As the inquiry publishes it final report, the chancellor is under pressure to find £10bn to put right a longstanding injustice
The chancellor, Jeremy Hunt, will come under pressure to stay true to his word and sign off on immediate compensation payments totalling up to £10bn to victims of the contaminated blood scandal when the long-awaited final report on the affair is published on Monday.
The scandal is described as the worst treatment disaster in NHS history, with more than 3,000 people having died as a result of receiving contaminated blood products in the 1970s and 1980s. It is estimated that, even today, a person infected during the scandal dies every four days.
I have followed the life of this desperate child as her life has been ruined by a bankrupt system
You’re a teenage girl and you’ve been locked in a bare hospital room for more than 15 months. Your bed is a platform attached to the floor. There’s a plastic toilet and a sink moulded into the wall. Your only human contact is through a hatch in the door. Sometimes you get to hold your mum’s hand through it.
You’ve tried to kill yourself multiple times, including trying to throw yourself off a bridge over the M6. That was after escaping being driven to an unregulated children’s home miles away from your family. You can’t understand why your mum’s not able to look after you, as she does with your two siblings.
Low-price deals in UK mean consumers are eating less-nourishing food more frequently, say experts
Office workers looking for a cheap lunch on the high street might struggle. With inflation pushing up prices in recent years, a sandwich, snack and drink at popular coffee chains can now cost upwards of £10, while even the average supermarket meal deal has risen by more than 21% in price since before the pandemic.
But now fast-food chains have moved to fill the gap in the market. In March, KFC introduced a new lunch deal for £5.49, offering a fried chicken wrap with a drink and side – either crisps or a cookie – and available from Monday to Friday until 3pm. “KFC is now workplace appropriate, for when finger lickin’ is not,” the chain said in its promotional material.
South West Water identifies ‘damaged valve’ as possible cause of cryptosporidium contamination in Brixham area
Health officials are expecting more cases of a waterborne disease in Devon, as an MP said “heads are going to roll” over the outbreak and that the anger among residents was “palpable”.
The UK Health Security Agency has confirmed 46 cases of cryptosporidium infection in the Brixham area, while more than 100 other people have reported symptoms, including diarrhoea, stomach pains and dehydration.
The wellness project claims to help users make ‘smarter food choices’ based on ‘world-leading science’. But many scientists claim its fee-based services are no better than generic advice
“Your body is unique, so is the food you need.” This is the central credo of personalised nutrition (PN), as professed by its leading UK advocate, the health science company Zoe. Since its launch in April 2022, 130,000 people have subscribed to the service – at one point it had a waiting list of 250,000 – which uses a pin prick blood test, stool sample and a wearable continuous glucose monitor (CGM) to suggest “smarter food choices for your body”.
Like other companies working in this space, Zoe has all the hallmarks of serious science. Its US equivalent Levels counts among its advisers many respected scientists, including Robert Lustig, famous for raising the alarm about the harms of refined carbohydrates such as sugar. Zoe is fronted by King’s College London scientist Tim Spector and claims to be “created with world-leading science”.
Source: www.databreachtoday.com – Author: 1 Breach Notification , Cybercrime , Fraud Management & Cybercrime Data Stolen Over a Year Ago, But WebTPA Didn’t Discover Hack Until December Marianne Kolbasuk McGee (HealthInfoSec) • May 17, 2024 Image: WebTPA A Texas-based firm that provides health plan administration services is notifying more than 2.4 million individuals […]
Children crying out for stability are paying the highest price for Britain’s chaotic and exploitative residential care
I’m a patron of a small local charity that helps struggling children to rebuild trust and connection. It’s called Sirona Therapeutic Horsemanship, and it works by bringing them together with rescued horses. The horses, like many of the children, arrive traumatised, anxious and frightened. They help each other to heal. Children who have lost their trust in humans can find it in horses, which neither threaten nor judge them, then build on that relationship gradually to reconnect with people.
It’s an astonishing, inspiring thing to witness, as the children begin to calm, uncurl and find purpose and hope. It can have life-changing results. But, though I can in no way speak on Sirona’s behalf, I’m painfully aware that such charities can help only a tiny fraction of the children in desperate need of stable relationships, trust and love.
A vivid cultural of digestion, from ancient Greece to All-Bran
Some people, observed Samuel Johnson, “have a foolish way of not minding, or pretending not to mind, what they eat. For my part, I mind my belly very studiously, and very carefully; for I look upon it, that he who does not mind his belly, will hardly mind anything else.” And while we are minding our belly, our belly minds us: so, at least, we are encouraged to think by modern hymns to the wisdom of the enteric nervous system and the gut microbiome, to which all manner of marvels are increasingly attributed.
Here, then, is a book-length exercise in minding the belly: a vivid cultural history of changing metaphorical, political and scientific visions of our guts. The stomach is a-flutter when we are in love, and the way to a man’s heart is through his stomach, though not for laparoscopic surgeons. (That phrase was apparently coined by the 19th-century American journalist Fanny Fern.) But our guts are also cerebral: the Greek physician Galen first observed that the stomach seemed to possess its own kind of intelligence, and to trust your gut is to tune into a more reliable source of truth. Donald Trump is here marvellously quoted as insisting that his gut can tell him more than other people’s brains can.
The author, a health historian, displays a touch of that academic tic whereby a book constantly narrates that it has just talked about something and is going to talk about something else next, but she is an engaging writer and adeptly traces a network of fascinating changes in ruling metaphors. “Today we speak in ecological terms – adverts for probiotics encourage us to nurture the microbial garden within – but in early modern Europe the stomach was imagined as being more alike to the bustling kitchen of a great country house, while 18th-century physicians fussed over it as a nervously afflicted invalid and through the Victorian period it was frequently condemned as an irascible foe, an enemy within implacably opposed to its owner’s comfort.”
In the long-running fable of the body politic, meanwhile, the digestive system has been two opposed things in series: first, an unruly populace to be kept in its place by a wise head; then the site of authentic proletarian value. The 20th-century American philosopher Stanley Cavell, discussing such metaphors in Shakespeare’s Coriolanus, concluded splendidly: “No one is in a position to say what the right expression is of our knowledge that we are strung out on both sides of a belly.”
For some, our ungovernable guts have always stood in the way of progress and humanity’s perfection, both technological and spiritual. The 17th-century hermit Roger Crab became famous for his ascetic diet of “herbes and roots”: only vegetarianism could lead to godliness. A prominent Victorian doctor, meanwhile, denounced the stomach as a “strangely wicked and ungrateful” organ that was “implacably opposed to man’s progress and comfort”. In the early 20th century, vivisectionists discovered new facts about the machinery of digestion by means of horrific experiments on living dogs in packed lecture theatres, and suffragists on hunger strike were force-fed by violence.
Women in particular, Richardson shows, have long been the focus of worries about digestion. Many accusations of witchcraft in the early modern period centred on allegations that women had spoiled food or milk; centuries later, constipation became coded as a particularly female complaint, to be cured by such quasi-medicinal products as Bile Beans (an Australian laxative introduced in 1899, to keep female customers “healthy, happy & slim”) and Kellogg’s cereals, which according to one 1930 advert for All-Bran would preserve a woman’s “bloom of youth” by keeping her regular. Contrariwise, to “have guts” in the sense of being tough is primarily thought of as a male virtue, while “intestinal fortitude” (coined by an American doctor after watching a football game in 1914) came to describe the warfighting capability of a nation’s men.
Now, however, our guts are peaceful: the alimentary system has been colonised anew by the wellness-industrial complex, with its probiotics and experimental faecal transplants. Dr Johnson might be tickled to learn that to mind one’s belly has become a cornerstone of mindfulness.
Sue Wathen, Joan Edgington and Nicola Leahey were diagnosed with hepatitis C after struggling through years of unexplained symptoms that were dismissed by doctors.
Enlarge/ Packaging for Wegovy, manufactured by Novo Nordisk, is seen in this illustration photo. (credit: Getty | Jakub Porzycki)
With the debut of remarkably effective weight-loss drugs, America's high obesity rate and its uniquely astronomical prescription drug pricing appear to be set on a catastrophic collision course—one that threatens to "bankrupt our entire health care system," according to a new Senate report that modeled the economic impact of the drugs in different uptake scenarios.
If just half of the adults in the US with obesity start taking a new weight-loss drug, such as Wegovy, the collective cost would total an estimated $411 billion per year, the analysis found. That's more than the $406 billion Americans spent in 2022 on all prescription drugs combined.
While the bulk of the spending on weight-loss drugs will occur in the commercial market—which could easily lead to spikes in health insurance premiums—taxpayer-funded Medicare and Medicaid programs will also see an extraordinary financial burden. In the scenario that half of adults with obesity go on the drug, the cost to those federal programs would total $166 billion per year, rivaling the programs' total 2022 drug costs of $175 billion.
AttackIQ has released a new attack graph in response to the recently published CISA Advisory (AA24-131A) which disseminates known Tactics, Techniques, and Procedures (TTPs) and Indicators of Compromise (IOCs) associated to Black Basta ransomware, a ransomware variant whose operators have encrypted and stolen data from at least 12 out of 16 critical infrastructure sectors, including the Healthcare and Public Health (HPH) Sector.
Patients are already dying as wonder drugs lose their effectiveness. International action is urgently needed
As apocalyptic horror stories go, it’s up there with the scariest. Yet it’s not fiction writers but top scientists who are warning of how the world could look once superbugs develop resistance to the remaining drugs against them in our hospital pharmacies. Patients will die who can currently be cured; routine surgery will become dangerous or impossible. Antimicrobial resistance (AMR) – it happens not only with bacteria but also viruses, fungi and parasites – is one of the top global public health threats facing humanity, says the World Health Organization (WHO). It kills 1.3 million people and contributes to 5 million deaths every year, predicted to be 10 million by 2050. In addition to the appalling human toll, it will increase the strain on and costs of health services. But is it high enough up the agenda? Covid-19 knocked it off, and the climate crisis gets more attention. AMR does not so often get top billing.
This week efforts have been made to change that, with talks at the UN triggering wider coverage chronicling the sorry plight we are in. From the pharmaceutical industry to the WHO to NHS England, the same tune is being played: we are not doing enough to avert disaster.
I was around for the Shrewsbury and Telford hospital trust report a couple of years ago. All those dead babies, all those mothers and parents talking about not being listened to or respected. All that handwringing from service providers, all those promises from politicians. The recommendations were set up to prevent the experiences we heard about this week (‘I was left lying on the ground in pain’: shocking stories from UK birth trauma inquiry, 13 May). For instance, continuity of midwifery care through the maternal pathway prevents so much of the stuff we read about now.
Exclusive: Experts call for higher taxes and tougher regulation as research shows cost to NHS, other public services and economy
The cost of alcohol abuse is laid bare in a new study that shows £27bn a year being spent in England on the health and social harms of drinking.
The research that found the extra burden on the NHS, social services, the criminal justice system and the labour market cost at least 37% more than in 2003, when comparable research by the Cabinet Office estimated the costs at between £18.5bn and £20bn.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
Last week, I scoured the internet in search of a robotic dog. I wanted a belated birthday present for my aunt, who was recently diagnosed with Alzheimer’s disease. Studies suggest that having a companion animal can stave off some of the loneliness, anxiety, and agitation that come with Alzheimer’s. My aunt would love a real dog, but she can’t have one.
That’s how I discovered the Golden Pup from Joy for All. It cocks its head. It sports a jaunty red bandana. It barks when you talk. It wags when you touch it. It has a realistic heartbeat. And it’s just one of the many, many robots designed for people with Alzheimer’s and dementia.
This week on The Checkup, join me as I go down a rabbit hole. Let’s look at the prospect of using robots to change dementia care.
As robots go, Golden Pup is decidedly low tech. It retails for $140. For around $6,000 you can opt for Paro, a fluffy robotic baby seal developed in Japan, which can sense touch, light, sound, temperature, and posture. Its manufacturer says it develops its own character, remembering behaviors that led its owner to give it attention.
Golden Pup and Paro are available now. But researchers are working on much more sophisticated robots for people with cognitive disorders—devices that leverage AI to converse and play games. Researchers from Indiana University Bloomington are tweaking a commercially available robot system called QT to serve people with dementia and Alzheimer’s. The researchers’ two-foot-tall robot looks a little like a toddler in an astronaut suit. Its round white head holds a screen that displays two eyebrows, two eyes, and a mouth that together form a variety of expressions. The robot engages people in conversation, asking AI-generated questions to keep them talking.
The AI model they’re using isn’t perfect, and neither are the robot’s responses. In one awkward conversation, a study participant told the robot that she has a sister. “I’m sorry to hear that,” the robot responded. “How are you doing?”
But as large language models improve—which is happening already—so will the quality of the conversations. When the QT robot made that awkward comment, it was running Open AI’s GPT-3, which was released in 2020. The latest version of that model, GPT-4o, which was released this week, is faster and provides for more seamless conversations. You can interrupt the conversation, and the model will adjust.
