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Monday, August 8, 2022

Waking Up at Night Could Be Your Brain Boosting Your Memory

 We tend to think a good night's sleep should be uninterrupted, but surprising new research from the University of Copenhagen suggests just the opposite: Brief awakenings may be a sign you’ve slept well.

The study, done on mice, found that the stress transmitter noradrenaline wakes up the brain many times a night. These "microarousals" were linked to memory consolidation, meaning they help you remember the previous day's events. In fact, the more "awake" you are during a microarousal, the better the memory boost, the research suggests.

"Every time I wake up in the middle of the night now, I think — ah, nice, I probably just had great memory-boosting sleep," says study author Celia Kjaerby, PhD, an assistant professor at the university's Center for Translational Neuromedicine.

The findings add insight to what happens in the brain during sleep and may help pave the way for new treatments for those who have sleep disorders.

Waves of Noradrenaline

Previous research has suggested that noradrenaline — a hormone that increases during stress but also helps you stay focused — is inactive during sleep. So, the researchers were surprised to see high levels of it in the brains of the sleeping rodents.

"I still remember seeing the first traces showing the brain activity of the norepinephrine stress system during sleep. We could not believe our eyes," Kjaerby says. "Everyone had thought the system would be quiet. And now we have found out that it completely controls the microarchitecture of sleep."

Those noradrenaline levels rise and fall like waves every 30 seconds during non-rapid eye movement (NREM) sleep. At each "peak" the brain is briefly awake, and at each "valley" it is asleep. Typically, these awakenings are so brief that the sleeping subject does not notice. But the higher the rise, the longer the awakening — and the more likely the sleeper may notice.

During the valleys, or when norepinephrine drops, so-called sleep spindles occur.

"These are short oscillatory bursts of brain activity linked to memory consolidation," Kjaerby says. Occasionally there is a "deep valley," lasting 3 to 5 minutes, leading to more sleep spindles. The mice with the most deep valleys also had the best memories, the researchers noted.

"We have shown that the amount of these super-boosts of sleep spindles, and not REM sleep, defines how well you remember the experiences you had prior to going to sleep," says Kjaerby.

Deep valleys were followed by longer awakenings, the researchers observed. So, the longer the valley, the longer the awakening — and the better the memory boost. This means that, though restless sleep is not good, waking up briefly may be a natural part of memory-related sleep phases and may even mean you've slept well.

What Happens in Our Brains When We Sleep: Piecing It Together

The findings fit with previous clinical data that shows we wake up roughly 100-plus times a night, mostly during NREM sleep stage 2 (the spindle-rich sleep stage), Kjaerby says.

Still, more research on these small awakenings is needed, Kjaerby says. She notes that professor Maiken Nedergaard, MD, another author of this study, has found that the brain cleans up waste products through a rinsing fluid system.

"It remains a puzzle why the fluid system is so active when we sleep"” Kjaerby says. "We believe these short awakenings could potentially be the key to answering this question."

Sources

Celia Kjaerby, PhD, assistant professor, Center for Translational Neuromedicine, University of Copenhagen.

Nature Neuroscience: "Memory-enhancing properties of sleep depend on the oscillatory amplitude of norepinephrine."

https://www.medscape.com/viewarticle/978566

Keeping Your Laundry Free From Monkeypox

 Is your laundry a way to spread monkeypox?

As monkeypox cases rise globally, health officials have warned that the virus mainly spreads through direct skin-to-skin contact with a monkeypox lesion. But according to the CDCpoxviruses like the monkeypox can survive in linens and clothing, and live particularly well in "dark, cool and low humidity environments." Indeed: The federal agency pointed to one study where live virus was found 15 days after a patient had left their home.

Keeping your laundry clean is good for your health and might be especially important if you or someone close to you has monkeypox. Read on for expert advice on how to keep your laundry monkeypox-free.

Cleaning Clothes With Monkeypox

The CDC says the virus can spread to clothing when it touches the rash or bodily fluids of someone with monkeypox. Other common household fabrics like bedding and towels can also potentially spread the virus.

Robert Glatter, MD, an emergency medicine doctor at Lenox Hill Hospital in New York City, says monkeypox may live in clothes for so long because materials like cotton are more porous and breathable than plastic or metal surfaces.

"It's advisable for persons with monkeypox to do their own laundry, assuming they feel well enough," he says. "Persons who do laundry for those who are infected should wear gloves, gown, and a mask to reduce potential for transmission."

Glatter recommends using hot water when washing clothing that has encountered someone that has monkeypox. The CDC also notes that if you do not have your own washer and dryer in your home, you should contact your local public health department for help with laundry that has come into contact with monkeypox.

But it's important to note that while monkeypox can spread from touching clothing and fabrics, Glatter says that the risk of this happening is "minimal," compared to the risk from skin-to-skin contact. He says that washing your hands with soap and warm water or using hand sanitizer after direct contact with someone with monkeypox is strongly recommended. The Environmental Protection Agency also has an online list of disinfectants that it recommends for killing the monkeypox virus.

