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What are PFAS and where do we find them?

Per- and polyfluoroalkyl substances (PFAS) are highly persistent synthetic chemicals comprising more than 4,700 fluorinated substances. PFAS are durable, heat-resistant, and grease- and water-repellent, resulting in their extensive application in the consumer sector.

The global footprint of PFAS

Despite being artificial and not found naturally in the environment, their near-ubiquitous incorporation in food packaging, fire-repellent foam, waterproofing material, paints, pesticides, and even cosmetics has resulted in PFAS being found from the peak of Mount Everest to the bottom of ocean trenches. Global studies have found PFAS in the tropics, the Arctic and Antarctic Poles, and everywhere in between.

The biological impact of PFAS

Alarmingly, PFAS have also been found in the bodies of virtually all plants and animals, including humans. Research has demonstrated the bioaccumulation and biomagnification of these substances across terrestrial and aquatic ecosystems, exposing humans to PFAS ingestion via inhalation, dermal contact, and dietary intake. Oral dietary intake predominates, with epidemiological studies linking increased serum PFAS concentrations with fish and shellfish consumption.

How do we consume PFAS?

PFAS have further been identified in fruits and vegetables, livestock, and processed foods, and given their use as food packaging, have been observed to contaminate food to direct migration from the packaging onto the food itself. PFAS have a strong affinity for proteins and bioaccumulate in protein-rich tissue. Research has identified high concentrations of PFAS in the human liver, where it has been associated with chronic diseases, including nonalcoholic fatty liver (NAFLD), hepatic fibrosis, and liver cancer.

PFAS and liver health

The present review aims to elucidate the sources and fates of PFAS in the environment, with a special focus on human exposure and PFAS-induced hepatotoxicity studies evaluating in vitro and in vivo murine models. The review is intended to raise public awareness about the demerits of PFAS contamination and its impacts on human liver health.

From production to pollution: The lifecycle of PFAS

PFAS, since their discovery and introduction in the 1980s, have been used extensively in consumer and industrial applications due to their durability and surfactant-like properties. After concerns about their environmental impacts came to the forefront in the early 2000s, PFAS manufacturers began phasing out long-chain PFAS (called 'legacy PFAS') and replacing them with short-chain variants ('emerging PFAS').

While additional research is required to confirm claims that short-chain PFAS are environmentally and medically safe, these emerging PFAS allow manufacturers to bypass legacy PFAS restrictions imposed during the Stockholm Convention and other global conferences.

How do PFAS get into our food and water?

Studies have identified industry wastewater and exhaust, wastewater treatment plants (WWTPs), untreated domestic wastewater, and aqueous film-forming foams (AFFFs) as the primary environmental PFAS pollutant sources. Uptake and use of this water by plants, aquatic organisms, and livestock results in bioaccumulation and biomagnification. This process, termed 'trophic transfer,' forms humans' main dietary source of PFAS.

Food packaging and nonstick cookware are rich in PFAS, especially polyfluoroalkyl phosphate esters (PAP) and fluorotelomer alcohols (FTOH). Studies have revealed that PFAS can migrate from packaging material and cookware to the food itself, with the degree and rate of migration dependent on PFAS characteristics (chain length) and the food matrix (pH, fat content, temperature, salt content). Migration is the primary source of PFAS in processed foods.

Effects of PFAS exposure in humans

Studies have identified PFASS in multiple human tissues, including the blood, brain, kidneys, cerebrospinal fluid, liver, placenta, and lungs. Exposure levels vary based on profession and age. Firefighters and fluorine-chemical industrial park workers are at much higher exposure risk than the general public due to their close contact with PFAS-secreting substances. For most humans, dietary habit is the critical determinant of PFAS exposure, with seafood diets generally resulting in higher PFAS concentrations than fruits and vegetables.

While some studies have identified reductions in serum PFAS levels in lactating women and loss of PFAS during menstruation, others have revealed that mother-to-child PFAS transmission can occur via direct umbilical cord blood and breastfeeding. Research has identified high concentrations of PFAS in dairy milk and infant formula, suggesting that infant exposure to PFAS is significantly higher than that of adults.

Following restrictions imposed by the Stockholm Convention and other international agreements, legacy PFAS in human serum shows an encouraging downward trend. Long-term studies in Sweden and the United States have revealed legacy PFAS serum reductions between 61% and 88%. However, while the overall PFAS concentrations in human serum seem to be in decline, legacy PFAS are being replaced by emerging short-chain PFAS such as chlorinated polyfluoroalkyl ether sulfonic acid (Cl-PFESA). These emerging PFAS have been linked to adverse pregnancy outcomes in Chinese studies.

Biological pathways of PFAS toxicity

In vivo, murine models have revealed PFAS absorption patterns in mammals. PFAS have a strong affinity for fatty-acid binding proteins found in the liver, resulting in the liver tissue usually having the highest PFAS concentrations in most humans. Most PFAS have chemically robust carbon‑fluorine bonds, preventing their biochemical metabolisms and resulting in bioaccumulation in human tissue.

"Several reports have shown that PFAS initially crosses the intestinal barrier and is distributed in the blood, binds to albumin and low-density lipoprotein in the blood, and then disperses into extraintestinal organ following blood circulation."

What do we know about PFAS-induced liver damage?

Epidemiological studies have elucidated extensive liver damage brought about by PFAS toxicity. PFAS has been associated with numerous liver-damage biomarkers, including alanine transaminase (ALT), Gamma-glutamyltransferase (GGT), and aspartate transaminase (AST). Studies have shown strong evidence for legacy PFAS being responsible for liver fibrosis and cancer, especially in women and older adults.

In vitro liver models have found that the cytotoxicity of PFAS depends on exposure duration, PFAS concentration, and carbon chain length. Alarmingly, some studies have found synergistic effects between multiple PFAS, causing more significant damage than the sum of individual PFAS.

In vivo studies have identified PFAS as being responsible for higher cholesterol levels and obesity in humans.

"A recent study showed that exposure to five PFAS mixtures (PFOS, PFHxS, PFOA, PFNA, and HFPO-DA) caused cholestasis in the liver and increased cholesterol and bile acid levels in the mice."

Conclusion

The present review elucidates the sources and environmental transmission of PFAS, a family of nearly 5,000 man-made substances with remarkable persistence. It provides an overview of the exposure routes for PFAS assimilation by humans and the adverse effects of PFAS toxicity in vitro and in vivo. Particular focus is paid to liver cytotoxicity, revealing that PFAS can result in chronic liver conditions, including cancer.

"This review aims to raise public awareness about food PFAS contamination and its potential risks to human liver health."

Journal reference:

Zhang, J., Hu, L., & Xu, H. (2024). Dietary exposure to per- and polyfluoroalkyl substances: Potential health impacts on human liver. Science of The Total Environment, 907, 167945, DOI – https://doi.org/10.1016/j.scitotenv.2023.167945, https://www.sciencedirect.com/science/article/abs/pii/S0048969723065725?via%3Dihub

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Perhaps one of the most unbelievable cases was a video of a two-legged adult red fox taken January 2023 in Derbyshire, England.

It's hard to tell what happened to the fox, but despite the fact it was missing both back legs it appeared to be in good health as it had clean and well-groomed fur. In the video, the fox goes about the business of scent marking with the grace of a gymnast, controlling its body with perfect balance and ease.

A 2015 study of dog owners found 91% of participants perceived no change in their dog's attitude after amputation. However, medical aftercare will have reduced the chances of infection, and pets don't need to forage or hunt if their owner buys food for them.

Wildlife can get caught in snares and may lose a limb trying to escape. If the animal is able to survive the trauma, limb loss will undoubtedly affect its ability to find, catch or eat food, or even outrun a predator.

