An algorithm determining which Stanford Medicine employees would receive its 5,000 initial doses of the COVID-19 vaccine included just seven medical residents / fellows on the list, according to a December 17th letter sent from Stanford Medicine's chief resident council. The Verge reports: Stanford Medicine leadership has since apologized and promised to re-evaluate the plan. "We take complete responsibility for the errors in the execution of our vaccine distribution plan," a Stanford Medicine spokesperson said in a statement to The Verge. "Our intent was to develop an ethical and equitable process for distribution of the vaccine. We apologize to our entire community, including our residents, fellows, and other frontline care providers, who have performed heroically during our pandemic response. We are immediately revising our plan to better sequence the distribution of the vaccine." The residents' letter also alleges that the error in the algorithm was found on Tuesday but that leadership opted not to make changes to the plan ahead of its December 17th release.

The initial plan led to demonstrations from medical staff in addition to the letter sent by the chief resident council. Here's how the algorithm reportedly worked, according to NPR: "According to an email sent by a chief resident to other residents, Stanford's leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents apparently did not have an assigned location, and along with their typically young age, they were dropped low on the priority list."

Following a 2018 study demonstrating how disrupted sleep can accelerate the buildup of toxic plaques associated with the disease, scientists from Washington University School of Medicine (WUSM) in St. Louis have now identified a protein implicated in the progression of the disease that appears highly regulated by the circadian rhythm, helping them join the dots and providing a potential new therapeutic target. New Atlas reports: In their previous research, the WUSM team set out to explore how disruptions to our natural sleep cycles, or circadian rhythm, may accelerate the accumulation of amyloid plaques in the brain, which are strongly linked to Alzheimer's disease. Through studies on humans and in mice, the team was able to show a strong correlation between the two, and now through follow up work, the team has identified a brain protein that appears to play a role in this relationship. The brain protein in question is called YKL-40 and for years has served as a biomarker for Alzheimer's, as high levels of it have been found in the cerebrospinal fluid of those suffering from the disease and these levels rise as the disease progresses. The researchers were screening for genes that are regulated by the circadian rhythm, and were intrigued to see the gene for this brain protein pop up.

From there, the team investigated this connection between YKL-40 and Alzheimer's, which is characterized by chronic inflammation, by exploring how much of the protein is made under inflammatory conditions both with and without a key circadian gene. Indeed, this demonstrated that the circadian rhythm controls how much YKL-40 is produced. Next up, the team worked with mice prone to developing amyloid plaques, and genetically modified one group of them to be lacking the gene for YKL-40. As the mice reached old age, the team analyzed their brains and found that those without the YKL-40 protein exhibited around half the amyloid plaques of the control group.

Digging deeper into the reasons why, the team found that the mice lacking the YKL-40 gene featured more microglia, which are immune cells that surround amyloid plaques and prevent them from spreading. Essentially, this meant that those mice had more hungry immune cells prepared to gobble up the amyloid. [...] The team also examined this idea in human subjects, drawing on genetic data on 778 subjects from aging and dementia studies and finding only a quarter of them featured a genetic variant that lowers levels of YKL-40, and that cognitive function declined 16 percent more slowly in that group. The research was published in the journal Science Translational Medicine.

An anonymous reader shares an article that's part of the Future Agenda, a series from Slate in which experts suggest specific, forward-looking actions the new Biden administration should implement. Here's an excerpt: Consumers in the U.S. face an infuriating lack of transparency when it comes to purchasing broadband services. Bills are convoluted, featuring complex pricing schemes. Roughly 7 in 10 U.S. adults surveyed by Consumer Reports who have used a cable, internet, or phone service provider in the past two years said they experienced unexpected or hidden fees. Unsurprisingly, 96 percent of those who had experienced hidden fees found them annoying. (To the other 4 percent: Are you OK?) We've been here before. In 1990, a similar crisis of consumer confidence prompted one Cabinet secretary to decry that "as consumers shop they encounter confusion and frustration." He said the market had become "a Tower of Babel, and consumers need to be linguists, scientists and mind readers to understand the many labels they see." While this diagnosis could apply almost word-for-word to today's broadband market, then-Secretary of Health and Human Services Louis W. Sullivan was talking about the grocery store. The solution then offers a ready-made formula for how the incoming Biden administration can help consumers now: add a label.

