The star has Stiff Person Syndrome, meaning moments of elation can trigger potentially lethal spasms. We meet the director who captured the singer’s Las Vegas home life – and one shocking attack that almost killed her

Irene Taylor has travelled the world to tell stories about sexual abuse scandals and oil spills, staunch conservationists and blind Nepalese farmers trying to regain their sight. The Portland-based film-maker is not someone you would usually associate with celebrity-obsessed mainstream America. But decidedly cushier environs are the setting for her latest project: a documentary about Canadian pop singer Celine Dion and her struggle to contend with a rare neurological disorder called Stiff Person Syndrome (SPS). The film is called I Am: Celine Dion.

Pop documentaries have become a bankable streaming-era trend, but if there is anyone equipped to avoid hagiography it’s Taylor, who readily admits to knowing hardly anything about Dion before signing on to the film. “When Titanic came out,” she says of the blockbuster Dion provided the theme tune for, “I was a mountain guide in the Himalayas. I don’t even think I remember when it came out.” When she was approached to work on the documentary, she adds, “I was not a fan. The Celine I understood was ‘Celine Dion’ – what I knew of her was the lowest-hanging fruit.”

Analysis of 400,000 healthy adults finds 4% higher mortality risk among those taking the supplements

Taking a daily multivitamin does not help people to live any longer and may actually increase the risk of an early death, a major study has found.

Researchers in the US analysed health records from nearly 400,000 adults with no major long-term diseases to see whether daily multivitamins reduced their risk of death over the next two decades.

We would like to hear from people who have had emergency NHS care after travelling abroad for treatment

The NHS is having to provide emergency care to patients suffering serious complications following weight loss surgery and hair transplants abroad amid a “boom” in medical tourism, doctors have warned.

If you have had medical treatment abroad and have returned to the UK for follow up care, we would like to hear from you. What treatment did you receive and what were your reasons for travelling abroad? What complications did you experience and how did the NHS help?

Hospitals are all part of London-based trusts hit by cancer care delays after Russian cyber-attack

Junior doctors have been granted permission to work at some hospitals during a looming strike in order to prevent potentially dangerous delays to cancer care, the British Medical Association has said.

The six hospitals where some junior doctors will be allowed to work during the industrial action are all part of the NHS trusts Lewisham and Greenwich, Guy’s and St Thomas’, and King’s College hospital, which are experiencing delays due to a Russian cyber-attack that has resulted in cancer surgeries having to be postponed.

Auditors say financial woes at tech firm Atos could hinder ability of its UK arm to continue as a going concern

The British arm of Atos, the French technology company that is a vital supplier of the NHS and UK government departments, is facing a “material uncertainty” over its ability to continue as a going concern, auditors have warned.

In the latest accounts for its UK holding company covering 2022, the company’s auditor, Grant Thornton, said financial problems facing its parent company in France could limit the UK arm’s ability to access cash and continue as a going concern.

From being popular to taking risks, a myth-busting study of adolescence

What does your reminiscence bump look like? If this sounds like a blow to the head with a touch of amnesia, it isn’t – but it might be just as painful. No, as Lucy Foulkes explains in her eye-opening guide to the psychology of adolescence, it’s the period of life during which people report the greatest number of important autobiographical memories. For most of us it starts around 10 and peaks at 20, taking in a plethora of firsts: first kiss, first love, first time drinking alcohol or taking drugs, first time away from home. Not to mention exams, bullying, breakups and bereavement. Thinking about it, maybe a concussion would be preferable. But then, as Foulkes shows, it’s these enduringly vivid years that define the adults we become.

Chloe’s reminiscence bump gets off to an accelerated start, thanks to her wild friend Natalie: “When I was 14, I broke my ankle, so was off school. Natalie knew where my spare key was so she let herself in, and she woke me up with a spliff and a bottle of alcopop. The school rang me but I said I hadn’t seen her.” Once the ankle had healed, they headed to Skegness to get tattoos, and then spent much of the coming years “having sex with lots of people, taking lots of drugs, truanting from school, going out in cars with much older men”.

Alarm over high mortality and miscarriage rates as mutated virus spreads in eastern Democratic Republic of the Congo

A dangerous strain of mpox that is killing children and causing miscarriages in the Democratic Republic of the Congo is the most transmissible yet and could spread internationally, scientists have warned.

The virus appears to be spreading from person to person via both sexual and non-sexual contact, in places ranging from brothels to schools.

UK researchers say study shows stopping use of the drugs is possible at scale without costly therapy

Almost half of long-term antidepressant users could stop taking the medication with GP support and access to internet or telephone helplines, a study suggests.

Scientists said more than 40% of people involved in the research who were well and not at risk of relapse managed to come off the drugs with advice from their doctors.

Music teacher Nathaniel Dye, 38, who had spoken about delays for treatment, gave update on Tuesday

A man who had a terminal cancer diagnosis, and who described Labour as “the party of hope for a brighter future I won’t live to see” at the party’s manifesto launch, is now cancer-free.

Nathaniel Dye, a 38-year-old music teacher, was diagnosed with stage four incurable bowel cancer in October 2022, and tumours were understood to have spread to his lungs, liver and lymph nodes.

Seventy years after research linked cigarettes with cancer, tighter controls have been delayed once again

Seventy years ago, the British government recognised that smoking caused lung cancer, thanks to a breakthrough in medical science. In an interview to mark the anniversary, Sir Richard Peto, a pioneer in this area, highlighted one way in which the discovery was significant. It led, he said, to a boost for public health comparable with 19th-century improvements in sewerage and water quality.

The shift in attitudes to smoking did not happen suddenly. The tobacco and vapes bill championed by Rishi Sunak, which fell when he called an election, was the culmination of a decades-long process. If the law is resurrected by the next government – as seems likely given the inclusion of similar measures in Labour’s manifesto – it will become illegal to sell tobacco to anyone born since 2009, and vapes will be more tightly controlled.

Health expert cautions against normalisation of tobacco deaths 70 years since direct link between smoking and cancer uncovered

Public health initiatives on smoking in the UK are comparable in scale with the interventions made regarding clean water and sanitation in the 19th century, a leading expert has said.

Sir Richard Peto, emeritus professor of medical statistics and epidemiology at the University of Oxford, worked alongside the scientist Richard Doll, who uncovered a direct link between smoking and cancer 70 years ago on Wednesday.

Britons increasingly seeking cheap weight loss surgery and hair transplants abroad

The NHS is having to provide emergency care to rising numbers of patients suffering serious complications following weight loss surgery and hair transplants abroad amid a “boom” in medical tourism, doctors have warned.

Medics said they were being left to “pick up the pieces” as more Britons seeking cheap operations overseas return with infections and other issues. In some cases, patients are dying as a result of botched surgeries performed in other countries.

Dr Rubin Minhas and Dr Tim Lavin respond to an article by Dr Rachel Clarke on concerns about the role of these healthcare professionals

I don’t recognise the challenges posed by the introduction of physician associates (PAs) in the same way as Dr Rachel Clarke does (What if your ‘physician’ wasn’t actually a doctor at all? Beware this new reckless experiment, 20 June). Introducing a new cohort of healthcare professionals is a tremendous responsibility, and local experience indicates that the capability to manage its implementation is often poor.

Our practice will soon employ four PAs, including two who left other practices where they were all but left to fend for themselves. One recounts how, on her first day in her first job, she was assigned a fully booked clinic with no induction, training or guidance, and made to feel a nuisance when seeking help. This is not uncommon.

UK government deal struck at height of pandemic described as ‘colossal misuse of public funds’

An estimated £1.4bn-worth of personal protective equipment (PPE) bought by the government in a single deal has been destroyed or written off, according to figures described as the worst example of waste in the Covid pandemic.

The figures obtained by the BBC under freedom of information laws showed that 1.57bn items from the NHS supplier Full Support Healthcare will never be used.

Alternatives to costly Wegovy and Saxenda will make such treatments more widely available worldwide

• Ozempic maker invests $4bn to meet US ‘skinny jab’ demand

Medicines that enable dramatic weight loss are likely to experience a new boom in uptake, experts have said, as the first generic versions hit the market this week at a lower cost than the original drugs.

The injections, dubbed “skinny jabs” by the media, can help people lose more than 10% of their body weight and have become hugely popular in recent years, with celebrities lauding their effects.

Anyone who has had a urinary tract infection knows how agonising they can be. Some infections go away on their own, but many need antibiotics.

Beneath the surface of this very common infection lie many mysteries, unanswered questions, and unnecessary suffering. And it gets to the heart of the challenge of tackling antimicrobial resistance.