Limb loss affects every species differently. Foxes, for example, do eat meat but also fruit, vegetables and insects. This omnivorous diet and their willingness to scavenge from humans probably contributed to the two legged fox's survival as it doesn't have to hunt prey.

Learning to live with it

Diet flexibility is not an option for carnivores however. The survival chances of a carnivore who loses a limb depends upon which limb or how much of it is lost.

A study comparing how dogs move with and without amputations found dogs use front limbs to slow down whereas back limbs are used for moving forward. So losing a back leg means they won't be able to move as fast. Dogs carry more weight on their front legs so their center of gravity changes more when a front limb is lost. This will make balancing harder, at least initially.

Both of these changes will affect other four-limbed animals and have serious repercussions on the ability of a predator to catch prey.

In 2011, an adult male lion's back limb was severed by a poacher's snare in Uganda, a fate which is common across the world. However, he seems to have endured at least five years in Murchison Falls National Park. The sight of a three-legged adult lioness struggling on a muddy river bank in Kafue National Park, Zambia in 2016 prompted an initiative to remove snares in the park. Although it was clearly tough for her, the lioness was surviving.

Both lions' injury was to a back leg. When hunting large prey like buffalo, lions launch themselves on to the prey using their back limbs, hold on with their front limbs and use their body weight to slow the prey down.

Lions may also use their front limbs to swipe at a prey's legs during the chase. But crucially, front claws can be used to grip the prey's neck or head either while delivering the killing bite to the throat or while the lion's jaw is clamped around the prey's nose and mouth. The loss of a back limb will make the chase and catch harder. However, the loss of a front leg would affect their ability to kill prey by themselves.

Since lions live in groups, the injured lions may have been able to depend on family members to provide support during a hunt or, more likely, access to food once it has been caught.

Lone hunters, such as male tigers, use their paws in a similar way to lions during a hunt but do not normally rely on other tigers' help. Incredibly though, a healthy looking male tiger was caught on camera in 2007 with the lower part of his right leg missing in Tesso Nilo National Park, Sumatra.

Like all big cats, tigers eat a wide variety of prey from birds to large deer. The injured male may have focused on hunting small prey, which tigers can kill with a bite to the back of the neck. The injured tiger may have also turned to easier sources of food than wild prey such as livestock.

The devastating effect of snares

Snares are a problem the world over. While working in South Africa as a guide just over a decade ago, I saw elephants with amputated trunks, sometimes up to two thirds shorter than they should have been. Trunks are invaluable to an elephant because they have such short necks. An elephant's trunk allows it to drink, pluck fruit and grass with pinpoint accuracy, pull down out of reach branches and transfer food to their mouth. Elephants also use their trucks to greet and communicate with other elephants.

And yet, some are able to adapt to trunk injuries, probably because elephants have close family bonds. I do not recall seeing any lone elephants with these injuries.

A study in Central Africa Republic found 38% of animals (including elephants, gorillas and pangolins) caught in snares managed to break them and escape, albeit with the snare still attached to them. But 3% left their limb behind (including African brush-tailed porcupines, small mammals called African palm civets and a type of small antelope called duikers). Another study from India that looked at camera trap images reported sloth bears, leopards, elephants, sambar deer and dhole wild dogs with snares around their bodies.

It shows incredible resilience that these animals survived a snare without succumbing to shock, exhaustion, blood loss or infection, as so many other animals inevitably do. These wild miracles are more than an inspiration—they should be a wake-up call for the damage humans are doing to animals globally.

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Frequent satellite launches may leave scars in the atmosphere, according to a new study published in Proceedings of the National Academy of Sciences. A team of atmospheric scientists flew a NASA aircraft over Alaska, sampling the stratosphere. They found traces of lithium, aluminum, copper and lead in higher quantities than what would be produced naturally. "We are finding this human-made material in what we consider a pristine area of the atmosphere," Dan Cziczo, one of the authors of the study, said in a statement. 

Experts have long believed that the world has a space junk problem. There have been a number of instances in which pieces of space junk fell to the surface of the Earth, injuring people, or disrupting space stations and space crafts. This research suggests that burning, disintegrating space junk and returning rockets are also polluting the crucial layer of atmosphere that holds the Earth's ozone shield.

This is "the first observational evidence that space activities are a very significant source of particulate pollution to the stratosphere," Slimane Bekki, an atmospheric scientist at the French research laboratory LATMOS, told Popular Science. And experts don't know how space junk pollution will affect the stratosphere or the planet below it.

"If something is changing in the stratosphere — this stable region of the atmosphere — that deserves a closer look," Czizco said. Scientists are concerned that the particulates could damage the ozone layer, though the effects of the pollution are still unknown. "What this research shows us is that the impact of human occupation and human spaceflight on the planet may be significant," he continued. 

Realistically, "the only way for these particles not to appear in the upper atmosphere is for the satellites not to be launched in the first place," Jamie Shutler, an atmospheric scientist at the University of Exeter, told Popular Science.

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The nestlings and chicks often perish from dehydration and the affects of thermoregulation, especially when they fledge in "open cup" nests and bird boxes located in unshaded fields, according to researchers at the University of California, Davis.

Their survival also depends on the ability of mating adults to forage for food and support the nest, both of which can be impeded by extreme temperatures.

“We know that habitat conversion [for agriculture] is already affecting biodiversity and species health on farms,” Katherine Lauck, co-lead author of the paper and a Ph.D. candidate in ecology at UC Davis, said in an interview.

“When you combine that with extreme heat associated with climate change, it’s creating some unique conditions that birds did not evolve with,” Lauck added. "Fundamentally, this is about whether nestlings survive or not.

The findings, published Thursday in the journal Science, add to a growing body of research about the effects of climate change on birds that scientists say are indicators of ecological decline. In 2019, experts from seven major ornithological institutions and nonprofits estimated that North America’s breeding adult birds had declined by 30 percent since 1970, a loss of nearly 3 billion birds.

While the declines were caused by a variety of factors — including habitat loss, predation, food scarcity and building collisions — nestlings are increasingly jeopardized by climate change, the UC Davis researchers found.

They determined that in unshaded farm fields — where temperatures can be 10 degrees Celsius higher than in nearby forests — mating adults have “significantly diminish[ed] reproductive success” compared to those living in forest areas. Scientists define reproduction success as having at least one fledgling emerge from a nest per breeding season.

While heat stress affects birds across all habitat types, the researchers found that “common generalist” species like western bluebirds and tree swallows were particularly vulnerable to heat in rural America, with “significant declines in nesting success when temperatures spiked in agricultural areas.”

They also found that birds living in unshaded open-cup nests and bird boxes were more vulnerable to heat waves than those nesting in tree holes and more shaded areas. The trends were observed across every farming region of the country.

“This suggests that species already in decline may have an even greater difficulty rearing young in the future as heat waves become more common and more land is converted to agriculture,” Daniel Karp, an associate professor of biology at UC Davis who led the data collection effort, said in a statement.

The findings are based on an analysis of 152,000 nesting records collected by NestWatch, a program by the Cornell Laboratory of Ornithology in which local volunteers monitor nests and report signs of bird health and behavior using an online app. Data includes things like the number of eggs laid, adult nesting behaviors and the activities of baby birds.

The approach allowed researchers to assess 58 bird species in habitats such as farms, forests, grasslands and developed areas. The data spanned a 23-year period beginning in 1998.

Conor Taff, a research associate at the Cornell lab, said the UC Davis study is notable for its nationwide scale and provides a large data source for researchers who have traditionally focused on distinct regions. He also said the paper provides a foundation upon which scientists can study more species and the effects climate change is having on their habitats.