Before regulatory changes in the late 1980s and early 1990s culminating in the 1994 adoption of the now-iconic Nutrition Facts panel, consumers were faced with a variety of hard-to-understand food labels peddling often-misleading information. While labels were required to list calories, serving sizes, and other nutritional information, including such a label was voluntary except when a company made nutritional claims about a food (such as "low in fat" or "high in vitamins"), or a food contained added nutrients. Without standards for what nutritional claims actually meant, and with no uniform nutrition label with which to compare products, consumers were left to decipher labels that were, according to the nonprofit Institute of Medicine, "at best, confusing and, at worst, deceptive economically and potentially harmful." Today, it's difficult to imagine not having the ability to read straightforward facts about the nutrition content of our food and comparison shop between competing products.

The same could be true for broadband. As far back as 2010, our organization has been advocating for the adoption of a broadband nutrition label. In fact, labeling is such a common-sense measure that it has been adopted in the broadband context before. In 2016, the FCC and the Consumer Financial Protection Bureau together rolled out their version of the "broadband nutrition label." "Broadband Facts" resembles Nutrition Facts, emulating a disclosure method the American public is already familiar with. It breaks down a plan's cost and performance, including all additional fees and taxes, so that people don't have to dig through complicated terms of service and contracts to find simple information.

Salesforce today peeled back the curtains on ReceptorNet, a machine learning system researchers at the company developed in partnership with clinicians at the University of Southern California's Lawrence J. Ellison Institute for Transformative Medicine of USC. From a report: The system, which can determine a critical biomarker for oncologists when deciding on the appropriate treatment for breast cancer patients, achieved 92% accuracy in a study published in the journal Nature Communications. Breast cancer affects more than 2 million women each year, with around one in eight women in the U.S. developing the disease over the course of their lifetime. In 2018 in the U.S. alone, there were also 2,550 new cases of breast cancer in men. And rates of breast cancer are increasing in nearly every region around the world.

In an effort to address this, Salesforce researchers developed an algorithm -- the aforementioned ReceptorNet -- that can predict hormone-receptor status from inexpensive and ubiquitous images of tissue. Typically, breast cancer cells extracted during a biopsy or surgery are tested to see if they contain proteins that act as estrogen or progesterone receptors. (When the hormones estrogen and progesterone attach to these receptors, they fuel the cancer growth.) But these types of biopsy images are less widely available and require a pathologist to review. In contrast to the immunohistochemistry process favored by clinicians, which requires a microscope and tends to be expensive and not readily available in parts of the world, ReceptorNet determines hormone receptor status via hematoxylin and eosin (H&E) staining, which takes into account the shape, size, and structure of cells. Salesforce researchers trained the system on several thousand H&E image slides from cancer patients in "dozens" of hospitals around the world.

Britain's medicine regulator warned people with significant allergies not to get Pfizer-BioNTech's COVID-19 vaccine after two people suffered adverse reactions, but was set to give more detailed guidance on Wednesday based on reviews of those cases. Reuters reports: Starting with the elderly and frontline workers, Britain began mass vaccinating its population on Tuesday, part of a global drive that poses one of the biggest logistical challenges in peacetime history. National Health Service medical director Stephen Powis said the advice had been changed as a precaution after two NHS workers reported anaphylactoid reactions from the vaccine. "Two people with a history of significant allergic reactions responded adversely yesterday," Powis said. "Both are recovering well."

