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Friday, April 26, 2024
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A new study in people with acute respiratory distress syndrome (ARDS) has found a link between a low diversity of fungi in their lungs and their likelihood of developing severe disease.

New research has found that the inflammatory cascade associated with ARDS is linked to a low diversity of fungi in a person’s lungs.

The findings, which the scientists are due to present at the virtual European Respiratory Society International Congress, contribute to burgeoning research on the microbiome. They may also be valuable for better understanding some of the effects of COVID-19.

What is ARDS?

According to the American Lung Association, ARDS is a type of lung injury wherein fluid is able to build up in a person’s lungs, restricting the amount of oxygen they can receive into their blood.

As blood oxygen levels decrease, it can damage vital organs and force them to shut down. This is life threatening. COVID-19, the disease at the heart of the current global pandemic, has been a prominent recent cause of ARDS.

Although the methods of treating ARDS have been improving, interventions still primarily aim to support the person, such as through mechanical ventilation of their lungs.

However, in the new research, the scientists identified a link between the severity of ARDS and the diversity of fungi in the person’s lungs.

This finding may open the door to future interventions that can do more than simply support the person with ARDS.

Lung microbiome

The microbiome comprises all the genetic material within the microbiota. This is the ecosystem of trillions of microbial cells that exist on and within a person’s body. People often associate the microbiome with the gut, and a lot of research has explored the gut-brain axis.

This research connects the health and functioning of a person’s gut microbiome with the health and functioning of their brain, meaning that interventions in one may affect illnesses in the other.

Although the microbiome consists of both bacteria and fungi, bacteria have typically “stolen the show” in terms of research. However, when it comes to the microbiome in a person’s lungs, fungi may also be important.

As study co-author Noel Britton, a Ph.D. candidate at the University of Pittsburgh in Pennsylvania, points out, “In terms of numbers of cells, fungi are outnumbered by bacteria by several orders of magnitude.”

“Additionally, while it is now well-established that the lungs play host to a distinct and dynamic microbiome, they don’t represent a rich environment for microbes to thrive, and they generally have many fewer microbes than the gut — the body site where scientists have focused the most microbiome research.”

“It can be difficult to pick up a signal from such a low mass of fungi and to be sure that the sequences identified are not due to contamination in the laboratory,” she adds.

However, the difficulties associated with assessing the fungi within the microbiome of a person’s lungs could mean that scientists are missing some interesting relationships between the lungs’ fungal microbiome and lung conditions.

As Britton notes, “We wanted to carry out this research as [ARDS] is characterized by a hyperinflammatory overreaction of the immune system, and we know that fungi can be involved in activating and regulating the human immune system.”

“There are no known therapies for the successful treatment of ARDS, and very little is known about why some patients have a hyperinflammatory response. The diversity of the microbiome, and specifically of fungi, may play an important role in understanding why some patients develop ARDS and some do not.” – Noel Britton

Next-generation sequencing

Between 2011 and 2019, Britton and colleagues enlisted into their study 202 mechanically ventilated patients with and at risk of ARDS.

Of these patients, 21% received a diagnosis of ARDS. Around 61% of the patients were women, and the average age was 50 years.

To analyze the lung fungi, the researchers took mucus samples from the trachea, which leads directly to the lungs, within 48 hours of intubation. The team then analyzed the DNA of these samples using next-generation sequencing.

Fungi diversity linked to severity

The researchers found that the patients with ARDS had a lower diversity of fungi in their lungs than the patients without ARDS.

Furthermore, organ failure, shock, and sepsis were all associated with a lower diversity of lung fungi among the patients with ARDS.

In general, a lower diversity of lung fungi was linked to worse lung injury and a greater amount of the protein pentraxin-3, which is a sign of inflammation.

For Britton, “the association of lower fungal diversity with clinical markers of disease severity is an important finding because it provides evidence for a relationship between the lung microbiome and clinical outcomes in critical illness.”

“We will continue to investigate this further because there is much that is not understood about the development and treatment of ARDS, and this study may point us toward an important diagnostic or treatment-based discovery.” – Noel Britton

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Although the sun has been quite scorching and temperature low, especially in the evenings, making many people to be indoors so as to keep warm. To avoid coming down with health conditions such as cold associated with this type of weather, medical experts have advised that necessary precautions be taken.

Children are especially vulnerable, as they easily succumb to certain ailments brought about by the weather. So, parents have been advised to ensure their children are well cared for, to protect against common cold.

To avoid the discomfort instigated by these ailments, some of the recommended safety measures include eating healthy foods that contain lots of vitamins, going to bed early, as well as wearing appropriate and comfortable clothes.

Former President, Association of Resident Doctors at the Lagos State University Teaching Hospital, Dr. Olubunmi Omojowolo, said common cold could be diagnosed by certain symptoms.

He said: “If your doctor suspects you have a bacterial infection or other condition, he or she may order a chest x-ray or other tests to exclude other causes of the signs and symptoms. Commonly used cold remedies include pain relievers.

“For a fever, sore throat and headache, many people turn to acetaminophen, tylenol, or other mild pain relievers. Acetaminophen should be used for the shortest time possible, and people should follow label directions to avoid side effects.

“It is important to use caution, when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin, which has been linked to Reye’s syndrome, a rare but potentially life-threatening condition in children.

“Consider giving your child over-the-counter (OTC) pain medications designed for infants or children. These include acetaminophen, children’s Tylenol, ibuprofen, children’s Advil and children’s Motrin, among others, to ease symptoms.