Madeleine Finlay speaks to Dr Jennifer Rohn, head of the centre for urological biology at University College London, about what we now understand about how UTIs take hold, and the complexity surrounding their treatment

For more information about chronic UTI, visit the CUTIC website.

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. 

Earlier this week, the US surgeon general, also known as the “nation’s doctor,” authored an article making the case that health warnings should accompany social media. The goal: to protect teenagers from its harmful effects. “Adolescents who spend more than three hours a day on social media face double the risk of anxiety and depression symptoms,” Vivek Murthy wrote in a piece published in the New York Times. “Additionally, nearly half of adolescents say social media makes them feel worse about their bodies.”

His concern instinctively resonates with me. I’m in my late 30s, and even I can end up feeling a lot worse about myself after a brief stint on Instagram. I have two young daughters, and I worry about how I’ll respond when they reach adolescence and start asking for access to whatever social media site their peers are using. My children already have a fascination with cell phones; the eldest, who is almost six, will often come into my bedroom at the crack of dawn, find my husband’s phone, and somehow figure out how to blast “Happy Xmas (War Is Over)” at full volume.

But I also know that the relationship between this technology and health isn’t black and white. Social media can affect users in different ways—often positively. So let’s take a closer look at the concerns, the evidence behind them, and how best to tackle them.

Murthy’s concerns aren’t new, of course. In fact, almost any time we are introduced to a new technology, some will warn of its potential dangers. Innovations like the printing press, radio, and television all had their critics back in the day. In 2009, the Daily Mail linked Facebook use to cancer.

More recently, concerns about social media have centered on young people. There’s a lot going on in our teenage years as our brains undergo maturation, our hormones shift, and we explore new ways to form relationships with others. We’re thought to be more vulnerable to mental-health disorders during this period too. Around half of such disorders are thought to develop by the age of 14, and suicide is the fourth-leading cause of death in people aged between 15 and 19, according to the World Health Organization. Many have claimed that social media only makes things worse.

Reports have variously cited cyberbullying, exposure to violent or harmful content, and the promotion of unrealistic body standards, for example, as potential key triggers of low mood and disorders like anxiety and depression. There have also been several high-profile cases of self-harm and suicide with links to social media use, often involving online bullying and abuse. Just this week, the suicide of an 18-year-old in Kerala, India, was linked to cyberbullying. And children have died after taking part in dangerous online challenges made viral on social media, whether from inhaling toxic substances, consuming ultra-spicy tortilla chips, or choking themselves.

Murthy’s new article follows an advisory on social media and youth mental health published by his office in 2023. The 25-page document, which lays out some of known benefits and harms of social media use as well as the “unknowns,” was intended to raise awareness of social media as a health issue. The problem is that things are not entirely clear cut.

“The evidence is currently quite limited,” says Ruth Plackett, a researcher at University College London who studies the impact of social media on mental health in young people. A lot of the research on social media and mental health is correlational. It doesn’t show that social media use causes mental health disorders, Plackett says.

The surgeon general’s advisory cites some of these correlational studies. It also points to survey-based studies, including one looking at mental well-being among college students after the rollout of Facebook in the mid-2000s. But even if you accept the authors’ conclusion that Facebook had a negative impact on the students’ mental health, it doesn’t mean that other social media platforms will have the same effect on other young people. Even Facebook, and the way we use it, has changed a lot in the last 20 years.

Other studies have found that social media has no effect on mental health. In a study published last year, Plackett and her colleagues surveyed 3,228 children in the UK to see how their social media use and mental well-being changed over time. The children were first surveyed when they were aged between 12 and 13, and again when they were 14 to 15 years old.

Plackett expected to find that social media use would harm the young participants. But when she conducted the second round of questionnaires, she found that was not the case. “Time spent on social media was not related to mental-health outcomes two years later,” she tells me.

Other research has found that social media use can be beneficial to young people, especially those from minority groups. It can help some avoid loneliness, strengthen relationships with their peers, and find a safe space to express their identities, says Plackett. Social media isn’t only for socializing, either. Today, young people use these platforms for news, entertainment, school, and even (in the case of influencers) business.

“It’s such a mixed bag of evidence,” says Plackett. “I’d say it’s hard to draw much of a conclusion at the minute.”

In his article, Murthy calls for a warning label to be applied to social media platforms, stating that “social media is associated with significant mental-health harms for adolescents.”

But while Murthy draws comparisons to the effectiveness of warning labels on tobacco products, bingeing on social media doesn’t have the same health risks as chain-smoking cigarettes. We have plenty of strong evidence linking smoking to a range of diseases, including gum disease, emphysema, and lung cancer, among others. We know that smoking can shorten a person’s life expectancy. We can’t make any such claims about social media, no matter what was written in that Daily Mail article.

Health warnings aren’t the only way to prevent any potential harms associated with social media use, as Murthy himself acknowledges. Tech companies could go further in reducing or eliminating violent and harmful content, for a start. And digital literacy education could help inform children and their caregivers how to alter the settings on various social media platforms to better control the content children see, and teach them how to assess the content that does make it to their screens.

I like the sound of these measures. They might even help me put an end to the early-morning Christmas songs. 

Now read the rest of The Checkup

Read more from MIT Technology Review’s archive:

Bills designed to make the internet safer for children have been popping up across the US. But individual states take different approaches, leaving the resulting picture a mess, as Tate Ryan-Mosley explored.

Dozens of US states sued Meta, the parent company of Facebook, last October. As Tate wrote at the time, the states claimed that the company knowingly harmed young users, misled them about safety features and harmful content, and violated laws on children’s privacy.  

China has been implementing increasingly tight controls over how children use the internet. In August last year, the country’s cyberspace administrator issued detailed guidelines that include, for example, a rule to limit use of smart devices to 40 minutes a day for children under the age of eight. And even that use should be limited to content about “elementary education, hobbies and interests, and liberal arts education.” My colleague Zeyi Yang had the story in a previous edition of his weekly newsletter, China Report.

Last year, TikTok set a 60-minute-per-day limit for users under the age of 18. But the Chinese domestic version of the app, Douyin, has even tighter controls, as Zeyi wrote last March.

One way that social media can benefit young people is by allowing them to express their identities in a safe space. Filters that superficially alter a person’s appearance to make it more feminine or masculine can help trans people play with gender expression, as Elizabeth Anne Brown wrote in 2022. She quoted Josie, a trans woman in her early 30s. “The Snapchat girl filter was the final straw in dropping a decade’s worth of repression,” Josie said. “[I] saw something that looked more ‘me’ than anything in a mirror, and I couldn’t go back.”

From around the web

Could gentle shock waves help regenerate heart tissue? A trial of what’s being dubbed a “space hairdryer” suggests the treatment could help people recover from bypass surgery. (BBC)

“We don’t know what’s going on with this virus coming out of China right now.” Anthony Fauci gives his insider account of the first three months of the covid-19 pandemic. (The Atlantic)

Microplastics are everywhere. It was only a matter of time before scientists found them in men’s penises. (The Guardian)

Is the singularity nearer? Ray Kurzweil believes so. He also thinks medical nanobots will allow us to live beyond 120. (Wired)

In a clean room in his lab, Sean Moore peers through a microscope at a bit of intestine, its dark squiggles and rounded structures standing out against a light gray background. This sample is not part of an actual intestine; rather, it’s human intestinal cells on a tiny plastic rectangle, one of 24 so-called “organs on chips” his lab bought three years ago.

Moore, a pediatric gastroenterologist at the University of Virginia School of Medicine, hopes the chips will offer answers to a particularly thorny research problem. He studies rotavirus, a common infection that causes severe diarrhea, vomiting, dehydration, and even death in young children. In the US and other rich nations, up to 98% of the children who are vaccinated against rotavirus develop lifelong immunity. But in low-income countries, only about a third of vaccinated children become immune. Moore wants to know why.

His lab uses mice for some protocols, but animal studies are notoriously bad at identifying human treatments. Around 95% of the drugs developed through animal research fail in people. Researchers have documented this translation gap since at least 1962. “All these pharmaceutical companies know the animal models stink,” says Don Ingber, founder of the Wyss Institute for Biologically Inspired Engineering at Harvard and a leading advocate for organs on chips. “The FDA knows they stink.” 

But until recently there was no other option. Research questions like Moore’s can’t ethically or practically be addressed with a randomized, double-blinded study in humans. Now these organs on chips, also known as microphysiological systems, may offer a truly viable alternative. They look remarkably prosaic: flexible polymer rectangles about the size of a thumb drive. In reality they’re triumphs of bioengineering, intricate constructions furrowed with tiny channels that are lined with living human tissues. These tissues expand and contract with the flow of fluid and air, mimicking key organ functions like breathing, blood flow, and peristalsis, the muscular contractions of the digestive system.