The Medicines and Healthcare Products Regulatory Agency (MHRA) initially advised anyone with "a history of a significant allergic reaction to a vaccine, medicine or food" to avoid taking the vaccine. However, by the end of Wednesday that guidance was set to be refined after discussions with experts on the nature of the reactions. "We're tweaking advice to make it very clear that if you've got a food allergy, you're not more at risk," Imperial College London's Paul Turner, an expert in allergy and immunology who has been advising the MHRA on their revised guidance, told Reuters. Pfizer and BioNTech said they were supporting the MHRA's investigation. In other vaccine-related news, the European Medicines Agency (EMA), the EU regulatory body in charge of approving COVID-19 vaccines, said today it was the victim of a cyberattack.

An anonymous reader quotes a report from New Atlas: A first-of-its-kind exploratory study, led by researchers from Yale School of Medicine, has found a single dose of the psychedelic psilocybin can reduce migraine frequency by 50 percent for a least two weeks. The preliminary trial was small, with follow-up work necessary to validate the results, but the promising findings suggest great potential for psychedelics to treat migraines and cluster headaches.

A new study, published in the journal Neurotherapeutics, is offering the first double-blind, placebo-controlled, cross-over study on the effects of a moderate psilocybin dose on migraine frequency and severity. The research is only preliminary and small but its results are deeply encouraging. Ten migraine sufferers were recruited for the trial. Each subject completed two sessions, one with a placebo and one with a moderate psilocybin dose. Headache diaries were used to track headache frequency and severity in the two weeks leading up to, and following, each experimental session. "Compared to placebo, a single administration of psilocybin reduced migraine frequency by about half over the two weeks measured," explains corresponding author on the new study Emmanuelle Schindler, in an email to New Atlas. "In addition, when migraine attacks did occur in those two weeks, pain intensity and functional impairment during attacks were reduced by approximately 30 percent each."

Perhaps the most intriguing finding from this small study was the lack of any correlation between the subjective strength of the psychedelic experience and the therapeutic effect. Prior trials using psilocybin to treat depression or addiction have suggested the overwhelming magnitude of a psychedelic experience seems to be fundamentally entwined with its therapeutic efficacy. So essentially, the more powerful the experience the better the result. But unexpectedly, this migraine/psilocybin trial did not detect that association. In fact, those subjects reporting the highest scores on a self-reported altered state of consciousness scale showed some of the smaller reductions in migraine burden. What this intriguingly suggests is that, in the case of psilocybin for migraine, it may be possible to separate out the drug's psychotropic effects from its therapeutic effects. This could be achieved either by exploring microdoses and sub-hallucinogenic doses, or even homing in on the mechanism by which the drug is helping prevent migraines and finding a new way to pharmacologically target it.

In some of the most remote and impoverished corners of the world, where respiratory illnesses abound and trained medical professionals fear to tread, diagnosis is increasingly powered by artificial intelligence and the internet. From a report: In less than a minute, a new app on a phone or a computer can scan an X-ray for signs of tuberculosis, Covid-19 and 27 other conditions. TB, the most deadly infectious disease in the world, claimed nearly 1.4 million lives last year. The app, called qXR, is one of many A.I.-based tools that have emerged over the past few years for screening and diagnosing TB. The tools offer hope of flagging the disease early and cutting the cost of unnecessary lab tests. Used at large scale, they may also spot emerging clusters of disease.

"Among all of the applications of A.I., I think digitally interpreting an image using an algorithm instead of a human radiologist is probably furthest along," said Madhukar Pai, the director of the McGill International TB Center in Montreal. Artificial intelligence cannot replace clinicians, Dr. Pai and other experts cautioned. But the combination of A.I. and clinical expertise is proving to be powerful. "The machine plus clinician is better than the clinician, and it's also better than machine alone," said Dr. Eric Topol, the director of the Scripps Research Translational Institute in San Diego and the author of a book on the use of A.I. in medicine. In India, where roughly one-quarter of the world's TB cases occur, an app that can flag the disease in remote locations is urgently needed.

Ars Technica glimpsed a possible future at the Johns Hopkins University Applied Physics Laboratory: a solar simulator "that can shine with the intensity of 20 Suns..."

