Damian Sendler In the last decade, the idea that other animals engage in behaviors that are culturally determined has gained more traction [2–13]. The emergence of new claims about animal culture has sparked a debate about the classification of humans as ‘ultra’ cultural. To put it another way, unlike non-human cultural forms, human cultural forms are: (1) cumulative, in that new innovations are gradually added to the collective body of knowledge and skill of a population, resulting in ever-evolving repertoires; (2) distinct from non-human cultural forms; and (3) shaped more strongly by social learning than non-human cultural forms [14–16].

Damian Jacob Sendler Even if we disregard the environmental harm we’ve done to the planet, our ability to create new ways of doing things that are highly diverse and adaptive to the context in which they’re used is truly remarkable and unmatched by any other species on the planet. Because of our abilities and strategies to navigate the social world rather than the physical world, we have been able to achieve this success [17–20]. Humans, as individuals and as a species, must be understood in terms of how we create and navigate culture—the constructed social and physical environment in which we live. As a starting point, we argue that understanding the differences between human and non-human social capacities, as well as the ontogeny of those abilities, and their local manifestations in different cultural contexts, is essential. Only by combining these two viewpoints will we be able to grasp the earliest origins of human culture.

Dr. Sendler Although it is common practice in psychology to compare children across age groups, the comparison of human versus non-human performance, and comparisons across human cultures, is rare, and the combination of both is almost non-existent [21]. It is clear from the contributions of Heyes [22], Schmelz & Call [23] and Keller [24] that attempts to understand the evolution of human mentality by integrating research from developmental, comparative, and cross-cultural psychology are of enormous value. Using this triadic approach, we will argue for its value and provide insight into some of the key elements that make us human: social learning, cooperation, prosociality and the ability to understand the thoughts or feelings of others.

It seems obvious that a model of human (as opposed to non-human) social learning would be included in any search for an account of human culture. When faced with the need or desire to learn new skills or behaviors, humans are extremely adept at gathering information from others. Studies have shown that infants can learn new actions and construct simple tools just by observing others at six months and 12 months of age, proving that our social learning skills are formed early in life [25]. From this point on, children’s ability and proclivity for social learning skyrocket, to the point where they engage in an activity now known as “overimitation” [26].

It is common for kids to over-imitate adults when interacting with a new object, and this includes actions that have no apparent connection to the outcome. As early as 12 months old, children witnessed an adult open a closed box by disengaging a latch located on the front of the box [27]. [20] The demonstration was made more difficult by the adult’s use of an oddball object, despite the fact that the box could easily be opened by hand. Infants as young as 12 months old observed the adult demonstrator and then tried to open the box with their hands. 24 month olds overwhelmingly attempted to open the box by using an object, frequently persisting in this comparatively unproductive approach to such an extent that they were unsuccessful.

Overimitation has been documented in a growing number of laboratories [28–32] and cultural groups [33–35] in subsequent studies. It is not uncommon for preschoolers to over-imitate, even when the goal is no longer met (e.g., wiping a stick across a box’s top after the box has been opened and the inside of the box is easily accessible), and even when the goal is no longer met (e.g., wiping the stick across a box’s top after the box has been opened and there is a toy inside).

Documented cultural differences have been found in social learning proclivities and processes (e.g. [37,38]). Though the phenomenon of overimitation seems to be universal, it appears to be a human trait that transcends contexts (for an exception, see [39]). Given that overimitation is common and stable across cultures, it is possible that it serves as an enabling factor for human culture. However, there isn’t enough evidence to support this claim based solely on developmental and cross-cultural data. Human social learning would also necessitate the existence of overimitation. So, in other closely related species, such as non-human great apes, this trait may be less prominent or absent altogether.

Children as young as three years old and young, wild-born chimpanzees in captivity were taught to use a stick by an adult demonstrator in Horner & Whiten’s [40] now-classic experiment. The experimenters had the adult demonstrater poke a stick through the box’s top and then poke a stick through the bottom. Because the box was opaque, the participants couldn’t see the link between the actions taking place inside and the final result. Both chimpanzees and children were able to replicate all of the demonstrated actions when they were given the opportunity to play with the box on their own. Another step was taken to make it clear that the stick didn’t get in contact with any reward-retrievable area when it was inserted into its top hole, so the opaque box was replaced with an open one, allowing each internal action to be clearly seen. In other words, there was no connection between the outcome and the action taken in the top hole. The chimpanzees acted as if the initial action had no bearing on their behavior now that it was clear that it had no causal effect. As a result, the children’s actions mirrored the model’s, including the blatantly unnecessary inserting of the stick into the top hole (see also [41]). These findings support the theory that overimitation is a species-specific enabler of human culture. Triadic approaches to human culture that combine development, cross-cultural and comparative comparisons have solved a piece of the puzzle that was previously unsolvable.

How does this difference in overimitation come about, then, naturally? The lack of overimitation in non-human animals suggests a fundamental, heritable gap between human and non-human social learning abilities. Heyes’s [22] review of the debate between active intermodal matching and associative sequence learning accounts of imitation provides an answer to this question. Whether or not we have a’module’ for imitating our social and cultural environments is one of the major points of contention between these perspectives, as noted by Heyes.

Damian Sendler

Triadic thinking can yield new insights. Firstly, Horner and Whiten’s comparison of humans and chimpanzees shows that our closest living relatives have the ability to learn from others, but Pan troglodytes’ approach to social learning is more pragmatic than that of Homo sapiens. Information that has been given to us by others is no more or no less valuable than information that we have gathered on our own [42], and actions that have no connection to the events in question are simply ignored as unimportant. A copy of an action that serves no useful purpose would not be made. [42] Humans on the other hand, are more receptive to information from others and pay more attention to the non-functional aspects of a demonstration. This suggests that social learning may not be primarily a result of a gap in the ability to learn from others, but rather a difference in the motivations underlying social learning in humans and chimpanzees. Humans, in contrast to chimpanzees, focus on the social consequences of social learning when they learn from others [17,18,43–47]. According to previous research, children do not begin to overimitate in earnest until their second year of life [29,43–54], but as more and more evidence mounts, it appears they do so for social and/or normative reasons. And last but not least, the fact that overimitation occurs in a wide range of cultural contexts [33–35] suggests that the sociocultural environment that serves as a resource for acquiring human-specific overimitation in social learning is shared by the majority of human communities.

Damian Jacob Markiewicz Sendler According to another aspect of social learning, the influence of the majority on individual social learning can be found. Researchers found that chimpanzees and humans alike tend to copy the actions of their peers, even if the alternatives are equally familiar, equally productive, and equally frequent [55]. A phenomenon dubbed ‘conformity’ has been observed in humans, in which people are willing to give up a behavior or judgment they know to be effective or correct in order to conform to what others are doing. In spite of claims by some researchers that non-human primates exhibit human-like conformity [59–62], other explanations such as primacy effects, conservatism, incomplete sampling, and random copying have yet to be ruled out [63–65]. Like overimitation, this difference may not be due to a fundamental discontinuity in the consideration of majority information in social learning, but rather a difference in motivational focus. If they have a different but equally effective strategy available to them, chimpanzees will not follow the majority when learning a new skill [66,67,68]. Even in the worst-case scenario, people still go along with the herd, but only if the majority is watching them—if they are allowed to act privately, without the majority watching them—do conformity rates drop [56,67,69]. As a result, it appears that the difference between human and non-human social learning is driven by social considerations once again. Conformity, like overimitation, is widespread across cultures [70] and occurs early in development [67,69,71,72]. However, the degree to which it occurs varies. Children in the West are becoming increasingly socially conscious as they grow older, which suggests that chimpanzees do not. As a result, there appears to be a disconnect between human and nonhuman social learning and culture.

The development of shared intentionality, which occurs in collaborative interactions where participants have a collective goal and coordinated action roles to achieve that goal, has also been an important factor in the emergence of human culture [73,74]. These characteristics have been argued to be central to the’socio-cognitive niche’ that has shaped our species’ evolution [20]. Because children naturally gravitate toward group activities from an early age [75], they acquire the social skills and proclivity for collaboration that are essential to human culture [76,77]. Children as young as 18 months old were given a task that required them to work together in order to operate separate handles embedded in an apparatus that was too far apart for one child to operate on its own. An animated musical toy was activated by pulling the handles together. Children as young as 30 months had little interest in cooperating with one another, but those same 30-month-olds were keen observers of the movements and locations of their partners and worked cooperatively to achieve the same goal. Children were found to be far more cooperative than chimpanzees when confronted with a task that required multiple steps to complete, according to Dean et al. [79]. They teamed up, shared ideas, and got better results as a result.

Children’s early cooperative abilities are frequently described as being extremely similar across different human populations. While children’s willingness and ability to cooperate may vary by culture [80,81] and the rules of conduct that govern cooperation [82], it appears that children of all cultures demonstrate similar cooperative abilities at roughly the same age. For example, Callaghan et al. [38] found that children from different cultures performed similarly in a variety of collaborative tasks in early childhood.

Therefore, should we consider cooperation to be an enabling condition for uniquely human culture given the relevance of cooperation for human culture, the early onset and the absence of cross-cultural variation? If this is the case, should we be surprised if it turns out to be a human autopomorphy, a phenomenon that only exists in humans? A qualified no, as explained by Schmelz & Call [23], is the correct response to the question raised. If you want to get chimpanzees to work together, you’ll need to provide them with a reward or incentive. When it comes to children, on the other hand, social interaction can be enough to keep them engaged. Children’s willingness to cooperate can vary depending on their cultural background, as previously mentioned [35,80,83]. A more nuanced understanding of the role of human cooperation in explaining our unique culture is necessitated by the triangulation, and this time it appears to be a difference in motivation rather than a fundamental difference in capability.

Children and chimpanzees approach collaborative tasks differently, and this extends to prosocial acts. It has long been known that infants and young children have a prosocial disposition [84]. Toys can be shared with an unfamiliar adult at the 15-month mark, and by 18 months, infants are capable of providing instrumental help, which is helping another person achieve a goal [87]. Brownell et al. [88] gave 18- and 25-month-old infants the task of pulling one of two handles attached to a pair of trays in order to get a reward as they got older [89,90]. An adult accomplice was given a loaded tray when one of the handles was pulled; a loaded tray was given only to the child who had been selected. Compared to the 18-month-olds, who required more verbal cues from the adult to recognize the shared goal, the 25-month-olds opted for the prosocial option, delivering food to both themselves and the adult at a higher rate. Using a similar design, House et al. [89] found high levels of prosocial behavior among 3- to 8-year-olds, indicating that spontaneous prosocial behavior is well-established throughout childhood. A growing body of research shows children are willing to put themselves in harm’s way in order to help others [90,91].

Damian Sendler We must, however, take a more nuanced stance when considering these data in light of their cultural context. Culture-specific affirmation of prosocial behavior is a part of the ontogenetic affirmation. Despite the fact that children in all communities have a prosocial disposition, as they grow older, they will adapt their behavior to the cross-culturally variable prosocial norms of their community. [92] House et al. Children aged 4–9 years from seven different cultures were studied by Blake et al. [93], who examined their reactions to disadvantageous and advantageous inequity aversion (DI and AI, respectively) when they were given the choice between receiving less than their peers or receiving more than their peers (Canada, India, Mexico, Peru, Senegal, Uganda and the US). Discrimination against women was found in all societies, with cultural differences in its emergence, ranging from the United States to Canada, and finally to Mexico. Furthermore, AI was only developed in three countries: the United States, Canada, and Uganda, and its prevalence grew with the aging population in these countries.

Children’s prosocial behavior and reactions to unfairness have culturally specific pathways, which are likely the result of varying socialization strategies that support various culture-specific objectives. It’s laid out in compelling detail in Keller’s [24] paper here. In contrast to children raised in societies where autonomy is highly valued, those raised in societies where a strong emphasis is placed on relatedness instill a sense of urgency in their children to share with others.

Damian Jacob Sendler

In spite of this, as of right now, the human tendency to help stands in stark contrast to the behavior of chimpanzees, who, as detailed by Schmelz & Call [23], require some kind of incentive to help others. It appears that chimpanzees have a more limited capacity for altruism than children raised in societies that place a higher value on prosocial behavior. Social factors are not a driving force in chimpanzee cooperation, as is the case with their propensity to mimic. Any shared intentionality as expressed in truly collaborative and joint attentional activities where participants have a shared goal and joint attention is missing [94]. Interactions involving shared intentionality alter human cognition in fundamental ways, according to Moll & Tomasello [95]. In the first place, it establishes a sense of perspective. As an example, think about how infants might learn that another person may see the same situation in a different light. As a result of these foundations, a core human capacity for understanding others and the development of what is known as a theory of mind springs forth from these foundations.

“Theory of mind” refers to a “common sense understanding” of the world [97,98] that acknowledges the existence of a variety of mental states, such as thoughts, beliefs, and desires, in both oneself and others [99]. These mental states are thought to be the basis for our actions. People behave in the world not according to how it really is, but according to how they see it. Children must learn that other people’s mental states can differ from their own as well as from reality in order to develop a comprehensive theory of mind. That is to say, other people’s mental states are influenced to some extent by their knowledge of past events, which comes from a variety of sources.

These tasks have become the standard tool for measuring the development of a child’s “theory of mind” because of this reasoning. Toys are placed in Box 1 by Agent X, who then leaves the testing environment with the child’s favorite toy. As soon as Agent Y is introduced, he takes the toy from Box 1 and puts it in Box 2 before leaving. As soon as Agent X arrives, children are asked where they should begin searching. When asked where Agent X will first look for the object, most Western children over the age of 4 will correctly answer “Box 1,” while younger children will incorrectly answer “Box 2.” A number of studies have found that in non-Western societies, there is considerable variation in the onset of false belief [100,101].

The realization that theory of mind does not suddenly appear at around 4 years with the onset of success on false belief tasks is more important than the question of variation in the onset of false belief reasoning. From 2 to 6 years old, Western children go through a developmental progression in which they master various mental state concepts sequentially, according to Wellman and Liu [103]. Among these steps are an appreciation for the fact that others may not have access to the right information (Knowledge Access), an understanding of false belief, and an understanding that they can deliberately hide how they feel (Hidden Emotions). It is important to note that using the Wellman and Liu scale has revealed cultural differences in the order in which each of these steps is learned. While Iranian children outperformed their Australian counterparts in terms of knowledge access, they lacked understanding of diverse beliefs, according to Shahaeian and colleagues [104]. (see also [105]). Studies comparing Chinese and American children [106] found a similar course of development. As a result, while it is clear that humans can learn to recognize other people’s erroneous beliefs, the path by which they do so is complex and poorly understood. For other closely related species to have false belief understanding, we would have to consider it a species-specific enabling condition for human culture.

Research into non-human primates’ capacity for theory of mind is well-documented by Schmelz & Call [23] in an engrossing paper. According to their findings, chimpanzees have not yet been exposed to the appropriate context in which they could pass a false belief test. It’s also possible that humans are the only species to possess this particular ability. Continuing cross-pollination between academic disciplines is essential in this context. A primate version of the Wellman and Liu scale has not yet been developed, to our knowledge. There are many obstacles in the way, but if it can be done, it would provide a wealth of information about the minds of our closest living relatives while also providing insight into the human mind and its capabilities.

Dr. Sendler

Sendler Damian Jacob

Damian Jacob Markiewicz Sendler

Damian Sendler: Some chronic diseases may necessitate frequent and long-term needle exposure in patients, and this may be a necessary part of treatment or even life support for some. Haemodialysis patients with kidney failure require an average of 6 large-bore needle insertions per week, or at least 312 insertions per year. Multiple injections, infusions, and blood tests are also required for chemotherapy or insulin treatments.

Damian Jacob Sendler:Needle apprehension is a common deterrent to medical care [1–3]. There is a wide range of needle phobias, from mild discomfort to full-blown apprehension [4]. In the Netherlands, 16.1 percent of the general adult population was found to be afraid of injections [5]. Adults in the Netherlands, South Korea, Sweden and the United States all have needle phobia. Females are more likely to suffer from needle phobia and needle fear than men [9–11]. These include desensitization therapy [12] and techniques to counteract vasovagal syncope, such as tense muscles [13]. There are a number of approaches that can be used to help people overcome more severe needle phobias or anxieties. Individuals with high levels of needle apprehension have previously been recommended for exposure-based interventions [4]. Patients who are willing to put up with needle discomfort as a cost of survival are likely to underreport it. In clinical care, it is not systematically measured; as a result, it is under-recognized, making management difficult for both clinicians and patients.

Dr. Sendler: Needle fear and its treatment have been studied mostly in children [14, 15] or infrequently exposed populations such as the ones undergoing dental procedures [12] and vaccinations [16, 17]. Given the rising prevalence of chronic diseases around the world[18, 20] and the need to assist clinicians in the treatment of this cohort, we synthesized the literature on the prevalence and management of needle phobia.

Among adults who had previously or currently received chemotherapy, the prevalence of needle phobia ranged from 17% to 52% [2, 24–26]. (Table 2, section 1a). There have been two studies looking at people’s reactions to blood and injections, and both found that 21/124 (17%) and 36/197 (18%) reported needle fear. The Blood-Injection Symptom Scale (BISS) [26], the Blood-Injection Injury Scale [25], and a semi-structured interview [2] were all self-report measures of ‘needle fear.’ Needle phobia was defined as a visual analogue scale anxiety, fear, aversion, and stress score of 5 [24].

Table 2, section 1b, shows that 25–47% of adults undergoing peritoneal dialysis or haemodialysis [1, 28–30] reported needle phobia. In the pilot study conducted by Mulder et al. [29] to validate the Dialysis Fear of Injection Questionnaire (DFIQ) in haemodialysis patients, 20/45 (44 percent) of the participants reported a fear of injection needles. Participants in the validation component (n = 86) reported feeling scared, nervous, or worried the “moment the nurse comes to insert the needle” in 22/86 (26 percent), 36/86 (41 percent), or worried in 28/86 (33 percent) of the cases.

A total of 198/551 peritoneal dialysis and haemodialysis patients (36%) and 73/208 (37%) indicated that they had needle fear in response to two questions administered by the researchers [30]. More than a quarter of those who refused haemodialysis cited their fear of needles and complications as a factor [1]. More than half of those surveyed (81/173, or 47 percent) said they were afraid of needles, according to a questionnaire developed by researchers [28]. 11/73 (15 percent) of haemodialysis patients interviewed in person stated that they were unable to get an arteriovenous fistula created because of a fear of needles [33].

Using the D-FISQ (Diabetes Fear of Injecting and Self-testing Questionnaire), researchers were able to estimate the percentage of adults with insulin-treated diabetes who were afraid to inject themselves (Table 2, section 1c) between 0.2% and 43%. D-FISQ scores were higher in patients with severe anxiety, as measured by the State Anxiety Scale (SAS), in 350 diabetics [36]. When searching for articles on the prevalence of needle fear, injection phobia or blood-injury-injection phobia, a literature review abstract found that 28 percent of insulin injection recipients had needle phobia [38].

Six percent of insulin-users scored 3 on the Barriers to Diabetes Questionnaire items “I am afraid of injecting myself” and “I am afraid to prick my finger,” indicating “serious problems” with needles. Patients with type 2 diabetes were surveyed via face-to-face interviews to determine the prevalence of primary non-adherence with insulin and the barriers to insulin initiation. 105/225 participants in this study were found to have delayed insulin treatment by 47 percent. As many as one in three patients (37/105) had needle phobia because they were afraid of the pain. Patients with Type 2 diabetes who received injectable antidiabetic therapies (IAT) were found to be afraid of injections, with 185/500 (37 percent) reporting that they felt fear when thinking about a needle. Fear of injection was cited by 67 percent of Endocrinologists in a survey of 200 physicians, according to the study.

Seventy-seven percent of Type 2 diabetics interviewed said they avoided insulin therapy because they feared the pain it would cause them. Of the 32 patients who refused insulin despite medical advice, this number rose to eighty percent (70%). “Needle phobia” was the most common negative attitude toward starting insulin in 205/293 (70 percent) of patients with type 1 diabetes who completed the Chinese Attitudes to Taking Insulin Questionnaire. An author-created questionnaire found that 33% of insulin-treated patients (115/115) had high injection anxiety scores, 14% had avoided injections, and 42% said they would be “troubled by more frequent injections” [43].

35–53 percent of diabetics who had never used insulin reported fear of self-injection or anticipation of pain during injections [3, 39]. No insulin was given to 56/200 (28%) of the non-insulin-dependent type 2 diabetes patients because of concerns about pain and a “inability to take” daily needling for 50% of the patients (although it is unclear whether this was due to distress or anxiety) [41]. More than one in three diabetic patients who initially refused insulin or were given it by a doctor said they were afraid of needles. 218/243 (90 percent) of unwilling diabetics were afraid of needles, compared with 130/225 (58 percent) of willing diabetics [52]. Based on results from The Fear Questionnaire [54], fewer blood glucose readings were taken and glycemic control was worse in patients with type 1 diabetes who were fearful of blood and injury [35].

One RCT of 25 adult chemotherapy patients [24], a report of a treatment protocol [27], a cross-sectional survey of 208 breast cancer patients [2], two case reports [31 and 48], a recommendation report [32] and a narrative report [49] were among the eight sources that discussed needle fear management.

A study by Kettwich et al. [24] included a stress-reducing needle and syringe (decorated barrel with colorful glitter stickers) in the chemotherapy treatment of 25 adults (Table 2, Section 1a). Anxiety, aversion, fear and overall stress were measured using a visual analogue scale of 0–10, with higher scores indicating greater fear. Before the intervention, 52% of the sample had a fear of butterfly needles (determined by a score of 5 or more). Using stress-relieving devices on this group resulted in a 92 percent (P0.001) reduction in aversion, anxiety, fear, and overall stress; however, no further data were collected.

It was found that stress management techniques like mindful moist mouth, stress balls, and progressive muscle relaxation can help patients undergoing intravenous chemotherapy cope with their stress [27]. Aside from medication and caregiver presence, other “anxiety control strategies” included safety behaviors (e.g. taking a break during procedures and distracting yourself with something else). Health professionals’ “discomfort warnings” contributed to patients’ discomfort, as noted by authors in their study There was no evaluation of strategies.

According to Cox & Fallowfield [2,] the treatment environment (e.g. room, bed, chair) should be “varierated” by the nursing staff in order to keep patients distracted and avoid needle anxiety before chemotherapy; however, implementation and evaluation were not carried out in this case.

Damian Sendler

Rapid desensitization and exposure were used in three sessions to help a 64-year-old dialysis patient who was afraid of needles get over his fear [31]. Lie down in a reclined position, keep your facial muscles and arms tense, and imagine a situation that makes you angry. Changes in blood pressure and pulse were observed as a result of biofeedback monitoring of blood pressure and pulse. A therapist used imaginal exposure to simulate needling. At other times, the patient was in charge of the twice-daily exposure tasks.

British Renal Society guidelines for dealing with patient needle anxiety were based on the consensus opinion of 15 nurses from 13 UK dialysis units and research evidence, where applicable [32]. [32] There was a wide range of suggestions for preparing patients for needling, desensitization, written arteriovenous access plans, visual routines, relaxation, and a calm environment included. Though not described in detail, listening, trusting one’s patients with one another, and using coping strategies were all emphasized by the authors.

In a study by Feitosa et al. [34], nurses, endocrinologists, dieticians, and obstetricians examined the impact of a multidisciplinary diabetes education program on the fear of self-injecting and testing in 65 pregnant women with pre- or gestational diabetes who were taking insulin during pregnancy. Hyperglycemia, diet, and lifestyle were all addressed, as was instruction in blood glucose self-monitoring and insulin injection administration. A brief D-FISQ was completed by women at their initial check-up and again within the final two weeks of pregnancy or shortly after delivery. 43.1 percent of pre-intervention participants reported having needle phobia. There were no specific strategies for needle fear in the intervention, but fear of self-injection decreased from 39 percent to 13 percent (p = 0.001) and fear of self-testing decreased from 28 percent to 14 percent (p 0.012). As a result of the study, women with pre-gestational diabetes who were afraid of self-injection and blood glucose testing decreased from 40% and 33%, respectively, to 15% and 15%. (not statistically significant).

Damian Jacob Markiewicz Sendler: Patients with “severe fear” (undefined) can be informed of alternative insulin pumps or desensitization techniques by a “behaviour counsellor” (undefined) as a way to address needle fear as a barrier to insulin use [49]. Behavioral modification techniques, topical anesthetic cream, anxiety education, pre-medication, and alternative therapies (no-needle jet injection devices) [48] were all used to manage a 33-year-old diabetic woman.

This study found that adults with cancer, diabetes, or kidney failure have a high prevalence of needle phobia and distress. A wide range of scientific methods, from non-evidence-based recommendations to a single randomised controlled trial, were used to identify 32 different heterogeneous articles. In adults with chronic diseases, only eight studies have addressed the management of needle fear. These were even less detailed in terms of strategies, such as when and how often they should be delivered, or how they should be evaluated. As a result, there is a lack of evidence that this issue is critical for patient well-being, where refusal or avoidance of treatments can lead to a lower quality of life, shorter lifespan, or death. When it comes to treatment avoidance among these groups, needle fear is frequently mentioned [1–3]. However, high-quality evidence of strategies or interventions is needed in clinical care to better manage this problem.

The prevalence of needle phobia in patients with diabetes, cancer, and kidney failure ranges from 0.2 to 80 percent, from 17 to 52 percent, and from 25 to 47 percent, according to various studies. Because of differences in demographics, frequency of medical procedures, or patient characteristics, needle fear may be more prevalent in certain populations [9, 24]. When it comes to measuring needle apprehension, there are many different ways to do it. Both the D-FISQ and the DFIQ have been used to assess fear of injection and self-testing in diabetics and kidney failure patients, respectively (see e.g. 29; 34; 36; 42; 45; 46; 53). These include psychometric self-report tools [25–26], investigator-created surveys [1, 28, 30, 41, 50–52], and face-to-face interviews [2, 33–40]. When it comes to needle phobia, self-report measures were used rather than a formal diagnostic assessment [2, 24, 28, 51].

Damian Jacob Sendler

There is a clear need for validated patient-reported measures in chronic disease cohorts where needle exposure is high to screen for needle fear on a regular basis based on the prevalence estimates. Where possible, needle fear assessment measures, like the D-FISQ, should be used in the context of a therapy program. As needle fear is linked to treatment refusal, screening may be warranted prior to treatment initiation or in the early weeks and months of therapy when fear appears elevated [1, 42, 43, 55]. [1, 33, 40, 44, 52] There may be an opportunity to educate and intervene early on if patients’ fears or misconceptions about therapy can be identified early on. Preventing complications and reducing stress for patients is likely to result from this. Simple questions about a patient’s preferences for treatment, including how they feel about needles, can help validate their fears and open a dialogue about how those fears can be managed when standardized measures aren’t available or feasible.

Damien Sendler: Fear of needles can range from mild to severe enough to be diagnosed as a phobia by a medical professional [56]. As a result, the authors in this review rarely made the distinction between fear of needles, fear of needle pain, and a diagnosed anxiety disorder like a phobia. Management can range from simple, targeted interventions to an intensive psychological treatment program, in accordance with the continuum of distress. Those with a medically documented fear of needles will need the latter, which can only be administered by a qualified clinician such as a psychologist or psychiatrist. Selected peer-reviewed studies included in this scoping review found evidence of the effectiveness of exposure therapy and desensitization therapy for such individuals, but there was no evidence of their use in conjunction with other chronic disease therapies, nor were there any studies that evaluated the efficacy in the context of these therapies.

Patients with a mild to moderate fear of needles may benefit from cognitive behavioral therapy that incorporates relaxation and cognitive restructuring techniques as well as educational programs. It was found that stress management, distraction, and relaxation were all effective methods for reducing fear [2, 27, 32]. Only one study described a formal evaluation of an educational program that resulted in a reduction in needle distress, even though it did not include targeted interventions for this [34]. The use of different needling devices and the provision of non-needle treatments were also suggested as therapeutic modifications [2, 24, 49]. A lack of high-quality evidence for intervention protocols to prevent or alleviate needle fear among adults with chronic disease has been identified in the current review, with little to no replication of findings. These findings may be due to the fact that healthcare providers fail to recognize patients’ needle distress and fail to conduct systematic screening. Pain and needle phobia were frequently found to be intertwined in certain individuals.

Chronic disease therapies necessitate a thorough examination of needle apprehension over time and the development of interventions tailored to the specific context and features.

Research articles on the fear of needles in patients afflicted by arthritis, asthma or other chronic conditions were not found in this review. In addition, these patients may necessitate regular blood draws as part of their clinical evaluation. Furthermore, invasive procedures performed in the hospital may be necessary. Future studies on needle phobia should include these patients as well.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian Jacob

Damian Sendler: People with dementia and those who care for them must be given immediate attention as the pandemic spreads. Dementia patients and their caregivers are in a precarious position due to a lack of resources. In order to reduce mortality and provide assistance to those suffering from dementia during the pandemic, cooperation and more research based on solid evidence are essential.

Damian Jacob Sendler: As a result of the current coronavirus disease (COVID-19, caused by the SARS-CoV-2 virus), a large number of people living with dementia are at increased risk of illness and death. Most people who die as a result of COVID-19 (O’Brien et al., 2020) have dementia as a co-morbidity. Long-term care facilities in Canada account for 85 percent of all COVID-19 deaths, with two-thirds of those afflicted by dementia (Alzheimer’s Disease International 2020b; Suárez-González et al. 2020). People with dementia accounted for half of the deaths in care homes in the UK, according to the Office for National Statistics (ONS) (Alzheimer’s Society 2020).

Dr. Sendler: A number of countries have implemented social distancing restrictions and lockdown measures in response to COVID-19, in an effort to reduce the virus’s spread. Restrictions on social gatherings, limited mobility outside the home, and restrictions or closures of all non-essential services such as home care and health clinic access have been implemented (Brown et al. 2020). People with dementia and their caregivers, on the other hand, are suffering as a result of these “protective” measures (Anderson and Parmar 2020; McGhan and McCaughey 2020).

People with dementia are at greater risk from COVID-19 and social isolation if they don’t have access to social support and healthcare services. According to research, social isolation has been linked to an increased risk of early death from all causes (National Academies of Sciences, Engineering, and Medicine 2020). Dementia and Alzheimer’s disease deaths at home in England have increased by 79.3% over the previous 5-year average during the pandemic (Office for National Statistics 2020). There may be additional deaths from the pandemic that are not directly related to missed COVID-19 diagnoses (e.g., misattribution of COVID-19 deaths to pneumonia or other respiratory illnesses, or delays in reporting of COVID-19 deaths) (Fineberg 2020; Woolf et al. 2020). COVID-19 confinement and social isolation, according to some studies, may contribute to the rapid decline of dementia patients and the rise in their mortality rates (Migliaccio and Bouzigues 2020; Killen et al. 2020). The COVID-19 experiences of people with dementia and their family caregivers are scarce, despite this knowledge. Determining how the pandemic will affect those living with Alzheimer’s disease and their care partners will require knowledge of the impact of COVID-19 (such as the difficulties and strategies for dealing with them). Consequently, the goal of this review was to synthesize the existing literature on the experiences of COVID-19 on people with dementia and their family caregivers.

COVID-19 restrictions and imposed confinement measures, according to research, have increased the already heavy workload of family caregivers for people with dementia (Cohen et al. 2020; Vaitheswaran et al. 2020). Ten of the articles focused on caregiver exhaustion and burnout (Barros et al. 2020; Brown et al. 2020; Canevelli et al. 2020; Cohen et al. 2020; Greenberg et al. 2020; Killen et al. 2020; Migliaccio and Bouzigues 2020; Roach et al. 2020; Savla et al. 2020; Vaitheswaran et al. 2020). Because of the limitations imposed by COVID-19, care partners’ workloads have increased as a result of being unable to access services such as respite care and daycare as well as meal programs and medical specialists (Cohen et al. 2020; Roach et al. 2020).

Dementia caretakers’ limited support and services have been exacerbated by the COVID-19 pandemic (Savla et al. 2020). In the literature, family care partners’ specific challenges during COVID-19 included increased household chores, limited social interaction (Savla et al. 2020), restricted movement outside the home, employment disruptions, financial concerns (Roach et al. 2020), technological challenges (Vaitheswaran et al. 2020), medication management for people with dementia (Brown et al. 2020), and restricted/terminated formal supports during the tense time period of the study (Barros et al. 2020). As a result of being solely responsible for care, care partners became increasingly frustrated and overburdened (Cohen et al. 2020; Savla et al. 2020).

According to Greenberg and colleagues (Greenberg et al. 2020), caregivers face increased difficulties if they are forced to perform difficult medical procedures like tube feeding, colostomy and catheter care, injections, and home dialysis without the assistance of home care providers. Since mental and physical health, as well as burnout (Brown and Roach 2020; Migliaccio and Bouzigues 2020), were the most common issues in the literature, the focus of this study was on the care partner’s mental and physical health (Barros et al. 2020; Cohen et al. 2020; Killen et al. 2020l; Canevelli et al. 2020; Savla et al. 2020; Vaitheswaran et al. 2020). For caregivers of people with advanced dementia, studies show a correlation between the amount of work they do and the length of time they spend at home or in the community (Cohen et al. 2020; Vaitheswaran et al. 2020).

This lockdown and closure of businesses that were not essential to the well-being of dementia sufferers was discussed in several articles. It has been reported that the COVID-19 lockdown has had a significant impact on people with dementia, such as altering daily routines, limiting physical activity and leading to social isolation. It has also been reported that health care services have been restricted or terminated as a result of the lockdown. Many other researchers have made the case that confined patients on COVID-19 are less active, less engaged in meaningful activities, less intellectually stimulated, and more socially isolated (Brown et al. 2020).

Many authors who wrote about the difficulties of COVID-19 confinement referred to a lack of access to health care and programs. Reduction or termination of access to day programs (Palermo et al. 2020), respite care (Savla et al. 2020), cognitive stimulation programs (Lara et al. 2020), meals, home care services, neurological rehabilitation therapy (Cohen et al. 2020), physical activity programs, health clinics (Killen et al. 2020), and demerit programs (Migliaccio et al. 2020) were among the specific services that were impacted by these policies (Vaitheswaran et al. 2020).

Dementia patients’ isolation from COVID-19, as well as physical distancing measures, contributed to social support difficulties. According to Boutoleau-Bretonniere et al. (2020), people with dementia were adversely affected by the cancellation of social gatherings, volunteer events, and religious activities. Furthermore, people with dementia who reside in long-term care facilities were found to be particularly vulnerable to the isolating effects of COVID-19 (Edelman et al. 2020). People with dementia who are isolated in long-term care facilities are more likely to suffer from depression, boredom, apathy, anxiety, irritability, restlessness, and difficulty sleeping, according to several studies (Velayudhan et al. 2020).

Damian Sendler

Twenty-one articles focused on the neuropsychiatric and cognitive effects of COVID-19 confinement on people with dementia (Barros et al. 2020; Boutoleau-Bretonniere et al. 2020; Canevelli et al. 2020; Chen and Chen 2020; Cohen et al. 2020; Goodman-Casanova et al. 2020; Lai et al. 2020; Lara et al. 2020; Palermo et al. 2020; Roach et al. 2020; Vaitheswaran et al. 2020; Wang et al. 2020). Boutoleau-Bretonniere et al. (2020) found that confinement had a negative impact on people with Alzheimer’s disease and low pre-pandemic cognitive function, for example, in terms of neuropsychiatric symptoms (such as agitation, depression, and anxiety). Disruptive behaviors, anxiety symptoms, irritability, and expressions of being upset about others wearing facemasks or their own facemasks were all reported by Vaitheswaran and colleagues (2020) in people with dementia. Other studies have suggested that confinement can worsen neuropsychiatric symptoms like agitation, apathy, anxiety, depression, sleep disorders, and cognitive decline (Lara et al. 2020; Chen and Chen 2020; Cohen et al. 2020). (Barros et al. 2020; Lai et al. 2020; Palermo et al. 2020; Roach et al. 2020). It was found that people with Alzheimer’s disease who lived alone or had a lower level of cognition were more likely to experience negative neuropsychiatric effects as a result of the lockdown (Boutoleau-Bretonniere et al. 2020; Cohen et al. 2020).

Damian Jacob Markiewicz Sendler: COVID-19’s challenges have been documented in numerous articles, but only four articles have focused on how people with dementia and their caregivers cope. A study of rural family caregivers found a variety of coping mechanisms, including gardening, spending time alone, spending time outdoors, making protective masks for care aides, using their cell phones, and playing computer games (Savla et al. 2020). People with dementia and their care partners can use a variety of coping strategies, such as maintaining daily routines that include housework, recreational activities (such as reading, computer games, and exercise), having access to family support networks and/or delivery services to get their groceries and medications, engaging in social interactions via phone or video chats (Brown et al. 2020; Canevelli et al. 2020), and staying in their own homes as long as possible (Goodman-Casanova et al. 2020). Engagement with technology was essential to many of these coping mechanisms.

eleven papers on COVID-19 identified the need for more evidence-informed research on home-based interventions to support people with dementia in pandemics and other emergencies (Brown et al. 2020; Chen and Chen 2020; Cheung and Peri 2020; Edelman et al. 2020; Greenberg et al. 2020; Lai et al. 2020; Canevelli et al. 2020; Migliaccio and Bouzigues 2020; Padala et al. 2020; Vaitheswaran et al. 2020). Research on the implementation of home-based technological interventions such as physical exercise programs, cognitive stimulation therapy and the expansion of telemedicine services (e.g., home video consultations, prescription refills and virtual access to health specialists) during the pandemic has been highlighted in the literature (Brown et al. 2020; Cheung and Peri 2020). (Edelman et al. 2020; Lai et al. 2020; Canevelli et al. 2020; Chen and Chen 2020; Vaitheswaran et al. 2020).

In contrast to technological interventions, home-based interventions for people with dementia and their caregivers are relatively new (Padala et al. 2020). Consequently, individuals with dementia (Brown et al. 2020) or their care partners may struggle to use technology and require guidance, online training, as well as tools to assist them (Barros et al. 2020; Vaitheswaran et al. 2020). Such research is necessary to understand the implementation and technological challenges from the perspective of people with dementia and their caregivers, according to Cheung and Peri (2020).

The need for more research on the implementation and evaluation of virtual social support interventions for people with dementia and their caregivers was also highlighted in the articles. (Migliaccio and Bouzigues 2020). Technology, such as FaceTime and WhatsApp, can make it easier to connect with others, as noted by Greenberg et al. (2020). People in long-term care facilities and nursing homes rely heavily on technology and social networking platforms because of the strict lockdown and visiting restrictions (Edelman et al. 2020; Padala et al. 2020). It is argued by Padala et al. (2020) that the ease of access and use of these applications in institutional care should be studied and evaluated.

Damien Sendler: The COVID-19 pandemic has placed an unprecedented financial and human toll on people living with dementia and those who care for them. Complicacies from COVID-19 are exacerbated by older age, frailty, and health conditions commonly associated with dementia (Alzheimer Society of Canada 2020; Centers for Disease Control and Prevention 2020). A study on how COVID-19 affects people with dementia (e.g., challenges, barriers, supports, and coping strategies) is not currently underway, despite these risks. The impact of COVID-19 on policies and programs for the support of people with dementia during the pandemic must be understood, however. As a result, the purpose of this scoping review was to identify and synthesize the existing literature on COVID-19 experiences of people with dementia and their family care partners.

Damian Jacob Sendler

The impact of COVID-19 on the lives of people with dementia and the caregivers who support them was examined in this scoping study (Roach et al. 2020; Savla et al. 2020). COVID-19 is causing significant difficulties for dementia patients, such as caregiver fatigue and burnout, confinement difficulties, worsening neuropsychiatric symptoms, and deteriorating cognitive function, according to our study’s findings This review examined a wide range of manuscript types and found that these issues were common to all of them (e.g., commentaries, letters to the editor, and original research studies). Factors like living alone, having advanced dementia, and the length of confinement to a community home in the wake of the pandemic were also found to worsen the pandemic’s effects (Goodman-Casanova and colleagues, 2020). (Boutoleau-Bretonniere et al. 2020; Cohen et al. 2020).

With limited or no access to formal services (e.g., home care, meal programs, and respite), COVID-19 found that family caregivers of people with advanced dementia were particularly vulnerable to care partner burnout (Savla et al. 2020). Aside from what has been documented in the literature, we have seen firsthand in our clinical practice that families of people with dementia face additional difficulties. It can be difficult to find and retain professional help, and it can be difficult to learn the intricacies of caring for a loved one with dementia without educational training. These difficulties can lead to increased family tension and disagreements about the care plan for a dementia patient.

Researchers and policymakers will benefit from the findings of this scoping review. More research into COVID-related coping strategies and support systems for people with dementia and their care partners is urgently needed, according to this review. Only a few articles dealt with how people with dementia can cope with COVID-19’s challenges, despite the fact that many articles discussed the difficulties (Brown et al. 2020; Goodman-Casanova et al. 2020; Canevelli et al. 2020; Savla et al. 2020). The pandemic has exacerbated the already heavy workload and scarcity of resources faced by family caregivers as a result of the disease’s spread (Savla et al. 2020). There has been an increase in mental health issues, exhaustion and burnout among care partners. To help caregivers in the event of a pandemic, more evidence-based research is needed to examine coping strategies (Roach et al. 2020; Savla et al. 2020; Vaitheswaran et al. 2020).

There is also a need for more evidence-based research on home-based interventions for people with dementia and their care partners (e.g. cognitive therapy, exercise programs, social support activities, and telemedicine). However, home-based interventions have only recently been made available to caregivers. Consequently, more research is needed to examine the implementation (for example, ease of use), scaling up (for example, geographic expansion to rural and remote communities) and evaluation of home-based interventions for people with dementia and their care partners.

Cooperative and evidence-informed research involving people with dementia and their care partners is critical in the development of COVID-19 policies to support those living with dementia. COVID-19 and dementia have been the subject of numerous articles (e.g., letters to the editor and commentaries), but few studies have been conducted with people with dementia. Dementia sufferers can contribute valuable information about the pandemic’s COVID-19 challenges and mitigation strategies because of their personal expertise and first-hand knowledge of COVID-19. As a result, effective COVID-19 policies for people with dementia and their caregivers must be developed through partnerships and collaborative research.

COVID-19’s effect on people with dementia and their caregivers is a growing unmet research need. Dementia patients are at greater risk from the pandemic’s spread than the general population because of social isolation and the physical distancing methods that are used to contain it. People with dementia and their caregivers have been severely impacted by the lack of access to health and support services as a result of restrictive confinement measures (Savla et al. 2020; Wang et al. 2020). COVID-19 appears to be causing significant difficulties for people with dementia, including caregiver exhaustion and burnout, confinement difficulties, and worsening neuropsychiatric symptoms and cognitive decline. However, only a few articles dealt with how people with dementia and their caregivers can cope with these COVID-related difficulties. Dementia sufferers and those who care for them are currently in a precarious position due to a lack of resources. The pandemic necessitates immediate action to help those with dementia and their caregivers.

Collaboration and more evidence-based research involving people with dementia and their care partners are essential in developing COVID-19 policies to support people with dementia. People suffering from dementia can contribute their personal expertise and lived experience of COVID-19 to the discussion of COVID-19 challenges and mitigation strategies. In order to reduce mortality and provide assistance to those suffering from dementia during the pandemic, cooperation and more research based on solid evidence are essential.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian Jacob

Damian Sendler: Obesity caused by a positive energy balance is a serious health problem. Obesity has been linked to a slew of diseases, including type 2 diabetes, coronary heart disease, and a variety of cancers. As a result, the prevention and treatment of weight gain are critical. The following treatments have been shown to be effective based on current research: lifestyle changes, special diet plans, prescription medications, and bariatric surgery. Each of these options takes into account the patient’s medical history as well as their BMI category and other co-morbidities. Change in behavior and an increase in energy expenditure are essential for all treatment options. Self-monitoring of food intake and physical activity is a powerful tool for weight loss behavior change. Self-monitoring with digital tools has the potential to improve weight management because they increase self-engagement. It is the goal of this narrative review to summarize the current available treatment approaches for obesity, to provide a selective overview of nutrition trends, and to present a scientific viewpoint on various nutrition concepts for weight loss.