Reprinted from E&E News with permission from POLITICO, LLC. Copyright 2023. E&E News provides essential news for energy and environment professionals.

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Currently, immunotherapy is the standard of care for patients with liver cancer. However, while newer immunotherapy medications, which use a person’s immune system to fight cancer, can slow the spread in many types of cancers, liver tumors often do not respond. University of Hawaiʻi Cancer Center researcher Benjamin Green led a team to conduct public impact research and published a study aimed to better understand why this happens.

“Sometimes, immunotherapy can cause the generation of pro-cancer immune cells called regulatory T cells or ‘Tregs’,” Green explained.

Using cutting-edge sequencing technology, Green and his team performed the most comprehensive analysis of liver Tregs to date in mice that received immunotherapy. They discovered that the Tregs in the liver that expressed a CD29 protein were more immunosuppressive, and increased in abundance when mice were treated with immunotherapy. 

Regardless of the type of cancer that was placed into a mouse’s liver, immunotherapy nearly doubled the quantity of CD29+ Tregs. Although the CD29 protein is understudied in Tregs, it likely has an impact on controlling the Treg population in the liver. 

“Our results may be applicable to a range of liver diseases. In liver cancer, we think that CD29 may represent a new potential drug target to help patients respond to immunotherapy,” said Green. “We will determine whether these Tregs can be killed to improve immunotherapy of liver cancer.”

Investigating liver cancer in local patients

Green received a pilot project grant from Ola Hawaii (a UH minority health research center) to continue this work, which he started at the National Institutes of Health. He is partnering with data scientists and molecular pathologists at the UH Mānoa John A. Burns School of Medicine, as well as liver cancer doctors at The Queen’s Medical Center to examine a number of liver tumors removed from Hawaiian and non-Hawaiian patients to see if they contain different percentages of CD29+ Tregs. 

“I am grateful to the UH Cancer Center and the patients in Hawaiʻi that have enabled me to continue this important research,” he said. “Working together, I believe that we will contribute to designing more effective medications for future patients suffering from liver cancers.” 

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Earlier in October, Pakistan and Azerbaijan joined the ILRS, a project jointly initiated by China and Russia in 2021 and widely seen as a rival to the U.S.-led Artemis programme.

Lunar missions this decade will establish a "basic" version of the research station, followed by more missions in the 2030s to construct a "full" version of the base.

By 2050, the ILRS is expected to be a fully operational station for lunar research, and potentially also a launch pad for crewed missions to other planets in the solar system.

Note: (*) denotes founding member

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The spacecraft Shenzhou-17, or "Divine Vessel", and its three passengers lifted off atop a Long March-2F rocket from the Jiuquan Satellite Launch Centre in northwest China.

Leading the six-month mission was former air force pilot Tang Hongbo, 48, who was on the first crewed mission to the space station in 2021.

His return to the orbiting outpost Tiangong, or "Celestial Palace" in Chinese, also set a new record for the shortest interval between two spaceflight missions by taikonauts - coined from the Chinese word for space - suggesting a faster rotation of taikonauts in coming years.

Tang, from China's second batch of astronauts in 2010, had to wait more than a decade before he was picked for his inaugural spaceflight in 2021.

By contrast, his fellow Shenzhou-17 crew members Tang Shengjie, 33, and Jiang Xinlin, 35, both travelling to space for the first time, joined China's third batch of astronauts in September 2020.

China has already kickstarted the selection process for the fourth batch of astronauts, seeking candidates with doctoral degrees in disciplines from biology, physics and chemistry to biomedical engineering and astronomy.

It is also opening the process to applicants from Hong Kong and Macau for the first time.

The first and second batches of astronauts were all former air force pilots, like Tang, who joined the People's Liberation Army in 1995 at age 20.

FOREIGN ASTRONAUTS

The selection and training process will commence soon for foreign astronauts looking to participate in joint flights to Tiangong, a senior official on China's manned space program said this year.

But as much as China is showcasing its efforts to internationalise its space missions, its space program has distinct Chinese characteristics, at least on Tiangong.

In a departure from the NASA-led International Space Station (ISS), where English is the working language, only Chinese is used on Tiangong, making Chinese-language skills a key criteria for foreign participants.

Tiangong has become a symbol of China's growing confidence in its space endeavours after being shut out of the ISS program for decades. China is banned by U.S. law from any collaboration, direct or indirect, with NASA.

Tiangong, completed in late 2022, can house a maximum of three astronauts at an orbital altitude of up to 450 km (280 miles) and will have an operational lifespan of more than 15 years.

The Shenzhou-17 astronauts will replace the Shenzhou-16 crew, who arrived at Tiangong at the end of May.

The Shenzhou-16 crew, consisting of veteran astronaut Jing Haipeng, Zhu Yangzhu and Gui Haichao, is scheduled to return to earth on Oct. 31.

Zhu and Gui, both in their 30s, are from China's third batch of astronauts.

Shenzhou-17 marks China's 12th crewed mission since Yang Liwei's solo spaceflight in October 2003, the first Chinese national in space.

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CLIMATEWIRE | Human activities are sending the planet hurtling toward a series of dangerous tipping points, scientists warn. The world is approaching thresholds of no return as temperatures rise, water resources shrink, plants and animals go extinct and humanmade materials accumulate in natural systems.

These tipping points could reshape life on Earth if human societies don’t swiftly and radically transform. Natural systems could collapse, food and water supplies could plummet, and human health and well-being could dramatically decline.

That’s the message of a stark United Nations University report, released Wednesday morning. The report warns of six impending global tipping points, each driven by rampant human pollution and extraction of natural resources.

Extinctions are accelerating. Groundwater resources are depleting. Mountain glaciers, with their valuable freshwater supplies, are melting and shrinking. The skies are filling up with space debris, threatening humanity's ability to launch satellites and monitor global warming and other changing conditions on Earth.

That's not all. Temperatures are skyrocketing, raising the risks of unsurvivable heat. And worsening climate disasters, including floods, wildfires and hurricanes, are driving insurance costs beyond affordable limits.

Past a certain threshold, each of these tipping points could have disastrous consequences for human life on Earth. And the consequences of any one tipping point is inextricably connected to all the others, the report suggests.

"The report also shows that risk tipping points are not isolated cases — they’re also interconnected,” said Jack O’Connor, a lead author of the report and a senior scientist at United Nations University's Institute for Environment and Human Security, at a press briefing announcing the findings Wednesday morning. “So passing a risk tipping point in one system can have cascading impacts that can put risk up in other systems.”

Shrinking water resources threaten agriculture and jeopardize both human survival and the health of natural ecosystems. Accelerating extinctions can cause entire natural systems to collapse, another threat to human supplies of food and resources.

The rising risk of unbearable heat can also threaten agriculture, water supplies and natural ecosystems, and it poses another major threat to human survival in the hottest parts of the world. It can trigger mass climate-driven migrations, too, which can spark conflict across the world.

Even space debris carries serious global implications. Earth's orbit is swiftly filling up with broken satellites, discarded rocket parts and other scraps. This “space junk” poses a growing risk of collision with active satellites. And past a certain threshold, the report warns, “existing space infrastructure would eventually be destroyed and future activities in space could become impossible.”

That’s a big problem. Humans use satellites for countless services. That includes communications, as well as observing global temperatures and monitoring the progression of climate change on Earth. That means space pollution also threatens humanity's ability to keep tabs on all the other tipping points on the list.

Meanwhile, rising insurance costs threaten the stability of human communities in the face of worsening climate disasters. The report notes that insurance costs in some areas have risen by as much as 57 percent since 2015, and insurance companies in certain at-risk areas have opted to limit coverage options or even leave the market entirely. One recent estimate found that around 520,940 homes in flood-prone Australia are predicted to be uninsurable by 2030.