"They think it could be the key to interstellar exploration." "It's really easy for someone to dismiss the idea and say, 'On the back of an envelope, it looks great, but if you actually build it, you're never going to get those theoretical numbers,'" says Benkoski, a materials scientist at the Applied Physics Laboratory and the leader of the team working on a solar thermal propulsion system. "What this is showing is that solar thermal propulsion is not just a fantasy. It could actually work."

In 2019, NASA tapped the Applied Physics Laboratory to study concepts for a dedicated interstellar mission. At the end of next year, the team will submit its research to the National Academies of Sciences, Engineering, and Medicine's Heliophysics decadal survey, which determines Sun-related science priorities for the next 10 years... In mid-November, [APL's] Interstellar Probe researchers met online for a weeklong conference to share updates as the study enters its final year. At the conference, teams from APL and NASA shared the results of their work on solar thermal propulsion, which they believe is the fastest way to get a probe into interstellar space.

The idea is to power a rocket engine with heat from the Sun, rather than combustion. According to Benkoski's calculations, this engine would be around three times more efficient than the best conventional chemical engines available today. "From a physics standpoint, it's hard for me to imagine anything that's going to beat solar thermal propulsion in terms of efficiency," says Benkoski. "But can you keep it from exploding...?" If the interstellar probe makes a close pass by the Sun and pushes hydrogen into its shield's vasculature, the hydrogen will expand and explode from a nozzle at the end of the pipe. The heat shield will generate thrust. It's simple in theory but incredibly hard in practice.

A solar thermal rocket is only effective if it can pull off an Oberth maneuver, an orbital-mechanics hack that turns the Sun into a giant slingshot. The Sun's gravity acts like a force multiplier that dramatically increases the craft's speed if a spacecraft fires its engines as it loops around the star... The big takeaway from his research, says Dean Cheikh, a materials technologist at NASAâ(TM)s Jet Propulsion Laboratory, is there's a lot of testing that needs to be done on heat shield materials before a solar thermal rocket is sent around the Sun. But it's not a deal-breaker. "Additive manufacturing is a key component of this, and we couldn't do that 20 years ago. Now I can 3D-print metal in the lab."

America's Food and Drug Administration granted emergency authorization Saturday to an experimental antibody treatment (for people already experiencing Covid-19), reports the Washington Post: The drug, made by Regeneron Pharmaceuticals, is designed to prevent infected people from developing severe illness. Instead of waiting for the body to develop its own protective immune response, the drug imitates the body's natural defenses. It is the second drug of this type — called a monoclonal antibody — to be cleared for treating covid-19. The FDA authorized Eli Lilly & Co.'s drug on Nov. 9.

Regeneron's drug is a cocktail of two monoclonal antibodies, called casirivimab and imdevimab. The FDA said in authorizing the cocktail that it may be effective in treating mild to moderate covid-19 in adults and children 12 or older, and is indicated for those at high risk of developing severe illness. Doctors hope the drugs will keep those patients from being hospitalized... Regeneron executives said on the company's earnings call in early November that they project having enough doses for 80,000 patients by the end of November, and 300,000 total doses by the end of January...

In a clinical trial, the Regeneron drug reduced hospitalizations or emergency room visits when given to people at high risk of developing severe disease. It was also shown to reduce the amount of virus in people's bodies... The safety and effectiveness of the drug will continue to be studied. It is not authorized for use in hospitalized patients... In a study published Oct. 28 in the New England Journal of Medicine, researchers said the Lilly cocktail lowered the risk of follow-up medical visits and reduced levels of virus in people with mild to moderate symptoms of covid-19.

The progress on monoclonal antibodies comes as pharmaceutical and biotech companies are racing to produce coronavirus vaccines... The antibody treatments can play an important role in making the disease less dangerous.

"I think the overwhelming body of evidence suggests that masks are effective," the lead author of a study recently cited by America's Center for Disease Control told the Washington Post.