The idea of using robots to keep dementia patients engaged and connected isn’t always an easy sell. Some people see it as an abdication of our social responsibilities. And then there are privacy concerns. The best robotic companions are personalized. They collect information about people’s lives, learn their likes and dislikes, and figure out when to approach them. That kind of data collection can be unnerving, not just for patients but also for medical staff. Lillian Hung, creator of the Innovation in Dementia care and Aging (IDEA) lab at the University of British Columbia in Vancouver, Canada, told one reporter about an incident that happened during a focus group at a care facility. She and her colleagues popped out for lunch. When they returned, they found that staff had unplugged the robot and placed a bag over its head. “They were worried it was secretly recording them,” she said.
On the other hand, robots have some advantages over humans in talking to people with dementia. Their attention doesn’t flag. They don’t get annoyed or angry when they have to repeat themselves. They can’t get stressed.
What’s more, there are increasing numbers of people with dementia, and too few people to care for them. According to the latest report from the Alzheimer’s Association, we’re going to need more than a million additional care workers to meet the needs of people living with dementia between 2021 and 2031. That is the largest gap between labor supply and demand for any single occupation in the United States.
Have you been in an understaffed or poorly staffed memory care facility? I have. Patients are often sedated to make them easier to deal with. They get strapped into wheelchairs and parked in hallways. We barely have enough care workers to take care of the physical needs of people with dementia, let alone provide them with social connection and an enriching environment.
“Caregiving is not just about tending to someone’s bodily concerns; it also means caring for the spirit,” writes Kat McGowan in this beautiful Wiredstory about her parents’ dementia and the promise of social robots. “The needs of adults with and without dementia are not so different: We all search for a sense of belonging, for meaning, for self-actualization.”
If robots can enrich the lives of people with dementia even in the smallest way, and if they can provide companionship where none exists, that’s a win.
“We are currently at an inflection point, where it is becoming relatively easy and inexpensive to develop and deploy [cognitively assistive robots] to deliver personalized interventions to people with dementia, and many companies are vying to capitalize on this trend,” write a team of researchers from the University of California, San Diego, in a 2021 article in Proceedings of We Robot. “However, it is important to carefully consider the ramifications.”
Many of the more advanced social robots may not be ready for prime time, but the low-tech Golden Pup is readily available. My aunt’s illness has been progressing rapidly, and she occasionally gets frustrated and agitated. I’m hoping that Golden Pup might provide a welcome (and calming) distraction. Maybe it will spark joy during a time that has been incredibly confusing and painful for my aunt and uncle. Or maybe not. Certainly a robotic pup isn’t for everyone. Golden Pup may not be a dog. But I’m hoping it can be a friendly companion.
Now read the rest of The Checkup
Read more from MIT Technology Review’s archive
Robots are cool, and with new advances in AI they might also finally be useful around the house, writes Melissa Heikkilä.
Social robots could help make personalized therapy more affordable and accessible to kids with autism. Karen Hao has the story.
Japan is already using robots to help with elder care, but in many cases they require as much work as they save. And reactions among the older people they’re meant to serve are mixed. James Wright wonders whether the robots are “a shiny, expensive distraction from tough choices about how we value people and allocate resources in our societies.”
From around the web
A tiny probe can work its way through arteries in the brain to help doctors spot clots and other problems. The new tool could help surgeons make diagnoses, decide on treatment strategies, and provide assurance that clots have been removed. (Stat)
Richard Slayman, the first recipient of a pig kidney transplant, has died, although the hospital that performed the transplant says the death doesn’t seem to be linked to the kidney. (Washington Post)
EcoHealth, the virus-hunting nonprofit at the center of covid lab-eak theories, has been banned from receiving federal funding. (NYT)
In a first, scientists report that they can translate brain signals into speech without any vocalization or mouth movements, at least for a handful of words. (Nature)
Authorities confirm 46 cases and warn of weeks-long disruption as firms in Brixham hit by cancellations before school half-term
Cases of an illness caused by a microscopic parasite in a Devon harbour town could continue for a further two weeks, experts said, with businesses predicting thousands of pounds of losses as school half-term approaches.
The comments came as the UK Health Security Agency confirmed that cases of cryptosporidium infection in the Brixham area had more than doubled from 22 to 46, with more than 100 others reporting symptoms of the disease.
Harris Wolobah, a previously healthy 14-year-old from Worcester, died September 1, 2023 hours after eating the chip—a 2023 Paqui One Chip Challenge chip—which were sold individually, wrapped in tin foil, and seasoned with two of hottest peppers in the world, the Naga Viper pepper and the Carolina Reaper pepper. Paqui sold the chip with a challenge in which eaters were dared to consume the chip, wait as long as possible before eating or drinking anything, and post the aftermath on social media, where the challenge went viral.
Harris' mother, Lois Wolobah, immediately suspected the chip was involved in his untimely death. At the time, she reportedly said she picked him up from school after getting a call from the nurse. He was clutching his stomach and, about two hours later, lost consciousness and was rushed to the hospital, where he died. She reported that he had no known medical conditions at the time.
A deadlier version of the infectious disease is ravaging the Democratic Republic of Congo, while the type that caused a 2022 outbreak among gay and bisexual men is regaining strength.
The North Carolina State Senate on Wednesday voted 30–15, along party lines, in favor of a Republican bill that would make it illegal for people in the state to wear a mask in public for health reasons. The bill is now moving to the House, where it could potentially see changes.
The proposed ban on health-based masking is part of a larger bill otherwise aimed at increasing penalties for people wearing masks to conceal their identity while committing a crime or impeding traffic. The bill was largely spurred by recent protests on university and college campuses across the country, including North Carolina-based schools, against the war in Gaza. In recent months, there have been demonstrations in Raleigh and Durham that have blocked roadways, as well as clashes on the nearby campus of the University of North Carolina at Chapel Hill. Some demonstrators were seen wearing masks in those events.
But the bill, House Bill 237, goes a step further by making it illegal to wear a mask in public for health and safety reasons, either to protect the wearer, those around them, or both. Specifically, the bill repeals a 2020 legal exemption enacted amid the COVID-19 pandemic, which allowed for public health-based masking for the first time in decades.
No matter who he called—his mother, his father, his brother, his cousins—the phone would just go to voicemail. Cell service was out around Maui as devastating wildfires swept through the Hawaiian island. But while Raven Imperial kept hoping for someone to answer, he couldn’t keep a terrifying thought from sneaking into his mind: What if his family members had perished in the blaze? What if all of them were gone?
Hours passed; then days. All Raven knew at that point was this: there had been a wildfire on August 8, 2023, in Lahaina, where his multigenerational, tight-knit family lived. But from where he was currently based in Northern California, Raven was in the dark. Had his family evacuated? Were they hurt? He watched from afar as horrifying video clips of Front Street burning circulated online.
Much of the area around Lahaina’s Pioneer Mill Smokestack was totally destroyed by wildfire.
ALAMY
The list of missing residents meanwhile climbed into the hundreds.
Raven remembers how frightened he felt: “I thought I had lost them.”
Raven had spent his youth in a four-bedroom, two-bathroom, cream-colored home on Kopili Street that had long housed not just his immediate family but also around 10 to 12 renters, since home prices were so high on Maui. When he and his brother, Raphael Jr., were kids, their dad put up a basketball hoop outside where they’d shoot hoops with neighbors. Raphael Jr.’s high school sweetheart, Christine Mariano, later moved in, and when the couple had a son in 2021, they raised him there too.
From the initial news reports and posts, it seemed as if the fire had destroyed the Imperials’ entire neighborhood near the Pioneer Mill Smokestack—a 225-foot-high structure left over from the days of Maui’s sugar plantations, which Raven’s grandfather had worked on as an immigrant from the Philippines in the mid-1900s.
Then, finally, on August 11, a call to Raven’s brother went through. He’d managed to get a cell signal while standing on the beach.
“Is everyone okay?” Raven asked.
“We’re just trying to find Dad,” Raphael Jr. told his brother.
From his current home in Northern California, Raven Imperial spent days not knowing what had happened to his family in Maui.
WINNI WINTERMEYER
In the three days following the fire, the rest of the family members had slowly found their way back to each other. Raven would learn that most of his immediate family had been separated for 72 hours: Raphael Jr. had been marooned in Kaanapali, four miles north of Lahaina; Christine had been stuck in Wailuku, more than 20 miles away; both young parents had been separated from their son, who escaped with Christine’s parents. Raven’s mother, Evelyn, had also been in Kaanapali, though not where Raphael Jr. had been.
But no one was in contact with Rafael Sr. Evelyn had left their home around noon on the day of the fire and headed to work. That was the last time she had seen him. The last time they had spoken was when she called him just after 3 p.m. and asked: “Are you working?” He replied “No,” before the phone abruptly cut off.
“Everybody was found,” Raven says. “Except for my father.”
Within the week, Raven boarded a plane and flew back to Maui. He would keep looking for him, he told himself, for as long as it took.
That same week, Kim Gin was also on a plane to Maui. It would take half a day to get there from Alabama, where she had moved after retiring from the Sacramento County Coroner’s Office in California a year earlier. But Gin, now an independent consultant on death investigations, knew she had something to offer the response teams in Lahaina. Of all the forensic investigators in the country, she was one of the few who had experience in the immediate aftermath of a wildfire on the vast scale of Maui’s. She was also one of the rare investigators well versed in employing rapid DNA analysis—an emerging but increasingly vital scientific tool used to identify victims in unfolding mass-casualty events.
Gin started her career in Sacramento in 2001 and was working as the coroner 17 years later when Butte County, California, close to 90 miles north, erupted in flames. She had worked fire investigations before, but nothing like the Camp Fire, which burned more than 150,000 acres—an area larger than the city of Chicago. The tiny town of Paradise, the epicenter of the blaze, didn’t have the capacity to handle the rising death toll. Gin’s office had a refrigerated box truck and a 52-foot semitrailer, as well as a morgue that could handle a couple of hundred bodies.
Kim Gin, the former Sacramento County coroner, had worked fire investigations in her career, but nothing prepared her for the 2018 Camp Fire.
BRYAN TARNOWSKI
“Even though I knew it was a fire, I expected more identifications by fingerprints or dental [records]. But that was just me being naïve,” she says. She quickly realized that putting names to the dead, many burned beyond recognition, would rely heavily on DNA.
“The problem then became how long it takes to do the traditional DNA [analysis],” Gin explains, speaking to a significant and long-standing challenge in the field—and the reason DNA identification has long been something of a last resort following large-scale disasters.
While more conventional identification methods—think fingerprints, dental information, or matching something like a knee replacement to medical records—can be a long, tedious process, they don’t take nearly as long as traditional DNA testing.
Historically, the process of making genetic identifications would often stretch on for months, even years. In fires and other situations that result in badly degraded bone or tissue, it can become even more challenging and time consuming to process DNA, which traditionally involves reading the 3 billion base pairs of the human genome and comparing samples found in the field against samples from a family member. Meanwhile, investigators frequently need equipment from the US Department of Justice or the county crime lab to test the samples, so backlogs often pile up.
A supply kit with swabs, gloves, and other items needed to take a DNA sample in the field.
A demo chip for ANDE’s rapid DNA box.
This creates a wait that can be horrendous for family members. Death certificates, federal assistance, insurance money—“all that hinges on that ID,” Gin says. Not to mention the emotional toll of not knowing if their loved ones are alive or dead.
But over the past several years, as fires and other climate-change-fueled disasters have become more common and more cataclysmic, the way their aftermath is processed and their victims identified has been transformed. The grim work following a disaster remains—surveying rubble and ash, distinguishing a piece of plastic from a tiny fragment of bone—but landing a positive identification can now take just a fraction of the time it once did, which may in turn bring families some semblance of peace more swiftly than ever before.
The key innovation driving this progress has been rapid DNA analysis, a methodology that focuses on just over two dozen regions of the genome. The 2018 Camp Fire was the first time the technology was used in a large, live disaster setting, and the first time it was used as the primary way to identify victims. The technology—deployed in small high-tech field devices developed by companies like industry leader ANDE, or in a lab with other rapid DNA techniques developed by Thermo Fisher—is increasingly being used by the US military on the battlefield, and by the FBI and local police departments after sexual assaults and in instances where confirming an ID is challenging, like cases of missing or murdered Indigenous people or migrants. Yet arguably the most effective way to use rapid DNA is in incidents of mass death. In the Camp Fire, 22 victims were identified using traditional methods, while rapid DNA analysis helped with 62 of the remaining 63 victims; it has also been used in recent years following hurricanes and floods, and in the war in Ukraine.
“These families are going to have to wait a long period of time to get identification. How do we make this go faster?”
Tiffany Roy, a forensic DNA expert with consulting company ForensicAid, says she’d be concerned about deploying the technology in a crime scene, where quality evidence is limited and can be quickly “exhausted” by well-meaning investigators who are “not trained DNA analysts.” But, on the whole, Roy and other experts see rapid DNA as a major net positive for the field. “It is definitely a game-changer,” adds Sarah Kerrigan, a professor of forensic science at Sam Houston State University and the director of its Institute for Forensic Research, Training, and Innovation.
But back in those early days after the Camp Fire, all Gin knew was that nearly 1,000 people had been listed as missing, and she was tasked with helping to identify the dead. “Oh my goodness,” she remembers thinking. “These families are going to have to wait a long period of time to get identification. How do we make this go faster?”
