Why Are Americans Taking It To Try and Treat COVID-19? (wfaa.com) 676

Ivermectin is making the rounds again online after Joe Rogan casually mentioned he took the drug after testing positive for COVID-19. Some researchers claim it helps treat symptoms of the virus; others, including the U.S. Food and Drug Administration (FDA), have yet to make that determination. "While there are approved uses for ivermectin in people and animals, it is not approved for the prevention or treatment of COVID-19," the FDA says in a FAQ.

So where did this drug come from and why have people been using it to try and treat COVID-19? WFAA, an ABC-affiliated television station licensed to Dallas, Texas, helps answer those questions: In the 1970s, Japanese biochemist Satoshi Omura discovered the avermectin family of compounds, which are a series of drugs used to treat parasites and insect pests. Ivermectin is one of these drugs. Ivermectin has a mixture of carbon, hydrogen and oxygen. It was modified and first introduced as medicine in 1981. It soon became registered around the world to treat parasitic worms in cattle, sheep, and other animals. It can be taken as a pill or applied to the skin depending on why it's needed.

By 1988, ivermectin was approved as a medical treatment in humans. This "wonder drug," as many called it, was prescribed to treat illnesses, which include head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis, and lymphatic filariasis. Since its discovery, ivermectin has been used by more than 700 million people in the world specifically to treat river blindness and lymphatic filariasis, according to a National Institutes of Health study.

A medical study led by Dr. Ahmed Elgazzar in Egypt was published in November 2020. It said that hospitalized patients with COVID-19 who received this antiparasitic drug improved more quickly and had a better chance of staying alive. It was retracted in July. Multiple medical agencies -- including the Centers for Disease Control (CDC), Food and Drug Administration (FDA) and National Institutes of Health (NIH) -- have been unable to find any evidence this drug helps with COVID-19. The CDC put out a press release in August, making clear that ivermectin is not authorized or approved by the FDA for the prevention or treatment of COVID-19. In that same CDC press release, health experts also warned about the dangers that can come from taking ivermectin incorrectly.

Science

Your Sense of Smell May Be the Key To a Balanced Diet (phys.org) 38

Scientists at Northwestern University found that people became less sensitive to food odors based on the meal they had eaten just before. These findings show that just as smell regulates what we eat, what we eat -- in turn -- regulates our sense of smell. Phys.Org reports: The study found that participants who had just eaten a meal of either cinnamon buns or pizza were less likely to perceive "meal-matched" odors, but not non-matched odors. The findings were then corroborated with brain scans that showed brain activity in parts of the brain that process odors was altered in a similar way.

Feedback between food intake and the olfactory system may have an evolutionary benefit, said senior and corresponding study author Thorsten Kahnt, an assistant professor of neurology and psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. "If you think about our ancestors roaming the forest trying to find food, they find and eat berries and then aren't as sensitive to the smell of berries anymore," Kahnt said. "But maybe they're still sensitive to the smell of mushrooms, so it could theoretically help facilitate diversity in food and nutrient intake."

Kahnt said while we don't see the hunter-gatherer adaptation come out in day-to-day decision-making, the connection between our nose, what we seek out and what we can detect with our nose may still be very important. If the nose isn't working right, for example, the feedback loop may be disrupted, leading to problems with disordered eating and obesity. There may even be links to disrupted sleep, another tie to the olfactory system the Kahnt lab is researching. Kahnt said with a better understanding of the feedback loop between smell and food intake, he's hoping to take the project full circle back to sleep deprivation to see if lack of sleep may impair the loop in some way. He added that with brain imaging, there are more questions about how the adaptation may impact sensory and decision-making circuits in the brain.
The study has been published in the journal PLOS Biology.
Medicine

First US COVID Deaths Came Earlier Than Previously Thought (mercurynews.com) 128

An anonymous reader quotes a report from The Mercury News, written by Harriet Blair Rowan: In a significant twist that could reshape our understanding of the early days of the coronavirus pandemic, death records now indicate the first COVID-related deaths in California and across the country occurred in January 2020, weeks earlier than originally thought and before officials knew the virus was circulating here. A half dozen death certificates from that month in six different states -- California, Alabama, Georgia, Kansas, Oklahoma and Wisconsin -- have been quietly amended to list COVID-19 as a contributing factor, suggesting the virus's deadly path quickly reached far beyond coastal regions that were the country's early known hotspots. Up until now, the Feb. 6, 2020, death of San Jose's Patricia Dowd had been considered the country's first coronavirus fatality, although where and how she was infected remains unknown.

