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Hate Listening to People Chewing? You Might Have Misophonia

Dennis Thompson wrote . . . . . . . . .

Most people have cherished memories of their grandparents reading to them as children.

Ekaterina Pesheva’s memories are quite different.

“I remember distinctly being very irritated and very angry listening to my grandmother reading children’s books to me, like fairy tales,” said Pesheva, 48, who lives in Boston. “I would become aware of her mouth getting dry, and that, for whatever reason, just irritated me unbelievably.”

Pesheva has misophonia, a disorder in which certain sounds cause extreme feelings of anger and disgust.

Up to now, it’s been thought that misophonia is triggered mainly by sounds related to the mouth and nose — chewing, sniffling, lip-smacking, even breathing.

For example, the smacking lips and pasty tongue caused by her grandmother’s dry mouth triggered Pesheva’s misophonia.

“It was all that I could hear. I was not able to hear the actual content of the story. I was all of a sudden just engulfed into listening to the sound,” Pesheva said. “I would plead, Grandma, please have some water! I would be just very angry at her. Of course, now I feel terrible about it, but it was a very visceral, very reflexive reaction.”

But new research now shows that other common sounds and noises might trigger misophonia: finger tapping, mouse clicking, the clack of high-heeled shoes, the whir of an electric fan.

“Typically, you can ignore the sound of a clock’s ticking, but this is something that is impaired in misophonia,” said lead researcher Heather Hansen, a doctoral student in psychology at Ohio State University.

“You have this increased emotional reaction of disgust or anger, and it’s something that tends to depend on context,” Hansen said. “Maybe your mom chewing would make you feel rage, but a stranger chewing would not.”

As many as 1 in 5 people are affected by misophonia, according to background notes from the research.

Primal responses

The effects of misophonia can go far beyond the mere irritation that an average person might feel when nerves are on edge and someone starts repetitively clicking their ballpoint pen, Hansen said.

Misophonia can cause such a visceral reaction that it prompts a primal fight-or-flight response in those affected, she said.

“Misophonia can have a real impact on your life,” Hansen said. “Individuals with misophonia report that they have cut off social relationships. They maybe don’t leave their house anymore. It changes the way they take job opportunities or pursue relationships and dating. Some attempt suicide.”

Pesheva, who is director of media relations for Harvard Medical School, describes misophonia as “this eruption of irritation and disgust and anger that you feel in the pit of your stomach. It just rises up like it’s volcanic in nature.”

Little is known about the disorder, despite the powerful effect it can have on some.

Misophonia is not yet acknowledged as a diagnosable mental condition in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), said Dean McKay, a professor of psychology at Fordham University in New York City.

The term was first coined two decades ago, and proposed diagnostic criteria for misophonia have been floating around for about 10 years now, said McKay, who wrote a chapter about misophonia for a book on obsessive-compulsive disorders.

“What I like to remind people is that all of us have an element of this,” he said. “Imagine the sound of a pet that decides to begin cleaning itself in the middle of the night while everything else is completely quiet, and the irritation that may arouse.”

“That’s an example of how most people experience some form of sound intolerance, but it’s more pervasive for people who struggle with misophonia,” McKay continued. “It may include everyday kind of activities that most people don’t think twice about, and it may also include specific individuals as opposed to others.”

Brain connections

Previous studies have suggested that misophonia is caused by overly sensitive connections between the brain center that processes sound and the motor control areas of the mouth and face, Hansen said. That’s why the classic triggers of misophonia involve chewing or breathing.

But Hansen’s new study, published recently in the journal Frontiers in Neuroscience, shows that even though sounds trigger misophonia, the brain’s auditory center might have nothing at all to do with it.

Misophonia instead appears to be linked to the insula, a part of the brain associated with strong emotions that include disgust, according to the findings.

In the study, 19 adults underwent MRI brain scans as they performed various tasks — saying certain nonsense syllables like “ba ga ra da” out loud, or tapping their fingers on their leg.

People more powerfully beset by symptoms of misophonia had stronger connections between the insula and brain regions associated with motor movements, the study showed. This was true of moving the mouth and also tapping fingers on a leg.

At the same time, researchers found no connection at all to the brain’s auditory center, Hansen said.

“The important connection was with the insula,” she said. “It’s important to note we didn’t actually play any sounds for them at all. We were only looking at body movements and the brain. And we found that the part of the brain that is active when individuals move their finger connects differently in individuals with misophonia compared to individuals without misophonia.”

