In a study published in Addiction Biology, researchers uncovered significant associations between use of electronic devices and signs of depression and anxiety, as well as cigarette smoking and alcohol drinking. The team also found certain genetic variants that were linked with these traits.
A review of studies on smartphone addiction found that anxiety and depression were commonly mediated mental health problems. A wide range of physical health sequelae was also associated with smartphone addiction. Furthermore, there was an association between smartphone addiction and neurological disorders.
The study included data on hundreds of thousands of individuals from the UK Biobank. Three indicators of use of electronic devices were included in the study: TV watching, computer using, and computer playing.
Their findings suggested that electronic devices use was associated with common mental traits and provided new clues for understanding genetic architecture of mental traits.
The authors wrote that the study’s findings suggest that reducing time spent using electronic devices may help reduce mental health burdens.
In a news release by Netcare, the company’s CEO Dr Richard Friedland said that more than three weeks after the discovery of the new Omicron variant in South Africa, data across its hospitals and primary healthcare facilities are demonstrating important early trends.
“Having personally seen many of our patients across our Gauteng hospitals, their symptoms are far milder than anything we experienced during the first three waves,” commented Dr Friedland.
“Approximately 90% of COVID patients currently in our hospitals require no form of oxygen therapy and are considered incidental cases. While we fully recognise that it is still early days, if this trend continues, it would appear that with a few exceptions of those requiring tertiary care, the fourth wave can be adequately treated at a primary care level.”
Rates of community transmission and hospital admission possibly decoupled During the first three waves, the rate of hospital admissions rose in tandem with the rate of community transmission (the number of people testing positive). Dr Friedland noted that, in the first three waves of the pandemic, Netcare treated 126 000 COVID patients across its 49 acute hospitals, of which 55 000 (44%) patients required admission and 26% of these patients were treated in High Care and Intensive Care (ICU). Significantly, all COVID patients admitted were sick and required some form of oxygen therapy. The high admission rate, as well as the high percentage of patients requiring ICU or High Care indicates the severity of cases during the first three waves.
“As of today we have 337 COVID positive patients admitted (72% in the Gauteng area and 18% in KwaZulu-Natal). Of these patients approximately 10% (33 patients) are on some form of oxygenation versus 100% in the first three waves. Eight of these patients (2%) are being ventilated and of these, two are primary trauma cases that are also COVID positive.”
Netcare’s policy is to test all patients for COVID before or on admission. Patients admitted for other primary diagnoses or surgical procedures who test positive for COVID] but do not require any form of oxygenation are considered to be incidental COVID cases, which currently accounts for 90% of COVID cases now in Netcare hospitals.
“During the first three waves, when the overall community positivity rate breached 26% across South Africa, we were inundated with COVID admissions to hospital. Within Netcare we had over 2000 COVID patients in hospitals during the first wave, over 2 250 patients in hospital during the second wave and over 3000 patients in hospital during the third wave. At present the 337 patients represent a fraction compared to previous waves,” said Dr Friedland.
“The very rapid rise in community transmission as compared to previous waves may partially explain this relatively low hospital admission rate. However, there does appear to be a decoupling in terms of the rate of hospital admissions at this early stage in the evolution of the fourth wave,” suggested Dr Friedland.
Majority of patients unvaccinated Dr Friedland added that of a total of 800 COVID positive patients that were admitted since 15 November, 75% of patients were unvaccinated. Netcare has seen seven deaths over this period in this group of patients, of which four may be ascribed to COVID. These four patients were 58 to 91 years of age and had significant co-morbidities. Of these patients, three were not vaccinated.
Dr Friedland observed that COVID patients admitted since 15 November are on average younger than those seen during the first three waves. Over 71% are under 50, with an average age of 38.5. This compares to only 40% below 50 in the first three waves, with an average age of 54.
Virtually all patients have presented with mild to moderate flu-like symptoms, including a blocked or runny nose, headache and a scratchy or sore throat and have been treated symptomatically.
Dr Friedland reiterated that the best way to support South Africa remains to take COVID extremely seriously and to be as cautious as ever.
While Omicron appears to be extremely transmissible and has been shown to have a greater ability to evade immunity from vaccination and prior infection, there is some evidence the Omicron variant may cause less severe disease.
In Gauteng, NICD hospital surveillance data show that 1904 COVID cases were admitted last week, and 177 COVID patients are currently in ICU with 51 ventilated as of yesterday. Nationwide, 13 147 new cases were detected with a positivity rate of 24.86%. While the fourth wave is still in the early stages, with a higher proportion of younger patients who develop less severe disease, anecdotal evidence points to reduced severity with the Omicron variant.