They were responding to another (very controversial) outlier study whose findings "conflict with those from a number of other studies," according to the New York Times, citing numerous experts. "Critics were quick to note [that] study's limitations, among them that the design depended heavily on participants reporting their own test results and behavior, at a time when both mask-wearing and infection were rare in Denmark."

The Washington Post reports: In the large, randomized study published Wednesday in the Annals of Internal Medicine, researchers observed more than 6,000 people in Denmark from April to June when mask-wearing was not required in the country. Fewer people in the group that was advised to wear masks contracted the virus — or about a 14 percent reduced risk because of mask-wearing — but the difference was not statistically significant, indicating that the medical masks issued were not particularly effective at preventing the wearers from being infected. Other experts, however, argue that the study was conducted when there was relatively less community spread of the virus and that testing the participants' antibodies cannot reliably measure whether they had the virus during the time of the study.

"We think you should wear a face mask at least to protect yourself, but you should also use it to protect others," lead author Henning Bundgaard told The Washington Post. "We consider that the conclusion is we should wear face masks." Bundgaard said even the small risk reduction masks offer "is very important, considering it is a life-threatening disease..."

"Because the issue has become so politicized, there's a real risk — and it's already being used in this way — that studies like this will be sort of cherry-picked and presented as conclusive evidence that masks are completely ineffective," Columbia University virologist Angela Rasmussen said... In letters and blog posts, public health experts express concern about the design of the study and warn that policymakers could misinterpret the research to mean that masks are ineffective. "However, the more accurate translation is that this study is uninformative regarding the benefits (or lack thereof) of wearing masks outside of the healthcare setting," one letter states. "As such, we caution decision-makers and the media from interpreting the results of this trial as being anything other than artifacts of weak design."
Even the Denmark study itself acknowledged its own limitations, citing "Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others."

And it also acknowledges large gaps in adherence to proper mask usage among its participants: "Based on the lowest adherence reported in the mask group during follow-up, 46% of participants wore the mask as recommended, 47% predominantly as recommended, and 7% not as recommended."

The Post notes that America's Center for Disease Control reiterated that people do benefit from wearing a mask that can filter out virus-carrying droplets, and last week "cited multiple studies evaluating mechanical evidence that concluded masks can block certain respiratory particles, depending on the material of the mask..."

Amazon is making its biggest push into the healthcare industry yet with the launch today of Amazon Pharmacy: a new service offering home delivery for prescription medication. From a report: Customers can sign up to the new store by creating a "secure pharmacy profile," with the option of adding information about their health insurance, any outstanding medical issues like allergies, and any regular prescriptions. The store will offer a range of "generic and brand-name drugs," reports CNBC, including "commonly prescribed drugs like insulin, triamcinolone steroid creams, metformin for controlling blood sugar, and sumatriptan for migraines." Notably, the pharmacy will not sell Schedule II medications, which includes many common opioids like Oxycontin. As usual for Amazon, Prime members will get a number of advantages over regular customers. These perks include free, two-day delivery on orders and discounts on medication. Amazon claims Prime members will be able to save "up to 80 percent off generic and 40 percent off brand name medications when paying without insurance." Prime members will also be able to save on medication bought in person from over 50,000 pharmacies across the US, including Rite Aid, CVS, Walmart, and Walgreens.

An anonymous reader quotes a report from The Guardian: More than 1 billion people could be immunized against coronavirus by the end of next year with shots from the first two companies to reveal positive results, after the latest vaccine was shown to be nearly 95% effective in trials. With the US's top infectious diseases official, Anthony Fauci, hailing "the light at the end of the tunnel", the US biotech firm Moderna announced impressive results for its mRNA vaccine on Monday, a week after interim results for a Pfizer/BioNTech vaccine showed 90% effectiveness.