In a way, it makes sense that misophonia might not be directly tied to sounds, even though it is triggered by them.

People with the condition also sometimes respond to visual triggers that remind them of the sound that bothers them, McKay said. For example, a person with misophonia might become angry or anxious watching someone prepare a meal or serve dinner.

“The visualization of it may lead to some anticipation that it’s going to be emotionally intense,” McKay said. “Some people will go as far as to avoid having meals with other people or avoid other settings where the noises might happen.”

Coping strategies

But McKay sounded a skeptical note about Hansen’s study, arguing that the findings would have been more interesting if researchers had also included people “who find certain of those same noises to be appealing.”

He points to the global phenomenon of ASMR (autonomous sensory meridian response), which is the polar opposite of misophonia.

People indulging in ASMR listen to gentle sounds that produce a feeling of well-being so strong that it is sometimes accompanied by a tingling sensation. These folks “find chewing and gustatory noises and other things like that to be very pleasing, very relaxing and soothing,” McKay said.

If the same brain centers light up for ASMR as they do for misophonia, “it may mean that those areas are active for certain sounds and it has little to do with the aversive response,” McKay said. “I didn’t see anything in the study that could shed light on why this in particular would be unpleasant. It only showed that those areas are activated, so it seems like that’s a really important missing ingredient here.”

Given that misophonia has been researched little, there aren’t many options today for treating or dealing with the condition, experts said.

Pesheva said her misophonia has persisted over the decades, and even might have gotten a little worse. She often finds herself begging her husband to blow his nose or have a drink of water to stop the noises that are driving her to distraction.

“Even though I fully realize rationally why this is happening, it does not necessarily make it better,” Pesheva said. “My way of dealing with it is avoidance. When possible, I walk away. It’s not always possible, but I’ve learned if I cannot remove myself from the sound, I just either bite my tongue and try not to listen or put my hands to my ears.”

Stress management and coping strategies might help some deal with their misophonia, McKay said.

“We don’t have a lot of good information on what the best approach might be for how to address this,” he said. “To my knowledge, there really aren’t any established or systematically studied approaches for treatment.”

Cognitive behavioral therapy might be another option, said Dr. Shae Datta, director of cognitive neurology at NYU Langone Hospital-Long Island in Mineola, N.Y.

“They’ll expose you to certain sounds and try to make you less sensitized to it over time,” Datta said. “There are also adjustments like wearing earphones or letting people know your triggers. That is the way people manage it currently.”

Source: HealthDay

Could Black Tea Lengthen Your Life?

Steven Reinberg wrote . . . . . . . . .

A cup of tea can soothe your spirit, but drinking a couple of cups each day may also lower your chances of dying early, new research suggests.

In the study of nearly 500,000 men and women who took part in the U.K. Biobank, researchers found that compared with people who didn’t drink tea, those who drank two or more cups a day lowered their risk of dying by 9% to 13%. And it made no difference if they took milk and sugar with their tea, or also drank coffee.

These results suggest that black tea, even at higher levels of intake, can be part of a healthy diet. Yet, “while these findings may offer reassurance to tea drinkers, they do not indicate that people should start drinking tea or increase their tea consumption for health benefits,” lead researcher Maki Inoue-Choi said during a recent media briefing by the U.S. National Institutes of Health. She’s a staff scientist in the Division of Cancer Epidemiology and Genetics at the U.S. National Cancer Institute.

Although this study can’t prove that tea alone is responsible for extending your life, it does contain compounds that have been linked to reducing inflammation, Inoue-Choi said.

“Compounds such as polyphenols and flavonoids, namely catechins, have the potential to reduce oxidative stress and inflammation, which protect against cancer, cardiovascular disease and other health conditions,” she said.

“If you drink one cup per day already, I think that is good,” Inoue-Choi said. “Please enjoy your cup of tea.”

The U.K. participants in the study were ages 40 to 69, and 89% reported drinking black tea.

Researchers also found that drinking tea reduced the risk of dying from cardiovascular disease but didn’t appear to have the same benefit when it came to deaths from cancer or respiratory disease, Inoue-Choi said.

The report was published in the Annals of Internal Medicine.