Best Practices for Clean Clothes Overall

Monkeypox aside, it's important to know how to keep laundry clean and free of things that can make you sick in general. Mold and mildew are two usual suspects that can make you feel under the weather if not taken care of.

Preeti Arya, PhD, an assistant professor of textile development and marketing at the Fashion Institute of Technology in New York City, says mold and mildew can travel from anywhere in your house to your laundry. Molds create cells called spores that they use to spread to other places and grow.

"Even if one spore sticks, they start growing," Arya says. She says mold and mildew grow in laundry because it's a "favorable environment"; they love warmth and humidity, which are easily found in washing machines. (The CDC also says that common spots in the home for mold include roofs, pipes, walls, and potted plants.)

Besides the unpleasant smell, mold and mildew in laundry can trigger allergy symptoms if they're not dealt with.

John Costa, MD, an allergy and immunology doctor at Brigham and Women's Hospital in Boston, says people can be allergic to common molds found in households. Molds can cause allergy symptoms in the eyes, nose, and lungs, similar to pollen or animal dander allergies.

That said, it would be "very unlikely" for mildew in clothing to make you sick, Costa says, as "the amount of mold exposure for those toxins to make you sick has to be massive and overwhelming."

Sources:

John Costa, MD, allergy and immunology doctor, Brigham and Women's Hospital, Boston.

Preeti Arya, PhD, assistant professor, textile development and marketing, Fashion Institute of Technology, New York City.

Robert Glatter, MD, emergency medicine doctor, Lenox Hill Hospital, New York City.

CDC: "Disinfection of the Home and Non-Healthcare Settings," "Monkeypox," "Basic Facts about Mold and Dampness."

Environmental Protection Agency: "What Are Molds?" "Disinfectants for Emerging Viral Pathogens (EVPs) List Q."

https://www.medscape.com/viewarticle/978870

Almost a Third of Patients Don't Take Drugs as Directed

 As many as one third of patients do not take their medications as directed, data indicate.

In a study that examined more than 200,000 patients and 91,000 unique prescriptions, overall nonadherence rates ranged from 13.7% for patients prescribed antidepressants to 30.3% for patients prescribed antihypertensive therapies.

"The eye-opening piece of information for me and our research team was how common nonadherence was," lead study author Alexander G. Singer, MB, BAO, BCh, associate professor of family medicine at the University of Manitoba, Winnipeg, Canada, told Medscape Medical News. "As physicians, we assume that people follow the instructions that we give them, and what we have shown is that, many times, they don't. As much as a quarter to a third of the time, they're not filling the prescriptions that we're giving them."

The study was published in the July issue of Canadian Family Physician.

No Predictors Identified

To investigate primary medication nonadherence, the researchers retrospectively examined primary care provider prescriptions that are linked to pharmacy-based dispensing data. The researchers included 91,660 prescriptions written from April 1, 2012, to December 31, 2014, in their analysis. The prescriptions were given to a cohort of more than 200,000 patients. The investigators examined the Manitoba Population Research Data Repository at the Manitoba Center for Health Policy to determine whether the prescriptions had been filled.

The researchers found that for conditions that typically are symptomatic (such as infections, depression, and anxiety), nonadherence ranged from 13.7% to 17.5%. For asymptomatic conditions (such as hypertensionosteoporosis, and diabetes), nonadherence rates ranged from 21.2% to 30.3%.

Lipid-lowering agents for asymptomatic hyperlipidemia and cardiovascular disease were an exception to this general trend. The primary nonadherence rate for these medicines was 15.2%.

One noteworthy aspect of the study was its failure to identify any demographic or clinical factors that predicted primary medication nonadherence, said Singer. "Our findings suggest that providers may not be able to use particular attributes to predict which patients will or will not fill a new prescription, adding to the notion that primary medication nonadherence is complex and often influenced by varying and competing factors," he added.

Drug cost may not have contributed to nonadherence. Manitobans with low income are eligible for the provincial Pharmacare program, which provides prescription drug coverage that is based on adjusted family income. "Our Pharmacare program probably blunted any of the major cost impacts, whereas other literature has shown that cost is an indicator," said Singer.

Certain patient and provider characteristics may play roles in nonadherence, but the dataset from administrative and electronic medical records that the investigators used does not account for all such variables, said Singer. "It doesn't have provider-reported outcomes, and there may be patient-experience outcomes that are missing," he added.

The most compelling findings from the study, said Singer, are how common nonadherence is "and how infrequently we ask about it. We assume that people are following our instructions. We're often giving people second and third prescriptions before we even check if they're taking their first one."

An Important Contribution

Commenting on the study for Medscape, Brady Bouchard, MBBS, president of the College of Family Physicians of Canada and a family physician in Saskatchewan, said that its large sample size makes it an important contribution to the literature. "Outside of an intensive research setting, which itself can introduce bias, capturing prescription fill data is likely the most viable method for tracking medication adherence," he said.