The inclusion of high-risk and elderly people in the Moderna trial suggested the vaccine would protect those most vulnerable to the disease, said Peter Openshaw, a professor of experimental medicine at Imperial College London, who described the results as "tremendously exciting." Though it is more expensive, Moderna's vaccine could potentially provide a major advantage over Pfizer's, which requires ultracold freezing between -70C (-94F) and -80C from production facility to patient. Moderna said it had improved the shelf life and stability, meaning its vaccine can be stored for six months at -20C for shipping and long-term storage, and at standard refrigeration temperatures of 2C to 8C for 30 days. Moderna said it could potentially manufacture 1bn doses by the end of 2021, adding to a further 1.3bn from Pfizer/BioNTech in the same timeframe. Both vaccines require two doses and are due to be assessed by regulators in coming weeks. Moderna is planning to apply to the FDA for emergency use authorization in the coming weeks. "The biotech company said it would have 20 million doses ready to ship in the U.S. before the end of 2020 and hoped to manufacture 500 million to 1 billion doses globally next year," reports The Guardian. It's not expected to be available outside the U.S. until next year.

Can algorithms identify unusual medication orders or profiles more accurately than humans? Not necessarily. From a report: A study coauthored by researchers at the Universite Laval and CHU Sainte-Justine in Montreal found that one model physicians used to screen patients performed poorly on some orders. The study offers a reminder that unvetted AI and machine learning may negatively impact outcomes in medicine. Pharmacists review lists of active medications -- i.e., pharmacological profiles -- for inpatients under their care. This process aims to identify medications that could be abused, but most medication orders don't show drug-related problems. Publications from over a decade ago illustrate technology's potential to help pharmacists streamline workflows by taking on tasks like reviewing orders. But while more recent research has investigated AI's potential in pharmacology, few studies have demonstrated its efficacy. The coauthors of this latest work looked at a model deployed in a tertiary-care mother-and-child academic hospital between April 2020 and August 2020. The model was trained on a dataset of 2,846,502 medication orders from 2005 to 2018. These had been extracted from a pharmacy database and preprocessed into 1,063,173 profiles. Prior to data collection, the model was retrained every month with 10 years of the most recent data from the database in order to minimize drift, which occurs when a model loses its predictive power.

Scientists from MIT have developed a new AI model that can detect COVID-19 from a simple forced cough. ScienceAlert reports: Evidence shows that the AI can spot differences in coughing that can't be heard with the human ear, and if the detection system can be incorporated into a device like a smartphone, the research team thinks it could become a useful early screening tool. The work builds on research that was already happening into Alzheimer's detection through coughing and talking. Once the pandemic started to spread, the team turned its attention to COVID-19 instead, tapping into what had already been learned about how disease can cause very small changes to speech and the other noises we make.

The Alzheimer's research repurposed for COVID-19 involved a neural network known as ResNet50. It was trained on a thousand hours of human speech, then on a dataset of words spoken in different emotional states, and then on a database of coughs to spot changes in lung and respiratory performance. When the three models were combined, a layer of noise was used to filter out stronger coughs from weaker ones. Across around 2,500 captured cough recordings of people confirmed to have COVID-19, the AI correctly identified 97.1 percent of them -- and 100 percent of the asymptomatic cases.

That's an impressive result, but there's more work to do yet. The researchers emphasize that its main value lies in spotting the difference between healthy coughs and unhealthy coughs in asymptomatic people -- not in actually diagnosing COVID-19, which a proper test would be required for. In other words, it's an early warning system. The researchers now want to test the engine on a more diverse set of data, and see if there are other factors involved in reaching such an impressively high detection rate. If it does make it to the phone app stage, there are obviously going to be privacy implications too, as few of us will want our devices constantly listening out for signs of ill health. The research has been published in the IEEE Open Journal of Engineering in Medicine and Biology.