Damian Jacob Sendler: Complex, multifactorial, and largely preventable obesity is defined as abnormal or excess fat accumulation [1]. Weight in kilograms divided by height in metres (kg/m2) is currently the most commonly used criterion for determining whether someone is obese. Obesity is defined as a body mass index (BMI) greater than or equal to 30 kg/m2 (Table 1). In addition to the health risks associated with being overweight or obese, the BMI also measures how much weight a person carries around in relation to their height (Table 1). BMI and waist circumference are used in clinical practice and medical guidelines to measure weight status and abdominal obesity because they are simple, objective, and reproducible. However, BMI alone should not be used to diagnose obesity; other anthropometric and clinical parameters should be considered as well. Body composition and adipose tissue depots can be assessed with the aid of instruments (e.g. bioimpedance analysis, Dual Energy X-ray Absorptiometry, and magnetic resonance imaging) that can be time and money consuming.

Dr. Sendler: Type 2 diabetes, hypertension, dyslipidaemia, cardiovascular disease, and a variety of cancers are all directly linked to being overweight or obese [4]. BMI has recently been shown to be a predictor of severe coronavirus disease 2019 (COVID-19) outcomes [5]. An increase in BMI may also decrease quality of life and shorten life expectancy [6,7,8,9].

Long-term imbalances in energy intake and expenditure are the primary causes of obesity [1, 6, 10, 11]. From 1971 to 2000, the average daily energy intake in men increased by 168 kilocalories (kcal)/day and in women by 335 kcal/day, according to the National Health and Nutrition Examination Survey (NHANES). Men can theoretically gain eight kilograms of weight per year, while women can theoretically gain 16 kilograms of weight per year without any active regulation or adaptation of energy balance. Over the past few decades, the amount of energy consumed has decreased. Adults in the United States walked an average of 5k steps per day in 2003, according to Basset and colleagues. For men, it’s a difference of 13,000 steps/day, and for women, it’s a difference of 9000 steps/day. Men and women gain an average of 31 kilograms per year from a decrease in physical activity without any physiological adaptation. Work-related daily energy expenditure has dropped by over 100 kcal/day in adults in The United States. Over the past five decades, there has been a significant increase in the population’s weight. Other contributing factors, such as diet and the surrounding environment, have been discovered in addition to a person’s way of life [15].

There has been an exponential rise in obesity rates over the last half century [3,6,16,17,18] that has reached pandemic proportions worldwide. Using data from 68.5 million people, the Global Burden of Disease study found that 603.7 million adults were obese in 2015 [19]. Obesity rates have doubled in over 70 countries since 1980 and are still rising in the majority of them [19]. It is predicted that 38% of adults in the world are overweight, and another 20% are obese [20] if current trends continue. As a result of the COVID-19 pandemic, people’s eating and exercise habits have shifted, creating an obesity-inducing environment. [21,22] have shown weight trajectories during the COVID-19 lockdown. Overweight and obesity are expected to rise as a result of this new COVID-19 pandemic [23].] [24, 25]. Obesity is on the rise, and in order to combat this public health problem, it is imperative that BMI be monitored and evidence-based interventions be identified, implemented, and evaluated [19].

In order to treat overweight and obesity, it is generally recommended that people adopt a negative energy balance-inducing lifestyle. Nutrition, physical activity, and behavior are the main components of a variety of lifestyles. An energy deficit of 500 kcal a day should be achieved by reducing energy intake and increasing physical activity, along with behavioral change techniques. Over the course of a year, a moderate amount of weight loss can be achieved. Losing weight alters the energy balance, necessitating a change in energy intake and expenditure. Weight loss results in a new energy equilibrium at a lower level because energy balance is dynamic. It can be difficult to stick to a healthy lifestyle intervention for many people who are overweight or obese. As part of a systematic review and meta-analysis, a focus on dietary intervention and social support were found to improve weight loss outcomes [24].

Diet and exercise are important factors in maintaining a healthy energy balance. Weight gain occurs when the amount of energy consumed exceeds the amount of energy expended. [25] The European Food Safety Authority (EFSA) recommends the daily dietary intake for carbohydrates of 45 to 65 percent, 20 to 35 percent fat, and 0.83 g protein/kg body weight [26]. To lose weight, a daily energy deficit of 500 kcal is recommended, and this can be achieved by avoiding high-calorie foods. The amount of energy provided by fat is more than twice as much as that provided by carbohydrates or protein, making it an extremely high-energy macronutrient. Reduced calorie consumption is supported by a reduction in daily fat consumption. Low-fat dairy products like cheese and yogurt, lean meat, and the avoidance of hidden fats can all help to reduce fat consumption.

Many low-carb diets have a carbohydrate intake of about 40% of the total daily intake. A ketogenic diet is a low-carbohydrate diet in which the goal is to eat as few carbohydrates as possible. Epidemiological data showed that a daily amount of carbohydrates of 50 to 55% correlates with the lowest mortality rate. High-carbohydrate and low-carbohydrate diets both raise mortality [29]. Low-carbohydrate diets tend to be lower in plant-based foods, which are known to be beneficial to health. Eight randomized controlled studies found that low-carbohydrate diets are better for lipid metabolism in overweight and obese people than diets with a low fat content [30]. Even though fat consumption as a percentage of total caloric intake has decreased, data from the NHANES show that compensatory overconsumption of sugars has increased total caloric intake (Figure 31). In general, the stone age diet is a low carb diet, but it isn’t defined in any particular way. Meat and protein make up a large part of this diet. Renouncing grain reduces the variety of foods available. The short-term effects of a paleo-conform diet were examined in small studies with methodological limitations. It was determined that 159 participants in four randomized controlled trials (RCTs) comparing the paleolithic diet with any other diet pattern were included in the study. There was no significant difference in anthropometric changes between a palaeolithic-type diet and the Nordic nutrition recommendations after 24 months in the dietary changes of 70 post-menopausal women with obesity, according to the results of a study comparing it to control diets [32].

Over the course of six and a half and a half months, participants in nearly 50 studies were found to lose an equal percentage weight regardless of their macronutrient composition [34]. Similarly, 811 people were randomly assigned to one of four diets, each consisting of a different combination of fat, protein, and carbohydrates, for the purposes of a different investigation (20, 15, and 65 percent ; 20, 25, and 55 percent ; 40, 15, and 45 percent ; 40, 25, and 35 percent , respectively). According to the completers-analysis, there were no significant differences between the groups after two years of intervention. Findings were also consistent between low-fat, low-energy, Mediterranean-style diets and low-carb, non-energy reduced diets. Following two years of intervention, the mean weight loss was 3.3, 4.6, and 5.5 kg, respectively [27]. The average weight loss after a year of intervention was approximately 6 kg (low carb diet) and 5 kg (low fat diet) in a study with 609 adults with BMI between 28 and 40 kg/m2 [35]. Better quality systematic reviews and randomised controlled trials (RCTs) are needed to establish the superiority of low-carbohydrate diets over other energy-reduced diets in terms of weight loss, according to an analysis of systematic reviews [36]. Moderate weight loss can be achieved even with plant-based versions of the Atkins diet or the Mediterranean diet. According to a meta-analysis, a Mediterranean diet that restricts energy intake is linked to moderate weight loss.

Dietary macronutrient composition has no significant effect on weight loss, as the research has shown. In order to lose weight, a negative energy balance is necessary when following a low carb or low fat diet.

Every day, at least one meal is replaced by a high-protein meal replacement. Supplementation with vitamins, minerals, and trace elements as well as the amount of energy in each serving is required for these products to be marketed for weight management purposes. You can get them in the form of shakes, soups, or meal bars, for example. Dietary and behavioral changes, as well as a meal replacement strategy, are popular weight-loss methods. A VLCD, which replaces all of a person’s meals with fewer than 800 calories per day, is one option. Additionally, you can try an extremely low-calorie diet (LCD) that provides more than 800 kcal/day, typically between 1200 and 1600 kcal/day. Total weight loss ranged from 8.9 to 15 kg in people with type 2 diabetes and 7.9 to 21 kg in people without diabetes in a systematic review and meta-analysis on VLCDs, which lasted from four to 52 weeks. The amount of time spent in the study had no effect on the amount of weight lost. A kilo of weight was lost on a weekly basis on average [40]. Another study compared the effects of meal replacements and other weight loss interventions on the weight of overweight and obese adults over the course of a year. Diets that provide less than 800 calories per day and total diet replacement were excluded from this review. Meal replacement diets, on the whole, resulted in greater year-over-year weight loss than control diets or alternative diets [41]. Diabetic remission clinical trial (DiRECT) of 306 patients with type 2 diabetes mellitus found that total diet replacement (825–853 kcal/day formula diet for 3–5 months), followed by food reintroduction (2–8 weeks), and followed by structured support for long-term weight loss maintenance effectively reversed type 2 diabetes. 86% of those who lost more than 15 kg (24%) were off all medications and in remission from type 2 diabetes at the end of the study’s 12-month follow-up period. A 46% one-year remission and 36% two-year remission of type 2 diabetes mellitus were observed in the intervention group [42,43].

Intermittent fasting can be done in a variety of ways. 16:8 is a time-restricted eating strategy in which people eat only for eight hours a day and fast for the other sixteen. The 5:2 diet consists of five days of regular eating, with no special recommendations or restrictions, and two days of fasting with an energy intake of 500 kcal or less. An energy-reduced diet was compared to a 5:2 diet (two days of 600 kcal and five days of ad libitum energy intake per week) by Conley M. et al. There was no difference in weight loss between the two groups after six months of intervention (5.3 kg (5:2) and 5.5 kg (standard). [44] Participants with obesity were enrolled in an RCT that compared the effects of alternate-day fasting and daily caloric restriction on their weight. Alternate day fasting (ADF) and caloric restriction (CR) both result in comparable weight loss after six months (6.0 percent versus 5.3 percent) [45]. The effects of intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes have been examined in a comprehensive review and meta-analysis of randomized controlled trials. Weight loss was similar between the two groups in the eleven studies that were included in this review [46]. Intermittent fasting has similar effects on weight loss and cardiometabolic parameters as a continuous energy restriction [47,48,49]. Over the course of three months, Allaf et al. conducted a Cochrane review and found that people who followed intermittent fasting concepts lost more weight than those who didn’t (evidence from seven studies in 224 people). The difference in weight loss between intermittent fasting and energy-restricted diets is lost if they are compared for longer periods of time (3 to 12 months; 4 studies; 279 people) [50]. Intermittent fasting has a positive effect on weight loss because of the energy restriction, not because of fasting alone [51,52].

The effects of fasting on metabolic regulation and cardiovascular health are also discussed in this article. When it comes to postprandial indices of cardiovascular and metabolic health, gut hormones, and gene expression in subcutaneous adipose tissue, there is no statistically significant difference between daily energy restriction and alternate-day fasting with or without energy restriction [51].

Damian Jacob Markiewicz Sendler: In a small study with eleven overweight participants, early time-restricted fasting (eating between 8am and 2pm) was examined for immediate effects on glucose metabolism and gene expression.. Sugar, glycaemic excursions, and the expression of the stress response gene sirtuin 1 (SIRT1) as well as the autophagy gene microtube associated protein 1 light chain 3 alpha (LC3A) increased in the morning before breakfast in comparison to the control group (eating between 8 a.m. and 8 p.m.). When compared to the gene expression patterns in the evening, this was a significant difference. Time-restricted feeding has been shown to improve cardiometabolic health in men with prediabetes, but this effect was found to be independent of weight loss in the study by Sutton et al. [54]. The metabolic effects of skipping breakfast and dinner were also studied in an RCT, which included 17 healthy individuals of normal weight. When compared to a control group that ate three meals a day, those who skipped breakfast or dinner used more energy. When breakfast was skipped, fat oxidation increased [55]. Breakfast skipping has been linked to a 21% increased risk of developing type 2 diabetes in a prospective cohort study [56].

In recent years, the concept of personalized nutrition has gained traction, particularly among commercial companies that offer genetic testing directly to consumers. The inter-individual variability of metabolic response to standardized meal challenges suggests that personalized diets can successfully modify elevated postprandial blood glucose and its metabolic consequences [57]. This is one of the main drivers for personalized dietary recommendations. Postprandial triglyceride (103%), glucose (68%) and insulin (59%) responses following identical meals were found to be highly variable between individuals in the Personalised Responses to Dietary Composition Trial (PREDICT1). The inter-individual variability can be predicted by a variety of intrinsic and extrinsic factors. Here, the scientific evidence for gene- and microbiome-based dietary recommendations is summarized.

Damian Sendler

Based on an individual’s genetic make-up, gene-based dietary recommendations are made. There are more than a hundred genetic loci that have been linked to anthropometric parameters [58, 59], which supports the idea that even the inter-individual variation in weight loss success indicates a genetic component. Genetic research shows that the FTO gene has the greatest impact on a person’s weight gain. Though the FTO gene has yet to be fully elucidated, studies have shown that the gene inhibits brown adipose tissue formation [60]. Numerous companies provide genotyping and diet or weight loss advice. Additionally, commercial DNA methylation profiling services have begun to appear. In contrast to the lack of scientific evidence that genotypes are associated with weight loss, these commercially available direct-to-consumer tests.

Single nucleotide polymorphisms play a minor role in the variation in weight loss between individuals, according to a recently published pooled analysis of weight loss data [61]. Genotype-based diet recommendations were found to have no effect on weight loss by the Food4Me study. No significant differences in weight, BMI (kg/m2), or waist circumference were observed when genetic testing results were incorporated into nutrition counseling compared to counseling and care that did not incorporate genetic findings [63, 64]. The American Society of Dietetics and Nutrition clearly states that “the use of nutrigenetic testing to provide dietary advice is not ready for routine dietetics practice.” Currently available research does not show that specific dietary recommendations for weight loss are particularly beneficial for people with a defined genetic make-up [65]. There is no evidence that gene–diet interactions are a major determinant of the success of obesity treatment, according to a systematic review on gene–diet interactions [66]. Due to the lack of clinical evidence for gene-based dietary recommendations on weight loss, more human studies are needed in the future. Polygenetic scores, instead of single nucleotide polymorphisms, will be used to characterize humans based on their genetic predisposition. For five diseases (coronary heart disease, atrial fibrillation, type 2 diabetes, inflammatory bowel disease, and breast cancer), Khera AV et al. developed and validated a genome-wide polygenetic score [67]. Further data analysis has yielded a polygenetic predictor for body weight [68].

Damien Sendler: Individuals’ diet, as well as the prevalence of diseases like obesity, have been linked to the microbiota of the gut. These connections suggest that microbiome-based personalized nutrition can help people lose weight [59]. Dietary interventions can have a significant impact on an individual’s microbiome and this change is person-specific, as well as influenced by the individual’s physiological characteristics [69]. Complex interactions may be better understood if the microbiome and other personal factors are integrated together [70]. A VLCD reduced bacterial abundance and restructured the gut microbiome, according to Von Schwarzenberg et al. Mice were given the microbiota after the VLCD and lost weight as a result of the transplantation. This study found that the relationship between diet and the microbiome influences energy metabolism. [71] Dietary intake affects gut microbiota structure regardless of weight loss [72]. Direct and indirect mechanisms for gut microbiome influence are discussed in a literature review. [73] Future human intervention studies will need to take into account the composition of the microbiota as well as the presence or absence of specific microbes and their metabolic activity. For personalized dietary recommendations, some companies use microbiome analysis similar to genetic direct-to-consumer tests. However, there are no scientific studies to support these claims as of now. Current research on the microbiome’s impact on health through diet is insufficient to support dietary recommendations based on the microbiome [74].

Programs that address nutrition, exercise, and behavior are available to help people lose weight more effectively. For the most part, these initiatives take place in a single country and are implemented by health insurances or healthcare providers. Worldwide Weight Loss (WW) is the most widely used weight loss program (formerly Weight Watchers). At 12 and 24 months, an international study found that the WW program resulted in a moderate amount of weight loss. After 12 months, the mean weight change (completers-analysis) was 6.65 kg, and the mean weight loss (completers-analysis) was 4.76 kg after two years. Johnston et al. have also shown that people who use all of the intervention tools (weekly meetings, the WW mobile app, and WW online tools) lose more weight than those who do not use all three methods [77]. In addition to OPTIFAST, another well-known program that provides scientific evidence of efficacy after a year, there is OPTIMIST. OPTIFAST is a 12-month program that begins with three months of complete dietary replacement, followed by nine months of lifestyle recommendations and group sessions led by professionals. At 52 weeks, the OPTIFAST program resulted in 10.5 percent weight loss compared to 5.5 percent weight loss when compared to a food-based diet [78]. Weight maintenance was allowed during this study’s active weight maintenance phase.

Damian Jacob Sendler

Behavioral obesity treatment relies heavily on self-monitoring of food intake and physical activity as a key component of weight loss success [79, 80]. Dietary self-monitoring and the frequency with which it is performed have been shown to be associated with weight loss [81]. In addition, when combined with other self-regulation techniques, such as goal setting and feedback, self-monitoring can have a positive impact on weight loss [82,83,84]. Digital self-monitoring was found to have a higher level of engagement than paper-based self-monitoring.

When it comes to long-term behavior change techniques, the use of digital tools like online tools and applications (apps), tracking technologies, or even internet-based support is becoming increasingly popular. In a randomized controlled trial (RCT), Carter et al. compared the acceptability and feasibility of a smartphone app-based weight management intervention to that of a website and paper diary. According to the findings, the smartphone app group lost an average of 4.6 pounds in six months, compared to 2.9 pounds for those who used a paper diary and 1.3 pounds for those who used a website. Some research suggests that apps for weight loss may improve weight-related outcomes, but the quality of the studies used to support this claim is mixed [87,88]. Villinger and his colleagues conducted a meta-analysis with over 6300 participants to find out whether or not apps can change people’s eating habits and their health outcomes [89]. Health-related data can be collected quickly and cheaply using digital tools like apps, which have the potential to be widely disseminated and scalable [85,90,91]. Even though there are numerous weight loss apps available, they rarely include evidence-based strategies for behavioral change [92,93].

Many drugs are available to treat obesity pharmacologically, including those that reduce hunger, empty the stomach more quickly, increase absorption of nutrients, or increase feelings of fullness. In the last six years, some of these have been approved for commercial use, while others are still in the testing phase. [94,95]. A total of five medications have been given the green light for use in the treatment of obesity by the Food and Drug Administration (FDA) in the United States and Europe (EMA), including orlistat (as well as phentermine/topiramate, naltrexone/bupropion, and liraglutide) [96]. The goal of pharmacotherapy in the treatment of obesity is to improve patient compliance with dietary and lifestyle changes while also countering the physiological changes that occur when a person loses weight.

Behavioural interventions with one anti-obesity medication can lead to greater weight loss than usual care conditions [96]. Over the course of a year, many anti-obesity medications are only able to reduce body weight by 5–10 percent, and weight loss typically lasts only six to eight months [98]. Five weight loss medications (orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, or liraglutide) were compared in a systematic review and network meta-analysis for their effectiveness in weight loss. In total, 28 RCTs with 29,018 patients were included in this review. There was a statistically significant difference between the placebo group and the drug group in terms of the odds of losing 5 percent of body weight after a year. For phentermine-topiramate, topiramate, liraglutide, bupropion, naltrexone, and orlistat, the excess weight loss was 8.8 kg, 5.3 kg, 5.0 kg, and 3.2 kg, respectively.

People who are morbidly obese may benefit from bariatric surgery. Bariatric surgery can be used for a variety of reasons in various countries. Bariatric surgery is generally only available to those who have tried and failed at other weight loss methods in most countries. Food restriction and malabsorption are the two primary mechanisms. By restricting the amount of food one can consume, one can keep the rest of one’s digestive system intact, thus reducing one’s risk of obesity. Bypassing or removing part of the meal results in a loss of calories and nutrients. Because food travels a shorter distance through the gut, fewer kilocalories and nutrients are absorbed. An annual report on all bariatric surgeries submitted to the Global Registry is published by the International Federation for Surgery of Obesity and Metabolic Disorders (IFSO) [100]. From 2014 to 2018, data from 51 countries where documented surgery had taken place was studied and analyzed. Sleeve gastrectomy (46.0%), Roux en Y gastric bypass (38.2%), one anastomosis gastric bypass (7.5%), and gastric banding (5.0%) were the most common surgical procedures [100]. Puzziferry et al. conducted a systematic review that examined 29 clinical studies involving 7971 patients. Gastric bypass was found to be more effective than gastric band weight loss [101]. All current bariatric procedures, according to a meta-analysis and systematic review, are associated with significant weight loss, but one-anastomosis gastric bypass and sleeve gastrectomy still need more long-term data [102]. In particular, patients who adhere better to their pre-surgery visits and behavior changes are more likely to experience greater weight loss following surgery [103]. In any case, the best results are only possible with thorough pre- and postoperative planning [104]. Preoperative evaluation necessitates a number of steps. Psychological readiness for bariatric surgery, professional nutrition assessment, and patient education are all important components of the bariatric surgery preparation process. Modifications to the gastrointestinal tract cause nutritional deficiencies to be a long-term clinical issue in patients [105]. Following bariatric surgery, European Association for Endoscopic Surgery (EAES) clinical practice guidelines recommend postoperative nutritional and behavioral advice [106]. As part of weight management after bariatric surgery, nutrition monitoring is critical for ensuring that patients adhere to healthy eating and supplementation regimens. Additional benefits include preventing weight gain and identifying possible nutritional deficiencies, as well as contributing to the preservation of a healthy lifestyle.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian Jacob

Damian Sendler: The theory of attachment looks at how people form and maintain close emotional ties with one another. In addition, it provides a framework for analyzing the central religious concept of one’s personal relationship with God. Normative attachment processes and individual differences in attachment are examined, as well as basic concepts in attachment theory and survey research. There is strong empirical evidence that many religious people see God as a source of resilience in their lives (e.g. a safe haven and secure base). In addition, we provide a summary of attachment-related religious development pathways. Finally, we review attachment-based research on religion and mental health and discuss future research directions.

Damian Jacob Sendler: Adherence to an attachment behavioral system (Bowlby [1] claims) motivates people to seek out supportive others (attachment figures) in times of need for protection and safety, according to Bowlby [1]. An attachment figure provides a safe haven (i.e. alleviation of distress and comfort) and a secure base from which to explore, learn, and thrive, according to Ainsworth [2]. A key component of attachment theory is the idea that people’s experiences with attachment figures and their subsequent storage of those memories in mental models of self and others (referred to as “internal working models,” or “IWMs”) lead to individual differences in how the attachment system functions. Positive IWMs of self-worth and other people’s goodwill are reinforced when children interact with mostly sensitive/responsive caregivers, leading to an expectation that support (a safe haven and a secure base) will be available when needed. Attachment insecurity can occur if attachment figures aren’t consistently responsive or sensitive. IWMs can indicate this.

Dr. Sendler: People’s distinct ways of forming and maintaining emotional connections to others have been studied extensively in the contexts of childhood and adulthood [5, 6]. To a certain extent, attachment-related avoidance reflects the degree to which a person distrusts the intentions of others and defensively strives to preserve their behavioral and emotional autonomy (attachment-system deactivation). Additionally, a person’s anxiousness related to attachment can be measured by the extent to which he or she fears that others will not be supportive (attachment-system hyperactivation). When it comes to attachment security, people who score low on both avoidance and anxiety are seen as more secure than those who score high on either (i.e. comfortable with intimacy and more secure interdependence with others). Years of research have largely confirmed that secure attachments help reduce anxiety and promote growth [6,7], and that sensitive/responsive caregiving can lead to the development of secure attachments.

According to [8••,9] the religion as attachment model, people’s religious thoughts, feelings, and actions can be explained. While many faith traditions view God as a source of love and comfort, Kirkpatrick and Shaver [10•] claimed that believers may perceive God as an especially powerful source of support based on their attachment bond with Him (i.e. a safe haven and secure base). Both doctrinal and experiential-affective representations of God’s role as an attachment figure [11•] When it comes to personal prayer, people who are religious report that they see God as a dialogical, relational partner [12].

There is a correlation between the development of attachment and a person’s devotion to God [8••]. Symbolic thought, mentalization, and other cognitive developments that decrease children’s reliance on physical contact with the caregiver and increase their ability to rely on internalized sources of security also allow them to represent noncorporeal entities like God as attachment figures.

[8••] There’s a lot of evidence that believers see God as their safe haven and secure base. Examples include petitionary prayer, raising one’s arms in a show of strength, and other rituals that explicitly ask for a safe haven [13]. Beck [14] also found that people who have a strong attachment to God are more likely to engage in theological and existential exploration, as well as be open to and accept differing viewpoints. Separation was used as a threat prime in two studies, and both adults and children reported an increased sense of spiritual intimacy as a result [15•,16•]. It was also found that believers’ cognitive access to God-related representations was enhanced by a threat prime (e.g. failure), and that a ‘God’ prime enhanced their cognitive access to positive, secure-base-related words and increased their positive affect in response to neutral stimuli. More evidence for the secure base function, Kupor et al. [18] found that those with a secure attachment to God were more likely to engage in exploratory risk-taking.

The correspondence hypothesis and the compensation hypothesis [9••,10•] have been proposed to explain how attachment-related experiences can influence a person’s religious development. There are two parts to the correspondence hypothesis. An IWM derived from an experience with another person can be extrapolated to include representations of God. Negative IWMs promote more negative depictions of God, while positive IWMs promote more positive depictions of God. A secure attachment orientation and sensitive/responsive caregiving help children learn social skills from their parental figures, which leads to greater religious affinity between parent and child (i.e. socialized correspondence). According to the compensation hypothesis, religious experiences can be used to make up for a lack of attachment security in intimate relationships.

Many studies [8••] have lent credence to these hypotheses. According to research [19,20,21], loving God images are positively linked to feelings of security and experiences of sensitive/responsive caregiving. Nkara et al. [24] found that estimates of sensitive/responsive caregiving on the AAI predicted more coherent, benevolent God representations on the RAI three years later using a Religious Attachment Interview (RAI) [22] modeled after the coded semi-structured Adult Attachment Interview (AAI) [23]. Confident attachment discourse predicted more benevolent depictions of God on the AAI.

A correlation between IWM and experimental studies has also been found. Following threat primes, participants with more secure attachment (as operationalized by recalled childhood attachment history [15•], child attachment representations [16•], and adult attachment style [17••]) showed higher levels of increased connection to God as well as greater access to God concepts. According to the AAI, children of mothers who had strong attachment representations reported a more personal relationship with God, further supporting the idea that there is an intergenerational connection [25•].

Damian Sendler

The correspondence hypothesis has also been supported by research into exploratory religious behavior. Higher attachment security was linked to more in-depth exploration of religious ideas in a study of adult Jewish converts and apostates [26]. Students who had a strong sense of belonging to a group of friends or family were more likely to express feelings of optimism and self-assurance in interviews about their religious exploration [27].

The intergenerational transmission of religion is also facilitated by secure attachment [20,28]. Individuals who report responsive caregiving have higher scores on religion variables than those who report less favorable caregiving at high levels of parental religiosity [10•,29]. Adults who are more attachment-secure tend to have religious changes that are in line with their parents’ levels of religiosity as children, according to Greenwald et al. [26]. attachment anxiety was linked to a greater number of abrupt shifts, a rejection of parents’ religion, and emotional compensation themes, whereas attachment avoidance was linked to a smaller number of exploratory and socialization themes. Last but not least, in a short-term prospective study of religious development in adolescence, secure attachment to parents predicted later reaffirmation of their parents’ faith [30].

Damian Jacob Markiewicz Sendler: Conversion to a new religion and the reasons for this appears to be where the majority of evidence supporting the compensation hypothesis comes from. Many studies have found that insensitive caregiving experiences and attachment insecurities are linked to religious instability, especially sudden-intense religious conversions that take place in turbulent life contexts [31•]. Self-report measures of attachment in adulthood, such as the recalled attachment to parents [32] and the current romantic attachment [26], as well as the AAI [21•], have both shown a link between religious instability and a lack of security in romantic relationships. A wide range of cultural contexts (e.g. monotheistic faiths, countries) have been found to be linked to these findings. There are many ways in which religion can be used as a form of compensatory therapy for people who are experiencing attachment system hyperactivation. But no systematic study has examined the extent to which attachment-insecure individuals can gain a sense of security over time through a compensatory relationship with God. Religious compensation, according to Granqvist [2], may facilitate earned security in exceptional cases, but not by default (because negative IWMs usually linger).

As an attachment model, religion-mental health linkage is well-understood [8••]. As a result, factors such as stress and low social well-being tend to amplify the positive relationship between religion and mental health. When it comes to mental health, religion has a significant impact on aspects such as freedom from worry/fear and a secure base to explore from (e.g. personal competence). Mental health is most closely associated with religious practices that foster a trusting relationship with a loving deity [35]. There are a number of methodological flaws in the relevant studies, including the use of cross-sectional designs, self-report measures, and small convenience samples [36]. Nevertheless, we present here studies that stand out for the quality of their designs, samples, or findings.

Damian Jacob Sendler

Emotional problems and psychological distress have been found to be inversely related to a Christian’s secure attachment to God. Even though Muslim-Jewish relationships have been described as more behavioral/ritual than emotional/relational, similar associations have been found for both religions. Secure attachment to God has been found to predict mental health above and beyond intrinsic religiosity, social support, and interpersonal attachment styles in these studies, which is significant.

Research suggests that there is a two-way relationship between one’s sense of spiritual well-being and one’s ability to cope with stress. Depressive feelings, for example, predicted later increases in insecure attachment to God [41•] among Belgian nursing home residents. When it comes to religious/spiritual struggles, a study of American undergraduates found that those who had more negative experiences of God (cf. an insecure attachment) six months later had more negative views of God one year later [42]. An impressive longitudinal study (N = 531), however, found that a lack of security in one’s relationship with God was linked to deteriorating mental health over time [43], and this effect outweighed the importance of one’s relationship with others. Furthermore, a long-term increase in self-esteem and optimism is predicted by a person’s sense of security with God [44]. A six-month follow-up study found that a person’s level of spiritual security was associated with an increase in the number of transformative sacred moments (e.g., transcendence and interconnectedness) [45]. A prayer intervention, according to Monroe and Jankowski [46], facilitated corrective experiences in attachment to God, which in turn led to better mental health.

Damien Sendler: Research supporting the religion-as-attachment model has been extensive. As far as normative aspects of attachment to God are concerned, there are still a number of unanswered questions. How does the loss of God’s presence in one’s life manifest itself?). Over-reliance on measures of self-report in the study of religious attachment and mental health has also led to issues of semantic overlap and shared method variances that need to be addressed. Few studies have examined the hypotheses in clinical samples or sought to improve the construct validity of the measures for distinct populations. In order to address these shortcomings, attachment-religion research needs to expand its repertoire of studies. As an illustration of the need for neuroscientific studies, well-validated implicit measures are required to capture representations of God at a level less conscious than conscious thought [cf. [12]]. More long-term longitudinal studies are also needed to examine religious/spiritual development from childhood to adulthood from an attachment perspective and the intergenerational transmission of religion. New-age spirituality [21•] and the replacement of God by a welfare state in secular cultures [53] are just a few of the intriguing questions raised by the religion-as-attachment model that merit further exploration.
As a conclusion, the religion as attachment model [8•,54] provides an effective theoretical framework and research program for studying normative processes and individual differences in people’s religious beliefs and relationships with God. With improved methodological rigor, we hope this review will lead to new studies expanding and refining the model.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian Jacob

Damian Sendler: Over the past 20 years, positive psychology interventions have been shown to be effective in improving the well-being of children and adolescents, as well as reducing their levels of anxiety and depression. Students’ cognitive and socio-emotional development has been fostered through positive psychology by strengthening positive relationships, positive emotions (such as optimism), character strengths (such as hope), and optimism (such as self-efficacy). It’s not clear how these interventions affect children under the age of five. It is the goal of this review to look at the impact of positive psychology interventions on the well-being of young children (under the age of six) in the preschool and family contexts. In accordance with the PRISMA guidelines, several electronic databases were searched. The results were then thoroughly reviewed and reported. Due to the low number of studies (n = 3), more research in this area is needed. As a result, all of the selected studies demonstrated the importance of positive psychology interventions with young children to promote positive aspects of development, such as gratitude and positive emotions. It is pointed out that the field has its limitations.

Damian Jacob Sendler: It is common knowledge that the well-being of children can be traced back to certain demographic and socioeconomic factors [1]. As with other environmental and social factors, poverty (lack of basic resources, limited access to health care, and lack of family time) has been shown to have a direct impact on the physical and mental health of young people (see, e.g., [2]). It could also have an impact on the child’s happiness, which is another indicator of well-being, in a variety of ways [3]. (p. 336). For example, well-being can also be defined more broadly as an individual’s subjective experience of how their lives are progressing (see, for example, [4], p. 295). Seligman [5] defines well-being as “the positive evaluation that people make of their lives” and it “includes positive emotion, engagement satisfaction and meaning” [6]. (p. 1). Positivist psychology takes into account both hedonic and subjective well-being when assessing health and happiness [7]. Hedonic well-being includes feelings of pleasure and contentment, while subjective well-being is concerned with negative feelings (such as sadness or grief). Eudemonic well-being is operationalized in terms of positive relationships, autonomy, and purpose in life [8]. “[8]” Despite the fact that the most widely used well-being measures assess overall satisfaction or happiness in life [9], these perspectives have implications for measurement. Positivity psychology emphasizes that it is critical to create supportive living environments (such as families or institutions) at all stages of life, even at the school or preschool level, even if studies on this topic are rare in the field of positive psychology. The well-being and mental health of children and young children can only be improved by promoting healthy environmental systems, particularly healthy school environments [10]. Children’s well-being and mental health depend just as much on their social and emotional development as anything else. Children’s ability to express their emotions effectively, as well as their ability to build strong self-confidence, are critical for their development even before they start school [11]. 52 systematic reviews and meta-analyses in support of the importance of early intervention with young children, especially in areas that develop emotional and social skills, to promote well-being and prevent mental health problems in schools [12].

Dr. Sendler: At present, many interventions are being developed and implemented in schools to develop and adjust social and emotional skills, such as programs promoting social and emotional learning (SEL) (e.g., [13]) or interventions promoting positive youth development (PYD) (see e.g., [14]). Nevertheless, it appears that additional programs are required that aim to improve young children’s mental health by focusing on well-being as a motivating factor to feel competent in future learning, reducing stress and increasing life satisfaction. Positive psychology, the science of well-being, and the study of optimal human functioning [15] are the focus of research in the field of positive psychology.

Positive psychology is a branch of psychology that seeks to better one’s mental health and well-being by emphasizing positive emotions and character traits. Positive emotions help children and adolescents, as well as adults, develop their social, physical, intellectual, and psychological resources [17]. It is true that the foundations of emotional development are established during childhood and influence the emergence of social and cognitive processes during this time. Adults and children alike can benefit from having positive character traits such as optimism [19] in their lives. It is important to instill a positive outlook in children in order to avoid developing anxiety and depression issues [21]. Furthermore, research has shown that children with higher levels of hope, another positive trait, are more positive about themselves and less depressed than children with lower levels of hope.

Researchers in positive psychology use placebo-controlled trials of positive psychology interventions in order to test practices that can improve well-being (PPIs). Based on positive psychology theory, these programs aim to promote long-term well-being [23]. Seligman’s [24] PERMA model, which refers to five conditions: positive emotions, which refer to feelings that motivate human actions, such as happiness, pleasure, and optimism; engagement, which refers to participation and concentration (flow state) in learning activities; relationships, which refers to the perception of having positive and secure relationships, receiving support and appreciation; and perceived meaning, which refers to the belief that one’s actions have a purpose and that one’s life has meaning. A sixth condition, health, has been added to this model in order to create the PERMA(H) model in the educational context. A person’s overall well-being is a combination of physical, emotional, and psychological health, all of which play a critical role in establishing healthy habits at an early age. These dimensions, which can be measured independently of each other, are essential for well-being as well as for fostering positive affect, establishing secure relationships, and increasing life satisfaction and decreasing the risk of mental health problems, including in young children, according to this model of well-being. If you’re looking at well-being through the lens of these dimensions, it’s helpful and beneficial, but it’s also true there is little to no consensus in the literature on the definition of well-being. Both conceptually and practically, the term “well-being” is ill-defined. It is thus possible to identify a number of factors that are either inherent to the phenomenon or against which the phenomenon can be recognized and/or measured (p. 183). According to previous research, Dodge et al. [30] proposed a new definition of well-being that aimed to be simple yet universal in nature, as close as possible to the need for equilibrium or homeostasis that exists in every human being. As a result, “well-being” is defined as the “point of equilibrium between an individual’s resource pool and the challenges faced” (p. 230). This definition’s optimism, which connects it to positive psychology, is another strength. As a result, people are viewed as having the power to influence their own happiness and well-being [5,30] by using their own resources and overcoming their own obstacles. What positive psychology intervention programs are trying to do is teach people how to manage their own well-being, and this is exactly what the PERMA(H) model is all about.

PPIs have been shown to improve well-being and reduce depressive, anxiety, and stress symptoms in both adults and children, according to several meta-analyses [31,32,33,34,35,36] and younger people, primarily those aged 8 to 18 [37,38,39] or both [40]. Samples from Western and non-Western countries were used in these meta-analyses. Significant small-to-medium effects on strength and quality of life have been reported by Carr et al. Meta-analyses [31,32 and 38] also reported that findings remained significant after follow-up (two to twelve months), such as decreased depressive symptoms or increased well-being in adults and young people. Carr et al. [40] found that PPIs’ effects on quality of life and well-being were higher in younger and older samples, respectively, based on moderator impacts (e.g., age, clinical status, and program duration). Furthermore, according to Sin and Lyubomirsky [35], age was one of the factors that influenced the effectiveness of the intervention, along with depression status, self-selection, format, and length. Carr et al. [40] also showed the greatest benefits when PPIs were provided in a long-term individual or group therapy format in clinical populations, in agreement with Bolier et al. [31] and Sin and Lyubomirsky [35]. For non-clinical populations, educational contexts or other contexts, and individuals, short PPIs were found to be more effective than longer ones [40]. Certain limitations, most notably the bias associated with small sample sizes, must be taken into account when interpreting some of these findings. That’s the case, in fact, with White and colleagues [41] revisiting some of the most widely cited meta-analyses on the efficacy of PPIs on well-being and depression, such as Sin and Lyubomirsky [35]. PPIs’ effects on well-being were smaller than those found by Bolier et al. [31] and Sin and Lyubomirsky but still significant when the small-sample-size bias is taken into consideration. “The effects of PPIs on depression were variable, dependent upon outliers and generally not significant,” according to their findings (p. 1). White et al. [41] called for more PPI research with a larger sample size in accordance with other researchers arguing for preliminary power analysis (e.g., [32,40]).

However, positive psychology’s application in the form of positive education and intervention in schools came later [42]. A common goal of PPIs in schools is to improve young people’s development and prevent future difficulties by teaching them positive behaviors [43]. Systematic meta-analyses [43] have demonstrated the advantages of positive psychology interventions in schools. To give one example, Brunwasser et al. [38] reported significant effects on young people’s depressive symptoms (but not on depressive diagnoses) of an intervention in resilience, namely lower levels, especially at the post-test follow-up measurement point (Penn Resiliency Program, PRP). Bastounis et al. conducted a meta-analysis to evaluate the effectiveness of a resilience intervention (PRP) for 8–17-year-old students to prevent depression and anxiety, and found no evidence of a reduction in depression or anxiety. Though Renshaw and Olinger Steeves [39] found that young people’s well-being can be predicted by their level of gratitude, they found that interventions based on this trait were ineffective. Aside from the fact that they have mixed results, positive psychology interventions have the advantage of addressing the needs of all students, whether they are troubled or not [14,44]. According to McCabe et al. [45], positive psychology exercises to teach concepts such as happiness, gratitude, and life satisfaction can be implemented in schools as measures of primary prevention to promote individual growth as well as positive interactions among all students, not just those at risk. ” (p. 180). Similarly, it appears that enjoyment of schoolwork plays a greater role in motivating students than anxiety does [47]. As a result, the school setting is viewed as a critical criterion for evaluating children’s well-being. As poor schooling has long-term consequences for the adult life course [48], children’s quality of life is also an important OECD survey indicator. Even more importantly, children’s happiness and well-being at school are influenced by a positive school climate [45].

PPIs were studied for their effect on positive and negative affect in two separate studies [55,57]. Their conclusions diverge just enough to warrant mentioning. All conditions had no effect on positive affect, according to Owens and Patterson [57]. (i.e., gratitude, best possible selves condition, or control condition). Even at a young age, children were able to express gratitude and experience gratitude for a wide range of people and events (i.e., through drawing and explaining what they were grateful for).

Shoshani and Slone [55] found a significant increase in positive emotions in the experimental group, especially empathy, as reported by the children themselves and their parents, despite the fact that neither Owens and Patterson [57] nor Shoshani and Slone [55] found any effects on negative emotions.

Qualitative evidence provided by teachers in the Elfrink et al. [56] study supports the claim that PPIs increase student involvement in classroom activities. Teachers also reported that the program had a positive impact on their ability to monitor and support student engagement. The intervention group (with a medium effect size) in Shoshani and Slone [55] teachers’ study reported a significant increase in children’s engagement, but the control group did not. However, they found no evidence that the PPI had any effect on children’s ability to self-regulate.

An increase in pro-social behavior in the intervention group but not in the control group was found by Shoshani and Slone [55]. Teachers’ perceptions of their relationships with students did not significantly change between pre- and post-intervention in Elfrink et al[56] .’s study, even though pro-social behavior can lead to better relationships. Subscale scores, however, showed that teachers’ closeness with students, including feelings of affection, warmth, and communication, improved significantly as a result of PPIs. There was a significant improvement in subscale scores such as “supportive cooperation and active learning”, “forbidding physical punishment and violence”, and “not tolerating bullying, harassment, and discrimination” as well as “promoting equal opportunities and participation in decision-making” as a result of the intervention, as reported by parents in this study (large effect size).

Damian Sendler

PPIs have been studied for their impact on children’s overall health in a number of research studies. Positive effects on children’s self-reports of health-related quality of life were found by Elfrink et al. [56], with a greater impact on younger children (p. 224). Owens and Patterson [57] and Shoshani and Slone [55] used life satisfaction as a measure of children’s well-being. Shoshani and Slone [55] found a significant rise in children’s life satisfaction in the intervention group, but not in the control group, in contrast to Owens and Patterson [57], who found no significant effect of the intervention on life satisfaction (regardless of condition). Owens and Patterson [57] found a significant increase over time in the best possible selves condition, but not in the gratitude or control conditions, which are commonly recognized as predictors of later health conditions.

The SDQ was used to measure well-being in terms of mental health (i.e., behavioral issues) in two separate studies. Also, the outcomes are different here. According to Elfrink et al. [56], the intervention had a positive effect on a variety of behavioral issues, including hyperactivity, emotional instability, and issues with interpersonal relationships. There were no significant changes in any of the subscales, despite the fact that the overall difficulty score decreased significantly between pre- and post-intervention (medium to large effect size). Teachers’ qualitative evidence backed up the quantitative findings, showing that PPI had a positive effect on children’s behavior. Behavioral issues were also said to be less frequent among the children’s peers. But Shoshani and Slone [55] could find no improvement in mental health problems following this intervention. Both the experimental and control groups showed a significant effect of time, i.e. a decrease in mental health difficulties.