“Adults can use decongestant drops or sprays for up to five days, as prolonged use could cause rebound symptoms. Children younger than six years should not use decongestant drops or sprays.”

A Family Physician, Dr. Chukwuma Ogunbor, said the Food and Drug Administration (FDA) and the American Academy of Pediatrics strongly kick against giving OTC cough and cold medicines to children younger than four years, as they may be harmful.

He said: “There is no good evidence that these remedies are beneficial or safe for children. It is not typically recommended that you give cough or cold medicines to an older child, but if you do, follow the label directions. Do not give your child two medicines with the same active ingredient, such as an antihistamine, decongestant or pain reliever.

“Too much of a single ingredient could lead to an accidental overdose.

You may know that cold and flu season is here with us, but that does not make it easier, when you see your little one struggling with a cough and stuffy nose. Children under the age of five, and particularly under two years are, at high risk during cold and flu season.”

He explained that colds and flus are viral infections. And antibiotics won’t help to clear up infection. However, there are steps that can be taken to help children feel better, while their immune system battles the virus.

He said: “Keep your child hydrated to help reduce cold and flu symptoms, and make them feel better. Fever can result in dehydration. Your child may not feel as thirsty as, he or she normally would, and may be uncomfortable when drinking. So, it’s important to encourage him or her to drink plenty of fluids.

“Dehydration can be very serious in babies, especially if they’re under three months. Call your pediatrician, if you suspect your baby is dehydrated. Some signs may include no tears when crying, dry lips, soft spots that seem sunken in, decreased activity and urinating less than three to four times in 24 hours.

“Attempt to breastfeed infants more frequently than usual. Babies may be less interested in breastfeeding, if they’re sick. So, you may have to give several short feeding sessions for them to consume enough fluid.

“Ask the doctor if an oral rehydration solution like pedialyte is appropriate. Remember that you should not give little ones sports drinks. Older children have more hydration options, which may include sports drinks, popsicles, juice, broth and flat white soda.”

According to him, medicated nasal sprays are not recommended for young children. However, there are several easy ways to clear up a stuffy nose without medication.

“Use a cool mist humidifier in the child’s room,” he said. “This will help break up mucus. Be sure to carefully clean the humidifier between uses to keep mould from developing in the machine.

“Another option is using a saline nasal spray or drops, which make thin mucus easier to blow out or remove with a bulb syringe. This is especially helpful before feeding and bedtime.”

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In this Special Feature, we hack into some of the myths that surround sleep duration. Among other questions, we ask whether anyone can truly get by on 5 hours of sleep each night. We also uncover whether sleep deprivation can be fatal.

Although we all know sleep is vital to maintain good health, there are still many unanswered questions. And, over the millennia, a variety of myths and half-truths have developed and stuck.

This feature is the second and final part of our series that tackles sleep-related myths. Find the first part here.

This time, we focus on myths that surround how much sleep the average person needs. We also discuss naps, the effects of sleeping too little or too long, and sleep in the animal kingdom.

1. Everyone needs 8 hours

As with many aspects of human biology, there is no one-size-fits-all approach to sleep. Overall, research suggests that for healthy young adults and adults with normal sleep, 7–9 hours is an appropriate amount.

The story gets a little more complicated, though. The amount of sleep we need each day varies throughout our lives:

  • newborns need 14–17 hours
  • infants need 12–15 hours
  • toddlers need 11–14 hours
  • preschoolers need 10–13 hours
  • school-aged children need 9–11 hours
  • teenagers need 8–10 hours
  • adults need 7–9 hours
  • older adults need 7–8 hours

You can train your body to need less sleep

There is a widely shared rumor that you can train your body to need fewer than 7–9 hours’ sleep. Sadly, this is a myth.

According to experts, it is rare for anyone to need fewer than 6 hours’ sleep to function. Although some people might claim to feel fine with limited sleep, scientists think it is more likely that they are used to the negative effects of reduced sleep.

People who sleep for 6 hours or fewer each night become accustomed to the effects of sleep deprivation, but this does not mean that their body needs any less sleep. Cynthia LaJambe, a sleep expert at the Pennsylvania Transportation Institute in Wingate, explains:

“Some people think they are adapting to being awake more, but are actually performing at a lower level. They don’t realize it because the functional decline happens so gradually.”

“In the end, there is no denying the effects of sleep deprivation. And training the body to sleep less is not a viable option.” – Cynthia LaJambe

However, it is worth noting that some rare individuals do seem to function fine with fewer than 6.5 hours’ sleep each night. There is evidence that this might be due to a rare genetic mutation, so it is probably not something that someone can train themselves to achieve.

2. Daytime naps are unhealthy

Generally, experts recommend people avoid naps to ensure a better night’s sleep. However, if someone has missed out on sleep during previous nights, a tactical nap can help repay some of the accrued sleep debt.

Around 20 minutes is a good nap length. This gives the body ample time to recharge. People who sleep much longer than this could mean they descend into a deep sleep, and once awake, they feel groggy.

Daytime napping is relatively common in the United States, but taking a “siesta” is the norm in some countries. Naturally, our bodies tend to dip in energy during the early afternoon, so perhaps napping around that time is more natural than avoiding sleep until nighttime.

After all, the vast majority of mammals are polyphasic sleepers, which means they sleep for short periods throughout the day.