According to the Financial Times, preliminary data from the Steve Biko and Tshwane District Hospital Complex showed that on December 2 only nine of the 42 patients on the COVID ward, all of whom were unvaccinated, were being treated for the virus and were in need of oxygen. The remainder of the patients were COVID positive but asymptomatic and were being treated for other conditions.
“My colleagues and I have all noticed this high number of patients on room air,” said Dr Fareed Abdullah, an infectious disease doctor at the Steve Biko hospital and a director of the South African Medical Research Council.
“You walked into a COVID ward any time in the past 18 months… you could hear the oxygen whooshing out of the wall sockets, you could hear the ventilators beeping… but now the vast majority of patients are like any other ward.”
US chief medical adviser Dr Anthony Fauci remarked that initial South African data was “a bit encouraging regarding the severity”.
“Thus far, it does not look like there’s a great degree of severity to it,” he said. “But we’ve really got to be careful before we make any determinations.” Existing vaccines could provide “a considerable degree” of protection against Omicron, he added.
A small positive note for South Africa was Dr Fauci saying the administration is reevaluating the travel ban on eight southern African countries as more becomes known about Omicron and its spread.
“That ban was done at a time when we were really in the dark – we had no idea what was going on,” he said.
Current guidelines could be causing cow’s milk allergy to be over-diagnosed in infants, according to a new study.
Researchers analysed data on 1303 healthy infants who were exclusively breastfed until at least three months of age, and found that 38% and 74% of infants had multiple mild-to-moderate milk allergy symptoms – as defined by current allergy guidelines – at three months and 12 months old, respectively. By comparison, non-IgE-mediated cow’s milk allergy has a prevalence of less than 1% in children.
The researchers’ findings, which are published in Clinical & Experimental Allergy, suggest that following current guidelines may lead to over-diagnoses in infants by labelling normal infant symptoms as possible milk allergies.
“There is an assumption that the existence of a guideline is more beneficial than no guideline. However, well-meaning guidelines need to be supported by robust data to avoid harms from over-diagnosis that exceed the damage of missed and delayed cow’s milk allergy diagnoses that they are seeking to prevent,” the researchers wrote.
A number of commonly prescribed older antipsychotic drugs, and some newer ones, are associated with a significant increase in risk of breast cancer, according to a new study. The findings are published online in the Journal of Clinical Psychopharmacology.
Previous research uncovered the link between antipsychotic drug use, prescribed for a wide array of mental health problems, and breast cancer risk. This study compared newer antipsychotics to older drugs, and examined how the drugs affect prolactin levels, which have been associated with breast cancer. However, many antipsychotics elevate prolactin levels and can produce side effects such as menstrual cycle irregularities, abnormal breast milk production and abnormal breast tissue growth.
“Many women with psychiatric illnesses such as schizophrenia and bipolar disorder will take antipsychotics for decades, and they are essential to keeping symptoms in check,” said first author Tahir Rahman, MD. “But both older antipsychotic medicines and some newer drugs raise levels of prolactin and increase the risk of breast cancer, which is concerning. Our study confirms findings from a smaller European study that advised women and their doctors to first try drugs that don’t affect prolactin levels. We agree with that advice and believe psychiatrists should start to monitor prolactin levels in their patients taking antipsychotics.”
Antipsychotic drugs were classified into three categories, based on their established effects on prolactin. Category 1 included drugs associated with high prolactin levels, such as haloperidol, paliperidone and risperidone. Category 2 had mid-range effects and included iloperidone, lurasidone and olanzapine. Category 3 had low-effect drugs such as aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, quetiapine and ziprasidone.
Comparing the three drug categories to anticonvulsant drugs and lithium, the relative risk of breast cancer was 62% higher for women who took Category 1 drugs and 54% higher for those taking Category 2 drugs, whereas Category 3 antipsychotics were not associated with any increase in breast cancer risk.
“Certain drugs are known to elevate prolactin, and the women taking those drugs were more likely to have breast cancer,” Dr Rahman said. “But we didn’t detect any increased risk in women taking antipsychotics that don’t raise prolactin levels.”
In mouse models, prolactin can help weaken systems keeping precancerous lesions from becoming breast cancer. In humans, prolactin levels tend to be lower in women who have had more children at a younger age than in women who have fewer children or wait until they are older to do so.
In this study using data collected from 2012 through 2016, the research team performed a retrospective, observational study of breast cancer risk in women ages 18 through 64 who took antipsychotics.