Damian Jacob Markiewicz Sendler: The moderator effects were accounted for in each study that made the cut. Just two variables (age and gender) were found to have a significant impact on socioeconomic status (e.g., educational level). In their study, Shoshani and Slone [55] found that the only variable associated with one outcome was a person’s chronological age (conduct problems). It was also discovered that younger age was associated with better subjective well-being and fewer mental health issues when they first began their research. There was a relationship between the frequency with which realistically possible selves responded in Owens and Patterson [57] studies (i.e., declining with age). Finally, Elfrink et al. [56] found that the PPI had a larger impact on quality of life (a health-related variable) in younger children than in older ones.

Owens and Patterson [57] found that girls reported their best possible selves more frequently than boys did, and that gender had a significant impact. Gender differences were also found by Shoshani and Slone [55], who found that boys had more behavioral issues and fewer positive and negative feelings than girls.

With the first published PPI study dating back to 2013, it is clear that there is a lot of interest in the effects of PPIs on infants and young children. These studies are extremely rare and have only been carried out in school or after-school settings, not in family settings, which makes them even more noteworthy. Only children ages 3–6 years old and those with special educational needs were included in the selected studies, which excludes children ages 0–2. Previous studies have shown that positive psychology interventions appear to be most effective with adults and adolescents in late childhood and adolescence, as well as in the educational context, and less so in the family context. According to Renshaw and Olinger Steeves [39], only five studies have examined the effects of gratitude-based interventions on young people (i.e., n = 5) in a related area. However, there are several hypotheses that deserve further investigation.

Educators who have been trained in PPIs are a prerequisite for their implementation in schools and other educational settings (such as daycare), as they can serve as a link between the school and families [68]. In order for parents to contribute and reinforce the message their children learn in school, they need to be trained [12]. In the initial training of teachers or educators, positive psychology is still not well developed, meaning researchers in this field must train participants, which takes time and resources. Two of the selected studies [55,56] in our review included training for teachers and/or parents in positive psychology or a related field in their intervention design. There were numerous benefits to training in the field of Positive Psychology before or during the intervention. The findings of Elfrink et al. [56] show that both teachers and parents found the professional workshops they attended to be beneficial. Teachers emphasized the importance of training that focused on practical strategies, guidelines, and activity-based resources to support the implementation and perpetuation of positive psychology interventions, particularly in the classroom (p. 225). It was found that the positive education program was gradually integrated into daily school activities and teachers were better able to understand their role in the program and to provide children with positive psychology-based activities throughout the school year. Adults in these programs must receive on-going instruction, and positive psychology practices must be incorporated into regular school activities and educational practices, as has already been shown for SEL programs [69,70]. However, a shift in educators’ attitudes, convictions, and values is more important than simply acquiring new skills and strategies [12].

Damien Sendler: The lack of research on the impact of PPIs on the well-being of young children may also be due to the fact that preschools and kindergartens place an over-emphasis on the cognitive aspects of being ready for school, while it would also be important to focus on well-being aspects (e.g., social and emotional aspects) from a young age [71]

Third, administering self-report questionnaires before and after the intervention may be a factor in determining the effectiveness of PPIs in measuring outcomes. Due to their inability to express themselves verbally and cognitively, self-report questionnaires are a limitation in research with very young children [3]. Similarly, if researchers are to use all five conditions of the PERMA model to measure well-being, it is difficult to include aspects of “meaning” in interventions with young children [72].

Although Owens and Patterson [57] found that children under the age of seven are cognitively mature enough to experience and express gratitude, the effectiveness of gratitude interventions in this age group is questionable. That’s why it’s difficult to determine the efficacy of gratitude interventions for younger children [39], because gratitude is a process that develops over several years and reaches its peak by mid-childhood [73].

Damian Jacob Sendler

Last but not least, positive psychology is a relatively new scientific discipline, which may account for the paucity of research on its effects on young children’s well-being (emerging in the early 2000s). It is not until the discipline has matured and researchers are able to conduct more comprehensive and longitudinal research studies, along with extensive meta-analyses, that the research field will begin to see the full potential of school-based positive psychology programs. [43] Chodkiewicz and Boyle (p. 72). SEL programs [70], which also provide systematic training in preschool settings on how to support children’s social-emotional development and improve their self-regulation skills, may explain why there are so few PPIs for young children.

In the introduction, it was stated that the difficulty in defining well-being can present significant obstacles to the implementation and evaluation of programs aimed at improving well-being in schools (see, for example, [74]). This model’s dimensions don’t define well-being, but they do represent the components that make up well-being and can be measured [30,75]. Indeed, these dimensions allowed us to not only select articles related to both positive psychology and well-being, but also to organize and aggregate research findings in this area.

Children’s well-being is positively impacted by a wide range of interventions, according to our findings from the PERMA(H) model outcomes. Two studies [55,57] examined the effect of PPIs on positive and negative emotions, respectively. Even so, only one study found an increase in positive emotions in the experimental group, highlighting the potential of these programs to promote positive feelings in young children, but also its inconsistency. Because Shoshani and Slone’s [55] intervention lasted longer (months) than Owens and Patterson’s [57] study, this increase in positive emotions may have been attributed to this difference in the duration of the intervention (weeks). Carr et al [40] found that in general, short PPIs are more effective in educational settings, but Weare and Nind [12] found that school-based interventions of all kinds that promote child well-being are consistent with their findings and recommendations. It’s possible that this discrepancy is due to the nature or format of the intervention, which could explain it. Preschool teachers were equipped with a manual containing practical and theoretical material on four modules, including one on positive emotions, in the study by Shoshani et al. [55]. As Villarreal et al. [76] reported, teachers’ commitment to a program is increased when they understand its theoretical underpinnings and practical applications. A research assistant was responsible for administering the intervention in Owens and Patterson’s [57] study. Teachers, on the other hand, may be better able to influence students’ positive feelings than a research assistant who has only a passing familiarity with them. Even when the intervention isn’t taking place, teachers can stay in touch with their students and reinforce the skills they’ve learned as a result of it [77]. Finally, Shoshani and Slone [55] found no evidence of an impact on negative emotions. As a result of a lack of time for children this young to learn how to manage their negative emotions, the authors believe this result can be explained. In fact, the regulatory framework is still in its infancy at this point in time. According to Owens and Patterson [57]’s findings, gratitude interventions failed to reduce the severity of children’s negative emotions for these very same reasons.

Results from two studies showed that teachers reported an increase in students’ school engagement as a result of the intervention. It’s worth noting, however, that the findings of Elfrink and colleagues [56] are consistent with those of studies that have shown how implementing a school-wide positive education approach improves students’ school engagement, academic achievement, and health. These findings are intriguing, given that (1) preschoolers’ positive engagement promotes better attention and impulse control and (2) pupils’ cognitive and behavioral skills at the time of school entry can be used to forecast their future school engagement [81,82]. As a result, children’s resources are valued over their limitations, allowing them to perform better in school [83].

There was no significant improvement in the overall teacher–student relationship reported by Elfrink et al. [56], but they did find that the program had a positive effect on a subscale, namely the closeness of teachers to children. A child’s behavior can be predicted over time by the quality of their relationship with their teacher [84]. Teacher-student relationships that are based on mutual respect and trust are conducive to a child’s ability to self-regulate. Children’s ability to control their behavior, emotions, and thoughts is also influenced by the demands and supports (e.g., provided by the teacher) in a preschool classroom [84]. Even more importantly, Elfrink and colleagues [56] found that the intervention improved supportive cooperation, promoted equal opportunity and participation in decision making, all of which contribute to positive relationships. Additionally, their intervention resulted in changes in behavior, such as the prohibition of physical punishment, violence, and the nontolerance of bullying, harassment, and discrimination.

Two studies [55,56] found evidence of accomplishment. As it pertains to education, this metric takes into account student progress across a variety of subject areas [25]. Teachers were more aware of their students’ talents, according to Elfrink et al. [56]. Compared to children in the control group, teachers in Shoshani and Slone’s [55] study reported that the experimental group had more positive approaches to learning (e.g. enthusiasm for learning, attention, persistence, and autonomy). However, the relationship between cognitive flexibility and school readiness would be moderated by attention and perseverance [85]. Children who have a better preschool functioning “lay the foundation for learning skills and engagement with learning, two important qualities that will influence subsequent academic success,” according to Shoshani and Slone [55]. (p. 8). Students’ flourishing in school will be enhanced by these strengths, which will lead to an increase in their level of satisfaction with school. When these positive psychology programs are implemented at a young age, students’ abilities can be nurtured by focusing on their strengths (such as those found in music, art, or sports), rather than their weaknesses.

In terms of health, PPIs aim to improve health in children as early as possible by focusing on their well-being and happiness. There was a significant increase in children’s self-reported life satisfaction [55] and a positive impact on younger children’s self-report of health-related quality of life [56] in the selected studies. Children who have received a positive psychology intervention are more likely to grow up with healthy emotional and social development, according to our findings. Weare and Nind [12] found the same thing, and they recommend that school-based interventions that promote mental health and prevent problems in schools begin with the youngest students, in particular to develop social and emotional capabilities.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian Jacob

Damian Sendler, M.D. – Is listening to music beneficial to one’s mental well-being? Clinical and nonclinical studies have found positive correlations between music engagement and improved quality of life, reduced depression or anxiety symptoms, and less frequent substance use, among other outcomes. It has also been suggested that some aspects of music engagement may even be associated with worse mental health outcomes, but many earlier studies were limited by small populations and methodological limitations,

Damian Jacob Sendler: People’s socio-emotional and cognitive development (e.g. socialization, personal/cultural identity, mood regulation, etc.) are influenced by music participation in all forms, including passive listening and active music-making (singing and instrument playing) [1–3]. Many studies have found positive correlations between music participation and various aspects of well-being, such as emotional competence and quality of life [4–8]. In spite of these advances that link music listening to a variety of health benefits, we still have a limited understanding of how music listening affects mental health, whether at the trait level (such as depression and anxiety symptoms, substance use behaviors), clinical diagnoses (such as associations with MDD or SUD diagnoses), or treatment.

Dr. Sendler: Musical engagement can be used as a means of promoting self-expression, developing emotional regulation and coping skills as well as building community [10–11]. Listening to music has an impact on a person’s heart rate, electrodermal activity as well as cortisol [12, 13]. The effects of music on the central nervous system (e.g., changes in autonomic activity) may be influenced by physical aspects of music (e.g., tempo) or rhythmic movements involved in making or listening to music [14], as well as by personality and context factors (e.g., shared social experiences) [15]. The neurochemical processes involved in reward processing [10, 13, 14, 16–18], as well as mental health disorders, are influenced by musical experiences as well (e.g., substance use; depression). An overall framework for studying music-mental health associations should incorporate psychological, physiological and neurochemical components. Expanding the scope of this study to include genetic and environmental risk factors, which may influence health and well-being, is our recommendation.

The hierarchical structure of psychopathology is critical to understanding mental health [19, 20]. MDD, generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and thought disorders such as bipolar disorder and schizophrenia all share many features and cluster into internalizing (MDD, GAD), externalizing (e.g., SUDs, conduct disorder), and thought disorders (e.g., bipolar disorder and schizophrenia). A lot of the comorbidity among individual disorders can be explained by these higher-order constructs, which have helped researchers to characterize the associations between psychopathology, cognition and personality. Our review is structured in a hierarchical manner. As a starting point, we review the growing body of research on the potential link between musical involvement and mental health, which shows promising results. Music participation is associated with internalizing traits, externalizing traits/behaviors, and thought disorders, among other factors. In this section, we critically examine the strengths and weaknesses of previous studies and how they might limit the conclusions drawn from this work.

Several studies have found a link between music engagement and general mental health, such as increased well-being or emotional competence, which lends support to the idea that music engagement may also be linked to better specific mental health outcomes. Emotional competence was linked to more hours of music practice and self-reported musical achievement in over 8,000 Swedish twins [5]. An analysis of 46 qualitative studies found that taking part in music-related activities improved well-being by promoting emotional regulation, self-discovery and development, distraction from stress and the development of social connections [28]. Music-related activities, such as singing or dancing with others or going to a concert, have a positive effect on people’s well-being, according to a study of more than 1,000 adults in Australia. In this sample, playing an instrument or composing music was not associated with a higher sense of well-being [4]. Infants’ and children’s early exposure to social music is associated with a variety of prosocial behaviors [6] and positive affect [7]. This includes song familiarity and synchronized movement to music. That music participation is associated with better mental health outcomes in children and adults has been shown in this study. However, the results vary depending on the type of music participation.

Internalizing disorders such as MDD, GAD, and PTSD are the most common [19, 24, 29, 30]. Research shows that music interventions are feasible and beneficial, but it is not yet rigorous enough to draw firm conclusions. A lack of appropriate control groups, few interventions with multiple sessions, and publications omitting important information about the intervention (e.g., intervention fidelity, inclusion/exclusion criteria, education status of the intervention leader) are the most serious limitations [31–33]. While musicians may be more prone to internalizing problems, correlational studies show that they use music engagement as a way to deal with these issues [34, 35].

Music interventions (including both music therapies administered by board-certified music therapists and other music interventions) have been shown to reduce depression, anxiety, and PTSD symptoms in randomized controlled trials [26, 27, 33, 36]. More than two-dozen studies found that music intervention groups were significantly less depressed than control groups, including nine studies that included active non-music intervention control groups (e.g., reading, “conductive-behavior” psychotherapy, and antidepressant drugs). It has been found that listening to music can reduce one’s level of self-reported anxiety in healthy people [26]. There were only four studies that were relevant to a review of music-based PTSD treatment studies [36]. Recent studies [37–39] support these findings, such as a randomized controlled trial that found that older adults who practiced musical improvisation exercises had lower levels of depression than those who engaged in light gymnastic activities [39].

Some studies have found effects even when comparing this work to traditional behavior therapies, which is encouraging [40, 41]. The number of studies comparing music therapy to other forms of treatment is small. Dialectic and cognitive behavior therapies [42, 43] have been incorporated into some music interventions but few directly compare how the inclusion of music enhances traditional behavioral therapy. As for the role of music in other non-music therapies, such as mindfulness, it’s not clear what role it plays. [43, 44]. For this reason, more systematic studies linking music to traditional therapies are urgently required. These studies will help identify the music interventions that use similar mechanisms (e.g., building coping mechanisms and community) as traditional therapies, as well as the ones that complement or sync with other approaches (e.g., by adding structure, reinforcement, predictability, and social context to traditional approaches).

It was found that the promising effects of music therapy were limited by small sample sizes and methodological shortcomings, including the lack of reporting of adverse events, exclusion criteria and possible confounders, and the characteristics of patients who were lost to follow-up [33]. Additionally, the study’s source population (e.g., selection of patients and proportion agreeing to participate in the study) was not adequately reported, and interviewers were not adequately masked when conducting the post-test. The results of all the studies which included these characteristics showed significant positive effects on mood. However, there was some evidence that therapies with active music participation, structured sessions and multiple sessions (i.e. four or more). Studies have focused on passive interventions like listening to music [26, 27]. As no direct comparison has been made between active (e.g. singing) and passive interventions [27], more research is needed to determine whether therapeutic effects are stronger with more engaging and active interventions.

Music’s role in emotional self-regulation has been studied correlatively. Particularly neurotic individuals appear to use music to help regulate their emotions [34, 35], with beneficial effects of music engagement on emotion regulation and well-being driven by cognitive reappraisal [45].. It is also possible that listening to music can reduce the link between neuroticism and depression in adolescents [46].

Individuals’ use of music activities to regulate their emotions has been studied using validated self-reported instruments in recent studies [47–50]. Adults’ subjective well-being, psychological well-being, and social well-being were all improved when they listened to music to control their anger and anxiety [50]. Music listening as a form of entertainment has been linked to lower levels of depression and anxiety in adolescents and undergraduates [51]. Adolescents who engage in “healthy” music use (i.e., listening to music to relax and connect with others) are more likely to be happy and satisfied at school [49]. As a result, “unhealthy” music engagement (e.g., “hiding” in music to block others out) was associated with lower well-being (e.g., happiness, school satisfaction, and greater depression and rumination) as well as higher levels of stress. According to other studies, valence plays an important role in these associations, with people who listen to happier music when they are feeling down reporting that music has a greater ability to influence their mood than those who listen to sad music when feeling down [52, 53].

These findings support the idea that people who are already suffering from depression, anxiety, or stress use music as a therapeutic tool to manage their emotions, and that some strategies are more effective than others when looking at associations between music and well-being and mental health. These correlational effects may not necessarily reflect causal associations, but may be due to bidirectional influences, as suggested by claims that musicians may be at greater risk for internalizing problems [54–56]. For example, participation in the arts may be more strongly associated with self-esteem in those with higher education [58], so demographic and socioeconomic factors must also be taken into account in these associations [57].

There needs to be a better understanding of whether or not musicians (both professional and non-professional) are already at a higher risk of internalizing issues. Professional musicians in Norway (N = 6372) were found to have a higher level of neuroticism than the general population [56]. Using text mining of medical records, another study of musicians (N = 9803) compared to controls (N = 49015) found that musicians have a higher risk of MDD (OR = 1.21), anxiety disorders (OR = 1.25) and posttraumatic stress disorder (PTSD) (OR = 1.13) [55]. Another study found no correlation between musician status and depression symptoms [5] while another found mixed results [59]. Professional and amateur musicians, for example, reported more symptoms of burnout in a study of 10,776 Swedish twins [54]. Both amateur musicianship and professional musicianship were found to have no significant impact on depression and anxiety diagnoses.

Findings such as these can still support the idea that music-making is beneficial and therapeutic even if musicians are at a higher risk (e.g., depression medication use is elevated in individuals with depressive symptoms because it is a treatment). Disentangling these links may require clinical samples, and a broader deployment of measures that capture emotion regulation strategies and motivations for engaging with music will help shed light on whether high-risk individuals engage with music in qualitatively different ways than others [51, 57]. [57, 57] For example, if people who are genetically or environmentally at risk for mental health issues choose to participate in music therapy because they believe it is beneficial, this could shed light on these questions.

Damian Jacob Markiewicz Sendler: Music therapy has been shown to benefit patients with SUDs in a variety of ways, including the reduction of withdrawal symptoms and stress, the ability to feel emotions without the desire to use drugs or alcohol, and the enhancement of patient motivation and enjoyment in treatment sessions [62–64]. (for a systematic review, see [65]). These studies, too, would benefit from larger samples, better controls, and higher reporting standards, just like the ones that looked at people’s ability to internalize traits.

Damian Sendler

Studies on the effectiveness of music therapy for ADHD are of the same quality. These treatments have been shown to improve reading comprehension in ADHD patients by decreasing inattention [66], lowering mood [67], and reducing negative emotions [68]. It’s possible that some children with ADHD find music distracting, while others are better able to focus when listening to music [69].

Musical interventions for impulsivity and conduct disorder have received scant attention, and the results have been mixed. If you’re looking for an example, a music therapy study of 251 children found that free improvisation had a significant impact on communication skills in children above the age of 13 [70]. There was no control group in another study that found that music therapy improved social skills and problem behaviors in 89 students with social/emotional problems [71]. There are conflicting results from smaller studies (N 20) on disruptive behaviors and aggression.

There are few studies on the correlation between externalizing traits and correlational studies. There have been a number of studies looking at the link between music listening habits and substance use [74–77]. Music genres are influenced by cultural and socioeconomic factors that change over time, so these studies do not provide strong evidence of a link between music engagement and substance use. A large study of electronic medical records in the United States [55] found no correlation between musicianship and higher rates of internalizing diagnoses like “tobacco use disorder,” “alcoholism,” “alcohol-related disorders,” or “substance addiction and disorders.” However, in sex-segregated analyses, female musicians were found to be significantly less likely to develop an addiction to tobacco (OR = 0.85). As a result, there is less evidence that musicians are more prone to externalizing their problems than those in other professions.

Externalizing, some studies have shown that children with ADHD have a poor sense of rhythm, which raises the possibility that working on rhythm skills could have an effect on ADHD. Because of its regular, predictable rhythmic beat, music may serve as a useful scaffold (e.g., for attention). If these associations with music rhythm are also observed for measures of musical engagement, especially in larger population studies, it will be important to investigate further. Musicians were found to be less impulsive than non-musicians in some studies, but these studies did not compare musicians to the general population [80, 81].

People with schizophrenia and bipolar disorder have participated in music therapy studies. It has been found that music therapy in combination with standard treatment for schizophrenia (and similar disorders) improves general mental health, reduces negative symptoms of schizophrenia, and enhances social functioning [82]. General functioning and positive symptoms of schizophrenia were unaffected. Comments mirrored those outlined in the previous paragraphs. Even though attrition bias was low in most studies, the vast majority of studies (>75 percent) had a high risk of bias from selection bias, performance bias, detection bias, and reporting bias. It is imperative that these studies provide more information about their study selection, blinding procedure, and outcomes.

Music therapy has been shown to have similar benefits for patients with psychosis and thought disorders [83, 84]. (e.g., one study did not include a control group). Music therapy has the potential to treat bipolar disorder symptoms and alleviate subthreshold symptoms in early stages of the disorder, according to a 2021 review that did not find any more recent studies on the subject.

Damian Jacob Sendler

Music participation has been linked to improved mental health outcomes. Quality of life, happiness, social connectedness and emotional competence are all linked to music participation. The risk of mental health problems, especially internalizing and thought disorders, may be higher among those who engage in music. For example, more research is needed to clarify how “healthy” music engagement (e.g., for relaxation or social connection) leads to greater well-being or successful emotion regulation, and to test whether some individuals (e.g., those with high neuroticism) are more likely to use music as a tool to regulate emotions. To determine whether musicians are at risk because they work in an artistic field (which may have lower pay or job security), or if the same associations are observed with continuous music engagement phenotypes, will be critical in this study (e.g., hours of practice). These complex associations can be clarified using genetically informative datasets, such as testing whether musicians have a higher genetic risk for mental health problems but their music engagement reduces these risks.

Damien Sendler: Clinical diagnoses such as depression, anxiety and SUDs can be alleviated through the use of music intervention studies. Nevertheless, these studies must be expanded to include larger samples, random sampling, and active control groups in order to compare the benefits of music interventions with traditional therapies and address potential confounds. Because of these limitations, it is difficult to determine how specific factors, such as the length and depth of music training, the age of the sample, confounding variables (such as socioeconomic status), and the type of intervention influence the effectiveness (e.g., individual vs. group sessions, song playing vs. songwriting, receptive vs. active methods). The wide range of music engagement activities and measures makes it difficult to identify the specific aspects of music engagement that have the greatest impact on health and well-being [87]. Therefore, it is imperative to improve the reporting quality of studies so that researchers can more easily identify these potential moderators or confounds using systematic approaches (e.g., meta-analyses).

Psychological (e.g., building communities, developing strategies for coping) [10, 11] and specific neurobiological drivers (e.g., oxytocin, cortisol, activity of the autonomic nervous system) [12–14] have both been proposed to explain the therapeutic effects of music on mental health. As a matter of fact, it is imperative that more systematic research be conducted to compare the effects of music interventions to existing therapeutic methods and other creative activities (e.g., art). Other treatments may benefit from the use of music interventions, such as their ability to be engaging and enjoyable, their ability to provide social context and their ability to help people feel more secure [89]. It’s also true that some psychotherapeutic models (e.g., mindfulness) incorporate music into their practice, while some music therapists use existing psychotherapeutic principles [42, 90]. With better reporting standards and high-quality experimental design, it will be possible to identify which aspects of music interventions best complement or enhance standard psychotherapeutic practices (which are also heterogeneous).

We now propose a theoretical framework to help guide future research into the relationship between music engagement and mental health. This framework is meant to capture and expand on these ideas.

Music engagement and brain structure and function need to be studied in order to understand the three pathways outlined above. Music listening has a strong connection to reward centers of the brain, such as the nucleus accumbens and ventral tegmental areas, which are implicated in the reward system for all drugs of abuse [109–112] and may be linked to internalizing problems [113–115]. [104–105] The caudate’s activity can also influence rhythmic sensorimotor synchronization, money reward processing, and prosocial behavior at the same time. Emotional stimuli can influence autonomic and physiological responses (e.g., in the hypothalamus), and music listening has been shown to induce the endorphinergic response blocked by naloxone (an opioid antagonist).

Some differences in brain structure and plasticity between musicians (such as greater fractional anisotropy in corpus callosum and superior longitudinal fasciculus) and non-musicians have been observed for white matter (e.g., greater fractional anisotropy in corpus callosum) [118–121]. longitudinal studies have shown that children and adolescents who play an instrument have thicker cortical cortices in the prefrontal and parietal areas that are linked to emotion and impulse control than non-musicians [122]. Cross-sectional and longitudinal structural differences between musicians and non-musicians could be explained by genetic correlations or the effects of music training, and this is important because the existing evidence is primarily correlational in nature (Fig. 2). Increasing our knowledge of music engagement’s neural correlates and the mechanisms that drive the associations discussed above will require a closer look at these possibilities.

The biological underpinnings of musical engagement can be seen through genetic designs [123]. Understanding the role of genetic risk factors is essential to testing causal or mechanistic models related to mental health. Twin and family studies can be used to estimate genetic correlations between musical ability or engagement measures and mental health traits or diagnoses at the most basic level It is possible to test competing models or average across different candidate models [102, 124] to examine genetic associations while simultaneously quantifying environmental correlations and evaluating (bidirectional) causal associations, informing Path 1.

As a result, researchers can examine whether people who have a higher genetic risk for psychopathology (e.g., for MDD) have stronger associations between music engagement measures and their mental health outcomes (Path 2). People with low genetic risk for MDD, for example, are unlikely to experience many depressive symptoms regardless of how much time they spend listening to music, so the link between depressive symptoms and time spent listening to music may be weak if this population is studied. Individuals with a high genetic risk for MDD may, however, experience fewer symptoms if they engage in musical activities (i.e., a stronger negative correlation). This is in accordance with recent research showing that the heritability of depression is doubled in those who have been traumatized compared to those who have not.

There has been a rise in the number of gene–environment interaction studies that use polygenic scores (i.e., summated indices of genetic risk based on GWAS). Music rhythm appears to be highly polygenic, as evidenced by the first large-scale GWAS of a music measure [131]. Multiple large GWAS have already been conducted on internalizing and externalizing traits. Importantly, it is not necessary to examine cross-trait relationships in the same sample of traits. For example, music engagement and genetic data can still be used to examine how polygenic scores for depression predict music engagement, or how music engagement measures interact with music engagement measures to predict other study outcomes, for example. It is shown in Figure 4 how to use a GWAS to compute and apply a polygenic score to test cross-trait predictions.

Experiment design can also be guided by a study of the neural mechanisms by which music affects mental health. Even though there is a vast and sometimes tumultuous body of literature on the neural underpinnings of music listening and engagement, there is unquestionably great potential to link this to existing research on the same topic. These developments can shed light on the mechanisms that lead to effective interventions and on the individuals who stand to gain the most from them. Among many possible interactions between music and mental health, we focus on two: (1) activation of reward circuitry by music, and (2) the impact music has on dynamic patterns of neural activity.

[139] The search for neuronally based biomarkers for aspects of mental illness, which hold promise for understanding heterogeneity within disorders and identifying common mechanistic pathways, has been a central thrust in the field. Musical effects on mental health may have neuro-mechanistic mediators that can be highlighted in this paper, but a comprehensive review is beyond the scope of this paper. A treatment for MDD, for example, has been proposed to increase activity in the emotional circuitry via neurofeedback [141]. There is potential for using music as an adjuvant or as a more actively controlled output target for neurofeedback because of the emotional effects of music. It’s becoming more and more common to use magnetic resonance imaging (MRI) or magneto-electroencephalography (MEG) to measure brain activity in health and disease, with abnormalities in dynamic complexity linked to mental illness [143]. Music engagement, on the other hand, is thought to reflect and possibly influence dynamic complexity.

These neuro-mechanistic studies are not exempt from the review’s cautions [146]. Non-musical outcomes of music engagement can only be reliably supported by high-quality experimental design (involving appropriate controls and randomized design) [103]. It has been demonstrated that analyzing M/EEG activity not at the scalp level but at the source level improves the power of biomarkers and their mechanistic interpretation [147, 148] for such studies to have maximum impact. Neuronal underpinnings for music-mental health associations may be highly multivariate, just like genetic influences that typically influence a trait through numerous small individual effects [149]. While current experimentalists can prepare by adopting standards for documentation, annotation and storage of data [150], in the long term large-scale studies and large-scale standardization and aggregation promise deeper cross-domain insights. [150]

Humans have a special affinity for music, and it has a profound impact on everything we do, from how we express ourselves socially and culturally, to the way we think and feel about the world. Despite decades of research, there was no conclusive evidence that music had a positive impact on mental health or that it could be used to treat mental illness. Scoping review and framework integrated across a wide range of smaller literatures relating music engagement to mental health traits and treatment effects, though it was potentially limited by the lack of systematic literature search or formal quality evaluation of individual studies. A growing body of research suggests that people with internalizing, externalizing, or thought disorder problems may find an outlet in music, which may help regulate emotions in multiple neurobiological pathways (e.g., reward center activity). In order to better understand how music engagement relates to these mental health traits, we need to conduct more rigorous experimental intervention studies, improve reporting standards, and harness large-scale population-wide data in combination with new genetic analytic methods. To better understand how music engagement and existing risk factors interact to support mental health and well-being, we have presented a framework that shows why genetic and environmental risk factors must be considered when examining these associations.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian

Damian Sendler: The flavivirus dengue virus is the cause of dengue fever, a mosquito-borne viral disease (DENV). Dengue is responsible for an estimated 400 million cases and 22,000 deaths around the world each year. Tropical and subtropical regions have reported cases of the disease. This virus (DENV) is transmitted by Aedes mosquitoes in large numbers. Three structural proteins and seven non-structural proteins are found in the four antigenically distinct serotypes DENV-1 to DENV-4, each of which has a distinct genotype. Severe cases of dengue hemorrhagic fever or dengue shock syndrome (DSS) can manifest as thrombocytopenia, leucopenia, and increased permeability of the blood vessels. Immune responses against DENV serotypes are triggered by primary infection, but heterotypic infection with different serotypes and antibody-dependent enhancement increase disease severity (ADE). Some countries have not approved tetravalent CYD Denvaxia, which is the first licensed DENV vaccine. Obstacles to vaccine development include: a lack of an appropriate animal model, insufficient pathogen pathogenesis mechanistic studies, and antibody-dependent epitope exchange (ADE).

Damian Jacob Sendler: It has been a major public health concern for the last few decades that dengue fever is caused by the dengue virus (DENV) (Bhatt et al. 2013). As a result, it has been labeled a “neglected tropical disease” (Hotez et al. 2009). Approximately 400 million cases of dengue fever and 22,000 deaths occur each year around the world (Bhatt et al. 2013; Shepard et al. 2016). Patients with dengue infection may go undiagnosed for months or even years, but the disease has spread throughout the world through endemic and epidemic transmission cycles (Bhatt et al. 2013).

Dr. Sendler: One of the most common viruses in the family Flaviviridae, DENV is positive (+) stranded RNA-containing flavivirus in the species Dengue virus. Others in this family include the viruses that cause Japanese encephalitis, West Nile virus, and the disease that causes yellow fever (YFV). DENV has four distinct serotypes (serotypes 1, 2, 3, and 4) that differ antigenically from one another. DENV-5, a newly discovered fifth serotype, was found in the blood of a Malaysian patient in 2007 (Mustafa et al. 2015). Numerous mutations in the viral genome give rise to different serotype subtypes and genotypes. Supplementary Table S11 summarizes the genotypes and the endemic regions for each of them. Dengue fever has been found in all of India’s serotypes. Dengue infection causes a wide range of symptoms, from mild fever to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). A single dengue serotype provides lifelong immunity to the disease, but only partial immunity to other dengue serotypes (Wahala and de Silva 2011). Dengue pathogenesis is complicated by the presence of an immune response known as antibody-dependent enhancement (Rothman and Ennis 1999).

Dengue virus infects humans in more than 100 countries each year, with roughly 3.6 billion people at risk (Diamond and Pierson 2015). (Diamond and Pierson 2015). Dengue fever has increased by 30 times in the last 50 years (CDC 2014). Travelers from endemic regions can contract DENV while on vacation in areas where the disease is prevalent. In addition to their impact on public health, these epidemics have a significant economic impact on the countries they affect, including India.

In Jakarta, Indonesia, and Cairo, Egypt, dengue fever was first documented in 1779. (Wu et al. 2011). A confirmed outbreak of the disease in North America occurred in Philadelphia in 1780, however (Rush 1951). In the years 2010–2016, the WHO (see WHO 1997) received an average number of suspected or confirmed dengue cases from around the world (Fig. 1). More than 1.6 million cases of dengue fever were reported in North and South America in 2010; 49 000 of these were severe cases.. More than 2.38 million cases of dengue fever were reported in the United States in 2016. Brazil accounted for the majority of the outbreak’s 1.5 million cases. More than 3 million cases of dengue fever have been reported in the United States so far this year (PAHO 2019).

Beginning in the early nineteenth century, outbreaks of dengue fever were documented in Africa’s eastern, western, and southern regions (Amarasinghe et al. 2011; Were 2012). Dengue virus serotypes 1, 2, and 3 were responsible for a number of outbreaks in East and West Africa between 1980 and 2000. (Sang 2007). Seychelles (1977-1979), Réunion Island (1977-1978), Djibouti (1992-1993), Comoros (1992-1993), and Cape Verde (2009) have all had large epidemics of dengue fever (Cornet 1993; Sang 2007).
After World War II, dengue outbreaks became a major problem in Southeast Asian countries, mainly because of urbanization (Ooi and Gubler 2009). Dengue hemorrhagic fever was first reported in the Philippines in 1953 and 1956, respectively, the first two outbreaks (Gubler 1998). There have been annual dengue epidemics in Southeast Asian countries since 1950. These outbreaks have affected countries like the Philippines and Bangkok in Thailand (Ooi and Gubler 2009). Indonesia had the second-highest number of dengue cases between 2004 and 2010, behind only Brazil. In 2009–2010, the majority of dengue cases in Indonesia were caused by serotype-4 (Taslim et al. 2018). However, severe dengue infection with serotype 3 was reported in 2013 (Lardo et al. 2016). Dengue virus serotype-1 was the most common in Indonesia between 2007 and 2010. (Sasmono et al. 2015).

Inoculating suckling mice with the serum of a dengue patient infected was how the dengue virus was first discovered in 1943 in Japan (Kimura 1944). Three dengue strains were isolated from dengue patients’ blood injected into the brains of white mice in successive generations between 1942 and 1945 using mice-brain passage experiments (Hotta 1952).

Dengue outbreaks involving all serotypes except DENV-5 have been reported on several occasions in the Indian subcontinent because of the region’s favorable climatic conditions (Dar et al. 2006; Mustafa et al. 2015). In India, there were approximately 16 000 cases and 545 deaths as a result of the 1996 epidemic (Mutheneni et al. 2017). Dengue’s incidence has risen steadily since 2010 to about 15 per million people in various states. In India, more than 100,000 infections result in death each year, and 200–400 people die as a result (NVBDCP 2021). In 2017, there was a dengue epidemic that resulted in 188,401 infections and 325 deaths (NVBDCP). In 1780, the first case of a clinical dengue-like illness was reported in Madras (today’s Chennai) (Gupta et al. 2012). It wasn’t until 1946 that a “virus” was found to be the cause of dengue fever (Gupta and Ballani 2014). There was no major dengue epidemic until 1963. All DENV serotypes were detected in the northern part of West Bengal, especially in the Siliguri, Darjeeling, Jalpaiguri, and Alipurduar regions in 2019–2020.

Spiral-shaped dengue virions have a diameter of approximately 50 nm, an outer protein layer on the surface of the lipid bilayer, and an inner nucleocapsid core, according to electron micrographs (Kuhn et al. 2002) This is shown in (Fig. 2B). Capsid (C), membrane (M), envelope (E), and seven other non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B and NS5) make up DENV’s three structural proteins (Perera and Kuhn 2008). Detailed information about DENV’s structural and nonstructural proteins can be found in Table 1. E protein dimers were found to be arranged in a herringbone-like pattern in virion envelope reconstructions from cryo-electron micrographs (Fig. 2B). Glycoproteins in an icosahedral shape are found on the outer surface of the spherical immature and mature particles, which are derived from the ER membrane. Lipid bilayer contains an inner-most nucleus made up of a ssRNA genome and capsid proteins (C). This nucleus is an RNA–protein complex. Mature and immature DENV are infectious and non-infectious depending on the conformational changes in the M and E proteins at different pH levels in the environment (Perera and Kuhn 2008). An immature (spiky) to an adult (smooth) morphology structural transition happens as a result of E protein conformational changes in the trans-Golgi network (TGN) (Modis et al. 2004). In the TGN (low pH), E proteins bound to membrane proteins undergo conformational changes prior to DENV maturation (Yu et al. 2008). Peptides that are released from E protein after maturation have infectious properties (pH 7.0) in the extracellular space (Figs 3A–3D). The molecular structures of the nonstructural proteins NS1, NS2A, NS4A, and NS44B are largely unknown at the present time for various reasons. NS1 aids viral RNA replication as well as viral defense by inhibiting complement activation (Lindenbach and Rice, 1999). (Chung et al. 2006). One part of the replication complex is made up of the NS2A protein and the NS4B protein (Chambers et al. 1989). One strand of the DENV genome is approximately 11 kilobases long (Miller et al. 2006). Untranslated regions (UTRs), open reading frames (ORFs), and the 3′ UTR region are all parts of the RNA genome (Fig. 4). The genome lacks a poly (A) tail at the 3′ end and has a type I cap (m7GpppAmp) at the 5′ end with a single ORF that encodes a polyprotein.

In the event of a successful infection, DENV primarily attacks and replicates in dendritic cells and infects macrophages, monocytes, and lymphocytes, as well (Wan et al. 2018). Cell surface molecules like Fc receptors, glycosaminoglycans (GAG), lipopolysaccharide-binding CD14 associated molecules, heparan sulfate, and DC-SIGN receptors are used for receptor-mediated endocytosis (dendritic cell-specific intercellular adhesion molecule 3-grabbing non-integrin). Cellular clathrin-coated vesicles allow DENV entry into cells (Seema and Jain 2005). Acidification of late endosomes results in structural changes to the E protein, which results in the fusion of viral and host cell membranes and the subsequent release of the nucleocapsid into the cytoplasm (Fig. 5). The acidic pH of the endosome helps the virus bind to the endosome membrane. Nucleocapsid (NC) release occurs after the RNA genome is uncoated and viral materials are transported to the ER by the cytoskeletal transport machinery. Cap-dependent translation of the DENV positive-stranded RNA into a polyprotein is the first step in the process. At the ER membrane, positive-sense RNA serves as a template for the replication of the RNA genome. To produce both negative and positive strand viral RNA, DENV’s NS5 protein, which is involved in RNA cap methylation and RdRp activity, is required (El Sahili and Lescar 2017). Translation of viral capsid proteins takes place in the cytoplasm, while viral E and M proteins are inserted into the ER membrane while translation is taking place. As soon as enough positive-sense anti-genome RNA copies have been transcribed from negative anti-genome RNA, capsid proteins in the cytoplasm wrap the genomic RNA and it enters the ER lumen where it picks up the M (produced by the furin-mediated proteolysis of the host protease PrM) and E-containing envelope from the ER (Fischl and Bartenschlager 2011). During virion assembly and release, pH affects the conformation and organization of the E protein on the mature virion surface (see Fig. 3). After passing through the ER and the trans-Golgi network, the virions that were previously enveloped are left in the lumen. ER-derived outer membranes are added to enveloped virions in the final step of the process, as they enter the cytoplasm (Fig. 5). To release the mature progeny virions from their envelopes, the ER membrane and plasma membrane fuse, allowing them to enter the extracellular space (Diamond and Pierson 2015).

Aedes aegypti and Aedes albopictus are the primary and secondary vectors of DENV, respectively (Carrington and Simmons 2014). Aedes aegypti is an endophilic (i.e., water-breeding in containers) and day-biting (i.e., blood-feeding) mosquito that lives primarily in tropical and subtropical regions and can be found on nearly every continent except Antarctica (Carrington and Simmons 2014). (Thavara et al. 2001). This species of mosquito is a more aggressive day-time biter, which is exophilic in natural field conditions, but it still feeds almost exclusively on humans. Aedes albopictus (Ponlawat and Harrington 2005; Delatte et al. 2010). Four DENV serotypes are transmitted in two cycles: sylvatic (wild animal transmission) and human (human infection) (Chen and Vasilakis 2011). The sylvatic cycle is distinct from the human transmission cycle in both ecology and evolution. Sylvatic environments of Southeast Asia and West Africa, peninsular Malaysia and eastern Senegal are maintained by non-human primates or by a monkey-Aedes-monkey cycle (Rudnick 1986).

Damian Sendler

Both laboratory diagnosis using a culture or blood sample and the detection of anti-dengue antibodies in serum/plasma are methods for detecting dengue infection. Serum, plasma, or circulating blood cells or tissue can contain DENV for the first 1 to 7 days after infection, which is when the fever is at its peak. As long as the appropriate primers are used, RT-PCR or conventional PCR (using appropriate oligonucleotides) can be used to isolate the virus or viral RNA for detection within that time period. Body fluid viral loads can be quantified using quantitative PCR (Q-PCR). Serum/plasma samples of patients are tested for anti-dengue immunoglobulin M (IgM) antibodies and/or non-structural protein 1 (NS-1) antigens using either enzyme-linked immunosorbent assays (ELISA) or immunochromatographic-based rapid card tests (Fig. 6). Hemagglutination-inhibition (HI), complement fixation (CF), neutralization (NT), IgM capture enzyme-linked immunosorbent assay (MAC-ELISA), and indirect IgG ELISA are the five most accurate serological tests for diagnosing dengue infection. Cross-reactivity with other flaviviruses (e.g. Zika virus) compromises the accuracy of the NS1 and IgM diagnostics (Wellekens et al. 2020).

A wide range of symptoms, ranging from a mild fever to more serious physiological conditions, are associated with dengue virus infection. Dengue fever (DF) is the most common symptom of a primary infection with a specific dengue serotype, which can be asymptomatic or cause mild disease symptoms (Mathew and Rothman 2008).

In DHF, hemostasis malfunction, increased vascular permeability, and severe increased vascular leakage can lead to DSS with shock, which is a severe febrile disease with these symptoms. Reduced peripheral perfusion from DSS, a hypovolemic shock, can cause tissue damage and multi-organ failure. The DHF goes through various stages, including critical and convalescent. Thrombocytopenia (less than 100 000 cells/cu. mm) and high hemoconcentration (up to 20% increase in hematocrit from baseline in patients of the same age) are required by the WHO to diagnose DHF.

Infected cells’ first line of defense is thought to be the production of interferons (IFNs) (Rodenhuis-Zybert et al. 2010). Interstitial dendritic cells (DCs) are first infected by DENV, which then activates the production of both Type I and Type II IFNs within hours (Shresta et al. 2004). Natural killer (NK) cells produce IFNs as part of the virus clearance process in the host (Azeredo et al. 2006). Infected cells have DENV sensors that are Toll-like receptors (TLRs). RNA from the dengue virus is primarily recognized by intracellular TLRs like TLR3, TLR7, and TLR8, all of which belong to the TLR family (Sariol et al. 2011). Following acidification of the endosome, TLR3 recognizes DENV RNA and induces strong IL-8 and IFN-/ responses (Green et al. 2014). It is believed that when TLR3 recognizes DENV-RNA, it activates the TIR domain-containing adaptor interferon (TRIF), which phosphorylates and engages in interactions with TRAF3 and TRAF6 (Fig. 7A). To activate NF-B, TRAF6 works with TAK1 to dephosphorylate IKB and activate AP1. Other than that, TRAF3 interacts with TNK-1 and IKK-1, leading to the phosphorylation of the IRF3 protein. Once activated, activated IRF3, AP-1, and NF-B translocate to the nucleus, where they induce transcription of IFN-, ISGs, and other cytokines (both interferons and chemokines), including IFN- and IFN-/. (Lee et al. 2012). MyD88, an adaptor molecule involved in the MAPK and NF-B pathways, is also involved in the induction of IFN-/ via TLR7/8/9 (Kao et al. 2018).