“I think it’s really good confirmation that tea can be a part of a good diet, a healthy diet,” said Lauri Wright, a national spokesperson for the Academy of Nutrition and Dietetics and an assistant professor at the University of South Florida.

It goes back to inflammation, she said, which seems to trigger so many chronic diseases. Tea has powerful anti-inflammatory properties that help offset inflammations that can lead to disease.

Wright, who wasn’t part of the study, added that tea by itself won’t counteract the effects of an unhealthy diet, but tea can amplify the benefits of a healthy diet.

“We’re looking at the whole diet and making sure that you include a lot of foods that have anti-inflammatory properties like fruits and vegetables and healthy fats from nuts and avocados,” she said. “So, it really is more of the whole diet that tea is a part of in helping decrease inflammation.”

Dr. Guy Mintz, director of cardiovascular health and lipidology at Northwell Health Sandra Atlas Bass Heart Hospital in Manhasset, N.Y., said a recent study in China also found benefits from tea. However, in that case, it was green tea.

“In China and Asia and Japan, they’re drinking more green tea. So, this study gives black tea a place on the mantel,” said Mintz, who had no role in the new research. “I think the takeaway message is tea may be protective.”

He cautioned that tea alone is not a substitute for keeping your blood pressure and cholesterol low. “Tea has beneficial cardiovascular and vascular benefits as an adjunct to medical recommendations,” Mintz said.

Source: HealthDay

A Brief History of Wastewater Testing and Pathogen Detection

Since humans started building permanent structures in which to live, even as far back as the Babylonians around 4,000 B.C., we have sought to get our waste as far away from ourselves as possible.1 That effort has continued to the modern-day, where the sewers under our feet carry billions of gallons of waste (every day!) away from our most populated areas.2

It is the pinnacle of ‘out of sight, out of mind.’

But in flushing and forgetting our waste, we are also flushing a wealth of information about our biology and the infectious diseases that threaten our health. What if, we could use our waste to spot the outbreak of disease before a community even starts to show symptoms? It’s a powerful thought and one that could change public health. And it’s not new. The concept of pathogen detection through wastewater testing is centuries old.

Monitoring the Complexities of the Human Microbiome

What makes wastewater pathogen detection so valuable is the incredible quantity of microbes that live within our digestive tracts. These microbes, comprising the gut microbiome, play an incredible (though poorly understood) role in overall human health, for everything from digestion to cardiac health to the immune system.3,4 Viruses, bacteria, fungi, and other microbes form a complex system within the gut, competing with invading pathogens for attachment sites and nutrients, aiding in carbohydrate digestion, producing vitamins, and more. Many biological functions that need to be executed for us to survive are carried out by the human microbiome. We can find evidence of the organisms contained within it in the fecal matter we eliminate and draw conclusions about the health of the subject or community from where it came. While the concept of getting this waste far away from where we live may be as old as human settlement, the idea to utilize that same waste to monitor health and disease on both the individual and community level is a much more recent development, dating back to the 19th century.

Wastewater Surveillance Through the Centuries: A Timeline

The first waterborne disease to be scientifically documented was the Broad Street cholera outbreak of 1854 in London.5 Impressively, Dr. John Snow (the father of epidemiology, not of Winterfell) was able to convince local officials of the disease’s source and vehicle of transmission decades before germ theory had been proven.6 Snow managed this feat by comparing the water sources of disease-stricken and untouched households and tracked the outbreak to a single pump on Broad Street. Ever since, epidemiologists have looked to water for answers about how diseases are spread, and how they might be tracked without relying on large-scale individualized testing.

In the 1940s, epidemiologists utilized wastewater to track and contain disease outbreaks in the United States, particularly polio.7 The cell culture methods used were crude by today’s standards, but effective nonetheless, and wastewater surveillance remains a critical tool for eradicating polio across the globe.8 Still, many pathogens are either difficult or impossible to culture, and more efficient and cost-effective methods have been developed, like hybridization with radioactive cDNA probes to monitor Hepatitis A in the 1980s.9 It wasn’t until the 1990s, however, that the gold standard of wastewater pathogen detection techniques was brought to the front lines with PCR.10,11

Because PCR can be quick and efficient, detection of pathogens in wastewater can be done even before those infected start to show symptoms.12 Recently, innovative and highthroughput PCR-based workflows have been used for ongoing monitoring of the COVID-19 pandemic. As nasal swab testing was limited and often delayed in the early stages of the global spread of SARS-CoV-2, wastewater testing was suggested as a way to bypass some of the bottlenecks in our testing infrastructure and identify areas where outbreaks were just starting, long before case numbers, hospitalizations, and deaths took off. Some universities used this strategy to identify which dormitories required individual testing. A recent study from a university may be good resource to add to this list (They used the KingFisher Flex platform). Here is the link to the preprint. Rapid, large-scale wastewater surveillance and automated reporting system enabled early detection of nearly 85% of COVID-19 cases on a University campus.

