Une étude rapporte que la perturbation de l’équilibre du microbiote intestinal par le stress dérègle la fonction des cellules immunitaires.

Au Canada, une personne sur cinq souffre d’arthrite, ce qui en fait la maladie chronique la plus répandue.

A review of 47,282 tree species by the International Union for Conservation of Nature found that more than one third are at risk of extinction

A science photo book probes the colors we can see—and even “forbidden” colors we can’t

At dusk and dawn, the sky dances with three phases of in-between light

This year won’t just be the hottest on record—it could be the first to surpass 1.5 degrees Celsius. The Paris climate accord aims to keep warming below that level when looking over multiple years

Droughts in 48 of 50 U.S. states, evidence of microplastics mucking up wastewater recycling and the science of a baseball mud bath in this week’s news roundup.

A Biden administration proposal that would require employers to provide cooling measures under extreme heat conditions may be scuttled by the incoming Trump administration

Reality has again failed to support the spin surrounding the 340B Drug Pricing Program.

For 2023, discounted purchases under the 340B program reached a record $66.3 billion—an astounding $12.6 billion (+23.4%) higher than its 2022 counterpart. The gross-to-net difference between list prices and discounted 340B purchases also grew, to $57.8 billion (+$5.5 billion). 340B purchases are now almost 40% larger than Medicaid’s prescription drug purchases.

Hospitals again accounted for 87% of 340B purchases for 2023. Purchases at every 340B covered entity type grew, despite drug prices that grew more slowly than overall inflation.

Lobbyists claim that manufacturers’ 340B contract pharmacy changes are “stripping billions of dollars from the healthcare safety net.” But every year, the data tell a very different story. Only in the U.S. healthcare system can billions more in payments and spreads be considered a cut.

Read on for full details and our analysis, along with fresh details of troubling behavior by the Health Resources and Services Administration (HRSA).
Read more »

<p>The European Commission (EC) granted marketing authorization for<b>&nbsp;</b>three ustekinumab biosimilars<b>:&nbsp;</b>Samsung Bioepis’ Eksunbi on 12 September 2024; Formycon’s Fymskina, and Fresenius Kabi’s&nbsp;Otulfi on 25 September 2024.</p>

Consultations on the reclassification of two progestogen-only contraceptive pills from prescription-only to pharmacy medicines have been launched.

Community pharmacies will receive an estimated 12 referrals from the Discharge Medicines Service per year.

Community pharmacies able to administer up to 400 COVID-19 vaccines per week can now apply to become designated vaccination sites, NHS England has said.

There has been considerable noise coming out of the UK lately about successes in clinical trial enrollment.

First, a couple months ago came the rather dramatic announcement that clinical trial participation in the UK had "tripled over the last 6 years". That announcement, by the chief executive of the

Sweet creature of bombast: is Sir John writing press releases for the NIHR?

National Institute of Health Research's Clinical Research Network, was quickly and uncritically picked up by the media.

That immediately caught my attention. In large, global trials, most pharmaceutical companies I've worked with can do a reasonable job of predicting accrual levels in a given country. I like to think that if participation rates in any given country had jumped that heavily, I’d have heard something.

(To give an example: looking at a quite-typical study I worked on a few years ago: UK sites were overall slightly below the global average. The highest-enrolling countries were about 2.5 times as fast. So, a 3-fold increase in accruals would have catapulted the UK from below average to the fastest-enrolling country in the world.)

Further inquiry, however, failed to turn up any evidence that the reported tripling actually corresponded to more human beings enrolled in clinical trials. Instead, there is some reason to believe that all we witnessed was increased reporting of trial participation numbers.

Now we have a new source of wonder, and a new giant multiplier coming out of the UK. As the Director of the NIHR's Mental Health Research Network, Til Wykes, put it in her blog coverage of her own paper:

Our research on the largest database of UK mental health studies shows that involving just one or two patients in the study team means studies are 4 times more likely to recruit successfully.