Even less is known about what are now believed to be the country's earliest victims of the pandemic. The Bay Area News Group discovered evidence of them in provisional coronavirus death counts of the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS) -- widely considered the definitive source for death data in the United States -- and confirmed the information through interviews with state and federal public health officials. But amid privacy concerns and fierce debate over pandemic policies, the names, precise locations and circumstances behind these deaths have not been publicly revealed. That is frustrating to some experts.

The existence of January 2020 deaths would dramatically revise the timeline of COVID's arrival in the United States. China first announced a mysterious viral pneumonia in late December 2019, and reported the first death from the illness on Jan. 9, 2020. The U.S. originally recorded its first case in mid-January when a traveler tested positive after returning from Wuhan, China. The first deaths reported in the United States, in late February, were also tied to travel. In its current death count, which reflects the six newly-discovered fatalities, the NCHS now lists the country's first COVID death during the week of Jan. 5-11 -- the first full week of 2020. The agency is in the final stages of preparing its 2020 annual mortality report, a review and analysis of all deaths in the United States last year.

Science

How Fructose In the Diet Contributes To Obesity (sciencedaily.com) 154

An anonymous reader quotes a report from ScienceDaily: Eating fructose appears to alter cells in the digestive tract in a way that enables it to take in more nutrients, according to a preclinical study from investigators at Weill Cornell Medicine and NewYork-Presbyterian. These changes could help to explain the well-known link between rising fructose consumption around the world and increased rates of obesity and certain cancers. The research, published August 18 in Nature, focused on the effect of a high-fructose diet on villi, the thin, hairlike structures that line the inside of the small intestine. Villi expand the surface area of the gut and help the body to absorb nutrients, including dietary fats, from food as it passes through the digestive tract. The study found that mice that were fed diets that included fructose had villi that were 25 percent to 40 percent longer than those of mice that were not fed fructose. Additionally, the increase in villus length was associated with increased nutrient absorption, weight gain and fat accumulation in the animals.

After observing that the villi were longer, the team wanted to determine whether those villi were functioning differently. So they put mice into three groups: a normal low-fat diet, a high-fat diet, and a high-fat diet with added fructose. Not only did the mice in the third group develop longer villi, but they became more obese than the mice receiving the high-fat diet without fructose. The researchers took a closer look at the changes in metabolism and found that a specific metabolite of fructose, called fructose-1-phosphate, was accumulating at high levels. This metabolite interacted with a glucose-metabolizing enzyme called pyruvate kinase, to alter cell metabolism and promote villus survival and elongation. When pyruvate kinase or the enzyme that makes fructose-1-phospate were removed, fructose had no effect on villus length. Previous animal studies have suggested that this metabolite of fructose also aids in tumor growth.
From an evolutionary standpoint, the findings make sense. "In mammals, especially hibernating mammals in temperate climates, you have fructose being very available in the fall months when the fruit is ripe," said one of the researchers. "Eating a lot of fructose may help these animals to absorb and convert more nutrients to fat, which they need to get through the winter."

Humans, on the other hand, did not evolve to eat the amount of fructose they consume now.
Medicine

COVID-19 Vaccines May Trigger Superimmunity In People Who Had SARS Long Ago (sciencemag.org) 133

sciencehabit shares a report from Science Magazine: Almost 20 years before SARS-CoV-2, a related and even more lethal coronavirus sowed panic, killing nearly 10% of the 8000 people who became infected. But the 2003 outbreak of severe acute respiratory syndrome (SARS) may have left some survivors with a gift. Former SARS patients who have been vaccinated against COVID-19 appear able to fend off all variants of SARS-CoV-2 in circulation, as well as ones that may soon emerge, a new study suggests. Their formidable antibodies may even protect against coronaviruses in other species that have yet to make the jump into humans -- and may hold clues to how to make a so-called pancoronavirus vaccine that could forestall future outbreaks.

A team led by emerging disease specialist Linfa Wang from Duke-NUS Medical School in Singapore identified eight SARS survivors who recently received two shots of a messenger RNA COVID-19 vaccine. In the test tube, antibodies sieved from their blood potently "neutralized" an early strain of SARS-CoV-2 as well as SARS-CoV, the virus that caused SARS, Wang and colleagues report today in The New England Journal of Medicine. The team further found these neutralizing antibodies worked well against the Alpha, Beta, and Delta variants of SARS-CoV-2 and stymied five related coronaviruses found in bats and pangolins that potentially could infect humans.