Inaccessible insurance can lead to catastrophic financial losses for people living in disaster-prone areas, the report warns. And it can worsen issues of inequality in communities around the globe. Wealthier people may have the option to move to less vulnerable areas, while lower-income people may be forced to stay and face the risks of living in disaster zones without insurance coverage.

Authors of the report likened the impending tipping points to a car speeding past warning signs to the edge of a cliff.

“What we see is that often not only are we failing to slow the car down, but often we are pressing our foot down further on the accelerator,” O’Connor said.

A GLOBAL TRANSFORMATION

The new report is the latest installment in an annual series on interconnected disasters, first published in 2021. The previous two reports have focused on specific examples of disasters around the world, including extreme weather and climate events, earthquakes, volcanic eruptions, extinction events and even the ammonium nitrate explosion in Beirut in 2020.

Each of these disasters is part of an interconnected web of human activities and natural systems, the reports argued. That’s true even for disasters that don’t have obvious roots in natural systems, such as the Beirut explosion. That event was worsened by insufficient disaster response efforts in Lebanon, an issue with the potential to exacerbate a variety of other disasters and extreme weather events, the authors argued.

The event also caused Covid-19 cases in Lebanon to skyrocket, as overwhelmed hospitals lowered their testing and isolating standards and displaced people were forced to shelter in large groups together.

The new report broadens its scope beyond recent individual disasters, focusing instead on the risk of broader global tipping points. Yet it makes a similar argument about the interconnected nature of these issues — none of them occur in isolation, and each tipping point has cascading effects on human and natural systems all over the world.

While the report paints a dire picture of the risks, it emphasizes that human societies still have agency over their future. Avoiding catastrophic tipping points is possible if human systems undergo a dramatic global transformation.

“Our report is not saying that we are doomed to cross these risk tipping points, but rather it’s supposed to empower us to see the paths ahead of us and to take steps toward a better future,” O’Connor said. “We are still driving the car, and we still have a choice.”

The solutions fall into two main categories, the report suggests. Human systems must avoid activities that raise the risk of crossing disastrous thresholds. And they must adapt to the damage they’ve already caused and the consequences of tipping points that can’t be entirely avoided.

Extreme heat is rising around the world, for instance. And mountain glaciers are swiftly melting, too, meaning some communities are now confronting the loss of their freshwater supplies. These are impacts that have already arrived, can’t be avoided and require immediate adaptation efforts.

Both avoidance and adaptation efforts have two main categories of future action, the report says. Communities must work to delay their progression toward catastrophic tipping points. And they must also move to fundamentally transform human systems, making them safe and sustainable for the future.

That means entirely reimagining the way daily life and human communities operate. It could involve strategies such as redesigning cities with more green spaces, efficient buildings, sustainable energy and transportation systems and equal accessibility to vital services to simultaneously reduce greenhouse gas emissions, cope with rising heat and reduce socioeconomic inequalities.

Many of the actions pursued by human societies today emphasize delay tactics, rather than transformation, said Zita Sebesvari, a lead author of the report and deputy director of United Nations University's Institute for Environment and Human Security, adding that they’re “clearly not enough to actually steer away society from those dangerous tipping points.”

“The report emphasizes that the real actions we have to look into are the so-called ‘transform’ actions,” she said. “Getting back to the car analogy, this would mean to get out together from the car and question why are we speeding toward that dangerous cliff.”

Such solutions must address the underlying problems that led to these tipping points in the first place, the report warns. And that requires collective global concern and collaboration.

“Changing established systems and behaviors is never easy, but this is the choice we must make if we want to avoid risk tipping points,” the authors state. “The question we face is simple, yet profound — what kind of future do we want?”

Reprinted from E&E News with permission from POLITICO, LLC. Copyright 2023. E&E News provides essential news for energy and environment professionals.

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If you are heading to the dentist, you may want to turn up a rousing Adele ballad. Researchers say our preferred tunes can not only prove to be powerful painkillers, but that moving music may be particularly potent.

Music has long been found to relieve pain, with recent research suggesting the effect may even occur in babies and other studies revealing that people’s preferred tunes could have a stronger painkilling effect than the relaxing music selected for them.

Now, researchers say there is evidence that the emotional responses generated by the music also matter.

“We can approximate that favourite music reduced pain by about one point on a 10-point scale, which is at least as strong as an over-the-counter painkiller like Advil [ibuprofen] under the same conditions. Moving music may have an even stronger effect,” said Darius Valevicius, the first author of the research from McGill University in Montreal, Canada.

Writing in the journal Frontiers in Pain Research, Valevicius and colleagues report how they asked 63 healthy participants to attend the Roy pain laboratory on the McGill campus, where researchers used a probe device to heat an area on their left arm – a sensation akin to a hot cup of coffee being held against the skin.

While undergoing the process, the participants either listened to two of their favourite tracks, relaxing music selected for them, scrambled music, or silence.

As the music, sound or silence continued, the participants were asked to rate the intensity and unpleasantness of the pain.

Each participant experienced each condition for around seven minutes, within which eight pain stimulations and eight ratings took place.

When the auditory period ended, participants were asked to rate the music’s pleasantness, their emotional arousal, and the number of “chills” they experienced – a phenomenon linked to sudden emotions or heightened attention, that can be felt as tingling, shivers or goosebumps.

The results reveal participants rated the pain as less intense by about four points on a 100-point scale, and less unpleasant by about nine points, when listening to their favourite tracks compared with silence or scrambled sound. Relaxing music selected for them did not produce such an effect.

Valevicius said it is unlikely the results are down to second-guessing. “We found a very strong correlation between music pleasantness and pain unpleasantness, but zero correlation between music pleasantness and pain intensity, which would be an unlikely finding if it was just placebo or expectation effects,” he said.

Further work revealed music that produced more chills was associated with lower pain intensity and pain unpleasantness, with lower scores for the latter also associated with music rated more pleasant.

“The difference in effect on pain intensity implies two mechanisms – chills may have a physiological sensory-gating effect, blocking ascending pain signals, while pleasantness may affect the emotional value of pain without affecting the sensation, so more at a cognitive-emotional level involving prefrontal brain areas,” said Valevicius, although he cautioned more work is needed to test these ideas.

Both music pleasantness and chills were rated more highly for moving or bittersweet tracks – although the direct effects of such tunes on pain were unclear.

The researchers say it is not yet known if moving music would have a similar chill-creating effect in those who do not favour it, or if people who favour such music are simply more prone to musical chills.

What’s more, they say the size of the study might mean some relationships cannot be detected, while the relaxing music may not have been played for long enough for an effect to have been seen.

Dr Brendan Rooney, of University College Dublin’s school of psychology, said he was not convinced there is some special quality about the music itself, not least as participants’ perception of pain when listening to a track might influence their report of how they feel.

But Rooney said the work supports findings from his own team that music chosen by participants appears to have a stronger painkilling effect.

“Together this paper and our work provide evidence that people who are experiencing pain should be empowered to curate their own analgesic experiences from music and entertainment,” he said.

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Two days before I had a heart attack in February 2017, I had just got back from Alaska, where I’d been leading an expedition. At home in Colorado, I thought the chest pains were to do with the change in altitude. I was 37, and active. I’d been in the Marine Corps until 2011, then I became a wilderness and survival skills guide. I was training for a 245km ultramarathon through the Peruvian jungle. Even when I got to hospital, I struggled to believe I was having a heart attack, but I was rushed into an operating room and a stent was fitted.