Ten days
One flier pleading for information about “Uncle Raffy,” as people in the community knew Rafael Sr., was posted on a brick-red stairwell outside Paradise Supermart, a Filipino store and restaurant in Kahului, 25 miles away from the destruction. In it, just below the words “MISSING Lahaina Victim,” the 63-year-old grandfather smiled with closed lips, wearing a blue Hawaiian shirt, his right hand curled in the shaka sign, thumb and pinky pointing out.
Raven remembers how hard his dad, Rafael, worked. His three jobs took him all over town and earned him the nickname “Mr. Aloha.”
COURTESY OF RAVEN IMPERIAL
“Everybody knew him from restaurant businesses,” Raven says. “He was all over Lahaina, very friendly to everybody.” Raven remembers how hard his dad worked, juggling three jobs: as a draft tech for Anheuser-Busch, setting up services and delivering beer all across town; as a security officer at Allied Universal security services; and as a parking booth attendant at the Sheraton Maui. He connected with so many people that coworkers, friends, and other locals gave him another nickname: “Mr. Aloha.”
Raven also remembers how his dad had always loved karaoke, where he would sing “My Way,” by Frank Sinatra. “That’s the only song that he would sing,” Raven says. “Like, on repeat.”
Since their home had burned down, the Imperials ran their search out of a rental unit in Kihei, which was owned by a local woman one of them knew through her job. The woman had opened her rental to three families in all. It quickly grew crowded with side-by-side beds and piles of donations.
Each day, Evelyn waited for her husband to call.
She managed to catch up with one of their former tenants, who recalled asking Rafael Sr. to leave the house on the day of the fires. But she did not know if he actually did. Evelyn spoke to other neighbors who also remembered seeing Rafael Sr. that day; they told her that they had seen him go back into the house. But they too did not know what happened to him after.
A friend of Raven’s who got into the largely restricted burn zone told him he’d spotted Rafael Sr.’s Toyota Tacoma on the street, not far from their house. He sent a photo. The pickup was burned out, but a passenger-side door was open. The family wondered: Could he have escaped?
Evelyn called the Red Cross. She called the police. Nothing. They waited and hoped.
Back in Paradise in 2018, as Gin worried about the scores of waiting families, she learned there might in fact be a better way to get a positive ID—and a much quicker one. A company called ANDE Rapid DNA had already volunteered its services to the Butte County sheriff and promised that its technology could process DNA and get a match in less than two hours.
“I’ll try anything at this point,” Gin remembers telling the sheriff. “Let’s see this magic box and what it’s going to do.”
In truth, Gin did not think it would work, and certainly not in two hours. When the device arrived, it was “not something huge and fantastical,” she recalls thinking. A little bigger than a microwave, it looked “like an ordinary box that beeps, and you put stuff in, and out comes a result.”
The “stuff,” more specifically, was a cheek or bloodstain swab, or a piece of muscle, or a fragment of bone that had been crushed and demineralized. Instead of reading 3 billion base pairs in this sample, Selden’s machine examined just 27 genome regions characterized by particular repeating sequences. It would be nearly impossible for two unrelated people to have the same repeating sequence in those regions. But a parent and child, or siblings, would match, meaning you could compare DNA found in human remains with DNA samples taken from potential victims’ family members. Making it even more efficient for a coroner like Gin, the machine could run up to five tests at a time and could be operated by anyone with just a little basic training.
ANDE’s chief scientific officer, Richard Selden, a pediatrician who has a PhD in genetics from Harvard, didn’t come up with the idea to focus on a smaller, more manageable number of base pairs to speed up DNA analysis. But it did become something of an obsession for him after he watched the O.J. Simpson trial in the mid-1990s and began to grasp just how long it took for DNA samples to get processed in crime cases. By this point, the FBI had already set up a system for identifying DNA by looking at just 13 regions of the genome; it would later add seven more. Researchers in other countries had also identified other sets of regions to analyze. Drawing on these various methodologies, Selden homed in on the 27 specific areas of DNA he thought would be most effective to examine, and he launched ANDE in 2004.
But he had to build a device to do the analysis. Selden wanted it to be small, portable, and easily used by anyone in the field. In a conventional lab, he says, “from the moment you take that cheek swab to the moment that you have the answer, there are hundreds of laboratory steps.” Traditionally, a human is holding test tubes and iPads and sorting through or processing paperwork. Selden compares it all to using a “conventional typewriter.” He effectively created the more efficient laptop version of DNA analysis by figuring out how to speed up that same process.
No longer would a human have to “open up this bottle and put [the sample] in a pipette and figure out how much, then move it into a tube here.” It is all automated, and the process is confined to a single device.
The rapid DNA analysis boxes from ANDE can be used in the field by anyone with just a bit of training.
ANDE
Once a sample is placed in the box, the DNA binds to a filter in water and the rest of the sample is washed away. Air pressure propels the purified DNA to a reconstitution chamber and then flattens it into a sheet less than a millimeter thick, which is subjected to about 6,000 volts of electricity. It’s “kind of an obstacle course for the DNA,” he explains.
The machine then interprets the donor’s genome and and provides an allele table with a graph showing the peaks for each region and its size. This data is then compared with samples from potential relatives, and the machine reports when it has a match.
Rapid DNA analysis as a technology first received approval for use by the US military in 2014, and in the FBI two years later. Then the Rapid DNA Act of 2017 enabled all US law enforcement agencies to use the technology on site and in real time as an alternative to sending samples off to labs and waiting for results.
But by the time of the Camp Fire the following year, most coroners and local police officers still had no familiarity or experience with it. Neither did Gin. So she decided to put the “magic box” through a test: she gave Selden, who had arrived at the scene to help with the technology, a DNA sample from a victim whose identity she’d already confirmed via fingerprint. The box took about 90 minutes to come back with a result. And to Gin’s surprise, it was the same identification she had already made. Just to make sure, she ran several more samples through the box, also from victims she had already identified. Again, results were returned swiftly, and they confirmed hers.
“I was a believer,” she says.
The next year, Gin helped investigators use rapid DNA technology in the 2019 Conception disaster, when a dive boat caught fire off the Channel Islands in Santa Barbara. “We ID’d 34 victims in 10 days,” Gin says. “Completely done.” Gin now works independently to assist other investigators in mass-fatality events and helps them learn to use the ANDE system.
Its speed made the box a groundbreaking innovation. Death investigations, Gin learned long ago, are not as much about the dead as about giving peace of mind, justice, and closure to the living.
Fourteen days
Many of the people who were initially on the Lahaina missing persons list turned up in the days following the fire. Tearful reunions ensued.
Two weeks after the fire, the Imperials hoped they’d have the same outcome as they loaded into a truck to check out some exciting news: someone had reported seeing Rafael Sr. at a local church. He’d been eating and had burns on his hands and looked disoriented. The caller said the sighting had occurred three days after the fire. Could he still be in the vicinity?
When the family arrived, they couldn’t confirm the lead.
“We were getting a lot of calls,” Raven says. “There were a lot of rumors saying that they found him.”
None of them panned out. They kept looking.
The scenes following large-scale destructive events like the fires in Paradise and Lahaina can be sprawling and dangerous, with victims sometimes dispersed across a large swath of land if many people died trying to escape. Teams need to meticulously and tediously search mountains of mixed, melted, or burned debris just to find bits of human remains that might otherwise be mistaken for a piece of plastic or drywall. Compounding the challenge is the comingling of remains—from people who died huddled together, or in the same location, or alongside pets or other animals.
This is when the work of forensic anthropologists is essential: they have the skills to differentiate between human and animal bones and to find the critical samples that are needed by DNA specialists, fire and arson investigators, forensic pathologists and dentists, and other experts. Rapid DNA analysis “works best in tandem with forensic anthropologists, particularly in wildfires,” Gin explains.
“The first step is determining, is it a bone?” says Robert Mann, a forensic anthropologist at the University of Hawaii John A. Burns School of Medicine on Oahu. Then, is it a human bone? And if so, which one?
Forensic anthropologist Robert Mann has spent his career identifying human remains.
AP PHOTO/LUCY PEMONI
Mann has served on teams that have helped identify the remains of victims after the terrorist attacks of September 11, 2001, and the 2004 Indian Ocean tsunami, among other mass-casualty events. He remembers how in one investigation he received an object believed to be a human bone; it turned out to be a plastic replica. In another case, he was looking through the wreckage of a car accident and spotted what appeared to be a human rib fragment. Upon closer examination, he identified it as a piece of rubber weather stripping from the rear window. “We examine every bone and tooth, no matter how small, fragmented, or burned it might be,” he says. “It’s a time-consuming but critical process because we can’t afford to make a mistake or overlook anything that might help us establish the identity of a person.”
For Mann, the Maui disaster felt particularly immediate. It was right near his home. He was deployed to Lahaina about a week after the fire, as one of more than a dozen forensic anthropologists on scene from universities in places including Oregon, California, and Hawaii.
While some anthropologists searched the recovery zone—looking through what was left of homes, cars, buildings, and streets, and preserving fragmented and burned bone, body parts, and teeth—Mann was stationed in the morgue, where samples were sent for processing.
It used to be much harder to find samples that scientists believed could provide DNA for analysis, but that’s also changed recently as researchers have learned more about what kind of DNA can survive disasters. Two kinds are used in forensic identity testing: nuclear DNA (found within the nuclei of eukaryotic cells) and mitochondrial DNA (found in the mitochondria, organelles located outside the nucleus). Both, it turns out, have survived plane crashes, wars, floods, volcanic eruptions, and fires.
Theories have also been evolving over the past few decades about how to preserve and recover DNA specifically after intense heat exposure. One 2018 study found that a majority of the samples actually survived high heat. Researchers are also learning more about how bone characteristics change depending on the degree. “Different temperatures and how long a body or bone has been exposed to high temperatures affect the likelihood that it will or will not yield usable DNA,” Mann says.
Typically, forensic anthropologists help select which bone or tooth to use for DNA testing, says Mann. Until recently, he explains, scientists believed “you cannot get usable DNA out of burned bone.” But thanks to these new developments, researchers are realizing that with some bone that has been charred, “they’re able to get usable, good DNA out of it,” Mann says. “And that’s new.” Indeed, Selden explains that “in a typical bad fire, what I would expect is 80% to 90% of the samples are going to have enough intact DNA” to get a result from rapid analysis. The rest, he says, may require deeper sequencing.
The aftermath of large-scale destructive events like the fire in Lahaina can be sprawling and dangerous. Teams need to meticulously search through mountains of mixed, melted, or burned debris to find bits of human remains.
GLENN FAWCETT VIA ALAMY
Anthropologists can often tell “simply by looking” if a sample will be good enough to help create an ID. If it’s been burned and blackened, “it might be a good candidate for DNA testing,” Mann says. But if it’s calcined (white and “china-like”), he says, the DNA has probably been destroyed.
On Maui, Mann adds, rapid DNA analysis made the entire process more efficient, with tests coming back in just two hours. “That means while you’re doing the examination of this individual right here on the table, you may be able to get results back on who this person is,” he says. From inside the lab, he watched the science unfold as the number of missing on Maui quickly began to go down.
Within three days, 42 people’s remains were recovered inside Maui homes or buildings and another 39 outside, along with 15 inside vehicles and one in the water. The first confirmed identification of a victim on the island occurred four days after the fire—this one via fingerprint. The ANDE rapid DNA team arrived two days after the fire and deployed four boxes to analyze multiple samples of DNA simultaneously. The first rapid DNA identification happened within that first week.
Sixteen days
More than two weeks after the fire, the list of missing and unaccounted-for individuals was dwindling, but it still had 388 people on it. Rafael Sr. was one of them.
Raven and Raphael Jr. raced to another location: Cupies café in Kahului, more than 20 miles from Lahaina. Someone had reported seeing him there.
Rafael’s family hung posters around the island, desperately hoping for reliable information. (Phone number redacted by MIT Technology Review.)
ERIKA HAYASAKI
The tip was another false lead.
As family and friends continued to search, they stopped by support hubs that had sprouted up around the island, receiving information about Red Cross and FEMA assistance or donation programs as volunteers distributed meals and clothes. These hubs also sometimes offered DNA testing.
Raven still had a “50-50” feeling that his dad might be out there somewhere. But he was beginning to lose some of that hope.
Gin was stationed at one of the support hubs, which offered food, shelter, clothes, and support. “You could also go in and give biological samples,” she says. “We actually moved one of the rapid DNA instruments into the family assistance center, and we were running the family samples there.” Eliminating the need to transport samples from a site to a testing center further cut down any lag time.
Selden had once believed that the biggest hurdle for his technology would be building the actual device, which took about eight years to design and another four years to perfect. But at least in Lahaina, it was something else: persuading distraught and traumatized family members to offer samples for the test.
Nationally, there are serious privacy concerns when it comes to rapid DNA technology. Organizations like the ACLU warn that as police departments and governments begin deploying it more often, there must be more oversight, monitoring, and training in place to ensure that it is always used responsibly, even if that adds some time and expense. But the space is still largely unregulated, and the ACLU fears it could give rise to rogue DNA databases “with far fewer quality, privacy, and security controls than federal databases.”
Family support centers popped up around Maui to offer clothing, food, and other assistance, and sometimes to take DNA samples to help find missing family members.
In a place like Hawaii, these fears are even more palpable. The islands have a long history of US colonialism, military dominance, and exploitation of the Native population and of the large immigrant working-class population employed in the tourism industry.