Medicine

WHO Expert 'Had Concerns' About Lab Close To 1st COVID Cases (apnews.com) 166

When a World Health Organization-led team traveled to China earlier this year to investigate the origins of the COVID-19 pandemic, a top official said he was worried about safety standards at a laboratory close to the seafood market where the first human cases were detected, according to a documentary released Thursday by Danish television channel TV2. The Associated Press reports: The Wuhan branch of the Chinese Center for Disease Control and Prevention was handling coronaviruses "without potentially having the same level of expertise or safety or who knows," Peter Ben Embarek said during a conference call in January, according to footage shown by TV2. Ben Embarek is a WHO expert on disease transmission from animals to humans and one of the team's leaders. But months later, when WHO released its dense report on its mission to Wuhan, the U.N. health agency concluded that a leak of the virus from the lab was "extremely unlikely" to have caused COVID-19. The WHO report even lent credence to a fringe theory promoted by the Chinese government that the virus may have been spread via frozen seafood packaging.

In recent weeks, however, WHO chief Tedros Adhanom Ghebreyesus has acknowledged it was "premature" to rule out a possible lab leak as the source of COVID-19, saying last month that he was asking China to be more transparent about the early days of the pandemic. "I was a lab technician myself. I'm an immunologist and I have worked in the lab and lab accidents happen," Tedros said. "It's common." In the Danish TV2 documentary, the WHO's Ben Embarek is pictured arriving in China, inspecting the stalls at the Huanan seafood market in Wuhan and examining what he hypothesizes might have been living quarters for people who handled live animals there -- raising the possibility that the virus may have jumped from animals to people at the market. "It would mean that the contact between the human beings and whatever may have been in the market i.e. virus and maybe live animals would have been more intense," Ben Embarek said. "It goes without saying that the close contact would be doubled many times between humans and animals if you are among them around the clock."

The Danish documentary also featured Ben Embarek expressing his worries in January about the Wuhan branch of the Chinese CDC, concerns that have never been publicly disclosed by WHO. While numerous experts have questioned whether there might have been a lab accident at the Wuhan Institute of Virology -- where scientists were studying coronaviruses -- there has been less interest in another nearby facility. "What is more concerning to me is the other lab," Ben Embarek said. "The one that is next to the market," he explained, referring to the Wuhan branch of the Chinese CDC, located just 500 meters (547 yards) away from the Huanan market. In a June interview, Ben Embarek told TV2 that the possibility of a lab staffer being infected with the coronavirus while collecting bat samples was "likely."

Science

Retracted COVID Paper Lives on in New Citations (medpagetoday.com) 66

Researchers around the world have continued breathing new life into a retracted study, which suggested that common antihypertensive medications were harmful in patients with COVID-19. From a report: Published online on May 1, 2020 in the New England Journal of Medicine, the study relied on Surgisphere data to claim an association between renin-angiotensin-aldosterone system (RAAS) inhibitor therapy and worse outcomes in hospitalized COVID-19 patients with cardiovascular disease. The journal retracted the paper due to concerns about fraudulent data on June 4, 2020 in a widely publicized move, but the study has continued to rack up citations -- totaling at least 652 as of May 31, 2021, reported Todd Lee, MD, MPH, of McGill University in Montreal, and colleagues.

Just 17.6% of verified citations acknowledged or noted that the paper was retracted, according to their research letter published in JAMA Internal Medicine. In May of this year alone -- 11 months after the article was retracted -- it was referenced 21 times. "Our findings challenge authors, peer reviewers, journal editors, and academic institutions to do a better job of addressing the broader issues of ongoing citations of retracted scientific studies and protecting the integrity of the medical literature," Lee's group urged. The hypothesis that angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) may be harmful in patients with COVID-19 has been floated since the early days of the pandemic, with the reasoning being that since the SARS-CoV-2 virus enters human cells through ACE2 receptors, upregulation of these receptors could put patients at risk.

AI

Hundreds of AI Tools Were Built to Catch Covid. None of Them Helped (technologyreview.com) 108

At the start of the pandemic, remembers MIT Technology Review's senior editor for AI, the community "rushed to develop software that many believed would allow hospitals to diagnose or triage patients faster, bringing much-needed support to the front lines — in theory.

"In the end, many hundreds of predictive tools were developed. None of them made a real difference, and some were potentially harmful." That's the damning conclusion of multiple studies published in the last few months. In June, the Turing Institute, the UK's national center for data science and AI, put out a report summing up discussions at a series of workshops it held in late 2020. The clear consensus was that AI tools had made little, if any, impact in the fight against covid.

