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Daily Archives: February 5, 2022

Heart Attack Survivors Could Experience More Rapid Brain Function Declines

Cognitive function declines faster in people who have heart attacks than in those who don’t, new research shows, suggesting that preventing heart attacks could help preserve brain health.

The study is one of the first to look at how sudden cardiac events such as heart attacks affect brain function over the short and long term. The findings will be presented next week at the American Stroke Association’s International Stroke Conference. The research is considered preliminary until the full findings are published in a peer-reviewed journal.

“For too long, we have thought about and addressed heart disease and brain disease as two separate conditions,” lead study author Dr. Michelle C. Johansen said in a news release. She is an assistant professor of cerebrovascular neurology at the Johns Hopkins University School of Medicine in Baltimore.

“We need to realize that what’s going on in the heart and brain are related. Managing risk factors to prevent a heart attack is actually good for your brain as well,” she said.

Researchers pooled data for 31,377 people enrolled in six long-term studies between 1971 and 2017 to analyze what happens to cognitive function in the years following a heart attack. Study participants were free of dementia and had not had a heart attack when they enrolled in the studies. They were followed for anywhere from about five to 20 years.

Participants were 60 years old, on average, when they took their first cognitive test. Cognitive performance was tested in three areas: memory, executive function and global cognition, which looks at overall performance on cognitive tests that include both memory and executive function. Because the tests were given at different intervals and with different screening methods, a team of neuroscientists and statisticians “harmonized” the data before it was analyzed.

While cognitive function between the groups did not change significantly immediately after a heart attack, researchers found it fell faster in the years that followed in those who had heart attacks than it did in those who did not. The changes occurred in all three areas of cognitive function.

“We have shown that having a heart attack can be detrimental to your brain health over time,” Johansen said. “Dementia is a slow, step-wise process. One doesn’t wake up out of the blue with dementia.”

Rather, she said, they found the significant change occurs several years after a heart attack.

“It’s important to know that cognitive decline is a possibility after a heart attack, so physicians are both managing patients’ heart disease and looking for signs of dementia following a heart attack,” she said. “It can even be a great conversation starter about why it’s important for patients to follow medical advice to prevent a heart attack.”

One way brain and heart health are connected is through shared risk factors, such as lifestyle behaviors and blood pressure control, Dr. Karen L. Furie said in the release. Furie, who was not involved in the new study, is chair of the department of neurology at Brown University’s Warren Alpert Medical School in Providence, Rhode Island.

“Some cognitive decline is expected as we age. Yet as we learn more about how our brains change with age, we’re finding the same risk factors that impact heart health may also affect brain health,” she said.

“Controlling those risk factors needs to become an early and lifelong commitment, because it’s your blood pressure measures when you’re in early to midlife – 30s, 40s and 50s – that affects dementia or heart disease, rather than your measures in late adulthood.”


Source: American Heart Association

In Pictures: 1987 Porsche 959 Komfort

Source : Bring A Trailer

從「資本主義」四重危機反思「一國兩制」

作者: 鄧峰 . . . . . . . . .

今年是「一國兩制」構想者、已故中共最高領導人鄧小平「九二南巡」30周年,重溫當時的「南方講話」,有助大家重新認識「一國兩制」當中「社會主義」和「資本主義」的關係。

30年前,面對東歐劇變、蘇聯解體,國際社會主義陣營轟然倒塌,社會主義思潮陷入前所未有危機的情勢下,但鄧小平依然認為「社會主義經歷一個長過程發展後必然代替資本主義」,相信「世界上贊成馬克思主義的人會多起來」。這背後顯然不只是因為他自少年時代便堅信社會主義,並受到20世紀世界社會主義運動的召喚,還因為他相信社會主義比資本主義更符合多數人的期待。