Modernizing the Approach to Wastewater Surveillance

While wastewater detection shows immense promise, both for the current pandemic and beyond, a detection method is only as effective as the quality of extracted proteins or nucleic acids (DNA or RNA) allows it to be. Our MagMAX Microbiome Ultra Nucleic Acid Extraction Kits can help with the challenging sample types required for microbiome detection and wastewater testing. And there’s a bonus: The kit is automation-ready, allowing higher throughput with Thermo Fisher’s KingFisher Flex sample purification system. Automated protocols require less hands-on time and enable faster workflows. Together, these products empower research and clinical laboratories to work smarter, not harder, and streamline processes to allow for high-throughput DNA/RNA extraction, suitable for many downstream applications.

KingFisher system-optimized kits, reagents, and protocols that can be used to maximize purity and yield for each extraction target and sample type. MagMAX kits are best suited for automated extraction of DNA or RNA due to their ease of use and reliability.

We should probably continue our practice of eliminating our waste from the places we live, but that doesn’t mean we have to flush the countless opportunities to improve our health by leveraging the vast information contained in such undesirable substances and sample types. From studying how disruptions of microbiota contribute to cancer to stopping the next global pandemic in its tracks, the answer could be in what we put in our toilets.

Source : ThermoFisher Scientific

COVID Virus’ Incubation Time Gets Shorter With Each New Variant

If you get infected with COVID-19, the time from infection to possible onset of symptoms — the incubation period — is significantly shorter now than it was at the beginning of the pandemic, new research shows.

Researchers in China who looked at data from 142 different studies found that people who got infected with the Alpha variant — the one that emerged in Wuhan in late 2019 — had an incubation period averaging five days.

By the time the Omicron variant arrived, incubation had shortened to less than 3.5 days, on average, the investigators reported.

The findings have real-world importance, because “identifying the incubation period of different variants is a key factor in determining the isolation period” for folks testing positive for COVID-19, the research team explained.

The new study was led by Min Liu, of the Department of Epidemiology and Biostatistics at Peking University’s School of Public Health in Beijing.

The researchers examined data on incubation periods from a myriad of studies conducted throughout the pandemic. A total of more than 8,100 COVID-19 patients were included.

“The findings of this study suggest that SARS-CoV-2 has evolved and mutated continuously throughout the COVID-19 pandemic,” Liu’s group said. The virus has constantly changed in terms of its ability to transmit between people, its level of severity, and its incubation period.

Focusing on incubation, the researchers found that the early Alpha variant COVID virus had an average incubation of five days before symptom onset.

When the Beta variant emerged in May 2020, that incubation rate had shortened to about 4.5 days.

The more highly transmissible Delta variant came on the scene in 2021. Its incubation period was even shorter, about 4.4 days, on average.

Incubation time became significantly shorter with the advent of the Omicron variant, however: Just 3.4 days, on average, according to the Chinese team.

They noted that when COVID-19 first emerged in its Alpha variant, its five-day incubation period was much longer than that seen with other common viral illnesses.

For example, common colds caused by coronavirus have an incubation of about 3.2 days; influenza’s incubation is just under two days, and rhinoviruses (the most common cause of colds) have an incubation of about a day and a half.

Liu and colleagues stressed that the numbers in their study are only averages, and incubation for any one COVID-19 patient could still vary widely. “In this study, the shortest mean incubation reported was 1.8 days and the longest incubation was 18.87 days,” they pointed out.

A shortening of the average incubation period for COVID-19 over time could affect recommendations for self-isolation.

“At present, some countries around the world require close contacts to be isolated for 14 days,” Liu’s group said. “However, with the shortening of the incubation period of new variants, the isolation period can be adjusted appropriately to reduce the pressure on the health system.”

The findings were published in the journal JAMA Network Open.