The researchers identified which patients were treated for breast cancer during a 12-month period and matched that information to patients taking antipsychotic drugs. Of the 540 737 women in the database taking antipsychotics, only 914 were identified as having breast cancer – a significant number of whom were taking drugs known to increase prolactin.
“Antipsychotic medications can be lifesaving for patients who have psychotic episodes where they experience symptoms such as hallucinations and delusions,” Dr Rahman said. “In recent years, the drugs have been approved to treat other conditions, too, including depression and bipolar disorder. As those high-prolactin agents are used more widely, the number at risk could increase. We’ve been advising against using these high-prolactin agents in women who already have breast cancer, but we’d like to investigate whether keeping prolactin levels lower even might prevent some of these cancers.”
In another recent study, the antipsychotic drug aripiprazole did not increase prolactin levels in women and that a few women who began the study with high prolactin levels experienced decreases in prolactin levels after 12 weeks of treatment.
Those findings, combined with preclinical evidence of the anticancer effects of some antipsychotics, have inspired Dr Rahman and colleagues to propose repurposing some antipsychotic drugs in the fight against breast cancer.
“We don’t want to alarm patients taking antipsychotic drugs for life-threatening mental health problems, but we also think it is time for doctors to track prolactin levels and vigilantly monitor their patients who are being treated with antipsychotics,” Dr Rahman said.
A novel study has isolated powerful anticoagulants from the saliva of ticks, which may have reduced potential for bleeding.
Blood-feeding animals rely on specific molecules in their saliva to overcome defence mechanisms of their mammalian hosts for successful survival. The saliva of ticks, for example, contains molecules that can prevent blood from clotting, and which can also suppress inflammation or immune response to enable continuous feeding on the same bite site for days, sometimes undetected by the host. The harmful effects of these parasites can actually be harnessed for medical treatments.
In their paper, published in Nature Communications, the authors explain how the cardiovascular team developed a series of thrombin inhibitors to be potent anticoagulants based on sequences of inhibitors of blood coagulation enzyme thrombin found in the tropical bont tick Amblyomma variegatum.
The team developed a series of thrombin inhibitors to be powerful anticoagulants.
Anticoagulants are used in conditions where there is an increased propensity to form blood clots in our body depriving blood supplies to important tissues and organs, otherwise known as thrombosis. These drugs are needed in many diseases caused by blood clots including heart attacks, strokes, deep vein thrombosis, pulmonary embolism and even some severe complications caused by SARS-CoV-2 infection.
These next-generation anticoagulants will now need to be tested in human trials to determine if they can effectively counteract clotting without the bleeding side effects of currently available anticoagulants.
Researchers have identified an important mediator of youthfulness in mouse muscle, which explains the ‘rejuvenating’ blood transfusions effect between young and old mice. The discovery could also lead to new therapies for age-related muscle loss.
Published in Nature Aging, the study showed that circulating shuttles called extracellular vesicles, or EVs, deliver genetic instructions for the longevity protein known as Klotho to muscle cells. Reduced muscle function and repair in old mice may be driven by aged EVs, which carry fewer instructions than those in young animals.
The findings help further as to understanding why muscle regeneration capacity diminishes with age.
“We’re really excited about this research for a couple of reasons,” said senior author Dr Fabrisia Ambrosio. “In one way, it helps us understand the basic biology of how muscle regeneration works and how it fails to work as we age. Then, taking that information to the next step, we can think about using extracellular vesicles as therapeutics to counteract these age-related defects.”
Decades of research have shown that when old mice are given blood from young mice, youthful features are restored to many cells and tissues. But until now, it was unclear which components of young blood confer these rejuvenating effects.
“Amrita Sahu releaseWe wondered if extracellular vesicles might contribute to muscle regeneration because these couriers travel between cells via the blood and other bodily fluids,” said lead author Dr Amrita Sahu. “Like a message in a bottle, EVs deliver information to target cells.”
Ambrosio and her team collected serum from young mice and injected it into aged mice with injured muscle. Mice that received young serum showed enhanced muscle regeneration and functional recovery compared to those that received a placebo treatment, but the serum’s restorative properties were lost when EVs were removed, indicating that it is these vesicles which deliver the beneficial effects of young blood.
The researchers then found that EVs deliver genetic instructions, or mRNA, encoding the anti-ageing protein Klotho to muscle progenitor cells, important stem cells for muscle regeneration. EVs collected from old mice carried fewer copies of Klotho instructions than those from young mice, causing muscle progenitor cells to produce less of this protein.