This echoes the results of two major studies that assessed hundreds of predictive tools developed last year. Laure Wynants, an epidemiologist at Maastricht University in the Netherlands who studies predictive tools, is lead author of one of them, a review in the British Medical Journal that is still being updated as new tools are released and existing ones tested. She and her colleagues have looked at 232 algorithms for diagnosing patients or predicting how sick those with the disease might get. They found that none of them were fit for clinical use. Just two have been singled out as being promising enough for future testing. "It's shocking," says Wynants. "I went into it with some worries, but this exceeded my fears."

Wynants's study is backed up by another large review carried out by Derek Driggs, a machine-learning researcher at the University of Cambridge, and his colleagues, and published in Nature Machine Intelligence. This team zoomed in on deep-learning models for diagnosing covid and predicting patient risk from medical images, such as chest x-rays and chest computer tomography (CT) scans. They looked at 415 published tools and, like Wynants and her colleagues, concluded that none were fit for clinical use. "This pandemic was a big test for AI and medicine," says Driggs, who is himself working on a machine-learning tool to help doctors during the pandemic. "It would have gone a long way to getting the public on our side," he says. "But I don't think we passed that test...."

If there's an upside, it is that the pandemic has made it clear to many researchers that the way AI tools are built needs to change. "The pandemic has put problems in the spotlight that we've been dragging along for some time," says Wynants.

The article suggests researchers collaborate on creating high-quality (and shared) data sets — possibly by creating a common data standard — and also disclose their ultimate models and training protocols for review and extension. "In a sense, this is an old problem with research. Academic researchers have few career incentives to share work or validate existing results.

"To address this issue, the World Health Organization is considering an emergency data-sharing contract that would kick in during international health crises."
Medicine

'The War Has Changed': Internal CDC Document Urges New Messaging, Warns Delta Infections Likely More Severe (washingtonpost.com) 422

Yasmeen Abutaleb, Carolyn Y. Johnson, and Joel Achenbach, reporting at Washington Post: The delta variant of the coronavirus appears to cause more severe illness than earlier variants and spreads as easily as chickenpox, according to an internal federal health document that argues officials must "acknowledge the war has changed." The document is an internal Centers for Disease Control and Prevention slide presentation, shared within the CDC and obtained by The Washington Post. It captures the struggle of the nation's top public health agency to persuade the public to embrace vaccination and prevention measures, including mask-wearing, as cases surge across the United States and new research suggests vaccinated people can spread the virus.

The document strikes an urgent note, revealing the agency knows it must revamp its public messaging to emphasize vaccination as the best defense against a variant so contagious that it acts almost like a different novel virus, leaping from target to target more swiftly than Ebola or the common cold. It cites a combination of recently obtained, still-unpublished data from outbreak investigations and outside studies showing that vaccinated individuals infected with delta may be able to transmit the virus as easily as those who are unvaccinated. Vaccinated people infected with delta have measurable viral loads similar to those who are unvaccinated and infected with the variant.

"I finished reading it significantly more concerned than when I began," Robert Wachter, chairman of the Department of Medicine at the University of California at San Francisco, wrote in an email. CDC scientists were so alarmed by the new research that the agency earlier this week significantly changed guidance for vaccinated people even before making new data public. The data and studies cited in the document played a key role in revamped recommendations that call for everyone -- vaccinated or not -- to wear masks indoors in public settings in certain circumstances, a federal health official said.

Medicine

39-Year-Old Becomes First US Patient To Receive 'Aeson' Artificial Heart Implant (sciencealert.com) 25

An anonymous reader quotes a report from ScienceAlert: [A] team of surgeons has successfully completed the first human implantation in the US of an artificial heart device called the 'Aeson', developed by French company CARMAT. The artificial heart has two ventricular chambers and four biological valves, just like the real organ, and is powered by an external device. Made from "biocompatible materials" including bovine tissue, the artificial heart uses a combination of sensors and algorithms to maintain its pace and keep blood circulating through the body. "We are encouraged that our patient is doing so well after the procedure," says cardiologist Carmelo Milano from the Duke University School of Medicine. "As we evaluate this device, we are both excited and hopeful that patients who otherwise have few to no options could have a lifeline."

