Medically Speaking Team

According to a recent University of Missouri study, sad moms frequently take longer to answer to their children during back-and-forth dialogues. The findings will be used to conduct more research to see whether the shortened response time affects children’s language development, vocabulary, or academic outcomes in the long run.

Nicholas Smith, an assistant professor in the MU School of Health Professions, and his colleagues listened to audio recordings of over 100 families participating in the Early Head Start programme, a federal child development programme for children whose families’ income is at or below the federal poverty line.

Some of the moms involved were struggling with depression, and Smith’s team documented how much time passed between responses for a mother and her child during back-and-forth dialogue. “We found that the time gap in between responses, in general, gets shorter between mother and child as the child ages, and we also found the mom’s timing tended to predict the child’s timing and vice versa,” Smith said.

“Mothers and children are in sync. Children who were slower to respond to their mom often had moms who were slower to respond to the child, and children who were faster to respond to their mom had moms who were faster to respond to the child. The significant new finding was that the moms who were more depressed took longer to respond to their child compared to moms who were less depressed.”

In the longitudinal study, using audio recordings, they compared the response time of back-and-forth dialogue between mothers and their children when the children were 14 months old and 36 months old. Going forward, Smith plans to further study the dialogue response timing for the same individuals that were recorded in this study when the children were in pre-kindergarten and also when they were in fifth grade to examine how these effects play out later on in the children’s development.

“The overall objective we are hoping to accomplish is to better understand how mother-child interaction works as well as the underlying mechanisms and potential factors at play,” Smith said. “Once we identify what factors drive successful development outcomes and what factors potentially impair development, we can better identify at-risk children and then tailor potential interventions toward those that can benefit from them the most.”

Following a claim that it had abandoned the search, World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus said on Wednesday (local time) that the organisation will keep pressing until it gets an answer to how the Covid-19 outbreak began.

“We need to continue to push until we get the answer,” Tedros Adhanom Ghebreyesus told reporters, referring to the search for the origins of the virus that first began spreading in China in late 2019. Solving the mystery of where the SARS-CoV-2 virus came from and how it began spreading among humans is considered vital for averting future pandemics.
“Knowing how this pandemic started is very, very important and very crucial,” said Ghebreyesus.

Notably, the WHO chief statement comes after an article on the Nature website alleged that the organization is faced with a lack of cooperation from China, where the outbreak began in late 2019, and the WHO had given up on the search.

Ghebreyesus said he had recently sent a letter to a top official in China “asking for cooperation because we need cooperation and transparency in the information… in order to know how this started.”

The two main theories that have been hotly debated have centred on the virus naturally spilling over from bats to an intermediary animal and into humans or The Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) was created “to conduct an independent assessment of the origins of COVID-19, but also to work more broadly to establish a framework to understand the origins of any future epidemic and pandemic pathogen, and the origins in which it emerges,” said Van Kerkhove, Infectious Disease Epidemiologist; COVID-19 Technical Lead, Emerging Diseases and Zoonoses Lead, WHO Health Emergencies Programme.

“We will continue to ask for countries to depoliticize this work, but we need cooperation from our colleagues in China to advance this,” she said.

Tedros said there were two reasons for not abandoning the origins search.
The first was scientific, he said: “We need to know how this started in order to prevent the next one.”
“The second (is) moral: millions of people lost their lives, and many suffered, and the whole world was taken hostage by a virus. “It’s morally very important to know how we lost our loved ones,” added WHO chief.

The WHO conducted the first phase of the study by dispatching a team of international experts to Wuhan, China, in January 2021 to write a first-phase report in collaboration with their Chinese colleagues.

While the initial plan was to send a second team, Van Kerkhove stated that the WHO had changed tactics and opted to form a team of scientists with a broader scope to examine new viruses and study ways to prevent future pandemics, while continuing to investigate the origins of COVID-19.

Sports psychology experts from Staffordshire University and Manchester Metropolitan University interviewed over 400 athletes from various sports, ages, and levels of experience for the study.

The findings show that athletes’ belief systems, specifically irrational beliefs, are associated with lower self-confidence and, as a result, increased competitive anxiety and depressive symptoms.

Phrases that reflect self-depreciating beliefs such as “if I lose, I’m a failure” or “If I face setbacks, it shows how stupid I am” are warning signs, say the authors.