Native Hawaiians in particular have a fraught relationship with DNA testing. Under a US law signed in 1921, thousands have a right to live on 200,000 designated acres of land trust, almost for free. It was a kind of reparations measure put in place to assist Native Hawaiians whose land had been stolen. Back in 1893, a small group of American sugar plantation owners and descendants of Christian missionaries, backed by US Marines, held Hawaii’s Queen Lili‘uokalani in her palace at gunpoint and forced her to sign over 1.8 million acres to the US, which ultimately seized the islands in 1898.
Hawaii’s Queen Lili‘uokalani was forced to sign over 1.8 million acres to the US.
PUBLIC DOMAIN VIA WIKIMEDIA COMMONS
To lay their claim to the designated land and property, individuals first must prove via DNA tests how much Hawaiian blood they have. But many residents who have submitted their DNA and qualified for the land have died on waiting lists before ever receiving it. Today, Native Hawaiians are struggling to stay on the islands amid skyrocketing housing prices, while others have been forced to move away.
Meanwhile, after the fires, Filipino families faced particularly stark barriers to getting information about financial support, government assistance, housing, and DNA testing. Filipinos make up about 25% of Hawaii’s population and 40% of its workers in the tourism industry. They also make up 46% of undocumented residents in Hawaii—more than any other group. Some encountered language barriers, since they primarily spoke Tagalog or Ilocano. Some worried that people would try to take over their burned land and develop it for themselves. For many, being asked for DNA samples only added to the confusion and suspicion.
Selden says he hears the overall concerns about DNA testing: “If you ask people about DNA in general, they think of Brave New World and [fear] the information is going to be used to somehow harm or control people.” But just like regular DNA analysis, he explains, rapid DNA analysis “has no information on the person’s appearance, their ethnicity, their health, their behavior either in the past, present, or future.” He describes it as a more accurate fingerprint.
Gin tried to help the Lahaina family members understand that their DNA “isn’t going to go anywhere else.” She told them their sample would ultimately be destroyed, something programmed to occur inside ANDE’s machine. (Selden says the boxes were designed to do this for privacy purposes.) But sometimes, Gin realizes, these promises are not enough.
“You still have a large population of people that, in my experience, don’t want to give up their DNA to a government entity,” she says. “They just don’t.”
Gin understands that family members are often nervous to give their DNA samples. She promises the process of rapid DNA analysis respects their privacy, but she knows sometimes promises aren’t enough.
BRYAN TARNOWSKI
The immediate aftermath of a disaster, when people are suffering from shock, PTSD, and displacement, is the worst possible moment to try to educate them about DNA tests and explain the technology and privacy policies. “A lot of them don’t have anything,” Gin says. “They’re just wondering where they’re going to lay their heads down, and how they’re going to get food and shelter and transportation.”
Unfortunately, Lahaina’s survivors won’t be the last people in this position. Particularly given the world’s current climate trajectory, the risk of deadly events in just about every neighborhood and community will rise. And figuring out who survived and who didn’t will be increasingly difficult. Mann recalls his work on the Indian Ocean tsunami, when over 227,000 people died. “The bodies would float off, and they ended up 100 miles away,” he says. Investigators were at times left with remains that had been consumed by sea creatures or degraded by water and weather. He remembers how they struggled to determine: “Who is the person?”
Mann has spent his own career identifying people including “missing soldiers, sailors, airmen, Marines, from all past wars,” as well as people who have died recently. That closure is meaningful for family members, some of them decades, or even lifetimes, removed.
In the end, distrust and conspiracy theories did in fact hinder DNA-identification efforts on Maui, according to a police department report.
33 days
By the time Raven went to a family resource center to submit a swab, some four weeks had gone by. He remembers the quick rub inside his cheek.
Some of his family had already offered their own samples before Raven provided his. For them, waiting wasn’t an issue of mistrusting the testing as much as experiencing confusion and chaos in the weeks after the fire. They believed Uncle Raffy was still alive, and they still held hope of finding him. Offering DNA was a final step in their search.
“I did it for my mom,” Raven says. She still wanted to believe he was alive, but Raven says: “I just had this feeling.” His father, he told himself, must be gone.
Just a day after he gave his sample—on September 11, more than a month after the fire—he was at the temporary house in Kihei when he got the call: “It was,” Raven says, “an automatic match.”
Raven gave a cheek swab about a month after the disappearance of his father. It didn’t take long for him to get a phone call: “It was an automatic match.”
WINNI WINTERMEYER
The investigators let the family know the address where the remains of Rafael Sr. had been found, several blocks away from their home. They put it into Google Maps and realized it was where some family friends lived. The mother and son of that family had been listed as missing too. Rafael Sr., it seemed, had been with or near them in the end.
By October, investigators in Lahaina had obtained and analyzed 215 DNA samples from family members of the missing. By December, DNA analysis had confirmed the identities of 63 of the most recent count of 101 victims. Seventeen more had been identified by fingerprint, 14 via dental records, and two through medical devices, along with three who died in the hospital. While some of the most damaged remains would still be undergoing DNA testing months after the fires, it’s a drastic improvement over the identification processes for 9/11 victims, for instance—today, over 20 years later, some are still being identified by DNA.
Raven remembers how much his father loved karaoke. His favorite song was “My Way,” by Frank Sinatra.
COURTESY OF RAVEN IMPERIAL
Rafael Sr. was born on October 22, 1959, in Naga City, the Philippines. The family held his funeral on his birthday last year. His relatives flew in from Michigan, the Philippines, and California.
Raven says in those weeks of waiting—after all the false tips, the searches, the prayers, the glimmers of hope—deep down the family had already known he was gone. But for Evelyn, Raphael Jr., and the rest of their family, DNA tests were necessary—and, ultimately, a relief, Raven says. “They just needed that closure.”
Erika Hayasaki is an independent journalist based in Southern California.
Zero exercise is not enough. Going for a walk every day is probably a good thing. And if you’re training for a marathon, you’ll be on your feet for a couple hours of hard workouts every week. But what is the benchmark for a human being just trying to squeeze enough healthy exercise into their life? Let’s break it down.
The basics: 150 minutes of cardio and two days of strength training every week
At least 150 minutes per week of moderate intensity (cardio) exercise like walking or easy jogging, or 75 minutes per week of vigorous exercise like running, or a combination. (If you can easily meet that, more is better.)
At least two days per week of muscle strengthening activity, like lifting weights or doing other strength training like pushups, resistance band exercises, or even heavy manual labor like shoveling.
A previous edition of the guidelines said that you need to do your cardio for a minimum of 10 minutes at a time for it to count, but the current recommendation is to get it in however you can, even if that includes some shorter bursts here and there.
What do "moderate" and "vigorous" cardio mean?
If you need help telling these two levels apart, moderate cardio is the kind you can do continuously without feeling too tired. Vigorous cardio is the kind where you find yourself hoping that you'll get a break soon, because oh god I can't keep this up much longer. Or if you're used to exercising with a heart rate monitor, moderate cardio is often considered zone 2 cardio, and vigorous is anything harder.
When you're doing moderate cardio, you'll be a little bit sweatier or breathing a little harder than when you're at rest, but the activity is sustainable: You can speak comfortably in full sentences—think of going on an easy jog with a friend while telling them how your week has been.
Here are some examples of moderate cardio:
A brisk walk (but if this feels too easy, you may need to jog to meet the same level of effort).
Jogging, if you're able to find an easy pace. Alternating between jogging and walking also counts.
Commuting or doing errands by bike, on relatively flat ground.
Using a spin bike or other cardio machines like the elliptical, so long as you do it at a low intensity, steady pace.
By contrast, vigorous cardio includes activities where you're working hard and breathing hard. You might not be able to keep it up very long. This could include:
Running fast
Bicycling uphill
Pushing yourself to finish a Crossfit WOD with a good time
Swimming laps
Playing a game of soccer or basketball
Can I combine moderate and vigorous cardio?
You can mix and match these two intensities. The math is simple if you think about 150 minutes as your target, and consider every minute of vigorous cardio counting double. Here are some examples:
A 20 minute brisk walk every weekday morning (20 minutes x 5 days = 100 minutes moderate cardio) plus a 30-minute spin class that has you working pretty hard (30 minutes counted double is 60; add that to the 100 and you're at 160 minutes).
An hour of hiking, three days a week (60 minutes x 3 sessions = 180 minutes moderate cardio)
Three 30-minute jogs (30 minutes x 3 = 90 minutes moderate cardio) plus a workout with 10 minutes easy jogging for a warmup and then 20 minutes of hard running, followed by a cooldown of another 10 minutes easy. (20 minutes vigorous x 2 is equivalent to 40 minutes moderate cardio, plus we can add the warmup and cooldown for another 20 moderate minutes). That gives you 150 total.
Go for a 30-minute easy bike ride on Monday. Try a 45-minute water aerobics class on Wednesday. Take a short hike on Saturday. Mow the lawn for an hour on Saturday. (30 + 45 + 30 + 60 = 165 moderate cardio)
If you’re pretty athletic, the above won’t sound like much. Good news! The WHO has set a secondary goal for folks like you. It’s simple: just do double the above. So you can aim for 300 minutes of moderate cardio, or 150 minutes per week of vigorous activity. Here's what that might look like:
An intense, hour-long martial arts class three times a week (60 x 3 = 180, but this is vigorous cardio, so the minutes count double)
Run 30 miles per week at an easy pace (if you're fit enough to run your easy pace at about a 10 minute mile, that's 300 minutes moderate cardio)
Commute to work, 20 minutes each way (40 minutes per day x 5 days per week = 200 minutes moderate cardio) and play rec league soccer for two matches per week (50 minutes each game, for some combination of moderate and vigorous cardio, definitely puts us over 300).
Can you get too much exercise?
What about an upper limit on how much exercise you get? There isn’t one, from a public health point of view. More is better. (And even if you are doing less than the recommendations, anything is better than nothing.) That said, it is always possible for you, as an individual, to do more exercise than your body is ready for. Don’t jump from a life of occasional strolling to a marathon training plan. (And if you are on that marathon training plan and you’re feeling worn down, take a break already.)
Strength, Flexibility, and More
So far we’ve been talking about aerobic exercise, which is the kind where you’re continuously moving (or, perhaps, doing quick work/rest intervals) and your heart rate is up. But there are other important forms of exercise, too. The WHO and other organizations recommend two days per week of “high intensity muscle strengthening activity,” which includes anything where you’re thinking in terms of sets and reps. (Three sets of eight to 10 reps is a good structure to start.)
That activity can be anything that challenges your muscles, and where the 10th rep is a lot harder than the first: lifting weights, or resistance band exercises, or bodyweight exercises like push-ups. So if you run three days per week but have time for more, don’t just fit in extra runs; try adding two days in the weight room instead.
The strength training recommendations are for two days per week, per muscle group. If you like to work your upper body and lower body separately, that would mean two upper body days and two lower body days. If you prefer workouts that work all your muscles, you only need to do those twice a week at minimum.
Enlarge/ Wegovy is an injectable prescription weight-loss medicine that has helped people with obesity. (credit: Getty | Michael Siluk)
A large, long-term trial of the weight-loss medication Wegovy (semaglutide) found that people tended to lose weight over the first 65 weeks on the drug—about one year and three months—but then hit a plateau or "set point." But that early weight loss was generally maintained for up to four years while people continued taking the weekly injections.
The findings, published Monday in Nature Medicine, come from a fresh analysis of data from the SELECT trial, which was designed to look at the drug's effects on cardiovascular health. The trial—a multicenter, double-blind, randomized, placebo-controlled trial—specifically enrolled people with existing cardiovascular disease who also were overweight or obese but did not have diabetes. In all, the trial included 17,604 people from 41 countries. Seventy-two percent of them were male, 84 percent were white, and the average age was about 62 years old.
Last year, researchers published the trial's primary results, which showed that semaglutide reduced participants' risk of heart attack, stroke, and cardiovascular-related deaths by 20 percent over the span of a little over three years.
Roller skating has always felt like freedom to me. When you're going fast, you're flying. Even when you're tootling around in a small space, doing little pivots on your wheels, you're moving on your feet in ways that the rest of the world, clad in their sad little shoes, could never. So how can you join the ranks of the roller skaters? It will take a little investment of time and practice, but soon, this could be you.
I used to play roller derby, so I spent years getting comfortable on my skates. In my spare time, I'd practice figure skating moves like turns and jumps, and silly little tricks like "shooting the duck." (During the pandemic lockdowns, I briefly dabbled in skate dancing, which it turns out I am not very good at.) Today I'm going to break down the most essential beginner tips so you can get started as quickly as possible.
Get some skates
When we're talking about "roller skating," I assume that you and I are both thinking of quad skates, the kind that have four wheels, two in the front and two in the back. (I also hear there is something out there called a “roller” “blade”? No idea about those.)
There are two types of quad roller skates you’ll see around. The ones with heeled boots that lace up the ankles are made for doing figure skating moves like jumps and spins, and they work well for casual skating as well. These are your classic retro-style roller skates.
The other type is a low-cut skate that looks more like a sneaker. These give you zero ankle support, but more flexibility. They’re great for the fancy footwork of jam skating, and this is also the style preferred among roller derby players.