The patient in question is 39-year-old Matthew Moore, from Shallotte in North Carolina. Moore was initially due to have heart bypass surgery, but as his condition deteriorated the medical staff started to run out of options; he became so ill that even a regular heart transplant was too risky. Fortunately, he was in the right place: the Aeson device is being tested at Duke University, pending approval from the US Food and Drug Administration (FDA). It's already been given the green light for use by regulators in Europe, after several years of tests in European patients, not all of which have been successful. The artificial heart has been developed specifically to help those whose hearts can no longer pump enough blood through both chambers. It replaces the entire natural heart, although it's not intended to be permanent -- it's designed to be a bridge towards a full heart transplant within six months or so.

Government

CIA Director Says He Is Escalating Efforts To Solve 'Havana Syndrome' Mystery (npr.org) 67

CIA Director William Burns says he has redoubled the agency's efforts to uncover the cause of Havana syndrome -- the mysterious set of ailments that has afflicted more than 200 U.S. officials and family members around the world. NPR reports: That includes the assignment of a senior officer who once led the hunt for Osama bin Laden to lead the investigation and tripling the size of a medical team involved in the probe, Burns told NPR on Thursday in his first sit-down interview since being confirmed as the agency's chief in March. "I am absolutely determined -- and I've spent a great deal of time and energy on this in the four months that I've been CIA director -- to get to the bottom of the question of what and who caused this," Burns said. "We're no longer the only big kid on the geopolitical block, especially with the rise of China. And as you know very well, there's a revolution in technology which is transforming the way we live, work, compete and fight. And so, CIA, like everyone else in the U.S. government, has to take that into account," he said.

Under Burns' direction, the CIA has tripled the number of full-time medical personnel at the agency who are focused on Havana syndrome and has shortened the waiting period for afflicted personnel to be admitted to the Walter Reed National Military Medical Center. "I'm certainly persuaded that what our officers and some family members, as well as other U.S. government employees, have experienced is real, and it's serious," Burns said. The director says he is seriously considering the "very strong possibility" that the syndrome is the result of intentional actions, adding that there are a limited number of "potential suspects" with the capability to carry out an action so widely across the globe. A report from last December by the National Academies of Sciences, Engineering, and Medicine found that microwave radiation is the "most plausible" explanation for the symptoms.

To head the task force investigating the syndrome, Burns has appointed a veteran officer who helped lead the hunt for Osama bin Laden. The identity of that officer is still undercover, according to The Wall Street Journal. "We're throwing the very best we have at this issue, because it is not only a very serious issue for our colleagues, as it is for others across the U.S. government, but it's a profound obligation, I think, of any leader to take care of your people," Burns said.
The syndrome first appeared in 2016 at the U.S. Embassy in Havana, where more than 40 diplomats complained of symptoms such as migraines, dizziness, and memory loss. Dozens more cases have been reported in the years since.

Last week, about two dozen U.S. intelligence officers, diplomats, and other government officials in Vienna have reported experiencing mysterious afflictions similar to the Havana Syndrome." The Biden administration is "vigorously investigating" the reports, but the causes of the syndrome still remain unclear.
AI

AI Firm DeepMind Puts Database of the Building Blocks of Life Online (theguardian.com) 19

Last year the artificial intelligence group DeepMind cracked a mystery that has flummoxed scientists for decades: stripping bare the structure of proteins, the building blocks of life. Now, having amassed a database of nearly all human protein structures, the company is making the resource available online free for researchers to use. From a report: The key to understanding our basic biological machinery is its architecture. The chains of amino acids that comprise proteins twist and turn to make the most confounding of 3D shapes. It is this elaborate form that explains protein function; from enzymes that are crucial to metabolism to antibodies that fight infectious attacks. Despite years of onerous and expensive lab work that began in the 1950s, scientists have only decoded the structure of a fraction of human proteins.

DeepMind's AI program, AlphaFold, has predicted the structure of nearly all 20,000 proteins expressed by humans. In an independent benchmark test that compared predictions to known structures, the system was able to predict the shape of a protein to a good standard 95% of time. DeepMind, which has partnered with the European Molecular Biology Laboratory's European Bioinformatics Institute (EMBL-EBI), hopes the database will help researchers to analyse how life works at an atomic scale by unpacking the apparatus that drives some diseases, make strides in the field of personalised medicine, create more nutritious crops and develop "green enzymes" that can break down plastic.

Medicine

Influential Ivermectin Study Accused of 'Totally Faked' Data (theguardian.com) 217

"The efficacy of a drug being promoted by rightwing figures worldwide for treating Covid-19 is in serious doubt," reports the Guardian, "after a major study suggesting the treatment is effective against the virus was withdrawn due to 'ethical concerns'." The preprint study on the efficacy and safety of ivermectin — a drug used against parasites such as worms and headlice — in treating Covid-19, led by Dr Ahmed Elgazzar from Benha University in Egypt, was published on the Research Square website in November. It claimed to be a randomised control trial, a type of study crucial in medicine because it is considered to provide the most reliable evidence on the effectiveness of interventions due to the minimal risk of confounding factors influencing the results...

