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Friday, July 2, 2021

Apple lists its products that may 'interfere' with cardiac devices

 Apple has released a long list of products it says should be kept away from implanted pacemakers and defibrillators because it may "interfere" with the medical devices. 

"Many consumer-electronic devices contain magnets or components and radios that emit electromagnetic fields," Apple said, adding that "to avoid any potential interactions with these types of medical devices, keep your Apple product a safe distance away from your medical device (more than 6 inches / 15 cm apart or more than 12 inches / 30 cm apart if wirelessly charging)."

Apple doesn't explain what could happen when its products come in close contact with pacemakers and defibrillators. Still, one could assume the worst circumstance could be the deactivation of a medical device and may result in death. 

"If you suspect that your Apple product is interfering with your medical device, stop using your Apple product and consult your physician and your medical-device manufacturer," the company warned. 

Here are the products Apple wants to keep away from your medical devices: 

AirPods and charging cases

  • AirPods and Charging Case
  • AirPods and Wireless Charging Case 
  • AirPods Pro and Wireless Charging Case
  • AirPods Max and Smart Case

Apple Watch and accessories

  • Apple Watch
  • Apple Watch bands with magnets
  • Apple Watch magnetic charging accessories

HomePod

  • HomePod 
  • HomePod mini

iPad and accessories

  • iPad
  • iPad mini
  • iPad Air
  • iPad Pro
  • iPad Smart Covers and Smart Folios
  • iPad Smart Keyboard and Smart Keyboard Folio
  • Magic Keyboard for iPad

iPhone and MagSafe accessories

  • iPhone 12 models
  • MagSafe accessories

Mac and accessories

  • Mac mini
  • Mac Pro
  • MacBook Air
  • MacBook Pro
  • iMac
  • Apple Pro Display XDR

Beats

  • Beats Flex
  • Beats X
  • PowerBeats Pro
  • UrBeats3

Perhaps Apple's warning comes as a new analysis in the American Heart Association Journal warns that certain Apple iPhones can cause significant issues with cardiac implantable electronic devices. 

https://www.zerohedge.com/medical/apple-warns-iphone-can-interfere-cardiac-devices

Prostate cancer drugs hold potential for treating COVID-19

 Drugs typically used to treat prostate cancer could be explored for treating patients with COVID-19, following encouraging new findings.

Researchers found that the treatment, a type of testosterone-blocker, also reduced the ability of the SARS-CoV-2 coronavirus to infect  cells in the lab.

The work, carried out by cancer researchers at Imperial College London and the University of Essex, is part of larger efforts to find existing drugs which can block COVID-19 by reducing the ability of the virus to enter cells.

The team says the study adds to a growing body of evidence from groups around the world, supporting further  to assess the efficacy of the drugs, called anti-androgens, in the treatment of patients with COVID-19.

Their findings are published in the journal Nature Communications.

Blocking infection

SARS-CoV-2, the virus which causes COVID-19, has been shown to attack multiple organs in the body, but is most destructive to the lungs. In the latest study, researchers focused on one of the proteins used by the virus to enter lung cells, called TMPRSS2, to see if reducing levels could block infection.

Male sex hormones, or androgens, are known to increase levels of TMPRSS2 in several tissues, most notably in the prostate. But drugs used to manage prostate cancer can block androgens, so countering the increase in TMPRSS2 and potentially offering a new treatment option to explore for COVID-19.

The team, co-led by Imperial's Professor Charlotte Bevan and Dr. Greg Brooke from Essex, found that the androgen-blocking  enzalutamide—a well-tolerated drug widely used in —reduced TMPRSS2 levels in lab cultures of human lung cells.

Importantly, they found that the treatment significantly reduced SARS-CoV-2 entry and infection in lung cells. The researchers say their study adds to a growing body of evidence from groups around the world, supporting further clinical trials to assess the efficacy of anti-androgens as a potential treatment for COVID-19.

Potential treatment

Professor Charlotte Bevan, from the Department of Surgery & Cancer, said: "This study not only supports further clinical investigation of these prostate cancer drugs but suggests other drugs we can test that could be useful in the COVID-19 effort. As we have learnt from cancer, it is important to have a range of drugs available in the armory. And drugs that are tried-and-tested and approved in other diseases have the advantage that they can be re-purposed in this way relatively quickly."