In a large review of the effects of napping, the authors explain afternoon naps in people who are not sleep deprived can lead to “subjective and behavioral improvements” and improvements in “mood and subjective levels of sleepiness and fatigue.” They found people who nap experience improved performance in tasks, such as “addition, logical reasoning, reaction time, and symbol recognition.”

Not all naps are equal, however. There is a great deal of variation, such as the time of day, duration, and frequency of naps. One author explains:

“Epidemiological studies suggest a decrease in the risk of cardiovascular and cognitive dysfunction by the practice of taking short naps several times a week.”

The author also acknowledges that much more research is needed to understand how factors associated with napping influence health outcomes. Medical News Today recently examined the relationship between napping and cardiovascular disease in a Special Feature.

It is also important to note if an individual experiences severe tiredness during the day, this might be a sign of a sleep disorder, such as sleep apnea.

Scientists will need to conduct more research before they can finally put all the napping myths and mysteries to bed.

3. All animals sleep

Because humans sleep, and our companion animals appear to sleep, many people assume all animals do the same. This is not true. The authors of a paper entitled “Do all animals sleep?” explain:

“Some animals never exhibit a state that meets the behavioral definition of sleep. Others suspend or greatly reduce ‘sleep’ behavior for many weeks during the postpartum period or during seasonal migrations without any consequent ‘sleep debt.’”

They also explain that some marine animals, reptiles, fish, and insects do not appear to enter REM sleep.

Because sleep is not simply a lack of consciousness, but a rhythmic cycle of distinct neural patterns, it is a challenge to distinguish whether an animal sleeps or takes a rest.

“[F]ewer than 50 of the nearly 60,000 vertebrate species have been tested for all of the criteria that define sleep,” the authors explain. “Of those, some do not meet the criteria for sleep at any time of their lives, and others appear able to greatly reduce or go without sleep for long periods of time.

4. More sleep is always better

Although many people struggle to get the amount of sleep they need to feel refreshed, some regularly sleep longer than their body needs. One might think this could endow these individuals with superpowers.

However, researchers identify a link between longer sleep durations and poorer health. For instance, one study, which followed 276 adults for 6 years, concluded:

“The risk of developing obesity was elevated for short and long duration sleepers, compared to average-duration sleepers, with 27% and 21% increases in risk, respectively.”

This finding held even when the scientists controlled the analysis for age, sex, and baseline body mass index. Sleep duration might also impact mortality, according to some researchers.

A meta-analysis, which appears in the journal Sleep, concludes “Both short and long duration of sleep are significant predictors of death in prospective population studies.”

5. Sleep deprivation can be lethal

There is no record of anyone dying from sleep deprivation. In theory, it may be possible, but as far as scientists can ascertain, it is improbable.

It is understandable why this myth may have taken root, though. Sleep deprivation, as many people can attest, can feel horrendous. However, the case of Randy Gardner demonstrates that extreme sleep deprivation is not fatal.

In 1965, when Gardner was just 16, he was part of a sleep deprivation experiment. In total, he stayed awake for 11 days and 24 minutes, which equates to 264.4 hours.

During this time, he was monitored closely by fellow students and sleep scientists. As the days rolled on, sleep deprivation symptoms worsened, but he survived. So why has this myth persisted?

The belief that sleep deprivation can kill might have its roots in a study from the 1980s. Rechtschaffen and colleagues found if they deprived rats of sleep with a particular experimental method, they would die after 2–3 weeks.

In their experiments, the researchers placed rats on a disc suspended above water. They continuously measured their brain activity. Whenever the animal fell asleep, the disc would automatically move, and the rat would need to act to avoid falling in the water.

Despite the fatalities in Rechtschaffen’s experiments, later research showed this is not the norm. Rats deprived of sleep using different methods do not die. Also, other researchers who used the disc method on pigeons found it was not fatal for these creatures.

Sleep deprivation is not painless for humans, though. Back in 1965, Gardner’s parents were worried about their son. They asked Lieutenant Commander John J. Ross from the U.S. Navy Medical Neuropsychiatric Research Unit in San Diego to observe him. He describes a steady deterioration in function.

For instance, by day 2, Gardner found it more difficult to focus his eyes. By day 4, he struggled to concentrate and became irritable and uncooperative. On day 4, he also reported his first hallucination and delusion of grandeur.

On day 6, Gardner’s speech became slower, and by day 7, he was slurring as his memory worsened. Paranoia kicked in during day 10, and on day 11, his facial expression and tone of voice became expressionless. Both his attention and memory span were significantly diminished.

However, he did not die and apparently, did not experience any long-term health issues.

Another reason why the myth that sleep deprivation can be fatal persists might be due to a condition called fatal familial insomnia. People with this rare genetic disorder become unable to sleep. However, when individuals with this disease die, it is due to the accompanying neurodegeneration rather than lack of sleep.

Although sleep deprivation will probably not kill you directly, it is worth adding a note of caution: being overtired does increase the risk of accidents. According to the National Highway Traffic Safety Administration, “Drowsy driving kills — it claimed 795 lives in 2017.”

Similarly, a review published in 2013 concludes, “[a]pproximately 13% of work injuries could be attributed to sleep problems.” So, although sleep deprivation is not deadly in a direct sense, it can have fatal consequences.

Additionally, if we consistently deprive our bodies of sleep for months or years, it increases the risk of developing several conditions, including cardiovascular disease, hypertension, obesity, type 2 diabetes, and some forms of cancer.