Paul Mansell, Lecturer in Sport and Exercise Psychology at Staffordshire University, said: “Despite the psychological benefits of physical activity, studies frequently report poor mental health in athletes, which may be exacerbated by adversities, such as injury, de-selection, and performance pressure.

“We investigated athletes’ beliefs, how they view stress, their levels of self-confidence and put all this data together to work out what might predict psychological wellbeing. We found irrational beliefs to be a core reason for symptoms of poor mental health manifesting in athletes.”

This is the first known study that has examined irrational beliefs, self-confidence, and the psychological wellbeing of athletes all together. Irrational beliefs are extreme, rigid, and illogical ideas that people hold. For example, a person might believe that they “must” get what they want, or that just because they have failed, that they are a “complete failure.”

Dr Martin Turner, from Manchester Metropolitan University, said: “In our recent study, self-depreciation beliefs were found to be the main predictor of low self-confidence. In simple terms, when an athlete put themselves down and uses language like “If I lose, it means I am a failure” it is most damaging and most likely to lead to losses of confidence. This is then likely to have a knock-on effect on performance and wellbeing.

“We can all work to help athletes develop mindsets that help them deal with the challenges of sport and life. By encouraging rational and logical beliefs about performance, we can help athletes to stay healthy amidst the high demands of competitive sport.”

The authors propose Rational Emotive Behaviour Therapy (REBT) as an effective tool for protecting self-confidence. REBT helps athletes to challenge these self-depreciation beliefs and develop beliefs that are more helpful and healthy. For example, rather than believe “I am a failure if I fail,” this might be countered with “failing is not ideal, but it does not mean that I am failure.”

Paul added: “The good news is that irrational beliefs can be challenged and weakened. A coach, teammate or a sports psychologist can listen out for irrational belief phrases and help athletes to counter them. Promoting helpful ‘self-talk’ or imagery can really help to shift somebody’s mindset from being rigid and illogical to being more rational, flexible and healthy.”

According to sources, the National Technical Advisory Group on Immunisation (NTAGI) met on February 8 to discuss the inclusion of Covid-19 vaccine Covovax as a heterologous booster dose for adults on the CoWin portal in order to increase dose uptake. The Serum Institute of India (SII) also wrote to the Union Health Ministry in January, requesting that its Covid vaccine Covovax be included on the CoWIN portal.

The Drugs Controller General of India (DCGI) approved the Serum Institute of India (SII) COVID jab Covovax as a heterologous booster dose on January 16.

Last week the government drug regulatory authority Drugs Controller General of India (DCGI) recommended market authorisation for Serum Institute of India’s Covid vaccine Covovax as a heterologous booster dose for those who have already taken two doses of Covishield or Covaxin.

Earlier, DCGI had approved Covovax for restricted use in emergency situations in adults on December 28, 2021, for ages between 12-17 on March 9, 2022, and also for children who come under 7- 11 years on June 28, 2022, subject to certain conditions.

Covovax is manufactured through technology transfer from Novavax. It has been approved by the European Medicines Agency for conditional marketing authorization. It was granted an emergency-use listing by the World Health Organization (WHO) on December 17, 2021.

Recently, Bharat Biotech’s nasal Covid vaccine for adults above 18 years old had been launched by the Government of India and its batches were also released.
The vaccine is available in private hospitals.
iNCOVACC is the world’s first Intranasal Vaccine to receive both Primary series and Heterologous booster approval.

According to Business Recorder, the Pakistan Pharmaceutical Manufacturers Association (PPMA) has asked the government to raise prices in response to rupee depreciation and rising input costs.

The industry has requested an increase in medicine prices in a letter to the prime minister and the federal minister for National Health Services and Regulations, citing the industry’s reliance on imported raw materials to ensure the continued availability of medicines in the country. Given the foregoing, as well as being compelled and constrained by circumstances beyond the pharmaceutical industry’s control, it has become entirely unsustainable to manufacture medicines and ensure their availability beyond the next seven days, according to the PPMA letter.

After receiving the letter, the Ministry of National Health Services agreed to discuss the increase in the price of medicines. According to the PPMA officials, a delegation of government headed by Heath Minister Abdul Qadir Patel is likely to meet the PPMA delegation in the next few days, reported Business Recorder.