Either type is fine to start with, and I’m not gonna judge you if you pick your skates based on what looks the cutest. Just a word of warning: While it’s often a good idea to buy the cheapest option first and upgrade when you wear it out or surpass its abilities, with skates you want to make sure you don’t go too cheap. Anything below $80 or so is suspect.
Some skates are too flimsy or don’t have proper equipment. To spot what's wrong with them, it helps to know a little skate anatomy. Under the boot (the shoe part), we have a plate. The plate needs to be strong enough to support your weight. And then, connecting the wheels to the plate, we have the trucks. These are a moving part that allows some movement between the wheel axle and the plate. It has cushions and is attached to the plate at an angle. Here's a video that explains the anatomy:
So as you're looking at skates, make sure your chosen pair actually has these parts. For example, if the area connecting the wheels is just a smooth piece of plastic, like on these kids’ skates, you don't have trucks at all. That means you can't adjust your trucks, which means you're really limited in the type of movement you can get out of them. You also don't have a way of replacing the trucks without replacing the entire skate.
Another thing to watch out for: Nylon (soft plastic) plates tend to flex too much for people who weigh over 200 pounds or so. Kids and lightweight adults will find these work just fine, but everyone else should look for aluminum or fiberglass plates instead.
Until you fully develop your instincts for falling safely, it’s smart to wear safety gear while you practice. You will fall on your knees, so get kneepads. The skater kind with hard caps are best, but if you want to live a little dangerously, I sometimes use thin dancers’ kneepads like these. If you fall with these on, it will still hurt, but the pad kinda takes the edge off. Get a helmet to protect your head, and consider elbow pads and wrist guards.
There’s a couple things you’ll need to do with your skates to keep them rolling smoothly. First, be able to tighten or loosen the nuts on your wheels. Often, skates will come with the nuts too tight. Make sure they’re loose enough that when you hold the skate up and flick the wheel, it spins freely.
A basic skate tool (like this one) will include a socket for the wheel nuts and a socket for the nuts on your trucks. Looser trucks will steer more sharply, but they’ll feel more wobbly. You’ll need to adjust your trucks to match your skill level and suit the type of skating you want to do.
If you mainly skate on hard indoor floors, you’ll want hard wheels (with a durometer rating in the 90s, such as 90A). If you skate outdoors, softer wheels will give you a smoother roll over rough pavement; the durometer rating for those will usually be in the 80's. Many skaters have a set of outdoor wheels and a set of indoor wheels, and swap them out accordingly.
Your toe stops are another thing to check. Some dance moves work best with no toe stops, so you might want to take yours out and replace them with little nubs called jam plugs. On the flip side, if you skate outside a lot, you may find yourself using your toe stops so much you wear them down. Toe stops can be replaced, and some types allow you to adjust the height, which usually requires an allen wrench.
Get comfortable on your skates
The first step in learning (or relearning) to skate is simply training your body in how to move when you have wheels under you. The fastest way to accomplish this is to just wear your skates at home, whether your house contains good places to skate or not.
That said, use common sense: Don't practice in an area where sharp or delicate things are within reach. Never try to go up or down stairs or navigate tricky terrain until you’re very sure of your skills.
Even if all your floors are carpeted, you’ll get the sense of where to place your weight on your foot as you walk around. Perhaps you’ll find yourself popping up onto your toe stops to get up from a chair. And when you wear your skates in a small space, like in your kitchen while you’re washing dishes, you’ll discover all kinds of ways to pivot and maneuver on your wheels while you’re standing still. All these skills will serve you well when you move out to the rink or the dance floor or the street.
Skate without falling down
You only need a small space to practice the basics. First up, your body position: Always bend your knees at least a little. This helps you to keep your balance, since now you can shift your weight as needed. (Locked knees are a no-no, at least until you're more advanced.)
Learn to stand in a T-stance: Put one foot perpendicularly behind the other. This is very stable, and is how you should stand when you aren't intending to roll anywhere. You can also push off from the sideways skate to get moving. For example, if the side of your right foot is behind your left heel, you can push from your right foot and skate gracefully forward on the left.
Steer on your skates by leaning to the side. With practice, you'll be able to skate in a circle on one foot. (The looser your trucks, the smaller the circle.) To stop, have all your weight on one foot, and slowly bring your other foot behind in that T position. To keep your ankles safe, make sure you're dragging all four wheels of the back foot on the ground, not just the two wheels closest to the moving skate.
Learn some moves
Now we get to the fun part! What are you going to do on your skates? If you plan to head outdoors, remember your helmet and kneepads and start with smooth, flat areas.
Indoors, you can do a lot in a small space. The video below shows some fancy-looking dance moves that are made out of basic steps, like sliding your feet back and forth.
Whatever you choose, stay safe, know your skates, and don’t be afraid to get creative. Support your instructors with a donation anytime you can, and post your moves to social media to encourage others. Happy skating!
To drink raw milk at any time is to flirt with dangerous germs. But, amid an unprecedented outbreak of H5N1 bird flu in US dairy cows, the risks have ratcheted up considerably. Health experts have stepped up warnings against drinking raw milk during the outbreak, the scope of which is still unknown.
Yet, raw milk enthusiasts are undaunted by the heightened risk. The California-based Raw Milk Institute called the warnings "clearly fearmongering." The institute's founder, Mark McAfee, told the Los Angeles Times this weekend that his customers are, in fact, specifically requesting raw milk from H5N1-infected cows. According to McAfee, his customers believe, without evidence, that directly drinking high levels of the avian influenza virus will give them immunity to the deadly pathogen.
Expert Michael Payne told the LA Times that the idea amounts to "playing Russian roulette with your health." Payne, a researcher and dairy outreach coordinator at the Western Institute for Food Safety and Security at UC Davis, added, "Deliberately trying to infect yourself with a known pathogen flies in the face of all medical knowledge and common sense."
Dr. Hilary Cass published a landmark report that led to restrictions on youth gender care in Britain. U.S. health groups said it did not change their support of the care.
Enlarge/ Opal Sandy (center), who was born completely deaf because of a rare genetic condition, can now hear unaided for the first time after receiving gene therapy at 11 months old. She is shown with her mother, father, and sister at their home in Eynsham, Oxfordshire, on May 7, 2024. (credit: Getty | Andrew Matthews)
There are few things more heartwarming than videos of children with deafness gaining the ability to hear, showing them happily turning their heads at the sound of their parents' voices and joyfully bobbing to newly discovered music. Thanks to recent advances in gene therapy, more kids are getting those sweet and triumphant moments—with no hearing aids or cochlear implants needed.
At the annual conference of the American Society for Gene & Cell Therapy held in Baltimore this week, researchers showed many of those videos to their audiences of experts. On Wednesday, Larry Lustig, an otolaryngologist at Columbia University, presented clinical trial data of two children with profound deafness—the most severe type of deafness—who are now able to hear at normal levels after receiving an experimental gene therapy. One of the children was 11 months old at the time of the treatment, marking her as the youngest child in the world to date to receive gene therapy for genetic deafness.
On Thursday, Yilai Shu, an otolaryngologist at Fudan University in Shanghai, provided a one-year progress report on six children who were treated in the first in-human trial of gene therapy for genetic deafness. Five of the six had their hearing restored.
A bioethicist, she pioneered bedside methods for helping patients, their families and doctors deal with anguishing life-and-death decisions in a high-tech age.
Nancy Dubler, director of the bioethics division at Montefiore Medical Center in the Bronx, spoke in 2005 with Fred Haber, who was at his wife’s bedside after a mediation session.
Enlarge/ The Colorado River toad, also known as the Sonoran Desert Toad. (credit: Mark Newman)
It is becoming increasingly accepted that classic psychedelics like LSD, psilocybin, ayahuasca, and mescaline can act as antidepressants and anti-anxiety treatments in addition to causing hallucinations. They act by binding to a serotonin receptor. But there are 14 known types of serotonin receptors, and most of the research into these compounds has focused on only one of them—the one these molecules like, called 5-HT2A. (5-HT, short for 5-hydroxytryptamine, is the chemical name for serotonin.)
The Colorado River toad (Incilius alvarius), also known as the Sonoran Desert toad, secretes a psychedelic compound that likes to bind to a different serotonin receptor subtype called 5-HT1A. And that difference may be the key to developing an entirely distinct class of antidepressants.
Uncovering novel biology
Like other psychedelics, the one the toad produces decreases depression and anxiety and induces meaningful and spiritually significant experiences. It has been used clinically to treat vets with post-traumatic stress disorder and is being developed as a treatment for other neurological disorders and drug abuse. 5-HT1A is a validated therapeutic target, as approved drugs, including the antidepressant Viibryd and the anti-anxiety med Buspar, bind to it. But little is known about how psychedelics engage with this receptor and which effects it mediates, so Daniel Wacker’s lab decided to look into it.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
The human brain is an engineering marvel: 86 billion neurons form some 100 trillion connections to create a network so complex that it is, ironically, mind boggling.
This week scientists published the highest-resolution map yet of one small piece of the brain, a tissue sample one cubic millimeter in size. The resulting data set comprised 1,400 terabytes. (If they were to reconstruct the entire human brain, the data set would be a full zettabyte. That’s a billion terabytes. That’s roughly a year’s worth of all the digital content in the world.)
This map is just one of many that have been in the news in recent years. (I wrote about another brain map last year.) So this week I thought we could walk through some of the ways researchers make these maps and how they hope to use them.
Scientists have been trying to map the brain for as long as they’ve been studying it. One of the most well-known brain maps came from German anatomist Korbinian Brodmann. In the early 1900s, he took sections of the brain that had been stained to highlight their structure and drew maps by hand, with 52 different areas divided according to how the neurons were organized. “He conjectured that they must do different things because the structure of their staining patterns are different,” says Michael Hawrylycz, a computational neuroscientist at the Allen Institute for Brain Science. Updated versions of his maps are still used today.
“With modern technology, we’ve been able to bring a lot more power to the construction,” he says. And over the past couple of decades we’ve seen an explosion of large, richly funded mapping efforts.
BigBrain, which was released in 2013, is a 3D rendering of the brain of a single donor, a 65-year-old woman. To create the atlas, researchers sliced the brain into more than 7,000 sections, took detailed images of each one, and stitched the sections into a three-dimensional reconstruction.
In the Human Connectome Project, researchers scanned 1,200 volunteers in MRI machines to map structural and functional connections in the brain. “They were able to map out what regions were activated in the brain at different times under different activities,” Hawrylycz says.
This kind of noninvasive imaging can provide valuable data, but “Its resolution is extremely coarse,” he adds. “Voxels [think: a 3D pixel] are of the size of a millimeter to three millimeters.”
And there are other projects too. The Synchrotron for Neuroscience—an Asia Pacific Strategic Enterprise, a.k.a. “SYNAPSE,” aims tomap the connections of an entire human brain at a very fine-grain resolution using synchrotron x-ray microscopy. The EBRAINS human brain atlas contains information on anatomy, connectivity, and function.
The work I wrote about last year is part of the $3 billion federally funded Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative, which launched in 2013. In this project, led by the Allen Institute for Brain Science, which has developed a number of brain atlases, researchers are working to develop a parts list detailing the vast array of cells in the human brain by sequencing single cells to look at gene expression. So far they’ve identified more than 3,000 types of brain cells, and they expect to find many more as they map more of the brain.
The draft map was based on brain tissue from just two donors. In the coming years, the team will add samples from hundreds more.
Mapping the cell types present in the brain seems like a straightforward task, but it’s not. The first stumbling block is deciding how to define a cell type. Seth Ament, a neuroscientist at the University of Maryland, likes to give his neuroscience graduate students a rundown of all the different ways brain cells can be defined: by their morphology, or by the way the cells fire, or by their activity during certain behaviors. But gene expression may be the Rosetta stone brain researchers have been looking for, he says: “If you look at cells from the perspective of just what genes are turned on in them, it corresponds almost one to one to all of those other kinds of properties of cells.” That’s the most remarkable discovery from all the cell atlases, he adds.
I have always assumed the point of all these atlases is to gain a better understanding of the brain. But Jeff Lichtman, a neuroscientist at Harvard University, doesn’t think “understanding” is the right word. He likens trying to understand the human brain to trying to understand New York City. It’s impossible. “There’s millions of things going on simultaneously, and everything is working, interacting, in different ways,” he says. “It’s too complicated.”
But as this latest paper shows, it is possible to describe the human brain in excruciating detail. “Having a satisfactory description means simply that if I look at a brain, I’m no longer surprised,” Lichtman says. That day is a long way off, though. The data Lichtman and his colleagues published this week was full of surprises—and many more are waiting to be uncovered.
Now read the rest of The Checkup
Another thing
The revolutionary AI tool AlphaFold, which predicts proteins’ structures on the basis of their genetic sequence, just got an upgrade, James O’Donnell reports. Now the tool can predict interactions between molecules.
And in 2017, we flagged the Human Cell Atlas project, which aims to categorize all the cells of the human body, as a breakthrough technology. That project is still underway.
All these big, costly efforts to map the brain haven’t exactly led to a breakthrough in our understanding of its function, writes Emily Mullin in this story from 2021.