Dr. Greg Brooke, from the School for Life Sciences at the University of Essex, explained: "Men are more likely to become seriously unwell and die from COVID-19 compared to women. This suggests the male sex hormone androgen may play a role in SARS-CoV-2 severity.

"For many years I have been working on the role of androgens in  so was able to use this knowledge to investigate if antiandrogens, drugs used for the treatment of , reduce SARS-CoV-2 infection.

"We demonstrated that these drugs reduce the ability of the virus to enter the lungs and, therefore, our data supports clinical trials to investigate if antiandrogens can reduce COVID-19 severity in people infected with the virus."

Two clinical trials assessing anti-androgens in the treatment of COVID-19 are already underway in the United States as well as Sweden, with early findings expected later this year.

"The antiandrogen enzalutamide downregulates TMPRSS2 and reduces cellular entry of SARS-CoV-2 in human lung cells," by et al is published in Nature Communications.


Explore further

Prostate cancer regulator plays role in COVID-19, providing a promising treatment lead

More information: D. A. Leach et al, The antiandrogen enzalutamide downregulates TMPRSS2 and reduces cellular entry of SARS-CoV-2 in human lung cells, Nature Communications (2021). DOI: 10.1038/s41467-021-24342-y
https://medicalxpress.com/news/2021-07-prostate-cancer-drugs-potential-covid-.html

Only 20 states used health equity committees in COVID-19 vaccine distribution planning

 During the large second wave of the COVID-19 pandemic in fall 2020, pulmonologist and critical care provider Juan C. Rojas, MD, reflected on how disproportionately members of minority populations were being affected by the disease. After hearing similar thoughts from colleagues in New Orleans and New York City, Rojas began to wonder how, if at all, state governments planned to ensure these disparities would be addressed when COVID-19 vaccines were rolled out to the public.

In a new study published July 2 in JAMA Network Open, Rojas and his team were surprised to find that while 43 states (out of 51, including all 50 states and Washington, D.C.) created a committee to develop a  distribution plan, only 20 plans mentioned using a health equity committee to assist with plan development. Of those 20 health equity committees, only 8 actually included minority group representatives, with remaining members including physicians, government officials, ethicists and clergy.

"It wasn't surprising to find that there was variability across states, but it was surprising to find that most states didn't have a committee of diverse stakeholders to help address this equity problem," said Rojas, who was senior author on the study. "There weren't many places where patient advocates were included on the committee to add a voice about the additional challenges that might exist for these vulnerable patients."

Additionally, the team found that states used different high-risk criteria and  to determine which group would get priority vaccine access.

"Some states prioritized people over 65, while others prioritize people over 75," said Rojas. "Diabetes and obesity were the most common high-risk conditions listed in the plans we looked at. But then, , which is much more common in African-Americans than in other ethnicities, was only listed as a high-risk condition in 72% of plans. But a high-risk condition is high-risk, no matter what state you live in. This shows that we could do better as a country to develop consistent parameters for these kinds of situations."

The researchers analyzed early versions of these plans, and acknowledge that most remained in "draft" status throughout their analysis since each state's task force continued to adjust and update vaccine rollout efforts. In future studies, the team hopes to investigate how those plans translated to outcomes in vaccine distribution.

"Now that we have more vaccine available, how have these states performed?" said Rojas. "We're looking county by county, and state by state, to see if the equity planning done by individual states actually bore out in better vaccination rates for those high-risk patient populations."

Rojas hopes that this work can be used to help inform ongoing COVID-19 vaccination efforts, but more importantly, that it can help guide policies for potential future healthcare crises.

"The important takeaway here is that having a standardized process in which states and the country can use to roll out something as valuable and complicated as a vaccine to our citizens, with an acknowledgement of existing healthcare disparities," he said. "There need to be conversations about equitable distribution, first by acknowledging that these disparities exist, and then by thinking about how we can create policies that will ensure adequate and equitable access to these vaccines."