Chief Executive Officer (CEO) Drug Regulatory Authority of Pakistan (DRAP) Dr Asim Rauf and other relevant stakeholders will also participate in the deliberation.

According to Business Recorder citing sources reported that the meeting would discuss the issues being faced by the pharma industry. The meeting would also consider the opening of letters of credit (LCs) to stop the shortage of medicines.

Earlier, around 40 companies informed the Drug Regulatory Authority that they going to halt production citing the unavailability of raw materials, and sought a price increase, Dawn reported.

Moreover, the medical companies also claimed that their cases looking for an increase in the price, under the ‘hardship category’ were not being decided by courts.

Under the hardship category, companies may file court cases to increase prices if production cost goes beyond the maximum sale price.

Pakistan Pharmaceutical Manufacturers Association chairman Syed Farooq Bukhari, while talking to Dawn, said PPMA had demanded a 28.5 per cent across-the-board increase in prices, reported Dawn.

“In 2018, one US dollar was around Rs140 but now, due to the depreciation of the rupee, that value has increased to around Rs270. Because of this situation, 40 companies have written letters to the health ministry and Drap that they will not be able to continue production of medicines [after] one week,” he said.

Pharma Bureau executive director Ayesha Tammy Haq, while talking to Dawn, said the companies were facing a severe shortage of dollars.

“It is unfortunate that the government has dollars to import vehicles but LCs (letters of credit) are not being opened. A number of containers are not being cleared. We have run out of raw materials. Moreover, there is a massive devaluation of the rupee as it has dropped by Rs60 against the dollar in just one month,” Dawn quoted Haq saying.

According to new Penn State College of Medicine research, the 150 minutes of moderate to vigorous aerobic activity per week recommended by the US Department of Health and Human Services can significantly reduce liver fat.

The team’s meta-analysis of 14 previous studies confirms that exercise reduces liver fat in patients with nonalcoholic fatty liver disease in a clinically meaningful way. While previous research suggested that physical activity was beneficial, it did not specify how much exercise was required to achieve clinically meaningful improvement.

“Our findings can give physicians the confidence to prescribe exercise as a treatment for nonalcoholic fatty liver disease,” said Jonathan Stine, associate professor of medicine and public health sciences, and hepatologist at Penn State Health Milton S. Hershey Medical Center. “Having a target amount of physical activity to aim for will be useful for health care and exercise professionals to develop personalized approaches as they help patients modify their lifestyles and become more physically active.”

“Our findings can give physicians the confidence to prescribe exercise as a treatment for nonalcoholic fatty liver disease,” said Jonathan Stine, associate professor of medicine and public health sciences, and hepatologist at Penn State Health Milton S. Hershey Medical Center. “Having a target amount of physical activity to aim for will be useful for health care and exercise professionals to develop personalized approaches as they help patients modify their lifestyles and become more physically active.”

Nonalcoholic fatty liver disease (NAFLD) affects close to 30% of the global population and over time, can lead to cirrhosis, also known as liver scarring, and cancer. There are no approved drug treatments or an effective cure for this common condition; however, research has shown that exercise can improve liver fat, physical fitness, body composition and quality of life for patients.

According to Stine, prior research had not deduced what the required “dose” of exercise was to help patients with NAFLD achieve clinically meaningful improvement — defined as at least a 30% relative reduction of liver fat, measured by magnetic resonance imaging (MRI).

Stine reviewed 14 studies with a total of 551 subjects who had NAFLD and participated in randomized, controlled trials involving exercise interventions. His team evaluated data pooled from all the studies including age, sex, body mass index, change in body weight, adherence to the exercise regimen and MRI-measured liver fat.

The researchers primary goal in the study was to examine the association between exercise training and a clinically relevant improvement in liver fat. Independent of weight loss, the team found exercise training was 3 1/2 times more likely to achieve clinically meaningful treatment response (greater than or equal to 30% relative reduction in MRI-measured liver fat) compared to standard clinical care.

In its secondary analysis, the team determined what the optimal “dose” of exercise was to achieve clinically meaningful improvements in liver fat. They found that 39% of patients prescribed greater than or equal to 750 metabolic equivalents of task (for example, 150 minutes per week of brisk walking) achieved significant treatment response compared to only 26% of those prescribed lesser doses of exercise. This is the same amount of physical activity recommended by the American Gastroenterological Association and the European Association for the Study of the Liver. The results were published in the American Journal of Gastroenterology.