Source: HealthDay

Chart: Is Your Government Ready for Another Pandemic?

Source : Statistica

Is It Parkinson’s? These 10 Signs Could Tell

Parkinson’s disease can be hard for the average person to identify, but 10 warning signs may offer an early clue that you or a loved one may be developing the disease.

The Parkinson’s Foundation suggests being aware of the signs, while knowing that having any one of them doesn’t mean the disease is present.

Tremor — such as in a finger, thumb, hand or chin — can suggest Parkinson’s, though it can also be a side effect of stress, injury, medication or a lot of exercise.

Parkinson’s can also cause a change in handwriting known as micrographia, where letter sizes become smaller and words more crowded.

People with Parkinson’s can also thrash around in sleep, something a spouse may notice.

Sense of smell may diminish with foods like bananas, dill pickles or licorice. Of course, viruses, including cold, flu and COVID-19 can also affect sense of smell.

Another possible sign of Parkinson’s is stiffness in the body, arms and legs. A person’s arms may no longer swing in a typical fashion or feet may feel like they’re “stuck to the floor.” Some other health conditions, such as arthritis, can also cause stiffness.

A change in voice may signal Parkinson’s. It may become softer, breathy or hoarse.

Another sign is “facial masking,” in which a person’s face looks serious, depressed or mad but doesn’t match their mood. But some medicines can also cause a person to have a serious look or stare.

Constipation, dizziness or fainting, and stooping or hunching when a person is standing are three additional signs of Parkinson’s disease.

If you have more than one of these symptoms, the Parkinson’s Foundation suggests talking with a doctor about the possibility of Parkinson’s disease.

Source: HealthDay

Non-nutritive Sweeteners Affect Human Microbiomes and Can Alter Glycemic Responses

Since the late 1800s non-nutritive sweeteners have promised to deliver all the sweetness of sugar with none of the calories. They have long been believed to have no effect on the human body, but researchers publishing in the journal Cell on August 19 challenge this notion by finding that these sugar substitutes are not inert, and, in fact, some can alter human consumers’ microbiomes in a way that can change their blood sugar levels.

In 2014, senior author Eran Elinav an immunologist and microbiome researcher at the Weizmann Institute of Science and the German National Cancer Center (DKFZ) and his team found that non-nutritive sweeteners affected the microbiomes of mice in ways that could impact their glycemic responses. The team was interested in whether these results would also be found in humans.

To address this important question, the research team carefully screened over 1300 individuals for those who strictly avoid non-nutritive sweeteners in their day-to-day lives, and identified a cohort of 120 individuals. These participants were broken into six groups: two controls and four who ingested well below the FDA daily allowances of either aspartame, saccharin, stevia, or sucralose.

“In subjects consuming the non-nutritive sweeteners, we could identify very distinct changes in the composition and function of gut microbes, and the molecules they secret into peripheral blood. This seemed to suggest that gut microbes in the human body are rather responsive to each of these sweeteners,” says Elinav. “When we looked at consumers of non-nutritive sweeteners as groups, we found that two of the non-nutritive sweeteners, saccharin and sucralose, significantly impacted glucose tolerance in healthy adults. Interestingly, changes in the microbes were highly correlated with the alterations noted in people’s glycemic responses.”

To establish causation, the researchers transferred microbial samples from the study subjects to germ-free mice — mice that have been raised in completely sterile conditions and have no microbiome of their own.

“The results were quite striking,” says Elinav. “In all of the non-nutritive sweetener groups, but in none of the controls, when we transferred into these sterile mice the microbiome of the top responder individuals collected at a time point in which they were consuming the respective non-nutritive sweeteners, the recipient mice developed glycemic alterations that very significantly mirrored those of the donor individuals. In contrast, the bottom responders’ microbiomes were mostly unable to elicit such glycemic responses,” he adds. “These results suggest that the microbiome changes in response to human consumption of non-nutritive sweetener may, at times, induce glycemic changes in consumers in a highly personalized manner.”

Elinav says that he expects the effects of the sweeteners will vary person to person because of the incredibly unique composition of our microbiome. “We need to raise awareness of the fact that non-nutritive sweeteners are not inert to the human body as we originally believed. With that said, the clinical health implications of the changes they may elicit in humans remain unknown and merit future long-term studies.”