The takehome

Overall, we should try and aim for 7–9 hours’ sleep every night. It sounds simple, but in our neon-lit, bustling, and noisy lives, it is more challenging than we might like. All we can do is keep making an effort to give sleep the space that it needs.

It is only through persistent research that we will eventually decode all the mysteries of sleep. If you are interested in reading more about the myths associated with sleep, part one of this series can be found here.

Finally, if you find it difficult to get the sleep you need, here is a link to an MNT article with tips for better sleeping.

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The authors of a recent study found that healthy older adults who took a daily, low dose of aspirin were at higher risk of receiving a diagnosis of advanced cancers and dying from cancer than those who took a placebo.

The findings raise the possibility that taking aspirin every day may make cancers worse once they have developed in this age group.

In recent years, there have been high hopes that taking a daily, low dose of aspirin might help protect older people from dementia, cognitive decline, and cancer.

Doctors widely prescribe daily aspirin to people at high risk of cardiovascular problems.

In addition, some clinical trials involving mostly middle-aged adults have found that aspirin may reduce the risk of developing cancer, especially colorectal cancer.

However, until recently, evidence for the drug’s use as a preventive treatment in otherwise healthy older people has been lacking.

A study originally published in March 2020 suggested that taking a daily low dose of aspirin did not protect older people from cognitive decline and dementia.

The latest study, which investigated the same cohort of individuals, reports that daily aspirin increases the risk of receiving a diagnosis of advanced cancers and cancer that has spread or metastasized.

The results found associations between daily aspirin and increased cancer mortality over the follow-up period.

The scientists published their findings in the Journal of the National Cancer Institute.

ASPREE trial

Researchers at Massachusetts General Hospital in Boston, the Berman Center in Minneapolis, MN, and Monash University in Melbourne, Australia, carried out the recent study.

They analyzed results from the Aspirin in Reducing Events in the Elderly (ASPREE) trial, which included 19,114 individuals living in Australia and the United States. None of the participants had cardiovascular disease, dementia, or physical disability at the start of the study.

Most participants were over 70 years of age, apart from African American and Hispanic participants in the U.S., who were over 65 years of age.

Researchers randomly assigned the participants to take either 100 milligrams of aspirin per day or a placebo.

An earlier analysis of outcomes in the two groups after a mean follow-up period of 4.7 years found a higher number of deaths from all causes in the aspirin group. Most of the excess deaths were due to cancer.

The latest study examined aspirin’s effect on cancer diagnoses and deaths as a result of cancer in greater detail.

Overall, 981 participants who were taking aspirin and 952 who were taking placebo developed cancer. This difference between the two groups was not statistically significant.

However, daily aspirin had associations with a 19% higher risk of metastatic cancer and a 22% higher risk of receiving a diagnosis of advanced cancer compared with a placebo.

The results also indicated that people in the aspirin group were at a higher risk of dying during follow-up due to advanced cancer.

“Deaths were particularly high among those on aspirin who were diagnosed with advanced solid cancers, suggesting a possible adverse effect of aspirin on the growth of cancers once they have already developed in older adults,” says senior author Dr. Andrew T. Chan of Massachusetts General Hospital and Harvard Medical School.

“Although these results suggest that we should be cautious about starting aspirin therapy in otherwise healthy older adults, this does not mean that individuals who are already taking aspirin — particularly if they began taking it at a younger age — should stop their aspirin regimen.” – Dr. Andrew T. Chan

In their paper, the researchers also point out that the increased cancer mortality risk associated with taking aspirin in their study equated to an extra 1.5 deaths per 1,000 person years. This is relatively small compared with the risk of mortality from other causes.

Blunted immune response?

Aspirin reduces inflammation in the body. The researchers write that one possible explanation for their finding may be that aspirin suppresses or “blunts” immune responses that are critical to controlling the growth and spread of cancer at later stages of its development.

They note that other research has found differences between the biology and behavior of tumors in older adults and younger individuals.

“These reports make it plausible that aspirin might also act differently, at the cellular or molecular level, in older individuals,” they write.

A meta-analysis of trials involving populations around 10 years younger than in ASPREE, published in 2019, found that taking daily low dose aspirin for around 5 years neither increased nor decreased cancer incidence or mortality.

Other research suggests that it may take at least 10 years of taking daily aspirin before there is a beneficial reduction in the incidence of colorectal cancer.

There may also be a delayed benefit in older people that only becomes apparent after a longer follow-up period. The authors of the current study write:

“Cancer molecular and genetic data give reason to suggest that the potential adverse impact of aspirin identified in ASPREE might be specific to this age group. The cohort continues to be followed to explore the possibility of a delayed reduction in cancer incidence and/or mortality that may emerge with longer-term observation.”

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Hallucinations are sensory perceptions that appear in the absence of stimuli. Although they are often associated with illnesses such as schizophrenia, these phenomena can occur in the absence of mental ill health. But what explains these uncanny occurrences?

There are many types of hallucinations. They can be visual (sight hallucinations), auditory (sound hallucinations), olfactory (smell hallucinations), gustatory (taste hallucinations), or tactile (touch hallucinations).

For every sense, a form of hallucination is possible. The reason for this is that these phenomena are “ghost sensations” — perceptions of stimuli in the absence of actual external stimuli.

More often than not, when people think of hallucinations, they associate them with illnesses that can involve psychosis, such as schizophrenia, or neurocognitive disorders, such as forms of dementia.

Hallucinations are also associated with the use of mind-altering drugs, including LSD and DMT.

But hallucinations are not always due to psychotic disorders or psychedelics. Sometimes, they occur in the absence of these factors.