According to Stine, when this amount of exercise was prescribed, clinically relevant reductions in MRI-measured liver fat were achieved at a rate similar to those reported in early-phase NASH drug trials evaluating medications that block fat production.

“Exercise is a lifestyle modification, so the fact that it might match the ability of in-development therapeutics to achieve the same outcome is significant,” said Stine, a Penn State Cancer Institute researcher. “Clinicians counseling patients with NAFLD should recommend this amount of activity to their patients. Brisk walking or light cycling for 1/2 an hour a day five times a week is just one example of a program that would meet these criteria.”

According to new research, adults who sustained any form of brain injury during a 30-year study period had double the rate of mortality as those who did not, and mortality rates among those with moderate or severe head injuries were nearly three times higher.

The study’s findings were reported in JAMA Neurology. Over 23 million persons aged 40 and over in the United States report a history of head injury with loss of consciousness. Head injuries can be caused by a variety of factors, including car accidents, inadvertent falls, and sports injuries. Furthermore, brain damage has been related to a variety of long-term health issues such as disability, late-onset epilepsy, dementia, and stroke.

Studies have previously shown increased short-term mortality associated with head injuries primarily among hospitalized patients. This longitudinal study evaluated 30 years of data from over 13,000 community-dwelling participants (those not hospitalized or living in nursing home facilities) to determine if a head injury has an impact on mortality rates in adults over the long term. Investigators found that 18.4 per cent of the participants reported one or more head injuries during the study period, and of those who suffered a head injury, 12.4 per cent were recorded as moderate or severe. The median period of time between a head injury and death was 4.7 years.

Death from all causes was recorded in 64.6 per cent of those individuals who suffered a head injury, and in 54.6 per cent of those without any head injury. Accounting for participant characteristics, investigators found that the mortality rate from all causes among participants with a head injury was 2.21 times the mortality rate among those with no head injury. Further, the mortality rate among those with more severe head injuries was 2.87 times the mortality rate among those with no head injury.

“Our data reveals that head injury is associated with increased mortality rates even long-term. This is particularly the case for individuals with multiple or severe head injuries,” explained the study’s lead author, Holly Elser, MD, PhD, MPH a Neurology resident at Penn. “This highlights the importance of safety measures, like wearing helmets and seatbelts, to prevent head injuries.”

Investigators also evaluated the data for specific causes of death among all participants. Overall, the most common causes of death were cancers, cardiovascular disease, and neurologic disorders (which include dementia, epilepsy, and stroke). Among individuals with head injuries, deaths caused by neurologic disorders and unintentional injury or trauma (like falls) occurred more frequently.

When investigators evaluated specific neurologic causes of death among participants with head injury, they found that nearly two-thirds of neurologic causes of death were attributed to neurodegenerative diseases, like Alzheimer’s and Parkinson’s disease. These diseases composed a greater proportion of overall deaths among individuals with head injury (14.2 per cent) versus those without (6.6 per cent).

“Study data doesn’t explain why the cause of death in individuals with head injuries is more likely to be from neurodegenerative diseases, which underscores the need for further research into the relationship between these disorders, head injury, and death,” said Andrea L.C. Schneider, MD, PhD, an assistant professor of Neurology at Penn.

Any women’s magazine you read will most likely offer advice on how to get more exercise. However, many individuals are unaware that the majority of exercise advice is based on research conducted nearly entirely on men. More than 90% of studies on exercise performance and fatigability exclude female volunteers because it is considered that menstrual cycle hormonal changes affect exercise capacity, which, if true, would muddy the data and make adding women in the study problematic.

A new study from Brigham Young University researchers, published in the Journal of Applied Physiology, shows why that assumption is misguided. Analyzing women’s exercise performance across their menstrual cycles, researchers found no variability in endurance thresholds or performance: from workout to workout, women’s performance was just as consistent as men’s. “Females with regular cycles performed the same between the high-estrogen phase, the high-progesterone phase and during menstruation, when there are low concentrations of both,” said Jessica Linde, who led the study for her BYU Master’s thesis in exercise science. “That information lifts a big barrier. It shows we shouldn’t be excluding women from research based on the idea that their menstrual cycles are going to skew the results.”