More than 60 companies now produce organs on chips commercially, focusing on five major organs: liver, kidney, lung, intestines, and brain. They’re already being used to understand diseases, discover and test new drugs, and explore personalized approaches to treatment.

As they continue to be refined, they could solve one of the biggest problems in medicine today. “You need to do three things when you’re making a drug,” says Lorna Ewart, a pharmacologist and chief scientific officer of Emulate, a biotech company based in Boston. “You need to show it’s safe. You need to show it works. You need to be able to make it.” 

All new compounds have to pass through a preclinical phase, where they’re tested for safety and effectiveness before moving to clinical trials in humans. Until recently, those tests had to run in at least two animal species—usually rats and dogs—before the drugs were tried on people. 

But in December 2022, President Biden signed the FDA Modernization Act, which amended the original FDA Act of 1938. With a few small word changes, the act opened the door for non-animal-based testing in preclinical trials. Anything that makes it faster and easier for pharmaceutical companies to identify safe and effective drugs means better, potentially cheaper treatments for all of us. 

Moore, for one, is banking on it, hoping the chips help him and his colleagues shed light on the rotavirus vaccine responses that confound them. “If you could figure out the answer,” he says, “you could save a lot of kids’ lives.”

While many teams have worked on organ chips over the last 30 years, the OG in the field is generally acknowledged to be Michael Shuler, a professor emeritus of chemical engineering at Cornell. In the 1980s, Shuler was a math and engineering guy who imagined an “animal on a chip,” a cell culture base seeded with a variety of human cells that could be used for testing drugs. He wanted to position a handful of different organ cells on the same chip, linked to one another, which could mimic the chemical communication between organs and the way drugs move through the body. “This was science fiction,” says Gordana Vunjak-Novakovic, a professor of biomedical engineering at Columbia University whose lab works with cardiac tissue on chips. “There was no body on a chip. There is still no body on a chip. God knows if there will ever be a body on a chip.”

Shuler had hoped to develop a computer model of a multi-organ system, but there were too many unknowns. The living cell culture system he dreamed up was his bid to fill in the blanks. For a while he played with the concept, but the materials simply weren’t good enough to build what he imagined. 

“You can force mice to menstruate, but it’s not really menstruation. You need the human being.”

Linda Griffith, founding professor of biological engineering at MIT and a 2006 recipient of a MacArthur “genius grant”

He wasn’t the only one working on the problem. Linda Griffith, a founding professor of biological engineering at MIT and a 2006 recipient of a MacArthur “genius grant,” designed a crude early version of a liver chip in the late 1990s: a flat silicon chip, just a few hundred micrometers tall, with endothelial cells, oxygen and liquid flowing in and out via pumps, silicone tubing, and a polymer membrane with microscopic holes. She put liver cells from rats on the chip, and those cells organized themselves into three-dimensional tissue. It wasn’t a liver, but it modeled a few of the things a functioning human liver could do. It was a start.

Griffith, who rides a motorcycle for fun and speaks with a soft Southern accent, suffers from endometriosis, an inflammatory condition where cells from the lining of the uterus grow throughout the abdomen. She’s endured decades of nausea, pain, blood loss, and repeated surgeries. She never took medical leaves, instead loading up on Percocet, Advil, and margaritas, keeping a heating pad and couch in her office—a strategy of necessity, as she saw no other choice for a working scientist. Especially a woman. 

And as a scientist, Griffith understood that the chronic diseases affecting women tend to be under-researched, underfunded, and poorly treated. She realized that decades of work with animals hadn’t done a damn thing to make life better for women like her. “We’ve got all this data, but most of that data does not lead to treatments for human diseases,” she says. “You can force mice to menstruate, but it’s not really menstruation. You need the human being.” 

Or, at least, the human cells. Shuler and Griffith, and other scientists in Europe, worked on some of those early chips, but things really kicked off around 2009, when Don Ingber’s lab in Cambridge, Massachusetts, created the first fully functioning organ on a chip. That “lung on a chip” was made from flexible silicone rubber, lined with human lung cells and capillary blood vessel cells that “breathed” like the alveoli—tiny air sacs—in a human lung. A few years later Ingber, an MD-PhD with the tidy good looks of a younger Michael Douglas, founded Emulate, one of the earliest biotech companies making microphysiological systems. Since then he’s become a kind of unofficial ambassador for in vitro technologies in general and organs on chips in particular, giving hundreds of talks, scoring millions in grant money, repping the field with scientists and laypeople. Stephen Colbert once ragged on him after the New York Times quoted him as describing a chip that “walks, talks, and quacks like a human vagina,” a quote Ingber says was taken out of context.

Ingber began his career working on cancer. But he struggled with the required animal research. “I really didn’t want to work with them anymore, because I love animals,” he says. “It was a conscious decision to focus on in vitro models.” He’s not alone; a growing number of young scientists are speaking up about the distress they feel when research protocols cause pain, trauma, injury, and death to lab animals. “I’m a master’s degree student in neuroscience and I think about this constantly. I’ve done such unspeakable, horrible things to mice all in the name of scientific progress, and I feel guilty about this every day,” wrote one anonymous student on Reddit. (Full disclosure: I switched out of a psychology major in college because I didn’t want to cause harm to animals.)

EMULATE

Taking an undergraduate art class led Ingber to an epiphany: mechanical forces are just as important as chemicals and genes in determining the way living creatures work. On a shelf in his office he still displays a model he built in that art class, a simple construction of sticks and fishing line, which helped him realize that cells pull and twist against each other. That realization foreshadowed his current work and helped him design dynamic microfluidic devices that incorporated shear and flow. 

Ingber coauthored a 2022 paper that’s sometimes cited as a watershed in the world of organs on chips. Researchers used Emulate’s liver chips to reevaluate 27 drugs that had previously made it through animal testing and had then gone on to kill 242 people and necessitate more than 60 liver transplants. The liver chips correctly flagged problems with 22 of the 27 drugs, an 87% success rate compared with a 0% success rate for animal testing. It was the first time organs on chips had been directly pitted against animal models, and the results got a lot of attention from the pharmaceutical industry. Dan Tagle, director of the Office of Special Initiatives for the National Center for Advancing Translational Sciences (NCATS), estimates that drug failures cost around $2.6 billion globally each year. The earlier in the process failing compounds can be weeded out, the more room there is for other drugs to succeed.

“The capacity we have to test drugs is more or less fixed in this country,” says Shuler, whose company, Hesperos, also manufactures organs on chips. “There are only so many clinical trials you can do. So if you put a loser into the system, that means something that could have won didn’t get into the system. We want to change the success rate from clinical trials to a much higher number.”

In 2011, the National Institutes of Health established NCATS and started investing in organs on chips and other in vitro technologies. Other government funders, like the Defense Advanced Research Projects Agency and the Food and Drug Administration, have followed suit. For instance, NIH recently funded NASA scientists to send heart tissue on chips into space. Six months in low gravity ages the cardiovascular system 10 years, so this experiment lets researchers study some of the effects of aging without harming animals or humans. 

Scientists have made liver chips, brain chips, heart chips, kidney chips, intestine chips, and even a female reproductive system on a chip (with cells from ovaries, fallopian tubes, and uteruses that release hormones and mimic an actual 28-day menstrual cycle). Each of these chips exhibits some of the specific functions of the organs in question. Cardiac chips, for instance, contain heart cells that beat just like heart muscle, making it possible for researchers to model disorders like cardiomyopathy. 

Shuler thinks organs on chips will revolutionize the world of research for rare diseases. “It is a very good model when you don’t have enough patients for normal clinical trials and you don’t have a good animal model,” he says. “So it’s a way to get drugs to people that couldn’t be developed in our current pharmaceutical model.” Shuler’s own biotech company used organs on chips to test a potential drug for myasthenia gravis, a rare neurological disorder. In 2022,the FDA approved the drug for clinical trials based on that data—one of six Hesperos drugs that have so far made it to that stage. 

Each chip starts with a physiologically based pharmacokinetic model, known as a PBPK model—a mathematical expression of how a chemical compound behaves in a human body. “We try and build a physical replica of the mathematical model of what really occurs in the body,” explains Shuler. That model guides the way the chip is designed, re-creating the amount of time a fluid or chemical stays in that particular organ—what’s known as the residence time. “As long as you have the same residence time, you should get the same response in terms of chemical conversion,” he says.