Explore further

Data points to Covid vaccine shortfall for Black Americans

More information: Amber Hardeman et al, Evaluation of Health Equity in COVID-19 Vaccine Distribution Plans in the United States JAMA Network Open (2021) DOI: 10.1001/jamanetworkopen.2021.15653
https://medicalxpress.com/news/2021-07-states-health-equity-committees-covid-.html

Assessing impact of short-term musical training on implicit emotion regulation

 Emotion regulation is an essential aspect of mental health and wellbeing. In fact, past studies have found associations between poor emotion regulation and several psychiatric disorders, including bipolar disorder, borderline personality disorder and complex post-traumatic stress disorder (PTSD).

During their everyday life, humans can regulate their negative emotions in different ways, most of which do not require any conscious cognitive engagement. For instance, they might take a bath, step outside for fresh air or listen to .

Researchers at Radboud University Nijmegen in The Netherlands, the Norwegian University of Science and Technology (NTNU), and University Hospital Aachen, Germany have recently carried out a study aimed at investigating the effects of a short-term  on implicit emotion regulation. Their paper, published in BMC Neuroscience, specifically examined whether musical training helped people to reduce the negative emotions elicited by unpleasant or disgusting odors.

"At the time of conception, my colleagues and I worked in the same department in Aachen," Nils Kohn, one of the researchers who carried out the study, told MedicalXpress. "The project was born out of our curiosity for emotions and the power of mood induction that is harbored by music. Mark Berthold-Losleben, being more of a trained musician than myself, was the perfect person to discuss this with."

Kohn, Berthold-Losleben and their colleagues decided to investigate whether, in a controlled environment, music could change people's  responses to unpleasant smells. They focused on olfaction because previous studies found that odors can consistently lead to emotional responses.

Their paper draws on previous knowledge about the stability of olfaction and its neuroanatomical connections, which was gathered by their research group in the past. In addition, it builds on Kohn's theoretical interpretation of how implicit emotion regulation works.

"In the first draft of our paper, we also wanted to explore implicit emotion regulation among professional musicians and/or composers," Berthold-Losleben said. "Therefore, we initiated a cooperation with the school for music and dance in Cologne to recruit participants. Unfortunately, most musicians didn't meet our schedule or the study's inclusion criteria. Another problem was that , or at least those we tried to recruit, did not like the positive auditory stimuli as much as non-professionals did. We assumed that this was because of their professional and therefore more complex approach to music. Maybe our stimuli were too well-known and boring to them."

To investigate the effects of musical training on implicit emotion regulation, Kohn, Berthold-Losleben and their colleagues designed a simple experiment in which they paired negative olfaction (eliciting a negative emotion) with positive music to create four different combinations of stimuli. They then recruited 31 healthy participants to take part in their experiment.

Essentially, participants were either exposed to an odor similar to rotten eggs or to no odors at all. Simultaneously, they either listened to an excerpt of classical music or to a neutral range of tones.

"We then added three weeks of passive listening to classical music as our musical intervention for participants and re-did the test," Kohn explained. "In the task, subjects had to always rate how disgusting the smell was, how they liked the music and how they felt in general. This was done while the subjects lay in the fMRI scanner."

Overall, the findings gathered by the researchers suggest that listening to music two times per day for three weeks can reduce negative emotions elicited by a bad odor, particularly if one hears music again. In other words, music could improve wellbeing and help people to regulate negative emotions elicited by an external stimulus.

If they were also applicable to individuals with , the findings gathered by this team of researchers could have important implications. For instance, they could highlight the value of musical interventions for increasing stress resilience and helping people with affective  to better regulate their emotions.

"Patients suffering from affective disorders like depression often find themselves in an endless circle of sameness," Berthold-Losleben said. "Once confronted with triggers that lead to negative affect, they react with negative emotions/feelings, negative body experiences and negative thinking. All of that itself can trigger a new negative affect. These patients tend to end up in a negative circle or spiral which it is difficult or impossible to get out of."

The overreaching goal of the work by Kohn, Berthold-Losleben and their colleagues is to devise simple musical interventions for people with depression or other affective disorders, which are easy to implement and could improve their ability to regulate negative emotions. Firstly, however, they had to gain a better understanding of emotion  and of the stimuli that can elicit or reduce .