Again, amazing! And not just a tripling – a quadrupling!

Understand: I spend a lot of my time trying to convince study teams to take a more patient-focused approach to clinical trial design and execution. I desperately want to believe this study, and I would love having hard evidence to bring to my clients.

At first glance, the data set seems robust. From the King's College press release:

Published in the British Journal of Psychiatry, the researchers analysed 374 studies registered with the Mental Health Research Network (MHRN).

Studies which included collaboration with service users in designing or running the trial were 1.63 times more likely to recruit to target than studies which only consulted service users.  Studies which involved more partnerships - a higher level of Patient and Public Involvement (PPI) - were 4.12 times more likely to recruit to target.

But here the first crack appears. It's clear from the paper that the analysis of recruitment success was not based on 374 studies, but rather a much smaller subset of 124 studies. That's not mentioned in either of the above-linked articles.

And at this point, we have to stop, set aside our enthusiasm, and read the full paper. And at this point, critical doubts begin to spring up, pretty much everywhere.

First and foremost: I don’t know any nice way to say this, but the "4 times more likely" line is, quite clearly, a fiction. What is reported in the paper is a 4.12 odds ratio between "low involvement" studies and "high involvement" studies (more on those terms in just a bit).  Odds ratios are often used in reporting differences between groups, but they are unequivocally not the same as "times more likely than".

This is not a technical statistical quibble. The authors unfortunately don’t provide the actual success rates for different kinds of studies, but here is a quick example that, given other data they present, is probably reasonably close:

• A Studies: 16 successful out of 20 
• Probability of success: 80% 
• Odds of success: 4 to 1
• B Studies: 40 successful out of 80
• Probability of success: 50%
• Odds of success: 1 to 1

From the above, it’s reasonable to conclude that A studies are 60% more likely to be successful than B studies (the A studies are 1.6 times as likely to succeed). However, the odds ratio is 4.0, similar to the difference in the paper. It makes no sense to say that A studies are 4 times more likely to succeed than B studies.

This is elementary stuff. I’m confident that everyone involved in the conduct and analysis of the MHRN paper knows this already. So why would Dr Wykes write this? I don’t know; it's baffling. Maybe someone with more knowledge of the politics of British medicine can enlighten me.

If a pharmaceutical company had promoted a drug with this math, the warning letters and fines would be flying in the door fast. And rightly so. But if a government leader says it, it just gets recycled verbatim.

The other part of Dr Wykes's statement is almost equally confusing. She claims that the enrollment benefit occurs when "involving just one or two patients in the study team". However, involving one or two patients would seem to correspond to either the lowest ("patient consultation") or the middle level of reported patient involvement (“researcher initiated collaboration”). In fact, the "high involvement" categories that are supposed to be associated with enrollment success are studies that were either fully designed by patients, or were initiated by patients and researchers equally. So, if there is truly a causal relationship at work here, improving enrollment would not be merely a function of adding a patient or two to the conversation.

There are a number of other frustrating aspects of this study as well. It doesn't actually measure patient involvement in any specific research program, but uses just 3 broad categories (that the researchers specified at the beginning of each study). It uses an arbitrary and undocumented 17-point scale to measure "study complexity", which collapses and quite likely underweights many critical factors into a single number. The enrollment analysis excluded 11 studies because they weren't adequate for a factor that was later deemed non-significant. And probably the most frustrating facet of the paper is that the authors share absolutely no descriptive data about the studies involved in the enrollment analysis. It would be completely impossible to attempt to replicate its methods or verify its analysis. Do the authors believe that "Public Involvement" is only good when it’s not focused on their own work?

However, my feelings about the study and paper are an insignificant fraction of the frustration I feel about the public portrayal of the data by people who should clearly know better. After all, limited evidence is still evidence, and every study can add something to our knowledge. But the public misrepresentation of the evidence by leaders in the area can only do us harm: it has the potential to actively distort research priorities and funding.