Virus-infected cells undergo an extensive reorganization of their membranes (e.g., unfolded protein response causes ER membrane expansion). As a result, DENV is able to maintain host metabolism and protein production without being degraded by host lysosomes. Cellular pathways are activated to promote ER expansion and increase fat metabolism, but the delicate balance between these two processes must be maintained to avoid the risk of ER stress-induced death being compromised. Autophagy is utilized by DENV to aid in viral replication. As a final point, DENV non-structural proteins directly affect the innate immune response signaling cascade, preventing the RNAi pathway and IFN-/ induction/signaling from taking effect. Non-structural protein 4B (NS4B) and subgenomic flavivirus RNA are both involved in DENV’s interference with RNAi pathways (sfRNA). To prevent RNAi, NS4B interferes with Dicer’s ability to function. DENV sfRNAs interfere with Dicer’s ability to cleave dsRNA by binding to RNase NS4B. Different mechanisms are used by DENV non-structural proteins to thwart the antiviral responses of the host. In order to avoid the innate immune system’s detection, the viral NS5 protein forms 2′-O-methylation on the 5′-cap structure of the viral RNA (Tremblay et al. 2019). Denial-of-service attacks (DENV) can also disrupt IFN induction by mimicking the function of melanoma differentiation-associated gene 5 (MDA5) (Dong et al. 2012). RIG-I/MAVS interaction is disrupted by DENV NS4A’s ability to bind to MAVS CARD domains and prevent host immune responses (He et al. 2016). By recruiting the viral NS2B-NS3 protease, DENV directly suppresses the host’s antiviral IFN (type I) pathway (Aguirre et al. 2012). The innate immune response is regulated by DENV NS2A and NS4B, which inhibit TBK1/IKK-directed downstream signaling (Dalrymple et al. 2015). Staining of STAT1 and nuclear translocation of ISGs are prevented by viral NS2A, NS4A and NS4B proteins (Fig. 7B). The DENV NS5 protein connects UBR-4 and STAT2 by binding to the STAT protein. ubiquitination and proteasome-mediated degradation of STAT2 are directed by this bridge (Ashour et al. 2009). Finally, DENV’s ability to disrupt the host’s innate immune response may influence the adaptive immune response and influence disease outcomes.

Damian Jacob Markiewicz Sendler: It takes approximately 6 days for an infection to trigger an adaptive immune response, during which cellular and humoral immunity are both developed. DENV antigens can be recognized by CD4+ T lymphocytes, which help to generate antibodies against DENV envelope protein (E) (domain III) and PrM glycoprotein on DENV’s surface (Gromowski and Barrett 2007; Lai et al. 2008). Evidence suggests that CD8+ T cells preferentially recognize non-structural proteins, but CD4+ T cells preferentially recognize structural proteins (Rivino et al. 2013). By activating naive CD4+ and CD8+ T cells to differentiate into virus-lysis effector T cells, or by producing cytokines, DENV infection causes an adaptive immune response (Rothman 2011). There are two ways in which activated CD4+ cells respond to viral infection with the aid of helper T cells: Th1 and Th2. Intracellular DENV infection is disrupted by the production of IL-2, IFN- and TNF- by Th1 cells, which in turn increases inflammatory responses and tissue damage. There are several cytokines secreted by Th2 cells that aid in T-cell activation and proliferation specific to these cell types, such as interleukin 4, 5, 6, 10, and 13. (Sun and Kochel 2013). B-cells produce the anti-NS1 antibody because the NS1 protein is so critical to DENV biology and is found in high concentrations in the sera of infected individuals. The complement system is activated by these NS1 soluble antibodies, which lyse DENV-infected cells. By binding to TLR4, the DENV NS1 protein activates macrophages and PBMCs, disrupting blood vessel endothelial cell monolayer integrity (Modhiran et al. 2015). DENV-infected cells’ NS1 proteins interact with TLR4 on platelets’ plasma membranes. P-selectin (e.g. CD62P or platelet activation dependent granule membrane protein) is upregulated, leading to an increase in apoptotic pathways and the destruction of platelets (Chao et al. 2019). Anti-DENV NS1 antibodies can activate the NF-B pathway, resulting in the release of multiple inflammatory factors (Lin et al. 2005). DHF’s pathogenesis is thought to be largely influenced by the imbalanced release of various cytokines. As a result of the interaction between viral epitopes on infected cells and memory T cells, pro-inflammatory cytokines are produced, which damage the vascular endothelium and cause plasma leakage. Disease severity in DHF and DSS is associated with elevated levels of IL-2R, soluble CD4, and soluble CD8 (Kurane et al. 1991).

Damian Jacob Sendler

Antipyretics and tepid sponging are the most common methods of treating a fever or pain from a dengue virus infection. However, several seaweed sulfated polysaccharides have been studied and found to have high antiviral activity against DENV, despite the lack of a specific antiviral drug for dengue (Damonte et al. 2004). G3d and C2S-3, two seaweed polysaccharide compounds, showed antiviral activity against all DENV serotypes by interfering with virus internalization inside the host cell by blocking host cell receptors (heparan sulfate) that allow the virus to enter the cell (Talarico et al. 2005). By interfering directly with the viral E protein and altering the structure of that protein, sulfated polysaccharide Curdlan also showed an inhibitory effect on DENV (Ichiyama et al. 2013). Caulerpa cupressoides, a coenocytic green seaweed, has also been shown to inhibit DENV-1 infection pathogenicity in vitro (Rodrigues et al. 2017). Nucleoside biosynthesis is inhibited in the host cell by the combination of ribavirin (a guanosine analog) and other nucleotide analogs (brequinar, INX-08189) (Patkar and Kuhn 2006; Yeo et al. 2015). Interferons against DENV are secreted in response to Glycyrrhizin and its derivatives or modified products, which inhibit DENV protein transport and post-translational modifications (Baltina et al. 2019). When taken up by cells, 6-azauridine, a uridine analogue, inhibits de novo pyrimidine synthesis and DNA synthesis and is converted intracellularly into mono-, di-, and triphosphate derivatives, which are then incorporated into RNA and inhibit protein synthesis (NCBI PubChem Database 2021). In vitro and in vivo studies have shown that NITD008 (a nucleoside adenosine analog) has antiviral effects against DENV and all other flaviviruses (Yin et al. 2009). Curcumin (from turmeric), an experimental antiviral drug, was recently tested for its anti-dengue activity. Inhibiting DENV replication, curcumin and its analogs, such as bis-demethoxy curcumin (CC2), acyclic curcumin (CC3), and cyclohexanone curcumin (CC5), showed efficacy in preventing severe infection (Balasubramanian et al. 2019). Other experimental antiviral treatments using CP26, CDDO-me, UV-4B, ivermectin, and ketotifen are also in trial and face great difficulties in controlling dengue fever (Wellekens et al. 2020).

In the absence of effective and long-term vector control, the development of a DENV vaccine has become a top priority. The main obstacles to the development of a DENV vaccine are the virus’s complicated pathogenesis and ADE effect, as well as the virus’s evolving genome. With an average mutation rate of 10–3 substitutions/nucleotide/replication round, DENV could evolve into a new lineage of viruses over time (Dolan et al. 2021). For example, in 2006–2008, a new lineage of DENV-3 emerged in India, and in 2011, a cosmopolitan genotype of DENV-2 emerged in India (Harapan et al. 2020). Dengue outbreaks are caused by the emergence and replacement of new genotypes of DENV, and developing a vaccine to combat this could be a difficult task.

Damien Sendler: The use of animal models is the most efficient and reliable method of evaluating the fundamental immunology for the development of vaccines against DENV infections (Shresta et al. 2006). Before testing in non-human primates, mice are the most commonly used animal model. Asian rhesus macaques of Indian origin may serve as an animal model for dengue hemorrhagic fever, according to recent research (Onlamoon et al. 2010). Researchers have created a dengue-infected mouse model (AG129) that shows both mild and severe signs and symptoms, as well as clinical features, that can be used for vaccine trials and antiviral drug discovery. C57BL/6J hTNF+++, IFN-/R / Tg, Tg HLA-A*02:01, and B10.Tg HLA-DR3 have also been established as genetically engineered or transgenic mouse dengue models for research purposes (reviewed in Coronel-Ruiz et al. 2020). Several studies have found that DENV can infect and replicate in the fibroblasts of the northern treeshrew, Tupaia belangeri (Bustos-Arriaga et al. 2011).
It is the most developed attenuated vaccine candidate that has undergone numerous phase I trials in the United States. Inactivated whole-virion vaccines, synthetic peptides, subunit vaccines, vector expression, recombinant live vector systems, infectious cDNA clone-derived vaccines, and naked DNA are just a few of the molecular technologies currently being used to develop an alternative DENV vaccine (Gubler 1998; Blaney et al. 2004). Sanofi Pasteur CYD-TDV (Dengvaxia), DENVax, and TV005 vaccines are currently being tested in large clinical trials for tetravalent DENV vaccines (Diamond and Pierson 2015). Phase III trials are currently underway for the latter two (Prompetchara et al. 2019).
The first licensed dengue vaccine, the tetravalent chimeric yellow fever virus-DENV (CYD), has just been approved for clinical use in Mexico, Thailand, Brazil, El Salvador, and Costa Rica, among other countries (Aguiar et al. 2016; Prompetchara et al. 2019). It was developed by Sanofi Pasteur (Mexico) based on a yellow fever (YF) 17D vaccine virus backbone, chimerized with prM and E proteins from DENV1-4 replacing the YF prM and E (Guy et al. 2015), and is currently registered in the European Union, the United States, and 20 other dengue-endemic countries (Guy et al. 2015) (Thomas and Yoon 2019). However, only Brazil and the Philippines have dengue vaccination programs in place (Thomas and Yoon 2019). Initially, it was only approved for use in dengue-endemic areas in specific doses for people aged 9–45 or 9–60. Children aged 9–16 in Latin America who received CYD-TDV had a favorable safety profile and developed antibodies against all four dengue serotypes (Villar et al. 2013). This recommendation was made in 2016, but only for patients aged 9 and over, and not for those who were not vaccinated against Dengvaxia. US Food and Drug Administration (FDA) approved Dengvaxia in the territories of Guam, Puerto Rico, and the US Virgin Islands as the first vaccine approved for the prevention of dengue disease caused by dengue virus serotypes 1, 2, 3, and 4 only for people between the ages of 9 and 16 who live in dengue-endemic areas and have confirmed dengue infections (Thomas and Yoon 2019).
Dengue vaccine DENVax, developed by the Centers for Disease Control and Prevention (CDC, USA) in collaboration with Inviragen and now licensed to Takeda, is another promising tetravalent recombinant live-attenuated vaccine (Osaka, Japan). For 48 months after vaccination, TAK-003 showed antibody responses against all four serotypes, with no risk of severity in the case of seropositive or seronegative baseline seropositive individuals (Tricou et al. 2020). TAK-003 demonstrated high efficacy in children aged 4–16 years in a phase III clinical trial involving both seropositive and seronegative patients (Biswal et al. 2020). DENV serotypes differed in terms of immunogenicity, but why this is the case is still a mystery to researchers. For DENV-1, DENV-2 (the most effective), and DENV-3, TAK-003 was effective (80.6 percent of the time) in both previously seropositive and previously seronegative participants (Biswal et al. 2019). Its effectiveness against DENV-4 infections, on the other hand, remains in question.
Another tetravalent vaccine candidate (TV005) (NIAID, USA) contains a mixture of modified full-length and chimeric DENV strains and is based on directed mutagenesis, resulting in attenuation without sacrificing immunogenicity. (Prompetchara et al. 2019). DENV-1, DENV-3, and DENV-4 strains were mutated at the 3′ end, and a DENV-2/4 chimera was constructed using the DENV-4 backbone and the DENV-2 prM and E, in place of the DENV-4 prM and E. (Whitehead 2016). There were four vaccine candidates used to make TV003 before it: rDEN1D30, rDEN2/4D30, rDEN3D30 and rDEN4D30. 90% of those who received TV005 developed neutralizing antibodies against all four DENV serotypes after just one dose (Kirkpatrick et al. 2015). V180 vaccine (DEN1-80, Hawaii Biotech) and D1ME100 DNA vaccine are two other vaccines currently being studied (Wellekens et al. 2020).
Three well-known Indian vaccine manufacturers, Panacea Biotec, Serum Institute, and Biological E, have received clinical development and commercialization licenses for the live-attenuated tetravalent vaccine TV003/TV005 (Swaminathan and Khanna 2019). The Indian National Regulatory Authority has given Pancea Biotech permission to conduct human trials on monovalent vaccines. First and second trials will be conducted in northern and southern India to evaluate the safety, reactogenicity, immunogenicity, and efficacy of TetraVax-DV (TV-003/TV-005) (Swaminathan and Khanna 2019). Panacea Biotech has tentatively scheduled its commercial launch for 2020 following the vaccine’s trial. Preclinical toxicity studies for TetraVax-DV are currently being conducted at the Serum Institute of India. Department of Biotechnology (DBT) under Indian Ministry of Science and Technology, Department of Health Research/ Indian Council of Medical Research (DHR/ICMR) under Indian Ministry of Health and Family Welfare and the National Institute of Allergy and Infectious Diseases (NIAID) of the United States National Institutes of Health, Department of Health and Human Services, have recently decided to prioritize collaborative research on promising dengs..

Due to the lack of an effective vaccine to control the severity of dengue by all serotypes, dengue has grown into a serious health problem for humans. An individual’s defense against the dengue virus has not yet been determined. Complex and multi-factored pathogenesis of DHF and DSS can be found in both viral and host factors. It is imperative that dengue virus vaccines be affordable because most countries affected by outbreaks are economically disadvantaged. Although some live-attenuated tetravalent vaccines are licensed for dengue and some are in the trial stage, the unique complexity of DENV pathogenesis and its relationship to immune enhancement are the main obstacles to the development of an efficient dengue vaccine. To better understand how the host’s genetics and soluble proteins, like cytokines and chemokines, affect the body’s resistance to dengue virus infection, more research is needed. PDVI and WHO have worked together to characterize antibody responses in order to distinguish between neutralizing and virally-enhancing features that may be present. Tetravalent vaccines based on live-attenuated DNA viral vectors are the subject of current research. The creation of an appropriate animal model for dengue infection should also be an important part of the research. Because the number of effective dengue drugs and vaccines is so small, we must also pay attention to vector control strategies. Additionally, human activities such as water retention in plastic, metal containers, and cement tanks increase the breeding of dengue-infectious mosquitoes, which in turn spreads the disease. The management of dengue vector mosquitoes should include environmental, chemical, and biological methods. In order to reduce the spread of the dengue virus, these strategies should concentrate on high-human–vector contact areas. Dengue virus infections could be reduced with insecticide-treated curtains and new mosquito traps. Surveillance is an important part of dengue prevention because it provides the necessary data for risk assessment and program implementation. We need data on DENV serotypes or genetic sequences infected people in epidemic areas, along with a correlation of mild/severe illness caused by primary or secondary infection, with the circulating serotype.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian

Damian Sendler: Since its inception, Polish psychiatry has been heavily influenced by German and Russian psychiatry. Many mental health facilities and staff in Poland have German or Austrian roots due to Poland having been part of Germany or Austria before 1918. Almost all mental hospitals were taken over by the Germans during the occupation, and patients were killed in mass shootings, sometimes all of them, sometimes just a portion of them. Separation of Jews from non-Jews and executions were carried out. Some institutions remained run by Germans and employed German directors after World War II. From a historical and organizational perspective, this paper will examine how Polish psychiatry attempted to survive during and after the war. 

Damian Jacob Sendler: “Trucks rolled up to the institution day after day. Each one had 60 patients on board. More than one vehicle could be counted on one hand. They were kidnapped and killed in the woods near Jeewo. (…) It took about five to six days to complete the liquidation. As many as 350 to 370 more patients were taken to Kocborowo, where they were also killed. This was told to me by a German with good ties to the Poles. He went into great detail about an execution he had witnessed over a glass of vodka. Described how three patients were taken out of the truck and shot in the back of their head at a time.  After that, the children’s barracks were demolished. Children were thrilled to be riding in a truck, but their excitement was short-lived when they too were hit by gunfire. In this manner, the children were killed. To begin, they were all led into a field and fired upon as if they were practicing for a game. (1). 

Dr. Sendler: Soldiers from the Wachsturmbann Kurt Eimann SS division forced their way into the psychiatric hospital in wiecie during the first few days of the Second World War between Warsaw and Danzig (2). Doctor Józef Bednarz was taken into custody. Patients were categorized into three groups: Jews, those who could not work, and those who could. Patients were first transported into the surrounding woods on September 10th, 1939. The Volksdeutscher Selbstschutz, led by a Bydgoszcz brewery owner, shot them there. When it was discovered that Doctor Bednarz had informed the families of his patients, he was executed with them (3). 

Conradstein, which was later renamed Kocborowo, was taken over by the SS early in September. When the SS began removing patients on September 22, they claimed that they were taking them to another hospital. In reality, the inmates were led into Spengawsken’s forest and shot. The SS enjoyed depraved revelry in between transports. As a result of their constant intoxication, a number of patients were able to escape. 130 children from the Gniewo branch of the institution were transferred to Conradstein in late autumn. A phenol injection was used to kill the younger children, while the older ones were also shot. Conradstein’s new director Waldemar Schimansky, who referred to himself as Siemens (4), began taking in new patients under his leadership (2). Signs reading “Only German may be spoken here” were displayed in every room. Using Polish was strictly forbidden in the course of study. One doctor took her own life after failing Schimansky/Siemens’ language test. Relatives were barred from the property. The mortality rate rose dramatically as a result of starvation, typhus, tuberculosis, and other deficiency illnesses. A Danzig anatomist named Rudolf Maria Spanner purchased the bodies of those who died in the institution so that he could conduct experiments on how to make soap and other basic commodities from human remains.

The 1,692 patients from the Kocborowo institution who were shot between September 1939 and the 21st of January 1940 were among the more than 10,000 bodies found in mass graves in the Spengawsken forest (5). 

The Germans put in place a sophisticated system of terror that included intimidation, raids, deportations, starvation, forced labor, theft, and the murder of innocent civilians. Nazi Germany’s “intellectual purge,” which by the end of 1940 had already claimed the lives of 80,000 people (civil servants, officers, clergy, academics, and teachers), as well as the Sonderkommando Lange (1-4) mobile gas chambers, the starvation camps for Jews, euphemistically termed “ghettos,” the “General Plan East,” and the “SS Sonderlaboratorium Himmlerstadt” (8, 9). The Germans only allowed the Poles to live if they could be of use. 

Damian Sendler

It is pretty obvious that the killing in Wartheland was orchestrated from the top down. Large and small mental health facilities, as well as nursing homes, were all impacted. S.S. Sonderkommando Lange soldiers escorted the patients in trucks to a nearby forest where they were shot for 10 Reichsmark each. Non-transportable patients were shot as they slept. Some of the institutions continued to receive transports of mentally ill Germans and German resettlers even after they were converted to military or general hospitals. How many sick people were sent to occupied Poland is unknown (1-3). 

As early as December 1939, Sonderkommando Lange began using a mobile gas chamber as part of its operations (2, 3). Exhaust fumes or gas from storage bottles were piped into the cargo space of a truck with the logo “Kaisers Kaffee-Geschäft.” The chemists Dr. Albert Widmann and August Becker, who had been working on Operation T4 since August 1939, oversaw the development of this murder weapon (4). 

A bunker at Fort VII in Posen, where the first execution with carbon monoxide gas is most likely to have taken place in November 1939. (2, 3). Taking advantage of the opportunity, Becker watched as his concept was put into action. 50 patients of the Owiska psychiatric institution were the first victims of gas murder (Treskau). The bodies of the victims were buried in the Oborniki forest. About 400 Owiska patients were gassed to death at Fort VII between October and November. As a result, the ambulances drove their patients straight into the woods. They were now ready to be loaded into the fuel truck. Refusing to get in, many of them were violently dragged into the truck. Before the “transfer,” a sedative was frequently prescribed. Gas was used to kill 1,000 patients in Owiska. At the time of the operation, there were 100 ethnic German patients at the Dziekanka facility (2, 3). 

Damian Jacob Markiewicz Sendler: It was also built by the Nazi civilian administration of Wartheland in November 1941 in a forest near Chemno (Kulmhof) (2, 3). 

Sonderkommando Lange executed at least 160,000 people from April 1943 to May 1944, including Poles and Jews from Wartheland, many Jews from the Ghetto Litzmannstadt, and a large number of patients from Kochanówka Mental Hospital and other places. They used three gas trucks to carry out the massacre. 

The SS and police director in Lublin Odilo Globocnik, coordinator of Operation Reinhard, was given command of 92 members of the T4 staff in summer 1942. Among Globocnik’s resources for the concentration camps Beec, Majdanek, Treblinka, and Sobibór were personnel as well as weapons from the T4 command structure. 

At the outset of the Ghetto Lodz (Litzmannstadt), 160,000 people lived in the ghetto, which was established by the Nazis to house Jews. Director of administration Hans Biebow wanted to maximize the use of his employees. Many of the newly constructed hospitals in the ghetto were a result of his repeated pleas to the locals. A total of 2,600 hospital beds were available in the ghetto. A psychiatric hospital with 50 beds opened in a building adjacent to the Jewish cemetery in the ghetto. The Germans began a series of hurried “evacuation operations” in March 1940. Because the patients refused to cooperate, scopolamine injections were administered prior to the procedure. The extermination camp Kulmhof received patients from other hospitals at short intervals, as well (2, 3). 

Damian Jacob Sendler 

From 1940 to 1942, supplies of essential goods flowing into the German Reich exceeded all German expectations in the Generalgouvernement (2, 3). Only 600 calories a day, according to Jost Walbaum, director of the Generalgouvernement health administration, made the Polish population so susceptible to contagious disease; 40% of the population had typhus in September 1941. A serious threat to the German military and the entire Reich was a major concern for Walbaum. The plight of Jews in ghettos and mentally ill patients, dubbed “useless eaters” by the Nazis, was even worse. In the end, Walbaum weighed the pros and cons of both shooting and starvation, believing that shooting was a more effective deterrent than starvation (2, 3). New regulations issued under Walbaum’s authority reduced the food supply yet again. 

Even when all patients had died, the SS did not wait for them all to die. 

The SS occupied Chem Lubelski’s school on 12 January 1940. (2, 3). Small groups of the 300 men, 124 women, and 17 children incarcerated there were led into the courtyard and shot. Chelm II, like Tiegenhof, was used as a cover for the murder of patients as part of Operation T4 in the same way (10). 

At the Kobierzyn psychiatric hospital in Kraków in 1940, 501 patients died of their ailments (2, 3, 12). The last of the Jewish patients were sent to Zofiówka in September of 1941. They loaded the remaining 535 Polish patients on to a train on June 23, 1942. They were told that they were being transferred to Drewnica, but in reality, they were sent right into gas chambers at Auschwitz-Birkenau. Bedridden patients at the institution were buried in the cemetery. The Hitler Youth used Kobierzyn as a weekend retreat after it was repurposed. 

Damien Sendler: Mistakes were made by Kroll in his efforts to keep the operation under wraps. An invoice from Eastern Rail for the transport of patients to Auschwitz-Birkenau arrived at Kobierzyn in the fall of 1942. The German cashier was stumped by this bill and sought the help of a former Polish administrative clerk. He instructed her to send the bill to Kroll. However, this information revealed the vehicle’s true destination. 

Patients under German command in Kulparkow near Lemberg (Lwów) were dying at an alarming rate (2, 3). He was relocated from Galkhausen (Rhine Province) to Kulparkow (Poland) in August 1943, where he remained until 1945. (13). According to his own recollection, he stayed there until the spring of 1944. During this time, the Rhineland saw an influx of patient transports. It is unknown how many Rhineland patients were sent to Kulparkow, where they were presumably starved to death. 

A children’s department was established at Lubliniec (Lublinitz, Loben) in 1941 by Dr. Ernst Buchalik and Dr. Elisabeth Hecker. 194 of the 256 “treated” children died (2, 3). 

Immediately following the surrender of Warsaw, the Germans took over the control of the Hospital of the Merciful Brothers on the outskirts of the city’s Old City (2, 3). Although there was a scarcity of food, the hospital staff continued to provide care for the patients and take part in the resistance movement nonetheless. Medicinal students were also given lectures by the underground university. Acute psychiatric crises plagued residents of the nearby ghetto, who flocked to the hospital in droves. They were soon relocated to institutions outside the city for security reasons (2, 3). 

Before 1939, many Polish psychiatrists had received a significant portion of their training in German-speaking institutions, dating back to the field’s beginnings in the 19th century. For more than four decades following the end of World War II, psychiatric communication between Poland and Germany was virtually nonexistent. Psychiatrists from the GDR and Poland had a few isolated encounters, but these did not lead to more extensive exchanges. 

In response to an invitation from Prof. Józef Bogusz, West German psychiatrists attended their first international conference on “War, Occupation, and Medicine” in Krakow in 1985. Psychiatrists from 27 different West German cities traveled to Poland in 1987. Sites where psychiatric patients from Germany and Poland were murdered by the Nazis were visited by the group. Finally, in Krakow, they attended the first German-Polish Symposium on Mental Health to round out their 10-day journey. 

By psychiatrists from Germany and Poland, the German-Polish Society for Mental Health was established in Münster in 1990. (14). German-Polish dialogue on psychiatry has included everyone from doctors and nurses to patients’ families and the general public since the beginning. Numerous collaborations between German and Polish clinics and other psychiatric institutions were formed out of a desire to learn about the “other” that had been previously unknown. As a result, several hundred people attend the annual German-Polish symposia on current psychiatric and human rights issues as well as societal taboo topics, which take place in Poland and Germany on an annual basis. 

A third party has joined the Polish-German dialogue since 1998: Israeli psychiatry. There are many Polish-born Israeli psychiatrists working in Israel today. Many joint conferences have been held between psychiatrists from the three countries. They have also taken joint trips to the Ukraine. Dialog’s 2002 and 2006 annual volumes, titled “Myth and taboo” (15) and “Human fate in critical times” (16), document many years of joint efforts to remember (dedicated to Irena Sendler). 

Dialogue in the field of psychiatry between Germans and Poles has built ties across historical divides. As long as we are willing to learn from our shared history, it will be a success.

Dr. Sendler

Damian Jacob Markiewicz Sendler

Sendler Damian 

Damian Sendler: Psychiatry is one of the fastest-growing clinical medical areas, because to the tremendous growth in mental diseases and mental illnesses. As a result, an increasing number of works in this topic have been published in scientific journals.

Damian Jacob Sendler: There were four phases in the development of psychiatry. Studies on child and adolescent psychiatry, diagnostic and classification criteria, brain imaging, and molecular genetics were found to be the most common research areas in the psychiatric profession.

The findings provide light on how and where psychiatric research has developed throughout time. In addition to providing appropriate proposals to steer psychiatric research and scientific data to assist in the successful prevention and treatment of mental problems, this study may also help researchers select the path of psychiatric research.

Dr. Sendler: The social lives of people. More than 4.5 billion people throughout the globe are thought to be affected by mental disease [1]. Mental illness is the leading cause of disability-adjusted life years (DALYs), according to the World Health Organization (WHO). This is more than cardiovascular disease, respiratory disease, and malignant tumors. One of the fastest-growing clinical medical areas is psychiatry because of the enormous growth in mental problems and illnesses.

Damian Sendler

Since its inception over a century ago, the discipline of psychiatry has evolved tremendously. In the latter half of the twentieth century, psychiatric research achieved significant improvements in methodology and in its application to the area of biomedical research. A significant number of researchers have focused their attention on psychiatry, which has resulted in significant new findings being added to the body of knowledge. To show how the discipline of psychiatry has changed throughout time, we employed visualization analysis. The path of psychiatric research in order to prevent and treat mental diseases was determined by identifying authors, published papers, and important issues in the area of psychiatry.

Uses document cocitation analysis, which is an approach to investigate on the development and emphasis of research in psychotherapy, in this investigation. Paper A and paper B have a co-citation connection when paper C simultaneously cites both papers A and B [5,6], according to the 1973 theory of document co-citation proposed by Small and Marshakora. After document co-citation analysis, clusters in research areas may be identified, and the change in these clusters over time can be used to track changes in the field of study. As a means of making our study findings more accessible, we used the visualization program CiteSpace (http://www.cis.drexel.edu / cchen/citespace) to create knowledge maps that show our findings in an easy-to-understand way. Chaomei Chen, a professor at Drexel University in the United States, was the brains behind CiteSpace’s creation. Dr. Chaomei Chen has researched and is a worldwide specialist in the technique of information visualization. This was done in CiteSpace by setting the ‘years per slice’ to one and the ‘years per slice’ to 1983–1992, 1993–2002, and 2003–2012. They included: “title,” “abstract,” “author keywords,” and “keywords and additional.” “cited reference” was used to choose the “node types.” Our “top N per slice” was set to 50, which meant that the most frequently referenced papers were picked for each “time slicing” of the data. In addition, we used the network analysis tool ‘pathfinder’ for this purpose. In the network, the nodes and lines were formed automatically [7]. There were various sized and colored nodes that represented the articles that built the overall network. An article’s citation history was shown in the form of citation tree-rings. Indicated by the color of the citation ring, when the citation was made may be deduced from it. The amount of citations in a time slice was directly related to the thickness of a ring [8]. One of the most significant theories or new concepts was symbolized by the purple ring. Multivariate, time-sharing, and dynamic complex network analysis are all made possible via the use of the visualization instrument, a new generation of information visualization tools. Using this strategy, researchers are able to examine and interpret information quickly to establish a model and the regularities of citations [9]. An activity’s position and authority in their social network are reflected in their degree of centrality. When an entity has a high centrality in a collaborative network, it is referred to as the “central entity” and is in charge of a significant amount of the collaborative network’s research resources.

Kraepelin, E’s “Psychological work experiments” was the first publication published in the subject of psychiatry back in 1921[10]. As a result of this study, Kraepelin is known since the “contemporary father of psychiatry,” as he provided the groundwork for the field. In 1950, Bleuler, E. wrote a book on Praecox dementia and schizophrenia. This study goes into great length on the symptoms and signs of schizophrenia as a mental illness. These new symptoms include associative disorder, affective disorder ambivalent disorders and autistic disorders.

Damian Jacob Markiewicz Sendler: Psychiatry’s attention was divided throughout this time between two main lines of inquiry. In addition, there was the diagnosis of mental diseases. In 1962, Overall, JE created “The brief psychiatric rating-scale” [11]. For functional psychosis, this scale has been extensively utilized in worldwide joint research. In an essay titled “Clinical criteria for psychiatric diagnosis and DSM-III” [12], Spitzer, RL created the Diagnostic and Statistical Manual of Mental Disorders in 1975. The study of psychopathology and aberrant brain morphology was also a major emphasis. Psychopathology was the subject of two important papers. Molecular pathology of schizophrenia-more than one disease process” by Crow, TJ and “Negative V positive schizophrenia-definition and validation” by Andreasen, NC were published in 1980 and 1982, respectively. “Cerebral ventricular size and neuropsychological impairment in young chronic schizophrenics” by Golden, CJ in 1980 [15] and “Persistence of cerebral in chronic schizophrenia as determined by positron emission tomography” by Wolkin, A in 1985 [16] were important articles on abnormal brain morphology. [15, 16]

Three other study avenues were pursued during this timeframe. It was first noted that the clinical effectiveness and security of electroconvulsive therapy (ECT) in patients with depression were examined in the 1965 publication “The diagnosis of depressive syndromes and the prediction ECT response” [17]. the “family and social influences on the course psychiatric illness” article According to the 1976 study “A comparison of schizophrenic and depressed neurotic patients” authored by Vaugh CE, society and family impact mental health patients [18]. [19, 20] To round out the data supporting the use of the dexamethasone suppression test (DST) in the diagnosis of melancholia, Carroll, BJ published a study titled “A specific laboratory test for the diagnosis of melancholia” [19].

Damian Jacob Sendler

It was in 1959 when one of the most important articles of this era appeared. The Hamilton Anxiety Scale (HAMA) was a commonly used anxiety scale, and Hamilton, M wrote a paper titled “The assessment of anxiety states by rating” in 1959. “A Rating Scale for Depression” by Hamilton, M was also frequently used in 1960 [21]. Another important work from this time period was “Development of a rating scale for primary depressive illness,” published in 1967 by Hamilton, M. In 1970, Simpson, GM released an essay titled “A rating scale for extrapyramidal side effects” that described the psychotropic medication scale’s extrapyramidal adverse effects. According to Spitzer’s “A diagnostic interview: The Schedule for Affective Disorders and Schizophrenia (SADS)” published in 1978, this measure was intended to decrease information variance in both the descriptive and diagnostic assessment of a subject [24].

Damien Sendler: During this period of time, research into psychopathology and aberrant brain morphology saw a huge surge in publications. An article on the definition and reliability of “negative symptoms in schizophrenia” was authored by Andreasen in 1982 [14]. JA Kovelman published “A neurohistological correlate of schizophrenia” in 1984. It has been shown that schizophrenia is linked to a decrease in the number of pyramidal cells in the brain [25]. It was Bogerts, B. in 1985 that wrote “Basal ganglia and limbic system pathology in schizophrenia” and expanded on the connection between the limbic system and schizophrenia in his book [26]. Dorsolateral prefrontal cortex physiologic dysfunction in schizophrenia was reported by Weinberger, DR in 1986 and 1987, respectively, in his two papers titled “Implications of normal brain development for the pathogenesis of schizophrenia.” It was indicated by these two papers that the association between schizophrenia and dysfunction in the dorsolateral prefrontal cortex was not a general occurrence. As a result of Kay, SR’s work in this area in 1987, the “positive and negative syndrome scale (PANSS) for schizophrenia” was developed as a way to identify between types of schizophrenia based on the presence of positive or negative symptoms.

In addition, a number of important studies were published during this time period that signaled significant developments in the discipline. As an example, in 1988, “Clozapine for the treatment-resistant schizophrenic” was authored by Kane, J.. Clozapine is a medication used to treat schizophrenia [30]. The field of neurological biochemistry has also expanded. Coccaro, EF authored “Serotonergic studies in patients with affective and personality disorders” back in 1989, for one example. This research found that a subset of individuals with significant affective and personality disorders had a decline in central serotonergic functioning, which was also linked to suicidal behaviors and impulsive violent behavior. Brain imaging research has also recently surfaced [31]. “A quantitative magnetic-resonance imaging study of temporal lobe abnormalities and thought disorder in schizophrenia” was authored by Shenton, ME in 1992. When it comes to determining whether someone has schizophrenia, postmortem exams, CT scans and magnetic resonance imaging (MRI) were all used to examine the brains of the deceased. Mayberg HS wrote “Reciprocal limbic-cortical function and negative mood: Converging PET findings in depression and normal sadness” in 1999. Using PET scans, researchers established a correlation between sadness and a negative mood in the limbic and cortex.

Psychiatry as a field of study dates back to the late 1800s. This discipline started to steadily grow in the 1920s. The paper “Psychological work experiments,” published in 1921 by E. Kraepelin, was a major publication that lay the groundwork for the study of psychiatry. So Kraepelin became known as the father of modern psychiatry. Psychiatry joined the realm of biomedicine in the latter half of the twentieth century. “Praecox dementia and schizophrenia,” written in 1950 by prominent psychiatrist Bleuler, E, presented the “4A” symptoms of the disorder. From 1983 to 2012, three distinct phases of growth and research orientations in the area of psychiatry were discernible.

There was a first stage of research on mental diseases in the 1960s through the 1970s. “The assessment of anxiety states by rating” and “A rating scale for depression,” both produced by Hamilton, M, served as the representative document. ‘ Spitzer, RL went on to write a slew of papers detailing the severity of various mental illnesses, all of which were critical to the field’s early growth.

The 1980s marked the beginning of the second phase of study into psychopathology and aberrant brain anatomy. “Molecular pathology of schizophrenia: more than one disease process” was authored by Crow, TJ in 1980. Positive signs of schizophrenia were shown to constitute a distinct disease process or distinct symptoms in this work; this was a major achievement in the research on developmental psychopathology in the psychiatric community. Weinberger, DR released a slew of publications at this period on schizophrenia’s aberrant brain morphology, laying the groundwork for future research.

In the 1990s, the third stage of study into the role of neurotransmitters in mental diseases came to a close. A new paradigm for psychiatric study was born during this time period when Coccaro, EF, Murray, AM, and Egan, MF published articles describing the many neurotransmitters associated with mental diseases.

Emotion and molecular genetics were the focus of psychiatric study in the early years of the twenty-first century. Psychiatric research has increasingly focused on molecular genetics and the finding of crucial candidate genes as a consequence of the human genome project’s advancements [58]. The publications authored by Purcell, SM during this era set the groundwork for study on molecular genetics in the area of psychiatric research.

Psychiatry has become one of the fastest-growing clinical medical specialties due to a rise in mental diseases and mental illnesses. We were able to zero down on certain areas of interest in the field of psychiatry using hierarchal grouping. Depression, schizophrenia, and the use of drugs to treat mental illness dominated psychiatric research throughout each of these historical periods. First and second-period research was also focused on the categorization and diagnosis of mental diseases. Obsessive-compulsive disorder (OCD) and changes in brain biochemistry (Figures 4, 5, and 6) dominated early research. The focus of study shifted to sleep problems during the second phase.

In addition, in recent years, research in the psychiatric profession has focused on mental illnesses in children and adolescence, brain imaging, and molecular genetics. Adolescent mental health is affected by elements that are distinct from those that influence adults because of the unique qualities of childhood and adolescence. Since the number of children and adolescents with mental problems has risen considerably in recent years, the study of mental disorders in childhood and adolescence has become a research trend. Anatomical structure, function and metabolic changes in the brain may now be studied using imaging technology. This technology has been extensively used in the research of major mental diseases.

In addition, molecular genetics is a current trend in the area of psychiatry. Studies demonstrate that mental illnesses are complicated polygenetic diseases, hence study into susceptibility genes for mental disorders has been a primary goal. In light of the tremendous advancements in molecular biology theory and technology, gene study is rapidly progressing. In addition, as genome-wide association analysis advances, additional potential genes for mental illness will be discovered. It is critical to identify genes that are associated with certain clinical symptoms of mental illnesses since these diseases are the most costly to society. Drug treatments may begin based on the genotypes of those who need them. As a result, individuals with a variety of mental diseases will be able to get tailored therapy.

The area of psychiatry has grown considerably since the 1980s. New methods of brain imaging have been made possible by advances in a variety of fields, including neurobiochemistry, psychopharmacology, and molecular genetics. Aside from these basic shifts in our understanding of mental diseases, the application of ideas from psychology and sociology has also helped to establish the biopsychosocial medical paradigm. The pathogenetic significance of psychological factors in mental diseases may now be understood at the molecular level and by people themselves. In the 21st century, the biopsychosocial approach, current medical theories, and new technological applications used to prevent, diagnose, and treat mental diseases will lead to major advancements in the discipline of psychiatry.

Dr. Sendler
Damian Jacob Markiewicz Sendler
Sendler Damian

Damian Sendler: Europe’s biggest medical specialty is psychiatry. However, despite attempts to bring about uniformity, training in psychiatry throughout Europe continues to be very disparate. After establishing a charter of standards for psychiatric training in 2000, the Union Européenne des Médecins Spécialistes (UEMS) followed it up with a European Framework for Competencies in Psychiatry in 2009, and a European Framework for Competencies in Psychiatry in 2010. Despite this, they have not been applied across the European Union. On the one hand, the cultural disparities across nations with respect to how mental health treatment is seen and built on, and on the other, the cultural differences between individuals throughout Europe in all states, are discussed in this study, which is divided into three sections. The importance of psychotherapy is emphasized throughout the text. What was formerly considered to be the cornerstone of psychiatry as a medical profession seems to have become a neglected field of study. It is necessary to evaluate the patient with mental health difficulties in his cultural setting, but it is also important to assess him in his familial environment. Training should be designed to enable trainees to gain the knowledge and skills necessary to become well-equipped professionals. This is the subject of the final paragraph, in which trainees consider their current position and early career psychiatrists reflect on their training to determine whether what they learned corresponds to what they need in their current working environment. A common standard for training and certification is required across Europe, not only for the benefit of the profession of psychiatrists, but also for the protection of patients and their families. To better serve its users, UEMS is advising them to collaborate with the Council of National Psychiatric Associations (NPAs) within the European Psychiatric Association (EPA), as well as training programs and early career psychiatrists, to discuss with them what standards should be implemented in all European countries and how a European board examination could ensure professional quality of psychiatrists across the continent.

Damian Jacob Sendler: When it comes to the European Union (EU), one of the most essential issues is harmonisation of training. The rationale for this is entrenched in the EU’s fundamental principles of freedom of movement of products, money, services, and labor. As a result, there is a pressing need for professional credentials to be recognized by their peers. For the safety of patients and the security of professionals, a process of standardisation in training programs, competence evaluation, and quality assessment must be implemented while maintaining sensitivity to existing cultural variety in order to ensure their protection.

Dr. Sendler: In addition to the issue of harmonisation, there is the pressing problem in many European countries of inadequate recruitment of medical graduates into psychiatry, which has resulted in a shortfall in the number of medical graduates required to maintain an adequate medical labor force in mental health facilities.

Damian Sendler

Mayer et al. [1] undertook a thorough search of the literature in order to identify primary information that assessed the variety of training across Europe. As a result of their search, the authors discovered just six original publications that fit their search criteria, four of which were about survey data, as a result of their search. They also selected and described six published postgraduate courses that they had found and published. Based on this information, the authors came to the conclusion that there is a significant disparity in training experience throughout Europe, which will provide a hurdle to the objective of harmonisation in the future. They advised that curriculum be made more widely available and uniformly standardised, and that an agreed-upon evaluation mechanism be established that leads to the certification of “Fellow of the European Board of Psychiatry” be established.

This is unfortunate, but not unexpected given what we know about medical education scholarship, which shows that published research seldom tackles concerns of efficacy [2], and the lack of information about trainee psychiatrists’ educational experiences in Europe. As Jan Illing [3] noted, acceptable types of evidence may be obtained from sources other than those available in the conventional scientific literature, which is important to keep in mind while teaching at medical schools. Acceptable approaches may include the qualitative, as well as the narrative, among other things. Experts’ narrative knowledge based on their experience and expertise based on their practice, particularly when tested by triangulation, may therefore be considered credible kinds of proof.

According to Mayer et al., their review tackles the subject of harmonisation, but it does not answer the question of what the harmonisation should concentrate on. There is little use in every European country providing psychiatrists in training with the same experience if that experience does not result in the production of physicians who can function successfully in order to deliver the treatments that mentally ill people in Europe need.

The purpose of this guideline paper is to expand on the work of Mayer et al. [1] by investigating the topic of a uniform European standard for training in psychiatry from a variety of viewpoints, including the following:

Lastly, we will employ a conceptual framework derived from the field of organizational science to investigate why efforts to harmonize training have been unsuccessful, and we will draw conclusions from this to formulate recommendations that may be more effective than those that have been implemented thus far. We will use this to argue for greater inclusivity in the discussions surrounding the harmonization and improvement of training standards and procedures.