“In the meantime, we need to continue searching for solutions to our sweet tooth craving, while avoiding sugar, which is clearly most harmful to our metabolic health,” says Elinav. “In my personal view, drinking only water seems to be the best solution.”

Source: Science Daily

Real-world Study Details Average Duration of Infectiousness for COVID-19

Emily Head, Ryan O’Hare wrote . . . . . . . . .

A new study of 57 people with mild COVID-19 estimates how long people are infectious for and when they can safely leave isolation.

The research, which is led by Imperial College London and published in The Lancet Respiratory Medicine journal, is the first to unveil how long infectiousness lasts for after natural COVID-19 infection in the community. The study team conducted detailed daily tests from when people were exposed to SARS-CoV-2 to look at how much infectious virus they were shedding throughout their infection.

The findings suggest that in people who develop symptoms, the majority are not infectious before symptoms develop, but two-thirds of cases are still infectious five days after their symptoms begin.

They also suggest that while lateral flow tests do not detect the start of infectiousness well, they more accurately identify when someone is no longer infectious and can safely leave isolation.

Study author, Professor Ajit Lalvani, Director of the NIHR Respiratory Infections Health Protection Research Unit at Imperial, said: “We closely monitored people in their homes from when they were first exposed to the virus, capturing the moment when they developed infection through until they ceased being infectious. Before this study we were missing half of the picture about infectiousness, because it’s hard to know when people are first exposed to SARS-CoV-2 and when they first become infectious. By using special daily tests to measure infectious virus (not just PCR) and daily symptom records we were able to define the window in which people are infectious. This is fundamental to controlling any pandemic and has not been previously defined for any respiratory infection in the community.”

He added: “Combining our results with what we know about the dynamics of Omicron infections, we believe that the duration of infectiousness we’ve observed is broadly generalisable to current SARS-CoV-2 variants, though their infectious window may be a bit shorter. Our evidence can be used to inform infection control policies and self-isolation guidance to help reduce the transmission of SARS-CoV-2.”

Co-author, Dr Seran Hakki, also from Imperial’s National Heart and Lung Institute, said: “There is no longer a legal requirement to self-isolate if you test positive for COVID-19, but most people still want to isolate until they are not infectious. Despite this, there is lack of clarity around how to come out of self-isolation safely. Our study is the first to assess how long infectiousness lasts for, using real life evidence from naturally acquired infection. Our findings can thus inform guidance as to how to safely end self-isolation.”

She added: “If you test positive for COVID-19 or have symptoms after being in contact with someone with confirmed COVID-19, you should try to stay at home and minimise contact with other people.”

Most complete picture of the course of infectiousness to date

Previous studies estimating how long someone is infectious for have been a laboratory-based human challenge study or have used mathematical modelling.

The new study followed people who were exposed to someone with PCR-confirmed COVID-19 in their home between September 2020 and March 2021 (pre-Alpha SARS-CoV-2 virus and Alpha variant waves) and May-October 2021 (Delta variant wave), including some who were vaccinated and others who were not.

Participants completed daily questionnaires about their symptoms and did daily nasal and throat swabs that were sent to a laboratory for PCR-testing. PCR-positive samples were then tested to determine if they contained infectious virus and how infectious the virus was. The researchers also completed 652 lateral flow tests on the samples to determine how accurate lateral flow tests were at identifying actual infectiousness as opposed to PCR-positivity.

Samples from a total of 57 people were used, but not all were included in some analyses because of some participants not sharing information about their symptoms, some people not shedding culturable virus, and some people shedding infectious virus before or beyond the sampling period. As a result, the duration of infectiousness was measured in 42 people. There were 38 people with a confirmed date of when their symptoms started and three were asymptomatic.

Real-world timeline of infectiousness

The study found that the overall median amount of time that people were infectious was five days.

Though 24 out of 38 people tested positive on a PCR test before they developed symptoms of COVID-19 this does not indicate infectiousness and most people only became infectious after they developed symptoms. Only one in five participants were infectious before symptom onset (7 out of 35 cases).

Although levels of infectiousness reduced during the course of infection, 22 of 34 cases continued to shed infectious virus five days after symptoms began, and eight of these people continued to shed infectious virus at seven days.

Current NHS guidance suggests that people should try to stay at home and avoid contact with others for just five days.

Safely self-isolating

To help understand when people may be able to safely leave isolation, the researchers compared levels of infectiousness with lateral flow test results.