When I came out of hospital three days later, I could barely walk and was put into cardiac rehab with a group of 85-year-olds. But I believed I needed something else to heal me. As an outdoors guy who could make stone tools and live off the land, I knew that was where I needed to be. And so, after several rehab sessions, I thought, “I’m out of here!” and went to live in a cave, near where I could hunt animals and drink from streams.

I spent around six months alternating between a conventional life and living in the Colorado wilderness. My wife and I were separating, but I didn’t want to be away from our two sons for too long, so I would come back often to connect with them. The longest stretch I was away in the wild was just under two months.

I hope to fuel people’s curiosity about the natural world’ … Dust with his dog Finn. Photograph: Supplied image

I had a series of caves and each had different amenities – some were next to springs, or near better fishing, hunting and foraging. The “main cave” had a bed in it – by which I mean a big pile of grass and leaves, which was comfortable. It had a bit of a skylight, so the smoke from my fire could rise through it and I could see the stars. I would jam a stick between the cave walls and dry clothes on it, and would keep an old soup can there for boiling water in. That was the cave that had the most resources, but I would move from cave to cave. I’d cache animal hides in one, and if I wanted to treat myself to something special, I’d put a jar of dried mangoes in another – I’d have a two-day walk to go and get it.

I didn’t bring much from modern life. I always had a notebook with me with a photo of my sons, and something to write with. Depending on what I was doing or how I was feeling, I’d bring a steel bottle back out to the caves, which made it a bit easier to boil water.

Foraged food formed most of my diet – plants, berries, tubers, roots. I caught fish, squirrels and rabbits. You learn to really appreciate food: “Yes, I’ve got a fish and five berries! Today is awesome.” I missed my sons, but I also knew that this was my time to really heal and reflect, and there was always something to do. I would make stone tools, build traps, baskets and clay pots, tan hides – all very simple but they gave me so much value. And you’re always collecting firewood.

One night in my main cave, the fire had gone out, and I was sleeping, when I started feeling a warm, wet sensation on my foot. When I woke up, I could see there was a juvenile black bear at my feet, licking my toes. I let out a scream, and the bear took off. I lit a big fire, and sat up the whole night waiting for him to return.

I was becoming part of the pattern of life that existed in the wild, understanding the sounds and the smells. You can choose to fight it, or to try to control it, but when you accept it, you reach a deeper understanding of who you are and what you’re doing out there. The day of my heart attack changed my life, because it was a reawakening. Knowing that eventually one day you will expire, you need to live the life that you want, find the value.

Now I live between the worlds. I rent a place, drive a truck, and have a TV. When I have my sons, we like to watch documentaries, but they’re teenage boys so they also have their own interests. For all the time I still spend in the wilderness, social media has actually become a big part of my life. Before my heart attack, I was never on it, but, afterwards, people encouraged me to start a YouTube channel sharing my skills. Now I’ve written books, done reality shows, and consulted for movies. I’ve embraced this element of modern life, and hope to fuel people’s curiosity about the natural world.

Many of us accept life is just the way it is, but there are some outliers who want something different. I don’t judge anybody for the choices they make, but I think some people get influenced to believe in things that don’t matter. My passion is doing less with more, in the simplest way possible. Ancient humans focused on family, community, and the natural world, and I think we can learn so much from that.

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Despite boredom being a common emotion experienced by many children, no research to date has looked experimentally at how much more children eat when bored. On average, the study shows that children who were feeling bored ate 95 kcal when they were already full, compared to children in a neutral mood condition who ate just 59 kcal.

The pioneering research was led by Dr. Rebecca Stone as part of her Ph.D., supervised by Professor Claire Farrow and Professor Jackie Blissett from Aston University, and Professor Emma Haycraft from Loughborough University. The work is published in the journal Food Quality and Preference.

Children's eating behavior is shaped by their genetics, temperament, and a range of other factors, including the feeding practices they experience.

In previous research, the authors explored the behaviors that make children more likely to eat when they experience negative emotions.

Often when children experience negative emotions such as boredom or sadness, adults will use food to soothe them. However, this behavior, which is known as emotional feeding, appears to enhance the likelihood of children eating more when they are upset, potentially teaching children to seek food when their mood is low.

As part of the study the researchers asked parents about the feeding practices that they used with their child and about their child's temperament. Children and parents were given a standard meal that they ate until they were full. Children then took part in a series of everyday conditions where their mood was assessed and one of these conditions was boring for the children.

The researchers found that if parents reported using food to soothe their child's emotions often and their child was highly emotional children ate five times more kilocalories when feeling bored (104 kcal) compared to in a neutral mood (21 kcal).

Dr. Stone said, "If children are eating this many more calories during one instance of boredom induced in a laboratory (a four-minute period), given that boredom is a commonly experienced emotion in children, the potential for excess calorie intake in response to being bored across one day, one week, or one year, is potentially very significant in a food abundant environment."

Previous studies on what can influence eating behavior in children have tended to be based on questionnaires, with all negative moods, including sadness, anger and anxiety, grouped together. Boredom is easily identifiable, and generally easily rectified, so helping parents to deal with children's boredom without using food would be a potentially helpful way of reducing less healthy snacking.

Dr. Stone stresses that the experience of boredom is important in the development of children's sense of self and creativity, so does not recommend that children could or should avoid being bored. Instead, she suggests that children need to learn to experience boredom without turning to food, and that parents could try to divert their child's attention away from food when feeling bored, or restructure the home food environment to make it less likely that children turn to food when they are bored.

Professor Farrow said, "It is commonly assumed that children tend to turn to food when bored and that some children are more likely to do this than others. This is the first study to experimentally test this in the laboratory.

"While there do appear to be individual differences between children in terms of their eating when bored, it is helpful to know that the feeding practices that adults use around food might shape the likelihood of this happening. Although it is tempting to use food as a tool to comfort children, research suggests that emotional feeding might lead to greater emotional eating in the future. It is important that parents and caregivers are aware that this short-term fix could create future challenges."

The research team are interested in exploring other negative mood states in children and in developing advice and support for families to find effective ways to manage challenges around child eating behavior.

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It’s what I love — fiercely, unwaveringly — about emergency medicine. It’s why I and other doctors pursued it as a specialty: to provide a safety net. For many, we may be the first health care workers they meet at their most dismal hour. But it’s also what makes our workplace so dangerous, more than ever, and jeopardizes the emergency care that everyone receives.

Last year one of my patients was on the phone, lamenting about how long he had been in the emergency room. He had already waited several hours to get a CT scan. Medications he was supposed to be given were repeatedly delayed. I heard his voice rise and fall, with each swell more expansive than the one before. When I turned to look at him, he yelled a racial epithet before hurling a desktop computer into the area where doctors and nurses sit. A seasoned nurse ducked. As I pushed an intern and medical student out of the way, he charged at us with a steel tray. Thankfully, no one was injured.

In a 2022 American College of Emergency Physicians survey of E.R. doctors, 55 percent said they had been physically assaulted, almost all by patients, with a third of those resulting in injuries. Eighty-five percent had been seriously threatened by patients. The risks can be even higher for E.R. nurses, with over 70 percent reporting they had sustained physical assaults at work. I don’t know anyone who works in the E.R. who hasn’t suffered some form of violence there. The health workers at the University of Vermont Health Network in the video above share examples of this.

“People, appropriately so, feel that the safety net should always be there, no matter what, and should serve its purpose of not letting people fall through the cracks,” Dr. Aisha Terry, the president of the American College of Emergency Physicians, told me. But it’s this tenet at the heart of emergency medicine that also allows it to be exploited. “Whether intentionally or unintentionally, those factors have resulted in us becoming more vulnerable to violence.”

