Untapped potential for TikTok to convey COVID-19 guidance

Research published in DeGruyter’s International Journal of Adolescent Medicine and Health suggests TikTok is rich with untapped educational potential. The platform could play a vital role in conveying important health information alongside lip-syncing videos and viral dance challenges, the paper’s authors say.

Led by researchers at William Paterson University and Columbia University, the new study, “COVID-19 on TikTok: Harnessing an emerging social media platform to convey important public health messages” explores how coronavirus information is being communicated on the platform. This has been a largely unexplored area—until now.

TikTok is a social media platform on which users share short videos. Since its worldwide release in 2018, it has soared in popularity—especially with teenagers and young people. It now has 800 million users worldwide and 37 billion monthly views in the United States alone.

Using a #Coronavirus hashtag, researchers examined and analyzed 117 TikTok videos, 17 of which were created by the World Health Organization (WHO). Altogether, the videos analyzed in the study received more than a billion views.

Fewer than 10% of the videos mentioned how the virus is transmitted, symptoms of COVID-19 and prevention of viral spread. None of the videos—including those uploaded by the WHO—discussed death and death rates, viral incubation time, wearing a face mask or travel restrictions.

The most commonly portrayed topics were anxiety and quarantine, with little focus on transmission and preventing infection. This may stem from the fact that teenagers are facing many social and emotional challenges as a result of lockdown measures—ranging from coping with school closures to the requirement to minimize contact with others.

The researchers behind the study think this indicates a missed opportunity to engage young people with vital health information related to the global pandemic. TikTok could potentially be used to convey messages about controlling the spread of coronavirus by the strict enforcement of social distancing. It is particularly important to impress this information upon the main TikTok audience of teenagers and young adults who can easily pass on the virus to more vulnerable and older family members.

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Easy to overdose on paracetamol if you’re selenium deficient, says research

A lack of the mineral selenium in the diet puts people at risk of paracetamol overdose, even when the painkiller is taken at levels claimed to be safe on the packaging, according to collaborative research emerging from the University of Bath and Southwest University in China.

Paracetamol (also called Tylenol) is best known for relieving mild pain and fever, and is a leading cause of liver failure when taken at dangerous levels. For adults, the recommended maximum daily dosage is 4g (amounting to two 500mg tablets taken four times). However, the team from Bath and Chongqing has found that the micronutrient selenium affects the speed at which the painkiller is flushed from the body. As a result, taking 4g of the medication in a given day can be dangerous for people with low levels of selenium in their bodies.

“People with a selenium deficiency can struggle to eliminate the drug fast enough to keep their livers healthy,” explained Dr. Charareh Pourzand who led the collaborative research from the University of Bath’s Department of Pharmacy and Pharmacology. “They can overdose even when they follow dosage guidelines.”

A huge amount of Paracetamol is consumed around the world, with an average person in the UK popping 70 tablets (or 35 grams) every year. Dr. Pourzand said: “For most people, paracetamol is safe up to the stated dose. But if you are frail, malnourished or elderly, your levels of selenium are likely to be somewhat depleted, and for these people I think it’s a bad idea to take paracetamol at the maximum level currently considered safe.”

It is thought that insufficient selenium intake affects up to 1 billion people worldwide—or one in seven of the globe’s population. It may be tempting to boost selenium levels through supplements, but based on the results of this study, Dr. Pourzand advises against this course of action, as an excess of the micronutrient can be just as dangerous to the body as a deficiency.

“There is a rather limited dose range for the beneficial effects of selenium,” she said. “Both mild selenium deprivation in the body and excess supplementation increase the severity of liver injury after you’ve taken paracetamol.”

She added: “This study shows that the link between selenium status in the diet and paracetamol toxicity is very important. I hope people pay attention to these findings, given everyone has paracetamol in their home. And now with people falling ill with COVID-19, paracetamol is being taken more than ever.”

Selenium helps maintain a healthy redox balance in the body within antioxidant enzymes called selenoproteins (selenium-containing proteins). Redox balance describes the mechanism by which each cell maintains a subtle balance between antioxidant and pro-oxidant levels (where some atoms gain electrons and others lose them, becoming free radicals). When the body’s selenium levels fall out of the beneficial range, antioxidant enzyme activities are decreased and too many free radicals are formed in liver—the main organ where paracetamol is metabolized. This results in damage both to an individual’s DNA and to their proteins.