They found that the sensitivity of these tests in identifying when someone was infectious was poor at the start of infection, but high after peak levels of infectiousness (sensitivity of 67% vs 92%, respectively). This suggests lateral flow tests are good at spotting when someone is no longer infectious and testing to release people from isolation may work, but they are not reliable for early diagnosis unless used daily.

Based on their findings, the researchers recommend that people with COVID-19 isolate for five days after symptoms begin, then complete lateral flow tests from the sixth day. If these tests are negative two days in a row, it is safe to leave isolation. If a person continues to test positive or does not have access to lateral flow devices, they should remain in isolation and, in order to minimise transmission to others, only leave on the 10th day after their symptoms began.

Professor Lalvani said: “Self-isolation is not necessary by law, but people who want to isolate need clear guidance on what to do. The NHS currently advises that if you test positive for COVID-19 you should try to stay at home and avoid contact with other people for five days, but our data suggest that under a crude five-day self-isolation period two-thirds of cases released into the community would still be infectious – though their level of infectiousness would have substantially reduced compared to earlier in the course of their infection.”

He added: “NHS guidance for those with symptoms but who test negative is less clear about how long people should isolate for. Our study finds that infectiousness usually begins soon after you develop COVID-19 symptoms. We recommend that anyone who has been exposed to the virus and has symptoms isolates for five days, then uses daily lateral flow tests to safely leave isolation when two consecutive daily tests are negative.”

The study did not assess the Omicron variants currently circulating. There is some evidence that Omicron variants have a lower viral load and shed for less time than other variants, and the researchers note that their recommendations may be cautious, but still applicable, if this is true.

Most participants in the study were white, middle-aged, had a healthy BMI, and had no medical conditions. In other age groups and in those with medical conditions, these results may vary as they may be slower at clearing the virus.

A person’s infectiousness is one factor involved in transmission, alongside behavioural and environmental factors, such as where people are mixing, and if they are in close proximity to one another.

Source: Imperial College London

Chart: Americans Spend Much More on Pharmaceuticals

Source : Stastista

Want That Pill to Work Fast? Your Body Position Matters

If you need to take a pill, you might want to take it lying down — on your right side, that is.

Researchers studying how body positioning affects the absorption of pills found that one taken when a person was lying on the right side speeded pills to the deepest part of the stomach. That pill could then dissolve 2.3 times faster than if the person was upright.

“We were very surprised that posture had such an immense effect on the dissolution rate of a pill,” said senior author Rajat Mittal, a professor at Johns Hopkins Whiting School of Engineering and an expert in fluid dynamics. “I never thought about whether I was doing it right or wrong but now I’ll definitely think about it every time I take a pill.”

For the study, researchers used a model called StomachSim, which relies on physics, biomechanics and fluid mechanics to mimic what happens inside one’s gut as it digests food or medicine.

Researchers knew that most pills don’t start working until the stomach ejects its contents into the intestine. That would mean that a pill landing in the last part of the stomach, an area called the antrum, would begin dissolving faster. It would also begin emptying its contents more quickly through the pylorus into the duodenum, the first part of the small intestine.

To land a pill there would require a posture that uses both gravity and the natural asymmetry of the stomach to its benefit.

In addition to the right side, the team tested taking pills on the left side, standing upright and lying straight back.

Surprisingly, a pill that dissolves in 10 minutes with a patient lying on his or her right side could take 23 minutes to dissolve in an upright posture and more than 100 minutes with the person on his or her left side. Lying straight back tied with standing upright in terms of pill dissolution.

“For elderly, sedentary or bedridden people, whether they’re turning to left or to the right can have a huge impact,” Mittal said in a Hopkins news release.

Lead author Jae Ho “Mike” Lee, a former postdoctoral researcher at Johns Hopkins, noted that even small changes in stomach conditions could significantly affect dissolution — when someone’s gut isn’t functioning at its best because of conditions such as diabetes and Parkinson’s syndrome, for example.

The impacts of posture and stomach disease were similar on drug dissolution.

“Posture itself has such a huge impact … it’s equivalent to somebody’s stomach having a very significant dysfunction as far as pill dissolution is concerned,” Mittal said.

Plans for future work include attempting to predict how changes in the biomechanics of the stomach affect how the body absorbs drugs.

The findings were recently published in the journal Physics of Fluids.

Source: HealthDay