From around the web
The Apple Watch’s atrial fibrillation (AFib) feature received FDA approval to track heart arrhythmias in clinical trials, making it the first digital health product to be qualified under the agency’s Medical Device Development Tools program. (Stat)
A CRISPR gene therapy improved vision in several people with an inherited form of blindness, according to an interim analysis of a small clinical trial to test the therapy. (CNN)
Long read: The covid vaccine, like all vaccines, can cause side effects. But many people who say they have been harmed by the vaccine feel that their injuries are being ignored. (NYT)
A team led by scientists from Harvard and Google has created a 3D, nanoscale-resolution map of a single cubic millimeter of the human brain. Although the map covers just a fraction of the organ—a whole brain is a million times larger—that piece contains roughly 57,000 cells, about 230 millimeters of blood vessels, and nearly 150 million synapses. It is currently the highest-resolution picture of the human brain ever created.
To make a map this finely detailed, the team had to cut the tissue sample into 5,000 slices and scan them with a high-speed electron microscope. Then they used a machine-learning model to help electronically stitch the slices back together and label the features. The raw data set alone took up 1.4 petabytes. “It’s probably the most computer-intensive work in all of neuroscience,” says Michael Hawrylycz, a computational neuroscientist at the Allen Institute for Brain Science, who was not involved in the research. “There is a Herculean amount of work involved.”
Many other brain atlases exist, but most provide much lower-resolution data. At the nanoscale, researchers can trace the brain’s wiring one neuron at a time to the synapses, the places where they connect. “To really understand how the human brain works, how it processes information, how it stores memories, we will ultimately need a map that’s at that resolution,” says Viren Jain, a senior research scientist at Google and coauthor on the paper, published in Science on May 9. The data set itself and a preprint version of this paper were released in 2021.
Brain atlases come in many forms. Some reveal how the cells are organized. Others cover gene expression. This one focuses on connections between cells, a field called “connectomics.” The outermost layer of the brain contains roughly 16 billion neurons that link up with each other to form trillions of connections. A single neuron might receive information from hundreds or even thousands of other neurons and send information to a similar number. That makes tracing these connections an exceedingly complex task, even in just a small piece of the brain..
To create this map, the team faced a number of hurdles. The first problem was finding a sample of brain tissue. The brain deteriorates quickly after death, so cadaver tissue doesn’t work. Instead, the team used a piece of tissue removed from a woman with epilepsy during brain surgery that was meant to help control her seizures.
Once the researchers had the sample, they had to carefully preserve it in resin so that it could be cut into slices, each about a thousandth the thickness of a human hair. Then they imaged the sections using a high-speed electron microscope designed specifically for this project.
Next came the computational challenge. “You have all of these wires traversing everywhere in three dimensions, making all kinds of different connections,” Jain says. The team at Google used a machine-learning model to stitch the slices back together, align each one with the next, color-code the wiring, and find the connections. This is harder than it might seem. “If you make a single mistake, then all of the connections attached to that wire are now incorrect,” Jain says.
“The ability to get this deep a reconstruction of any human brain sample is an important advance,” says Seth Ament, a neuroscientist at the University of Maryland. The map is “the closest to the ground truth that we can get right now.” But he also cautions that it’s a single brain specimen taken from a single individual.
The map, which is freely available at a web platform called Neuroglancer, is meant to be a resource other researchers can use to make their own discoveries. “Now anybody who’s interested in studying the human cortex in this level of detail can go into the data themselves. They can proofread certain structures to make sure everything is correct, and then publish their own findings,” Jain says. (The preprint has already been cited at least 136 times.)
The team has already identified some surprises. For example, some of the long tendrils that carry signals from one neuron to the next formed “whorls,” spots where they twirled around themselves. Axons typically form a single synapse to transmit information to the next cell. The team identified single axons that formed repeated connections—in some cases, 50 separate synapses. Why that might be isn’t yet clear, but the strong bonds could help facilitate very quick or strong reactions to certain stimuli, Jain says. “It’s a very simple finding about the organization of the human cortex,” he says. But “we didn’t know this before because we didn’t have maps at this resolution.”
The data set was full of surprises, says Jeff Lichtman, a neuroscientist at Harvard University who helped lead the research. “There were just so many things in it that were incompatible with what you would read in a textbook.” The researchers may not have explanations for what they’re seeing, but they have plenty of new questions: “That’s the way science moves forward.”
Correction: Due to a transcription error, a quote from Viren Jain referred to how the brain ‘exports’ memories. It has been updated to reflect that he was speaking of how the brain ‘stores’ memories.
A psychiatrist, he ran New York-Presbyterian after a landmark merger, improving its patient care and finances and raising money to expand its footprint across the region.
Ascension, one of the largest nonprofit healthcare systems in the United States, is facing disruptions in clinical operations due to a cyberattack that prompted the organization to take some of its systems offline.
The organization detected unusual activity on select technology network systems on Wednesday, prompting immediate response, investigation initiation and activation of remediation efforts.
Consequently, access to certain systems has been interrupted during the ongoing investigation process.
The healthcare organization has advised its business partners to temporarily sever connections to its systems as a precautionary measure and said it would notify partners when it is safe to reconnect.
The cyber incident has disrupted clinical operations, prompting an investigation into the extent and duration of the disruption. Ascension has notified relevant authorities about the cyberattack and enlisted the services of Mandiant incident response experts to aid in the investigation and remediation efforts.
The organization operates in 19 states and the District of Columbia, Ascension oversees 140 hospitals and 40 senior care facilities.
It also boasts of a significant workforce comprising of 8,500 providers, 35,000 affiliated providers and 134,000 associates. In 2023, Ascension’s total revenue amounted to $28.3 billion.
Patients Say Chaos on Display at Ascension Healthcare
Talking about the disruptions at the healthcare facility, Ascension said, “Our care teams are trained for these kinds of disruptions and have initiated procedures to ensure patient care delivery continues to be safe and as minimally impacted as possible.” But the ground reality seems to be different, as per a patient account.
Talking to local news media Fox 2, a patient named Zackery Lopez said “chaos” was on display this Wednesday in Ascension Providence Southfield hospital where he had to wait nearly seven hours to get a pain medication for his cancer resurgence.
“Right now it is crazy. Nurses are running around. Doctors are running around. There’s no computers whatsoever they can use," Lopez said. "So, they’re actually using charts.”
Lisa Watson, a nurse at Ascension Via Christi St. Joseph in Wichita, Kansas, told another local news outlet that the hospital shut down its operating rooms on Wednesday following the cybersecurity issue. She also said that system’s, which the hospital uses to scan medications of patients was down, along with their electronic charts.
“We are paper-charting all medications, and all lab orders are being hand-written and sent by pneumatic tube systems to the unit they’re supposed to go to,” said Watson.
Natalie Sirianni, an MD at one of the hospital linked to Ascension concurred on the chaos that ensued.
“No one knew where the forms were. Thank god we have a separate sign out with our pts (patients) meds. Nurses were writing them down from memory. This is a new reality we need to be better prepared,” Sirianni wrote on platform X.
She added that the EMR (Electronic Medical Records) was completely down, and that she had to do multiple rounds to make sure her patients got their meds and to check their vitals.
"No one knew where they (forms) were or which ones to use for hours. We need to have the forms ready to go to switch to paper charting. I left still not knowing how to place lab orders, talked with dozens of people from lab to phlebotomy to management, no one knew. No one was prepared and patients suffered."
“We have endless incessant modules about stupid policies to save hospitals money but never about downtime protocol,” she added.
Lopez is also concerned that his personal information was possibly at risk but said he has not received a convincing answer from the authorities yet. "They really didn’t tell me if it was protected or not," he said. "They really kind of just brushed it off when I asked them. They say they’re trying to get everything back on, back on track."
**Update on May 10, 1 AM ET**
The company in a Thursday update said that it did not have a definite timeline to restore systems that were pulled offline as a result of the cybersecurity incident.
“Systems that are currently unavailable include our electronic health records system, MyChart (which enables patients to view their medical records and communicate with their providers), some phone systems, and various systems utilized to order certain tests, procedures and medications.”
It added that patient care was being provided with established downtime protocols and procedures, in which Ascension's workforce is well trained.
“It is expected that we will be utilizing downtime procedures for some time. Patients should bring to their appointment notes on their symptoms and a list of current medications and prescription numbers or the prescription bottles so their care team can call in medication needs to pharmacies,” the update said.
As a precautionary measure, some non-emergent elective procedures, tests and appointments have been temporarily paused and patients appointments or procedures will need to be rescheduled.
“Due to downtime procedures, several hospitals are currently on diversion for emergency medical services in order to ensure emergency cases are triaged immediately.”
Healthcare Breaches on the Rise
This incident adds to a growing list of healthcare breaches and ransomware attacks, including the Change Healthcare that caused widespread disruptions across U.S. Initially described as an “enterprise-wide connectivity issue,” the severity of the attack went a bar above when Blackcat – also known as Alphv ransomware gang claimed responsibility for it.
The Russia-based ransomware and extortion gang claimed to have stolen millions of Americans’ sensitive health and patient information, a tactic commonly employed by ransomware gangs to exert pressure on victims. However, on February 29, Blackcat withdrew its claim on the breached data of the healthcare group, raising questions if a ransom was paid.
The company did confirm that is paid a $22 million ransom later but it now faces multiple lawsuits for alleged negligence in safeguarding clients’ personal information. The parent company UnitedHealth has allocated over $2 billion to fight the fallout of the Change Healthcare data breach.
The company last week also stated that a lack of multi-factor authentication (MFA) resulted into the massive hack.
In a related development, the U.S. Department of Health and Human Services (HHS) recently cautioned about threat actors employing social engineering tactics to target IT help desks in the Healthcare and Public Health (HPH) sector.
These attackers employ deception to enroll new multi-factor authentication (MFA) devices under their control, thereby gaining access to corporate resources, the HHS warned.
Media Disclaimer: This report is based on internal and external research obtained through various means. The information provided is for reference purposes only, and users bear full responsibility for their reliance on it. The Cyber Express assumes no liability for the accuracy or consequences of using this information.
KINGSTON — Four years after shelving the project due to the COVID-19 pandemic, the city is to look at adding fluoride to the municipal water supply. Read More
Biodiversity loss, global warming, pollution and the spread of invasive species are making infectious diseases more dangerous to organisms around the world.
White-footed mice, the primary reservoir for Lyme disease, have become more dominant in the U.S. as other rarer mammals have disappeared, one potential explanation for rising disease rates.
MedStar Health, a prominent non-profit healthcare provider disclosed a data breach that impacts more than 183,000 patients from its hundreds of care locations which it operates in the Baltimore-Washington area in the U.S.
The not-for-profit healthcare provider is worth $7.7 billion and is one of the largest employers in the region with more than 34,000 associates working across 300 care locations including 10 hospitals and 33 urgent care clinics, ambulatory care centers and primary and specialty care providers. They together treat hundreds of thousands of patients on a yearly basis.
The impacted individuals' personal data may have been compromised when an outsider gained access to emails and files of three employees, MedStar Health said in a statement on the data breach.
MedStar Health reported notifying 183,709 affected patients via letters and filed a notice with the Department of Health and Human Services.
The unauthorized access occurred sporadically between January and October last year, with patient information found in breached files and emails. Although there's no indication of actual acquisition or viewing of patient data, the company couldn't rule out such access.
Patient information including names, addresses, dates of birth, service dates, provider names and insurance details, were contained in the compromised emails and files, MedStar Health said.
The healthcare provider urged affected patients to monitor healthcare statements for any unusual activities and assured implementation of new safeguards to prevent future breaches.
Earlier MedStar Health Data Breach
The digital woes of the healthcare provider are not new. In fact, this is the second time in a decade that MedStar Health is facing a massive data breach scare.
In 2016, a virus, likely a ransomware malware infected the computer network of MedStar Health. This prompted a complete shutdown of services for the healthcare giant, which resulted in diversion of new patients to other hospitals and the care givers had to resort to pen and paper to continue regular operations.
The impact was such that the FBI was called in to investigate the MedStar Health data breach, which followed similar cyberattacks on at least three other medical institutions in California and Kentucky.
Healthcare Breaches on the Rise
This incident adds to a growing list of healthcare breaches and ransomware attacks, including the Change Healthcare that caused widespread disruptions across U.S. Initially described as an “enterprise-wide connectivity issue,” the severity of the attack went a bar above when Blackcat – also known as Alphv – ransomware gang claimed responsibility for it.
The Russia-based ransomware and extortion gang claimed to have stolen millions of Americans’ sensitive health and patient information, a tactic commonly employed by ransomware gangs to exert pressure on victims. However, on February 29, Blackcat withdrew its claim on the breached data of the healthcare group, raising questions if a ransom was paid.
The company did confirm that is paid a $22 million ransom later but it now faces multiple lawsuits for alleged negligence in safeguarding clients' personal information. The parent company UnitedHealth has allocated over $2 billion to fight the fallout of the Change Healthcare data breach.
The company last week also stated that a lack of multi-factor authentication (MFA) resulted into the massive hack.
Blackcat in September 2023 claimed a similar data breach on McLaren Healthcare, where nearly 6 terabytes worth of data was siphoned. Owing to such large scale healthcare data breaches, the U.S. Cybersecurity and Infrastructure Security Agency in March unveiled a cybersecurity toolkit for healthcare sector that would help them implement advanced tools, that fortify their defenses against evolving threats.