In the E.R., there’s a certain level of resignation that violence is just part of the job, like getting bloodstains on our shoes. We have come to endure racist, sexist and homophobic slurs, choosing silence over confrontation, to fulfill our duty to care for human life. After all, we pledge to hold our patients’ well-being above all else.

In some sense, violence in the E.R. is stark evidence of society’s broader neglect: a medical system in which mental health beds are scarce, primary care remains elusive and prescription costs soar; a shelter network that’s buckling; a country where parents may not make enough to feed their children. All of this can lead to intolerable overcrowding and interminable waiting in the E.R., which can rupture into frustration, anger and incivility.

Even before the Covid pandemic, the trajectory was troubling. The U.S. Bureau of Labor Statistics reports that the rate of injuries from workplace violence against health care workers grew by nearly two-thirds from 2011 to 2018. The pandemic worsened the situation, cracking society wide open and exposing its systemic failures. During the pandemic, more than 40 percent of American adults reported high psychological distress, which may contribute to outbursts. It has also sown profound mistrust between patients and medical professionals.

The repercussions of this are being felt. Only 15 percent of surveyed hospital nurses said they would continue in the same job in one year; a third of nurses said they had considered exiting the profession because of the pandemic. The burnout rate among E.R. doctors climbed to 65 percent, the highest rate among all specialties. When employees leave, those who remain face terribly short-staffed workplaces. Or employees meet a revolving door of new colleagues, making it impossible to understand one another’s strengths or compensate for one another’s shortcomings — to become a team. This can worsen outcomes for patients.

Organizations and lawmakers are starting to address violence against health care workers. The Joint Commission, a group that accredits hospitals, added workplace violence regulations last year. This year Virginia became the first state to pass a law requiring that all emergency departments keep a security officer on site around the clock. Federal legislation is also in progress: If passed, the Workplace Violence Prevention for Health Care and Social Service Workers Act would mandate health employers to adopt plans to prevent workplace violence. Another bill, the Safety From Violence for Healthcare Employees Act, modeled on protections in the airline industry, would create federal criminal penalties for people who assault health care workers.

Health care, though, is not the same as air transportation. Because of the Emergency Medical Treatment and Labor Act, in place since 1986, every person who goes to an E.R. for treatment must be medically examined and assessed. Hospitals don’t create no-fly lists, akin to airlines, nor should they. A patient can be aggressive and also be seriously ill. Patients struggling with mental illness, addiction or delirium may have violent episodes but also need compassionate care.

Federal and state laws are necessary as backstops, permitting warning signs to be posted, so that everyone knows a boundary exists that will be enforced. But hospital administrators also need to prioritize their staff members’ safety. Hospital systems have added electronic flags to the charts of patients who threatened or assaulted staff members in the past. Currently, these flags are put in by providers to warn one another and don’t go beyond individual charts. This is a starting point, but more must be done.

Simple confidential reporting systems that encourage employees to formally record these incidents in detail for further review, as they would with any medication error, should be instituted. Hospital administrators need to then perform thorough dissections of the events to diagnose what went wrong, applying the same rigor as they would to clinical mistakes, and intervene with specific remedies — whether it’s bolstering security in certain areas or equipping staff members with personal panic buttons. Some health care workers have already taken matters into their own hands by undergoing self-defense training, even looking into wearing body armor.

What has stayed with me most is not the near miss of a thrown computer or a slur a patient used but a medical student saying to me after he witnessed a violent episode, “I learned today that I don’t want to go into emergency medicine.” The field is seeing a steep decline in applicants. Who will tend to waiting patients? What will happen when society’s safety net withers away?

Standing up to end violence against health care workers does not mean taking care away from anyone. Instead, it promises to make care better for everyone.

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The new survey, taken across 142 countries, found 24% of people age 15 and older self-reported feeling very or fairly lonely in response to the question, “How lonely do you feel?”

The survey also found that the rates of loneliness were highest in young adults, with 27% of young adults ages 19 to 29 reporting feeling very or fairly lonely. The lowest rates were found in older adults. Only 17% of people age 65 and older reported feeling lonely.

Over half of adults age 45 and older reported not feeling lonely at all, while the majority of those younger than 45 answered that they felt at least a little lonely, if not very or fairly lonely.

“There is a lot of research pointing to the dangers of loneliness and social isolation among older adults,” Ellyn Maese, a senior research consultant with Gallup, told CNN. This survey “is a really good reminder that loneliness is not just a problem of aging — it’s a problem that can affect everyone at any age.”

While there was little or no difference in the reported loneliness between men and women, some countries had substantial gaps in both directions, depending on the country’s cultural context, Maese said. Overall, 79 out of the 142 countries had a higher self-reported rate of loneliness in women than men.

There is a loneliness epidemic

About 1,000 people per country were surveyed from June 2022 to February 2023, through a mixture of phone calls and face-to-face surveys. The countries represent about 77% of the world’s adult population, according to the survey.

The survey also pointed to a December 2020 report from the World Health Organization and a May advisory from the US surgeon general that illuminate the dangers of loneliness, including a negative impact on mental and physical health that could even lead to early mortality.

Clinical psychologist Dr. Ami Rokach, an associate professor at the Center for Academic Studies in Or Yehuda, Israel, was initially surprised by the low number of positive respondents. But Rokach, who has studied the experience of loneliness, believes there may be even higher global rates of people who feel lonely than reported — particularly young adults. He was not involved in the Gallup survey.

Rokach, who also teaches in the department of psychology at York University in Toronto, said that younger people who are in a transitional stage of becoming an adult experience more uncertainty in many areas of life, including “a tumultuous love life, uncertainty about a professional path, and in the process of separating from their parents.” Young adults are therefore more likely to experience more loneliness than older adults who have already accumulated “wisdom, friends, a family which may be supportive, and a community which cares for them,” he said in an email.

What to do to combat loneliness

While 49% of the total adults surveyed reported not feeling at all lonely, over half had answered that they felt at least a little lonely. Maese said that the findings also served as an opportunity to examine the social connections that people still have a strong drive to make following the pandemic.

“Being alone does not necessarily mean loneliness, and many people need to be aware of it,” said Rokach, who is currently working on an academic paper that will address ways to cope with loneliness.

While being alone could be refreshing and energizing, Rokach said, other people could be a buffer against loneliness or help people not feel lonely anymore. “Making friends, volunteering, taking courses where we may meet people, and learning how to be with ourselves and enjoy it, could be very beneficial,” he said.

“Human beings need social connections to thrive, and being embedded in strong supportive networks can protect our wellbeing when we’re faced with difficulties in life,” said Dr. Olivia Remes, a mental health researcher at the University of Cambridge in the United Kingdom, in an email. She was not involved in the survey.

Social media is often a tool young adults use to connect with one another, but it can be more harmful than it is good, Remes said, if users are participating in “passive scrolling.” She described the behavior as only taking in the rosy posts of others and comparing it with one’s reality. Remes suggested actively engaging instead by sharing a status update or a picture, interacting with friend’s posts, or sending a private message to a friend.

Within your daily routine, Remes — who is the author of the book “The Instant Mood Fix,” which includes strategies for combating loneliness — recommended talking to as many people as possible. “Taking the steps to practice chatting with those you encounter as you go about your day can pay off. It can make you feel better, boost your mood, and even stave off loneliness,” she said.

Gallup is set to release a report focusing on the global state of social connections on November 1. The research will include these findings as well as other detailed country-level findings to further explore similarities and differences of feelings of loneliness across the globe.

Maese hopes the survey spurs further research on how loneliness can vary by country, age and gender, “and will spur deeper dives into what is going on with loneliness and social connection.”