Damian Jacob Sendler

This guideline document is intended for those who are most directly involved: trainees and instructors. We want to contact national and worldwide professional organizations that are responsible for the creation and assessment of training programs in a more indirect manner.

The guideline will take into account a variety of forms of evidence, including that generated from experts by experience and that derived from expert practitioners in the area, in accordance with Illing’s [3] directive to employ diverse sources of evidence.

Damian Jacob Markiewicz Sendler: The European Economic Community was established in 1957 as a result of the signing of the Treaty of Rome (EEC). It established a single market among its member countries, allowing for the free movement of people, services, products, and money among them. The reciprocal recognition of professional degrees was a necessary precondition for the free movement of professionals in the European Economic Community. Since 1975, member nations of the European Community (EEC) have been compelled to recognize each other’s basic and specialty medical degrees. This provision was codified in Council Directive 93/16/EEC [4], which came into effect on April 5, 1993. In accordance with the Directive, member states are required to recognize basic medical credentials obtained in other member states. Additionally, the Directive mandated that basic medical training should be completed within six years.

Europe’s Union of Medical Specialists (UEMS, unofficially known as the European Union of Medical Specialists) was established in 1958 by professional organizations of medical specialists from across the European Community. With its support for the European Union’s idea of free movement of medical experts, the United Medical Specialists of Europe (UEMS) aims to provide high-quality training, continued medical education and professional development, and high-quality practice across all disciplines. It rapidly got engaged in programs aimed at enhancing the overall quality of life. As a culmination of this effort, the Charter on the Training of Medical Specialists in the European Community was published in October 1993 [5] and became effective. A condition of this Charter is that physicians get the training that was deemed essential to prepare them for the appropriate level of specialized practice in any member state. The criteria were broken down into six sections. The first five are general requirements for all programs of specialist training, while the remaining five are specific to each program. The so-called Chapter Six, which is prepared by the UEMS Board of the speciality in question, outlines the quality requirements that must be met in order to train in that specific specialty.

The University of Maryland Medical System Board of Psychiatry was formed in 1992. In April 2000 [6, the Board of Psychiatric issued the psychiatry specialist training chapter of the Charter, which was written by the American Academy of Neurology]. It is specified in this chapter how long psychiatric specialist training should last, how it should be organized, what it should cover, and how it should be monitored for quality. Briefly summarized, the chapter specifies that training should last a minimum of 5 years; trainees should rotate between clinical services and treat a variety of psychiatric disorders during their training; trainees should have experience in general adult psychiatry, old age psychiatry, substance misuse psychiatry, developmental psychiatry, as well as supervised experience in psychotherapy; and there should be established internal quality assurance systems within training institutions.

[7] Despite the considerable work that went into the development of UEMS criteria, their influence was limited by the fact that they were advisory in nature, the paucity of resources available to the Board of Psychiatry, and the wide range of mental health services offered across Europe. Research conducted in the years following the publication of Chapter Six of the UEMS Charter on Training Institutions and Trainees revealed that only the bare minimum requirements of the EEC Directive were consistently met, and that there was a significant variation in the content and structure of training delivered across Europe, as well as in the methods used to assess training outcomes and to ensure training quality [8–10]. The fact that people have differing perspectives on what is meant by mental health services as well as inequalities in how mental health services are delivered is particularly concerning [11].

Damien Sendler: In order to address these concerns of inconsistency, the UEMS Board of Psychiatry took the next step and developed curricular guidelines. On the basis of a European consensus declaration on the fundamental skills of a psychiatrist [12], this was to be implemented. The European Framework for Competencies in Psychiatry (EFCP) [13] was published in 2009 following an iterative development process that included key stakeholders such as psychiatric educators, national psychiatric associations, psychiatrists in training, and people who use mental health services as well as their families and caregivers. A high degree of participation in the creation of the EFCP by professionals with practical experience (trainees, users, and caretakers) increases the validity of the content of the EFCP as a statement of what the European Specialist Psychiatrist should be able to achieve by the conclusion of training.

There are currently no official statistics available to describe the effect of the EFCP. On the basis of anecdotal data, it seems that several national psychiatric training programs have been developed in order to achieve the goals of the EFCP. The EFCP seems to have had the same uneven influence on training as the UEMS Charter, based on the evidence available thus far.

Even though the variation in different aspects of training is a source of concern in and of itself [11], the greater concern is the possibility that this will manifest itself as variation in the quality of psychiatric practice.

In a particular society, psychiatry training is embedded in the mental health services that are available, and these services are embedded in the national and regional cultures of that society. As a result of their concern about what they termed “national conditions,” those who wrote the EFCP purposefully avoided developing an educational curriculum based on the capabilities outlined in the framework. They defer to local governments for the specifics of such matters. The fact that a curriculum is supposed to outline the techniques of learning and growth within a certain training program suggests that it may be heavily impacted by national circumstances.

There is a great deal of variation in the way mental health services are delivered across Europe. A combined number of psychiatric beds per 100,000 people in Europe ranges from 185 in Malta to 8 in Italy, according to the World Health Organization (WHO), as of 2014 [15]. Admission rates to inpatient units per 100.000 inhabitants vary from 1.301 in Romania and 1.240 in Germany to 87 in Albania, with Romania having the highest rate at 1.301 and Germany at 1.240. According to the World Health Organization, the number of outpatient visits per 100,000 people ranges from 28.2 in Slovakia and 26.1 in Finland to 1.08 in Albania and 1.07 in the United Kingdom.

The makeup of the workforce exhibits a similar degree of variety. The number of psychiatrists per 100,000 population ranges from 30 per 100,000 in Switzerland and 26 in Finland to 3 in Albania and 1 in Turkey, with Switzerland having the highest rate at 30 per 100,000.

The number of nurses who work in mental health care varies from country to country, ranging from 163 nurses per 100,000 people in Finland to 3 nurses per 100,000 people in Greece 7.

Because of the heterogeneity in the structure of the mental health workforce, it is likely that various professions will take on different types of work throughout Europe, which will in turn impact the content of postgraduate training in mental health care.

Europe is a diverse continent with a diverse range of cultures and sub-cultures, which has seen a significant inflow of even more cultures from all over the world in recent decades. It is likely that these cultural variations will have as much of an influence on how medicine and psychiatry are practiced in various nations as differences in the makeup of the mental health workforce. They also emphasize the significance of obtaining expertise in cultural psychiatric practice. Professionals are able to travel freely within the European Union, at least in theory. However, if the standards for the specialization are significantly different from those in the hosting nation, governments might request extra requirements such as appropriate language skills in the hosting country and further training in the host country.

There are some disparities between the cultures of psychiatric practice in different parts of Europe when the practice is analyzed. A long-standing tradition exists in several nations that psychiatry and psychoanalysis are synonymous. On the other hand, the influence of psychoanalysis on psychiatry has all but evaporated in several areas. Thus, there are conflicts among the many international, regional, state-level, and national psychiatric organisations, which represent the various schools of thought in neurobiology and psychoanalysis. In certain cases, this may result in political and governmental authorities exercising influence over curriculum as well as registration and board exams.

Central and Eastern European nations have a long history of political regimes in which psychiatry was connected with “discretely eliminating from society” politically problematic persons. This legacy may be traced back many decades. At the same time, psychiatry was the most despised area of health care, with a long history of institutionalization, inadequate finances, and outdated conditions, making it the least popular choice. The issue of stigma and prejudice towards those who suffer from mental illnesses continues to be a major concern, despite the fact that the environment has changed considerably.

The north-western region of Europe is now characterized by a strong empirically driven psychiatry, a research-driven medical profession that has gained prominence in universities, in society, and in the political arenas.

The result is that one is confronted with a continent that has wildly disparate “psychiatry,” which makes establishing Europe-wide standards a difficult undertaking. Although it would be inappropriate to enforce a single model throughout Europe, an agreement on principles that are shared by everyone may serve as a foundation that could then be supplemented with local values and habits within agreed limitations. However, in order to determine how the certification should be modified when a registered psychiatrist transfers from one area of the continent to another, it will be necessary to investigate the cultural variations in more depth in each location.

Individuals have various cultural identities in addition to their core cultural identity, which are influenced by a variety of circumstances such as their professional background, location of training, and place of employment. These identities will have an impact on how you seek treatment and how you perceive the world. All of our identities are tied to the cultural framework that we bring with us. Some of these characteristics may be more difficult to give up than others. In the context of migration or not, acculturation is a complicated time of adjustment to new ideas, attitudes, and behaviors that occurs as a result of direct or indirect interaction with other cultures. Acculturation may take place with or without migration. Individuals move for a variety of reasons, both within and across nations. Even within cultural groupings, there are differences, and physicians must be aware of these differences in order to provide effective treatment. Individuals may suffer cultural mourning as a consequence of their losses as a result of migration [17, 18]). Individuals may suffer cultural conflict as a result of differing cultural values within the same family or across cultures. Cultural conflict has been connected to willful self-harm among South Asian girls in the United Kingdom [19]. It is characterized as an emotional response [21] and is an experience that some migrants may have after arriving in a new country [20].

Psychiatric training is primarily concerned with preparing residents to be effective clinicians in their fields. It is critical to take cultural factors into account throughout training in order to produce physicians who are culturally competent. Good clinical practice, on the other hand, is about being competent with all patients, regardless of their cultural background. In order to be culturally competent, one must exhibit cultural sensitivity as well as knowledge of other cultures, empathy for others and the ability to provide culturally acceptable interactions. One must also be conscious of one’s own cultural strengths and shortcomings. The cultural formulation must include the individual’s cultural identity, their beliefs and values, their symptoms in their cultural context, their relationship with the environment, factors that reinforce their symptoms, distress as a result of the problems, their explanations for the distress, whether the doctor and the patient have a shared understanding of the problems and a shared plan for addressing the problems, the quality and nature of the interaction, and the nature and quality of the interaction with the doctor. This is the most important part of the training. However, it is also crucial for therapists to be conscious of their own cultural history and to understand if they are mono-cultural, bicultural, or multicultural in nature. It’s also important for them to be conscious of the signals they get from different cultural groups and how these messages influence their therapeutic practice. Personal qualities, such as the ability to recognize and explore one’s own strengths and flaws, are essential in therapy. They should be highly conscious of the worldview that they are promoting. It is also important to verify whether the pattern is similar to or differs from that of the patient at each visit. Trainees must be educated not to be color blind, but rather to be conscious of the parallels and variances between their own cultural beliefs and those of their patients.

Each family system has its own culture on a “micro-level,” or on a smaller scale. During the course of training to become effective therapists, it is imperative that students learn to consider the environment and family context.

For example, our families, as our earliest socializing agents, may serve as a site for both better understanding the origins of mental disorders and as a resource to help us grow as individuals. However, according to scientific epistemology, the term “family” refers to a systemic and network unit. There are several meanings of the term “family,” including family healthy functioning and dysfunctioning [21]. Even within a society, conceptions of family differ based on cultural and social groups. As civilizations grow more enriched with various cultures, their conventional notions of family are being challenged. An essential component of modern psychiatric treatment is the use of evidence-based biopsychosocial formulations to diagnose and treat mental diseases and issues. In that activity, we unavoidably come into contact with families. Among the questions we ask are regarding family histories of medical and mental conditions, high-risk behaviors (such as suicide, addiction, eating disorders, etc.), and the use of social media by patients and family members, to name a few examples. As a result, we need family assistance as well as communication abilities. In the diagnosis and treatment of people suffering from mental illnesses, there is a significant distinction between treating them as individuals and treating them as members of broader social (familial) groups. When it comes to family and systemic practice, the EFCP categorizes supporting competences under essential competencies that relate to treatment, communication, and the prevention of mental illness.

In a room where a psychiatric examination is taking place, dealing with more than one individual at the same time is a difficult job to do. For a psychiatrist working in clinical practice, there is a fundamental need for interviewing and intervention skills in order to interact and assist not just with one but often with a group of persons that are surrounding the patient. Family interviewing abilities do not imply the practice of family psychotherapy in any way. It refers to the ability to foster quick family contact, a brief greeting, or a 10-minute encounter, all of which contribute to the development of alliance. Family interventions, such as psychoeducational family intervention, family consultation, family education, family support, advocacy, and self-help groups [22], are important for the training of competent clinicians. Systemic family and network therapy are also important for the training of competent clinicians.

Additionally, the competent clinician must have had training in psychotherapy as part of their program [1, 23] so that they are able to interact with the patient and his or her immediate surroundings in a psychotherapeutic manner [1, 23, 24].

Damian Jacob Markiewicz Sendler

Dr. Sendler

Damien Sendler

Sendler Damian

Damian Sendler: In order to keep the body’s homeostasis intact, vascular endothelial cells (ECs) play an important role. COVID-19 suffers from the classic symptoms of this deadly illness due to damage to the EC barrier: swelling, inflammation of the blood vessels, and abnormalities in blood clotting. However, it is not known how COVID-19 affects ECs. SARS-CoV-2 spike protein alone stimulates the EC inflammatory phenotype in a way reliant on integrin 51 signaling, as shown in this study. To induce nuclear translocation of NF-B and the subsequent expression of leukocyte adhesion molecules (VCAM1 and ICAM1), coagulation factors (TF and FVIII), proinflammatory cytokines (TNF, IL-1, and IL-6), as well as adhesion of peripheral blood leukocytes and EC monolayer hyperpermeability, researchers incubated human umbilical vein ECs with whole spike protein, its receptor-binding domain, or the In addition, integrin 51 activation inhibitors were shown to have no impact. It was also found that these vascular effects occur in vivo when spike was administered intravenously and found to increase lung, liver, kidney, and eye expression of ICAM1, VCAM1, CD45 and TNF, IL-1 and IL-6 as well as to disrupt retinal capillary barrier function when spike was administered intravitreally. Our findings suggest that the spike protein, through its RGD motif in the receptor-binding domain of the receptor, is capable of binding and activating the NF-B target gene expression programs responsible for vascular leakage and leukocyte adhesion in endothelial cells (ECs), which in turn promotes leukocyte migration. A novel direct effect of SARS-CoV-2 has been discovered on EC dysfunction, and this discovery introduces the potential for using integrin 51 to treat COVID-19 inflammation.

Damian Jacob Sendler: COVID-19 has been linked to endothelial cell dysfunction (EC dysfunction) (1, 2, 3). Vasopermeability and coagulation and inflammation are prevented, and ECs retain their barrier function when at rest. Because of the damage or infection, endothelial cells (EC) are stimulated and release chemoattractants (cytokines), adhesion molecules (integrins), and leukocyte infiltration (4). Acute respiratory distress syndrome, pulmonary edema, cytokine storm, multiple organ failure, and disseminated intravascular coagulation (5) are the most common causes of death in persons with severe COVID-19, all of which are indicative of EC failure (1, 2, 3). A number of chronic endothelial diseases, such as aging, obesity, hypertension, diabetes, and cardiovascular disease, are linked to severe COVID-19 instances or fatalities (6, 7).

Damian Sendler

Dr. Sendler: When SARS-CoV-2 enters and replicates, it may cause the EC death mechanism described above (8), which may then result in mitochondrial dysfunction (9), as well as the downregulation of the SARS-CoV-2 spike protein and activation of the proinflammatory ACE2 receptor, as well as a buildup of proinflammatory and vasoconstrictor angiotensin II (2). Proinflammatory cytokines and chemokines may be activated by the spike protein, as well as harmful reactive oxygen species and cell death (12). However, the underlying mechanisms of many of these impacts remain a mystery to this day.
Integrins may play a role in modulating SARS-CoV-2 infection in place of ACE2. Blood clotting, inflammation, and angiogenesis are all affected by the hemostatic, heterodimeric, transmembrane adhesion molecules known as integrins. One of the receptor-binding domains of the spike protein has an integrin-binding RGD motif that is exposed and binds to 1 integrins on pulmonary epithelial cells and monocytes (13, 14). (15). COVID-19’s therapeutic effectiveness is shown by blocking the binding of the spike protein to the integrin 51, which prevents the infection of SARS-CoV-2 in vitro (16) and in vivo (17). NF-B, the transcription factor that regulates the production of proteins involved in inflammation and angiogenesis, is activated by the ligation of integrin 51 in ECs by fibronectin (18). As a result of these findings, we investigated the role of spike in inducing the endothelial proinflammatory phenotype via binding to the integrin 51.

The capacity of ECs to attach leukocytes, a characteristic of the inflammatory process, may be used to measure inflammatory alterations. Human umbilical vein endothelial cells (HUVEC) were pretreated for 16 hours with spike, the receptor-binding domain of spike, the RGD tripeptide, or TNF as a pro-inflammatory control, and peripheral blood leukocytes were incubated for 1 hour (Figure 1 ). Leukocyte adhesion to HUVEC was enhanced by Spike with great efficacy (EC50 = 1.6 nM) and resembled that generated by TNF, which is a major EC pro-inflammatory change initiator (19) (19) (Figure 1a, b). It was also shown that spike and the RGD tripeptide had comparable dose-response curves (EC50=1.8 nM) because of their receptor-binding domains (Figure 1c). According to these findings, the RGD sequence found in the spike receptor-binding domain is responsible for triggering the ECs’ proinflammatory response when used alone.
Many ligands for integrins include RGD as the integrin-binding motif, such as fibronectin, which is the primary ligand for the integrin 51. The EC inflammatory program is activated by the upregulation of fibronectin during inflammation (20). (18). In order to establish that spike binds to integrin 51, we performed ELISA (16). When spike or the receptor-binding domain of spike was treated with integrin 51 or neutralizing antibodies against integrin 51 or the integrin 5 subunit, the plates were coated with RGD tripeptide or neutralizing antibodies. RGD tripeptide and anti-5 antibodies blocked integrin binding to Spike and its receptor-binding domain (Kd = 200pM) as predicted (Figure 2 a) (Figure 2b). The promotion of leukocyte attachment by spikes may be explained if fibronectin ligation of integrin 51 results in the production of adhesion molecules in endothelial cells (ECs) (18). A dosage (100 nM) of spike, spike receptor-binding domain, RGD tripeptide, or TNF (1 nM) with maximum stimulatory impact on leukocyte adherence to HUVEC was examined to determine that evoked effects were successfully taking place before anti-51 or anti-5 antibodies were used (Figure 2c). Both antibodies prevented leukocyte adherence in response to spike, the spike receptor-binding domain, and the RGD tripeptide, consistent with an integrin 51-dependent action. TNF’s action was not altered, indicating that it is not reliant on integrins (21).

Spike’s ability to increase leukocyte adherence was examined since the activation of NF-B in endothelial cells (ECs) causes inflammation (18). A protein known as inhibitors of kappa B (IB) inhibits the activity of NF-kappa B, a transcriptional factor for a number of genes associated with inflammation, in the cytoplasm. For NF-B to be transported into the nucleus and bind to target genes’ promoters and enhancers, it must first be phosphorylated or degraded (22). Fluorescence cytochemistry and a monoclonal antibody against the p65 component of NF-B were used to investigate the cellular distribution of NF-B in HUVECs (Figure 3 a). In the absence of treatment, cells’ cytoplasms were evenly dispersed with p65. This redistribution of p65 was similar to that caused by TNF, which was triggered by Spike. Nuclear translocation of p65 in response to spike and TNF was inhibited by anti-5 antibodies, but was not inhibited by same antibodies when spike was combined with anti-NF-B inhibitor BAY11-7085 (Figure 3a). Anti-5 antibodies inhibited the degradation of IB in response to spike, but not in reaction to TNF, while BAY11-7085 protected IB degradation by both spike- and TNF-induced stimuli (Figure 3b). Spike seems to activate NF-B through integrin 51, according to our findings.
COVID-19 has been classified as a vascular disease as a result of growing evidence (1, 2, 3, 34). Because of the edema, intravascular coagulation, vascular inflammation, and unregulated inflammation cell infiltration that result from blood vessel injury in severe COVID-19, progressive lung damage and multi-organ failure are also possible outcomes. Vascular dysfunction in COVID-19 has been linked to a number of different pathways (1, 2, 34), but little is known about how SARS-CoV-2 interacts directly with ECs (9, 11).
It has been shown that ACE2 is the best-known host receptor for spike (35, 36, 37), while alternative spike cell surface receptors have been discovered, including neuropilin-1, toll-like receptors (10), and RGD-binding integrins (39). (15, 16). It is known that the RGD-binding integrin 51 facilitates the entrance of SARS-CoV-2 into epithelial cells and monocytes in vitro and enhances lung viral load and inflammation in vivo after spike binding to it (16). (17). Proinflammatory genes in ECs may be activated by the binding of fibronectin RGD to integrin 51 in ECs (18), but the influence of spike on the EC response has not been examined.

Damian Jacob Sendler

Damian Jacob Markiewicz Sendler: EC inflammation is activated when spikes are bound to the integrin 51 receptor, as shown in this study. TNF, a well-known EC inflammatory response-inducing agent, was shown to enhance the production of ICAM1 and VCAM1 and the attachment of leukocytes to the EC monolayers (Figure 8). (19). No impact of spike on ICAM1 or VCAM1 proteins was detected, however mRNA and protein levels for both adhesion molecules were shown to be closely correlated in human vascular endothelial cells treated with several inflammatory mediators.. (40, 41). In addition, the increase in VCAM1 and ICAM1 mRNA levels and leukocyte adhesion had a strong dose-response relationship. An increase in VCAM1 and ICAM1 activity in EC may be linked to spikes, according to this association. ICAM1 and VCAM1 and leukocyte marker CD45 expression were elevated in retinal capillaries after intravenous injection of spike. This suggests that spike increases leukocyte adhesion across the various capillary beds.

RGD tripeptide and receptor binding domain of spike elicited similar responses to those of a spike, and that the RGD tripeptide itself blocked spike- and spike receptor-binding domain-binding to integrin 5-1, and that spike-induced proinflammatory effect in ECs was prevented by integrin 5-1 neutralizing antibodies indicated that spike, through its RGD motif in its receptor-binding domain, binds the receptor 5-1 in ECs to promote inflammation (Figure 8). ECs’ 51 signaling in response to spike is heavily reliant on the transcription factor NF-B, as well. Anti-NF-B and anti-5 antibodies blocked all of Spike’s activities on ECs, which included IB breakdown, nuclear translocation of NF-B, production of adhesion molecules, coagulation factors (TF and FVIII), proinflammatory cytokines (TNF, IL-1, and IL-6), and leukocyte adherence (Figure 8). In ECs, ligation of fibronectin to 51 upregulates the expression of proinflammatory genes through the NF-B signaling pathway, according to this research (18). In fact, proinflammatory cytokines like TNF activate NF-B as a major signaling molecule in ECs through an integrin-independent pathway (19).

Toll-like receptor-induced cytokine release by neutrophils, macrophages, and lung epithelial cells in response to spike (10, 39) and the envelope protein (42) provides a mechanism for the cytokine storm found in severe COVID-19 (25). When toll-like receptors are activated, they may work in tandem with integrins like 5 to enhance their signaling pathways (43). There are few or no toll-like receptors on the surface of human endothelial cells, indicating that interactions between toll receptors and integrin 51 do not contribute to the proinflammatory impact of spike on the endothelium. Additionally, ACE2 is upregulated in the ECs after the activation of 51-NF-B signaling by spike (Figure 8). By binding to EC’s ACE2 receptor, spike reduces ACE2 protein levels, inhibiting mitochondrial function and eNOS activity, and ultimately damaging the EC (9). A decrease in the expression of ACE2 would lead to an increase in inflammation, as ACE2 is anti-inflammatory and its overexpression protects against severe COVID-19 symptoms (45). Interestingly, we discovered that spiking NF-B signaling in ECs boosts ACE2 mRNA levels in an anti-parallel manner. If this impact is translated into an increase in the amount of ACE2 protein, these data imply two different scenarios: By supplying more SARS-CoV-2 receptors for infection, elevation of ACE2 expression increases viral infection of endothelial cells (ECs) in a protective manner.
Another characteristic of severe COVID-19 is excessive vasopermeability, which results in edema. In this study, we demonstrated that spike binding to integrin 51 increased EC monolayer hyperpermeability through the RGD motif (Figure 8). The receptor-binding domain and the RGD tripeptide imitated spike-induced hyperpermeability in monolayers, while antibodies against the 51 integrin and the 5-integrin subunit inhibited it. Furthermore, intravitreal injection of spike resulted in several hemorrhagic regions and accelerated extravasation of Evans-blue-linked albumin in retinal capillaries, demonstrating spike-induced promotion of EC hyperpermeability. Disruption in barrier function of retinal capillaries caused by a spike is similar to that caused by intravitreal injections of an anti-inflammatory agent known as vascular endothelial growth factor (VEGF) (46, 47).

Damien Sendler: EC-cell junctions are known to be stabilized by 1-integrins throughout development (48), but inflammation may potentially lead to their breakdown (26). One of the most important mechanisms for inducing inflammation is the activation of integrins, such as those found on the cell membranes of endothelial cells (ECs) (49). We found that the spike signals via 51 promoted the production of stress fibers, endothelial cell retraction, and inter-endothelial gap creation in accordance with this finding (Figure 8). Spike increased RhoA and Cdc42 GTPases and downregulated Rac1 in EC, which are all Rho family GTPases that govern these activities With respect to EC junctions and EC matrix adhesion, Rho GTPases act in two ways, depending on the situation in which they are activated. RhoA is linked to the breakdown of the barrier, Rac1 to its upkeep, and Cdc42 to its stability and recovery during inflammation (50).

According to the observations presented above, spike interfered with the peripheral distribution of CD31 in stable EC monolayers (Figure 8). CD31’s altered location in ECs is compatible with enhanced vasopermeability since it shows sticky capabilities and is mostly localized at junctions between neighboring cells (27). EC junctional proteins are downregulated in both normal and diabetic animals when spike is administered, which is consistent with a previous study revealing that spike compromises the endothelium barrier’s integrity (51). After that, spike phosphorylated/activated eNOS in the endothelial cells (EC), and NO is a major vasorelaxant and vasopermeability factor (31, 52) (Figure 8).

We have shown that by binding to 51, spike alters the EC phenotype to induce vascular inflammation in vitro and in vivo (Figure 8). To regulate permeability or quiesce leukocytes is lost when spike-mediated 51 activation occurs, which are both signs of EC failure (19). As a result of these discoveries, we can better understand why COVID-19 is a vascular illness and how to treat it.

There is a possibility that vaccination with the spike protein in COVID-19 vaccines might lead to EC dysfunction. According to this research, the EC50 value of spike was discovered to be [300ng-1], which is substantially lower than that observed in the COVID-19 severe COVID-19 (53), which had spike protein levels of [30 ng mL-1]. Because the majority of the spike stays attached to cells, it does not disperse much from the injection site. Moreover (54). Because antibodies created by a previous immunization rapidly and efficiently eliminate any trace quantities of spike that may have entered the blood, spike is no longer detectable following the second vaccination (54). So immunization should assist avoid EC damage in COVID-19 rather than aggravate it.

Damian Jacob Markiewicz Sendler

Dr. Sendler

Damien Sendler

Sendler Damian

Damian Sendler: An early study of ARDS’s molecular biology revealed that the disease is very variable across individuals. Inflammation, coagulation, alveolar epithelial damage, and vascular endothelial activation might vary significantly across patients suggesting a role for molecular subphenotyping in unraveling heterogeneity. 

There are two distinct subphenotypes that tend to respond differently to several therapies in secondary analysis of clinical trials based on clinical and biological data from trials and observational cohorts of patients. 

Damian Jacob Sendler: Identifying novel treatment targets may be possible if we better understand the underlying underpinnings of heterogeneity. Biological variation may be attributed to clinical heterogeneity, but not all of it. A person’s tendency to ARDS may be influenced by hereditary susceptibility to viral and non-infectious pro-inflammatory stimuli. 43 Genetic variations have a direct impact on the pathogen–host relationship in certain lung illnesses. 44 Predicted levels of sRAGE (a measure of inflammation and alveolar epithelial damage) and angiopoietin 2 (an indicator of endothelium activation) in the blood are linked to an increased risk of ARDS during sepsis. 46 and 45 Genes coding for cell matrix proteins, vascular endothelial growth factor receptor 1, and haptoglobin are all associated with ARDS risk. Two and a half, three and four Genetic polymorphisms may be a key source of biological variation in lung damage resolution and healing, according to these results. 

Dr. Sendler: ARDS heterogeneity may potentially be influenced by differences in the microbiomes of the lungs and the digestive tract. In healthy alveoli, commensal bacteria are not able to thrive because they lack nutrients and contain bactericidal surfactant, which inhibits bacterial development. 50 Alveolar flooding by protein-rich fluids and surfactant inactivation, on the other hand, creates an ideal habitat for the development of bacteria, which may lead to more inflammation and damage in a feedback loop. 51 Bacterial overgrowth in the lungs is possible, as is the entry of pathogen-associated molecular patterns and translocated gut bacteria into the alveoli. 52 The therapeutic implications of this dysbiosis have not been thoroughly investigated. 

Damian Sendler

Precision medicine in ARDS has difficulties. 

Damian Jacob Markiewicz Sendler: There is a strong argument for increasing precision medicine in the treatment of ARDS (panel 1), but there are also several challenges. Identifying individuals with abnormal pathways is challenging due to a lack of knowledge about crucial nodal sites in the several routes that cause acute lung damage. Chronic lung disease is a multi-step process that includes endothelial cell failure, alveolar cell necrosis and malfunction, loss of surfactant, activation of coagulation cascades in the lung, and the activation of complicated immune pathways. 6 Pathways leading to resolution and repair are still unclear, and the relevance of a single route may vary based on the origin of lung damage, the patient’s susceptibility, and other variables. 

As a further obstacle, the time period for characterizing individuals is limited since ARDS develops fast and medications may be most effective when started early. In a recent study of ARDS, however, 48-hour mortality was 10% and 96-hour mortality was 16%, even though current precision medicine techniques to staging and molecular classification of breast and lung cancer need days to weeks of preparation and testing time. 53 The development of rapid assays is required to quickly determine biological phenotypes, which may take anywhere from minutes to a few hours. 54 Large-scale human clinical trials seldom use close-up biospecimens, such as those from bronchoalveolar lavage, since they need extra, invasive procedures. Even when specimens are acquired, the collection and processing methodologies vary widely across studies. Due to procedural risk and the fact that identifying widespread alveolar damage does not significantly alter therapy, tissue samples are seldom acquired. Chronic and acute comorbidities affect the risk of developing and surviving acute respiratory distress syndrome (ARDS) in different ways. 56 In spite of the fact that comorbidities do not alter the response to biological therapy, they do have an effect on the likelihood of mortality due to ARDS. 57 Clinical trials in ARDS are complicated by the fact that there is no universally acknowledged surrogate endpoint, which makes them difficult to conduct in the early stages of development.

There is no animal model that can perfectly mimic the complexity of human ARDS. The cellular and molecular causes of illness, however, are still critical to the creation of a precision medicine approach for ARDS, and they remain vital (panel 2). With rigorous human study observation, it is possible to find biomarkers for the targeted pathways in animal research that are extremely successful in modeling a specific biological aspect of lung damage or treatable attribute (eg, endothelial barrier disruption).

Damian Jacob Sendler

Reverse translation is one of the most effective functions of animal models in helping to identify crucial nodes of mechanistic pathways that have been discovered in rigorous human investigations (figure ). These routes and nodes may be used to identify potential drug development targets, which can then be put to the test in clinical trials. 

Damien Sendler: The use of animal models to influence the development of precision medicine for ARDS is an important example of how precision medicine might be included into paediatric sepsis treatment. Biomarker panels for human mortality from paediatric sepsis were generated via cohort studies, and comparable biomarkers were later proven to be predictive of death in murine models of sepsis. 60 They next tested medicines targeting the predictive biomarkers to see whether they were linked to outcomes and discovered additional biological traits (ie, a larger bacteria load) associated with the high projected mortality group. It is possible that preliminary testing of putative medicines in preclinical models may allow researchers to better grasp the consequences of biological heterogeneity and, as a result, better advise clinical trial design. 60 

To understand why some attractive candidate medicines fail in human clinical trials, reverse translation may play an essential role. Although simvastatin8 and rosuvastatin9 were shown to have different effects on patients with ARDS based on their latent class subphenotypes, rosuvastatin did not. 61 Preclinical models could be used to identify key mechanistic factors underlying the differential response to simvastatin and rosuvastatin for clinically defined subphenotypes of ARDS, and also identify novel, mechanistically driven biomarkers that better predict a beneficial treatment response to one statin over another. 

Finding out what makes people so different from one another 

Introduction of human ARDS-specific heterogeneity into preclinical models may help uncover downstream biological implications and point to new treatment targets. However, it may be implemented in a variety of ways, including but not limited to changing the host’s sensitivity or modulating the severity or kind of insult. 

In order to better understand complicated features such as inflammation and wound healing, it may be necessary to crossbreed mice. Using reciprocal intercross breeding between eight founder strains, the Collaborative Cross model for complex trait study generates 200 different recombinant inbred mouse strains. 62 Genetic variables that govern the host’s susceptibility to numerous infectious diseases have been deciphered using the Collaborative Cross model via the mapping of phenotypic variation to gene loci. 63 A genetic foundation for ARDS heterogeneity might be uncovered by combining this model with human genome-wide association data. 

As a consequence, it may be possible to better understand the mechanisms of therapy response by varying the mechanism and the amount of lung damage stimulation. An outbred mouse model of experimental sepsis uses caecal ligation and puncture to produce a heterogeneous insult in genetically heterogeneous animals64. This makes it possible to investigate biological mechanisms that may affect the heterogeneity of the host response and the treatment effect.64. An experiment with an outbred mouse model that varied the severity of the caecal ligation and puncture phenotype found two distinct types of sepsis: one with a high mortality rate and early onset of cardiogenic shock, and the other with a low mortality rate and intact cardiac function that responded differently to hydrocortisone, ascorbic acid, and thiamine treatment.

Patients with ARDS are more likely to suffer from long-term physical, cognitive, and psychological impairments. 

The kidneys, brain, and other important organ systems have been shown to have bidirectional pathogenic interactions with the lungs. It’s possible that a secondary inflammatory insult, such as acute kidney injury, might lead to lung injury that in turn worsens renal damage. 67 Neuroinflammatory signaling from a brain injury may also predispose to lung damage,68 which in turn may worsen the brain injury. 69 There are several common routes of multiorgan crosstalk among critical illness syndromes, therefore they may be regarded clinically rather than as specific to a single disease state. 58 For example, a better understanding of the processes of multisystem interactions might lead to new treatments for ARDS and other critical disease syndromes by using preclinical models as well as human data. 

Dr. Damian Jacob Sendler and his media team provided the content for this article.

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Damian Sendler: For this year, I have found that a daily practice of appreciation has helped me get through it. Lastly, in honor of the upcoming holiday, I would want to express my gratitude to all of you for tuning in to this week’s Wonder Theory. Thank you for joining us on our journeys into the mysteries of the universe and the scientific method. We appreciate you taking the time to read Wonder Theory and leave a comment. We look forward to your future contributions. Also, many thanks for your enquiring mind. Curiosity is a blessing in disguise for me. One of the things that appears to be the most difficult to maintain as we get older is our sense of wonder. Every week, it is a thrill to remain fascinated with you all.

Damian Jacob Sendler: As it turns out, even when they are not on Earth, astronauts take part in traditional Thanksgiving celebrations. On Thursday, the crew of the International Space Station sat down for a special lunch. In the future, people may be able to make bread in space as well as eat it. The greatest way to spread fascinating tales like “What is for dinner in outer space?” is to share them with others, and there is nothing better for me than to be able to do just that with you.
Kingdom of the wild

Tough love is sometimes necessary. A mother otter teaches her young how to swim, and this photograph by Chee Kee Teo was selected as the winner of the Creatures Under the Water contest.

It is hard to beat a cute animal caught on camera at at the right time.

Comedic Wildlife Photography Awards winners have been announced, and they are guaranteed to put a big smile on your face! Some of the images include an uncomfortably posed monkey, a singing fish, and a kangaroo swinging in the wind.

This year’s awards not only give you something to laugh about, but they also help raise money for a worthy cause.

Save Wild Orangutans, a Borneo conservation group, will receive 10% of this year’s competition’s net proceeds. A pleasant and cuddly feeling is warranted here.

It is unusual to stumble across dinosaur fossils in the Midwest, but one excavation site in Missouri has turned up four rare species — and there may be more.

Damian Sendler

Species Parrosaurus missouriensis, a dinosaur found only in the Show-Me State, was discovered in fossil form in October.

The duck-billed dinosaur fossil was unearthed in 2017 following a year-long excavation effort.

There may be more information about the old environment and what lived there millions of years ago at the dig site than currently exists.

As long as it is still there, it is the little chopper that could. Salutations to the Ingenuity helicopter, which continues to soar above Mars’ atmosphere and well exceeds all expectations.

In April, we shared the joy of Ingenuity’s maiden voyage to Mars in our first Wonder Theory newsletter.

Since then, the Perseverance rover’s helicopter has completed 15 additional successful flights, allowing the rover to conduct hitherto unimaginable research on Mars.

Take a look back at the extraordinary voyage of Ingenuity so far, and enjoy the communal thrill of witnessing the chopper achieve the impossible to soar higher, longer and further.
It is worth your time.

A log in a lake might be an exciting discovery on occasion. Sometimes it is a canoe that is 1,200 years old. That is what divers in Madison, Wisconsin, found and resurfaced in Lake Mendota.

Because wood seldom survives in historical records, the dugout canoe is one of the earliest entire watercraft ever unearthed in the state.

The Ho-Chunk Nation, often known as the “People of the Sacred Voice,” constructed dugout boats in what is now Dane County.

Scientists will work on maintaining and safeguarding the boat for the next two years until it is shown.

For many people, this weekend is all about the tree since it falls on Christmas Day, which is coming up.

While some families like the aroma of a live tree, others prefer the convenience of a reused artificial tree.

Damian Jacob Sendler

However, in terms of environmental impact, which is preferable: a genuine tree or a fake one? There is a lot more to the story than you may believe, however.

Each has its advantages and disadvantages, and we have spoken with experts to help you decide which is best for you this holiday season.

Xenobots, the first living robots made by US scientists, can now reproduce in a manner that has never been observed before in plants or animals, according to the scientists.

Smaller than a millimeter (0.04 inches) diameter, xenobots are made from the stem cells of the African clawed frog (Xenopus laevis) from which they gain their name. Experiments in 2020 indicated that the blobs were able to move, operate in groups and self-heal.

Damian Jacob Markiewicz Sendler: A new kind of biological reproduction has recently been identified by scientists at the University of Vermont, Tuft’s University, and Harvard University’s Wyss Institute for Biologically Inspired Engineering, according to the researchers.

Michael Levin, a biology professor at Tufts University and co-author of the new study, said he was “amazed” by the findings.

Frogs have a means of reproducing that they typically utilize but when you separate the cells from the rest of the embryo and give them a chance to find out how to survive in a new environment, not only do they figure out a new way to move, but they also figure out presumably a new way to procreate. “.”

To produce children, the C-shaped parent xenobots gather and compress free stem cells.

Unspecialized cells, stem cells may differentiate into a variety of cell types. The xenobots were created by scraping embryonic frog stem cells and allowing them to incubate. There is no gene-editing involved in this procedure.

Professor Josh Bongard of the University of Vermont’s Department of Computer Science and Robotics, the study’s lead author, said, “Most people think of robots as being made of metals and ceramics, but it is not so much what a robot is made of as what it does, which is act on its own behalf of people.

While it is a robot, it is also plainly a creature derived from a genetically unaltered frog cell.

According to Bongard, the xenobots, which were originally sphere-shaped and composed of roughly 3,000 cells, were capable of self-replication. Even yet, it was very uncommon and occurred only under certain conditions. A mechanism known to occur at the molecular level but never previously witnessed at the size of entire cells or species has been employed by the xenobots.

Damien Sendler: The researchers then evaluated billions of body types using artificial intelligence to make the xenobots more efficient at this replication type. As a result, the supercomputer generated a C-shape that was reminiscent of the Pac-Man video game from the 1980’s. Using a petri dish, they discovered that it was able to identify little stem cells, collect hundreds of them into its mouth, and a few days later, the bundle of cells generated young xenobots.

A big ball of stem cells is being rotated by the parent to produce a new xenobot.

“These machines were not programmed the way we do in the programming world. In the end, it came up with this Pac-Man shape after sculpting and forming it “Bongard made the statement.

“In essence, the form is the program. The xenobots’ behavior is amplified by the form, which has an effect on how they act.”

There are hardly any practical uses for xenobots currently since they are such primitive technology — think of a computer from the 1940s. Nevertheless, the researchers believe that this combination of molecular biology and artificial intelligence might be employed for a wide range of functions in both our bodies and the environment. Microplastics in the seas, root system inspections, and regenerative medicine are a few examples.

The researchers noted that the living machines were confined in a lab and quickly extinguished, since they are biodegradable and supervised by ethical experts, despite the fact that the idea of self-replicating biotechnology may cause alarm.

The Defense Advanced Research Projects Body, a government agency in charge of supervising the development of military technologies, contributed to the study’s funding.

According to Bongard, “many things are feasible if we use this sort [of] flexibility and ability of cells”

On Monday, the research was published in the peer-reviewed scientific journal PNAS.
This report was compiled by Jessie Yeung in Hong Kong.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

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Damian Sendler: On Monday, Pope Francis urged people to be vaccinated against the coronavirus because it was a “moral duty.” “in which she blasted the public for rejecting one of the most efficient ways to save lives during the epidemic due to their reliance on “baseless information.” 

Damian Jacob Sendler: Some of the most eloquent words Francis has ever used in an address to the Holy See’s ambassadors, an annual occasion in which he lays out the Vatican’s foreign policy priorities for 2017.

A “moral duty” is a phrase that Francis, 85, has avoided using, however his COVID-19 advisers have used the term “moral responsibility.”” Refusing to be vaccinated, on the other hand, is a “suicidal act,” according to Pope Francis. 

Individuals must take responsibility for their own health “and this regard for the health of others around us,” he said on Monday. He maintained that providing health care was a moral imperative. 

Damian Sendler

Ideological differences are deterring individuals from being immunized, according to him. 

This distortion is sometimes fueled by “baseless information or badly recorded facts,” he added. “Reality therapy” should be used to remove this distortion, he said, advocating for it to be adopted. 

There is no miracle cure, but there is no doubt that vaccines are the most realistic approach for illness prevention in addition to other therapies that need to be developed, he noted. 

Controversial American Catholic leaders, such as certain U.S. archbishops, have said that vaccinations made from aborted foetuses are morally wrong and have refused to acquire them. 

It has been determined that research using cells from aborted babies is “morally permissible” by the Vatican’s doctrinal office, nevertheless, for Catholics to get the COVID-19 vaccinations. Pfizer-BioNTech vaccines have been administered to Pope Francis and Pope Emeritus Benedict XVI. 

Even in nations with low vaccination rates, Francis reiterated his appeal for universal vaccine availability and asked for changes to patent laws so that poorer countries might produce their own vaccines. 

To prevent monopolistic regulations from hindering global manufacturing and uniform access to health care, “it is important that organizations like the World Trade Organization and the World Intellectual Property Organization modify their legal tools,” he added. 

A smaller gathering of diplomats than usual attended the address, and Francis bypassed the opportunity for ambassadors to meet him and share a few words. Coronavirus cases in Italy have increased at an exponential rate since the limits were put in place. 

Francis also spoke on Syria’s devastation, asking for “political and constitutional changes” to help the country “reborn,” and urging that any sanctions against the country should not target innocent people. Francis. While he did not mention Russia by name, he urged “acceptable and sustainable solutions.” “”reciprocal trust and willingness to participate in peaceful conversation” for Ukraine and the southern Caucasus. 

As part of this effort, he called for more open dialogue in order to avert cultural wars, but he avoided referencing gender ideology or other hot-button issues. 