Tiny channels on each chip, each between 10 and 100 microns in diameter, help bring fluids and oxygen to the cells. “When you get down to less than one micron, you can’t use normal fluid dynamics,” says Shuler. And fluid dynamics matters, because if the fluid moves through the device too quickly, the cells might die; too slowly, and the cells won’t react normally. 

Chip technology, while sophisticated, has some downsides. One of them is user friendliness. “We need to get rid of all this tubing and pumps and make something that’s as simple as a well plate for culturing cells,” says Vunjak-Novakovic. Her lab and others are working on simplifying the design and function of such chips so they’re easier to operate and are compatible with robots, which do repetitive tasks like pipetting in many labs. 

Cost and sourcing can also be challenging. Emulate’s base model, which looks like a simple rectangular box from the outside,starts at around $100,000 and rises steeply from there. Most human cells come from commercial suppliers that arrange for donations from hospital patients. During the pandemic, when people had fewer elective surgeries, many of those sources dried up. As microphysiological systems become more mainstream, finding reliable sources of human cells will be critical.

“As your confidence in using the chips grows, you might say, Okay, we don’t need two animals anymore— we could go with chip plus one animal.”

Lorna Ewart, Chief Scientific Officer, Emulate

Another challenge is that every company producing organs on chips uses its own proprietary methods and technologies. Ingber compares the landscape to the early days of personal computing, when every company developed its own hardware and software, and none of them meshed well. For instance, the microfluidic systems in Emulate’s intestine chips are fueled by micropumps, while those made by Mimetas, another biotech company, use an electronic rocker and gravity to circulate fluids and air. “This is not an academic lab type of challenge,” emphasizes Ingber. “It’s a commercial challenge. There’s no way you can get the same results anywhere in the world with individual academics making [organs on chips], so you have to have commercialization.”

Namandje Bumpus, the FDA’s chief scientist, agrees. “You can find differences [in outcomes] depending even on what types of reagents you’re using,” she says. Those differences mean research can’t be easily reproduced, which diminishes its validity and usefulness. “It would be great to have some standardization,” she adds.

On the plus side, the chip technology could help researchers address some of the most deeply entrenched health inequities in science. Clinical trials have historically recruited white men, underrepresenting people of color, women (especially pregnant and lactating women), the elderly, and other groups. And treatments derived from those trials all too often fail in members of those underrepresented groups, as in Moore’s rotavirus vaccine mystery. “With organs on a chip, you may be able to create systems by which you are very, very thoughtful—where you spread the net wider than has ever been done before,” says Moore.

FELICE FRANKEL

Another advantage is that chips will eventually reduce the need for animals in the lab even as they lead to better human outcomes. “There are aspects of animal research that make all of us uncomfortable, even people that do it,” acknowledges Moore. “The same values that make us uncomfortable about animal research are also the same values that make us uncomfortable with seeing human beings suffer with diseases that we don’t have cures for yet. So we always sort of balance that desire to reduce suffering in all the forms that we see it.”

Lorna Ewart, who spent 20 years at the pharma giant AstraZeneca before joining Emulate, thinks we’re entering a kind of transition time in research, in which scientists use in vitro technologies like organs on chips alongside traditional cell culture methods and animals. “As your confidence in using the chips grows, you might say, Okay, we don’t need two animals anymore—we could go with chip plus one animal,” she says. 

In the meantime, Sean Moore is excited about incorporating intestine chips more and more deeply into his research. His lab has been funded by the Gates Foundation to do what he laughingly describes as a bake-off between intestine chips made by Emulate and Mimetas. They’re infecting the chips with different strains of rotavirus to try to identify the pros and cons of each company’s design. It’s too early for any substantive results, but Moore says he does have data showing that organ chips are a viable model for studying rotavirus infection. That could ultimately be a real game-changer in his lab and in labs around the world.

“There’s more players in the space right now,” says Moore. “And that competition is going to be a healthy thing.” 

Harriet Brown writes about health, medicine, and science. Her most recent book is Shadow Daughter: A Memoir of Estrangement. She’s a professor of magazine, news, and digital journalism at Syracuse University’s Newhouse School. 

Chris Pashley's Background and Experience

The constant vigilance required to protect against evolving threats, and the sheer volume of routine tasks that demand attention contribute significantly to burnout.

The post Cybersecurity Worker Burnout Costing Businesses Big appeared first on Security Boulevard.

NHS Dumfries and Galloway Breach

Risks and Recommendations

With a record-breaking heat dome roasting the eastern half of the United States this week, it’s important to not only stay cool for comfort but to actively avoid experiencing heat exhaustion and its more serious cousin, heat stroke. Knowing the signs of both can help keep you and your friends and family safe.

Heat stroke is a serious condition that can result in seizures, organ failure, and more. And before you get heat stroke, you’ll experience a milder condition called heat exhaustion. Both conditions occur when the body overheats. Normally, our bodies try to cool us down by bringing hot blood from our core to the surface of the skin, where we radiate that heat into our environment. The evaporation that results from sweating also helps to cool our skin. We get into trouble when the environment is too hot or too humid for these mechanisms to cool us down.

Who is at risk for heat exhaustion and heat stroke?

Heat stroke in healthy people is often associated with exercise, since working out raises your core temperature. This is especially the case if you’re not very fit, or if you’re used to working out in cooler weather. As you get used to exercising in the heat, your body learns how to cool itself more efficiently.

Things that increase the risk of heat exhaustion and heat stroke include:

• Exercising in high temperatures and humidity

• Poor fitness

• Being large (regardless of your body type—having a lot of fat or a lot of muscle both affect your ability to cool down)

• Dehydration

• Wearing or carrying gear, like football pads or a hiking pack

• Drinking alcohol

• Using certain medications or supplements, including beta blockers and diuretics

• Any disability or illness that makes it harder for you to get out of the heat or to cool yourself

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Signs and symptoms of heat exhaustion

Heat exhaustion occurs when your core body temperature is elevated, but not enough to involve your brain. If you or an overheated friend shows any sign of being confused, for example, assume it’s heat stroke and get medical help right away.

Signs and symptoms of heat exhaustion may include, according to the CDC:

• Dizziness

• Nausea and vomiting

• Headache

• Fatigue or weakness

• Heavy sweating

• Cold, pale, and clammy skin

• A fast, weak pulse

If you begin to feel these symptoms, start cooling yourself down right away: move to the shade or air conditioning, loosen your clothing, have a cold drink, and keep watch for any signs that you’re feeling worse or not getting better. If you haven’t recovered within an hour, seek medical help.

Signs and symptoms of heat stroke

Heat stroke occurs when the body’s temperature is extremely high (over 104, taken rectally) and can affect the brain as well as the body. The person with heat stroke may be too confused to realize that they are in danger, so watch out for the signs in other people.

Heat stroke is a serious condition, so if you suspect it, get medical help right away. If you’re at an event with medical staff (like if you’re running a marathon or playing in a football game), alert them. Otherwise, call 911 or the emergency number for your area. Signs of heat stroke can include some of the symptoms above, like headache, dizziness, and nausea, plus:

• Confusion, irritability, or hallucination

• Passing out or collapsing

• Trouble walking

• Seizures

• Reddened skin, with or without sweating

You can help the person cool down while you wait for help. Medical staff may decide it’s best to cool the person down before transporting them to a hospital, but that depends on whether the person needs other medical treatment. The ideal way of cooling down a person with heat stroke is to put them in a tub of cold water with ice, and stir the water constantly.

If that’s not possible, a cold shower or a cold hose can work, or apply icy wet towels to the person’s body and swap them out every three minutes or whenever they stop being icy cold.

Nobody likes to feel sluggish and sweaty, so when the sun is set to “broil,” I understand that you’d rather take your workout to an air-conditioned gym. But the human body really can acclimate to exercising in the heat! After a few weeks, these temperatures will be your new normal—and research suggests you may enjoy a small performance boost when the weather cools down again.

Hot workouts can be dangerous, so I trust that you know common sense advice about running in the heat. Among the most important: Drink to thirst (or a little bit more), and stop and get help if you start feeling symptoms of heat illness like nausea, dizziness, or weakness. And while it’s great to work on your ability to run in the heat, don’t be stupid about it—stay inside if the temperature is hotter than you can handle, and stay aware of smog and ozone levels (which get worse on hot days) if you live in an urban area.

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Why exercising in the heat feels so miserable

Running is miserable and heat is miserable, therefore running in the heat is miserable. But there’s more to it than that, and exercising in the heat feels even worse than you'd expect from stacking those two factors together.