"We are now trying to initiate a collaboration between Radboud University Nijmegen and the Norwegian University of Science and Technology in Trondheim to continue this line of research, as I'm still very interested in what challenges our abilities to regulate ourselves in our daily life and what can support us," Kohn said. "Music would truly be such an easy, powerful and supportive tool for ."


Explore further

Aggressive music related to anxiety in men

More information: Short-term musical training affects implicit emotion regulation only in behavior but not in brain activity. BMC Neuroscience(2021). DOI: 10.1186/s12868-021-00636-1.
https://medicalxpress.com/news/2021-06-neuroscientists-impact-short-term-musical-implicit.html

Potential path to a broadly protective COVID-19 vaccine using T cells

 Gaurav Gaiha, MD, DPhil, a member of the Ragon Institute of MGH, MIT and Harvard, studies HIV, one of the fastest-mutating viruses known to humankind. But HIV's ability to mutate isn't unique among RNA viruses—most viruses develop mutations, or changes in their genetic code, over time. If a virus is disease-causing, the right mutation can allow the virus to escape the immune response by changing the viral pieces the immune system uses to recognize the virus as a threat, pieces scientists call epitopes.

To combat HIV's high rate of mutation, Gaiha and Elizabeth Rossin, MD, Ph.D., a Retina Fellow at Massachusetts Eye and Ear, a member of Mass General Brigham, developed an approach known as structure-based . With this, they can identify viral pieces that are constrained, or restricted, from mutation. Changes in mutationally constrained epitopes are rare, as they can cause the virus to lose its ability to infect and replicate, essentially rendering it unable to propagate itself.

When the pandemic began, Gaiha immediately recognized an opportunity to apply the principles of HIV structure-based network analysis to SARS-CoV-2, the virus that causes COVID-19. He and his team reasoned that the virus would likely mutate, potentially in ways that would allow it to escape both natural and vaccine-induced immunity. Using this approach, the team identified mutationally constrained SARS-CoV-2 epitopes that can be recognized by  known as T cells. These epitopes could then be used in a vaccine to train T cells, providing protective immunity. Recently published in Cell, this work highlights the possibility of a T cell vaccine which could offer broad protection against new and emerging variants of SARS-CoV-2 and other SARS-like coronaviruses.

From the earliest stages of the COVID-19 pandemic, the team knew it was imperative to prepare against potential future mutations. Other labs already had published the protein structures (blueprints) of roughly 40% of the SARS-CoV-2 virus, and studies indicated that patients with a robust T cell response, specifically a CD8+ T cell response, were more likely to survive COVID-19 infection.

Gaiha's team knew these insights could be combined with their unique approach: the network analysis platform to identify mutationally constrained epitopes and an assay they had just developed, a report on which is currently in press at Cell Reports, to identify epitopes that were successfully targeted by CD8+ T cells in HIV-infected individuals. Applying these advances to the SARS-CoV-2 virus, they identified 311 highly networked epitopes in SARS-CoV-2 likely to be both mutationally constrained and recognized by CD8+ T .

"These highly networked viral epitopes are connected to many other viral parts, which likely provides a form of stability to the virus," says Anusha Nathan, a medical student in the Harvard-MIT Health Sciences and Technology program and co-first author of the study. "Therefore, the virus is unlikely to tolerate any structural changes in these highly networked areas, making them resistant to mutations."

You can think of a virus's structure like the design of a house, explains Nathan. The stability of a house depends on a few vital elements, like support beams and a foundation, which connect to and support the rest of the house's structure. It is therefore possible to change the shape or size of features like doors and windows without endangering the house itself. Changes to structural elements, like support beams, however, are far riskier. In biological terms, these support beams would be mutationally constrained—any significant changes to size or shape would risk the structural integrity of the house and could easily lead to its collapse.

Highly networked epitopes in a virus function as support beams, connecting to many other parts of the virus. Mutations in such epitopes can risk the 's ability to infect, replicate, and ultimately survive. These highly networked epitopes, therefore, are often identical, or nearly identical, across different viral variants and even across closely related  in the same family, making them an ideal vaccine target.