For everyone, there’s an “opportunity to reduce everyday loneliness in their lives and for other people through social connection,” she said.

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New Jersey Attorney General Matthew Platkin said Tuesday the suit seeks to “once and for all hold Meta and its CEO, Mark Zuckerberg, accountable for deceptive, manipulative practices on Instagram and Facebook that they knew were harmful” to young people.

In a statement, Meta said it was “disappointed that instead of working productively with companies across the industry to create clear, age-appropriate standards for the many apps teens use, the attorneys general have chosen this path.”

The wide-ranging, 233-page complaint also accuses the social media platforms of collecting data from children without their parents’ consent in violation of federal law.

“Meta has harnessed powerful and unprecedented technologies to entice, engage, and ultimately ensnare youth and teens,” the complaint states. “Its motive is profit, and in seeking to maximize its financial gains, Meta has repeatedly misled the public about the substantial dangers of its social media platforms.”

Social media use is ubiquitous among teens in the U.S., with up to 95% of youth aged 13 to 17 having some online presence, according to the Pew Research Center.

Experts say social media is exposing children to harmful content, including violent and sexual imagery, and intensifying the harms of bullying at a crucial developmental stage. U.S. Surgeon General Dr. Vivek Murthy has declared the situation a “youth mental health crisis.”

The lawsuit, filed in federal court in California, stemmed from an investigation co-led by authorities in New Jersey following revelations the company ignored alarm bells about its products’ harm on children and teens — particularly young girls.

“As New Jersey’s state’s chief law enforcement officer and as a parent, I feel strongly that there is nothing more important than ensuring the well-being of our children,” Platkin said Tuesday.

“And we know that in the era of social media, their mental health has never been more at risk.”

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Two more nations just signed on to help China build its moon base.

Pakistan and Belarus have come aboard the International Lunar Research Station (ILRS), a China-led project that will be constructed in the 2030s, if all goes according to plan.

Belarus announced its involvement on Monday (Oct. 23), while Pakistan's became known late last week.

There are now seven nations in the ILRS coalition, according to SpaceNews: China, Russia, Belarus, Pakistan, Azerbaijan, Venezuela and South Africa. 

The latter five countries aren't exactly space heavyweights, but technical contributions aren't the only criteria that China is interested in.

"Pakistan does not have its own launch capabilities — it depends on China for that — and Pakistan has only three active satellites on orbit, while China has over 800," Victoria Samson, Washington office director for the nonprofit Secure World Foundation, told SpaceNews in an email.

"So in terms of it contributing substantively to the ILRS, I'm not entirely certain it will have a lot of technical things to add," she added. "But there is something to be said for political support, and it is a statement endorsing China's moon plans if nothing else."

NASA is building a moon coalition of its own, via a set of agreements known as the Artemis Accords. The Accords lay out guidelines for responsible and peaceful lunar exploration, which the American space agency is undertaking via its Artemis program.

Twenty-nine nations have signed the Artemis Accords to date, including Australia, Brazil, Canada, France, Germany, India, Japan, South Korea and the United Kingdom.

One of the Artemis program's main goals is the construction of one or more bases near the moon's south pole, which is thought to be rich in water ice, by the end of the 2020s. The skills and lessons learned in doing so will help NASA get astronauts to Mars by the late 2030s or early 2040s, agency officials have said.

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New research reveals that the nation’s most widely prescribed type of sedative may be less effective than clinicians and scientists have been led to believe, based on publications in medical journals.

The study, which was published on October 19 in the journal Psychological Medicine, examined both published and unpublished data from five randomized controlled clinical trials reviewed by the U.S. Food and Drug Administration (FDA) for alprazolam, known by the trade name Xanax XR. It is one of a class of sedatives known as benzodiazepines, widely prescribed since the 1970s to treat medical conditions such as anxiety and insomnia.

Associated Risks and Clinical Implications

In recent years, benzodiazepines have been associated with serious clinical risks, including dependence, withdrawal, falls, and cognitive impairment.

“Clinicians are well aware of these safety issues, but there’s been essentially no questioning of their effectiveness,” said senior author Erick Turner, M.D., professor of psychiatry at the Oregon Health & Science University School of Medicine and former FDA reviewer. “Our study throws some cold water on the efficacy of this drug. It shows it may be less effective than people have assumed.”

Benzodiazepines Overview

Benzodiazepines are a class of drugs primarily used to treat anxiety, insomnia, seizures, and muscle spasms. They work by depressing the central nervous system, producing a calming effect on the brain. Common types of benzodiazepines and their associated brand names include:

• Alprazolam (Xanax): Typically prescribed for anxiety and panic disorders.
• Diazepam (Valium): Used for anxiety, muscle spasms, and seizures.
• Lorazepam (Ativan): Commonly prescribed for anxiety disorders.
• Clonazepam (Klonopin): Used for panic disorders and certain types of seizures.
• Temazepam (Restoril): Prescribed mainly for insomnia.

Benzodiazepines should be used with caution due to potential risks such as dependence and withdrawal.

Study Details and Findings
 

Turner and co-author Rosa Ahn-Horst, M.D., M.P.H., a resident in psychiatry at Harvard University, reviewed publicly available FDA data from phase 2 and phase 3 clinical trials conducted for extended-release alprazolam for the treatment of panic disorder. The extended-release formulation was approved by the FDA in 2003, while the original immediate-release formulation was approved in 1981.

They found that five trials had been conducted, but only three of them had been published in medical journals. Further, when the FDA reviewed the drug company’s trial results on how well the drug performed compared with a placebo, Turner said they determined that only one of the five trials had a clearly positive outcome.

Using meta-analysis, a statistical method of combining all study results, they found that alprazolam extended-release was still superior to a placebo, but not as much as the published data had conveyed. Specifically, they found that publication bias inflated the drug’s efficacy by more than 40%.
Turner said the findings may be especially relevant to patients and clinicians who haven’t used benzodiazepines previously, as opposed to those who use the drug infrequently or who have already become physically dependent. 

“This study will reinforce being cautious about starting a prescription,” Turner said.

Reference: “Unpublished trials of alprazolam XR and their influence on its apparent efficacy for panic disorder” by Rosa Y. Ahn-Horst and Erick H. Turner, 19 October 2023, Psychological Medicine.

DOI: 10.1017/S0033291723002830

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In a new study published in Nutrients, researchers found that each plant source of insoluble fiber contains unique bioactives—compounds that have been linked to lower incidence of cardiovascular disease, cancer and Type 2 diabetes—offering potential health benefits beyond those of the fiber itself.

"People understand the need for fiber and how it relates to gut health—an area of wellness that is becoming increasingly important as scientific research continues to reveal its impact on overall health and well-being," said Joanne Slavin, co-author of the paper and a professor in the College of Food, Agricultural and Natural Resource Sciences at the University of Minnesota.

"Fiber is the marker of health that is included in our dietary guidelines and found on product labels, but our research indicates that we need to ensure the other valuable components of fiber-containing plant sources—the bioactives—are also recognized as providing valuable benefits for human health."

The study aggregated the available literature on the health benefits of bioactives in plant sources of insoluble dietary fiber.

They found:

• A variety of plant foods, including fruits, vegetables, legumes, nuts, seeds and whole grains contain insoluble dietary fiber, and each source contains unique bioactives that support health in different ways.

• Desirable bioactives like Quercetin, Resveratrol, Catechins, Anthocyanins, Lutein, Lycopene and Beta-Carotene were found in a variety of plant foods that also contain insoluble dietary fiber.

• Plant sources with bioactives and insoluble dietary fiber could be used to fortify processed foods to increase their nutritional value. Food production byproducts such as peel, hulls, pulp or pomace are generally high in fiber and bioactives and therefore offer unique nutritional value from sustainable sources.