Dr. Pourzand emphasizes the importance of a good diet in keeping selenium levels within the recommended range. “A healthy, balanced diet is especially important if you take paracetamol on a regular basis, for instance for chronic pain,” she said.

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Pseudoislet system expected to advance pancreas and diabetes research

The multicellular, 3-D structure of human pancreatic islets—the areas of the pancreas containing hormone-producing or endocrine cells—has presented challenges to researchers as they study and manipulate these cells’ function, but Vanderbilt University Medical Center researchers have now developed a pseudoislet system that allows for much easier study of islet function.

A pancreatic islet is composed primarily of beta cells, alpha cells and delta cells, but also includes many supporting cells, such as endothelial cells, nerve fibers and immune cells, which act in concert as a mini organ to control blood glucose through hormone secretion. Insulin, secreted from beta islet cells, lowers blood glucose by stimulating glucose uptake in peripheral tissues, while glucagon, secreted from alpha islet cells, raises blood glucose through its actions in the liver.

Dysfunction of these islet cells is a primary component of all forms of diabetes, and a better understanding of this dysfunction can lead to improved treatment and management of the disease. Vanderbilt scientists and others around the world have identified potential targets for diabetes using both mouse models and human tissue, however the lack of a system to manipulate these pathways in human islet cells has limited the field.

The VUMC team led by Marcela Brissova, Ph.D., research professor of Medicine and director of the Islet Procurement and Analysis Core of the Diabetes Research and Training Center, began attempting a protocol for the pseudoislet system in 2016, performing countless trials. In late 2017, Rachana Haliyur, then a Vanderbilt MD/Ph.D. student, combined media containing factors that support vascular cells and endocrine cells into what the group named the Vanderbilt Pseudoislet Media. The team watched as the cells began reaggregating, or organizing themselves in a way that resembled native islets.

“A lot of things in science happen serendipitously, and this was one of those,” said Brissova. “We tried and failed many times, and basically it came down to the media we used for our cells. In our recent publication, we have provided all experimental details and our protocol so others can make the media and create pseudoislets in their own laboratories.”

Because of the complex structure of the human islet, it is difficult to introduce and manipulate cells past the first cell-layer of the islet sphere. The pseudoislet system allows investigators to separate the pancreatic islet into single cells, introduce a virus into the cells which allows genetic manipulation and then combine the cells back together again into a pseudoislet. This allows researchers to target certain cell types or replicate changes happening in disease and study them in the 3-D environment of the islet.

John “Jack” Walker, an MD/Ph.D. student in the Powers & Brissova Research Group, continued to refine the pseudoislet system protocol and was co-first author on a recent study based on the system published in JCI Insight, an open access journal published by the American Society for Clinical Investigation (ASCI).

The pseudoislet system allowed the VUMC investigators to more clearly examine intracellular signaling pathways, allowing genetic manipulation of those pathways to change their function and better understand how insulin and glucagon secretion are altered with that manipulation. They determined that activation of Gi protein signaling reduced insulin and glucagon secretion while activation of Gq protein signaling stimulated glucagon secretion but had both stimulatory and inhibitory effects on insulin secretion.

In addition, this approach allowed the scientists to introduce biosensors into the islet cells to measure intercellular signaling events within the cells and better understand how those are linked to hormone secretion.

Another advance was the combination of the pseudoislet system with a unique microfluidic device, developed by co-authors Matthew Ishahak and Ashutosh Agarwal, Ph.D., from the University of Miami, that allowed the investigators to simultaneously document the changes in both calcium ions and hormone secretion.

“The exciting thing about this approach is that we both deconstruct the islet for our manipulation and reconstruct it to understand functional consequences at a larger level,” Walker said. “Since we put the islet cells back together, we can look at both insulin and glucagon secretion, but in a coordinated manner. Both of the secretion profiles measured are reflective of intra-islet interactions that are happening as well.”