You may have noticed a rash of provocative headlines this week suggesting that mouthwash can "inactivate" coronaviruses and help curb their spread. While the news is based on a new study from researchers at the Penn State College of Medicine, it's important to note that the study focused on a coronavirus that causes common colds -- not the one that causes COVID-19. "Not only did the study not investigate this deadly new virus, but it also did not test whether mouthwash affects how viruses spread from person to person," adds Katherine J. Wu via The New York Times. From the report: "I don't have a problem with using Listerine," said Angela Rasmussen, a virologist at Columbia University. "But it's not an antiviral." The study, which was published last month in the Journal of Medical Virology, looked only at a coronavirus called 229E that causes common colds -- not the new coronavirus, which goes by the formal name of SARS-CoV-2, and causes far more serious disease. Researchers can study SARS-CoV-2 only in high-security labs after undergoing rigorous training. The two viruses are in the same family, and, in broad strokes, look anatomically similar, which can make 229E a good proxy for SARS-CoV-2 in certain experiments. But the two viruses shouldn't be thought of as interchangeable, Dr. Rasmussen said.

The researchers tested the virus-destroying effects of several products, including a watered-down mixture of Johnson's baby shampoo -- which is sometimes used to flush out the inside of the nose -- and mouthwashes made by Listerine, Crest, Orajel, Equate and C.V.S. They flooded 229E coronaviruses, which had been grown in human liver cells in the lab, with these chemicals for 30 seconds, 1 minute or 2 minutes -- longer than the typical swig or spritz into a nose or mouth. Around 90 to 99 percent of the viruses could no longer infect cells after this exposure, the study found.

But because the study didn't recruit any human volunteers to gargle the products in question, the findings have limited value for the real world, other experts said. The human mouth, full of nooks and crannies and a slurry of chemicals secreted by a diverse cadre of cells, is far more complicated than the inside of a laboratory dish. Nothing should be considered conclusive "unless human studies are performed," said Dr. Maricar Malinis, an infectious disease expert at Yale University. [...] Even if people did a very thorough job coating the inside of their mouths or noses with a coronavirus-killing chemical, a substantial amount of the virus would still remain in the body. The new coronavirus infiltrates not only the mouth and nose, but also the deep throat and lungs, where mouthwash and nasal washes hopefully never enter. Viruses that have already hidden away inside cells will also be shielded from the fast-acting chemicals found in these products.

The Covid-19 treatment remdesivir has no substantial effect on a patient's chances of survival [Editor's note: the link may be paywalled; alternative source], a clinical trial by the World Health Organization has found, delivering a significant blow to hopes of identifying existing medicines to treat the disease. From a report: Results from the WHO's highly anticipated Solidarity trial, which studied the effects of remdesivir and three other potential drug regimens in 11,266 hospitalised patients, found that none of the treatments "substantially affected mortality" or reduced the need to ventilate patients, according to a copy of the study seen by the Financial Times. "These remdesivir, hydroxychloroquine, lopinavir and interferon regimens appeared to have little effect on in-hospital mortality," the study found. The results of the WHO trial also showed that the drugs had little effect on how long patients stayed in hospital. However, WHO researchers said the study was primarily designed to assess impact on in-hospital mortality. The study has not yet been peer-reviewed. Remdesivir was one of a series of drugs used to treat US President Donald Trump after he tested positive for Covid-19. It was developed by US drugmaker Gilead Sciences, initially as a potential medicine to treat Ebola.

A network of scientists is chasing the pandemic's holy grail: an antibody that protects against not just the virus, but also related pathogens that may threaten humans. From a report: Dozens of companies and academic groups are racing to develop antibody therapies. Already Regeneron and the drug company Eli Lilly have requested emergency use authorizations for their products from the Food and Drug Administration. These drug companies have the long experience and deep pockets needed to win the race for a powerful antibody treatment. But some scientists are betting on a dark horse: Prometheus, a ragtag group of scientists who are months behind in the competition -- and yet may ultimately deliver the most powerful antibody. Prometheus is a collaboration between academic labs, the United States Army Medical Research Institute of Infectious Diseases, and a New Hampshire-based antibody company called Adimab. The group's antibody is not expected to be in human trials until late December, but it may be worth the wait. Unlike the antibodies made by Regeneron and Eli Lilly, which fade in the body within weeks, Prometheus's antibody aims to be effective for up to six months. "A single dose goes a long way, meaning we can treat more people," said Kartik Chandran, a virologist at Albert Einstein College of Medicine and the group's leader.