• Consumer research found that utilizing this fortification at a low level did not decrease consumer acceptability of the food product.

"The suggestion to eat more fruits and vegetables isn't a novel idea, but it's something most people still struggle to do," said Jan-Willem Van Klinken, co-author of the study and senior vice president of medical, scientific, and regulatory affairs for Brightseed. "If we can offer widely accessible fiber-fortified products that have been developed to enhance rather than negate bioactive content, we can provide consumers with increased nutritional value."

This most recent research on bioactives' impact on human health further illuminates the need for industry, academia and government to join forces to champion broad awareness and education of bioactives in food and health systems.

"The collection of literature we reviewed and the results of this research can serve as a paradigm shift in how the food and health industries, as well as consumers, view insoluble dietary fiber and bioactives," said lead author Madeline Timm, who co-authored the research for her graduate project at the University of Minnesota. "Continued research and broad inclusion of bioactives in foods and supplements can have a real impact on human health."

Further research is required to identify extraction and processing methods that preserve and optimize bioactive compounds.

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With expectations that 2023 will be the hottest year on record, regions across the planet have been scorched by deadly heat waves.

Others have been hit by floods, or in some cases, have suffered both extremes in quick succession.

"The truth is that we are shocked by the ferocity of the extreme weather events in 2023. We are afraid of the uncharted territory that we have now entered," said an international coalition of authors in a new report published in the journal BioScience.

Their stark assessment: "Life on planet Earth is under siege."

They said humanity had made "minimal progress" in curbing its planet-heating emissions, with major greenhouse gases at record levels, and subsidies for fossil fuels soaring last year.

The damning assessment comes just a month ahead of UN COP28 climate negotiations to be held in oil-rich United Arab Emirates.

"We must shift our perspective on the climate emergency from being just an isolated environmental issue to a systemic, existential threat," the authors said.

The study on the state of the climate looked at recent data on 35 planetary "vital signs" and found 20 of these were at record extremes this year.

'Off the chart'

Just roughly 1.2 degrees Celsius of temperature rise above pre-industrial levels has triggered a range of calamitous and costly consequences.

This year has also seen the beginning of a warming El Niño weather phenomenon.

The European Union's Copernicus Climate Change Service has said that the three months to September were the hottest period ever recorded, and likely the hottest in approximately 120,000 years.

Many climate-related records were broken by "enormous margins" in 2023, the report said, particularly temperatures in the oceans, which have absorbed almost all the excess heat caused by human carbon pollution.

Co-author Johan Rockstrom, director of the Potsdam Institute for Climate Impact Research, said recorded sea surface temperatures "go completely off the chart" and scientists are not yet able to fully explain why.

The potentially serious impacts include threats to sea life and coral reefs and an increase in the intensity of large tropical storms, the report said.

People across the planet have faced heatwaves and droughts this year, while severe flooding has struck in the US, China and India and beyond.

In Canada, record wildfires partly related to climate change released more carbon dioxide than the country's total 2021 greenhouse gas emissions, the report said.

1.5°C era

Before 2023, days with global average temperatures more than 1.5°C above pre-industrial levels were a rarity, the authors said. This year had already registered 38 such days by mid-September.

The more ambitious Paris Agreement target of 1.5°C will be measured over decades.

But lead author William Ripple, professor at Oregon State University, said we are likely entering a period where annual temperatures will reach that level or higher, risking danger from climate feedback loops and tipping points.

"Once crossed, these tipping points could change our climate in ways that may be difficult or impossible to reverse," he told AFP.

These could include the meltdown of the ice sheets in Greenland and West Antarctica, thawing of large areas of permafrost and widespread coral reef die back.

With some tipping points "we're not going to avoid them now, it's more about slowing the damage," said co-author Tim Lenton, director of the Global Systems Institute at the University of Exeter

To do that, emissions must be slashed and temperature rise curbed.

Every fraction of a degree matters, Lenton told AFP: "There's still a lot to play for."

That includes the number of people who might face intolerable conditions in coming decades, like severe heat, limited food availability and climate extremes.

The report said three to six billion people could be "confined beyond the livable region" by century's end.

"Many world leaders have generally continued to support business as usual, rather than enacting policies to curb climate change and sustain life on Earth," said Ripple.

"We hope recent extreme weather events will help motivate policymakers at the upcoming COP28 climate conference to support massive cuts in fossil fuel emissions and increased funding for climate adaptation, especially in the world's most vulnerable regions." — Agence France-Presse

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The lethal form of bird flu that has been killing millions of wild birds around the world has spread south to the Antarctic region, where it is feared it will have a devastating impact on seals and whales as well as birds such as penguins and albatrosses. It could even lead to extinctions.

“There are species on some of the Antarctic islands and sub-Antarctic islands that are unique to those islands, and only occur in small numbers, in hundreds or thousands,” says Thijs Kuiken at Erasmus University Rotterdam in the Netherlands. “If the virus reaches those populations, they are in threat of extinction.”

If the virus spreads around Antarctica, there is also a risk of migratory birds carrying it to New Zealand and Australia for the first time, says Kuiken.

The highly pathogenic form of H5N1 bird flu that has been killing many wild birds in Europe, Asia and Africa since 2020 was carried across the Atlantic to North America in 2021. In October 2022, it was detected in South America.

There it is known to have killed thousands of marine mammals as well as hundreds of thousands of birds of many different species, and the true numbers are likely to be much higher. By December 2022, it had spread to the southern tip of South America.

In recent days, researchers at a British Antarctic Survey station on Bird Island, just off the larger island of South Georgia, found some sick brown skuas and giant petrels, and sent samples back to the UK for testing.

“The test came back yesterday, and they were indeed positive,” says Norman Ratcliffe, a seabird ecologist at the British Antarctic Survey.

So far, only 30 dead birds have been found, but the fear is that H5N1 could spread rapidly in the large and dense bird colonies on Bird Island and South Georgia.

Skuas and giant petrels will kill or scavenge other birds, making them particularly likely to get infected. They also winter off the coast of South America and migrate to places like South Georgia for the summer, says Ratcliffe. So it was thought that these birds are the species likely to spread the disease in the Antarctic region.

Animals in the Antarctic have never been exposed to highly pathogenic bird flu before, but “there is a real chance that the virus will reach, or has already reached, the mainland of Antarctica”, says Kuiken, one of the authors of an August report warning of the risk of highly pathogenic bird flu reaching Antarctica.

There are only a few stations on the mainland, and the tourist season hasn’t yet begun, so Antarctic birds could already be dying without being noticed, says Ratcliffe. “There’s very little observation going on there.”

Birds such as penguins and albatrosses are slow breeders, says Kuiken. “So if there is mortality in a breeding colony of, let’s say, 50 or 70 per cent, as we have seen in some seabird colonies in Europe, then it will take years, if not decades, for these populations to return to their previous levels.”

Rare species at risk from the virus include several species of parakeet found only on the Auckland and Antipodes islands south of New Zealand, the flightless Falkland steamer duck, the Kerguelen tern and the New Zealand sea lion, according to the August report.

Antarctic researchers are taking precautions such as disinfecting footwear and equipment, and sites where the disease is present will be closed to tourism, but other than that there isn’t much that can be done to stop the spread of the virus. “It’s most likely that transmission will be bird to bird,” says Ratcliffe.

The viruses from Bird Island are now being sequenced, says Ian Brown at the UK’s Animal and Plant Health Agency, which did the initial testing. “We know it’s H5N1 but further characterisation is under way, including genomics, which will confirm the relationship to other viruses and therefore likely origins,” he says.

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