This work greatly benefited from the research environment and infrastructure at Vanderbilt, particularly the National Institutes of Health (NIH)-funded Diabetes Research and Training Center (DRTC) and the Vanderbilt Cell Imaging Shared Resource.

“Another research direction will be creating pseudoislets that replicate a specific disease state, such as pseudo-islets that look like native islets from an individual with type 1 diabetes,” Haliyur said.

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Transcranial stimulation to prevent fear memories from returning

A research group from the University of Bologna has succeeded in modifying the negative effect of a returning memory that triggers fear, and developed a new non-invasive experimental protocol. The result of this study, published in the journal Current Biology, is an innovative protocol that combines fear conditioning—a stimulus associated with something unpleasant that induces a negative memory—and the neurostimulation of a specific site of the prefrontal cortex.

This process alters the perception of an unpleasant (aversive) event so that it will no longer induce fear. “This experimental protocol combining transcranial stimulation and memory reconsolidation allowed us to modify an aversive memory that the participants had learned the day before,” explains Sara Borgomaneri, a researcher at the University of Bologna and first author of the study. “This result has relevant repercussions for understanding how memory works. It might even lead to the development of new therapies to deal with traumatic memories.”

Can memories be altered?

The primary focus of the research group is the process of reconsolidation. This process maintains, strengthens and alters those events that are already stored in long-term memory. “Every time an event is recalled in our memory, there is a limited period of time in which it can be altered,” explains Simone Battaglia, researcher and co-author of this study. “The protocol we developed exploits this short time window and can, therefore, interfere with the reconsolidation process of learned aversive memories.”

Researchers used TMS (Transcranial Magnetic Stimulation) to “erase” the fear induced by a negative memory. With an electromagnetic coil placed on the head of the participant, TMS creates magnetic fields that can alter the neural activity of specific brain areas. TMS is a non-invasive procedure that does not require surgery or any action on the participant and for this reason, is widespread in research as well as in clinic and rehabilitation programs.

“With TMS, we could alter the functioning of the prefrontal cortex, which proved to be fundamental in the reconsolidation process of aversive memories,” says Sara Borgomaneri. “Thanks to this procedure, we obtained results that, until now, were only possible by delivering drugs to patients.”

The trial

The research group developed this protocol through a trial involving 98 healthy people. Every participant had learned an aversive memory and the next day underwent a TMS session over the prefrontal cortex.

“First, we created the aversive memory by combining an unpleasant stimulation with some images,” explains Borgomaneri. “The day after, we presented a group of participants with the same stimulus, which, in their memory, was recorded as aversive. Using TMS immediately afterwards, we interfered with their prefrontal cortex activity.”

To test the effectiveness of the protocol, other groups of participants underwent TMS without their aversive memory to be recalled (no reconsolidation was triggered), and some other groups were stimulated with TMS in control brain areas, not involved in memory reconsolidation.

At that point, the only thing left to do for researchers was to evaluate the effectiveness of TMS. They waited for another day and once again tested how the participants reacted when the aversive memory was recalled. And they obtained encouraging results. Participants who had their prefrontal cortex activity inhibited by TMS showed a reduced psychophysiological response to the unpleasant stimulus. They remembered the event (explicit memory) but its negative effect was substantially reduced.

“This trial showed that it is feasible to alter the persistence of potentially traumatic memories. This may have crucial repercussions in the fields of rehabilitation and clinical medicine,” says Professor Giuseppe di Pellegrino, who coordinated the study. “We’re dealing with a new technique that can be employed in different contexts and can assume a variety of functions, starting from treating PTSD, which will be the focus of our next study.”

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Ever heard of a surgical assistant? Meet a new boost to your medical bills

Izzy Benasso was playing a casual game of tennis with her father on a summer Saturday when she felt her knee pop. She had torn a meniscus, one of the friction-reducing pads in the knee, locking it in place at a 45-degree angle.

Although she suspected she had torn something, the 21-year-old senior at the University of Colorado in Boulder had to endure an anxious weekend in July 2019 until she could get an MRI that Monday.

“It was kind of emotional for her,” said her father, Steve Benasso. “Just sitting there thinking about all the things she wasn’t going to be able to do.”