A medical student in London, Jack Lawrence, was among the first to identify serious concerns about the paper, leading to the retraction... He found the introduction section of the paper appeared to have been almost entirely plagiarised. It appeared that the authors had run entire paragraphs from press releases and websites about ivermectin and Covid-19 through a thesaurus to change key words. "Humorously, this led to them changing 'severe acute respiratory syndrome' to 'extreme intense respiratory syndrome' on one occasion," Lawrence said.

The data also looked suspicious to Lawrence... "In their paper, the authors claim that four out of 100 patients died in their standard treatment group for mild and moderate Covid-19," Lawrence said. "According to the original data, the number was 0, the same as the ivermectin treatment group. In their ivermectin treatment group for severe Covid-19, the authors claim two patients died, but the number in their raw data is four..." Lawrence contacted an Australian chronic disease epidemiologist from the University of Wollongong, Gideon Meyerowitz-Katz, and a data analyst affiliated with Linnaeus University in Sweden who reviews scientific papers for errors, Nick Brown, for help analysing the data and study results more thoroughly... "The main error is that at least 79 of the patient records are obvious clones of other records," Brown told the Guardian. "It's certainly the hardest to explain away as innocent error, especially since the clones aren't even pure copies. There are signs that they have tried to change one or two fields to make them look more natural..."

Meyerowitz-Katz told the Guardian that "this is one of the biggest ivermectin studies out there", and it appeared to him the data was "just totally faked".

Meta-analyses incorporating the "just totally faked" data were then published in Oxford Academic's Open Forum Infectious Diseases and in the American Journal of Therapeutics.

Meanwhile, the Guardian also notes a new (and peer-reviewed) paper that was just published last month in the journal Clinical Infectious Diseases. Its finding? Iermectin is "not a viable option to treat COVID-19 patients".
Medicine

Brain Signals Converted Into Words 'Speak' For Person With Paralysis (sciencemag.org) 24

sciencehabit shares a report from Science Magazine: A man unable to speak after a stroke has produced sentences through a system that reads electrical signals from speech production areas of his brain, researchers report this week. The approach has previously been used in non-disabled volunteers to reconstruct spoken or imagined sentences, but this is the first demonstration of its potential in the type of patient it's intended to help. The participant had a stroke more than 10 years ago that left him with anarthria -- an inability to control the muscles involved in speech. Researchers used a computational model known as a deep-learning algorithm to interpret patterns of brain activity in the sensorimotor cortex, a brain region involved in producing speech, and 'decoded' sentences he attempted to read aloud.

In the new study, [the researchers] temporarily removed a portion of the participant's skull and laid a thin sheet of electrodes smaller than a credit card directly over his sensorimotor cortex. To "train" a computer algorithm to associate brain activity patterns with the onset of speech and with particular words, the team needed reliable information about what the man intended to say and when. So the researchers repeatedly presented one of 50 words on a screen and asked the man to attempt to say it on cue. Once the algorithm was trained with data from the individual word task, the man tried to read sentences built from the same set of 50 words, such as "Bring my glasses, please." To improve the algorithm's guesses, the researchers added a processing component called a natural language model, which uses common word sequences to predict the likely next word in a sentence. With that approach, the system only got about 25% of the words in a sentence wrong, they report today in The New England Journal of Medicine. With the new approach, the man could produce sentences at a rate of up to 18 words per minute.

Medicine

HIV Vaccine Trial Starts at Oxford (ox.ac.uk) 124

The University of Oxford this week started vaccinations of a novel HIV vaccine candidate as part of a Phase I clinical trial in the UK. From a report: The goal of the trial, known as HIV-CORE 0052, is to evaluate the safety, tolerability, and immunogenicity of the HIVconsvX vaccine -- a mosaic vaccine targeting a broad range of HIV-1 variants, making it potentially applicable for HIV strains in any geographical region. Thirteen healthy, HIV-negative adults, aged 18-65 and who are considered not to be at high risk of infection, will initially receive one dose of the vaccine followed by a further booster dose at four weeks. The trial is part of the European Aids Vaccine Initiative (EAVI2020), an internationally collaborative research project funded by the European Commission under Horizon 2020 health programme for research and innovation.