So what explains hallucinations, how common are they, and what role might they teach us about ourselves? In this Special Feature, we investigate.

More common an occurrence than we think

A study that appeared in the British Journal of Psychiatry in 2017 suggests that hallucinations are far more common among people without psychotic disorders than scientists had previously thought.

The study authors — Dr. Ian Kelleher, from the Royal College of Surgeons in Ireland, and Jordan DeVylder, Ph.D., from the University of Maryland in Baltimore — analyzed data that they had obtained through the 2007 Adult Psychiatric Morbidity Survey, a nationally representative study of mental health in England.

These data included information on the mental health of 7,403 people aged 16 years and older throughout 1 year.

Dr. Kelleher and DeVylder found that visual and auditory hallucinations were almost equally prevalent among participants with borderline personality disorder and those with a nonpsychotic mental illness.

They also found that more than 4% of all the survey respondents — including those who had no diagnosed mental health issues — reported experiencing visual or auditory hallucinations.

“Hallucinations are more common than people realize. They can be frightening experiences, and few people openly talk about it,” Dr. Kelleher observed in an interview for International Business Times.

“Our research is valuable because it can show them they are not alone and that having these symptoms is not necessarily associated with having a mental health disorder. It breaks the taboo,” he added.

Research published in the Scandinavian Journal of Psychology in 2015 also showed that auditory hallucinations were surprisingly common in a representative sample of the general population in Norway.

In a cohort of 2,533 individuals, the “current lifetime prevalence of [auditory verbal hallucinations] was 7.3%.”

Phantom smells also seem to be a more common occurrence than people might think. In 2018, a study published in JAMA Otolaryngology — Head & Neck Surgery showed that 6.5% of people aged 40 years and over had experienced phantom odor perception.

This percentage is based on data from a cohort of 7,417 participants with a mean age of 58 years. However, when it came to explaining this phenomenon, the researchers were at a loss.

“The causes of phantom odor perception are not understood. The condition could be related to overactive odor-sensing cells in the nasal cavity or perhaps a malfunction in the part of the brain that understands odor signals,” says first author Kathleen Bainbridge, Ph.D., from the National Institute on Deafness and Other Communication Disorders at the National Institutes of Health (NIH) in Bethesda, MD.

Surprising potential mechanisms

Researchers have been trying to build a better understanding of the biological mechanisms behind the different types of hallucinations.

In 2019, investigators from the University of Oregon in Eugene conducted a study in mice to try to find out how hallucinations manifest in the brain.

Their study paper — published in Cell Reports — revealed some surprising findings. As the researchers induced visual hallucinations in the rodents by injecting them with a hallucinogenic substance, they saw that this did not “map out” how they expected it to in the brain.

The researchers observed that the hallucinating mice experienced fewer signals firing between the neurons of the visual cortex, the brain region associated with the interpretation of visual information.

“You might expect visual hallucinations would result from neurons in the brain firing like crazy or by mismatched signals. We were surprised to find that a hallucinogenic drug instead led to a reduction of activity in the visual cortex.” – Senior author Prof. Cris Niell

Despite the initial surprise, the study’s senior author notes that it makes sense that visual hallucinations should appear in the brain in this way.

“Understanding what’s happening in the world is a balance of taking in information and your interpretation of that information. If you’re putting less weight on what’s going on around you but then overinterpreting it, that could lead to hallucinations,” he explains.

There is also a large amount of research into the causes and mechanisms associated with auditory hallucinations — some of the most fascinating kinds of ghost sensations.

For instance, a 2017 study featuring in eLife goes some way toward explaining how and why some people may think they hear voices that are actually not there.

According to the authors, this may be the effect of an error or “short-circuit” in processing internal speech and differentiating it from speaking out loud.

When people speak out loud, the researchers explain, the brain does two things. First, it sends instructions to the vocal cords, tongue, and lips — our vocal apparatus — to prompt them to move in the right way so as to vocalize the correct sounds.

At the same time, the brain also makes an internal copy of these instructions, which scientists call the “efference copy.” This duplicate allows the brain regions associated with hearing to predict the sounds that the vocal apparatus is about to make correctly.

This is part of how we recognize our own voice and speech.

“The efference copy dampens the brain’s response to self-generated vocalizations, giving less mental resources to these sounds because they are so predictable,” explains first author Prof. Thomas Whitford.

Through their study, Prof. Whitford and his colleagues found that the brain makes an efference copy not just of the thoughts intended for vocalization, but also of the inner talk — the internal chatter that people process in the background without expressing out loud.

It is likely, the scientists hypothesize, that auditory hallucinations arise when something goes wrong with the efference copy of people’s internal monologues.

“We all hear voices in our heads. Perhaps the problem arises when our brain is unable to tell that we are the ones producing them.” – Prof. Thomas Whitford

What hallucinations teach us

Many of the hallucinations that people might experience are, in fact, of the run-of-the-mill variety. For example, a vague sensation that you have heard the phone ringing when no one actually called or catching the shadow of a silhouette from the corner of the eye when there is no one there.

Dr. Philip Corlett and Dr. Albert Powers, two scientists from Yale University and the Connecticut Mental Health Center in New Haven, CT, have conducted many experiments into the nature of hallucinations.

They argue that there is a spectrum of phantom sensations and that many hallucinations might actually reflect how our brains work — namely, by making predictions about stimuli and the environments that we navigate.