At the UCHealth Steadman Hawkins Clinic Denver, the MRI confirmed the tear, and she was scheduled for surgery on Thursday. Her father, who works in human resources, told her exactly what to ask the clinic regarding her insurance coverage.

Steve had double-checked that the hospital; the surgeon, Dr. James Genuario; and Genuario’s clinic were in her Cigna health plan’s network.

“We were pretty conscious going into it,” he said.

Isabel met with Genuario’s physician assistant on Wednesday, and the following day underwent a successful meniscus repair operation.

“I had already gotten a ski pass at that point,” she said. “So that was depressing.” But she was heartened to hear that with time and rehab she would get back to her active lifestyle.

Then the letter arrived, portending of bills to come.

The Patient: Izzy Benasso, a 21-year-old college student covered by her mother’s Cigna health plan.

The Total Bill: $96,377 for the surgery was billed by the hospital, Sky Ridge Medical Center in Lone Tree, Colorado, part of HealthONE, a division of the for-profit hospital chain HCA. It accepted a $3,216.60 payment from the insurance company, as well as $357.40 from the Benassos, as payment in full. The surgical assistant billed separately for $1,167.

Service Provider: Eric Griffith, a surgical assistant who works as an independent contractor.

Medical Service: Outpatient arthroscopic meniscus repair surgery.

What Gives: The Benassos had stumbled into a growing trend in health care: third-party surgical assistants who aren’t part of a hospital staff or a surgeon’s practice. They tend to stay out-of-network with health plans, either accepting what a health plan will pay them or billing the patient directly. That, in turn, is leading to many surprise bills.

Even before any other medical bills showed up, Izzy received a notice from someone whose name she didn’t recognize.

“I’m writing this letter as a courtesy to remind you of my presence during your surgery,” the letter read.

It came from Eric Griffith, a Denver-based surgical assistant. He went on to write that he had submitted a claim to her health plan requesting payment for his services, but that it was too early to know whether the plan would cover his fee. It didn’t talk dollars and cents.

Steve Benasso said he was perplexed by the letter’s meaning, adding: “We had never read or heard of anything like that before.”

Surgical assistants serve as an extra set of hands for surgeons, allowing them to concentrate on the technical aspects of the surgery. Oftentimes other surgeons or physician assistants—or, in teaching hospitals, medical residents or surgical fellows—fill that role at no extra charge. But some doctors rely on certified surgical assistants, who generally have an undergraduate science degree, complete a 12- to 24-month training program, and then pass a certification exam.

Surgeons generally decide when they need surgical assistants, although the Centers for Medicare & Medicaid Services maintains lists of procedures for which a surgical assistant can and cannot bill. Meniscus repair is on the list of allowed procedures.

A Sky Ridge spokesperson said that it is the responsibility of the surgeon to preauthorize the use and payment of a surgical assistant during outpatient surgery, and that HealthOne hospitals do not hire surgical assistants. Neither the assistant nor the surgeon works directly for the hospital. UC School of Medicine, the surgeon’s employer, declined requests for comment from Genuario.

Karen Ludwig, executive director of the Association of Surgical Assistants, estimates that 75% of certified surgical assistants are employed by hospitals, while the rest are independent contractors or work for surgical assistant groups.

“We’re seeing more of the third parties,” said Dr. Karan Chhabra, a surgeon and health policy researcher at the University of Michigan Medical School. “This is an emerging area of business.”

And it can be lucrative: Some of the larger surgical assistant companies are backed by private equity investment. Private equity firms often target segments of the health care system where patients have little choice in who provides their care. Indeed, under anesthesia for surgery, patients are often unaware the assistants are in the operating room. The private equity business models include keeping such helpers out-of-network so they can bill patients for larger amounts than they could negotiate from insurance companies.

Surgical assistants counter that many insurance plans are unwilling to contract with them.

“They’re not interested,” said Luis Aragon, a Chicago-area surgical assistant and managing director of American Surgical Professionals, a private equity-backed group in Houston.

Chhabra and his colleagues at the University of Michigan recently found that 1 in 5 privately insured patients undergoing surgery by in-network doctors at in-network facilities still receive a surprise out-of-network bill. Of those, 37% are from surgical assistants, tied with anesthesiologists as the most frequent offenders. The researchers found 13% of arthroscopic meniscal repairs resulted in surprise bills, at an average of $1,591 per bill.