Why This Matters

We all seem to agree that research is too slow. Low clinical trial enrollment wastes time, money, and the health of patients who need better treatment options.

However, what's also clear is that we lack reliable evidence on what activities enable us to accelerate the pace of enrollment without sacrificing quality. If we are serious about improving clinical trial accrual, we owe it to our patients to demand robust evidence for what works and what doesn’t. Relying on weak evidence that we've already solved the problem ("we've tripled enrollment!") or have a method to magically solve it ("PPI quadrupled enrollment!") will cause us to divert significant time, energy, and human health into areas that are politically favored but less than certain to produce benefit. And the overhyping those results by research leadership compounds that problem substantially. NIHR leadership should reconsider its approach to public discussion of its research, and practice what it preaches: critical assessment of the data.
Ennis L, & Wykes T (2013). Impact of patient involvement in mental health research: longitudinal study. The British journal of psychiatry : the journal of mental science PMID: 24029538

Journalist Annie Lowrey has a rare disease that causes a near-constant itch that doesn't respond to most treatments. She likens the itchiness to a car alarm: "You can't stop thinking about it."

Did that rock move, or is it a squirrel crossing the road? Tracking objects that look a lot like their surroundings is a big problem for many autonomous vision systems. AI algorithms can solve this camouflage problem, but they take time and computing power. A new camera designed by researchers in South Korea provides a faster solution. The camera takes inspiration from the eyes of a cat, using two modifications that let it distinguish objects from their background, even at night.

“In the future … a variety of intelligent robots will require the development of vision systems that are best suited for their specific visual tasks,” says Young Min Song, a professor of electrical engineering and computer science at Gwangju Institute of Science and Technology and one of the camera’s designers. Song’s recent research has been focused on using the “perfectly adapted” eyes of animals to enhance camera hardware, allowing for specialized cameras for different jobs. For example, fish eyes have wider fields of view as a consequence of their curved retinas. Cats may be common and easy to overlook, he says, but their eyes actually offer a lot of inspiration.

This particular camera copied two adaptations from cats’ eyes: their vertical pupils and a reflective structure behind their retinas. Combined, these allowed the camera to be 10 percent more accurate at distinguishing camouflaged objects from their backgrounds and 52 percent more efficient at absorbing incoming light.

Using a vertical pupil to narrow focus

While conventional cameras can clearly see the foreground and background of an image, the slitted pupils of a cat focus directly on a target, preventing it from blending in with its surroundings. Kim et al./Science Advances

In conventional camera systems, when there is adequate light, the aperture—the camera’s version of a pupil—is small and circular. This structure allows for a large depth of field (the distance between the closest and farthest objects in focus), clearly seeing both the foreground and the background. By contrast, cat eyes narrow to a vertical pupil during the day. This shifts the focus to a target, distinguishing it more clearly from the background.

The researchers 3D printed a vertical slit to use as an aperture for their camera. They tested the vertical slit using seven computer vision algorithms designed to track moving objects. The vertical slit increased contrast between a target object and its background, even if they were visually similar. It beat the conventional camera on five of the seven tests. For the two tests it performed worse than the conventional camera, the accuracies of the two cameras were within 10 percent of each other.

Using a reflector to gather additional light

Cats can see more clearly at night than conventional cameras due to reflectors in their eyes that bring extra light to their retinas.Kim et al./Science Advances

Cat eyes have an in-built reflector, called a tapetum lucidum, which sits behind the retina. It reflects light that passes through the retina back at it, so it can process both the incoming light and reflected light, giving felines superior night vision. You can see this biological adaptation yourself by looking at a cat’s eyes at night: they will glow.

The researchers created an artificial version of this biological structure by placing a silver reflector under each photodiode in the camera. Photodiodes without a reflector generated current when more than 1.39 watts per square meter of light fell on them, while photodiodes with a reflector activated with 0.007 W/m² of light. That means the photodiode could generate an image with about 1/200th the light.