眾所周知,社會主義本是對資本主義的一種反抗和超越。在18、19世紀,西方資本主義野蠻生長和原始積累時期,面對當時日益嚴重的社會矛盾和貧富分化、底層困苦問題,社會主義作為一種寄託許多人理想的思潮開始產生。不論是最初的空想社會主義,還是馬克思(Karl Heinrich Marx)、恩格斯(Friedrich Engels)提出的科學社會主義,莫不如此。進入20世紀,列寧(Lenin)發起俄國革命,建立蘇聯社會主義體制,第一次讓社會主義從理念、工人運動轉化為具體的國家實踐。

遺憾的是,憑藉以計劃經濟為基礎的高度集中的政治經濟體制,蘇聯雖然一度大放異彩,在短時間內快速實現工業化,與美國主導的資本主義陣營並駕齊驅,但終究還是眼看他起高樓,眼看他宴賓客,眼看他樓塌了。蘇聯及其主導的國際社會主義陣營轟然解體後,社會主義在世界範圍內被許多人貼上落後、失敗的標籤,彷彿資本主義才是人類的未來或宿命。但從蘇聯解體30年以來,世界範圍內資本主義狂飆突進的情況來看,想必很多人都難以對資本主義的未來抱持信心。

當然,這樣說絕不是要重回早已被歷史證明不可行的蘇聯模式社會主義,而是說資本主義未必是人類的宿命,人類應該在借鑑資本主義經驗的基礎上探索更好的未來。

毫無疑問,就像馬克思所說的「資產階級在它的不到一百年的階級統治中所創造的生產力,比過去一切世代創造的全部生產力還要多,還要大」,資本主義有其優點,能為經濟發展賦予極強的動能。而且自馬克思當年批判資本主義以來,資本主義早已發生許多改變,不完全是曾經那個被詬病「每一個毛孔都滴着產業工人的血和淚」的資本主義。尤其是羅斯福(Franklin Delano Roosevelt)新政和二戰後民權運動興起後,西方資本主義國家紛紛進行改良,吸收許多社會主義元素,以至於就普通民眾的生活水平來說,西方國家遠比當時的蘇聯更像社會主義。但自蘇東劇變後,社會主義被污名化,新自由主義大行其道,成為帶有某種意識形態宰制地位的風潮。

然而,在失去社會主義陣營作為競爭對手的時時反襯、督促和警示後,因新自由主義而膨脹的資本主義日益有倒退回馬克思那個時代的趨勢。法國經濟學家皮凱提(Thomas Piketty)的名作《二十一世紀資本論》已揭示出,新自由主義盛行以來資本主義國家的貧富分化嚴重程度日益倒退回19世紀。

當今世界資本主義至少包括四組難以克服的矛盾。

其一,資本主義勢必容易加劇的貧富兩極分化與人類社會對於公平的渴望之間的矛盾。儘管不同時期、不同形態的資本主義社會,貧富分化的嚴重程度並不相同,但不容迴避的是,以逐利為核心追求的資本,在經濟關係和經濟結構基本上均是私有制的社會形態下,必然會在不斷擴張過程中,產生和加劇貧富分化,甚至形成拼爹資本主義,即繼承財富的增長速度遠遠高於勞動收入,財富的多寡取決於繼承、出身而非後天的努力、勞動。但與此同時,渴望公平是基本人性,起碼的公平是社會穩定的基石。當資本主義產生的日益嚴重的貧富分化與人類對於公平的渴望狹路相逢,勢必問題叢生,嚴重妨礙社會穩定和民主機制的運行。為了應對這一問題,通常資本主義社會都會進行周期性的自我調節,以期緩和社會矛盾,但往往維持不了多久,治標不治本,社會依舊陷入某種周期性的溫水煮青蛙困境之中。

其二,資本主義經濟邏輯的假設前提是理性人,是市場主體能在自身理性的指引下做出明智的決斷,甚至說整個社會的所有市場參與者都有着同等的智慧、理性能力以及同樣豐富的訊息資源,才能達到理想的自由、平等競爭狀態,但無數事例已經反覆證明,人的理性是有限的,並深受非理性因素干擾,不同人的理性水平和掌握的訊息資源往往參差不齊。這樣既會造成貧富分化、壟斷、大魚吃小魚,又容易使得市場主體經常陷入羊群效應之中,出現各種不理性、盲目、狂熱、短視的行為,時不時導致周期性的經濟危機以及大量的低效活動、資源浪費、環境污染。