Colorado has surprise billing protections for consumers like the Benassos who have state-regulated health plans. But state protections don’t apply to the 61% of American workers who have self-funded employer plans. Colorado Consumer Health Initiative, which helps consumers dispute surprise bills, has seen a lot of cases involving surgical assistants, said Adam Fox, director of strategic engagement.

Resolution: Initially, the Benassos ignored the missive. Izzy didn’t recall meeting Griffith or being told a surgical assistant would be involved in her case.

But a month and a half later, when Steve logged on to check his daughter’s explanation of benefits, he saw that Griffith had billed the plan for $1,167. Cigna had not paid any of it.

Realizing then that the assistant was likely out-of-network, Steve sent him a letter saying “we had no intention of paying.”

Griffith declined to comment on the specifics of the Benasso case but said he sends letters to every patient so no one is surprised when he submits a claim.

“With all the different people talking to you in pre-op, and the stress of surgery, even if we do meet, they may forget who I was or that I was even there,” he said. “So the intention of the letter is just to say, ‘Hey, I was part of your surgery.'”

After KHN inquired, Cigna officials reviewed the case and Genuario’s operative report, determined that the services of an assistant surgeon were appropriate for the procedure and approved Griffith’s claim. Because Griffith was an out-of-network provider, Cigna applied his fee to Benasso’s $2,000 outpatient deductible. The Benassos have not received a bill for that fee.

Griffith says insurers often require more information before determining whether to pay for a surgical assistant’s services. If the plan pays anything, he accepts that as payment in full. If the plan pays nothing, Griffith usually bills the patient.

The Takeaway: As hospitals across the country restart elective surgeries, patients should be aware of this common pitfall.

Chhabra said he’s hearing more anecdotal reports about insurance plans simply not paying for surgical assistants, which leaves the patient stuck with the bill.

Chhabra said patients should ask their surgeons before surgery whether an assistant will be involved and whether that assistant is in-network.

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Bacteria in the gut have a direct line to the brain

With its 100 million neurons, the gut has earned a reputation as the body’s “second brain”—corresponding with the real brain to manage things like intestinal muscle activity and enzyme secretions. A growing community of scientists are now seeking to understand how gut neurons interact with their brain counterparts, and how failures in this process may lead to disease.

Now, new research shows that gut bacteria play a direct role in these neuronal communications, determining the pace of intestinal motility. The research, conducted in mice and published in Nature, suggests a remarkable degree of communication between our nervous system and the microbiota. It may also have implications for treating gastrointestinal conditions.

“We describe how microbes can regulate a neuronal circuit that starts in the gut, goes to the brain, and comes back to the gut,” says Rockefeller’s Daniel Mucida, associate professor and head of the Laboratory of Mucosal Immunology. “Some of the neurons within this circuit are associated with irritable bowel syndrome, so it is possible that dysregulation of this circuit predisposes to IBS.”

The work was led by Paul A. Muller, a former graduate student in the Mucida lab.

How microbes control motility

To understand how the central nervous system senses microbes within the intestines, Mucida and his colleagues analyzed gut-connected neurons in mice that lacked microbes entirely, so-called germ-free mice that are raised from birth in an isolated environment, and given only food and water that has been thoroughly sterilized. They found that some gut-connected neurons are more active in the germ-free mice than in controls and express high levels of a gene called cFos, which is a marker for neuronal activity.

This increase in neuronal activity, in turn, causes food to move more slowly than usual through the digestive tract of the mice. When the researchers treated the germ-free mice with a drug that silences these gut neurons, they saw intestinal motility speed up.

It’s unclear how the neurons sense the presence of gut microbes, but Mucida and his colleagues found hints that the key may be a set of compounds known as short-chain fatty acids, which are made by gut bacteria. They found that lower levels of these fatty acids within the guts of mice were associated with greater activity of the gut-connected neurons. And when they boosted the animal’s gut levels of these compounds, the activity of their gut neurons decreased. Other microbial compounds and gut hormones that change with the microbiota were also found to regulate neuronal activity, suggesting additional players in this circuit.