Each photodiode was placed above a reflector and joined by metal electrodes to create a curved image sensor.Kim et al./Science Advances

To decrease visual aberrations (imperfections in the way the lens of the camera focuses light), Song and his team opted to create a curved image sensor, like the back of the human eye. In such a setup, a standard image sensor chip won’t work, because it’s rigid and flat. Instead it often relies on many individual photodiodes arranged on a curved substrate. A common problem with such curved sensors is that they require ultrathin silicon photodiodes, which inherently absorb less light than a standard imager’s pixels. But reflectors behind each photodiode in the artificial cat’s eye compensated for this, enabling the researchers to create a curved imager without sacrificing light absorption.

Together, vertical slits and reflectors led to a camera that could see more clearly in the dark and isn’t fooled by camouflage. “Applying these two characteristics to autonomous vehicles or intelligent robots could naturally improve their ability to see objects more clearly at night and to identify specific targets more accurately,” says Song. He foresees this camera being used for self-driving cars or drones in complex urban environments.

Song’s lab is continuing to work on using biological solutions to solve artificial vision problems. Currently, they are developing devices that mimic how brains process images, hoping to one day combine them with their biologically-inspired cameras. The goal, says Song, is to “mimic the neural systems of nature.”

Song and his colleague’s work was published this week in the journal Science Advances.

This article appears in the November 2024 print issue.

Value-based care contracting is especially difficult for behavioral health providers, Taft Parsons III, chief psychiatric officer at CVS Health/Aetna, pointed out during a conference this week.

The post CVS Health Exec: Payers Need to Stop Making Behavioral Health Providers Jump Through Hoops In Order to Participate in Value-Based Care appeared first on MedCity News.

The vast majority of older adults want to age at home. To support that goal, doctors should encourage them to consider their care options — long before they need assistance.

The post Through Early Discussions About Elder Care, Doctors Can Empower Seniors to Age in Place appeared first on MedCity News.

By fostering collaboration and seamless data integration into healthcare systems, the industry is laying the groundwork for a future in which “personalized medicine” is so commonplace within clinical practice that we will just start calling it “medicine.”

The post Driving Genetic Testing Adoption and Improved Patient Care through Health Data Intelligence appeared first on MedCity News.

AbbVie schizophrenia drug candidate emraclidine failed to beat a placebo in two Phase 2 clinical trials. The drug, once projected to compete with Bristol Myers Squibb’s Cobenfy, is from AbbVie’s $8.7 billion acquisition of Cerevel Therapeutics.

The post AbbVie Drug Expected to Rival Bristol Myers’s New Schizophrenia Med Flunks Phase 2 Test appeared first on MedCity News.

Yesterday’s conference sessions surfaced interesting questions and approaches regarding the post-acute sector, bundled payment, emergency medicine and anesthesia. Post-Acute Focus: With more and more focus on the need to rationalize and re-organize the post-acute sector, we have seen multiple industry leaders start to evolve their strategies.  I blogged yesterday about AccentCare’s interesting strategy in the...… Continue Reading

LONDON - Kate, UK's Princess of Wales, will make her most prominent return to royal engagements since having treatment for cancer next month when she hosts an annual Christmas carol service at London's Westminster Abbey. Kate, the wife of heir to the throne Prince William, has only made a handful of public appearances after having major abdominal surgery in January, and then undergoing a course of preventative chemotherapy when subsequent tests revealed the presence of cancer. Last weekend, she attended two high-profile Remembrance events to commemorate those who lost their lives in conflict as part of her gradual return to official duties, but the carol service — ​​​​​the fourth she has organised, will be the first major royal event she has hosted herself. "This year's service provides a moment to reflect upon the importance of love and empathy, and how much we need each other, especially in the most difficult times of our lives," her office, Kensington Palace, said in a statement.