The team studied the identified 311 epitopes to find which were both present in large amounts and likely to be recognized by the vast majority of human immune systems. They ended up with 53 epitopes, each of which represents a potential target for a broadly protective T cell vaccine. Since patients who have recovered from COVID-19 infection have a T cell response, the team was able to verify their work by seeing if their epitopes were the same as ones that had provoked a T cell response in patients who had recovered from COVID-19. Half of the recovered COVID-19 patients studied had T cell responses to highly networked epitopes identified by the research team. This confirmed that the epitopes identified were capable of inducing an immune reaction, making them promising candidates for use in vaccines.

"A T cell vaccine that effectively targets these highly networked epitopes," says Rossin, who is also a co-first author of the study, "would potentially be able to provide long-lasting protection against multiple variants of SARS-CoV-2, including future variants."

By this time, it was February 2021, more than a year into the pandemic, and new variants of concern were showing up across the globe. If the team's predictions about SARS-CoV-2 were correct, these variants of concerns should have had little to no mutations in the highly networked epitopes they had identified.

The team obtained sequences from the newly circulating B.1.1.7 Alpha, B.1.351 Beta, P1 Gamma, and B.1.617.2 Delta SARS-CoV-2 variants of concern. They compared these sequences with the original SARS-CoV-2 genome, cross-checking the genetic changes against their highly networked epitopes. Remarkably, of all the mutations they identified, only three mutations were found to affect highly networked epitopes sequences, and none of the changes affected the ability of these epitopes to interact with the immune system.

"Initially, it was all prediction," says Gaiha, an investigator in the MGH Division of Gastroenterology and senior author of the study. "But when we compared our network scores with sequences from the variants of concern and the composite of circulating variants, it was like nature was confirming our predictions."

In the same time period, mRNA vaccines were being deployed and immune responses to those vaccines were being studied. While the vaccines induce a strong and effective antibody response, Gaiha's group determined they had a much smaller T cell response against highly networked epitopes compared to patients who had recovered from COVID-19 infections.

While the current vaccines provide strong protection against COVID-19, Gaiha explains, it's unclear if they will continue to provide equally strong protection as more and more variants of concern begin to circulate. This study, however, shows that it may be possible to develop a broadly protective T cell vaccine that can protect against the variants of concern, such as the Delta variant, and potentially even extend protection to future SARS-CoV-2 variants and similar coronaviruses that may emerge.


Explore further

SARS-CoV-2 infections may trigger antibody responses against multiple virus proteins

More information: Anusha Nathan et al, Structure-guided T cell vaccine design for SARS-CoV-2 variants and sarbecoviruses, Cell (2021). DOI: 10.1016/j.cell.2021.06.029
https://medicalxpress.com/news/2021-07-potential-path-broadly-covid-vaccine.html

More than 1/3 of health organizations hit by ransomware last year

 

  • More than a third of healthcare organizations were hit by a ransomware attack in 2020 and of those, 65% said the cybercriminals were successful in encrypting their data, a report from cybersecurity company Sophos found.
  • The report also found that roughly a third of organizations that had data stolen paid the ransom to recover their information, but on average only 69% of the encrypted data was restored after the ransom was paid.
  • The average bill to recover after a ransomware attack was almost $1.3 million, which is among the lowest sum of all industries surveyed in the report.
Ransomware is a type of malware that encrypts a victim's files, rendering them inaccessible to their owner, unless a ransom is paid to decrypt them.

Sophos commissioned independent research company Vanson Bourne to survey 5,400 IT decisionmakers across a range of industries worldwide, including more than 300 small and mid-size organizations from healthcare, early this year.

The report found ransomware was relatively prevalent in the healthcare sector, with 34% of organizations hit by such an attack in the past year. Of those not hit, 41% said they expected an attack in the future, while just 24% said they felt safe from future attacks.

Healthcare actually fared relatively well compared to other sectors. The global average for organizations attacked was 37%, with the retail and education industries experiencing the highest number of ransomware attacks at 44%.

"With healthcare often making headlines for ransomware attacks, it's perhaps a welcome surprise that this sector experiences below average numbers of attacks," the report said. "Their over-representation in the news reports is likely due to healthcare organizations' obligations to make public an attack, where many commercial organizations are able to keep the bad news private."

But despite the lower prevalence of attacks, healthcare is less able to stop ransomware than other sectors, Sophos found. Attackers' success rate in encrypting healthcare data was 65%, compared to the global average of 54%, likely due to the financial and resource challenges in health IT. The teams are commonly understaffed, and have been especially stressed during the coronavirus pandemic.