In a paper published in World Psychiatry in 2018, they write that hallucinations might emerge from a “mismatch” between the predictions that our brains make about our surrounding reality and the actual reality.

In another study paper, published in 2017 in the journal Science, the two researchers and Dr. Christoph Mathys, an associate professor at Aarhus University in Denmark, present the evidence they collected through a series of experiments that appear to support this notion.

“When we go about the world, we’re not just passively perceiving sensory inputs through our eyes and ears. We actually build a model in our minds of what we expect to be present,” Dr. Corlett told The Atlantic, noting that when those expectations do not come to pass, this may sometimes translate as a hallucination.

Other scientists note that even more pronounced hallucinations could sometimes be of benefit to the person experiencing them.

In a 2017 paper in Psychology and Psychotherapy: Theory, Research and Practice, Drs. Filippo Varese, Warren Mansell, and Sara Tai — from the University of Manchester in the United Kingdom — note that not all auditory hallucinations are distressing.

Their study, which enlisted people with mental health issues who also experienced auditory hallucinations, found that how people reacted to the voices that they thought they heard made an important difference to whether those voices hindered or encouraged them in their daily pursuits.

“Most voice-hearers with mental health difficulties in our study experienced their voices as a hindrance to achieving their goals and viewed their voices as distressing and problematic. But other voice-hearers find that voices facilitate their valued goals and are, therefore, a pleasant and constructive part of their lives,” Dr. Varese points out.

Going forward, the researchers say, such insights might help mental health professionals assist their clients in turning the tables on potentially distressing hallucinations.

“[…] we should seek to help clients explore how their voices relate to goals that are important to them and empower them to progress toward those goals. That would be a more meaningful and acceptable way of supporting them,” he suggests.

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People of African descent have up to three times the risk of dying from strokes as people of European descent, yet there has been little investigation of if and how genetic variants contribute to their elevated stroke risk.

A large international team of scientists has completed the largest analysis of stroke-risk genes ever undertaken in individuals of African descent. The new study examined the genomes of more than 22,000 people of African ancestry, identifying important genetic contributors to stroke risk. These findings will help doctors better understand stroke risk, identify those at high risk and prevent the debilitating condition.

“Given the undue burden that people of African ancestry endure from stroke and other cerebrovascular disease, the lack of investigation of risk factors in this group has been a substantial gap,” said researcher Bradford B. Worrall, MD, a neurologist at University of Virginia (UVA) Health System, United States of America (USA). “Our work is an important step toward filling that gap, albeit with much more work to be done. These findings will provide greater insight into ethnic-specific and global risk factors to reduce the second leading cause of death worldwide.”

Stroke is the leading cause of adult disability in the United States. But strokes strike African-Americans more often and at younger ages than people of European descent. In addition, African-Americans who survive strokes often face greater disability. Family history is a major risk factor for stroke, suggesting our genes play a significant role in our stroke risk. But most genetic stroke studies, until now, have primarily focused on people of European descent. And the results have not always held true in African-Americans.

The new meta-analysis comes from the Consortium of Minority Population genome-wide Association Studies of Stroke (COMPASS). The researchers revisited previous studies to identify genetic risk factors specific to people of African descent. In total, they examined the genomes of 3,734 people who had suffered strokes and more than 18,000 who had not.

The researchers discovered that a common variation near the HNF1A gene was strongly associated with increased stroke risk in those of African ancestry. The gene previously has been associated to both stroke and cardiovascular disease.

While that variant had the strongest link to stroke risk, the researchers identified 29 other variants that also appear likely to influence stroke risk.

The variants occur at 24 different locations on human chromosomes. Sixteen of the “loci,” as the locations are known, appeared also to influence stroke risk in other populations, the researchers report.

“Studies of this nature are critical given the paucity of genetic studies focused on people of African descent and other minority populations and the substantial health disparities related to stroke in these groups,” said Keith Keene, PhD, a former UVA researcher and frequent collaborator of Worrall’s who now leads the Center for Health Disparities at East Carolina University’s Brody School of Medicine.
“Furthermore, we increasingly recognize the power of looking at genetic risk factors across different race ethnic groups, known as trans-ethnic analyses, for unlocking the underlying biology of diseases like stroke. If we understand the biology, we can develop new treatment and prevention strategies.”

In a paper outlining their findings, the researchers note the importance of such studies in understanding stroke risk among minorities. These studies have “huge potential to provide insight into the mechanisms underlying stroke disparities,” the researchers write. “Our study identified novel associations for stroke that might not otherwise be detected in primarily European cohort studies. Collectively, this highlights the critical nature and importance of genetic studies in a more diverse population with a high stroke burden.”

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Leptospirosis is a bacterial disease that affects humans and animals. Bacteria of the genus Leptospira cause it. In humans, it can cause a wide range of symptoms, some of which may be mistaken for other diseases. Some infected persons, however, may have no symptoms at all.

Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.
Infection

The bacteria that cause leptospirosis are spread through the urine of infected animals, which can get into water or soil and can survive there for weeks to months. Many different kinds of wild and domestic animals carry the bacterium.

These can include, but are not limited to: cattle, pigs, horses, dogs, rodents, and wild animals. When these animals are infected, they may have no symptoms of the disease.

Infected animals may continue to excrete the bacteria into the environment continuously or every once in a while for a few months up to several years. Humans can become infected through: contact with urine (or other body fluids, except saliva) from infected animals and contact with water, soil, or food contaminated with the urine of infected animals.

The bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch. Drinking contaminated water can also cause infection. Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters. Person to person transmission is rare.
Sign and symptoms

In humans, Leptospirosis can cause a wide range of symptoms, including: high fever, headache, chills, muscle aches, vomiting, jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhea, and rash.

Many of these symptoms can be mistaken for other diseases. In addition, some infected persons may have no symptoms at all.The time between a person’s exposure to a contaminated source and becoming sick is two days to four weeks. Illness usually begins abruptly with fever and other symptoms. Leptospirosis may occur in two phases: after the first phase (with fever, chills, headache, muscle aches, vomiting, or diarrhea) the patient may recover for a time but become ill again; and if a second phase occurs, it is more severe; the person may have kidney or liver failure or meningitis.

The illness lasts from a few days to three weeks or longer. Without treatment, recovery may take several months.
Prevention

The risk of acquiring leptospirosis can be greatly reduced by not swimming or wading in water that might be contaminated with animal urine, or eliminating contact with potentially infected animals. Protective clothing or footwear should be worn by those exposed to contaminated water or soil because of their job or recreational activities.
Prevention

Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease. Intravenous antibiotics may be required for persons with more severe symptoms. Persons with symptoms suggestive of leptospirosis should contact a health care provider.

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In recognition of World Breastfeeding Week, Medela breast pump announced its new partnership with The Wellbeing Foundation Africa (WBFA) to improve breastfeeding support and resources in Neonatal Intensive Care Units (NICUs) in Nigeria. Medela is one of the breast pumps recommended by doctors and used in hospitals.

As part of this partnership, Medela and The Wellbeing Foundation Africa will work together to improve the support offered to new mothers in Nigeria by delivering NICU-specific education and training on the value of human milk and how to build sufficient milk supply for long-term breastfeeding. This work will involve frontline healthcare workers, nonprofit organisations and government agencies.

Founder and president of Wellbeing Foundation Africa, Toyin Ojora Saraki, said: “Medela’s long history as a global player in breastfeeding research, products, technology and innovation is the perfect partner for Wellbeing Foundation Africa in our quest to improve Nigeria’s prevalence of breastfeeding and our focus on NICU support.

“Ensuring new mothers are wholly supported to breastfeed is not only critical for the health and wellbeing of the baby: it can be linked to all 17 of the United Nations Sustainable Development Goals.”

Nigeria ranks 6th worst country in the world for infant mortality and complications due to prematurity, which is the leading cause of death. In children younger than five years, 47 per cent of deaths occur in the first 28 days of life, many of them are preventable and can be addressed through improved nutrition with mother’s milk. Today Nigeria has one of the lowest breastfeeding rates in the world with only 17 per cent of mothers exclusively breastfeeding their children through six months. To improve these statistics, the United Nations set a global goal to improve breastfeeding rates to 50 per cent by the year 2030. Medela hopes to contribute to the solution through this partnership with the WBFA. As a supporting member of the Global UN Compact and the UN’s Every Woman, Every Child initiative, Medela is committed to partnering with organisations to improve breastfeeding rates globally to meet the 2030 Breastfeeding goals. Medela’s new global corporate social responsibility program, Medela Cares, is dedicated to improving the lives of moms, babies and patients through education and support, as well as through technologies, research and services.

“Research shows us that breast milk is critical for growth and overall health for newborns and is a low-cost and highly effective intervention that can prevent infant death,” said Annette Brüls, CEO of Medela worldwide. “We are thrilled to partner with The Wellbeing Foundation Africa as part of our commitment to the UN’s Every Woman, Every Child movement to better the lactation care provided to mothers and ultimately improve the infant feeding and health outcomes in Nigeria.”

The partnership will commence with a webinar on August 7, 2020 about Breastfeeding in High Risk Countries, a panel discussion with Her Excellency Toyin Saraki, Founder WBFA, Annette Brüls, CEO of Medela, Dr. Prof. Diane Spatz, PhD, RN-BC, FAAN, and Rita Momoh, lead midwife at WBFA, moderated by Tolu Adeleke, founder of Tolu The Midwife Healthcare Solutions and CEO of Maternity Hub (Nigeria). This group will discuss the need to address infant mortality and share how midwives and mothers can be supported to champion breastfeeding efforts in high-risk countries such as Nigeria.

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Women on birth control pills could be at a higher risk of dying if they are exposed to coronavirus, experts have warned. It is already well known that some types of birth control can increase the risk of blood clots.

But researchers say that being infected with Coronavirus disease (COVID-19) causes the threat of blood clotting to be even higher.

Doctors have been learning more about the virus as the pandemic unfolds, but studies show that it can cause clots, also known as thrombosis, and could be contributing to the number of people who are dying.

Medical experts have previously warned that up to a third of patients who are seriously ill with COVID are developing thrombosis. Now, new research from the US suggests that pregnant women, taking the Pill or on hormone replacement therapy (HRT) face the same danger.

Study co-author, Dr. Daniel Spratt, of Maine Medical Center in Portland, United States of America (USA), said: “During this pandemic, we need additional research to determine if women who become infected during pregnancy should receive anti-coagulation therapy – or if women taking birth control pills or hormone replacement therapy should discontinue them.”

Coronavirus can cause blood clots to form – even in previously healthy people, said Spratt.

What is more, oestrogen fuels potentially deadly deep vein thrombosis in some mothers-to-be – and in women using the pill or Hormone Replacement Therapy (HRT).