In about a week’s time we shall mark the sixtieth anniversary of the death of India’s first Prime Minister, Jawaharlal Nehru. This column focuses on one key aspect of Nehru’s political career, his collaboration with Vallabhbhai Patel. These two men worked shoulder-to-shoulder during the freedom struggle and in the early years of Independence. They had [...]

Spoke of DMK leader's attempted ‘blackmail' on Sri Lanka, warned that the Congress ‘will carry this grudge and retaliate at the right time'

The resignation drama has helped distract attention from the DMK party's woes in advance of next years Parliamentary elections.

Chinese officials had approached the Indian government for more information but had since been reportedly told by the Indian government that the information presented was sufficient to justify the listing.

Jun 21, 2022

Simon Saradzhyan was invited to publicly brief the National Academy of Sciences (NAS) committee addressing the adequacy of strategies to prevent, counter, and respond to nuclear terrorism, and identify technical, policy, and resource gaps. The consensus study is a congressionally mandated analysis included in the 2021 National Defense Authorization Act (Section 1299I) sponsored by the Office of the Secretary of Defense (Policy).  Nearly 60 stakeholders concerned about this topic from the Department of Defense, US Department of Energy, National Nuclear Security Administration, State Department, National Security Council, US Congress, the National Labs, and many non-governmental organizations were in attendance. The briefings are available at the NAS event website. Video of the presentation can be found here.

Mar 25, 2024

Bystander video feeds show scenes of fire and destruction, flames engulfing pipelines and smoke billowing from oil tank farms. In one clip, a twin-tailed aircraft flies slowly over a burning refinery. It loiters, banks, and then plunges precisely into the top of a tall, hydrocarbon filled distillation tower followed by explosions and more fire.

Kyiv is turning the tables on Russia by striking at its hydrocarbon lifeblood. Ukraine’s justified and effective homegrown response to Putin’s two-year campaign of attacks on the nation’s energy infrastructure shows Russia that what goes around comes around.

Mar 15, 2024

On March 13, President Vladimir Putin granted an interview, in which he again delved into the conditions under which he says he would initiate the use of nuclear weapons. His remarks were so ambiguous that it caused mainstream Western media organizations—which tend to agree on what to emphasize in news out of the Kremlin—to put divergent headlines on the news stories that they ran about this particular interview. “Putin, in Pre-Election Messaging, Is Less Strident on Nuclear War. The Russian leader struck a softer tone about nuclear weapons in an interview with state television,” was the NYT’s headline. In contrast, the FT’s headline was “Russia ‘prepared’ for nuclear war, warns Vladimir Putin. President resumes bullish rhetoric over use of atomic arsenal if west threatens Moscow’s sovereignty,” while CBS News ran with “Putin again threatens to use nuclear weapons, claims Russia's arsenal ‘much more’ advanced than America's” and WSJ led with “Putin Rattles Nuclear Saber Ahead of Presidential Elections; Raising specter of nuclear confrontation.” So, which is it? Has Putin just struck a softer tone about nuclear weapons or has he rattled his nuclear saber yet again? The answer is both.

Mar 18, 2024

Harvard Kennedy School hosted Jahi Wise, Senior Adviser to the Administrator of the U.S. Environmental Protection Agency, to discuss the design and implementation of the Greenhouse Gas Reduction Fund, a historic investment in American clean energy technology finance.

Presenting The Great Carol Comeback.

Christy Turlington en vid�o

#ChangeTheNumbers - Entdecken Sie die Ergebnisse der Studie

Esurance Pass It On Sweepstakes goes into overtime with grand prize giveaway of $250,000.

Volvo Lets You Have Your Christmas Shopping Delivered Directly To Your Car

Enjoy the Road This Winter with Helpful Tips

Every bottle of Bellucci starts in a family grove.

Elliott Vichinsky, MD, University of California, San Francisco (UCSF) Benioff Children's Hospital Oakland

#5MoreNow

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When Christen Press puts her game face on, she makes sure she helps protect it with Coppertone� Sport. Use and reapply as directed.