In many groups and public institutions, a ‘cancel culture,’ characterized by attitudes that do not allow for freedom of speech, has taken hold. To protect variety, it obliterates every feeling of self-identity, which has the potential to silence viewpoints “He forewarned. 

Damien Sendler: We want to make it easy for people to meet other people who share their interests and hobbies in a safe and fun environment. We have decided to temporarily halt article comments in order to enhance our community experience. 

As soon as Israel revealed that two young pregnant women had tested positive for both the coronavirus and flu, many people across the globe started looking up “flurone” to find out more information. 

Flu and coronavirus vaccines have long been recommended by doctors, who fear a “twindemic” if influenza cases continue to rise and covid-19 infections overrun hospitals. Although “flurona” refers to having two respiratory diseases at the same time, health experts fear that this is possible as the extremely infectious omicron type of coronavirus surges this winter. 

Many local and international media sources termed it “flurona” in headlines after two young pregnant women in Israel tested positive for both the coronavirus and influenza. The British newspaper The Sun was the first to name the concomitant illness “”Double whammy!” 

Damian Jacob Sendler

The flu season might coincide with an increase in coronavirus infections in the winter months. You should know the following information. 

You should know about the flu and coronavirus. 

Flu and covid-19 co-infections are not a new phenomenon, despite the increased use of the term. Flurona, on the other hand, is not an illness in and of itself; rather, it is a term used to describe someone who has been afflicted with both viruses. In nations including the USA, Israel, Brazil, the Philippines, and Hungary, flurona cases have been found long before the name was created. 

According to an article in the Atlantic, cases of co-infection were first discovered in the United States over two years ago. He was admitted to the hospital with a high temperature and a coughing fit in February of the following year in New York. The coronavirus had not yet been officially reported in the city at the time. The patient was diagnosed with influenza and tested for the coronavirus, both of which came back positive. After a few weeks, tests proved that he and three members of his family had both viruses in their systems. 

The United States has had additional recent incidents. After acquiring both the coronavirus and the flu at the same time, a Houston kid was forced to spend Christmas Day alone in his room. Test findings showed Alec Zierlein, who had been vaccinated against the coronavirus but not flu yet was nevertheless experiencing “like a slight cold,” had the former two illnesses instead of flu. The coronavirus and flu may “build on one another,” something Zierlein did not know before his diagnosis, and he plans to receive a flu vaccination going forward as a precaution. 

It is not uncommon, according to a health authority in the Philippines. One of the members of the national health department’s technical advisory committee Edsel Salvana indicated that the country’s first covid-related fatality occurred in early 2020. Reporters were informed by Salvana that the early pandemic patient, a Chinese citizen, had covid-19 and influenza B, as well as streptococcus pneumonia. 

Damian Jacob Markiewicz Sendler: Reports from the first reported death outside of China of a covid-19 patient, who had a fever as well as other symptoms, were published. Salvana, urging people to be vaccinated against the flu and pneumonia, said, “It is a terrible confluence of circumstances that you are exposed to two infections.” 

RTL reported on Monday that authorities in Hungary had discovered at least two new flurona cases in the last few weeks. Both patients, like those in Israel, were characterized as being in their twenties or thirties. 

At the same time as instances of omicron are on the rise, Brazil is dealing with an out-of-season flu epidemic. Flurona has been reported in six people in three states, according to local health authorities. Mayor Daniel Soranz of Rio de Janeiro said to the Spanish news agency EFE that investigators were looking into an additional 17 incidents. The mother of a 16-year-old boy who was found to be infected with both viruses told Brazilian media that her son had only mild symptoms since he had been properly immunized against both viruses. 

Both coronavirus and influenza A cases are on the rise at Israel’s Beilinson Hospital, where physicians recently identified two pregnant women with both diseases. According to Arnon Vizhnitser, the head of gynecology, this is due to the omicron epidemic. 

As Vizhnitser said to The Washington Post, the flu is making a comeback after being absent last year due to stricter lockdown measures and social isolation. 

“In comparison to previous year, things have changed. We now face a new obstacle “Co-infections are likely to persist, he added, predicting that they will. 

It seems that a “twindemic” outbreak in 2020 has been all but averted thanks in part to proactive efforts aimed at limiting coronavirus propagation. 

That is what is happening in the US right now, as flu infections are on the rise after last winter’s record-breaking lows. Both influenza seasons in the United States and Europe are now in full swing. 

At the same time, Vizhnitser reported that both pregnant ladies experienced the exact identical symptoms and were treated to bring their fevers down. In both cases, they were quickly quarantined and returned home with healthy children. Only one of the ladies had been inoculated against the coronavirus, according to Vizhnitser. She would gotten a raise as well. The second patient had not been vaccinated against any of the viruses in question. 

The Israeli hospital Beilinson tests pregnant women for both viruses if they show signs of illness upon admission. As Israel continues to aggressively increase its immunization program, medical staff and those over 60 are being provided a second shot. 

Dr. Sendler: Coronavirus and flu cases are being tracked in several nations; however, it is unclear how many individuals are simultaneously infected. Health experts and physicians continue to underline that coronavirus and flu vaccinations are the best approach to prevent against serious illnesses as more instances emerge of co-infections. 

The flu and coronavirus are “quite mild” if vaccinated, Vizhnitser added. “As a result, women who had not been vaccinated against covid were very ill.” 

Because hospitals all across the globe use diverse methods for treating and diagnosing patients, some patients may not be given testing for both illnesses.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

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Damian Sendler: A dedicated orbital volcano observatory might save countless lives and millions of money, yet we don’t have one. 

An case may be made that geologists, in particular, have a hard time conceptualizing “large” in the context of Earth science. In other words, there aren’t any interesting topics to ask or new areas of study to explore. In contrast to astronomers and physicists, geologists prefer to suggest smaller projects. 

Damian Jacob Sendler: Geologists have just lately begun to send high-profile objects into space, and most of the time they’re searching for life on other planets. Let me suggest that it’s time for us to begin considering how to learn more about our planet from space in an engaging fashion for the public. 

Damian Sendler

The idea of studying the Earth from space is a novel one. We’ve launched an increasing number of Earth-observing satellites since the Landsat program began. Like the recently-launched Landsat 9, some of these are large and ostentatious. Others, like Planet’s Dove satellites, are tiny enough to take around with you. Climate and geophysical surveyors, such as the Orbiting Carbon Observatory 2 and the twin GRACE satellites, have also been launched. A wealth of Earth scientific data has been amassed by these missions and many more. 

Recognizing the Heat 

For the purpose of monitoring volcanoes from orbit, infrared imaging is essential. The heat generated by magma rising to the surface is immense. It’s possible that the heat will show itself in the form of molten rock (lava!) or in the steam and ash emissions from a volcano. While most EOS have infrared capabilities, they run into two major issues when it comes to volcanoes: they don’t watch volcanoes often enough (time) and they can’t monitor volcanoes at a high enough level of detail to be genuinely helpful (resolution). 

The Bulletin of Volcanology has published a study by Michael Ramsey and colleagues arguing that our present Earth-observing satellites are not equal to the challenge of becoming orbital volcano observatories. A bigger problem is that there hasn’t been much research into how we might enhance infrared imaging from space in order to fulfill the objectives of volcanologists. The essential data that volcanologists would need to monitor and anticipate volcano activity — especially timely, detailed infrared — just does not exist, despite the fact that we can capture daily photographs of practically every location on the earth. 

The perfect orbital volcano observation (which I’m calling LAVA: Looking At Volcanic Activity) has a number of crucial qualities, according to Ramsey. For starters, it would need to be in the same polar orbit as our weather and Earth observation satellites. As a result, all of the world’s main volcanic zones may be reached. 

The Best Orbiter in the World 

Damian Jacob Markiewicz Sendler: The dimensions of time and space, on the other hand, are crucial considerations. At the absolute least, a dedicated LAVA orbiter should be able to provide daily or even numerous daily observations of the same volcano. Multiple orbiters may be required to achieve this level of temporal precision; our finest Earth-observation satellites obtain daily coverage, while others may only see the same regions once every few weeks. The length of such periods might give some insight, although volcanic catastrophes can take anything from days to hours to develop. 

Damian Jacob Sendler

Ideally, the LAVA orbiter should provide infrared picture resolution of less than 100 meters and as near as possible to millimeter-scale. Volcanologists may be able to get a better sense of what’s going on in volcanic craters and lava flow areas because to this technology. As lava reaches temperatures of above 2200°F (1250°C), you need to ensure that your imager does not get saturated by the IR radiation. 

According to Ramsey, any orbiter should be scheduled to fly over volcanic zones in the morning so that cloud-cover and sun heating are as little as possible, providing for the greatest infrared imagery possible. Not a single existing or upcoming space mission uses this time. 

It all comes down to the fact that, despite the fact that we have a slew of satellites orbiting our globe, none are specifically designed to monitor volcanoes. Yes, if the correct satellite is in the right position at the right time, we may get photographs of an eruption as it begins, but this is often simply a matter of chance. If the LAVA orbiter has the correct infrared imaging equipment, it might be a benefit to volcano monitoring throughout the world. 

Do You Know How Much It’s Going To Cost You? 

Damien Sendler: Of course, the most pressing problem is the expense of the technology. Launched by the European Space Agency (ESA), the two Copernicus Sentinel-2 spacecraft cost roughly $200 million each. Landsat-9, a massive Earth-observing satellite, cost $750 million to build. Launched in 1999, the Terra satellite project cost little over $1 billion. Missions like the James Webb Space Telescope, on the other hand, cost a lot more than that. In all likelihood, they’re more costly than the LAVA orbiter. Dove mini-satellites, on the other hand, cost hundreds of thousands of dollars. 

As a result, it’s possible that a LAVA orbiter will cost between $300 million and $500 million. Even if we take into account previous volcanic catastrophes, such the 1991 eruption of Pinatubo, Eyjafjallajokull in 2010 ($4 billion), or the 2018 Kilauea eruption, we can see how rapidly the damage piles up. The LAVA orbiter might pay for itself rapidly during its estimated 10- to 20-year career by making eruption monitoring and forecasting simpler. 

It all comes down to who and how. An orbiter like LAVA might become a reality with the help of institutions like as the United States Geological Survey, the Japan Meteorological Agency, the Icelandic Meteorological Office, and others. Earth scientists just need to think “large” to support such an orbiting observatory, which is a perfect next step in learning how volcanoes on our globe function.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: 67 degrees Fahrenheit was the highest temperature ever recorded in December in the Alaskan city of Kodiak, which has become used to such high temperatures as climate change continues to rewrite history. 

Damian Jacob Sendler: A record high of 65 degrees was recorded at Kodiak Airport, which was 20 degrees higher than Kodiak’s prior 45-degree mark, according to the National Weather Service, which was set on December 26, 1984. 

By comparison to other U.S. states, Alaska has warmed twice as quickly as the global average since the mid-20th century, according to data from NOAA. 

Damian Sendler

Alaska’s Changing Environment reports that since 2014, there have been 5 to 30 times more record-high temperatures set than record lows,” the NOAA stated on its website. 

New worldwide high temperature records outpaced new low-temperature records by a two-to-one ratio in 2019. The Environmental Protection Agency backed up this finding. 

Highs and lows would account for around half of all records made if climate were perfectly stable. According to the EPA, record-breaking daily high temperatures have grown more prevalent in the US during the 1970s than record-breaking daily low temperatures. From 2000 to 2009, there were twice as many records set in the highs as in the lows. 

Other studies have shown that the ratio will continue to rise as global temperatures continue to rise due to human emissions of greenhouse gases. 

When it comes to overall temperatures, the ratio is what matters most in Alaska in November, even if several places saw record low temperatures.

Damian Jacob Sendler

In addition to the unusually warm December, Alaska has also had unusually significant rainfall for the time of year. The Portage Glacier received a record-breaking 30 inches of rain in late October, according to the Washington Post. 

On Sunday, Fairbanks, Alaska, received 1.93 inches of rain, the wettest December day ever recorded. 

Damien Sendler: As unusual as it may seem, it’s not just in Alaska where precipitation has become more common due to global warming. For the first time since records began in 1950, rain fell on Greenland’s tallest mountain in August. 

There has never been anything like this. We’re entering unknown terrain in the atmosphere, says John Walsh, an atmospheric sciences professor at the University of Alaska-Fairbanks. 

Over the course of three abnormally warm August days, Greenland received a total of 7 billion tonnes of rain, which accelerated the thawing of its ice sheet. Greenland lost seven times as much ice as it normally would during this time of year as a result of the rain. 

Sea ice loss is thought to be a major factor in the Arctic warming up four times faster than the rest of the world, according to research.

In 2021, many high temperature records were broken around the world, including the record for the hottest Christmas in the United States, but in Fairbanks and Anchorage, Alaska, temperatures broke records in a single day. 

Record-breaking temperatures in 2019 have led to these new highs. 

Damian Jacob Markiewicz Sendler: Temperatures in Alaska were 20 to 30 degrees above average for several days beginning on July 4th, according to the NOAA’s website. Kenai, Palmer, King Salmon, and the Anchorage International Airport all established all-time high temperature records on July 4th,” A record-breaking 90°F was recorded at the airport, surpassing the previous record by 5°F!”

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: University of Waterloo researchers find that what happens in comedies and cartoons where one character has an angel on their shoulder and the other has a demon is quite close to what people believe about the actual world. 

Damian Jacob Sendler: The moral nature and motivations of the supernatural beings are evident in order to show the characters’ decision-making difficulty with comic effects. When it comes to persons they perceive to be nice or bad, people have similar expectations. 

Damian Sendler

Expectations about how good and bad people respond to requests were examined by the researchers. While angels are rarely represented as willing to grant unintentional requests, demons are frequently depicted this way in movies and folktales. 

According to their findings, people’s perceptions of everyday people have an impact on their perceptions of good and bad characters.

Ori Friedman, a developmental psychology professor at Waterloo and the study’s lead author, said, “Our results suggest people expect good agents will be sensitive to intentions behind requests whereas they expect evil individuals will be relatively insensitive to these intentions,” “People’s expectations are shaped by these findings when it comes to both human and supernatural requests.” 

According to the findings, people’s conceptions of how good or poor behavior affects the decisions of others differ widely. When it comes to things that do not immediately affect their goals, people assume that wicked people are uninterested in them. 

Damian Jacob Sendler

People’s everyday opinions about supernatural beings may be influenced by how they perceive humans, according to the findings of this study. 

When we label someone as wicked, we tend to expect that person to place less importance on other people’s intentions and more attention on the results of their acts, says study co-author and doctoral student in developmental psychology Brandon Goulding. “As opposed to our presumption that “a good person will weigh what someone intended to accomplish against what they actually did.” 

Five tests were conducted to study people’s perceptions of good and evil agents. Study participants were asked to rate the likelihood that a protagonist’s request would be granted by human or supernatural beings after reading short stories about such requests. Ratings were based on how well the requester comprehended what they were asking for when the request was made to a decent person. Just as often as good people granted requests that didn’t accurately reflect the requester’s intent, evil people were expected to do the same. 

Damien Sendler: “People’s perceptions of good and evil are revealed by this research, which shows that wicked agents aren’t merely focused on creating harm. Instead, people think of evil as a lack of concern for others’ well-being “Friedman claimed this.

Damian Jacob Markiewicz Sendler:  “According to this interpretation, moral goodness involves more than just achieving positive results. People also believe that moral virtue is linked to a concern for the goals and intentions of others.”

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: On December 8, many Americans with weakened immune systems felt as if a miracle had occurred. An antiviral medication for persons with compromised immune systems was approved by the FDA on that day.. 

When patients discovered that the government had only contracted for enough doses to treat less than one-tenth of those eligible, their euphoria swiftly turned to despair. 

In a statement from the US Department of Health and Human Services, the first batch of the medicine, Evusheld, was shipped out on Monday. Experts at the Massachusetts General Hospital and Brigham and Women’s Hospital say they expect to get only a fraction of the thousands of patients with impaired immune systems that will need to be treated by this cargo. 

Damian Jacob Sendler: Many patients with impaired immune systems were protected against the virus by the Covid-19 vaccines, but this was not the case for everyone. Monoclonal antibodies, such as Evusheld, work in a way that vaccinations do not, therefore doctors intended to administer it to immune-compromised patients. 

Damian Sendler

Immune-compromised people worry me a lot, says Dr. Kotton. As a result, “I am disappointed that we don’t have better access, and I hope that we have better access very soon so that we can prevent as much illness and potentially death in this population as possible,” he says. 

According to Dr. Dorry Segev, a transplant surgeon at Johns Hopkins University and a leading researcher on vaccine effectiveness for people with compromised immune systems, it’s a shame that something that could be a game changer for those who didn’t have a good vaccine response is now something that is in short supply. 

New antiviral medication for the treatment of Covid-19 approved by the FDA 

More than 5,000 people participated in a research experiment in which Evusheld — which is administered in two doses, one straight after the other — was found to have a 77% lower risk of acquiring Covid-19 than those who received a placebo. 

According to a corporate representative, 4% of those taking part in the experiment had immune system problems; however, the outcomes of those patients have not been made public. 

Twenty-two people with compromised immune systems were questioned by CNN because they had not received full immunity to Covid-19 vaccinations. 

When I saw the headline about Evusheld, I burst into tears of pleasure. The truth is settling in,” remarked 51-year-old Diane Barron after her optimism was dashed. 

As a result of her cancer and rheumatoid arthritis, Barron’s immune system is compromised. Covid-19 antibodies have not been detected in her blood even after three doses of Pfizer’s vaccine. Barron, who is at high risk of dying from the illness, is confined to her Fort Lauderdale, Florida, home. 

People with impaired immune systems, such as those who have undergone a transplant, or those who have cancer or autoimmune illnesses, are also at risk. 

AstraZeneca, the drug’s maker, estimates that 7 million adults in the United States have immune system problems and potentially benefit from Evusheld. Only 700,000 doses of the medicine have been ordered by the federal government, which is the sole distributor. 

There are an estimated 7 million people in the United States who are immunocompromised, according to data from the US Centers for Disease Control and Prevention. Immune-compromised adolescents between the ages of 12 and 17 are also eligible for the therapy. 

A business spokeswoman confirmed to CNN that AstraZeneca does have additional dosages for sale. 

“The US government could purchase more doses if they wanted to,” a firm spokeswoman responded in an e-mail. To put it simply: “We already have finished product on hand that exceeds the near-term forecast demand, and manufacturing capacity has been reserved with significant additional quantities already in the supply chain.” 

“The government is preparing to purchase substantially more Evusheld” than the 700,000 pills,” a health official said to CNN. 

For the sake of candor, this official, as well as others who spoke with CNN, asked to remain nameless. 

An HHS spokesman, when asked why the government has only contracted for 700,000 doses, responded that “primary protection from COVID-19-related disease involving immunocompromised groups is still through vaccination. 

A monoclonal antibody could help millions of immunocompromised patients who didn’t receive protective immunity from vaccinations, according to Segev, who spoke to CNN on the topic. 

AstraZeneca claims that in a clinical experiment, the protection against Covid-19 lasted at least six months. Although the experiment was conducted prior to the Omicron variant’s release, the business claims that laboratory studies demonstrate that Evusheld is still effective against it. 

In a statement to CNN, those with damaged immune systems who have not received protective immunity from the Covid-19 vaccine say the projected shortage of Evusheld is the latest example of how the federal government has failed to safeguard those with compromised immune systems. 

Damian Jacob Sendler

Antiviral Covid-19 pills will be purchased for $10 through a WHO-led initiative. 

“Frustrated. Abandoned. Forgotten. People in Janet Handal’s group are “angry,” she said when asked how they feel about the government’s efforts to safeguard them from infection. 

There are only two options for persons with impaired immune systems when it comes to pre-exposure prevention: Evusheld and Tamiflu. According to the official, “built an arsenal of treatments” for those who have Covid-19 and who are at danger of developing severe Covid-19. 

There are a variety of treatment options available because “We haven’t put all eggs in one basket, and we continue to grow these supplies and bring more products online to have an array of treatment tools at our disposal,” as the official explained in an email to CNN. 

States will be responsible for distributing Evusheld “in accordance with clinical guidelines and recommendations for those who should receive them,” according to an official. 

To make sure that the product gets to people who need it the most, the official added, “As always, equity remains central to our planning, which is why we are encouraging states to incorporate equity considerations into their distribution plans to ensure this product reaches those who need it most,” 

Immunocompromised individuals and vaccines have been the subject of numerous advisories for several months. 

Other Evusheld users, including Handal, want to know why the government contracted for just 700,000 doses of the drug when it had been expected for months that many more would be required. 

In March, John Hopkins researchers published a letter in the journal JAMA assessing the immunological responses of 436 transplant recipients who had received one dose of either the Moderna or Pfizer/BioNTech vaccine. 

“disappointingly,” only 17% of patients developed detectable antibodies in response to the injection, according to a Hopkins news release. 

Lead author Dr. Brian Boyarsky explained that “This is in stark contrast to people with healthy immune systems who are vaccinated, nearly all of whom mount a sufficient antibody defense against COVID-19,” he stated. 

Study after study revealed that even with two or three doses of Covid-19 vaccinations, many people with impaired immune systems were not receiving protective protection in the following months in the United States and other countries. 

After three doses and a single booster, this individual is vulnerable to Covid-19. 

The issue is with the immunizations themselves. They serve as a guide for the immune system, instructing it on how to produce antibodies against the virus that causes Covid. However, a weakened immune system may not be able to understand or respond to these instructions. 

“They make very poor immune responses,” Dr. Anthony Fauci, President Joe Biden’s chief medical adviser told CNN in June. To appropriately defend these folks, you’ll have to come up with a new strategy. 

In contrast to vaccinations, monoclonal antibodies have a different mechanism of action. Antibodies cannot be synthesized using the methods described here. They only administer antibodies via injection or infusion. 

“the benefit of prevention using monoclonal antibodies” and how they could have a “major effect” in the prevention of Covid-19 were discussed at a White House briefing in August. 

“Face the Nation” host Dr. Scott Gottlieb, a former FDA Commissioner, suggested in October that “we could be using the antibody drugs on a prophylactic basis” for those with impaired immune systems. 

Is it safe to go to religious services over the holidays now that the Omicron variety is spreading? The opinions of experts are taken into consideration. 

According to an FDA official, monoclonal antibodies are needed in some people with impaired immune systems. 

It’s “pretty well bet” that cancer or autoimmune disease patients who take certain medicines “will not respond to vaccination, and you probably want to be pursuing some prophylactic strategies with a monoclonal,” said Dr. Peter Marks of the FDA’s Center for Biologics Evaluation Research. 

“We need these monoclonal antibodies to be approved for pre-exposure prophylaxis,” Dr. Myron Cohen remarked at the same event, so that if an immune-compromised person does not respond to the vaccination, “we have something to give them.” ‘ 

It is difficult for doctors when they don’t have an alternative to offer their patients with compromised immune systems who didn’t fully respond to the vaccines, according to Dr. Cohen, the director of the University of North Carolina School of Medicine Institute for Global Health and Infectious Diseases. 

“It’s very upsetting to physicians, the situation that we’re in right now,” he remarked. 

‘I had to do it myself’ 

Many people with impaired immune systems are shocked by this statistic: According to CDC-cited short studies, 40-44 percent of completely vaccinated patients who got Covid-19 and ended up in the hospital had impaired immune systems. 

Many people like them didn’t benefit from the Covid-19 vaccination, which was a miracle for others. 

The immune-compromised scrambled all summer long as the Delta variety raced through the United States, killing hundreds of thousands of people. 

Transplant recipient Handal says she might not be here today if she had followed FDA advice. 

Damien Sendler: In April, as more and more research came to light, French health officials began recommending third dosages for those with severely impaired immune systems. 

Although the FDA recommended two doses of the Moderna or Pfizer vaccinations to all Americans, including those with impaired immune systems, in April, this recommendation has since been withdrawn. 

A former White House IT specialist who now lives in New York City, Handal, 71, decided to take action. 

The two doses of Moderna she had received as part of the Hopkins research had given her very low levels of antibodies, which she was aware of. 

For the second year in a row, hospital staff will have to deal with the grief of the Covid-19 deaths. 

Handal added that after talking with her nephrologist, who confirmed he had no objections, she received a third dose of the Covid-19 vaccination on April 28. 

Antibodies in Handal’s system rose considerably. When compared to two doses, she felt more protected, even if the levels weren’t as high as those reported in healthy individuals. 

On August 12, more than three months later, the FDA granted emergency use authorisation for a third shot for immunocompromised individuals. The following day, the CDC officially recommended a third vaccination for immune-compromised people. 

In light of the rapid spread of Delta in the US between April and August and Handal’s compromised immune system, she fears what may have happened if she had waited for regulatory approval before obtaining her third dose. 

She’s well aware that she’s in a fortunate position. As part of the Hopkins trial, she was aware of her low antibody levels and was willing to flout government regulations. 

As Handal put it, “I had to DIY it,” In this epidemic, “the immune-compromised have been left behind in the thinking.” 

You’re fully vaccinated but have Covid-19. How long should you isolate? The issue is open to dispute 

This is a life or death situation for me, and the FDA and CDC are still playing catch-up,” she said. For whatever reason, the government is only now catching up.” As a result of their lack of concern for us, we’ve forced to take matters into our own hands. 

“committed to quickly and thoroughly” an FDA representative stated. 

To enable for the use of an additional dose in immunocompromised patients, once clinically meaningful data were available, the agency acted rapidly to authorize the Pfizer-BioNTech and Moderna COVID-19 vaccines.” 

According to the spokeswoman, Chanapa Tantibanchachai, “the authorization was ultimately based on the science and data available at that time, as has been the case throughout the pandemic.” To guarantee that the public, including those with impaired immune systems, have the greatest possible means to defend themselves during this epidemic,” the Food and Drug Administration has worked “around the clock.” 

A CNN inquiry for comment was not answered by a CDC spokeswoman. 

Recipient of a kidney transplant discovers a flaw 

The “DIY it.” approach has been used by other immunocompromised people. In order to obtain monoclonal antibodies against Covid-19, they had to employ their resourcefulness in finding government loopholes once they found that their weakened immune systems had not responded properly to the Covid-19 vaccine. 

Many of them characterize it as a self-protective “Hunger Games”-style struggle. 

Some people have made it. Others have fallen short. 

Their frantic cries aren’t uncommon, according to UNC infectious disease expert Cohen. 

Cohen described receiving emails as “Every day I get emails — it breaks my heart,” on a daily basis. What a bummer. “They’re in so much pain,” he said. 

Due to his work on Regeneron, the first monoclonal antibody to get FDA emergency use authorisation, patients send Cohen these emails. 

Damian Jacob Markiewicz Sendler: Patients want to avoid infection, but Regeneron is only allowed to treat those who have Covid-19 or have been exposed to the virus (its most famous patient is former President Donald Trump). 

Omicron has been shown to have a lower risk of Covid-19 hospitalization compared to Delta. 

Some patients, on the other hand, develop workarounds. 

It was Jef Kinney’s perseverance that led him to the one he sought. 

62-year-old kidney transplant recipient Kinney notified his nephrologist in April that he had gotten two doses of Moderna and planned to get out of the house and resume his social life. 

As a result of my questioning, I received the following response: “Whoa, cowboy, it will be 2022 before you are out and about.” After saying, “Excuse me?” Kinney recalls this. “She said, ‘You need to lead your life like you’re unvaccinated.’ ” 

It was a blessing in disguise for Kinney that his doctor warned him that the immunizations might have been ineffective for him due to his compromised immune system. Handal and other members of the patient group she co-founded, the Transplant Recipients and Immunocompromised Patient Advocacy Group, claim doctors and transplant facilities often did not reach out to patients to offer them this warning during Delta’s wrath in the spring and summer of 2013. 

Kinney, a self-described “data hog,” got to work immediately after receiving the go-ahead. 

A former Fannie Mae vice president of innovation development, he instantly found the Hopkins studies and emailed Segev, one of the authors, to inquire about their findings. 

In response to Segev’s letter, Kinney enrolled in the trial and learnt that his two dosages of Moderna had left him with no measurable antibody levels. 

He remarked, “I felt pretty naked out there, with no protection,” 

In a search online, Kinney came upon an article mentioning Leah Lipsich, an executive at Regeneron. After Lipsich received an email from him, she referred him to the “compassionate use” team that manages the company’s program. 

Under compassionate use, clinicians can request authorization from Regeneron and the FDA to use the company’s monoclonal antibody medication in certain situations. 

Because of Omicron and holiday preparations, it’s difficult to locate a Covid-19 test right now in the United States. 

He asked one of his physicians to submit the documentation, but the physician declined. Compassionate use applications require a great deal of paperwork, and doctors say they don’t have the time to undertake it for all of their patients with impaired immune systems. 

Another hurdle arose when Kinney’s family doctor, whom Kinney calls a “small town doc,” consented to submit the papers. Doctors must seek approval from an Institutional Review Board before submitting petitions for compassionate use. Individual doctors, on the other hand, don’t often have access to such boards. 

As Kinney and his doctor worked on the compassionate use application, the months passed by slowly but steadily It was only a matter of time before Kinney’s nephrologist agreed to submit the papers for compassionate usage. Finally in November, after a seven-month wait, Kinney received his first dosage of Regeneron’s monoclonal antibody monoclonal. 

Nothing would have happened if Kinney hadn’t been on top of things, he added. “You have to be smart and persistent. A lot of folks don’t want to get involved.” 

“I go after people with a lot of vigor. Some people may not be able to afford it, or may not know how to do it, or may look at a doctor and say, “Well, I can’t be bothering a doctor,” but I’m not one of those people. That is not something I deal with.”

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: National Institute of Allergy and Infectious Diseases (NIAID) scientists said that an experimental HIV vaccine based on mRNA—the same platform technology utilized in two extremely efficient COVID-19 vaccines—has shown promising results in mice and non-human primates. This new vaccination proved safe and elicited desired antibody and cellular immune responses against an HIV-like virus, according to their findings in Nature Medicine. Priming and subsequent booster vaccinations reduced the probability of simian-human immunodeficiency virus (SHIV) infection by 79 percent in rhesus macaques compared to uninfected animals. A team of scientists from the National Institute of Allergy and Infectious Diseases, Moderna, Inc., and other institutions were involved in the study led by Paolo Lusso of the NIAID’s Laboratory of Immunoregulation. 

Damian Jacob Sendler: “Despite nearly four decades of effort by the global research community, an effective vaccine to prevent HIV remains an elusive goal,” said NIAID Director Anthony S. Fauci, M.D., chief of the Laboratory, and a paper co-author. With its combination of traits that may overcome some of the drawbacks in earlier experimental anti-HIV vaccination approaches, this vaccine is considered to be an exciting new development.” 

Damian Sendler

The experimental vaccination is similar to mRNA COVID-19 vaccines in its ability to protect against influenza. As an alternative, the vaccine provides mRNA instructions for two essential HIV proteins (Env and Gag) instead of the coronavirus spike protein. These two proteins are assembled by muscle cells in an inoculated animal to form virus-like particles (VLPs) with many Env copies on their surface. Antibody responses to these VLPs can be compared to those elicited by entire, infectious HIV, even though these VLPs cannot induce infection or sickness because of their lack of complete genetic code. 

Neutralizing antibodies were shown in all mice that received two injections of the VLP-forming mRNA vaccine, according to the study’s authors. Env proteins produced by the mRNA instructions in mice closely resembled those in the entire virus, an improvement over prior experimental HIV vaccines. It’s one of the unique properties of our platform that closely mimics real infection and may have had a role in triggering the desired immune responses, said Dr. Lusso. 

The Env-Gag VLP mRNA vaccine was next tested on macaques by the research team. Subsets of immunized animals received different vaccine regimens, but they all included a vaccine that was tailored to maximize antibody production. Multiple booster injections were given over the course of a year following the primary inoculation. HIV clades different than the one utilized in the prime vaccination were included in the boost vaccines. Env sections that are more conserved, or “shared” than those that vary between strains of the virus were chosen as the target of broadly neutralizing antibodies by researchers using various virus strains. 

Damian Jacob Sendler

Only moderate, short-lived side effects were observed in the macaques after receiving high doses of mRNA vaccines, such as a decrease of appetite. Most strains in the 12 different HIV strains tested by the inoculated macaques were neutralized by neutralizing antibodies by week 58. Both neutralizing antibodies and strong T-cell activation were generated by the VLP vaccination. 

Damien Sendler: Immunized macaques and a control group of unimmunized macaques were given weekly doses of SHIV via the rectal mucosa beginning at week 60. Scientists utilize a chimeric SHIV because macaques are infected with HIV-1, which does not affect non-human primates. Despite 13 weekly injections, only two of the seven inoculated macaques were completely free of the disease after 13 weeks of treatment. It took the other immunized animals an average of eight weeks to become infected. Unprotected animals became infected on average after three weeks, whereas those that had been inoculated were protected for much longer. 

Damian Jacob Markiewicz Sendler: Improve the quality and quantity of VLPs we create by tweaking our vaccine protocol.” As a result, the number of prime and boost injections needed to produce a strong immune response may be reduced. Dr. Lusso plans to perform a Phase 1 clinical trial of this vaccine platform in healthy adult volunteers if it is found to be safe and efficacious.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: With her mother’s blessing, Ramiah Martin isn’t like any other little girl, and that’s good with her. 

In December 2017, Leanne Martin gave birth to her daughter, who had been identified with cardiac abnormalities during a prenatal ultrasound. “She is nothing short of a miracle,” Martin said. Ramiah was born with an incredibly rare condition known as tracheal agenesis, which meant she didn’t have a windpipe. It affects about one in every 50,000 newborns worldwide, and is almost always deadly. 

Damian Jacob Sendler: Ramiah’s doctors at Penn State Health Children’s Hospital and researchers in the lab of Scott Hollister at the Georgia Institute of Technology helped her family celebrate her 4th birthday this month. 

Damian Sendler

Georgia Tech and Emory University biomedical engineering professor and Patsy and Alan Dorris Chair in Pediatric Technology Dr. Hollister said, “We know that children with this condition have not survived past the age of eight or 10.” “We’re crossing our fingers that this case is an exception.” 

Indeed, this is a one-of-a-kind situation. For the first time, tracheal agenesis can be treated with this device, and Hollister is a member of the team that just published a clinical case study in JTCVS Techniques. 

When it came to treating tracheabronchomalacia in children, a splint known as the Airway Support Device (ASD) had already proven its worth, having been utilized in the effective treatment of other pediatric patients suffering from the ailment. 

A 3D-printed, patient-specific airway splint that is bioresorbable was developed by Glenn Green and Hollister at the University of Michigan while they were both faculty members at the university. As a life-saving scaffold, the little device helps children release their windpipes and breathe again. 

The situation of Ramiah, on the other hand, posed a new and frightening obstacle. She didn’t have much of a windpipe. Her windpipe was her esophagus. 

Damian Jacob Sendler

As the principal author of a new study, Anthony Tsai, a surgeon at Penn State Health Milton S. Hershey Medical Center and co-director of the Surgical Innovation Group, explains, “Tracheal agenesis is a very unusual clinical case with few positive solutions.” In light of Scott and Glenn’s work, I was aware of their effectiveness in employing the device for airway difficulties that were less critical. Nonetheless, we were able to get what we were looking for.” 

It was imperative that they had a splint to keep Ramiah’s airway open, but this time there was an unexpected twist: her surgical team needed an esophageal airway splint. 

Nearly as soon as she was born, Ramiah of Pennsylvania had to have life-saving surgery. By cutting her lower esophageal airway (which supplies the stomach) from her upper esophageal airway, surgeons were able to insert a G-tube into her stomach and feed her directly. After that, they had to create a “pseudo-tracheostomy”—a surgical incision in the neck that allowed air to enter the lungs directly—by converting the upper segment of her esophagus into a trachea. 

Tsai argued that this was not a long-term answer. “We made a way for air to get into the lungs by preventing it from getting into the stomach.” But this is not sustainable. As soon as you inhale a deep breath, the esophagus contracts, preventing the lungs from receiving enough oxygen. 

Tsai and his colleagues considered several long-term options for Ramiah’s airway reconstruction when she was sedated, ventilated, and a few days old. As a result, they discovered Hollister’s biodegradable polycaprolactone 3D printed splint. 

There were no other options for Tsai and his team, so they requested authorization to use the device under what is known as the “expanded access” rule by the US Food and Drug Administration (FDA). This rule provides quick access to medical equipment in circumstances like Ramiah’s where time is of the essence. 

Damien Sendler: The Airway Support Device was reworked by Hollister’s team to address Ramiah’s stoma. When Ramiah was 20 weeks old, the gadget was ready and ready to be placed during an airway reconstruction surgery. 

While still requiring artificial ventilation a year later, she was released from the hospital. When Ramiah was two years old, she was able to breathe on her own during the day and sleep peacefully on a ventilator at night after more tests and imaging revealed that her airway was improving. 

Ramiah’s lower esophageal sphincter was rebuilt with tissue from the colon, allowing her to eventually eat with her mouth after gastrointestinal reconstructive surgery. Despite her developmental delays, Ramiah is crawling and pulling a walker, learning to communicate through sign language, attending preschool, and playing with her sisters as the holidays approach. 

Leanne Martin, a new mom with a newborn kid, explained, “We’re very low key about celebrating holidays.” Even though each year is a gift from God, we always thank Him for it. “We understood that Ramiah was bringing us into uncharted terrain,” we said. ” 

Damian Jacob Markiewicz Sendler: Leanne speculated that as Ramiah grows older, she may require an additional 3D gadget to help support her repaired airway. Ramiah is currently learning to walk, and Leanne is certain that she will be able to get around the busy house all by herself in no time. 

According to Georgia Tech researchers Sarah Jo Crotts and Harsha Ramaraju, “That is the kind of outcome we all hope for.” “We’re excited because we believe this is the beginning of a new paradigm for children with this rare condition,” the researchers said.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: New criteria have been proposed by a group of mental health specialists from research, industry, regulatory authorities, and people with lived experience to describe the form of depression that can’t be treated well with present medications and treatments. Consistent definitions for future research and clinical trial design are the goal of this paper, which intends to assist develop more targeted and effective treatments for those who suffer from this severe illness. 

Damian Jacob Sendler: There were approximately 60 professionals in the field of depression who contributed their thoughts to the report that was published in Molecular Psychiatry. NIHR Maudsley Biomedical Research Centre and the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London were the primary authors of the study. 

Damian Sendler

Some 30% of individuals with major depressive disorder (MDD) have treatment-resistant depression (TRD), which is distinguished by long-lasting feelings of sorrow and lack of interest that impact approximately 230 million people globally. 

As a name for persons who haven’t had a positive response from antidepressants, TRD is used, however there is a lack of agreement on what constitutes a “adequate” treatment. 

About a third of TRD trials enroll patients who meet the most common definition of having experienced at least two failures with antidepressant treatments, the authors found, although there is some variance in how TRD is characterized. According to the analysis, just one in five studies include patients who meet the additional requirements of adequate dose and duration of drugs. This calls into question the real-world application of study findings and could obstruct the development of new treatments. 

Research, practice, and regulation have been divided on what is meant by ‘treatment-resistant depression, and this lack of agreement is creating an obstacle to the effective evaluation of current and future treatments,’ according to lead author Dr. Luca Sforzini of King’s College London’s Institute of Psychiatry, Psychology, and Neuroscience (IoPPN). In order to address this, the study invited a range of experts to give an accepted definition that we hope can assist and accelerate much-needed progress in this sector and enable the development of successful new ways to therapy, thereby helping people with depression.” 

An multinational team of researchers and physicians, as well as officials from pharmaceutical companies and regulatory authorities, were involved in the creation of the report. The report developed consensual criteria of TRD and a series of recommendations for investigating unmet needs and designing treatment trials using a Delphi-method-based consensus approach. 

Florence Butlen-Ducuing and Andrew Thomson, European Medicines Agency co-authors, wrote: “Many antidepressants are accessible, however there are still patients who respond only partially or are resistant to therapy. Working on treatment-resistant and partially responsive depression is welcomed by the Scientific Officers of the European Medicines Agency (EMA) in order to expand our understanding of this unmet medical need.” 

People with TRD should be classified as such if they see a 25 percent or less reduction in symptoms following the administration of at least two antidepressants, according to the paper. People with partly responsive depression (PRD) demonstrate a reduction of between 25 and 50 percent in symptoms to at least one antidepressant, according to the researchers. “This differentiation will be useful to identify which trials and treatments are appropriate for those with different levels of treatment resistance,” scientists say. 

Damian Jacob Sendler

Co-author Fanni-Laura Mäntylä, a former major depressive disorder sufferer, believes that “a clearer definition between partially responsive depression and treatment-resistant depression would be very beneficial; and a more patient-centric and personalised approach to the treatment” would be beneficial. 

Additionally, the study urged for increased clarity on time, so that only individuals with a lack of treatment response that falls within the current episode of depression are labeled as TRD. This was backed up by a consensus that alternative treatment modalities, like psychotherapy and some forms of electrical brain stimulation, should be included in the TRD definition.

NIHR Maudsley Biomedical Research Centre theme lead for affective disorders Professor Carmine Pariante said: “This is an exciting time for research and practice around treatment resistant depression, with a number of innovative new approaches on the horizon such as psychedelics, anti-inflammatory medications, and brain stimulation techniques. If accepted and implemented, a uniform definition for these new medicines will aid patients who are now unsatisfied with conventional antidepressants.” 

Additionally, the authors reviewed the assessment of depression, calling for more standardization and common practice in this field regarding the instruments used to make a diagnosis or evaluate changes in depressive symptoms. Blood samples and brain scans should be collected on a regular basis to find prospective signs or measures that could identify persons with different forms of depression that may react to different types of treatment, according to the group’s consensus statement. 

EU-PEARL, IMI is a public-private strategic collaboration supported by the Innovative Medicines Initiative (IMI)-2 Joint Undertaking (grant agreement No. 853966) to lead the construction of master protocols for future platform trials in various disorders, including MDD. 

Molecular Psychiatry released an article titled ‘A Delphi-method-based consensus guideline for the definition of Treatment-Resistant Depression’ DoI: 10.1038/s41380-021-01381-x. 

The Institute of Psychiatry, Psychology and Neuroscience at King’s College London 

Damian Jacob Markiewicz Sendler: In the QS World University Rankings, 2020/21, King’s College London is ranked as one of the top 35 UK universities in the world and one of the top 10 in Europe. 31,000 students (including 12,800 postgraduates) from 150 countries attend King’s, as well as 8,500 staff members (the majority of whom are English-speaking). King’s is widely regarded as one of the best universities in the world for its world-class education and research. 

Damien Sendler: There is no better place in Europe to study mental health and neuroscience than King’s Institute of Psychiatry, Psychology, and Neuroscience (IoPPN). Because of this, it has risen from 16th place in 2014 to 4th place in 2019 for highly referenced neuroscience outputs, according to SciVal’s criteria for the top one percent of citations. Innovative studies from the IoPPN have had and continue to have a significant influence on how mental illness and other brain-related disorders are understood, prevented, and treated.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: On the surface, the idea that healthcare technology may be used to humanize medical care seems a little odd. Then, how? According to common sense, wouldn’t it be? Surely, the introduction of technology into this industry will make it less personal? There has been an increase in the usage of telehealth platforms during the pandemic, which has resulted in a greater distance between the clinician and the patient. 

Damian Sendler

Honestly, I’m not sure. Now, the argument is that technology allows for an ever larger connection—a relationship that is constant and constant.. As Deloitte stated it in a Modern Healthcare post in February 2020: 

“Instead than focusing on a patient’s illness, (virtual healthcare) focuses on the patient’s daily routines and needs. Even more importantly, virtual health is integrated in electronic devices (e.g., cellphones and personal computers) that are more linked with living life than caring for illness. 