In fact, the study demonstrated why it’s crucial to include women in research. While women’s menstrual cycles didn’t affect their exercise, there were key differences between how women’s and men’s endurance played out. For example, women reached exhaustion from muscle fatigue about 18 per cent faster than men, even when adjusting for muscle mass, possibly because women’s bodies may naturally reserve more energy.

“The assumption in exercise research has long been that women are like men, just smaller,” said BYU exercise science professor and co-author Jayson Gifford. “Our study suggests that they’re not, that there are important differences between women’s and men’s exercise. Including more women in research will allow us to fine tune approaches to women’s physiology.”

For the study, seven women and 10 men completed intense cycling sessions, the women at three points during the menstrual cycle confirmed through blood draws and ovulation tests, and the men at 10-day intervals. As participants exercised, researchers measured heart and respiratory rates to assess performance.

“Previous studies have looked at maybe one intensity of exercise in the menstrual cycle, but Jessica was extremely comprehensive and looked at five. It was one of the most thorough studies I’ve seen to date, and the data were extremely convincing,” Gifford said.

Although female participants often told the researchers that their menstrual cycles affected how they were feeling and how well they expected to perform, their measurable results showed “absolutely no change,” the researchers said. While hormones like estrogen are known to influence how well arteries dilate and how blood flows to muscles, those underlying processes “didn’t amount to impaired overall performance.”

Linde and Gifford were careful to note that the study focused only on cycling and included only women without menstrual disorders. More research is needed to determine how irregular menstruation might affect exercise. Learning more about women’s exercise is especially important now that there are more female athletes than ever — Linde, who is now continuing her research as a Ph.D. student at Marquette University, was herself inspired to pursue the research because of her experiences as a Division I athlete in college.

“I had never considered my female physiology impacting my performance until I got injured, and it was brought up,” Linde said. “I think sometimes we just don’t think of these questions. But in the last Olympics, the number of female and male athletes was finally equal. We have so many female athletes and women in general who are exercising and want answers about how they perform, so we need to study them.”

Union Health Minister Dr. Mansukh Mandaviya along with Technology Minister Jitendra Singh launched ‘iNCOVACC,’ the world’s first made-in-India nasal vaccination, on 26 January, 2023.

Hyderabad-based Bharat Biotech’s Intranasal heterologous booster dosage is expected to be ready in the market by the first week of February and is priced at ₹325 per shot for procurement by government and ₹800 per shot for private centres.

Bharat Biotech has launched iNCOVACC® (BBV154) as a booster dosage in India.

Earlier this month, Bharat Biotech received approval from the Central Drugs Standard Control Organization (CDSCO) for the use of heterologous booster doses of iNCOVACC®.

The vaccine is still not available on CoWin. According to the statement issued by the company, iNCOVACC® i is priced at Rs 800 for private markets and priced at Rs 325 for supplies to the government of India and State Governments.

“iNCOVACC® is a recombinant replication-deficient adenovirus vectored vaccine with a pre-fusion-stabilized SARS-CoV-2 spike protein. This vaccine candidate was evaluated in phases I, II and III clinical trials with successful results. iNCOVACC® has been specifically formulated to allow intranasal delivery through nasal drops. The nasal delivery system has been designed and developed to be cost-effective in low- and middle-income countries.” the statement read.

Dr Krishna Ella, Executive Chairman said; “We have achieved the goals we set for ourselves during this pandemic. We have developed COVAXIN® and iNCOVACC®, two COVID vaccines from two different platforms, with two different delivery systems. The vectored intranasal delivery platform gives us the capability for rapid product development, scale-up, easy and painless immunization during public health emergencies and pandemics. We thank the Ministry of Health, CDSCO, Dept of Biotechnology, Govt of India, Technology Development Board, and Washington University, St Louis, for their support and guidance.”

As a needleless vaccination, Bharat Biotech’s iNCOVACC® will be India’s first such booster dose.
On the occasion of the launch, the Union Minister of State (Independent Charge) Science & Technology; Minister of State (Independent Charge) Earth Sciences; MoS PMO, Personnel, Public Grievances, Pensions, Atomic Energy and Space, Dr. Jitendra Singh, Dr Krishna Ella, Executive Chairman , Bharat Biotech and Suchitra Ellla, Joint Managing Director, Bharat Biotech will also be present.