Dr. Lewicky-Gaupp knows what a significant problem UI can be for millions of women � many of whom suffer in silence. Here she explains why the PeriCoach System is an important new treatment option.

Christine Attia lost her fianc� just two years ago after he lost a courageous six-month battle with acute myeloid leukemia. She reminds everyone, while breakthrough therapies are saving lives, work still needs to be done to find cures.

Institut Marqu�s

A self-reflection on the paradox of sexuality and coming to terms with why I need to claim mine.

U.S. District Judge Matthew W. Brann speaking to the only lawyer still willing to argue Trump's case in Pennsylvania, Rudolph Giuliani, on Tuesday:

“You’re alleging that the two individual plaintiffs were denied the right to vote. But at bottom, you’re asking this court to invalidate more than 6.8 million votes, thereby disenfranchising every single voter in the commonwealth. Can you tell me how this result can possibly be justified?”

Hello everyone. You might expect that while we are having to endure this comical yet terrifying attempted coup, my subconscious mind would be having a field day, giving me creative dreams as usual. But here's the dream I had Tuesday night, after that disgraceful show in Michigan: A Republican demagogue, anticipating his loss in the next election and wanting to prime public opinion, begins shouting as loud as he can about how the Democrats are going to steal the election. He loses the election. Then he tries to steal the election, again by accusing the Democratic victors of stealing the election. Rank-and-file Republicans fall in around him, supporting his baseless claims. A depressingly shocking number of voters believe him.

Not a lot of creativity there, subconscious.

For me, the most stressful part of all of this is how terrifying the GOP has become. A massive web of baseless lies that are believed by a gigantic number of people is terrifying. It's what my books are about. Of course, as a fantasy writer, I've always known I'm writing about real life.

 I found a recent episode of the Ezra Klein Show helpful in contextualizing the crisis that's been created by the Republican Party. In it, Ezra talks with Anne Applebaum, who studies authoritarianism. As a writer, I appreciated that the episode included a close study in character. The character of real people, of course, like Lindsey Graham and Laura Ingraham, but writers are naturally interested in the characters of real people. It's how we write believable imaginary people! Anyway, check it out if a grim perspective will help you get your feet on the ground. Don't check it out if what you need right now is comfort or reassurance, however. Those are valid needs too. And I have a couple of TV recommendations for that as well!

About a month ago, I finished watching Jane the Virgin, which now has a permanent place in the upper echelon of my favorite TV shows of all time. It is so funny, so sweet and full of heart. It has political relevance, in a way that will make you feel hopeful. It's about families, writing, relationships between women, parenthood, magic, and it has characters you'll love so much that when you finally finish the last episode, you'll wander around feeling bereft for a while, or at least that's what happened to me. The plot is so absurd that you don't have to worry too much about bad things happening. The voiceover narrator is an absolute delight. I love this show so much, and if you've never seen it before, now might be the time!

Also, last week I started watching Crash Landing on You, a South Korean TV drama in which a South Korean heiress has a hang-gliding mishap that drops her into the North Korean section of the DMZ. A very serious (and brooding) captain in the North Korean Special Police Force finds her and reluctantly decides to help her hide. It's very, very funny and keeps surprising me with its sweet moments — one of my favorite combinations in a TV show — and like with Jane, I'm falling for all the characters. Each episode seems to be incrementally longer than the last episode, to the point that my addiction to the show is interfering with the rest of my life, but I'm enjoying it too much to care. :o)

By Source, Fair use, https://en.wikipedia.org/w/index.php?curid=62530475

These are my recommendations for today… Hang in there, everyone. ????

Here are four new Chrome iOS features making it even easier to use this browser across devices.

For 18 months after Charlie’s death, my only desire was to grieve. I celebrate how deeply I let myself experience my grief and how completely I prioritized myself during this time. I took a sabbatical, and only did what I felt like doing. At first it was mostly crying in bed. After a couple of […]