The blockages usually start in the legs, but they can move up – triggering a heart attack or stroke. Oral contraceptives are known to carry a small risk of the condition – which may be exacerbated by the coronavirus, according to the paper published in the journal Endocrinology.

Announcing their findings, the team said: “If infected with Covid-19, these women’s risk of blood clotting could be even higher.”

Spratt said: “Research that helps us understand how the coronavirus causes blood clots may also provide us with new knowledge regarding how they form in other settings and how to prevent them.” The links between blood clots and COVID-19 – including the effects of oestrogen therapy or pregnancy – are complicated. Spratt said several studies using innovative animal and tissue models will be required to shed light on them.

Birth control pills remain the most popular method of contraception in the UK – despite alternatives such as injections and implants.

More than three million British women take them at any one time, despite potential side effects ranging from depression to mood changes. They also carry up to a fourfold increase in a woman’s chance of developing a blood clot.

Most contain oestrogen and a synthetic form of progesterone – the hormones that sustain pregnancy and, by imitating the condition, prevent it. But they also raise clotting factors. For the average woman, the absolute risk of a blood clot just one in a thousand – but the threat of coronavirus may raise this significantly.

Spratt said: “As more information emerges regarding the effects of COVID-19, questions arise as to whether infection aggravates blood clots and strokes associated with combined oral contraceptives and other oestrogen therapies, as well as pregnancy-associated risks.”

“Rates of strokes double from about four to eight in 100,000 young women a year, while similar figures have been found for older women on HRT.”

Spratt said: “In pregnancy, the risk of blood clots increases four to fivefold. The mechanisms for these and the duration of the effect after discontinuing therapy remain unclear.

“A common recommendation is to discontinue oestrogen-containing preparations two weeks before planned activities that may cause thrombosis such as surgery or long flights.”

He added: “Conversations between clinicians, researchers, endocrinologists and haemotologists are necessary to explore potential interactions between COVID-19 and pregnancy or oestrogen therapy that could guide management.”

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Researchers in Italy found that a continued lack of sleep for 5 consecutive nights predisposes people to see pleasant and neutral images adversely, indicating that poor sleep may generate a negative emotional bias.

The feeling of having a sleepless night is a familiar one to many people. Lack of sleep can affect a person’s performance at work, as well as their emotional state.

People are more likely to be irritable and frustrated when they have not slept properly the night before.

The influence of limited sleep on emotional well-being is of growing interest as a lack of sleep is widespread in modern society. The Centers for Disease Control and Prevention (CDC) report that about 35% of adults in the United States sleep less than 7 hours per night.

Although several reports suggest that lack of sleep influences our emotional state, a new study published in the Journal of Sleep Research has formalized this.

In the study, participants looked at “pleasant and neutral images” after 5 nights of normal sleep and 5 nights of restricted sleep. The results showed that the participants were more likely to have negative responses to these images after the periods of disturbed sleep than after normal sleep.

The authors conclude that lack of sleep imposes a negative emotional bias on people and has important implications for daily life, as well as in clinic settings.

Continued sleep restriction

Numerous studies have investigated the behavioral effects of lack of sleep. However, most have looked at the impact of a total lack of sleep, rather than slightly reduced sleep over a more extended period.

To test the impact of partial sleep deprivation on emotional reactions, the researchers behind this study asked 42 people to change their sleep patterns for 2 weeks.

During the 2-weeks, participants had 5 consecutive nights of normal sleep followed by 5 consecutive nights of restricted sleep in which they could sleep no more than 5 hours per night. In the sleep-restricted phase, participants went to bed at approximately 2 am and woke up at about 7 am.

The researchers switched the order of the sleep patterns between the participants, with a two-day ‘wash out’ period in-between to allow people to reset before the next period.

The morning after each 5-day period, the researchers asked the participants to rate images on a nine-item scale of emotions.

The researchers took the images from the International Affective Picture System (IAPS), a database of pictures that psychologists use to study emotion and attention. The database contains a vast, wide-ranging selection of images that depict pleasant, neutral, and unpleasant events.

The researchers randomized the order of the pictures and assessed the emotion the image evoked, as well as the intensity of the emotion.

Impact on emotional outlook

The researchers found that participants rated pleasant and neutral images more negatively after having 5 nights of restricted sleep than when they had slept normally.

Even when the researchers took account of mood changes, they continued to find that people viewed images more negatively under restricted sleep conditions.

“Insufficient sleep may impose a negative emotional bias, leading to an increased tendency to evaluate emotional stimuli as negative.” – Daniela Tempesta, Ph.D., of the University of L’Aquila in Italy

This suggests that sleep-deprived people are likely to perceive emotional stimuli — such as events or personal interactions in their daily life — as worse than they really are.

The researchers did not find any significant difference in how people rated the unpleasant pictures under different sleep conditions.

Sleep and mood disorders

These findings suggest that lack of sleep may cause significant changes in emotional reactions, perhaps leading to an overall more negative outlook. Given how commonplace lack of sleep is in today’s society, these results will be relevant to many.

“Considering the pervasiveness of insufficient sleep in modern society, our results have potential implications for daily life, as well as in clinical settings,” says lead author Dr. Daniela Tempesta.

Although each person requires a different amount of sleep, the authors also say that future studies should investigate exactly how sleep loss leads to emotional changes.

Understanding how continued lack of sleep affects the brain could improve clinical outcomes for people with sleep disorders, as evidence suggests that disturbed sleep may be involved in mood disorders and post-traumatic stress disorder.

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