Your brain perceives effort differently in the heat, so even before you overheat, you feel sluggish. In a study published in the European Journal of Physiology, cyclists who worked out in a lab with a temperature of 95 degrees were slower than when they did the same time trial at 59 degrees. That makes sense, but here’s the weird part: They didn’t overheat and then slow down. They were slower from the start. It seems our brains slow our bodies down proactively on hot days in order to conserve energy.

As a workout continues, our bodies heat up. In another study, published in the Journal of Applied Physiology, when asked to cycle to exhaustion, participants pooped out when their core temperatures reached 104 degrees, no matter what temperature they started at. The athletes that took the longest to reach that temperature were the ones who wore a fancy water-cooling jacket. You can mimic this effect in your own workouts by drinking ice-cold beverages and pouring water over your head. The longer you can keep your body cool, the longer you can keep up a hard effort.

It's the heat and the humidity

But cooling your body isn’t a complete solution. Dumping a cup of ice water over your head or putting one into your belly only provides momentary relief, and water-cooling jackets aren’t practical outside of physiology labs. So let’s look at what happens in real world conditions.

Your body tries to cool off, in part, by sweating. When moisture evaporates from your skin, it takes some body heat with it. In humid weather, though, sweat doesn’t evaporate as easily because the air is already full of water vapor. So when we’re talking about “heat,” we really mean something more like “perceived heat,” which is a combination of heat and humidity. This heat index chart shows the relationship:

Credit: NOAA

You’ll run slower in the heat (and humidity). While you can find charts like this one that predict how much slower you will run a race, the truth is that heat's effect on your running depends on whether you’re used to the heat, and on your body size.

That’s right—not your fitness level, but your actual physical size. People who are larger have more muscle, fat, or both. Muscle generates heat, and fat acts as an insulator. On the other hand, smaller folks generate less heat, but have more skin through which to dissipate that heat—the ol’ surface area to volume ratio. This is why petite runners place better in races on hot days.

Some people think being more fit makes you better at dealing with heat, but that's only partially true: The fitter you are, the more body heat you produce, just because you’re so good at working hard. Short of changing your body shape (which is possible, but hardly a short-term fix), what can you do to tolerate exercising in the heat better? The answer is simple: Spend more time exercising in the heat.

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Why you should start a heat adaptation protocol

Running in the heat makes you better at running in the heat—and it makes you better, period.

Say you do all your workouts outdoors this summer, while your equally fit twin does identical workouts on a treadmill in an air-conditioned gym. Who do you think will finish first in a 5K on a hot weekend in August? That’s right, you will.

But even if the weather is unseasonably cool on that August day, your heat training will still help you beat your twin. Part of the magic of heat training is that it increases the amount of blood in your veins (the better to put it towards your skin for cooling, while still having enough to fuel your muscles). The effect has been compared to a mild, totally legal version of blood doping. Scientists are still debating exactly how this effect works, and whether it always happens when people attempt to adapt to heat adaptation, but overall the evidence is strong enough that I believe we should all try to get some of those adaptations if we can do so safely.

Here’s the bad news: Heat adaptation takes work. It’s not enough to sit around in the air conditioning all summer, only venturing outside for occasional workouts. A study published in the European Journal of Applied Physiology found that people who made no particular effort to exercise in the heat didn’t have any better heat tolerance in the fall than in the spring. If you want the advantages of heat training, you have to work for them.

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How to adapt to exercising in the heat

Option 1: Train normally, but without avoiding the heat, for two weeks

In scientific research, heat acclimation protocols for athletes generally involve 7 to 10 consecutive days of exercising in the heat, for 60 to 90 minutes each day. A simpler method that can be done by entire teams, or by individuals, is to simply do your normal training in the heat for about two weeks.

Take it easy at first. Remember that your body is still trying to convince you that you are super tired and need to slow down. Safety guidelines for workers provide a reality check here. On their first day in the heat, the Occupational Safety and Health Administration (OSHA) recommends giving workers just 20% of their usual workload. Within a week, they should slowly ramp up to 100%.

Option 2: Spend two hours in the heat every day, whether you're exercising or not

This US Army training protocol provides a good road map for adapting yourself to the heat: Spend at least two hours in the heat each day, it says, and include cardiovascular exercise (like running, cycling, or anything that gets your heart rate up) as part of that. If you can’t handle two hours without feeling symptoms like nausea or dizziness, do what you can and view the two-hour benchmark as a goal to work toward.

You can expect to be better adapted to the heat after about two weeks of spending two hours per day in the heat, although you may be able to start seeing results in just a few days.

Option 3: Visit the sauna after each workout

A way to combine the protocols above, without relying on the weather, is to step into a sauna or hot bath after your workout. If your gym has a sauna, this is a great way to use it. The post-workout sauna time will help your heat adaptation, and you can do it even if your workout was done in less-than-sweltering temperatures. The time spent in the sauna can be 15 to 30 minutes, starting with a shorter time and working up to longer.

How to keep your heat adaptations even when the weather cools off

To stay adapted to the heat, you have to keep spending time in it. You can take a few days off, but if you slack off for a week, you’ll start to lose your hot weather superpowers. This snowballs quickly: you'll lose about 75% of your adaptations after three weeks, according to the Army’s estimates.

To keep up your heat training in cool weather, you can try wearing long sleeves and tights, like elite runner Kara Goucher did when training for a world championship race in muggy Osaka. (She won a bronze medal, the first American ever to do so). She also spent a few weeks in Osaka before the race began; traveling to experience the heat might be an option worth considering if you’re a dedicated athlete with vacation time to burn.

You can also try the opposite of this keep-cool advice, and choose to run at the hottest time of day on asphalt roads with no shade. Or return to the sauna protocol after your cooler-weather workouts. Whatever you do, stay safe, and enjoy your new superpowers.

Data Breach at Los Angeles County DPH: What Happened

• First and last names
• Dates of birth
• Diagnosis and prescription details
• Medical record numbers/patient IDs
• Medicare/Med-Cal numbers
• Health insurance information
• Social Security numbers
• Other financial information

 Data Breach at Los Angeles County DPH Notification 

Response and Preventive Measures

Steps for Individuals to Protect Themselves

• Reviewing Medical Records: Individuals should review their medical records and Explanation of Benefits statements for any discrepancies or unauthorized services. Any irregularities should be reported to their healthcare provider or health plan.
• Requesting Credit Reports: Individuals should remain vigilant against identity theft and fraud by regularly reviewing their financial statements and credit reports. Under US law, individuals are entitled to one free credit report annually from each of the three major credit reporting bureaus: Equifax, Experian, and TransUnion. Free credit reports can be requested at www.annualcreditreport.com or by calling 1-877-322-8228.
• Placing Fraud Alerts: Individuals can place a fraud alert on their credit files, which notifies creditors to take additional steps to verify identity before granting credit. Fraud alerts can be set up by contacting any of the major credit bureaus.
• Security Freezes: A security freeze can also be placed on credit reports, which prevents credit bureaus from releasing any information without written authorization. This measure can help prevent unauthorized credit activity but may delay the approval of new credit requests.

Enlarge / Ryan Gosling in The Fall Guy. (credit: Universal Pictures)

Ryan Gosling plays a Hollywood stuntman in the new action comedy The Fall Guy, a loose adaptation of the popular 1980s TV series of the same name starring Lee Majors. Gosling even did a few of his own stunts, although professional stunt performers handled the most dangerous sequences. It's their job to assume the risk so the stars don't get injured but that can translate into a high rate of head injuries in particular. According to a study published in the Journal of Occupational Medicine and Toxicology, a significant fraction of stunt performers never report such injuries, largely because it's a competitive industry, and they are afraid of losing work. The impacts can lead to more serious cognitive issues later in life.

“Many stunt performers are afraid to report their injuries, especially head trauma, in fear they will be put on a do-not-hire list or looked at as a liability,” said co-author Jeffrey Russell of Ohio University. “The more injuries or trauma, the harder it may be to find work. But that should not be how it is; production companies and their unions should be ensuring stunt performers are taken care of and not reprimanded for any injuries sustained on the job.”

The work builds on Russell's prior research, published last year, looking at the prevalence of head trauma and concussion in stunt performers and how well such injuries are managed. The prevalence of such injuries means that stunt performers are at high risk for chronic traumatic encephalopathy (CTE)—a degenerative brain disease associated with a history of repetitive head impacts that is a cause of much concern in collision sports like football and ice hockey—over the course of their careers.