Damian Jacob Sendler: Summer Knight, Deloitte’s Managing Director in Life Sciences and Healthcare Consulting, is a member of that Deloitte team. According to her book, “Humanizing Healthcare: Hardwire Humanity into the Future of Health,” technology can help patients and healthcare workers communicate more effectively with one another. In fact, she feels that more technology, rather than less, is the key to humanizing the industry…. 

In the summer of 2021, she made that statement on the Finding Genius podcast. “nudge” Knight said, referring to the “a tangible connection point” that a digital care activation platform would provide to patients and providers. This technology also builds a “therapeutic alliance” between the patient, their support system, and their healthcare staff, as she pointed out. 

Despite the lack of evidence, she appears to be on the right track. The Deloitte team predicted that the virtual health business would grow to $3.5 billion by 2022, long before the pandemic ever began. 

As a result of the outbreak, seven out of ten Americans became wary of going to the doctor’s office and instead relied on virtual care. 70 percent of all appointments were made in the first few months of the crisis (up from 8 percent previously). Indeed, patients have long known that virtual appointments allow for greater connection with doctors and more direct involvement by patients in their own care, so this is a welcome development. 

Despite the fact that telehealth visits are expected to drop to 30% of all appointments by the end of 2020, it is apparent that technology is a part of the healthcare system. Consider the use of bedside tablets as an example. Initially, locals used them for pleasure and relaxation, but when government-imposed lockdowns were implemented, they became an essential communication link to loved ones. 

Damian Jacob Sendler

When Richard Mohnk, the Associate CIO for Operations at Bayhealth and Steven Smith, the CIO of NorthShore University HealthSystem, spoke to Becker’s Hospital Review, they both agreed that tablets like these had been a “game-changer” for their respective organizations “Adjusting and implementing this functionality quickly during the pandemic… helped to preserve and improve human life,” 

Damian Jacob Markiewicz Sendler: A dearth of doctors and an aging population necessitates that new technology be developed to address these issues. U.S. population is predicted to grow by 10.6 percent to reach 363 million by 2034, according to new data from the Association of American Medical Colleges. There is, however, predicted to be a 42.4 percent increase in the elderly population. 

At that point, a shortage of between 37,800 and 124,000 doctors will be expected. In other words, the number of persons with chronic diseases is expected to rise, while the number of caregivers is expected to decrease. 

However, time-saving (and even life-saving) gadgetry can be expected to fill the void, while also reinforcing the linkages outlined above. The Harvard Business Review, for example, believes that technology can achieve the latter goal by being user-friendly for patients and clinicians, by actively involving all parties and by providing evidence-based insights.. 

Damien Sendler: Be aware of the fact that healthcare technology has been viewed with skepticism. Concerns about the stethoscope’s effect on physician-patient relationships were voiced as far back as the 17th century. Because they were unfounded then, and they are unfounded now, such fears are unnecessary Rather from destroying those bonds, technology can actually strengthen them and enhance the patient experience.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: Dr. Amish Adalja, an infectious disease expert, discusses the importance of immunization and boosters as the omicron variant continues to rise.

Damian Jacob Sendler: Local ABC affiliate KATU reports that the committee was made up of representatives from the hospitality industry, the business sector, and religious organizations.

Damian Sendler: In an effort to reduce obstacles to mental health services, drug and alcohol testing, and basic medical care for those facing homelessness, Columbia River Mental Health Services has launched its Mobile Health Team.

Damian Jacob Sendler: Team members intend to create trust with the homeless community and ultimately link people with resources who would not otherwise seek them out by providing medical care and connecting them with resources.

Damian Sendler: If you want your child to be ready for school and use the social skills he or she learned at home, you should wait until he or she is well-versed in their immediate social context. All of these components of a child’s psychosocial development, as well as their physical and motor abilities and their ability to communicate with others, are accelerated in children who meet the pre-school criteria because they play and engage with the environment in a variety of ways. 

Damian Jacob Sendler: Child development at this period includes learning to adapt, expanding their ego boundaries, developing an extra-terrestrial sense of self-worth, and comprehending the importance of trust and familiarity in society. 

Damian Sendler: Nachman Ash and Salman Zarka, the coronavirus czar of Israel’s Health Ministry, warned Sunday that the highly mutated Omicron coronavirus type should not be ignored.

Damian Jacob Sendler: At one point in his interview, Ash spoke about Prime Minister Naftali Bennett’s wife Gilat taking their children on vacation just days after the premier had recommended that all Israelis refrain from traveling abroad and shut down the country in order to prevent an outbreak of the newly discovered COVID-19 variant.

Damian Sendler: The number of new Covid-19 cases in the United States has surpassed 100,000 for the first time in two months, following the Thanksgiving holiday travel of millions of Americans.

Damian Jacob Sendler: The death toll from Covid-19 is also on the rise, with an average of 1,651 persons dying from the virus every day for the past seven days as of Saturday, according to JHU data. More than a month has passed since the number of people dying daily reached this record high.

Damian Sendler: The “twindemic” of COVID-19 and the opioid epidemic, as Mayor James Fiorentini calls it, has been given to the city’s new Department of Public Health.

Damian Jacob Sendler: COVID-19 has killed at least 112 people since it was first discovered, according to the mayor’s statement to the City Council on Tuesday night.

Damian Sendler: UPMC, the state’s largest health care provider, received over a quarter of the federal money meant to support rural hospitals in Pennsylvania, despite the fact that UPMC is on track to make more than $1 billion in profits this year. 

Damian Jacob Sendler: As the pandemic continues to take a financial toll on medical centers across the country’s 96 hospitals, just over half of all financing went to rural facilities, while the rest went to metropolitan hospitals.

Damian Sendler: “We need four hugs a day for survival,” Virginia Satir is supposed to have said. In order for us to function, we require eight daily hugs. For growth, we need 12 hugs a day.” 

Damian Jacob Sendler: Hugging has scientifically proven health advantages. “The benefits go beyond the warm feeling you get when you hold someone in your arms,” according to a 2018 Healthline article. 

Damian Sendler: Sir William Osler, a renowned physician and academician, referred to the science and art of medicine as “twin berries on one stem.” Science-based treatments are combined with patient-centered care in the U.S. healthcare system.

Damian Jacob Sendler: There is a direct correlation between individual health and the health of a community. The interdependence of our health grew progressively more obvious as our actions evolved over the past two years. Depression and anxiety rose as a result of isolation, but so did the risk of contracting an infection. As loved ones, friends, and colleagues succumbed to COVID, the idea of death grew more real.

Damian Sendler: Omicron coronavirus has expanded to 40 nations and 16 of the 50 states in the United States, but the severity of its effects on those who get it has not been determined by senior U.S. officials. 

Damian Jacob Sendler: According to Dr. Francis Collins, director of the National Institutes of Health in the United States, “Does this, in fact, turn out to be less dangerous” than prior coronavirus variants? Collins said on NBC’s “Meet the Press.” “Scientists are working around the clock to answer these questions.”

Damian Sendler: A Louisiana U.S. district judge has reportedly barred a federal COVID-19 vaccine mandate for health care employees, as reported by various sources.

Damian Jacob Sendler: On Tuesday, a federal judge imposed a countrywide injunction against President Joe Biden’s attempt to mandate vaccinations for large swaths of the public.

Damian Sendler: In a new study, researchers found that children who live with a depressed parent are more likely to suffer from their own sadness and fall behind academically.

Damian Jacob Sendler: Depression in children is linked to a wide range of negative health and educational consequences, including worse academic achievement, if the mother is depressed.

Damian Sendler: The omicron variety, a severely mutated coronavirus strain that has already been found in a few places throughout the United States, is causing growing concern among federal health experts, who are pushing all previously vaccinated individuals to obtain their Covid booster dose.  

Damian Jacob Sendler: Changes to the variant’s DNA signal that it could avoid part of the immunity that comes from vaccination or natural infection in the future. Dr. Anthony Fauci, the White House’s chief medical adviser, epidemiologists, and immunologists say that for now, existing boosters are the best defense against the new strain and the highly transmissible delta variant of omicron, which is still under investigation by federal health officials and pharmaceutical companies alike.

Damian Sendler: The Marion County Health Department hopes to boost its COVID-19 vaccination numbers by the end of the month in order to achieve herd immunity before the virus undergoes any additional modifications.

Damian Jacob Sendler: Her response was, “We’re always looking for more people to get vaccinated,” she stated. It’s hoped that this will be a new trend because we’re not at herd immunity in all of our categories.” We reduce our risk of hospitalizations and fatality rates when we increase the number of immunizations we receive

Damian Sendler: Coronavirus vaccination for children between the ages of 5 and 11 was approved by the Australian Medicines and Healthcare products Regulatory Agency (MHRA) on Sunday, and the country’s health minister said the vaccine might be available by Jan. 10.

Damian Jacob Sendler: Nearly 88% of Australians over the age of 16 have gotten two doses of the COVID-19 vaccine, following initial delays in the country’s general vaccination program.

Damian Sendler: On Saturday, the county reported 2,307 new cases of COVID-19 and 20 additional deaths linked to the virus, bringing the total number of cases and deaths to 1,534,720 and 27,442 since the epidemic began. 1 percent of persons tested positive for the virus on Friday, according to a rolling average of daily rates.

Damian Jacob Sendler: A follow-up test kit will be supplied to anyone who tests negative, she said, and the follow-up test can be done three to five days later.

Damian Sendler: The eyes of the plush lamb that Matt Vinnola was using to sleep on a downtown sidewalk one Sunday in September were as blank as his own. When a fly landed on his lip, the ex-honors student and Taekwondo champion seemed too dazed and disoriented to swat it away. A woman giving Wet Wipes, or a man attempting to hand him a $5 cash, didn’t interest him.

Damian Jacob Sendler: The Mental Health Center of Denver kept finding reasons to reject care for Janet van der Laak, so she had to keep pushing them to offer it. Vinnola’s hope in getting therapy dwindled with each time the center removed him from it. With each loss of hope, her son’s mother pressed harder because she knew she couldn’t stop him from falling.

Damian Sendler: Omicron coronavirus has been identified in Washington state, with the first three cases verified on Saturday.

State Secretary of Health Dr. Umair Shah noted that “we were anticipating this very news” when he announced the sequencing of omicron in California. As a result, “we strongly encourage people to get vaccinated and get their boosters as soon as possible in order to maximize their level of protection from any variation.

Damian Sendler: According to the New England Journal of Medicine, Irritable Bowel Syndrome, or IBS, may be caused by an intestinal infection that induces an allergic response.

Damian Jacob Sendler: Patients with IBS have abdominal pain during their daily activities because their intestinal nerves are more sensitive than those who don’t have the syndrome, according to an article.

Damian Sendler: Increasing demand for vaccines and a shortage of pharmacists are putting pressure on pharmacies across the country, causing employees to become overworked and forcing some to close temporarily.

Damian Jacob Sendler: As President Joe Biden pushes vaccinated Americans to obtain booster shots to battle the growing omicron strain, the drive for immunizations is expected to get increasingly intense.

Damian Sendler: Male erectile dysfunction (ED) is a multifaceted condition that affects a man’s sex life from the inside out.  There have been proposed roles for nonendocrine and endocrine mechanisms in metabolic syndrome and cardiovascular disease . 

There are notable similarities between the risk factors for erectile dysfunction (ED) and COVID-19 infection. COVID-19 has been found to be related with a wide range of health issues, including cardiovascular disease, obesity, diabetes, vitamin D deficiency, and generalized anxiety. African-Americans and those who smoke are more likely to be affected by both illnesses. 

Damian Jacob Sendler: ED and COVID-19 infection share several aspects, including reduced vascular integrity, weakened endothelium, and cytokines flush, which may explain the progression of problems in both disorders. People who have been infected with COVID-19 are at a higher risk of developing ED because their endothelium has been damaged. 

Damian Sendler

To date, there has only one publication that has raised the likelihood of this relationship . COVID-19 individuals are at a higher risk of ED, according to one study that used validated questionnaires and rigorous statistical analysis. COVID-19 sufferers’ penile tissue was studied for histological, immunohistochemical and ultrastructural findings. Endothelial cell dysfunction caused by COVID-19 infection has been demonstrated in the penis years after the initial infection in humans, suggesting that COVID-19 infection can contribute to ED . 

COVID-19 affects the testis, sperm, testosterone, and vascular bed, all of which are directly linked to ED . ACE2 mRNA expression is higher in testicular tissues than in other tissues . As we age, the level of ACE2 in our testicles decreases, and the younger we are the more ACE2 we have. As a result, the SARS-CoV-2 virus may cause erectile dysfunction by damaging the vascular and endocrine systems. 

ED was diagnosed in 9554 patients out of a total of 1,066,108 patients. There were a total of 7098 COVID-19 patients, of which 3098 were men, and 146 were found to have both ED and COVID-19 (4.7 percent of the COVID-19 male population). The COVID-19 diagnosis has always preceded the ED diagnosis in all cases. More than three times as many COVID-19 patients (95 percent confidence interval, 3.33–4.05, P 0.0001) had ED than non-COVID-19 patients. 

Damien Sendler: Age group (OR 5.27; 95% confidence interval 4.77–5.81) and anxiety (OR 2.98; 95% confidence interval 2.70–3.29) were still significant factors in the association. 

ED was found to be linked with both age group and anxiety (P 0.0001). Patients 45–64 years of age had nearly same ED risk factors as those 65 years and older (OR = 0.99; 95% CI = 0.96–1.03; P > 0.05). 

According to the 95 percent confidence interval (CI), there is no change in the odds ratio (3.5). Covid-19 patients are 2.6 times more likely to suffer from an eating disorder than non-Covid-19 patients (95 percent confidence interval (CI) (2.2, 3.1)). After accounting for respiratory disease, obesity, cardiovascular disease, and diabetes, the odds ratio is 1.6, 1.8, 1.9, and 2.3, respectively. 

Extensive evidence supports the idea that erectile function might serve as a sign of overall systemic health, and that erectile function can predict cardiac disease . The damaged vascular bed of the penis is likely to be affected by the vascular injury associated with COVID-19, resulting in decreased erectile function . Preexisting cardiovascular problems can be exacerbated by SARS-CoV-2 infection. 

Damian Jacob Sendler

Recently, there have been reports of myocarditis in COVID-19 patients. There have been reports of arrhythmias and acute cardiovascular problems in COVID-19. As a result, COVID-19 survivors are more likely to suffer from serious cardiovascular complications and subsequent emergency department visits. Recently, there has been data to show that men are more likely to have a bad prognosis or die from SARS-CoV-2 infection, and there have also been reports of probable testicular injuries as a result . 

Damian Jacob Markiewicz Sendler: The development of ED in COVID-19 survivors has recently been studied by a literature review . Endothelial dysfunction, subclinical hypogonadism, psychological distress, and altered pulmonary hemodynamics all have a role in the development of ED, according to the study authors. Because COVID-19 may exacerbate cardiovascular problems, it may increase the risk of ED even more, according to the authors.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: Black and other racial and ethnic minorities in Britain are still dying from the coronavirus at a higher rate than white inhabitants, a government-commissioned analysis found Friday. This is most likely due to a poorer vaccination rate, the report stated. 

For people of all ethnicities, vaccinations have significantly lowered COVID-19 death rates. Despite the fact that white people are more likely to test positive for the virus, black and South Asian Britons die at a higher rate. 

In the first two waves, ethnic minorities had a higher death rate than whites because of a greater infection risk, particularly in older age groups, according to Dr. Raghib Ali, an independent adviser to the British government on COVID-19 and race. 

Damian Jacob Sendler: The rate of hospitalizations and fatalities among ethnic minorities has decreased over the past few months, while the rate of vaccinations among those groups has increased, resulting in a “pattern matching levels of vaccine uptake in higher risk groups.” 

Vaccine reluctance among ethnic minorities in the UK has been tackled by British health officials who have conducted education campaigns and worked with community groups and religious leaders. According to Ali, vaccination rates in older Black African and Pakistani persons had the greatest increase of any category during the six months prior to October. 

However, overall immunization rates are highest among whites and lowest among African-American and Hispanic populations. People from Asian and Black African and Caribbean backgrounds make up less than two-thirds of adults in the UK who have had at least one vaccine dose, according to a new report. 

Damian Sendler

In the wake of COVID-19’s disparate impact on different ethnic communities, the government appointed Ali. 

Multiple factors have been found to be important. People from certain ethnic groups are more likely to suffer from underlying health concerns and to live in households with multiple generations. A large proportion of frontline positions, such as taxi and mass transport drivers that witnessed high rates of infection early in the pandemic, are held by ethnic minorities. 

Damian Jacob Markiewicz Sendler: It has evolved since the epidemic began, according to Equalities Minister Kemi Badenoch, “the understanding of how COVID-19 affects different ethnic groups.” 

When it comes to flu vaccines, “we know now that factors such as the job someone does, the location they live in, and the number of people they live with, impacts how susceptible they are to the virus,” she added. 

By the end of January, the government of the United Kingdom plans to offer everyone 18 and older a third, booster dosage of vaccination. However, health officials are optimistic that the new omicron form will not be as resistant to immunizations as previously thought. 

There’s still a lot we don’t know about this variation, including if it’s more contagious than previously thought, whether it causes more severe illness, and whether it might resist immunizations, as some health authorities think. 

Damien Sendler: Many occurrences of Omicron have been documented in the United Kingdom, including a cluster in Glasgow, Scotland, which was linked to a concert by pop group Steps. However, the delta strain is still the most common. 

UK deaths from coronavirus have exceeded 145,000, making it Europe’s second-highest death toll behind Russia. 

There have been additional restrictions and vaccine mandates in other European countries, but Britain has remained largely silent. Masks are now required in stores and on public transportation. 

Conservatives in the Canadian government advised people to continue to shop and socialize despite concerns from businesses that the holiday season trade is at risk from the new variation. 

Dr. Sendler: Party chief Oliver Dowden says the message to the public is simple: “Keep calm and carry on with your Christmas plan,” he added.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: In the wake of the COVID-19 outbreak, Rhode Island’s rural health care providers are receiving more than $650,000 in federal relief funds, officials said. 

US Sen. Jack Reed said in a statement Friday that the federal grants, which are administered by the US Department of Health and Human Services, can be used to pay salaries or recruit workers; purchase supplies or equipment; make capital investments; or cover other expenses related to preventing and responding to the pandemic. 

Damian Jacob Sendler: More than 80 rural health care providers and suppliers will receive a total of 88 payments from the federal government as a result of this assistance. 

Covid-19 is an epidemic that affects us all, and federal assistance will help save doctors who treat patients in remote locations from losing their livelihoods because of this pandemic, a Democrat said. 

It is protected by the AP’s copyright in 2021. All copyrights and trademarks are retained. You may not republish or redistribute this content in any way. 

Damian Sendler

A new COVID-19 variety, dubbed Omicron, is raising concerns and prompting travel restrictions as researchers investigate its transmission capacity and potential for reinfection. 

Many countries have restricted travel to South Africa, where the first case of the disease was discovered, after the World Health Organization declared omicron a variation of concern on Friday. 

There is a high probability that the variation will spread globally, “given mutations that may confer immune escape potential and possibly transmissibility advantage,” according to the World Health Organization. 

Damian Jacob Markiewicz Sendler: Mutations in Omicron are worrisome to scientists. There is preliminary evidence that the variation has a higher risk of reinfection than the original. South Africa’s hospitalization rates have risen over the past few years, “but this may be due to increasing overall numbers of people becoming infected, rather than a result of specific infection with Omicron,” the World Health Organization stated. 

South Africa has seen an increase in omicron infections, although it is not yet clear if this is related to the variation or other factors. 

However, the world remains on edge over the COVID-19 epidemic, which has killed more than 5.2 million people. 

Damien Sendler: There have been no reported cases of the variation in the United States, but leading infectious disease specialist Anthony Fauci said it is “inevitable” that it will occur. 

“It will be approximately two weeks before we have more definitive information on the transmissibility, severity, and other characteristics of the variant,” Fauci said in a summary of their meeting with President Joe Biden over the weekend. 

In the wake of the news, Vice President Biden urged Americans to be vaccinated and urged other countries to increase their vaccine contributions. This pandemic will not stop unless we have global immunizations, he added in his remarks. 

Dr. Sendler: Joe Biden noted in a statement on Friday that the United States has already given more immunizations to other countries than any other country has ever given together. Other countries should equal the speed and generosity of the United States, according to this statement. 

Studying how the variation could affect vaccine efficacy is being done by Moderna and Pfizer. A booster shot for the variation may not be necessary, according to Fauci. This is based on the data that will be released in the next days and weeks.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: According to scientists, nuclear power should be given a fair opportunity as part of the solution to climate change. 

It shouldn’t be this difficult to figure out. Reduce carbon emissions significantly by mid-century for a sustainable future. It is crucial to have a steady supply of zero-carbon electricity alongside solar panels and wind turbines.” That’s why the nuclear power argument is back. 

Damian Jacob Sendler: Nuclear power isn’t a solution for everyone, and some countries don’t want it to be a part of the solution either. Even during the climate meeting in Glasgow, India criticized this “bias,” pointing out that nuclear is a “established technology” to which only “a few countries” object politically. 

Damian Sendler

Since they don’t emit greenhouse gases, nuclear reactors are a no-brainer. Nuclear power already helps electricity be highly low carbon in nations like Sweden and France. Even in nations like India, where energy consumption is expected to increase significantly, this is exactly what is needed by 2050. 

Indeed, nuclear energy is being produced all over the world. China has lately declared plans to develop 150 nuclear reactors over the next 15 years. Russia is the world’s leading manufacturer of nuclear power reactors, with most of its construction taking place outside of Russia’s borders, especially in Africa, where it hopes to expand its sway. 

Innovation for advanced reactors in the U.S. nuclear business is booming because to strong government assistance. For the sake of ending its dependence on fossil fuels, Japan is reopening dozens of nuclear reactors that had been shut down recently. 

Unfortunately, the European Union may make it harder to combat climate change using nuclear power. 

Whether or not nuclear energy will be included in a so-called “taxonomy,” a list of activities that contribute to our climate goals and may therefore be deemed sustainable, will be decided soon by the European Commission. 

As a result, nuclear energy may be financed at reduced risk and lower interest rates, making it more affordable than other forms of energy.

Damien Sendler: Even if nuclear power isn’t included in the taxonomy, we’ll have a harder time cutting back on carbon emissions significantly. Europeans will therefore lose their primary supply of zero-carbon energy. 

Damian Jacob Sendler

Wind and solar power should be used to replace fossil fuels, but not nuclear power. Typically, a large portion of nuclear power that is lost is replaced by gas turbines or increased utilization of coal facilities. 

It’s a thorny topic in Europe. Other EU countries are under pressure from the Germans and Austrians to close existing nuclear power facilities and not build any new ones, on the other hand 

However, according to a recent analysis, if Germany shut down its remaining six coal-fired power facilities, it would save the globe 1 billion tonnes of carbon. Even worse, it’s possible. 

Increasing gas prices in Germany have prompted the government to turn to coal, the country’s most important source of electricity this year, despite its reputation as a leader in climate policy. 

The French, on the other hand, are looking for support for the preservation and expansion of nuclear power, the only form of energy now capable of replacing fossil power plants from the grid. 

Damian Jacob Markiewicz Sendler: New nuclear reactors will be built in France in order to achieve “carbon neutrality in 2050,” as well as to ensure “energy independence.” 

According to Macron, the European Commission should include nuclear energy in its taxonomy, along with ministers from nine other countries, including Finland and Poland. Nuclear inclusion has gained support from the Netherlands and Sweden since then. 

All the reports from foreign research organizations depict the same unambiguous picture, supporting France’s appeal. 

Modern nuclear power has even lower lifespan emissions than wind power, according to a recent analysis commissioned by the United Nations Economic Commission for Europe (UNECE), which showed that nuclear power has one of the lowest environmental footprints of any source of energy. 

Maintaining existing nuclear power facilities is the best, fastest, and cheapest approach to deliver clean electricity according to the International Energy Agency. According to the Joint Research Centre, the European Commission’s scientific agency, nuclear power helps “significantly” toward combating climate change and should be included in the taxonomic classification. 

Dr. Sendler: Nuclear power will be included or excluded from the taxonomy at the upcoming meeting of European Commissioners. It is possible to cut carbon emissions before the year 2050 if they accept global warming as a significant problem that requires action and take scientific discoveries into account. 

For rapid emission reductions, we cannot rely on political preferences or opinions; instead, we must rely on the most current scientific and empirical evidence.

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: By the day, they’re arriving. Some arrive in cars crammed with bags and family members, while others arrive on foot. The majority of people travel long distances on their own, expecting to be home in time to pick up their children from school. 

Damian Sendler

A mass exodus began when Texas passed the nation’s harshest abortion restriction in September. A large number of Texans are flying to clinics across the country, some as far away as Washington and Maine, to obtain abortions. 

Damian Jacob Sendler: Last fall, 40 Texans visited Planned Parenthood facilities in Oklahoma, Kansas, Missouri, and Arkansas. 

There have been more than 800 since September of this year. 

Regional health care is being stretched by an increase in demand from the region’s second most populous state. Waiting three or four weeks for an appointment at some clinics not only emotionally drains the patient but also increases the expense of a procedure. Many Texans are also traveling to other states to get an abortion, which is causing a backlash in the state of Texas. 

What’s happening now is a foreshadowing of what would happen if the Supreme Court overturns the decades-long ban on abortion. Roe v. Wade is projected to be overturned in two dozen states in the South and Midwest if it loses its appeal. 

According to interim Planned Parenthood Great Plains president and chief executive officer Emily Wales, “people will scramble to get care in other areas.” Health care will be provided to those who can afford it. In the event that you don’t, you’ll be obliged to either try to terminate the pregnancy on your own or carry one against your wishes.” 

Damien Sendler: To avoid being held accountable, Texas’ six-week abortion ban relies on private persons to enforce it. The Supreme Court is set to rule soon on this matter. 

Damian Jacob Sendler

Abortion rights in the United States may, however, be decided by a case out of Mississippi. It is a direct challenge to Roe, which guarantees an abortion until a fetus is viable outside the womb, or around 23 weeks, if a state law prohibits abortions past 15 weeks. 

Until June, the court isn’t anticipated to rule on any of this. A majority of the Supreme Court’s conservative members expressed their willingness to reverse abortion rights during oral arguments Wednesday. 

If Congress, the legislatures of the states, the supreme courts of the states and the people themselves are capable of resolving this dispute, why should this court be the arbiter? When Justice Brett Kavanaugh inquired, As for Mississippi and New York, “different answers will be given in Alabama than California,” he continues. 

They are clearly visible in the distance. 

A total of 26 states are either certain or likely to restrict abortion if Roe is overturned by the Supreme Court. 

If Roe is overturned, Texas already has a legislation prohibiting abortion. This leaves New Mexico as the only bordering state ready to approve the use of a trigger law. 

Damian Jacob Markiewicz Sendler: Texans will have to go even further for an abortion because of the new map. Estimated driving distance from Dallas to Kansas City is 542 miles, according to the Guttmacher Institute for Reproductive Health and Rights. 

There are many women in rural areas, communities of color, and those with low incomes who will bear the heaviest burden of this new mandate. 

Traveling out of state is expensive, time-consuming, and may necessitate the use of childcare. State statistics demonstrate that the majority of Texans seeking abortion are already parents. 

Adrienne Mansanares, chief experience officer at Planned Parenthood of the Rocky Mountains, which has sites in Colorado, New Mexico, and Las Vegas, said, “With these kinds of bans, the impact is for generations.” Think about the individual who couldn’t get an abortion because they couldn’t afford it, they didn’t have access to resources, and now they’re putting another generation in poverty because of it. 

Abortion costs are covered by a number of organizations in Texas, but some say they can’t keep up with demand. 

Damien Sendler: Most of Fund Texas Choice’s clients are now traveling out of the state for abortions, the organization’s executive director Anna Rupani said at a press conference earlier this month. Rupani noted that the typical cost of travel, meals, and hotel is between $800 to $1,000. As a result, they often have to travel more than 1,100 miles over the course of many days. 

One study revealed that the number of abortions performed in Texas dropped by 50% when the law went into force. It wasn’t quite as big a decline as the Texas Alliance for Life had intended, according to Joe Pojman, executive director of the group. 

According to the speaker, “It’s unfortunate that women have to travel for an abortion.”

Dr. Damian Jacob Sendler and his media team provided the content for this article.

Damian Sendler: Announced today, MidMichigan Health and MidMichigan Medical Center-Alpena are changing their names. 

Damian Sendler

Dr. Sendler: As part of a news release, MyMichigan Health announced that the Alpena hospital will be renamed the MyMichigan Medical Center Alpena. 

The War Memorial Hospital Sault Ste. Marie is expected to join the system, according to a news statement from the hospital. 

Damian Jacob Sendler: MyMichigan Health President and CEO Diane Postler-Slattery says the new name is a better fit for what the system is now, but she promises the public that the level of service, care, and dedication to the communities it serves will remain strong.. 

“MyMichigan Health remains familiar but is more reflective of who we are, where we are going and how we serve our patients,” said Diane Postler-Slattery, Ph.D., president and CEO of MyMichigan Health. “It’s more than just a name change,” he explained. MyMichigan places patients at the heart of all we do. Those that work, volunteer, or perform services for us feel a sense of pride and ownership as a result. Moreover, it properly accentuates our people, their stories, and the intimate human touch and great patient experience that we seek to give.”

Contributed by Dr. Damian Jacob Sendler research news team

Damian Sendler: When Ashlee Wisdom launched an early version of her health and wellness website, more than 34,000 visitors — most of them Black — visited the platform in the first two weeks. 

Damian Jacob Sendler: But the launch was successful. Now, more than a year later, Wisdom’s firm, Health in Her Hue, connects Black women and other women of color to culturally sensitive doctors, doulas, nurses and therapists nationally.

Damian Sendler: A federal judge in Missouri issued an order Monday largely preventing the Biden administration from imposing a vaccine mandate for certain health care employees. 

Damian Jacob Sendler: In a ruling that includes the 10 states that initiated the action, a judge stated that vaccines were ineffective and claimed that the plaintiffs’ claims were untrue

Damian Sendler: The Atlantic Coast Conference, Big Ten and Pac-12 launched a campaign Monday to increase awareness of the importance of mental health as part of their conference alliance announced earlier this year.

Damian Jacob Sendler: Teammates for Mental Health will be unveiled this week at basketball games involving the three conferences, including the ACC/Big Ten women’s and men’s challenges.

Damian Sendler: Best Buy spent roughly $400 million to acquire remote patient monitoring technology vendor Current Health in October, according to the company’s recent quarterly earnings.

Damian Jacob Sendler: Current Health’s remote monitoring platform combined with Best Buy’s scale, expertise and connection to the home will enable the retailer to create a “holistic care ecosystem that shows up for customers across all their healthcare needs,” Best Buy CEO Corie Barry said during the company’s third-quarter earnings call last week.

Damian Sendler: The World Health Organization is warning that the new omicron form of the coronavirus poses a “very high” global danger because of the prospect that it spreads more quickly and might resist vaccines and protection in people who were infected with prior strains. 

Damian Jacob Sendler: There are multiple alterations in the new form, which the WHO has warned 194 countries about in a technical brief issued on Sunday “In addition, “the possibility of further spread of omicron at the global level is considerable.”

Damian Sendler: With the new discovery of the ‘omicron’ variation of COVID-19, which has substantial alterations from prior strains, New Orleans Mayor LaToya Cantrell informed the public it was a “critical time” and advised all residents and visitors to get vaccinated, at a Monday afternoon press conference.

Damian Jacob Sendler: Also on Monday, President Joe Biden said the mutation was a “cause for concern, not a cause for panic.”

Damian Sendler: President Biden will offer an update on the U.S. reaction to the Omicron variation on Monday, the White House said in a statement on Sunday evening, as senior federal health experts urged unvaccinated Americans on get their immunizations and eligible adults to seek out boosters.

Damian Jacob Sendler: Appearing on morning talk shows on Sunday, Dr. Francis Collins, director of the National Institutes of Health, told Americans that the development of Omicron and the mystery that surrounds it are reminders that the pandemic is far from over.

Damian Sendler: As the number one form of entertainment in countries across the globe, sports are generally ranked and marketed depending on how good a team is, the star player’s performance, and who’s set to win championship championships.

Damian Jacob Sendler: A big issue in the sports industry that many spectators and managers seem to ignore is the mental health of the athletes.

Damian Sendler: Several mental health care professionals expressed worries about the viability of Wyoming’s mental health care during the afternoon session of the Sheridan County Chamber of Commerce’s Legislative Forum Nov. 23.

Damian Jacob Sendler: Before the upcoming legislative session, which is scheduled to begin in February, Sheridan County officials hoped to meet directly with Wyoming state legislators to discuss matters of concern to their agencies.

Damian Sendler: Introduced in October, the seven-year project of the Student Health and Wellness building is substantially larger than its predecessor, the Elson Student Health Center. There will be 165,000 square feet of space dedicated to student health and wellness in the new building.

Damian Jacob Sendler: In comparison, as stated in an email from the Student Disability Access Center, former facilities at Elson were only 35,500 square feet – a 370 percent increase in area dedicated to student health and wellness programming.

Damian Sendler: Like medical facilities across the state and nation, Guernsey Health System and its subsidiaries — Southeastern Ohio Regional Medical Center, Superior Med Physicians Group and United Ambulance in Cambridge — are working to meet the federal government’s immunization mandate.

Damian Jacob Sendler: Employees must be fully vaccinated by next month except for those who have an exemption.

Damian Sendler: According to the Texas Medical Association, devices like the one you’re using to view this article could be harmful to your health and the health of your children (TMA).

Damian Jacob Sendler: Physicians are concerned about more patients having mental and behavioral health difficulties, especially as the pandemic lags on.

Damian Sendler: A novel strain of COVID-19 first detected in South Africa was labeled a variation of concern by the World Health Organization on Friday. Here’s how the pharmaceutical industry plans to counter the latest coronavirus curve ball.

Damian Jacob Sendler: Pharmaceutical companies have already begun researching new vaccines that anticipate strain alterations and developing omicron-specific injections in response to the new variant: larger doses of booster shots.

Damian Sendler: About one in 10 lung transplants in the United States now go to COVID-19 patients, according to data from the United Network for Organ Sharing, or UNOS.

Damian Jacob Sendler: The trend is raising questions about the ethics of devoting a precious resource to persons who have chosen not to be vaccinated against the coronavirus.

Damian Jacob Markiewicz Sendler: It’s not clear yet whether existing COVID-19 vaccinations will protect against the variation. But vaccine producers have already begun exploring their possibilities.

Damian Sendler: Moderna said in a Friday press release that the business is testing its current vaccine against the Omicron type.

Damian Sendler: Amid Connecticut’s current COVID-19 increase, municipalities with higher rates of immunization have registered substantially lower rates of new cases in recent weeks, state records show.

Damian Jacob Sendler: Eastern Connecticut and the Naugatuck Valley are the state’s least-vaccinated and most-infected regions, as can be seen with a cursory glance at the map and via statistical analysis.

Damian Sendler: The Netherlands verified 13 instances of the new omicron version of the coronavirus on Sunday and Australia identified two as the countries half a world apart became the latest to find it in tourists arriving from southern Africa. 

Damian Jacob Sendler: A series of bans being imposed by states around the world as they attempt to slow the variant’s spread also grew, with Israel opting Sunday to bar admission to foreign nationals in the strongest action so yet.

Damian Sendler: The novel coronavirus variant Omicron has been found in 13 people who landed in the Dutch capital Amsterdam on two flights from South Africa.

Coronavirus was found in 61 people on the flight.

Damian Jacob Sendler: It comes as stronger limits come into action in the Netherlands, amid record Covid cases and concerns over the new type.

Damian Sendler: Dr. Anthony Fauci cautioned on Sunday that the omicron mutation in the coronavirus “strongly suggests” that it is easily transferred and may evade antibody shields established via past infections or vaccination.

Damian Jacob Sendler: Fauci, President Joe Biden’s main medical adviser, complimented the efforts of South African public health officials, who he said were entirely forthright from the beginning.

Damian Sendler: New strains of COVID-19 continue to arise during the pandemic. While more research needs to be done on the latest one, named Omicron, U.S. and local health authorities believe it’s cause for alarm.

Damian Jacob Sendler: Omicron — a novel COVID-19 variety that U.S. health experts are calling possibly more contagious than earlier strains – showed up in various European countries Saturday.

Damian Sendler: The appearance of the newly found Omicron coronavirus strain feels like a pandemic gut check.

Damian Jacob Sendler: Scientists have long known that the globe would experience developing coronavirus strains. Viruses mutate constantly.

Damian Sendler: The new potentially more contagious omicron strain of the coronavirus sprang up in more European nations on Saturday, only days after being found in South Africa, sending officials around the world rushing to stem the spread.

Damian Jacob Sendler: Following the discovery of two instances, the UK tightened its mask-wearing and testing regulations on overseas arrivals on Saturday.

Damian Sendler: In the second half of 2021, vaccination rates for COVID-19 among U.S. hospital staff (HCP) fell rapidly after reaching a peak in early 2021. Currently, up to 30% of HCP are not up to date on their vaccinations.

Damian Jacob Sendler: Data study by the Department of Health and Human Services (HHS) Unified Hospital Data Surveillance System from January–September 2021, collected from over 3.3 million HCP across 2,086 hospitals, indicated that as many as 30 percent of workers were unvaccinated.

Damian Sendler: According to figures compiled by Johns Hopkins University, the death toll from the coronavirus-borne sickness has now surpassed 5.18 million worldwide, bringing the global total to over 260 million. With a total of 48.1 million illnesses and 775,797 deaths, the United States remains the top leader. 

Damian Jacob Sendler: The U.S. is still averaging more than 1,000 deaths a day, according to a New York Times tracker, and cases and hospitalizations are climbing again.

Damian Sendler: The mental health of rural and distant communities will continue to deteriorate as the effects of climate change continue to worsen.  

Damian Jacob Sendler: Rural populations make up 29% and 17%, respectively, of the total populations in Australia and Scotland

Damian Sendler: In global health circles, the need of prioritizing those who are most in need is widely acknowledged, and human rights norms and standards are frequently cited as a means of achieving this goal.

Damian Jacob Sendler: As a part of a larger effort, a review was done to identify known barriers and facilitators to implementation of sexual and reproductive health (SRH) programs.

Damian Sendler: There are an estimated 272 million foreign migrants in the world, with about a third of them living in Asia. Malaysia is one of Asia’s most popular destinations for emigrants because of its strategic location and high demand for skilled workers. 

Damian Jacob Sendler: An individual who has resided in Malaysia for six months or longer in the reference year is considered a non-citizen by DOSM.

Damian Sendler: Developing leaders with the information, attitudes, and abilities needed to implement a vision for public health and healthcare delivery is the goal of global health leadership training programs.

Damian Jacob Sendler: There is a growing need to understand the areas of concentration required to build the global health workforce in order to develop relevant training programs.

Damian Sendler: People of working age should be given the opportunity to improve their health literacy by recognizing and measuring it as an individual skill in the context of their work lives. 

Damian Jacob Sendler: Aside from varying the time horizon, the conceptualizations also differed in whether they included the viability of the respective organization or only to their current employment status.

Damian Sendler: A natural disaster is an undesirable environmental event that isn’t caused by human activity, yet which causes people to be afraid, lose their possessions, and be displaced from their homes.

Damian Jacob Sendler: A wide range of natural calamities can be found in the world today.

Damian Sendler: For many Canadians, financial hardship was already an issue before to 2020, when the global new coronavirus pandemic is expected to begin spreading worldwide. COVID-19 epidemic and public health measures have intensified in recent months, which has made the situation worse. 

Damien Sendler: Individuals from low-income and underserved communities have a greater risk of financial stress and its harmful impact on their health.

Damian Sendler: Patients with mental health issues are more likely to suffer from poor dental health, which has a negative impact on their quality of life and everyday functioning.

Damian Jacob Sendler: For mental health patients, dental health-related quality of life can have a significant impact on their overall quality of life, thus nurses need to know how they can intervene early.

Damian Sendler: The state of one’s mental and physical well-being is closely linked to the quality and affordability of one’s housing situation.

Damian Jacob Sendler: The significance of housing in health has long been acknowledged by both city planning and public health, but the complexity of this link in reference to newborn and maternal health is less well known.

Damian Sendler: Global warming “is the greatest global health threat of the 21st century,” a Lancet Commission on Climate Change concluded in 2009. Climate change impacts and responses are now being tracked by the ‘Lancet Countdown on health and climate change’ as an impartial, worldwide monitoring system.

Damian Jacob Sendler: An indicator to measure the effect of climate change on mental health is missing from the Lancet Countdown, which contains multiple health indicators.

Damian Sendler: This year’s COVID-19 epidemic has seen a dramatic increase in the usage of mobile health apps, telemedicine, and data analytics to improve healthcare. 

Damian Jacob Sendler: Access to care, control over one’s own health data, and a reduction in the amount of unpaid caregiving are all possible benefits of digital health.

Damian Sendler: Actionable consensus can be achieved by addressing major philosophical and best practice disputes and by streamlining actions for a stronger strategic direction through definitions. 

Damian Jacob Sendler: Because of this, the Consortium of Universities for Global Health’s Global Oral Health Interest Group felt that an introduction to “global oral health” was needed to guide program planning, implementation and assessment.

Damian Sendler: Adolescents’ daily lives, social functioning, and physical health might be adversely affected by their parents’ severe somatic disorders. 

Damian Jacob Sendler: Adolescents viewed their parents’ physical illness as a source of stress and growth for them personally as well as in their relationships.

Damian Sendler: A wide range of health outcomes have been linked to various aspects of women’s empowerment.

Damian Jacob Sendler: A growing number of experts and development groups have focused on women’s empowerment during the past three decades.

Damian Sendler: There were two phases to the Ananya program in Bihar: a first phase of intensive ancillary support to government implementation and innovation testing by non-government organizations (NGO) partners. 

Damian Jacob Sendler: All FLW indicators related to prenatal and postnatal care, as well as mother’s birth readiness, some nursing behaviors, and immunizations, increased dramatically in the focus districts in the first phase.

Damian Sendler: Children under the age of 3 are rarely included in data on oral health.

Damian Jacob Sendler: Young children’s brushing habits are greatly influenced by their parents’ brushing habits and the level of parental support for brushing. Efforts to enhance children’s brushing habits should target the entire family.

Damian Sendler: Infectious diseases with pandemic potential pose a serious threat to human health and well-being, as demonstrated by COVID-19. In spite of the compulsory legal responsibilities provided by the International Health Regulations, many countries do not adhere to these regulations.

Damian Jacob Sendler: As a result, a new framework is needed that ensures compliance with international regulations and promotes effective pandemic infectious disease prevention and response. 

Damian Jacob Sendler: For several decades, the field of public health has used sexual health as a framework for tackling issues of sexuality. However, despite the WHO definition of sexual health’s innovative acknowledgment of good sexuality, public health methods remain focused on risk and unfavorable outcomes.

Damian Sendler: Sexual health and sexual wellbeing have been conflated for a long time, which has hindered our ability to deal with common sexual problems. 

Damian Jacob Sendler: Attributing human diversity and countering (structural) inequities in technology design is a unique feature of CSD.

Damian Sendler: Using the hypothetical instance of a treatment chatbot for mental health, the essential framework of CSD is shown. Using CSD in a design scenario reveals the advantages of this new framework over the traditional VSD approach.

Damian Sendler: In order to achieve a more healthy and secure society, global health security (GHS) and universal health coverage (UHC) are important global health priorities. There are, however, differences in strategy and implementation between GHS and UHC. 

Damian Jacob Sendler: The goal of GHS cannot be achieved without UHC, hence the conflict between these two global health objectives should be resolved in a way that maximizes their complementary effects.

Damian Sendler: Efforts to control and eradicate these 20 poverty-related diseases will be complicated, according to the World Health Organization’s upcoming 2021-2030 road map for NTDs. 