With advancing age, muscle doesn’t recover from damage as well because scar tissue is laid down. In earlier work, Ambrosio and her team showed that Klotho is an important regulator of regenerative capacity in muscle progenitor cells and that this protein declines with age.
The new study shows for the first time that age-related shifts in EV cargo contribute to depleted Klotho in aged stem cells, suggesting that EVs could be developed into novel therapies for healing damaged muscle tissue.
“EVs may be beneficial for boosting regenerative capacity of muscle in older individuals and improving functional recovery after an injury,” said Ambrosio. “One of the ideas we’re really excited about is engineering EVs with specific cargoes, so that we can dictate the responses of target cells.”
Beyond muscles, EVs also could help reverse other effects of ageing. Previous work has demonstrated that young blood can boost cognitive performance of aged mice.
In a novel study, researchers conducted a randomised controlled trial comparing the potential health effects between families of Mexican descent that consumed a low allotment of avocados (three per week) and families that consumed a high allotment (14 per week).
They found that the high avocado allotment families self-reported lower caloric consumption, reducing their intake of other foods, including dairy, meats and refined grains and their associated negative nutrients, such as saturated fat and sodium.
The findings, published in Nutrients, may offer insights into how to better address the burgeoning public health issues of obesity and related diseases, particularly in high-risk communities, said the authors.
“Data regarding the effects of avocado intake on family nutritional status has been non-existent,” said senior author Matthew Allison, MD, professor at UC San Diego School of Medicine.
“Recent trials have focused on individuals, primarily adults, and limited to changes in cardiometabolic disease blood markers. Our trial’s results provide evidence that a nutrition education and high avocado allotment reduces total caloric energy in Mexican heritage families.”
The soft and buttery insides of the avocado are rich in vitamins C, E, K and B6, plus riboflavin, niacin, folate, pantothenic acid, magnesium, potassium, lutein, beta carotene and omega-3 fatty acids.
Half of a medium-sized fruit provides up to 20% of the recommended daily fibre, 10% potassium, 5% magnesium, 15% folate and 7.5 grams of monounsaturated fatty acids.
For the study, researchers enrolled 72 families (231 individuals) consisting of at least three members each over the age of five, residing in the same home, free of severe chronic disease, not on specific diets, and of Mexican heritage. The families were randomised into two groups for six months, during which time both groups also received bi-weekly nutrition education sessions.
Researchers wanted to assess if increased but moderated consumption of a single, nutrient-dense food might measurably improve overall health and decrease diet-related disparities.
While no change in BMI or waist circumference was seen between the two groups during the trial, researchers noted that consuming more avocados appeared to speed satiety. Fats and some dietary fibres, such as those found in avocados, can impact total energy intake by influencing gastrointestinal functions, such as introducing bulk that slows gastric emptying, regulating glucose and insulin reactions, prolonging nutrient absorption and modifying key peptide hormones that signal fullness.
Interestingly, the study found that families consuming more avocados correspondingly reduced their consumption of animal protein, specifically chicken, eggs and processed meats, the latter of which are typically higher in fat and sodium. Current nutrition guidelines recommend reduced consumption of both fat and sodium.
But surprisingly, high avocado consumers also recorded decreased intake of calcium, iron, sodium, vitamin D, potassium and magnesium, which researchers said might be associated with eating less.
“Our results show that the nutrition education and high avocado intake intervention group significantly reduced their family total energy intake, as well as carbohydrate, protein, fat (including saturated), calcium, magnesium, sodium, iron, potassium and vitamin D,” said first author Lorena Pacheco.
“In secondary energy-adjusted analyses, the nutrition education and high avocado allotment group significantly increased their intake of dietary fibre, monounsaturated fatty acids, potassium, vitamin E and folate.”
A new opinion piece provides an exhaustive examination of the ethics of using hospital resources on unvaccinated-by-choice COVID patients with pneumonia, versus patients with other serious but slower illnesses.
In his article published online in the Annals of the American Thoracic Society, William F. Parker, MD, PhD, looked at cases in which hospitals delayed time-sensitive and medically necessary procedures for vaccinated adults when they were overwhelmed with unvaccinated patients who had severe, life-threatening COVID pneumonia and suggested an ethical framework for triaging these patients.
“These vaccinated patients are directly harmed when hospitals use all their resources to care for the many unvaccinated patients with COVID,” he wrote. “For example, delaying breast cancer surgery by just four weeks increases the relative risk of death from the disease by 8%.”