Neurons in control

Further experiments revealed a conundrum, however. The scientists saw that the particular type of gut-connected neurons activated by the absence of microbes did not extend to the exposed surface of the intestines, suggesting that they cannot sense the fatty acid levels directly.

So Mucida and his colleagues decided to trace the circuit backwards and found a set of brainstem neurons that show increased activity in the germ-free mice. When the researchers manipulated control mice to specifically activate these same neurons, they saw an increase in the activity of the gut neurons and a decrease in intestinal motility.

The researchers continued to work backwards, next focusing their attention on the sensory neurons that send signals from the intestines to the brainstem. Their experiments revealed these sensory neurons extended to the interface of areas of the intestine that are exposed to high-levels of microbial compounds, including fatty acids. They turned off these neurons, to mimic what happens in germ-free mice that lack the fatty acids, or associated gut signals, and observed activated neurons in the brainstem, as well as activation of the gut neurons that control intestinal motility.

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In nation’s 2 largest metros, Blacks and Latinos are more likely to die from COVID-19

A study published today by the UCLA Latino Policy and Politics Initiative found that Latino and Black residents of Los Angeles County and New York City are roughly twice as likely as white residents to die from COVID-19. The research also revealed that high-poverty neighborhoods in both regions have the highest rates of COVID-19 cases and COVID-19–related deaths.

Sonja Diaz, founding director of the policy initiative, said two significant reasons for those trends are that low-income Black and Latino people in both regions tend to have a greater need to work outside of the home and a greater reliance on public transportation, both of which put them at a greater risk for exposure to the coronavirus.

“We are now seven months into the pandemic, and we are starting to have clear information about the disproportionate health and economic impacts that communities of color are facing,” Diaz said. “It’s time to address the specific ways that COVID-19 hurts Latino and Black families and to protect our most vulnerable communities as the virus surges across the nation.”

In Los Angeles County, the age-adjusted death rate was 54 per 100,000 for Latino residents and 46 per 100,000 for Black residents, compared to 23 per 100,000 for white residents; in New York City, the age-adjusted death rates were 247 per 100,000 for Latino residents, 237 per 100,000 for Black residents and 120 per 100,000 for white residents.

The authors recommend that six measures be implemented immediately in cities with large populations of vulnerable communities:

  • Increase testing for low-income communities of color.
  • Provide access to health services and healthy food in low-income communities.
  • Add protections on public transportation, including providing hand sanitizing stations and free masks.
  • Expand access to health care and paid sick leave for essential workers.
  • Increase access to telehealth for low-income residents and the uninsured to bridge the lack of medical care.
  • Ensure that accurate race and ethnicity information is being collected so that elected officials and public health experts can understand the impact of COVID-19 in communities of color.

The researchers analyzed data from Los Angeles County and New York City, two areas that have been hard-hit during the pandemic and are home to large Latino and Black populations. They found that residents who didn’t have health insurance, lived in overcrowded housing conditions and had limited access to the Internet will encounter inequitable access to health care during the pandemic.

In addition, the authors found that people between the ages of 18 and 40 have the highest rate of infection in Los Angeles County; in New York, people over age 45 are most affected. Men in both regions have higher rates of infection than women.

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Neurons are genetically programmed to have long lives

When our neurons—the principle cells of the brain—die, so do we.

Most neurons are created during embryonic development and have no “backup” after birth. Researchers have generally believed that their survival is determined nearly extrinsically, or by outside forces, such as the tissues and cells that neurons supply with nerve cells.

A research team led by Sika Zheng, a biomedical scientist at the University of California, Riverside, has challenged this notion and reports the continuous survival of neurons is also intrinsically programmed during development.

The study, published in the journal Neuron, identifies a mechanism the researchers say is triggered at neuron birth to intrinsically decrease a general form of cell death—or “apoptosis”—specifically in neurons. When this genetic regulation is stopped, continuous neuronal survival is disrupted and leads to the death of the animal.