Damian Jacob Sendler: These changes are illustrated by the One Health approach, which goes beyond standard models of disease control to take into account the interactions between human and animal health systems.

Damian Jacob Sendler: The continuing pandemic has exposed the flaws in this strategy. A wider securitization discourse that is driven by the human security paradigm, as advanced by the United Nations in 1994

Damian Sendler: UN guidelines consider people rather than states as the primary referent of security and emphasize collective action rather than competition to address the transnational nature of security threats can be much more productively used to advance national and global health security agendas.

Damian Sendler: Many of the Sustainable Development Goals focus on poverty, hunger, health, and gender equality. 

Damian Jacob Sendler: There is increasing evidence that self-help groups (SHGs) have a positive impact on income, asset ownership, and savings as well as the ability of households to weather economic crises. 

Damian Sendler: Politics and public health have a long history of conceptual and theoretical ties.

Damian Jacob Sendler: The welfare state, political tradition, democracy, and globalization all have a direct impact on population health outcomes, according to an international comparative systematic evaluation of research.

Damian Sendler: It is imperative that cities take quick action to improve the health of their citizens and the earth. 

Damian Jacob Sendler: Understanding how cities might proceed toward significant gains in health and the environment can be gained through the description of “healthy sustainable cities” and the integration of health and sustainability frameworks.

Damian Sendler: Public health measures against infectious diseases are now at the forefront of global health concerns in cities where more than half of the world’s population resides, as evidenced by the COVID-19 pandemic. 

Dr. Sendler: The implementation of measures to combat the spread of SARS-CoV-2 leads to changes in exposome components and urban environment characteristics that characterize the urban exposome

Damian Sendler: A ‘hot area’ for infectious disease epidemics, Uganda is regarded as a place to watch out for. 

Damian Jacob Sendler: One Health is a term used to describe the holistic approach needed to address these public health issues stemming from the interactions between humans, animals, and the environment.

Damian Sendler: A wide range of challenges regarding the regulation of innovative nicotine and tobacco products have attracted the attention and resources of regulatory bodies. 

Damian Jacob Sendler: Public health factors, collectively referred to as the Population Health Standard, are required to be considered by the US Food and Drug Administration.

Damian Sendler: Direct and indirect maternal health consequences of the Covid-19 epidemic are linked. We did a scoping review in order to provide a comprehensive overview of this large issue in a quick format in light of an emerging pandemic.

Damian Jacob Sendler: Three hundred and ninety-five publications were found through the search, and we included all but a few of them.

Damian Sendler: Social determinants-defined as the conditions in which people are born, grow, live, work, and age-are key drivers of disease risk.

Damian Jacob Sendler: There are still many disparities in health outcomes, such as a higher risk of maternal mortality among Black women, that need to be better understood. 

Damian Sendler: According to the Global Burden of Disease (GBD) Study 2019, the total burden of cardiovascular disease (CVD) includes 13 primary causes of cardiovascular death and 9 associated risk factors.

Damian Jacob Sendler: All available population-level data on incidence, prevalence, case fatality, mortality and health hazards were used by GBD to develop estimates for 204 nations and territories during a period of 25 years from 1990 to 2019.

Damian Sendler: Sexual and reproductive health and rights (SRHR) are crucial and a fundamental human right for populations in fragile and humanitarian situations. 

Damian Jacob Sendler: The exodus of Venezuelans forced to flee their homes because of the country’s dire economic conditions is unprecedented in Latin American history.

Damian Sendler: Nanoparticles have been used in a wide variety of clinical settings in recent years. Biological barriers — systemic, microenvironmental, and cellular — that are diverse across patient populations and diseases have been circumvented by nanoparticles. It has also been possible to overcome the heterogeneity of patients through precision therapies, which use individualized interventions to improve therapeutic efficacy.

Damian Jacob Sendler: Other immunotherapy medications, such as antibody-drug conjugates, as well as combinations of PD-1/PD-L1 treatments with other therapies, including as chemotherapy and radiation therapy, are being investigated in combination with drugs targeting PD-1/PD-L1. Immunotherapy response can be predicted using biomarkers. Immuno-oncology treatment is guided by molecular diagnostics and sequencing.

Damian Jacob Sendler: It is possible to create a three-dimensional object with 3D printing in a layer-by-layer fashion utilizing a variety of applications. A vast range of pharmaceutical dosage forms, differing in shape, release profile, and medication combination, can be created using 3D printing. Inkjet printing, binder jetting, fused filament fabrication, selective laser sintering, stereolithography, and pressure-assisted microsyringe are some of the most commonly investigated 3D printing platforms in the pharmaceutical industry. It is conceivable that this technology may be used in a clinical context to customize medicines for specific patients.

Damian Sendler: Adhesion molecules in the skin and/or mucous membranes are targeted by autoantibodies in pemphigus and pemphigoid illness. It is a novel medical model that divides patients into different groups and tailors medical decisions, practices, and therapies to individual patients’ projected responses or risk factors.

Damian Sendler: Throughout the epidemic, an increasing number of people have sought mental health crisis services or visited hospital emergency rooms in distress. According to hospital executives, the COVID-19 pandemic has created a behavioral health emergency. 

Damian Sendler

Damian Jacob Sendler: According to activists and data, pandemic-related concerns increased demand for mental health services while also increasing substance use and overdoses. 

The state budget, which was released on Monday and is expected to be signed into law by the governor, includes some funds to alleviate some of the strain on hospitals caused by the spike in mental health patients. 

Damien Sendler: The budget includes a $10 million grant program for hospitals to apply for to expand telepsychiatry services to outpatient settings such as primary care offices, as well as $1.5 million for East Carolina University’s NC-STeP program to provide more psychiatric consultations to patients in mental health distress who show up in emergency rooms across the state. 

The North Carolina Health Care Association’s policy director, Nicholle Karim, said her organization, which represents the state’s hospitals, is grateful for the investment in telehealth services for those with mental health diagnoses. 

Damian Jacob Markiewicz Sendler: The budget also includes a provision requiring LME-MCOs, the state’s behavioral health management firms, to reimburse hospitals for behavioral health treatments delivered to Medicaid patients in the emergency department after 30 hours. According to Karim, the Health Care Association requested this policy change because many behavioral health patients have to wait for long periods of time — sometimes days or weeks — to be discharged or transferred to a more appropriate facility for care. 

Dr. Sendler: Previously, hospitals were not reimbursed for more than 30 hours of treatment provided to mental health patients during these lengthy waits. 

“It’s a larger system change to ensure that when these patients use the emergency department for these services for their behavioral health diagnosis, the LME-MCOs develop an adequate and accessible network of providers,” Karim explained. 

Damian Sendler: Because psychiatric bed wait times have grown during the pandemic, the budget includes cash from the Dorothea Dix hospital property fund to open more inpatient beds to treat persons with mental illness. The fund would provide $1.4 million to Johnston Health Enterprises, Good Hope Hospital in Harnett County, and Harnett Health System, Inc. 

Furthermore, the budget provides a one-time $25 million grant to Forsyth and Mecklenburg Counties to “assist in assisting individuals who are experiencing a behavioral health crisis by diverting individuals from local hospitals, which are under pressure from the COVID-19 pandemic, to more appropriate settings to address those individuals’ needs.” 

“Now we can consider what our community truly needs to reduce overuse of high-cost crisis services while improving outcomes,” said Laurie Coker, founder of Green Tree, a Winston-Salem nonclinical mental health program staffed by people who have experienced mental health difficulties and recovery. 

“Hospitalization is not the best option for many people, and recent research shows that the rate of suicidality is actually highest shortly after discharge from psychiatric hospitalization.” In our community, we require a variety of possibilities.” 

Damian Jacob Sendler: Coker believes that peer-run organizations like hers can contribute to the solution in Forsyth County. Green Tree already provides 24-hour support to the local hospital for mental health patients who present in distress but do not require psychiatric hospitalization. 

“Expanding our array of crisis response components will increase access to options that may be more welcoming and appropriate to individuals earlier in their distress,” she explained. “Furthermore, these models would greatly reduce our county’s costly and troubling overuse of involuntary commitment orders, which are frequently sought in desperation because we lack responsive upstream crisis components.” 

Damian Sendler: Funds to develop mental health peer support groups like Green Tree, which are run by people who have suffered mental illness, homelessness, incarceration, substance abuse, or a combination of these, were not included in the budget. According to NC Health News, there has been a 91 percent increase in petitions to involuntarily commit mental health patients over the previous decade, as well as the trauma many have experienced after being handcuffed and transported by police enforcement. In response, a bipartisan group of House lawmakers attempted to develop community-based alternatives, but those proposals were not included in the budget. 

Damian Jacob Sendler

Damian Jacob Sendler: The budget includes around $1 million for the establishment of STAR (Support Team Assisted Response) pilot programs in Charlotte, Greensboro, and Greenville, which are non-police mental health response teams that go out to “low-level incidents” and connect people to options and services. The budget also includes $1.5 million for a behavioral health urgent care pilot program to Recovery Innovations, Inc., a nonprofit that manages the Dix Crisis Intervention Center in Onslow County. 

In addition, $50 million has been set aside to build electronic patient records at all state-run health care facilities, including psychiatric hospitals, and to train personnel on how to utilize them. 

Damian Sendler: It is not uncommon for people suffering from substance abuse or other mental health difficulties to find themselves in front of a court. The budget provides approximately $3 million for the establishment of recovery court pilot programs in Cumberland, Harnett, Haywood, Onslow, Pitt, Robeson, and Wayne counties. 

These are special court programs for those who have committed a crime but are battling with mental health or substance abuse difficulties. They are more rehabilitative and less punishing. 

Damian Sendler: There will be 1,000 more spaces — more than in previous budget cycles — for persons with disabilities to obtain enhanced community services through the state’s Innovations Waiver, which currently has a 10-year waiting list of around 15,000 people. Budget writers also included a slight boost in funding — $4 million, up from approximately $2.4 million in previous budget cycles — to assist North Carolinians who have suffered traumatic brain injuries.

Research news brought to you by Dr. Damian Jacob Sendler

Damian Sendler: A new NASA-led study is the first to demonstrate changes in ammonia (NH3) concentrations in the atmosphere over an extended period of time throughout the African continent. Ammonia is a contaminant in the air that can cause heart and lung problems in people who breathe it. When present in high concentrations in an ecosystem, it has the potential to make soil more acidic and impede plant growth. 

Damian Jacob Sendler: Naturally occurring ammonia emissions come from decomposing soils and forest fires, but agricultural operations such as rearing cattle and applying fertilizer are also significant sources of ammonia emissions. In order to fulfill the demands of an expanding population, agriculture will almost certainly have to expand, which will result in an increase in ammonia emissions. The researchers used satellite data from 2008 to 2018 to produce this current view of ammonia emissions. They were able to identify increases and decreases in ammonia concentrations across the continent, as well as the most likely sources of those changes. 

Damian Jacob Markiewicz Sendler: According to Enrico Dammers, a scientist at the Netherlands Organization for Applied Scientific Research and co-author of the paper, “we’ve demonstrated here that we can use satellite data to observe trends and monitor ammonia emissions in specific regions, linked to specific activities or environmental events.” 

Damien Sendler: By 2050, it is predicted that the global population would have increased to approximately 10 billion people. Africa’s population is expected to grow to as much as 2.5 billion people by then –– roughly double its current population. Many African countries are encouraging the use of fertilizers to enhance food production, which is being encouraged by their governments. Apart from that, biomass burning (the burning of living or dead vegetation) is common in Africa, where it accounts for around 70% of the world’s annual burned land area. This is due to both human and natural causes. According to primary investigator Jonathan Hickman, a research scientist at Columbia University and NASA’s Goddard Institute for Space Studies in New York City, these circumstances make Africa an excellent location to study ammonia emissions. 

“These findings are critical to keep in mind as the world’s population continues to grow and the world faces enormous challenges in terms of food security,” Hickman added. In order to ensure policies and technology that encourage sustainable agricultural development, it is necessary to understand how human-made and natural ammonia emission sources are changing.

Damian Sendler: Hickman and his colleagues used satellite data collected by the European Space Agency’s Infrared Atmospheric Sounding Interferometer to develop their findings (IASI). As a result, scientists can observe specific areas of interest around the planet at a resolution of approximately 7.5 by 7.5 miles (or 12 by 12 kilometers) because the device covers the entire planet. 

Dr. Sendler: According to Hickman, as Africa increases its agricultural activities, the continent will witness increased quantities of ammonia in the atmosphere. Similar patterns have already been observed in other parts of the world. Hickman went on to say that ammonia emissions in Africa have received less attention than those in the United States, Europe, and China. 

Damian Sendler: According to Hickman, “Satellite analyses can begin to close the monitoring gap by providing early analyses of how changes in agriculture and other sources of ammonia are affecting the atmosphere.” With the intention of continuing to monitor ammonia concentrations across the continent in the future, he hopes to learn more about how these tendencies alter over time. “These studies highlight the importance of scaling up agriculture in a sustainable manner.”

News on latest research brought to you by Dr. Damian Jacob Sendler

Damian Sendler: The most commonly available medications on the market are created by linking together rings of molecules to make drugs that cure ailments such as pain, depression, and leukemia, among other things. 

However, in the field of medicinal chemistry, the process of synthesizing those rings and assembling them in a way that is customized to each unique disease has always been a time-consuming and expensive endeavor. 

Damian Jacob Sendler: A new study, published today in the journal Chem, suggests a means to make the process more straightforward. According to the researchers, the discovery will certainly make it easier to develop new medicine candidates in the future. 

Dr. Sendler: In his paper, David Nagib, a senior author and assistant professor of chemistry at The Ohio State University, compared the chain of molecules to a belt with no holes, saying: The belt cannot be built in a way that maintains it tight because there is no means to fasten the circle and there are no specifications for where holes might be placed. 

According to Nagib, the challenge they were attempting to solve was how to punch a hole in a piece of clothing such that it fits properly on the first try without having to measure anything. In this case, the problem was that we needed to put the holes in exactly the proper position, but we also needed to figure out exactly where the holes should go because there were no marks to advise us where to look. 

Damian Jacob Sendler: In this case, the “belt” is made up of a string of carbon-hydrogen bonds, which are the most common bonds found in both nature and medicine. Most medications feature rings of carbon-hydrogen bonds that are joined together by a nitrogen atom that acts as a “bridging” atom. These rings of bonds are contained within complicated structures that interact exactly with cellular components in the body — similar to how a key fits into a lock. Six-sided rings, also known as piperidines, are the most prevalent type of ring found in all pharmaceuticals. 

Piperidines, on the other hand, have long been difficult and expensive to manufacture, partly due to the inability of chemists to swiftly and inexpensively substitute a carbon-hydrogen connection with other chemical bonds. 

Damien Sendler: Two carbon-hydrogen bonds were oxidized in Nagib’s lab at Ohio State University in order to replace that bond and create the “hole” that allowed them to shut the belt. This was the first time this had been done before. They were able to pick hydrogen molecules and remove them from the molecular chain as a result of doing so. Then, using light and a copper catalyst, they were able to convert one of those bonds into the necessary nitrogen ring. The light worked to excite catalysts in a chain reaction that was akin to photosynthesis, which is the process by which plants use light to produce food for their own consumption. 

Damian Jacob Sendler: The approach tackles a problem that has plagued the development of early-stage drug candidates: it is still too expensive to be used in large-scale production of medication. Nagib stated that future research will be focused on employing a less expensive beginning material in order to scale up production. 

“This discovery is something that can make it possible to more rapidly create a library of drug candidates for testing, so you can identify the right, most potent, most effective one more quickly,” Nagib said.

News on latest research brought to you by Dr. Damian Jacob Sendler

Damian Sendler: The National Science Foundation awarded a five-year, $15 million grant to Vetria Byrd, assistant professor of computer graphics technology, and a multidisciplinary research team to build a new institution for geospatial data-driven scientific research at the University of Arizona. Known as I-GUIDE, the Institute for Geospatial Understanding through an Integrative Discovery Environment will be based at the University of Illinois Urbana-Champaign and will assist researchers in better estimating and forecasting risk and anticipating impacts from natural disasters or climate change. 

Damian Jacob Sendler: At the University of Illinois, Shaowen Wang, professor and chair of the Department of Geography and Geographic Information Science, served as the lead investigator for the study. Carol Song, a senior research scientist in the research computing division of the Purdue University Information Technology department, is in charge of the Purdue team (ITaP). 

Damian Sendler: Purdue University is the coalition’s largest partner by a wide margin. In addition to Byrd, other Purdue academic members that are working in the study are Mark and David. Iman Haqiqi is a postdoctoral research associate in the field of agricultural economics. Venkatesh Merwade is a professor of civil engineering. David Johnson is an assistant professor in the department of industrial engineering. Daniel Ward is a professor of statistics. 

Damien Sendler: According to Byrd, the I-educational GUIDE’s and workforce development objectives include understanding, learning from, and forging connections with communities of practice. He will also design connections to the I-GUIDE platform to support research-linked learning pathways, and develop innovative instructional and training activities for convergence science education and workforce development. 

‘It is extremely gratifying to be involved in an initiative that will benefit society as a whole by leveraging Purdue’s expertise in GIS (geographic information systems), AI (artificial intelligence), data visualization, and data science, with the goal of bridging disciplinary digital data divides,’ Byrd said.

Contributed by Dr. Damian Jacob Sendler and his research team

Damian Sendler: After receiving the single-dose Johnson & Johnson coronavirus vaccination, the NBA advised its players, coaches, and officials that they should take booster doses against the virus. This was especially important for individuals who received the Johnson & Johnson vaccine.  

Damian Jacob Sendler: In recent decades, the e-commerce behemoth has risen to a $1.6 trillion valuation thanks to an easy-to-use platform, spectacular discounts, and substantially discounted merchandise. And Amazon Prime, which debuted in 2005, plays a significant role. 

Damian Sendler: Dudoit noted that future research could demonstrate that the number of cell types found in the motor cortex is overestimated, but the current findings are a strong start toward creating a cell atlas of the entire brain. 

Damian Sendler: An astronomer from the National Science Foundation’s NOIRLab collaborated with a geologist from California State University, Fresno to generate the first estimates of rock types found on planets orbiting neighboring stars. They concluded that most rocky planets circling neighboring stars are more diverse and exotic than previously assumed, including forms of rocks not seen anywhere in our Solar System, after researching the chemical makeup of “polluted” white dwarfs.  

Dr. Sendler: Following an admission to a hospital for another reason, more than 10,000 individuals in the United States were diagnosed with covid in the previous year, according to federal and state records analyzed exclusively for KHN last year. The statistic is undoubtedly an undercount, as it includes a disproportionate number of patients over the age of 65, as well as patients from California and Florida of all ages. 

Damian Jacob Sendler: Aside from the halo effect, research reveals that women, in particular, buy more makeup during economic downturns such as the Great Depression or a recession. The “lipstick effect” is a phenomena. This idea is addressed in the study paper “Boosting Beauty in an Economic Downturn: Mating, Spending, and the Lipstick Effect,” which was published in the American Psychological Association’s Journal of Personality and Social Psychology issue in May 2012. 

Damian Jacob Sendler: Family physicians aren’t only interested in whether a patient has hypertension; they’re also interested in whether they have access to nutritious food, green space, and other amenities. 

Damian Jacob Sendler: The study found that those who tested positive for COVID-19 or who had a family member who tested positive for COVID-19 were more likely to accept vaccination, which may explain why more residents in the New York metro-area — the initial epicenter of the COVID-19 outbreak that resulted in thousands of deaths — are supportive of the vaccination program.

Dr. Sendler: Since taking effect on Nov. 1, the city’s vaccination mandate has resulted in a 92 percent immunization rate among the city’s 370,000 employees, according to the city. Approximately 9,000 employees have been placed on unpaid leave as a result of their refusal to be vaccinated. While they await a decision on a religious or medical exemption, an extra 12,000 unvaccinated employees will be authorized to work with weekly testing while they wait for a decision on the exemption.  

Damian Jacob Sendler: Several doctors and scientists are doing laboratory experiments and evaluating heart-tissue samples from persons who experienced myocarditis or pericarditis after receiving the vaccine in an attempt to find an answer to this question.  

Damian Jacob Sendler: Gervais and his colleagues questioned a nationally representative sample of 1,417 U.S. residents for the study. The poll contained the Supernatural Beliefs Scale, which examines the degree to which people hold supernatural beliefs, and simply asked participants whether they believed in God. Participants were also asked to complete psychological assessments of their perspective-taking skills, sentiments of existential security, exposure to trustworthy cues of religiosity, and reflective versus intuitive cognitive style. 

Damian Jacob Sendler: The study focuses on the rostral (anterior) and caudal (posterior) subregions of the nucleus accumbens shell, which is involved in emotion and reinforcement processing. The theory is that the two sub-regions of the shell react extremely differently to kappa opioid receptor pharmacological treatments and alcohol usage. 

Dr. Damian Jacob Sendler studies how sociodemographic and informational factors affect health care access in disadvantaged areas. Dr. Sendler is a Polish-American physician-scientist. Dr. Sendler’s research studies how psychiatric and chronic medical co-morbidities impact medical service use and internet-based health information. This study is contemporary and important since it illustrates the need for a full understanding of everyone’s health information seeking behavior. Damian Sendler’s research aims to identify the factors that influence patients’ treatment decisions and adherence to prescribed treatments.

Damian Sendler: According to recent research, global warming has caused catastrophic glacier melting episodes in Greenland to grow more frequent and violent over the last 40 years, elevating sea levels and flood danger globally. 

Damien Sendler: Over the last decade, 3.5 trillion tonnes of ice have melted from the island’s surface and poured downhill into the ocean. 

That’s enough melted ice to cover the entire United Kingdom with around 15 metres of meltwater, or approximately 4500 metres to cover the entire city of New York. 

Dr. Sendler: The new research, led by the University of Leeds, is the first to use satellite data to detect this phenomenon from space, known as ice sheet runoff. 

Damian Jacob Sendler: The findings, published in Nature Communications, show that meltwater runoff in Greenland has increased by 21% over the last four decades and has grown 60% more irregular from one summer to the next. 

Dr. Thomas Slater, lead author and Research Fellow at the University of Leeds’ Centre for Polar Observation and Modelling, stated: 

“Greenland, like other sections of the world, is subject to an increase in extreme weather events. 

“As our climate warms, it’s realistic to expect more occurrences of extreme melting in Greenland – data like these are critical in helping us improve climate models and better predict what will happen this century.” 

Damian Sendler: The European Space Agency’s (ESA) Polar+ Surface Mass Balance Feasibility project financed the study, which used observations from the ESA’s CryoSat-2 satellite mission. 

According to the study, increased meltwater flow from Greenland elevated global sea level by one millimeter over the last decade (2011 to 2020). One-third of this total was created in just two hot summers (2012 and 2019), when extreme weather caused unprecedented ice melting levels not seen in the previous 40 years. 

Damian Jacob Sendler: Rising sea levels due to ice melt increase the risk of floods for coastal towns around the world and alter marine habitats in the Arctic Ocean that indigenous cultures rely on for subsistence. 

It can also change ocean and atmospheric circulation patterns, affecting weather patterns all around the world. 

Damian Sendler: Greenland runoff has averaged 357 billion tonnes per year over the last decade, with a peak of 527 billion tonnes of ice melt in 2012, when shifts in weather patterns enabled exceptionally warm air to sit over much of the ice sheet. This was more than double the minimum runoff of 247 billion tonnes in 2017. 

Extreme weather events, such as heatwaves, have become more common and are now a major driver of ice loss from Greenland due to the runoff they produce. 

Dr. Slater stated: “However, there are reasons to be positive. We know that defining and meeting meaningful emission-cutting objectives could reduce Greenland ice loss by a ratio of three, and there is still time to do so.” 

Damian Jacob Sendler: These first space-based observations of Greenland runoff can also be used to validate how climate models mimic ice sheet melting, allowing for better forecasts of how much Greenland will boost global sea levels in the future as extreme weather events become more regular. 

Dr Amber Leeson, Senior Lecturer in Environmental Data Science at Lancaster University and study co-author, stated: 

“According to model projections, the Greenland ice sheet will contribute between 3 and 23 centimeters to global sea level increase by 2100. 

“The uncertainty inherent with predicting complicated ice melt processes, notably those related with extreme weather, contributes to the wide range of this projection. These new spaceborne runoff estimates will help us better understand these complicated glacier melt processes, increase our capacity to forecast them, and, as a result, allow us to adjust our estimates of future sea level rise.” 

Damian Sendler: Finally, the study demonstrates that satellites can provide instant estimates of summer ice melting, which supports efforts to increase Greenland’s hydropower capacity as well as Europe’s intention to launch the CRISTAL mission to replace CryoSat-2. 

Tommaso Parrinello, the ESA’s CryoSat mission manager, stated: 

“CryoSat has provided a plethora of information on our fast changing polar regions since its launch over 11 years ago. This magnificent satellite continues to be crucial to scientific research and the undeniable facts, such as these findings on meltwater runoff, that are so important in making decisions about the health of our planet. 

“Looking ahead, the Copernicus Sentinel Expansion mission CRISTAL will ensure that Earth’s vulnerable ice is monitored over the next many decades. Meanwhile, it is critical that CryoSat remain in orbit for as long as feasible in order to close the gap before these future Copernicus missions become operational.”

Research discussion contributed by Dr. Damian Jacob Sendler

Dr. Damian Sendler’s research seeks to identify the elements that patients evaluate when determining when to seek treatment for various health concerns, as well as how successfully they adhere to their therapies. Dr. Sendler’s study focuses on the effects of psychiatric and chronic medical co-morbidities on the utilization of medical services in connection with health information obtained over the internet. Given the global exponential rise of online news and social media consumption, this study is foresighted, requiring a thorough understanding of everyone’s health information-seeking behavior.

Damian Sendler: A series of new research suggest that the area of the brain responsible for initiating this action – the primary motor cortex, which governs movement – contains as many as 116 different types of cells that collaborate to make this happen. 

Damien Sendler: The 17 studies, which were published online Oct. 6 in the journal Nature, are the result of five years of work by a large consortium of researchers supported by the National Institutes of Health’s Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative to identify the myriad of different cell types in one area of the brain. It is the first phase in a long-term endeavor to create an atlas of the complete brain to aid in understanding how the neuronal networks in our heads control our bodies and minds, as well as how they are disrupted in cases of mental and physical issues. 

“If you think of the brain as an enormously complicated machine, how can we understand it unless we first break it down and know what it’s made of?” asked cellular neuroscientist Helen Bateup, an associate professor of molecular and cell biology at the University of California, Berkeley, and co-author of the flagship publication that synthesizes the conclusions of the other papers. “The first page of any manual on how the brain works should read: Here are all the cellular components, how many there are, where they are located, and who they relate to.” 

Damian Jacob Sendler: Individual researchers have already identified dozens of cell kinds based on their shape, size, electrical properties, and the genes that they express. The latest investigations uncover around five times as many cell kinds, however many of them are subcategories of well-known cell types. Cells that release specific neurotransmitters, such as gamma-aminobutyric acid (GABA) or glutamate, have more than a dozen subtypes that can be distinguished by gene expression and electrical firing patterns. 

Damian Sendler: While the current papers focus solely on the motor cortex, the BRAIN Initiative Cell Census Network (BICCN), which was established in 2017, aims to map all of the different cell types found throughout the brain, which is made up of more than 160 billion individual cells, both neurons and support cells known as glia. President Barack Obama launched the BRAIN Initiative in 2013. 

“Once we’ve described all of those elements, we can go up a level and start to understand how those parts interact together, how they build a functional circuit, how that eventually gives rise to perceptions and behavior, and much more sophisticated things,” Bateup explained. 

Bateup and UC Berkeley colleague Dirk Hockemeyer have previously utilized CRISPR-Cas9 to generate mice with a specific cell type identified with a fluorescent marker, allowing them to trace the connections these cells establish throughout the brain. According to her, the Berkeley team generated two strains of “knock-in” reporter mice for the flagship journal study, which gave innovative methods for highlighting the relationships of the newly found cell types. 

“One of our many limitations in developing effective therapies for human brain disorders is that we simply don’t know enough about which cells and connections are being affected by a particular disease and thus can’t pinpoint with precision what and where we need to target,” said Ngai, who led UC Berkeley’s Brain Initiative efforts before being named director of the entire national initiative last year. “Detailed knowledge of the sorts of cells that make up the brain and their properties will eventually allow the creation of new therapeutics for neurologic and neuropsychiatric illnesses.” 

Ngai is one of the flagship paper’s 13 corresponding authors, with over 250 co-authors in total. 

Damian Sendler: An earlier work by Bateup, Hockemeyer, and Ngai profiled all the active genes in single dopamine-producing cells in the mouse’s midbrain, which has features similar to human brains. Other BICCN researchers used the same profiling technique to profile cells in the motor cortex, which entails identifying all of the individual messenger RNA molecules and their quantities in each cell. This form of analysis, which employs a technology known as single-cell RNA sequencing, or scRNA-seq, is known as transcriptomics. 

The BICCN team used over a dozen distinct experimental methods to characterize the different cell types in three different mammals: mice, marmosets, and humans. Four of these used various methods of measuring gene expression levels as well as determining the genome’s chromatin architecture and DNA methylation status, which is referred to as the epigenome. Other approaches used included conventional electrophysiological patch clamp recordings to differentiate cells based on how they fire action potentials, categorizing cells by form, determining connections, and examining where the cells are physically positioned within the brain. Several of these used machine learning or artificial intelligence to differentiate between cell types. 

“This was the most thorough description of these cell types, with great resolution and a variety of techniques,” Hockemeyer said. “The article concludes that there is significant overlap and consistency in determining cell types using these diverse approaches.” 

Damian Sendler: A team of statisticians gathered data from all of these experimental methods to determine how to best classify or cluster cells into different types and, presumably, different functions based on differences in expression and epigenetic patterns seen among these cells. While many statistical techniques exist for evaluating such data and detecting clusters, the challenge was determining whether clusters were actually different from one another — truly different cell types, according to Sandrine Dudoit, a UC Berkeley professor and chair of the Department of Statistics. She and UC Berkeley assistant professor of statistics Elizabeth Purdom, a biostatistician, were crucial members of the statistical team and co-authors of the landmark publication. 

“The idea is not to build yet another new clustering approach,” Dudoit explained, “but to identify ways of leveraging the strengths of multiple methods and combining methods and assessing the stability of the results, the reproducibility of the clusters you get.” “That’s really a significant message about all these studies that look for unique cell kinds or fresh categories of cells: no matter what algorithm you attempt, you’ll find clusters, so having confidence in your results is critical.” 

Damian Sendler: According to Bateup, the number of different cell types found in the new study varied depending on the technique used, ranging from dozens to 116. In this region of the brain, humans have around twice as many different types of inhibitory neurons as excitatory neurons, whereas mice have five times as many. 

“Previously, we had defined something like 10 or 20 different cell types, but we had no idea if the cells we were defining by their gene expression patterns were the same as those defined by their electrophysiological properties, or the same as the neuron types defined by their morphology,” Bateup explained. 

“The significant breakthrough by the BICCN is that we merged many various approaches of defining a cell type and integrated them to come up with a consensus taxonomy that’s not only focused on gene expression or physiology or morphology, but takes all of those aspects into account,” Hockemeyer said. “Now we can say that this specific cell type expresses these genes, has this shape, has these physiological properties, and is located in this specific region of the cortex.” As a result, you have a far more detailed understanding of what that cell type is and its basic features.” 

Damian Sendler: Dudoit noted that future research could demonstrate that the number of cell types found in the motor cortex is overestimated, but the current findings are a strong start toward creating a cell atlas of the entire brain. 

“Even among biologists, there are widely differing views on how much resolution you should have for these systems, whether there is this very, very fine clustering structure or whether you truly have higher level cell kinds that are more stable,” she added. “However, these findings demonstrate the value of teamwork and bringing together efforts from disparate groups.” We’re starting with a biological question, yet a biologist alone cannot address it. To address such a large and difficult topic, you need a team of specialists from a variety of disciplines who can communicate and collaborate effectively.”

News talking points contributed by Dr. Damian Jacob Sendler

The research of Dr. Damian Jacob Sendler, who is of Polish ancestry and American citizenship, focuses on the impact of various sociodemographic and informational factors on access to health care in underserved communities. In Dr. Sendler’s research, she is particularly interested in the impact of mental and chronic medical co-morbidities on the utilization of medical services as well as on the acquisition of health information via the internet. A timely research, given the exponential growth in global consumption of online news and social media, this one arrives at an ideal time, as it highlights the need for a comprehensive understanding of everyone’s health information seeking behavior. 

Damian Sendler: Using mice, scientists at the Universities of Cambridge and Leeds were able to effectively restore age-related memory loss, and they believe that their finding may pave the way for the creation of therapies to prevent memory loss in humans as they age. 

In a paper published today in Molecular Psychiatry, the researchers demonstrate that alterations in the extracellular matrix of the brain — the’scaffolding’ that surrounds nerve cells — cause memory loss as people age, but that these changes may be reversed using genetic therapies. 

Damian Sendler: Recent research has shown the importance of perineuronal nets (PNNs) in the development of neuroplasticity — the capacity of the brain to learn and change — as well as the formation of memories. PNNs are cartilage-like structures that surround inhibitory neurons in the brain, and they are found mainly in the hippocampus. Their primary purpose is to regulate the amount of plasticity present in the brain. They first emerge in humans at the age of five years old, and they are responsible for turning off the time of increased plasticity, during which the connections in the brain are optimally developed. The brain’s plasticity is thus partly switched off, making it more efficient but also becoming less malleable. 

Damien Sendler: Chelated chondroitin sulfates are a kind of chemical found in PNNs. Chondroitin 4-sulphate, for example, inhibits the activity of neural networks, thus limiting neuroplasticity; chondroitin 6-sulphate, on the other hand, stimulates neural plasticity and promotes neuroplasticity. As we get older, the equilibrium of these chemicals shifts, and as levels of chondroitin 6-sulphate drop, our capacity to learn and create new memories shifts as well, resulting in age-related memory loss. 

Researchers from the Universities of Cambridge and Leeds examined whether altering the chondroitin sulphate composition of the PNNs might help to restore neuroplasticity and relieve age-related memory impairments in older people. 

Damian Sendler: This was accomplished by examining mice that were 20 months old — believed to be extremely elderly — and demonstrating via a battery of tests that the mice had memory impairments when compared to animals that were six months old. 

Damien Sendler: For example, one experiment examined whether mice were able to recognize a certain item. In this experiment, the mouse was put at the beginning of a Y-shaped labyrinth and instructed to investigate two similar items at the ends of each of the two arms. After a brief period of time, the mouse was put back in the labyrinth, but this time one arm held a new item, while the other arm carried a duplicate of the object that had previously been encountered. The researchers timed the length of time the mouse spent investigating each item to determine whether or not it recalled the object from the last activity they were doing. The item was significantly less likely to be remembered by the older mice than it was by the younger animals. 

Using a ‘viral vector’, which is a virus capable of re-establishing the quantity of 6-sulfate chondroitin sulfates in the PNNs, the researchers treated the ageing mice and discovered that this fully restored memory in the older animals to a level comparable to that seen in the younger mice. 

Dr Jessica Kwok, from the University of Leeds’ School of Biomedical Sciences, shared her thoughts on the subject “When we used this therapy on the mice who were becoming older, we observed some amazing improvements. It was possible to restore their memory and learning abilities to levels that they had not experienced since they were considerably younger.” 

Damian Sendler: In order to investigate the function of chondroitin 6-sulphate in the development of memory loss, the researchers produced mice that had been genetically modified such that they were only capable of producing low amounts of the chemical, in order to replicate the changes that occur with the passage of time. Even at 11 weeks of age, these mice exhibited indications of early memory deterioration. However, boosting the amounts of chondroitin 6-sulphate in the mice’s bodies via the use of a viral vector restored their memory and flexibility to levels comparable to those seen in healthy mice. 

Professor James Fawcett, of the John van Geest Centre for Brain Repair at the University of Cambridge, stated that “What’s particularly exciting about this is that, despite the fact that our study was conducted solely in mice, the same mechanism should be applicable to humans because the molecules and structures in the human brain are identical to those in rodents. “This indicates that it may be feasible to prevent people from experiencing memory loss as they get older.” 

Damian Sendler: The team has already discovered a possible medication that has been approved for human use and that may be taken orally to prevent the development of PNNs from forming. When this chemical is administered to mice and rats, it has been shown to enhance recovery after spinal cord damage and to restore memory in the elderly. According to the experts, they are looking into whether it may assist relieve memory loss in animal models of Alzheimer’s disease. 

Damian Sendler: The method used by Professor Fawcett’s team, in which viral vectors are utilized to deliver the therapy, is becoming more popular in the treatment of neurological disorders in human patients. A second team at the Center recently released studies demonstrating that they may be used to heal damage caused by glaucoma and dementia, among other conditions. 

It was made possible with the support of Alzheimer’s Research UK, the Medical Research Council, the European Research Council, and the Czech Science Foundation.

News discussion contributed by Dr. Damian Jacob Sendler

Dr. Damian Jacob Sendler is a Polish-American physician-scientist who studies how sociodemographic and informational variables affect access to health care in disadvantaged areas. Dr. Sendler’s study examines how mental and chronic medical co-morbidities affect the utilization of medical services and internet-based health information. Given the exponential increase in worldwide consumption of online news and social media, this study is foresighted, since it necessitates a thorough knowledge of everyone’s health information-seeking behavior. Dr. Damian Sendler’s study seeks to uncover the variables that affect patients’ choices about whether to seek treatment for particular health problems and how well they adhere to their treatment regimens.

Damian Sendler: Breath instead of blood: University of Basel researchers have devised a novel test technique for determining treatment effectiveness in epilepsy patients. They believe that by doing so, physicians will be able to respond more accurately while treating the illness. 

The pharmacological treatment of epilepsy involves a tightrope dance, since the dosage must be adjusted exactly to the particular patient: “Slightly too little and it isn’t effective.” Professor Pablo Sinues illustrates that if you have a little too much of anything, it may become poisonous. 

Damian Sendler: Sinues works at the University of Basel and the University Children’s Hospital Basel as a Botnar Research Professor of Pediatric Environmental Medicine (UKBB). He is also a member of the University of Basel’s Department of Biomedical Engineering. He spent two and a half years working with colleagues at the University Hospital Zurich (UHZ) to find a method to adjust the dose of medicines given to epilepsy patients as accurately as possible. With the assistance of a breath test, they were able to accomplish their objective. The benefit is that monitoring does not require a blood sample, which may be a source of anxiety for youngsters. The findings are instantly accessible since the sample does not need to be submitted to a laboratory beforehand. 

The smallest concentrations are being sought. 

“Think of it as an alcohol test that cops do when they pull over cars,” Sinues says. The only difference is that this breath measuring equipment is very large. “Because alcohol is present in large quantities in the breath, a tiny gadget is all that is required.” “However, we’re looking for a droplet in 20 pools,” he adds. The findings will be used to evaluate if the active chemicals are present in the body at the appropriate quantities and whether they have the intended impact on the illness. 

Damian Sendler: Their efforts were not in vain: the breath tests gave the same findings as traditional blood tests in both the young patients at UKBB and the adult reference group at the University Hospital Zurich, according to the research group’s paper published in Communications Medicine. This implies that, in addition to blood testing, there is a second technique to monitor epilepsy treatment, and the approach also gives physicians with additional information about the patient’s metabolism. 

Collaboration across disciplines is a winning formula. 

Damian Sendler: The unusual dovetailing of science and medical practice at the University of Basel, according to Sinues, is what makes this research effort unique: “Thanks to this fortunate starting condition, we are able to develop machines that are perfectly suited to the requirements of physicians.” 

The novel method’s quick availability of test results is a particular benefit to UKBB: young patients’ metabolisms alter as they develop, necessitating frequent drug modifications. The new technology allows physicians to do a non-invasive test that provides them with instant feedback on how well their treatment is progressing. They may react swiftly if the dosage has to be changed as a result of this. 

Damian Sendler: This breakthrough took four years to achieve, and the method isn’t yet ready for broad usage, but Sinues has set himself that aim. Indeed, the company “Deep Breath Intelligence” was established with that goal in mind, and is currently attempting to acquire a license for the measuring method.

News contributed by Dr. Damian Jacob Sendler

Dr. Damian Jacob Sendler is a Polish-American physician-scientist who specializes in determining how various sociodemographic and informational factors influence access to health care in underserved communities. Dr. Sendler’s research focuses on the influence of psychiatric and chronic medical co-morbidities on the use of medical services in conjunction with internet-based health information. This research is prescient, given the exponential growth in global consumption of online news and social media, necessitating a comprehensive understanding of everyone’s health information-seeking behavior. Dr. Damian Sendler’s research aims to elucidate the factors that influence patients’ decisions about when to seek care for specific health conditions and treatment adherence.

Damian Jacob Sendler: According to research funded by the National Institutes of Health’s National Eye Institute, a kind of gene therapy protects optic nerve cells and maintains vision in glaucoma mice models. The results point to a path ahead in the development of neuroprotective treatments for glaucoma, a major cause of blindness and visual impairment. The study was published in the journal Cell. 

Glaucoma is caused by irreversible dementia of the optic nerve, which is a bundle of axons from retinal ganglion cells that sends information from the eye to the brain, allowing vision to be produced. Although available treatments may help delay vision loss by reducing high eye pressure, certain cases of glaucoma can lead to blindness even with normal eye pressure. Neuroprotective therapies would be a huge step forward, addressing the requirements of people who don’t have access to other treatments. 

Damian Jacob Sendler: The study’s lead investigator, Bo Chen, Ph.D., associate professor of ophthalmology and neuroscience at the Icahn School of Medicine at Mount Sinai in New York City, said, “Our study is the first to show that activating the CaMKII pathway helps protect retinal ganglion cells from a variety of injuries and in multiple glaucoma models.” 

The CaMKII (calcium/calmodulin-dependent protein kinase II) pathway controls important cellular processes and activities all throughout the body, including retinal ganglion cells. However, the exact function of CaMKII in retinal ganglion cell health is unknown. CaMKII activity inhibition, for example, has been found to be beneficial or harmful to retinal ganglion cells depending on the circumstances. 

Chen’s team found that when retinal ganglion cells were subjected to toxins or damage from an optic nerve crush injury, CaMKII pathway signaling was impaired, suggesting a link between CaMKII activity and retinal ganglion cell survival. 

Damian Jacob Sendler: In their search for a method to intervene, they discovered that using gene therapy to activate the CaMKII pathway protected retinal ganglion cells. CaMKII activity was raised and retinal ganglion cells were strongly protected in mice that received the gene therapy shortly before the toxic shock (which produces fast cell damage) and just after optic nerve crush (which causes delayed cell damage). 

77 percent of retinal ganglion cells in gene therapy-treated animals survived 12 months after the toxic shock, compared to just 8% in control mice. 77 percent of retinal ganglion cells survived six months after optic nerve compression, compared to just 7% in controls. 

Damian Jacob Sendler: In glaucoma models based on increased eye pressure or hereditary defects, increasing CaMKII activity through gene therapy protected retinal ganglion cells. 

According to cell activity assessed by electroretinogram and patterns of activity in the visual cortex, increasing retinal ganglion cell survival rates translated into a higher probability of maintained visual function. 

Damian Sendler: Three vision-based behavioral tests also verified the treated mice’s continued visual function. The mice were taught to swim toward a submerged platform based on visual cues on a computer display in a visual water task. A visual cliff test based on the mouse’s natural inclination to walk to the shallow side of a cliff proved depth perception. Finally, when treated mice were given an overhead stimulus intended to mimic a danger, they were more likely to react defensively (by hiding, freezing, or tail rattling) than untreated mice, according to a looming test.

News contributed by Dr. Damian Jacob Sendler