A research fellow at the University of Oxford's Wellcome Centre for Ethics and Humanities writes in Scientific American: How would you feel about a new therapy for your chronic pain, which — although far more effective than any available alternative — might also change your religious beliefs? Or a treatment for lymphoma that brings one in three patients into remission, but also made them more likely to vote for your least preferred political party?

These seem like idle hypothetical questions about impossible side effects. After all, this is not how medicine works. But a new mental health treatment, set to be licensed next year, poses just this sort of problem. Psychotherapy assisted by psilocybin, the psychedelic compound in "magic mushrooms," seems to be remarkably effective in treating a wide range of psychopathologies, but also causes a raft of unusual nonclinical changes not seen elsewhere in medicine...

[E]merging evidence suggests the relationship could be causal, with clinically administered psilocybin actively shifting political values, just as it shifts many other nonclinical characteristics. Notably, one study of psilocybin for treatment-resistant depression reported that the treatment decreased authoritarian political views in patients. That clinical trial also detected another effect that had previously been reported in healthy participants: psilocybin use leads to increases in the personality domain of openness, itself a predictor of liberal values... With sample sizes currently small, more research is needed to understand whether there truly is a causal relationship at work, and, if so, what its nature might be. Perhaps psilocybin doesn't so much induce liberal values, but rather consolidates whatever values were present before treatment. A health care modality that entrenches preexisting political sentiments is, at the least, unlikely to make enemies.

The same could not be said of a treatment that shifts patients in one direction along the political spectrum.

BishopBerkeley writes: In another first, the editors of the The New England Journal of Medicine (NEJM) endorse Joe Biden by stating that the current government needs to be fired. Although they don't mention any names, the editors of the NEJM state in shockingly forceful and accusatory language that the current administration is totally incompetent and does not deserve to keep its job. The editorial, somberly titled "Dying in a Leadership Vacuum" bases its opinion on some dispiriting statistics:

"The magnitude of this failure is astonishing. According to the Johns Hopkins Center for Systems Science and Engineering, the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China. The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000. Covid-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly."

The Administration's extreme rhetoric and extreme actions are earning extreme reactions. Last month, Scientific American broke a 175-year tradition of not endorsing a presidential candidate by throwing their support behind Joe Biden. "We'd love to stay out of politics, but this president has been so anti-science that we can't ignore it," editor in chief, Laura Helmuth told The Washington Post.

The editor in chief of Science Magazine also denounced Trump, but stopped short of endorsing presidential candidate Joe Biden.

Scientists have shown shocking the tongue -- combined with a carefully designed sound program -- can reduce symptoms of tinnitus, not just while patients are being treated, but up to 1 year later. Science Magazine reports: In the team's experiment, 326 people with tinnitus sat for up to 1 hour at a time with a small plastic paddle on their tongue. Tiny electrodes in the paddle delivered an electrical current designed to broadly excite the brain, getting activity going through a number of interconnected regions. The electrical stimulation feels a little like pop rocks candy fizzing in your mouth, [says Hubert Lim, a biomedical engineer at the University of Minnesota, Twin Cities]. Subjects also wore headphones that delivered a more targeted hit to the brain's auditory system. Each person heard a rapidly changing series of pure tones at different frequencies, against a background noise that sounds "kind of like electronic music," Lim says. The goal of the two together was to distract the brain by heightening its sensitivity, forcing it to suppress the activity that causes tinnitus. "The brain can only pay attention to so many things," Lim says.

Over the 12 weeks of treatment, the patients' tinnitus symptoms improved dramatically. More than 80% of those who complied with the prescribed regimen saw an improvement. And they saw an average drop of about 14 points on a tinnitus severity score of one to 100, the researchers report today in Science Translational Medicine. When the team followed up after 12 months, 80% of the participants still had lower tinnitus scores, with average drops of 12.7 and 14.5 points.