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Enlarge / Lars Fruergaard Jorgensen, chief executive officer Novo Nordisk A/S, during an interview at the company's headquarters in Bagsvaerd, Denmark, on Monday, June 12, 2023. (credit: Getty | Carsten Snejbjerg)

After some persuasion from Sen. Bernie Sanders (I-Vt.), the CEO of Novo Nordisk will testify before lawmakers later this year on the "outrageously high cost" of the company's diabetes and weight-loss drugs—Ozempic and Wegovy—in the US.

CEO Lars Jørgensen will appear before the Senate Committee on Health, Education, Labor, and Pensions (HELP), which is chaired by Sanders, in early September. The agreement came after a conversation with Sanders in which the CEO reportedly "reconsidered his position" and agreed to testify voluntarily. As such, Sanders has canceled a vote scheduled for June 18 on whether to subpoena Novo Nordisk to discuss its US prices, which are considerably higher than those of other countries.

The independent lawmaker has been working for months to pressure Novo Nordisk into lowering its prices and appearing before the committee. In April, Sanders sent Jørgensen a letter announcing an investigation into the prices and included a lengthy set of information requests. In May, the committee's investigation released a report suggesting that Novo Nordisk's current pricing threatens to "bankrupt our entire health care system."

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Enlarge (credit: MirageC | Moment)

US Surgeon General Vivek Murthy wants to put a warning label on social media platforms, alerting young users of potential mental health harms.

"It is time to require a surgeon general’s warning label on social media platforms stating that social media is associated with significant mental health harms for adolescents," Murthy wrote in a New York Times op-ed published Monday.

Murthy argued that a warning label is urgently needed because the "mental health crisis among young people is an emergency," and adolescents overusing social media can increase risks of anxiety and depression and negatively impact body image.

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Enlarge / Ten milligram tablets of the hyperactivity drug, Adderall, made by Shire Plc, is shown in a Cambridge, Massachusetts pharmacy Thursday, January 19, 2006. (credit: Getty | Jb Reed)

The Centers for Disease Control and Prevention on Thursday warned that a federal indictment of an allegedly fraudulent telehealth company may lead to a massive, nationwide disruption in access to ADHD medications—namely Adderall, but also other stimulants—and could possibly increase the risk of injuries and overdoses.

"A disruption involving this large telehealth company could impact as many as 30,000 to 50,000 patients ages 18 years and older across all 50 US states," the CDC wrote in its health alert.

The CDC warning came on the heels of an announcement from the Justice Department Thursday that federal agents had arrested two people in connection with an alleged scheme to illegally distribute Adderall and other stimulants through a subscription-based online telehealth company called Done Global.  The company's CEO and founder, Ruthia He, was arrested in Los Angeles, and its clinical president, David Brody, was arrested in San Rafael, California.

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We eat a lot of ultra-processed food. It's everywhere, and the cheapest grocery options are often ultra-processed ones. That's why it's concerning that ultra-processed foods have been linked to a variety of health problems, including heart disease, diabetes, mental health disorders, and everyone's favorite, all-cause mortality. So what counts as ultra-processed food? Let's dig in, and maybe question a few assumptions along the way.

Here's a big caveat worth remembering: When studies look at the health of people who do and don't eat ultra-processed foods, they're not necessarily studying the fact that the food is ultra-processed. We can say that a diet high in candy bars is bad for us, but is that because the candy bars are ultra-processed, or because they're full of sugar? That's not a question that the current research can really untangle, but it's important to ask ourselves as we learn more. Are ultra-processed foods always bad, or are they just a category that includes a lot of food we should eat less of?

How are ultra-processed foods defined?

This terminology comes from a classification scheme called NOVA that splits foods into four groups:

• Unprocessed or “minimally processed” foods (group 1) include fruits, vegetables, and meats. Perhaps you’ve pulled a carrot out of the ground and washed it, or killed a cow and sliced off a steak. Foods in this category can be processed in ways that don’t add extra ingredients. They can be cooked, ground, dried, or frozen.

• Processed culinary ingredients (group 2) include sugar, salt, and oils. If you combine ingredients in this group, for example to make salted butter, they stay in this group.

• Processed foods (group 3) are what you get when you combine groups 1 and 2. Bread, wine, and canned veggies are included. Additives are allowed if they “preserve [a food’s] original properties” like ascorbic acid added to canned fruit to keep it from browning.

• Ultra-processed foods (group 4) don’t have a strict definition, but NOVA hints at some properties. They “typically” have five or more ingredients. They may be aggressively marketed and highly profitable. A food is automatically in group 4 if it includes “substances not commonly used in culinary preparations, and additives whose purpose is to imitate sensory qualities of group 1 foods or of culinary preparations of these foods, or to disguise undesirable sensory qualities of the final product.”

That last group feels a little disingenuous. I’ve definitely seen things in my kitchen that are supposedly only used to make “ultra-processed” foods: food coloring, flavor extracts, artificial sweeteners, anti-caking agents (cornstarch, anyone?) and tools for extrusion and molding, to name a few.

Are ultra-processed foods always bad?

So we've learned that packaged snack cakes are ultra-processed, and so is a factory-baked loaf of bread that has 20 ingredients. Orange juice whose flavor has been manipulated would count, too. Coke and Diet Coke are both solidly in this category. It seems logical that we should eat less of these things.

But you could argue that the real problem with these foods is that they’re often sugary and high calorie, and many of the less-healthy members of the category are what stock the vending machines and convenience stores that beckon to us when we’re hungry and haven’t packed a lunch. The problem with these foods is that a diet full of them is unbalanced, due to the nutrition they do or don’t contain. The processing itself isn’t the problem.

So when we talk about ultra-processed foods, we have to remember that it’s a vague category that only loosely communicates the nutrition of its foods. Just like BMI combines muscley athletes with obese people because it makes for convenient math, NOVA categories combine things of drastically different nutritional quality.

Why the level of processing isn't always the most important thing

Illustrating the point above, the USDA published their own study showing how you can create a healthy diet out of ultra-processed foods. A homemade breakfast burrito, for example, might contain canned beans, liquid egg whites, shredded cheese, and a store-bought tortilla. Those ingredients might be ultra-processed, but they're nutritionally nothing like grabbing a Cinnabon on your way to work.

A pet peeve of mine is that the NOVA classification sometimes draws distinctions between things that aren’t really nutritionally different. Wine is in group 3 next to cheese and fresh bread, but cocktails are in group 4 with the Twinkies. Hard liquor has been distilled, you see, so it’s ultra-processed.

Canned vegetables are in group 3 (processed) while their fresh counterparts are in group 1. But canned veggies aren’t any less nutritious. Meanwhile, dried fruit is in group 1 (so wholesome!) even though it can be more sugary than cakes or cookies.

There's a lot of overlap between unhealthy(?) foods and ultra-processed foods, so I understand why scientists are studying ultra-processed foods as a group. But demonizing UPF, as they're sometimes called, often ends up putting the cheapest, most widely available food in the most shameful category. Is that fair, or does it just make you feel better when you’re eating fresh green beans and scoffing at people who buy canned?

The NOVA scale isn’t totally useless: It helps researchers keep an eye on how much of our food is coming from large-scale manufacturers. But it’s not a great way to evaluate what’s in our grocery bags, or on our plates.

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 outbreak of avian influenza on US dairy farms has started to make milk seem a lot less wholesome. Milk that’s raw, or unpasteurized, can actually infect mice that drink it, and a few dairy workers have already caught the bug. 

The FDA says that commercial milk is safe because it is pasteurized, killing the germs. Even so, it’s enough to make a person ponder a life beyond milk—say, taking your coffee black or maybe drinking oat milk.

But for those of us who can’t do without the real thing, it turns out some genetic engineers are working on ways to keep the milk and get rid of the cows instead. They’re doing it by engineering yeasts and plants with bovine genes so they make the key proteins responsible for milk’s color, satisfying taste, and nutritional punch.

The proteins they’re copying are casein, a floppy polymer that’s the most abundant protein in milk and is what makes pizza cheese stretch, and whey, a nutritious combo of essential amino acids that’s often used in energy powders.

It’s part of a larger trend of replacing animals with ingredients grown in labs, steel vessels, or plant crops. Think of the Impossible burger, the veggie patty made mouthwatering with the addition of heme, a component of blood that’s produced in the roots of genetically modified soybeans.

One of the milk innovators is Remilk, an Israeli startup founded in 2019, which has engineered yeast so it will produce beta-lactoglobulin (the main component of whey). Company cofounder Ori Cohavi says a single biotech factory of bubbling yeast vats feeding on sugar could in theory “replace 50,000 to 100,000 cows.” 