Professor Tomas Hanke, Professor of Vaccine Immunology at the Jenner Institute, University of Oxford, and lead researcher on the trial, said: 'An effective HIV vaccine has been elusive for 40 years. This trial is the first in a series of evaluations of this novel vaccine strategy in both HIV-negative individuals for prevention and in people living with HIV for cure.' While most HIV vaccine candidates work by inducing antibodies generated by B-cells, HIVconsvX induces the immune system's potent, pathogen obliterating T cells, targeting them to highly conserved and therefore vulnerable regions of HIV -- an "Achilles heel" common to most HIV variants.

Medicine

COVID Vaccines To Reach Poorest Countries in 2023 -- Despite Recent Pledges (nature.com) 164

Most people in the poorest countries will need to wait another two years before they are vaccinated against COVID-19, researchers have told Nature. From a report: Around 11 billion doses are needed to fully vaccinate 70% of the world's population against COVID-19. As of 4 July, 3.2 billion doses had been administered. At the current vaccination rate, this will increase to around six billion doses by the end of the year, researchers from the International Monetary Fund, based in Washington DC, project. But so far, more than 80% of the doses have gone to people in high-income and upper-middle-income countries. Only 1% of people in low-income countries have been given at least one dose, according to the website Our World in Data.

Last month, the leaders of the G7 group of wealthy nations pledged extra doses for low- and middle-income countries (LMICs) by the end of 2022, at a summit in Cornwall, UK. The centrepiece was a promise from US President Joe Biden to donate 500 million doses of the vaccine made by pharmaceutical company Pfizer of New York City and biotechnology company BioNTech in Mainz, Germany. This is in addition to 87.5 million previously pledged. The United Kingdom pledged 100 million, and France, Germany and Japan have pledged around 30 million each.

Medicine

As Delta Variant Surges, Outbreaks Return in Many Parts of the World (nytimes.com) 363

The highly contagious Delta variant is on the rise, and countries that hoped they had seen the worst of Covid-19 are being battered again. From a report: The nightmare is returning. In Indonesia, grave diggers are working into the night, as oxygen and vaccines are in short supply. In Europe, countries are slamming their doors shut once again, with quarantines and travel bans. In Bangladesh, urban garment workers fleeing an impending lockdown are almost assuredly seeding another coronavirus surge in their impoverished home villages. And in countries like South Korea and Israel that seemed to have largely vanquished the virus, new clusters of disease have proliferated. Chinese health officials announced on Monday that they would build a giant quarantine center with up to 5,000 rooms to hold international travelers. Australia has ordered millions to stay at home.

A year and a half since it began racing across the globe with exponential efficiency, the pandemic is on the rise again in vast stretches of the world, driven largely by the new variants, particularly the highly contagious Delta variant first identified in India. From Africa to Asia, countries are suffering from record Covid-19 caseloads and deaths, even as wealthier nations with high vaccination rates have let their guard down, dispensing with mask mandates and reveling in life edging back toward normalcy. Scientists believe the Delta variant may be twice as transmissible as the original coronavirus, and its potential to infect some partially vaccinated people has alarmed public health officials.

Medicine

Mixing Covid Vaccines Gives Good Protection, Study Suggests (bbc.com) 49

A mix-and-match approach to Covid vaccines -- using different brands of jab for first and second doses -- gives good protection against the pandemic virus, a UK study has found. From a report: The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system. This knowledge could offer flexibility for vaccine rollout, say experts. The trial results also hint that people who have already received two doses of AstraZeneca vaccine could have a stronger immune response if they were given a different jab as a booster if recommended in the autumn. The UK's deputy chief medical officer, Prof Jonathan Van-Tam, said there was no reason to change the current successful same dose vaccine schedules in the UK, however, given vaccines were in good supply and saving lives. But he says it might be something to look at in the future: "Mixing doses could provide us with even greater flexibility for a booster programme, while also supporting countries who have further to go with their vaccine rollouts, and who may be experiencing supply difficulties."
Medicine

Ivermectin To Be Studied As Possible COVID-19 Treatment In UK (bbc.com) 86

University of Oxford scientists are trialing giving Ivermectin to people with Covid symptoms to see if it can keep them out of hospital. The BBC reports: The Principle study will compare those given the drug to patients receiving the usual NHS care. The drug has become controversial after being promoted for use across Latin America and in South Africa, despite being so far unproven. Previous studies of Ivermectin have generally been small or low quality. Most commonly used to treat parasitic infections such as river blindness, spread by flies, Ivermectin has also been shown to kill viruses in petri dishes in the lab -- although, at much higher doses than would usually be prescribed to people.