其三,逐利的資本主義將人和人的關係異化為狹隘、赤裸裸的經濟關係,但人和人的關係本應是複雜多維度的。無論哪個社會,一旦資本主義大行其道後,都難以避免將人異化為工具、商品,人不再是目的而是淪為手段,一個人在社會、團體和家庭中的地位和處境往往都被庸俗化、階級化,大眾對於金錢、資本趨之若鶩,財富多寡成為最主要的評判標準,溫情、道德、人生理想、精神追求均會被擠壓。

其四,資本的全球化、無國界和以民族國家為基本競爭單位的世界秩序的矛盾。在全球化進程下,資本尤其是金融資本利用現有民族國家體系的縫隙獲取最大利益。相較於受制於主權範圍的一個個具體的民族國家,資本是在全世界範圍內流動,變得比以往更不受控,更難以被有效節制和監管,比主權國家有更大的活動範圍和更靈活的運作體系,而主權國家為了發展本國經濟不得不依賴於全球化資本,在節制資本時要麼有心無力,要麼投鼠忌器,其結果是資本主義將全球納入其中,資本賺得盆滿缽滿,以往一國之內的階級分化,演變為全球範圍內的階級分化。

總之,資本主義雖然在激發人的積極性、主動性、建立經濟組織、促進經濟增長上,具有極強的動能,但以上四個難以克服的內在矛盾足以說明資本主義不應該也不會是人類的宿命。那些奉行資本主義的社會,只有不斷吸收公平正義、保障弱勢群體、人與自然和諧相處等因素,才能滿足世人對於美好生活不斷增長的需要。而這樣的資本主義會和社會主義愈來愈趨同。蘇東劇變所代表的國際社會主義陣營崩潰,不是社會主義的失敗,而只不過是蘇聯模式的社會主義體制的失敗,不能因為具體一些國家實踐的失敗就一概否定社會主義本身代表的理想性和超越性。

資本主義搭載新自由主義的政治快車,於蘇東劇變後盛行世界30年,幾乎沒有競爭對手,持續膨脹,造成了全球範圍內大量的深層次問題。今天,重新認識資本主義,在吸取蘇聯解體教訓的基礎上尋求另一種可能,具有強烈的現實意義,香港同樣如是。


Source : HK01

A Different COVID-19 Vaccine Debate: Do We Need New Ones?

Lauran Neergaard wrote . . . . . . . . .

COVID-19 vaccines are saving an untold number of lives, but they can’t stop the chaos when a hugely contagious new mutant bursts on the scene, leading people to wonder: Will we need boosters every few months? A new vaccine recipe? A new type of shot altogether?

That’s far from settled, but with the shots still doing their main job many experts are cautioning against setting too high a bar.

“We need collectively to be rethinking what is the goal of vaccination,” said Dr. Daniel Kuritzkes, infectious disease chief at Brigham & Women’s Hospital. “It’s unrealistic … to believe that any kind of vaccination is going to protect people from infection, from mild symptomatic disease, forever.”

If the goal is preventing serious illness, “we may not need to be doing as much fine-tuning of the vaccines every time a new variant comes.”

The virus is essentially shape-shifting as it mutates, with no way to know how bad the next variant will be. Already a sub-strain of omicron bearing its own unique mutations is circulating. Research is underway to create next-generation vaccines that might offer broader protection against future mutants — but they won’t be ready anytime soon.

The immediate solution: Getting today’s shots into more arms will “reduce the opportunities for the virus to mutate and spawn new Greek letters that we then have to worry about,” said Jennifer Nuzzo of the Johns Hopkins Center for Health Security.