Additionally, healthcare organizations are among the most likely to pay a ransom to recover their data, likely worried about continuity of care for their patients and a lack of back-ups. Some 34% of respondents whose data was encrypted said they paid to get it back, compared to a cross-sector average of 32%.

However, paying a ransom is no certainty that data will be recovered — one reason why giving into demands for ransom is highly discouraged by the federal government and cybersecurity experts. Organizations that shelled out the ransom on average received just 65% of their data, while another third was left unaccessible.

The average healthcare ransom payment was roughly $131,000, lower than the global average. Healthcare also had the lowest overall cost to recover from a ransomware attack than any other industry, at $1.27 million for issues like downtime, hours lost, device and network cost, ransom and so on. By comparison, the cross-sector average is $1.85 million.

Though healthcare seems to be doing relatively well compared to other industries when it comes to ransomware attacks specifically, the industry faces a number of unique challenges stemming from its outdated infrastructure, including underfunded IT departments and legacy medical devices with little-to-no cybersecurity featuresFewer than half of healthcare organizations met national cybersecurity standards in 2019, even as cyberattacks grow in complexity.

The percentage of organizations across all sectors hit by ransomware in 2020 dropped from 2019, Sophos found. That's a good sign, but may indicate attacker behavior is evolving to smaller-scale, more targeted attacks, which have higher potential for damage.

As a result, the report called on healthcare companies to invest more heavily in cybersecurity moving forward.

https://www.healthcaredive.com/news/more-than-13-of-health-organizations-hit-by-ransomware-last-year-report-f/602329/

Half of ambulance rides could still result in surprise bill: KFF

 

  • Slightly more than half of emergency ground ambulance rides resulted in an out-of-network bill, according to a new analysis from the Kaiser Family Foundation.
  • In seven states — Washington, California, Florida, Colorado, Texas, Illinois and Wisconsin — more than two-thirds of emergency ambulance rides resulted in out-of-network billing.
  • Congress' ban on surprise bills kicks into effect next year, but ambulances are exempt from the legislation, meaning patients will still be on the hook for those pricey, unexpected bills.
  • Tamping down on surprise bills, which occur when a patient unknowingly receives care from an out-of-network provider or facility, was one of the hottest health policy discussions in Washington before the coronavirus slammed onto the scene. It's a pervasive issue: Previous research from KFF found that among large group health plan enrollees, one in five emergency room visits and one in six admissions to an in-network hospital led to a surprise medical bill.

In December last year, Congress passed the No Surprises Act, which prohibits surprise out-of-network billing beginning in 2022. The legislation requires plans to apply in-network cost sharing to surprise medical bills and prohibits out-of-network providers from balance billing patients for the unexpected costs.

However, the law doesn't apply to ground ambulances, though it did call for an advisory committee to review options for restricting surprise ambulance bills. Critics said at the time it was a notable oversight, as a large proportion of emergency rides result in surprise bills.

The new KFF analysis adds credence to that perspective. Researchers found ambulances bring on average 3 million privately insured people to an ER each year, and just over half of those rides posed a risk of a surprise bill. Using data from 2018, KFF found 51% of emergency ground ambulance rides and 39% of non-emergency ground ambulance rides included an out-of-network charge.

In the absence of sweeping federal protections, a number of states and local governments have stepped up to try to regulate patient billing, though they can't touch the self-funded employer plans that cover roughly two-thirds of U.S. workers. Many states protect patients from getting a ground ambulance surprise bill if they're covered by fully-insured plans, though many regulations only apply to a subset of ambulance companies, KFF said.

Researchers stressed additional protections are needed, given as many as 1.5 million privately insured patients brought to an ER by an ambulance could be at risk for a surprise bill.

"The regulation and delivery of ground ambulance services could present complexities beyond those involved in preventing other surprise medical bills," the report reads. "Yet, from the perspective of patients, ambulance rides are exactly the kinds of situations where they feel powerless to avoid surprise bills."

https://www.healthcaredive.com/news/half-of-ambulance-rides-could-result-in-surprise-bill-kff-finds/602435/