An organism’s survival, brain function, and fitness are dependent upon the survival of its neurons. In higher organisms, neurons control breathing, feeding, sensation, motion, memory, emotion, and cognition. They can die of many unnatural causes, such as neurodegenerative diseases, injury, infection, and trauma. Neurons are long-lived cells, but the genetic controls that enable their longevity are unknown.

Zheng’s team now reports the central piece of the mechanism involved is a small piece of genetic sequence in Bak1, a pro-apoptotic gene whose activation leads to apoptosis. Bak1 expression is turned off when this small piece of genetic sequence, termed microexon, is spliced in the final Bak1 gene product. Exons are sequences that make up messenger RNA.

“Apoptosis is a pathway that controls cell turnover and tissue homeostasis in all metazoans,” explained Zheng, an associate professor of biomedical sciences. “Most non-neural cells readily engage in apoptosis in response to intrinsic and extrinsic stress. But this cellular suicidal program needs to be reined in for neurons so that they live for many years. We now show how genetic attenuation of neuronal apoptosis takes place.”

Zheng’s team identified the Bak1 microexon through a large-scale analysis of expression data from human tissues, mouse tissues, human developing brains, mouse developing forebrains, and mouse developing midbrains. The team first compared neural tissues with non-neural tissues in both humans and mice to identify neural-specific exons. Then, they found cortical neurons reduce their sensitivity to apoptosis as early as neuron birth. They also found apoptosis is gradually reduced during neuronal development before neurons make connections or innervate other cells, suggesting factors other than extrinsic signals can play a role.

“We show neurons transform how they regulate cell death during development,” Zheng said. “This is to ensure neuronal longevity, which is needed to maintain the integrity of neural circuits for brain functions.”

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Attention Ladies: Everything You Need to Know About Breast Cancer

The threat of breast cancer is well known these days . Without any scintilla of doubt, breast cancer is one of the deadliest diseases in existence that ravages the human population at an alarming rate. This killer disease claims more than 6 million human lives every year.

The disease starts to develop when cells in the breast begin to grow out of control, These cells are usually from a tumor that can be seen on an X-ray. If the tumor is malignant (cancerous), it will eventually grow into the surrounding tissues or will spread to distant areas of the body. It is very important to understand that in most cases breast lumps are not cancerous: they are benign. Benign breast tumors have abnormal growths, but they do not spread outside of the breast and they are not life threatening.

BREAST CANCER HEREDITARY FACTORS

Researchers have shown that about 5-10% of the breast cancers are linked to gene mutations passing through the generations of a family. Several inherited mutated genes that are likely to increase the tendency of breast cancer have been identified. The most common are the breast cancer gene 1 with the code BRCA1 and the breast cancer gene 2 BRAC2, both of which significantly increase the risk of breast cancer.

In most cases, doctors recommend that a person with a strong family history of breast cancer should have a blood test done to help identify specific mutations in BRCA or other genes that might have been passed on genetically.

Similarly, a genetic counselor to review the family health history may be recommended if breast cancer is hereditary. Breast cancers of various forms have been identified over the years, depending on the affected area which could be ducts, lobules, or tissue.

HEALTH CARE INSURANCE FOR BREAST CANCER

The health care insurance scheme is the best avenue for anyone who develops the disease, because long term treatment for the disease can be financially devastating.

Therefore, it is very important to be involved in a health care plan that offers accurate screening to an early detection and a comprehensive treatment of breast cancer if needed.

Understanding the health care provider’s policy and their coverage is a necessity for those at risk.

CAUSES OF BREAST CANCER

It’s not clear what causes breast cancer, but doctors know that breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass.

Researchers have identified hormonal, lifestyle, and environmental factors that may increase your risk of developing breast cancer. But it still remains unclear why some people who have no risk factors develop cancer, yet other people with risk factors never do. It’s likely that breast cancer is caused by a complex interaction of your genetic makeup and your environment.

PREVENTING BREAST CANCER

To prevent breast cancer, scientists have identified the following measures to help you live a healthy life and reduce the chances of developing cancer:

1. Early detection – Early detection means that you need to know the look and feel of your breasts in a normal situation so you can pick up any change or deviation, no matter how small. Your breasts undergo many changes in your life as a result of hormonal changes during menstruation, pregnancy, breastfeeding, menopause, and fluctuation in body weight. In most of cases, any lumps that appear will be benign, but in any case you must report them immediately to your doctor and make sure that your response is serious.