Media Disclaimer: This report is based on internal and external research obtained through various means. The information provided is for reference purposes only, and users bear full responsibility for their reliance on it. The Cyber Express assumes no liability for the accuracy or consequences of using this information.
Enlarge/ Dispensers for Charged Lemondade, a caffeinated lemonade drink, at Panera Bread, Walnut Creek, California, March 27, 2023. (credit: Getty | Smith Collection/Gado)
Panera Bread will stop selling its highly caffeinated "Charged" drinks, which have been the subject of at least three lawsuits and linked to at least two deaths.
It is unclear when exactly the company will pull the plug on the potent potables, but in a statement to Ars Tuesday, Panera said it was undergoing a "menu transformation" that includes an "enhanced beverage portfolio." The company plans to roll out various new drinks, including a lemonade and tea, but a spokesperson confirmed that the new flavors would not contain added caffeine as the "charged" drinks did.
The fast-casual cafe-style chain drew national attention in 2022 for the unexpectedly high caffeine levels in the drinks, which were initially offered as self-serve with free refills.
Enlarge/ Cleveland doctor Sherri Tenpenny gives false testimony on June 8, 2021, saying COVID-19 vaccines magnetize people. (credit: The Ohio Channel)
An anti-vaccine doctor best known for losing her medical license after falsely claiming that COVID-19 vaccines cause people to become magnetic and "interface" with 5G towers, has had her medical license restored, according to local media reports.
Sherri Tenpenny, an osteopathic doctor in the Cleveland area, beamed into the national spotlight in June 2021 while giving repelling testimony before state lawmakers about COVID-19 vaccine recipients. "I'm sure you've seen the pictures all over the Internet of people who have had these shots and now they're magnetized," Tenpenny said in her viral testimony. "You can put a key on their forehead—it sticks. You can put spoons and forks all over and they can stick because now we think there is a metal piece to that."
Her testimony was in support of a bill that would largely ban vaccine mandates in Ohio. The bill never made it out of committee. But the state's medical board opened an investigation the next month. The board intended to ask Tenpenny a variety of questions, including about her statements "regarding COVID-19 vaccines causing people to become magnetized or creating an interface with 5G towers… and regarding some major metropolitan areas liquefying dead bodies and pouring them into the water supply," according to a board report.
Five years ago I split my first apple in half, inspired by a video clip on the internet and the audacity to think that maybe, if I really believed in myself, I might be able to join the ranks of the apple-splitters. I achieved glory and success (the apple did in fact break in my hands) and I've been riding that high ever since. Today, I return to retell that story and provide an innovation: a way to cheat if your apple-splitting is not going as well as you hoped.
What do you mean, split an apple?
I mean you break it in half, in a way that looks like it could have been cut with a knife. Right down the middle. Here's a video of Paul Rudd wowing the internet with this feat (and, be warned, using some adult language in the process). Amazing! What human being can do that? Surely nobody but Paul Rudd!
I love a good feat of strength and/or skill. In fact, the only thing I love more is hearing that it may be more accessible than at first I assumed. (See also: my brief obsessions with bending nails and flipping kettlebells.) So I was intrigued when strength coach Adam Fisher provided a different perspective:
I don’t mean to diminish the accomplishment of cracking open an apple. It is a feat of strength, and not everybody can do it. But far more people can do it than probably suspect they can. It turns out, Adam is right.
I saw his tweet while I was at a conference, and there was a giant basket of apples in the lobby, so I could test out the apple-splitting trick ASAP. I watched a few YouTube videos on apple splitting, but ultimately it is the apple that teaches you.
How to crack that apple
First, if you have small hands, choose a small apple. And make sure the apple is a crunchy one; a fresh Honeycrisp works well. (My first try was a medium size Gala, and it was tough but I got it.) Consider removing the stem, not for any mechanical advantage but just so it won’t poke you as you are squeezing.
Then:
Locate the squishy, meaty muscle at the base of your thumb. Wedge the thumb meat of both hands into the divot at the top of the apple.
Compress the apple top to bottom as hard as you can. It may help to press the apple against your knee or another convenient surface.
While doing this, pull the apple apart, like opening a book.
If you run into trouble, try a smaller or crispier apple.
And don’t get discouraged. I grabbed three Gala apples from the basket at the hotel, and was only able to crack one of them. Later, when I got home, I bought a bag of small Honeycrisps and was able to split them so easily that I did a few in a row for my kids and then encouraged them to try. None of them quite managed, but I told them all to try again next year when they have grown a bit bigger. Then, suddenly nobody wanted to eat any of the apples, so I’m over here gnawing on them all by myself. Anyway. Give it a try—you might surprise yourself!
How to make the apple easier to split (aka how to cheat)
Look closely—there are two fingernail gouges on the top surface of the apple.Credit: Beth Skwarecki
I sat down with an apple today, thinking my only job was to take a new photo to update this post. But the apple I had on hand--a Kanzi--wasn't cooperating. What to do? I could get some different apples at the store. I could treat this as a strength performance (which it kind of is) and schedule an apple-splitting session for a day I was better rested. Or maybe I could just cheat.
I know from experience that the apple-splitting phenomenon starts with a small, audible crack. You'll hear a soft noise as it begins to split apart, and if you keep applying pressure, all of a sudden the rest of the apple will give.
So what if I give that initial split just a little bit of help? I didn't have a knife within reach, so I dug my thumbnail into the top of the apple, along the line where I imagined it would break. Then I returned to my apple-splitting efforts.
As I predicted, the cracking noise began almost immediately. My cheat didn't make the apple easy to split, but it seemed to get my foot in the door, so to speak. I kept the pressure on, and soon the apple cracked in half just as I was hoping. A few fingernail gouges would be easy to apply surreptitiously if you're doing this trick in front of friends, and honestly you're still splitting an apple in half with no tools other than your bare hands. I hereby deem this a not-too-cheaty-cheat. So go forth and split an apple, ya cheater.
It was a cool morning at the beef teaching unit in Gainesville, Florida, and cow number #307 was bucking in her metal cradle as the arm of a student perched on a stool disappeared into her cervix. The arm held a squirt bottle of water.
Seven other animals stood nearby behind a railing; it would be their turn next to get their uterus flushed out. As soon as the contents of #307’s womb spilled into a bucket, a worker rushed it to a small laboratory set up under the barn’s corrugated gables.
“It’s something!” said a postdoc named Hao Ming, dressed in blue overalls and muck boots, corralling a pink wisp of tissue under the lens of a microscope. But then he stepped back, not as sure. “It’s hard to tell.”
The experiment, at the University of Florida, is an attempt to create a large animal starting only from stem cells—no egg, no sperm, and no conception. A week earlier, “synthetic embryos,” artificial structures created in a lab, had been transferred to the uteruses of all eight cows. Now it was time to see what had grown.
About a decade ago, biologists started to observe that stem cells, left alone in a walled plastic container, will spontaneously self-assemble and try to make an embryo. These structures, sometimes called “embryo models” or embryoids, have gradually become increasingly realistic. In 2022, a lab in Israel grew the mouse version in a jar until cranial folds and a beating heart appeared.
At the Florida center, researchers are now attempting to go all the way. They want to make a live animal. If they do, it wouldn’t just be a totally new way to breed cattle. It could shake our notion of what life even is. “There has never been a birth without an egg,” says Zongliang “Carl” Jiang, the reproductive biologist heading the project. “Everyone says it is so cool, so important, but show me more data—show me it can go into a pregnancy. So that is our goal.”
For now, success isn’t certain, mostly because lab-made embryos generated from stem cells still aren’t exactly like the real thing. They’re more like an embryo seen through a fun-house mirror; the right parts, but in the wrong proportions. That’s why these are being flushed out after just a week—so the researchers can check how far they’ve grown and to learn how to make better ones.
“The stem cells are so smart they know what their fate is,” says Jiang. “But they also need help.”
So far, most research on synthetic embryos has involved mouse or human cells, and it’s stayed in the lab. But last year Jiang, along with researchers in Texas, published a recipe for making a bovine version, which they called “cattle blastoids” for their resemblance to blastocysts, the stage of the embryo suitable for IVF procedures.
Some researchers think that stem-cell animals could be as big a deal as Dolly the sheep, whose birth in 1996 brought cloning technology to barnyards. Cloning, in which an adult cell is placed in an egg, has allowed scientists to copy mice, cattle, pet dogs, and even polo ponies. The players on one Argentine team all ride clones of the same champion mare, named Dolfina.
Synthetic embryos are clones, too—of the starting cells you grow them from. But they’re made without the need for eggs and can be created in far larger numbers—in theory, by the tens of thousands. And that’s what could revolutionize cattle breeding. Imagine that each year’s calves were all copies of the most muscled steer in the world, perfectly designed to turn grass into steak.
“I would love to see this become cloning 2.0,” says Carlos Pinzón-Arteaga, the veterinarian who spearheaded the laboratory work in Texas. “It’s like Star Wars with cows.”
Endangered species
Industry has started to circle around. A company called Genus PLC, which specializes in assisted reproduction of “genetically superior” pigs and cattle, has begun buying patents on synthetic embryos. This year it started funding Jiang’s lab to support his effort, locking up a commercial option to any discoveries he might make.
Zoos are interested too. With many endangered animals, assisted reproduction is difficult. And with recently extinct ones, it’s impossible. All that remains is some tissue in a freezer. But this technology could, theoretically, blow life back into these specimens—turning them into embryos, which could be brought to term in a surrogate of a sister species.
But there’s an even bigger—and stranger—reason to pay attention to Jiang’s effort to make a calf: several labs are creating super-realistic synthetic human embryos as well. It’s an ethically charged arena, particularly given recent changes in US abortion laws. Although these human embryoids are considered nonviable—mere “models” that are fair-game for research—all that could all change quickly if the Florida project succeeds.
“If it can work in an animal, it can work in a human,” says Pinzón-Arteaga, who is now working at Harvard Medical School. “And that’s the Black Mirror episode.”
Industrial embryos
Three weeks before cow #307 stood in the dock, she and seven other heifers had been given stimulating hormones, to trick their bodies into thinking they were pregnant. After that, Jiang’s students had loaded blastoids into a straw they used like a popgun to shoot them towards each animal’s oviducts.
Many researchers think that if a stem-cell animal is born, the first one is likely to be a mouse. Mice are cheap to work with and reproduce fast. And one team has already grown a synthetic mouse embryo for eight days in an artificial womb—a big step, since a mouse pregnancy lasts only three weeks.
But bovines may not be far behind. There’s a large assisted-reproduction industry in cattle, with more than a million IVF attempts a year, half of them in North America. Many other beef and dairy cattle are artificially inseminated with semen from top-rated bulls. “Cattle is harder,” says Jiang. “But we have all the technology.”
Inspecting a “synthetic” embryo that gestated in a cow for a week at the University of Florida, Gainesville.
ANTONIO REGALADO
The thing that came out of cow #307 turned out to be damaged, just a fragment. But later that day, in Jiang’s main laboratory, students were speed-walking across the linoleum holding something in a petri dish. They’d retrieved intact embryonic structures from some of the other cows. These looked long and stringy, like worms, or the skin shed by a miniature snake.
That’s precisely what a two-week-old cattle embryo should look like. But the outer appearance is deceiving, Jiang says. After staining chemicals are added, the specimens are put under a microscope. Then the disorder inside them is apparent. These “elongated structures,” as Jiang calls them, have the right parts—cells of the embryonic disc and placenta—but nothing is in quite the right place.
“I wouldn’t call them embryos yet, because we still can’t say if they are healthy or not,” he says. “Those lineages are there, but they are disorganized.”
Cloning 2.0
Jiang demonstrated how the blastoids are grown in a plastic plate in his lab. First, his students deposit stem cells into narrow tubes. In confinement, the cells begin communicating and very quickly start trying to form a blastoid. “We can generate hundreds of thousands of blastoids. So it’s an industrial process,” he says. “It’s really simple.”
That scalability is what could make blastoids a powerful replacement for cloning technology. Cattle cloning is still a tricky process, which only skilled technicians can manage, and it requires eggs, too, which come from slaughterhouses. But unlike blastoids, cloning is well established and actually works, says Cody Kime, R&D director at Trans Ova Genetics, in Sioux Center, Iowa. Each year, his company clones thousands of pigs as well as hundreds of prize-winning cattle.
“A lot of people would like to see a way to amplify the very best animals as easily as you can,” Kime says. “But blastoids aren’t functional yet. The gene expression is aberrant to the point of total failure. The embryos look blurry, like someone sculpted them out of oatmeal or Play-Doh. It’s not the beautiful thing that you expect. The finer details are missing.”
This spring, Jiang learned that the US Department of Agriculture shared that skepticism, when they rejected his application for $650,000 in funding. “I got criticism: ‘Oh, this is not going to work.’ That this is high risk and low efficiency,” he says. “But to me, this would change the entire breeding program.”
One problem may be the starting cells. Jiang uses bovine embryonic stem cells—taken from cattle embryos. But these stem cells aren’t as quite as versatile as they need to be. For instance, to make the first cattle blastoids, the team in Texas had to add a second type of cell, one that can make a placenta.