Remilk has been making trial batches and is testing ways to formulate the protein with plant oils and sugar to make spreadable cheese, ice cream, and milk drinks. So yes, we’re talking “processed” food—one partner is a local Coca-Cola bottler, and advising the company are former executives of Nestlé, Danone, and PepsiCo.

But regular milk isn’t exactly so natural either. At milking time, animals stand inside elaborate robots, and it looks for all the world as if they’re being abducted by aliens. “The notion of a cow standing in some nice green scenery is very far from how we get our milk,” says Cohavi. And there are environmental effects: cattle burp methane, a potent greenhouse gas, and a lactating cow needs to drink around 40 gallons of water a day. 

“There are hundreds of millions of dairy cows on the planet producing greenhouse waste, using a lot of water and land,” says Cohavi. “It can’t be the best way to produce food.”  

For biotech ventures trying to displace milk, the big challenge will be keeping their own costs of production low enough to compete with cows. Dairies get government protections and subsidies, and they don’t only make milk. Dairy cows are eventually turned into gelatin, McDonald’s burgers, and the leather seats of your Range Rover. Not much goes to waste.

At Alpine Bio, a biotech company in San Francisco (also known as Nobell Foods), researchers have engineered soybeans to produce casein. While not yet cleared for sale, the beans are already being grown on USDA-sanctioned test plots in the Midwest, says Alpine’s CEO, Magi Richani. 

Richani chose soybeans because they’re already a major commodity and the cheapest source of protein around. “We are working with farmers who are already growing soybeans for animal feed,” she says. “And we are saying, ‘Hey, you can grow this to feed humans.’ If you want to compete with a commodity system, you have to have a commodity crop.”

Alpine intends to crush the beans, extract the protein, and—much like Remilk—sell the ingredient to larger food companies.

Everyone agrees that cow’s milk will be difficult to displace. It holds a special place in the human psyche, and we owe civilization itself, in part, to domesticated animals. In fact, they’ve  left their mark in our genes, with many of us carrying DNA mutations that make cow’s milk easier to digest.  

But that’s why it might be time for the next technological step, says Richani. “We raise 60 billion animals for food every year, and that is insane. We took it too far, and we need options,” she says. “We need options that are better for the environment, that overcome the use of antibiotics, and that overcome the disease risk.”

It’s not clear yet whether the bird flu outbreak on dairy farms is a big danger to humans. But making milk without cows would definitely cut the risk that an animal virus will cause a new pandemic. As Richani says: “Soybeans don’t transmit diseases to humans.”

Now read the rest of The Checkup

Read more from MIT Technology Review’s archive

Hungry for more from the frontiers of fromage? In the Build issue of our print magazine, Andrew Rosenblum tasted a yummy brie made only from plants. Harder to swallow was the claim by developer Climax Foods that its cheese was designed using artificial intelligence.

The idea of using yeast to create food ingredients, chemicals, and even fuel via fermentation is one of the dreams of synthetic biology. But it’s not easy. In 2021, we raised questions about high-flying startup Ginkgo Bioworks. This week its stock hit an all-time low of $0.49 per share as the company struggles to make … well, anything.

This spring, I traveled to Florida to watch attempts to create life in a totally new way: using a synthetic embryo made in a lab. The action involved cattle at the animal science department of the University of Florida, Gainesville.

From around the web

How many human bird flu cases are there? No one knows, because there’s barely any testing. Scientists warn we’re flying blind as US dairy farms struggle with an outbreak. (NBC)  

Moderna, one of the companies behind the covid-19 shots, is seeing early success with a cancer vaccine. It uses the same basic technology: gene messages packed into nanoparticles. (Nature)

It’s the covid-19 theory that won’t go away. This week the New York Times published an op-ed arguing that the virus was the result of a lab accident. We previously profiled the author, Alina Chan, who is a scientist with the Broad Institute. (NYTimes)

Sales of potent weight loss drugs, like Ozempic, are booming. But it’s not just humans who are overweight. Now the pet care industry is dreaming of treating chubby cats and dogs, too. (Bloomberg)

Enlarge / Mifepristone (Mifeprex) and misoprostol, the two drugs used in a medication abortion, are seen at the Women's Reproductive Clinic, which provides legal medication abortion services, in Santa Teresa, New Mexico, on June 17, 2022. (credit: Getty | Robyn Beck)

The US Supreme Court on Thursday struck down a case that threatened to remove or at least restrict access to mifepristone, a pill approved by the Food and Drug Administration for medication abortions and used in miscarriage care. The drug has been used for decades, racking up a remarkably good safety record in that time. It is currently used in the majority of abortions in the US.

The high court found that the anti-abortion medical groups that legally challenged the FDA's decision to approve the drug in 2000 and then ease usage restrictions in 2016 and 2021 simply lacked standing to challenge any of those decisions. That is, the groups failed to demonstrate that they were harmed by the FDA's decision and therefore had no grounds to legally challenge the government agency's actions. The ruling tracks closely with comments and questions the justices raised during oral arguments in March.

"Plaintiffs are pro-life, oppose elective abortion, and have sincere legal, moral, ideological, and policy objections to mifepristone being prescribed and used by others," the Supreme Court noted in its opinion, which included the emphasis on "by others." The court summarized that the groups offered "complicated causation theories to connect FDA’s actions to the plaintiffs’ alleged injuries in fact," and the court found that "none of these theories suffices" to prove harm.

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When Naissa tells his mother Daniela that he identifies as a trans man she struggles to understand. Through candid personal letters exchanged over three years, Dear Mamma follows Naissa as he stands firmly for his independence and identity, and Daniela as she wrestles with her fear of losing a child. As Naissa embarks on his professional dance career and proudly embodies his gender, his mother also embarks on a journey of understanding and acceptance of her son’s choices

Enlarge / Diamond Shruumz's "extremely potent" infused cones in "sprinkles" flavor. (credit: Diamond Shruumz)

More people have reported severe poisonings in an ongoing outbreak marked by people seizing and needing to be intubated after consuming microdose candies made by Diamond Shruumz, the Food and Drug Administration reported Tuesday.

There are now at least 12 reported cases across eight states. All 12 people were ill enough to seek medical care, and 10 needed to be hospitalized. The symptoms reported so far include seizures, central nervous system depression (loss of consciousness, confusion, sleepiness), agitation, abnormal heart rates, hyper/hypotension, nausea, and vomiting, the FDA reported.

In Tuesday's update, the FDA also expanded the products linked to the illnesses. In addition to all flavors of Diamond Shruumz's Microdosing Chocolate Bars, the agency's warning now covers all flavors of the brand's Infused Cones and Micro Dose and Macro Dose Gummies.

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Enlarge / A Diamond Shruumz chocolate bar, which come in a variety of flavors. (credit: diamondshruumz.com)

Various federal and state health officials are sounding the alarm on Diamond Shruumz-brand Microdosing Chocolate Bars. The candy, said to be infused with mushrooms, has been linked to severe illnesses, including seizures, loss of consciousness, confusion, sleepiness, agitation, abnormal heart rates, hyper/hypotension, nausea, and vomiting, according to an outbreak alert released by the Food and Drug Administration on Friday.

So far, eight people across four states have been sickened—four in Arizona, two in Indiana, one in Nevada, and one in Pennsylvania, the FDA reported. Of the eight, six have been hospitalized.

"We are urging the public to use extreme caution due to the very serious effects of these products," Maureen Roland, director of the Banner Poison and Drug Information Center in Phoenix, said in a press release earlier this week.

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Enlarge / Precision’s Layer 7 Cortical Interface array. (credit: Precision)

Work toward brain-computer interfaces has never been more charged. Though neuroscientists have toiled for decades to tap directly into human thoughts, recent advances have the field buzzing with anticipation—and the involvement of one polarizing billionaire has drawn a new level of attention.

With competition amping up in this space, Ars spoke with Ben Rapoport, who is a neurosurgeon, electrical engineer, and co-founder of the brain-computer interface (BCI) company Precision Neuroscience. Precision is at the forefront of the field, having placed its BCI on the brains of 14 human patients so far, with two more scheduled this month. Rapoport says he hopes to at least double that number of human participants by the end of this year. In fact, the 3-year-old company expects to have its first BCI on the market next year.