2. Getting examined regularly – It is important to contact a surgeon with experience in breast examination for periodic review.

3. Knowing your risk factors – Getting familiar with your family’s cancer history is important in the prevention of breast cancer formation.

4. Consistent breastfeeding – Studies have shown that consistent breastfeeding dramatically reduces the chances of developing breast cancer.

5. Limit hormone therapy – Introducing additional hormones to your body is always a risk. One of the many possible side effects is developing breast cancer, so keep that in mind before considering hormone therapy.

6. Eating right – Maintaining proper nutrition may help prevent the development of the disease.

Warning signs that are worth monitoring

It is worth noting the following changes:
*Breast size changes (one or both)
*The appearance of a lump or thickening on the breast or armpit that is felt differently from the normal breast structure
*Shrinkage or formation of dimples on the skin in the breast area
*Swelling of the armpit or around the collarbone (where the ligaments and lymph nodes are located)
*Exceptional effects on the mammary: skin peeling, withdrawal, thickening, or secretion
*The appearance of redness and lumpiness on the skin of the breasts
*The appearance of swelling in the breast
*The formation of ulcers on the breast surface
*Varicose veins on the breast
*Persistent pain in the breast or underarms
*Dermal discharge from the mammary
*Quick change in the appearance of one breast
*Condensation, heaviness or enlargement of one breast
*Change in breast color
*Unusual warmth of the breast
*Bumps on the skin that make the breast look like orange peel
*Itching
*Pain
*Flattening or flipping inward of the mammary
*Cracks in or swelling of the mammary, changing the coronal color

It is important to distinguish between natural and healthy congestion and an unfamiliar lump in the breasts. Natural congestion in the breast is defined as hard (it has bumps resembling the blocks in a cottage cheese). A lump, however, can be small or large, soft or hard, and has clear boundaries. It may be close to the skin’s surface, deep and close to the ribs and chest, mobile or fixed in one place.

Breast health awareness during your adult life is an essential part of taking responsibility for your body and life. 

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Cassie Shows Off Postpartum Body, But We Wish She Didn't Have To

Since having daughter Frankie in December, singer and model Cassie has not the most prolific of new celebrity moms on social media. But on Monday, she took to her Instagram Stories with an admission that we think might explain her absence. She seems to have gone back and forth with accepting her postpartum body.

“I haven’t posted anything like this in a while, but I’m very proud of myself,” wrote Cassie, who married trainer and bull-rider Alex Fine last year, shortly after ending her 10-plus-year relationship with Diddy. “The female body is truly an amazing thing. I didn’t rush to lose weight after having Frankie in December, but when I was ready to, I struggled with it for some months.”

After spending her career modeling and performing, we imagine it was difficult for Cassie not to feel she was in the same physical shape as she had been in for most of her life. Pregnancy and childbirth take a toll on the body — changing everything from lung capacity to bone density — and it’s not necessarily realistic to expect that once the baby is finally outside your body that you can get it “back” just by exercising and dieting a lot.

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♐️♍️

A post shared by Casandra (@cassie) on

But we very much wish that no new parent felt that this is something they have to do. If we could live in a world in which women weren’t compelled to show off how they lost the baby weight — or even feel the need to explain that doing so is taking some time — we might all be a little healthier and happier.

For her part, Cassie said she realized she needed to be easier on herself.

“I stopped putting so much pressure on myself and with less stress and healthier habits,” she wrote. “This is me today 7 months postpartum. Feeling really good, I’m healthy and working on my strength. Love your body!”

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Day dreaming ✨

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Congratulations to Cassie for feeling good and being proud of herself, truly. Everyone else reading this, please know that you absolutely do not need to have abs like that seven months after having a baby, or ever. Do postpartum workouts and eat right so that you have the strength and endurance to care for your child and do everything else that makes your life fulfilling, not so that you have that extra line down your middle when you wear a bikini.

Cassie has managed to spend her career going by just one name. We wonder if her daughter or any of these celebrity kids with unique names will have the same privilege.

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