WHY IMMUNITY ISN’T PERFECT

The job of blocking infection falls to antibodies, which form after either vaccination or a prior bout with COVID-19, ready to fight back the next time someone’s exposed.

One problem: Mutations change the appearance of the spike protein that covers the coronavirus much like a crook switches disguises to evade capture. That’s why omicron was more able to slip past that first defense than earlier variants — its spike coating was harder for existing antibodies to recognize.

Also, the immune system isn’t designed to be in a constant state of high alert, so the antibodies that fend off infection do wane over time. Several months after two doses of the Pfizer or Moderna vaccines, people had little protection against an omicron infection — a result of both waning antibodies and the variant’s mutation.

Thankfully, different immune system soldiers called T cells are key to prevent an infection from turning into severe illness — and that protection is lasting longer because T cells are recognizing other parts of the virus that don’t mutate as easily.

A THIRD DOSE MATTERS

After a booster, protection against symptomatic disease from omicron is about 70% — not as good as the 94% protection seen with earlier variants that more closely matched the vaccine yet highly effective. Importantly, the booster also further strengthened protection against serious illness.

Researchers are closely tracking if infection-fighting antibodies stick around longer after a third dose — but at some point, those levels are guaranteed to wane again. So-called memory cells can make more the next time the body senses they’re needed.

Still, Israel is offering a fourth dose to some people, including those 60 and older, and mulling giving the additional booster to all adults.

The debate is whether repeated boosting really is the best approach — especially since scary new variants are less likely to form once more of the world’s population gets initial vaccinations.

Endless boosting just to keep antibody levels constantly high is “not a public health strategy that works,” said Dr. Paul Offit, a vaccine expert at the Children’s Hospital of Philadelphia.

Pfizer and Moderna are testing omicron-specific boosters in some American adults, although it’s far from clear if authorities would abandon a vaccine recipe proven to save lives for a tweaked version in hopes of fewer breakthrough infections. Brewing a single shot with two kinds of vaccine is technically possible but, again, they’d have to prove the mixture doesn’t weaken the original protection against severe illness.

NEW APPROACHES IN THE PIPELINE

Whatever happens with omicron, it’s clear the coronavirus is here to stay and the U.S. National Institutes of Health is funding about $43 million in projects to develop so-called “pan-coronavirus” vaccines that promise to protect against more than one type. One possibility: Nanoparticles that carry pieces of spike proteins from four to eight different versions of the virus rather than the single type in today’s vaccines.

It’s a tantalizing idea, but NIH infectious diseases chief Dr. Anthony Fauci called it a years-long endeavor. “I don’t want anyone to think that pan-coronavirus vaccines are literally around the corner,” he said.

A possibly more direct approach: Creating COVID-19 vaccines that can be squirted into the nose to form antibodies ready to fight the virus right where we first encounter it. Nasal vaccines are harder to develop than injected versions but attempts are underway, including a large study just announced by India’s Bharat Biotech.

PROTECTION VARIES GLOBALLY

Complicating any possible change to vaccine strategy is the grim reality that only 10% of people in low-income countries have received at least one vaccine dose. Also, recent studies show that some types of vaccines used around the world appear easier than others for omicron to evade, meaning booster strategies may need to be tailored.

Yale University researchers found no omicron-targeted antibodies in the blood of people given two doses of vaccine made by China’s Sinovac. Following those initial shots with a Pfizer booster — a very different kind of vaccine — helped but not enough, only increasing antibody levels to the amount seen by Pfizer recipients who didn’t get a booster.

Overshadowing all of these questions is that “we don’t know how to predict the next strain,” said Dr. Jesse Goodman of Georgetown University, a former Food and Drug Administration vaccine chief. He wants to see a global strategy that defines the trigger for any vaccine change. “Otherwise we are going to have a confused public, again.”


Source : AP

Chart: Olympic Winter Games Bring In Billions for the IOC

Source : Statista

In Pictures: China National Ski Resorts