Dr Aurora Baluja, an anaesthesiologist and critical care doctor, said Ivermectin was often being given in parts of the world where there are high incidences of parasitic infections. Covid patients who are also fighting a parasitic disease at the same time would be likely to fare worse and that might explains some of its seemingly positive effect. Though there have been some early "promising" results from small and observational studies, Principle joint chief investigator Prof Richard Hobbs said it would be "premature" to recommend Ivermectin for Covid. [...] The Oxford team said they had selected Ivermectin to be included in the trial because it was "readily available globally" and known to be relatively safe (although, like most things, it can be toxic at very high doses). People aged 18-64 with an underlying health condition or experiencing breathlessness, and anyone aged 65 or over, can sign up to the Principle study within 14 days of having Covid symptoms or receiving a positive test.
"All in all, though, the most compelling reports of ivermectin's effects seem to come from the smallest and least controlled samples (all the way down to anecdotal results) while the larger and more well-controlled trials tend to produce equivocal evidence at best," writes Derek Lowe, a medical chemist working in the pharmaceutical industry. "My current opinion is pretty much exactly that of the WHO guidance: I do not think that the current evidence is strong enough to say that ivermectin is a useful therapy for coronavirus patients. I know that there are quite a few studies out there in the literature, but they suffer from various combinations of small sample size, poor trial design, not enough data reported, and (in many cases) inconclusive statistics."

Should people on their deathbeds be allowed to try anything to save themselves? Should the entire world be allowed to practice self-care on a grand scale? These are some of the questions American author, journalist, and podcaster Matt Taibbi poses in an article via Substack. He argues that ivermectin "has become hostage to a larger global fight between populists and anti-populists."

UPDATE (2/18/2021): CNN reports "The antiparasitic drug ivermectin doesn't prevent severe disease from Covid-19 any more effectively than symptom management and close observation by medical professionals, according to a study published Friday in the journal JAMA Internal Medicine." In fact, slightly more patients in the ivermectin group went on to need extra oxygen compared with those who took a placebo, though the difference was not statistically significant.... [T]hey also looked at whether patients needed to be hospitalized, had to go on a ventilator, needed intensive care or died from their infections. There was no meaningful difference in outcomes between the group that took ivermectin and those who got the placebo treatment.

It was a randomized-controlled trial, the gold standard of medical research, in which researchers test an intervention against a placebo....

In addition to the fact that ivermectin didn't work, people who took it had more side effects than those who didn't, and sometimes those side effects were severe, including heart attacks, anemia and diarrhea that led to shock.

Medicine

Blood Test That Finds 50 Types of Cancer Is Accurate Enough To Be Rolled Out (theguardian.com) 32

A simple blood test that can detect more than 50 types of cancer before any clinical signs or symptoms of the disease emerge in a person is accurate enough to be rolled out as a screening test, according to scientists. The Guardian reports: The test, which is also being piloted by NHS England in the autumn, is aimed at people at higher risk of the disease including patients aged 50 or older. It is able to identify many types of the disease that are difficult to diagnose in the early stages such as head and neck, ovarian, pancreatic, esophageal and some blood cancers. Scientists said their findings, published in the journal Annals of Oncology, show that the test accurately detects cancer often before any signs or symptoms appear, while having a very low false positive rate.

The test, developed by US-based company Grail, looks for chemical changes in fragments of genetic code "cell-free DNA (cfDNA)" that leak from tumors into the bloodstream. The Guardian first reported on the test last year and how it had been developed using a machine learning algorithm a type of artificial intelligence. It works by examining the DNA that is shed by tumors and found circulating in the blood. More specifically, it focuses on chemical changes to this DNA, known as methylation patterns. Now the latest study has revealed the test has an impressively high level of accuracy. Scientists analyzed the performance of the test in 2,823 people with the disease and 1,254 people without. It correctly identified when cancer was present in 51.5% of cases, across all stages of the disease, and wrongly detected cancer in only 0.5% of cases.

In solid tumors that do not have any screening options "such as esophageal, liver and pancreatic cancers" the ability to generate a positive test result was twice as high (65.6%) as that for solid tumors that do have screening options such as breast, bowel, cervical and prostate cancers. Meanwhile, the overall ability to generate a positive test result in cancers of the blood, such as lymphoma and myeloma, was 55.1%. The test correctly also identified the tissue in which the cancer was located in the body in 88.7% of cases.

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