Dr Parker argues for a contingency care standard prioritising emergency life-support, regardless of vaccination status, in order to save the most lives. “Simply rejecting the use of vaccination in prioritisation of medical resources without analysis ignores the very real tradeoffs at play during a pandemic. The pain and suffering of the vaccinated from deferred medical care require a deeper defense of caring for the unvaccinated.”
Eliminating double standards He stated: “Even though the vast majority of patients who develop life-threatening COVID pneumonia are unvaccinated, hospitals still have ethical obligations to expand capacity and focus operations on caring for them—even if it means making vaccinated patients wait for important but less urgent care like cancer and heart surgeries.”
“If tertiary care centers turn inward and stop taking transfers of COVID patients from overwhelmed community hospitals, this will result in de facto triage in favor of lower benefit care and cause systematic harm to both the vaccinated and unvaccinated in vulnerable communities,” he adds. “Hospitals must justify their nonprofit status by accepting transfers and prioritizing life-saving care during a pandemic surge.”
He cited the example of a surge in Los Angeles, when the public health department had to issue an order forcing elite hospitals to stop doing financially lucrative elective procedures and accept patient transfers from community hospitals with ICUs overwhelmed by COVID.
Reciprocity and proportionality The principle of reciprocity supports a possible tiebreaker role for vaccination status when two patients have equivalent survival benefit from a scarce health care resource. However, a universal exclusion of the unvaccinated from life support during a pandemic surge fails the test of proportionality for reciprocity, according to Dr Parker.
Reciprocity is rewarding one positive action with another. One example of this principle is giving vaccinated people access to sporting or entertainment events that are off limits to the unvaccinated (even if negative for COVID). Proportionality is the principle that ‘payback’ should be proportional to the magnitude of the act. For example, living kidney donors get moved way up the waitlist- the equivalent of four years of waiting time on dialysis. This satisfies the proportionality principle.
Dr Parker points out that while the increased relative risk of death of 8% from deferring breast cancer surgery is awful, the absolute increase in risk is only one per 100, and perhaps only one per 200 for a two-week deferral. “After the surge is over, the hospital can catch up on deferred elective surgeries,” he wrote. “The harm from a coronary artery bypass or cancer surgery delayed two weeks is real, but tiny in comparison to certain death from denying life support for respiratory failure.”
He concluded that: “There is a defensible role for vaccination status in triage as a limited tiebreaker, not as a categorical exclusion, but only in the context of a well-defined and transparent triage algorithm. Despite the enormous financial pressure to do otherwise, elite academic centres are obligated to prioritise life support for emergency conditions to save as many lives as possible during COVID surges.”
Researchers have found that a mere ten minutes of running at moderate intensity boosts blood flow to thebilateral prefrontal cortex, improving cognitive function and mood. These findings, published in Scientific Reports, may contribute to the development of a wider range of treatment recommendations to benefit mental health.
Physical activity has many benefits as noted by a great body of evidence, such as the ability to lift mood, but in previous studies, cycling was often the form of exercise studied. However, running has always played an important role in the well-being of humans. Human running’s unique form and efficiency, which includes the ability to sustain this form of exertion (ie, by jogging as opposed to sprinting), and human evolutionary success are closely linked.
Despite this fact, researchers had not yet looked closely at the effects of running on brain regions that control mood and executive functions. “Given the extent of executive control required in coordinating balance, movement, and propulsion during running, it is logical that there would be increased neuronal activation in the prefrontal cortex and that other functions in this region would benefit from this increase in brain resources,” explained senior author Professor Hideaki Soya at the University of Tsukuba, Japan.
To test their hypothesis, the research team used the well-established Stroop Colour–Word Test and measured haemodynamic changes associated with brain activity while participants were engaged in each task. For example, in one task, incongruent information is shown, eg the word ‘red’ is written in green, and the participant must name the colour rather than read out the word. To do so, the brain must process both sets of information and inhibit the extraneous information. The Stroop interference effect was quantified by the difference in response times for this task and those for a simpler version of the task – stating the names of colour swatches.
The results show that, after ten minutes of moderate-intensity running, there was a significant reduction in Stroop interference effect time. Furthermore, bilateral prefrontal activation had significantly increased during the Stroop task and participants also reported being in a better mood. “This was supported by findings of coincident activations in the prefrontal cortical regions involved in mood regulation,” noted first author Chorphaka Damrongthai.
Given that many characteristics of the human prefrontal cortex are uniquely human, this study not only sheds light on the present benefits of running but also on the possible role that these benefits may have played in the evolutionary past of humans.