What’s needed instead are specially prepared “naïve” cells that are better poised to form the entire conceptus—both the embryo and placenta. Jiang showed me a PowerPoint with a large grid of different growth factors and lab conditions he is testing. Growing stem cells in different chemicals can shift the pattern of genes that are turned on. The latest batch of blastoids, he says, were made using a newer recipe and only needed to start with one type of cell.
Slaughterhouse
Jiang can’t say how long it will be before he makes a calf. His immediate goal is a pregnancy that lasts 30 days. If a synthetic embryo can grow that long, he thinks, it could go all the way, since “most pregnancy loss in cattle is in the first month.”
For a project to reinvent reproduction, Jiang’s budget isn’t particularly large, and he frets about the $2-a-day bill to feed each of his cows. During a tour of UFL’s animal science department, he opened the door to a slaughter room, a vaulted space with tracks and chains overhead, where a man in a slicker was running a hose. It smelled like freshly cleaned blood.
Reproductive biologist Carl Jiang leads an effort to make animals from stem cells. The cow stands in a “hydraulic squeeze chute” while its uterus is checked.
ANTONIO REGALADO
This is where cow #307 ended up. After a about 20 embryo transfers over three years, her cervix was worn out, and she came here. She was butchered, her meat wrapped and labeled, and sold to the public at market prices from a small shop at the front of the building. It’s important to everyone at the university that the research subjects aren’t wasted. “They are food,” says Jiang.
But there’s still a limit to how many cows he can use. He had 18 fresh heifers ready to join the experiment, but what if only 1% of embryos ever develop correctly? That would mean he’d need 100 surrogate mothers to see anything. It reminds Jiang of the first attempts at cloning: Dolly the sheep was one of 277 tries, and the others went nowhere. “How soon it happens may depend on industry. They have a lot of animals. It might take 30 years without them,” he says.
“It’s going to be hard,” agrees Peter Hansen, a distinguished professor in Jiang’s department. “But whoever does it first …” He lets the thought hang. “In vitrobreeding is the next big thing.”
Human question
Cattle aren’t the only species in which researchers are checking the potential of synthetic embryos to keep developing into fetuses. Researchers in China have transplanted synthetic embryos into the wombs of monkeys several times. A report in 2023 found that the transplants caused hormonal signals of pregnancy, although no monkey fetus emerged.
Because monkeys are primates, like us, such experiments raise an obvious question. Will a lab somewhere try to transfer a synthetic embryo to a person? In many countries that would be illegal, and scientific groups say such an experiment should be strictly forbidden.
This summer, research leaders were alarmed by a media frenzy around reports of super-realistic models of human embryos that had been created in labs in the UK and Israel—some of which seemed to be nearly perfect mimics. To quell speculation, in June the International Society for Stem Cell Research, a powerful science and lobbying group, put out a statement declaring that the models “are not embryos” and “cannot and will not develop to the equivalent of postnatal stage humans.”
Some researchers worry that was a reckless thing to say. That’s because the statement would be disproved, biologically, as soon as any kind of stem-cell animal is born. And many top scientists expect that to happen. “I do think there is a pathway. Especially in mice, I think we will get there,” says Jun Wu, who leads the research group at UT Southwestern Medical Center, in Dallas, that collaborated with Jiang. “The question is, if that happens, how will we handle a similar technology in humans?”
Jiang says he doesn’t think anyone is going to make a person from stem cells. And he’s certainly not interested in doing so. He’s just a cattle researcher at an animal science department. “Scientists belong to society, and we need to follow ethical guidelines. So we can’t do it. It’s not allowed,” he says. “But in large animals, we are allowed. We’re encouraged. And so we can make it happen.”
New research finds that the death rate among Black youths soared by 37 percent, and among Native American youths by 22 percent, between 2014 and 2020, compared with less than 5 percent for white youths.
Flowers for Karon Blake, 13, who was shot and killed in Washington, D.C., in January 2023. Gun-related deaths were two to four times higher among Black and Native American youth than among white youth.
A cyberattack targeting a Victorian company has resulted in the exposure of personal data belonging to thousands of victims of family violence and sexual assault, as well as about 60,000 current and former students at Melbourne Polytechnic.
Monash Health Data Breach
Monash Health, the state's largest health service, confirmed it was caught in the cross-hairs of a data breach, which also affected government entities that were clients of the company ZircoDATA.
Monash Health, Victoria's largest health service, found itself entangled in the aftermath of a data breach, which compromised sensitive information collected by family violence and sexual support units between 1970 and 1993.
The breach, attributed to an unauthorized third party gaining access to the systems of document-scanning business ZircoDATA, impacted approximately 4000 individuals who had sought support from these vital services.
The disclosure of details about the sexual violence and assault support units has been deeply distressing for affected victim-survivors. The breach, which involved personal data collected over decades, has raised concerns about the safety and privacy of those who relied on these support services during times of vulnerability.
Amid the fallout from the breach, efforts have been underway to mitigate the risks and support those affected. Monash Health, in collaboration with relevant authorities, has been diligently verifying the identities and addresses of the impacted individuals before initiating contact, ensuring that victims are not inadvertently exposed to further harm.
“The majority of these entities are still in the process of working with ZircoDATA to identify impacted data and any victims, and are yet to begin notifying impacted individuals,” newly appointed coordinator Lieutenant-General Michelle McGuinness said in a statement on X.
In addition to Monash Health, other government entities that were clients of ZircoDATA have also been affected by the breach but “the impact for most government entities is likely to be minimal,” the National Cyber Security Coordinator said.
The breach has prompted federal authorities, including the Australian Federal Police, to launch investigations and coordinate responses to address the scope of the incident and safeguard affected individuals.
ZircoDATA Breach Also Impacts Melbourne Polytechnic
Meanwhile, Melbourne Polytechnic, a prominent educational institution, announced that enrollment information for 60,000 past and present students, stored by ZircoDATA, had been accessed in the breach. Although the breach primarily involved "low-risk identity attributes," the institution has taken proactive steps to offer affected individuals access to cyber support and identity services.
The cybersecurity landscape continues to evolve rapidly, with healthcare emerging as one of the sectors most vulnerable to cyberattacks. A recent report by cybersecurity firm Sophos revealed that healthcare was one of only five sectors to report an increase in cyberattacks over the last year, highlighting the urgent need for heightened vigilance and resilience in safeguarding sensitive data and critical infrastructure.
As organizations grapple with the aftermath of data breaches, there is a pressing need to strengthen cybersecurity measures and response protocols to effectively mitigate risks and protect individuals' privacy and security.
Collaborative efforts between government agencies, healthcare providers, educational institutions, and cybersecurity experts are essential in addressing the complex challenges posed by cyber threats and ensuring the resilience of our digital infrastructure.
In the wake of this cyberattack, authorities have emphasized the importance of transparency, accountability, and support for those affected. By prioritizing the safety and well-being of individuals impacted by data breaches, we can collectively work towards building a more secure and resilient digital ecosystem that safeguards the privacy and security of all stakeholders.
Media Disclaimer: This report is based on internal and external research obtained through various means. The information provided is for reference purposes only, and users bear full responsibility for their reliance on it. The Cyber Express assumes no liability for the accuracy or consequences of using this information.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
Last week, Moderna and Merck launched a large clinical trial in the UK of a promising new cancer therapy: a personalized vaccine that targets a specific set of mutations found in each individual’s tumor. This study is enrolling patients with melanoma. But the companies have also launched a phase III trial for lung cancer. And earlier this month BioNTech and Genentech announced that a personalized vaccine they developed in collaboration shows promise in pancreatic cancer, which has a notoriously poor survival rate.
Drug developers have been working for decades on vaccines to help the body’s immune system fight cancer, without much success. But promising results in the past year suggest that the strategy may be reaching a turning point. Will these therapies finally live up to their promise?
This week in The Checkup, let’s talk cancer vaccines. (And, you guessed it, mRNA.)
Long before companies leveraged mRNA to fight covid, they were developing mRNA vaccines to combat cancer. BioNTech delivered its first mRNA vaccines to people with treatment-resistant melanoma nearly a decade ago. But when the pandemic hit, development of mRNA vaccines jumped into warp drive. Now dozens of trials are underway to test whether these shots can transform cancer the way they did covid.
Recent news has some experts cautiously optimistic. In December, Merck and Moderna announced results from an earlier trial that included 150 people with melanoma who had undergone surgery to have their cancer removed. Doctors administered nine doses of the vaccine over about six months, as well as what’s known as an immune checkpoint inhibitor. After three years of follow-up, the combination had cut the risk of recurrence or death by almost half compared with the checkpoint inhibitor alone.
The new results reported by BioNTech and Genentech, from a small trial of 16 patients with pancreatic cancer, are equally exciting. After surgery to remove the cancer, the participants received immunotherapy, followed by the cancer vaccine and a standard chemotherapy regimen. Half of them responded to the vaccine, and three years after treatment, six of those people still had not had a recurrence of their cancer. The other two had relapsed. Of the eight participants who did not respond to the vaccine, seven had relapsed. Some of these patients might not have responded because they lacked a spleen, which plays an important role in the immune system. The organ was removed as part of their cancer treatment.
The hope is that the strategy will work in many different kinds of cancer. In addition to pancreatic cancer, BioNTech’s personalized vaccine is being tested in colorectal cancer, melanoma, and metastatic cancers.
The purpose of a cancer vaccine is to train the immune system to better recognize malignant cells, so it can destroy them. The immune system has the capacity to clear cancer cells if it can find them. But tumors are slippery. They can hide in plain sight and employ all sorts of tricks to evade our immune defenses. And cancer cells often look like the body’s own cells because, well, they are the body’s own cells.
There are differences between cancer cells and healthy cells, however. Cancer cells acquire mutations that help them grow and survive, and some of those mutations give rise to proteins that stud the surface of the cell—so-called neoantigens.
Personalized cancer vaccines like the ones Moderna and BioNTech are developing are tailored to each patient’s particular cancer. The researchers collect a piece of the patient’s tumor and a sample of healthy cells. They sequence these two samples and compare them in order to identify mutations that are specific to the tumor. Those mutations are then fed into an AI algorithm that selects those most likely to elicit an immune response. Together these neoantigens form a kind of police sketch of the tumor, a rough picture that helps the immune system recognize cancerous cells.
“A lot of immunotherapies stimulate the immune response in a nonspecific way—that is, not directly against the cancer,” said Patrick Ott, director of the Center for Personal Cancer Vaccines at the Dana-Farber Cancer Institute, in a 2022 interview. “Personalized cancer vaccines can direct the immune response to exactly where it needs to be.”
How many neoantigens do you need to create that sketch? “We don’t really know what the magical number is,” says Michelle Brown, vice president of individualized neoantigen therapy at Moderna. Moderna’s vaccine has 34. “It comes down to what we could fit on the mRNA strand, and it gives us multiple shots to ensure that the immune system is stimulated in the right way,” she says. BioNTech is using 20.
The neoantigens are put on an mRNA strand and injected into the patient. From there, they are taken up by cells and translated into proteins, and those proteins are expressed on the cell’s surface, raising an immune response
mRNA isn’t the only way to teach the immune system to recognize neoantigens. Researchers are also delivering neoantigens as DNA, as peptides, or via immune cells or viral vectors. And many companies are working on “off the shelf” cancer vaccines that aren’t personalized, which would save time and expense. Out of about 400 ongoing clinical trials assessing cancer vaccines last fall, roughly 50 included personalized vaccines.
There’s no guarantee any of these strategies will pan out. Even if they do, success in one type of cancer doesn’t automatically mean success against all. Plenty of cancer therapies have shown enormous promise initially, only to fail when they’re moved into large clinical trials.
But the burst of renewed interest and activity around cancer vaccines is encouraging. And personalized vaccines might have a shot at succeeding where others have failed. The strategy makes sense for “a lot of different tumor types and a lot of different settings,” Brown says. “With this technology, we really have a lot of aspirations.”
Now read the rest of The Checkup
Read more from MIT Technology Review’s archive
mRNA vaccines transformed the pandemic. But they can do so much more. In this feature from 2023, Jessica Hamzelou covered the myriad other uses of these shots, including fighting cancer.
This article from 2020 covers some of the background on BioNTech’s efforts to develop personalized cancer vaccines. Adam Piore had the story.
Years before the pandemic, Emily Mullin wrote about early efforts to develop personalized cancer vaccines—the promise and the pitfalls.
From around the web
Yes, there’s bird flu in the nation’s milk supply. About one in five samples had evidence of the H5N1 virus. But new testing by the FDA suggests that the virus is unable to replicate. Pasteurization works! (NYT)
Studies in which volunteers are deliberately infected with covid—so-called challenge trials—have been floated as a way to test drugs and vaccines, and even to learn more about the virus. But it turns out it’s tougher to infect people than you might think. (Nature)
When should women get their first mammogram to screen for breast cancer? It’s a matter of hot debate. In 2009, an expert panel raised the age from 40 to 50. This week they lowered it to 40 again in response to rising cancer rates among younger women. Women with an average risk of breast cancer should get screened every two years, the panel says. (NYT)
Wastewater surveillance helped us track covid. Why not H5N1? A team of researchers from New York argues it might be our best tool for monitoring the spread of this virus. (Stat)
Long read: This story looks at how AI could help us better understand how babies learn language, and focuses on the lab I covered in this story about an AI model trained on the sights and sounds experienced by a single baby. (NYT)
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