In addition to the swift progress, Precision is notable for its divergence from its competitor's strategies, namely Neuralink, the most high-profile BCI company and headed by Elon Musk. In 2016, Rapoport co-founded Neuralink alongside Musk and other scientists. But he didn't stay long and went on to co-found Precision in 2021. In previous interviews, Rapoport suggested his split from Neuralink related to the issues of safety and invasiveness of the BCI design. While Neuralink's device is going deeper into the brain—trying to eavesdrop on neuron signals with electrodes at close range to decode thoughts and intended motions and speech—Precision is staying at the surface, where there is little to no risk of damaging brain tissue.

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On Tuesday, the FDA asked a panel of experts to weigh in on whether the evidence shows that MDMA, also known as ecstasy, is a safe and efficacious treatment for PTSD. The answer was a resounding no. Just two out of 11 panel members agreed that MDMA-assisted therapy is effective. And only one panel member thought the benefits of the therapy outweighed the risks.

The outcome came as a surprise to many, given that trial results have been positive. And it is also a blow for advocates who have been working to bring psychedelic therapy into mainstream medicine for more than two decades. This isn’t the final decision on MDMA. The FDA has until August 11 to make that ruling. But while the agency is under no obligation to follow the recommendations of its advisory committees, it rarely breaks with their decisions.  

Today on The Checkup, let’s unpack the advisory committee’s vote and talk about what it means for the approval of other recreational drugs as therapies.

One of the main stumbling blocks for the committee was the design of the two efficacy studies that have been completed. Trial participants weren’t supposed to know whether they were in the treatment group, but the effects of MDMA make it pretty easy to tell whether you’ve been given a hefty dose, and most correctly guessed which group they had landed in. 

In 2021, MIT Technology Review’s Charlotte Jee interviewed an MDMA trial participant named Nathan McGee. “Almost as soon as I said I didn’t think I’d taken it, it kicked in. I mean, I knew,” he told her. “I remember going to the bathroom and looking in the mirror, and seeing my pupils looking like saucers. I was like, ‘Wow, okay.’”

The Multidisciplinary Association for Psychedelic Studies, better known as MAPS, has been working with the FDA to develop MDMA as a treatment since 2001. When the organization met with the FDA in 2016 to hash out the details of its phase III trials, studies to test whether a treatment works, agency officials suggested that MAPS use an active compound for the control group to help mask whether participants had received the drug. But MAPS pushed back, and the trial forged ahead with a placebo. 

No surprise, then, that about 90% of those assigned to the MDMA group and 75% of those assigned to the placebo group accurately identified which arm of the study they had landed in. And it wasn’t just participants. Therapists treating the participants also likely knew whether those under their supervision had been given the drug. It’s called “functional unblinding,” and the issue came up at the committee meeting again and again. Here’s why it’s a problem: If a participant strongly believes that MDMA will help their PTSD and they know they’ve received MDMA, this expectation bias could amplify the treatment effect. This is especially a problem when the outcome is based on subjective measures like how a person feels rather than, say, laboratory data.

Another sticking point was the therapy component of the treatment. Lykos Therapeutics (the for-profit spinoff of MAPS) asked the FDA to approve MDMA-assisted therapy: that’s MDMA administered in concert with psychotherapy. Therapists oversaw participants during the three MDMA sessions. But participants also received three therapy sessions before getting the drug, and three therapy sessions afterwards to help them process their experience. 

Because the two treatments were administered together, there was no good way to tell how much of the effect was due to MDMA and how much was due to the therapy. What’s more, “the content or approach of these integrated sessions was not standardized in the treatment manuals and was mainly left up to the individual therapist,” said David Millis, a clinical reviewer for the FDA, at the committee meeting. 

Several committee members also raised safety concerns. They worried that MDMA’s effects might make people more suggestible and vulnerable to abuse, and they brought up allegations of ethics violations outlined in a recent report from the Institute for Clinical and Economic Review. 

Because of these issues and others, most committee members felt compelled to vote against MDMA-assisted therapy. “I felt that the large positive effect was denuded by the significant confounders,” said committee member Maryann Amirshahi, a professor of emergency medicine at Georgetown University School of Medicine, after the vote. “Although I do believe that there was a signal, it just needs to be better studied.”

Whether this decision will be a setback for the entire field remains to be seen. “To make it crystal clear: It isn’t MDMA itself that was rejected per se, but the specific, poor data set provided by Lykos Therapeutics; in my opinion, there is still a strong chance that MDMA, with a properly conducted clinical Phase 3 trial program that addresses those concerns of the FDA advisory committee, will get approved.” wrote Christian Angermayer, founder of ATAI Therapeutics, a company that is also working to develop MDMA as a therapy.

If the FDA denies approval of MDMA therapy, Lykos or another company could conduct additional studies and reapply. Many of the committee members said they believed MDMA does hold promise, but that the studies conducted thus far were inadequate to demonstrate the drug’s safety and efficacy. 

Psilocybin is likely to be the next psychedelic therapy considered by the FDA, and in some ways, it might have an easier path to approval. The idea behind MDMA is that it alleviates PTSD by helping facilitate psychotherapy. The therapy is a crucial component of the treatment, which is problematic because the FDA regulates drugs, not psychotherapy. With psilocybin, a therapist is present, but the drug appears to do the heavy lifting. “We are not offering therapy; we are offering psychological support that’s designed for the patient’s safety and well-being,” says Kabir Nath, CEO of Compass Pathways, the company working to bring psilocybin to market. “What we actually find during a six- to eight-hour session is most of it is silent. There’s actually no interaction.”

That could make the approval process more straightforward. “The difficult thing … is that we don’t regulate psychotherapy, and also we don’t really have any say in the design or the implementation of the particular therapy that is going to be used,” said Tiffany  Farchione, director of the FDA’s division of psychiatry, at the committee meeting. “This is something unprecedented, so we certainly want to get as many opinions and as much input as we can.” 

Another thing

Earlier this week, I explored what might happen if MDMA gets FDA approval and how the decision could affect other psychedelic therapies. 

Sally Adee dives deep into the messy history of electric medicine and what the future might hold for research into electric therapies. “Instead of focusing only on the nervous system—the highway that carries electrical messages between the brain and the body—a growing number of researchers are finding clever ways to electrically manipulate cells elsewhere in the body, such as skin and kidney cells, more directly than ever before,” she writes. 

Now read the rest of The Checkup

Read more from MIT Technology Review’s archive

Psychedelics are undeniably having a moment, and the therapy might prove particularly beneficial to women, wrote Taylor Majewski in this feature from 2022.

In a previous issue of The Checkup, Jessica Hamzelou argued that the psychedelic hype bubble might be about to burst.

MDMA does seem to have helped some individuals. Nathan McGee, who took the drug as part of a clinical trial, told Charlotte Jee that he “understands what joy is now.” 

Researchers are working to design virtual-reality programs that recreate the trippy experience of taking psychedelics. Hana Kiros has the story. 

From around the web

In April I wrote about Lisa Pisano, the second person to receive a pig kidney. This week doctors removed the kidney after it failed owing to lack of blood flow.

Bird flu is still very much in the news.

–   Finland is poised to become the first country to start administering bird flu vaccine—albeit to a very limited subset of people, including poultry and mink farmers, vets, and scientists who study the virus  (Stat)

–   What are the most pressing questions about bird flu? They revolve around what’s happening in cows, what’s happening in farm workers, and what’s happening to the virus. (Stat)

– A man in Mexico has died of H5N2, a strain of bird flu that has never before been reported in humans. (CNN)

Biodegradable, squishy sensors injected into the brain hold promise for detecting changes following a head injury or cancer treatment. (Nature)

A synthetic version of a hallucinogenic toad toxin could be a promising treatment for mental-health disorders. (Undark)

Enlarge / An MMR and VAR vaccine ready for a pediatric vaccination at Kaiser Permanente East Medical offices in Denver in 2015. (credit: Getty | Joe Amon)

For years, the US Centers for Disease Control and Prevention has bluntly stated the truth: "Vaccines do not cause autism," the agency affirms on its website. Yet, nearly a quarter of Americans still don't believe it.

In an April 2024 survey by the Annenberg Public Policy Center (APPC) of the University of Pennsylvania, 24 percent of US adults denied or disputed that the CDC ever said that. Specifically, the survey asked them to assess the accuracy of the statement that the CDC has said there is no evidence linking vaccines to autism. Six percent called the statement "very inaccurate," and 18 percent said it was "somewhat inaccurate." An additional 3 percent responded that they were "not sure." Of the remaining 73 percent, only 41 percent considered it "very accurate," and 32 percent said it was "somewhat accurate."

The results are largely unchanged from responses in 2018 when survey respondents were asked the same question. In that year, 26 percent of adults reported that the statement was "very inaccurate" or "somewhat inaccurate."

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