The study also confirms how serious and overlooked medication nonadherence is. "Just asking patients about their adherence is likely inaccurate," Bouchard said. "Each patient's recall bias would tend to overestimate adherence as a fact of human nature."

The study highlights the challenge of medication adherence for asymptomatic conditions. "When starting a new, necessary medication for an asymptomatic condition, hypertension being a common one, it is likely very helpful to carefully explain the motivations for treatment and in particular explaining long-term complications, such as heart attack or stroke, that may be avoided," Bouchard said. "Visual aids such as that used by the CVD Risk/Benefit Calculator could likely be helpful."

Although the study does not indicate that drug cost is a barrier to adherence, it "gives us more ammunition in important advocacy work in trying to convince the federal government to implement and fund a national Pharmacare for all," said Bouchard. "It would be very interesting to look at a similar dataset but one that's segmented based on the availability of public or private drug benefit plans. I suspect they would see a significant difference in rates of medication adherence."

The study was independently supported. Singer received a grant from the Canadian Institute for Military and Veteran Health Research with funding and in-kind support from IBM. Bouchard has disclosed no relevant financial relationships.

Can Fam Physician. 2022;68:520-527. Full text

https://www.medscape.com/viewarticle/978837

China's Hainan Beach Resort Expands COVID-19 Lockdowns

The capital of China’s Hainan province has locked down its residents for 13 hours on Monday as a COVID-19 outbreak grows on the tropical island during the summer school holidays.

The temporary lockdown of Haikou city from 7 a.m. to 8 p.m. follows an ongoing and indefinite lockdown of the beach resort of Sanya since Saturday—which is confining vacationers to their hotels for a week—and lockdowns that started in four other cities in Hainan on Sunday.

More than 470 new cases were recorded in the province on Sunday, of which 245 did not show symptoms. Overall, China reported more than 760 new daily cases, the National Health Commission said Monday.

https://time.com/6204278/china-hainan-covid-outbreak-lockdown/

States tell U.S. court CDC lacks authority to set transportation mask rules

 A group of 23 states led by Florida told a federal court on Monday that the U.S. Centers for Disease Control and Prevention (CDC) lacks the legal authority to impose a nationwide transportation mask mandate.

In May, the U.S. Justice Department asked a federal appeals court to overturn a U.S. District Court judge's April order that declared the government mandate requiring masks on airplanes, buses and in transit hubs unlawful. Hours after the federal judge in Florida declared the mandate unlawful, the Biden administration said it would no longer enforce it.

https://sports.yahoo.com/states-tell-u-court-cdc-215424966.html

Why do men face a higher risk of most types of cancer than women?

 Rates of most types of cancer are higher in men than in women for reasons that are unclear. Results from a recent study published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, suggest that the cause may be underlying biological sex differences rather than behavioral differences related to smoking, alcohol use, diet, and other factors.

Understanding the reasons for sex differences in cancer risk could provide important information to improve prevention and treatment. To investigate, Sarah S. Jackson, PhD, of the National Cancer Institute, part of the National Institutes of Health, and her colleagues, assessed differences in cancer risk for each of 21 cancer sites among 171,274 male and 122,826 female adults aged 50–71 years who were participating in the NIH-AARP Diet and Health study from 1995–2011.

During that time, 17,951 new cancers arose in men and 8,742 in women. Incidence was lower in men than women only for thyroid and gallbladder cancers, and risks were 1.3- to 10.8-times higher in men than women at other anatomic sites. The greatest increased risks in men were seen for esophageal cancer (a 10.8-times higher risk), larynx (a 3.5-times higher risk), gastric cardia (a 3.5-times higher risk), and bladder cancer (a 3.3-times higher risk).

Men had an increased risk of most cancers even after adjusting for a wide range of risk behaviors and carcinogenic exposures. Indeed, differences in risk behaviors and carcinogenic exposures between the sexes only accounted for a modest proportion of the male predominance of most cancers (ranging from 11% for esophageal cancer to 50% for lung cancer).

The findings suggest that biological differences between sexes—such as physiological, immunological, genetic, and other differences—play a major role in the cancer susceptibility of men versus women.

“Our results show that there are differences in cancer incidence that are not explained by environmental exposures alone. This suggests that there are intrinsic biological differences between men and women that affect susceptibility to cancer,” said Dr. Jackson.

An accompanying editorial discusses the study’s findings and notes that a multifaceted approach needs to be in place to address sex disparities in cancer. “Strategically including sex as a biological variable should be enforced along the whole cancer continuum from risk prediction and cancer primary prevention, cancer screening and secondary prevention, to cancer treatment and patient management,” the authors wrote. “Examining and addressing sex disparities in cancer and other diseases is an ongoing quest. Bench to bedside translational studies which effectively transform the existing research findings into clinical practice is a scalable means within easy reach to achieve precision medicine and will mitigate—and may ultimately eradicate—sex disparities in cancer.”


Full Citations:

“Sex disparities in the incidence of 21 cancer types: quantification of the contribution of risk factors.” Sarah S. Jackson, Morgan A. Marks, Hormuzd A. Katki, Michael B. Cook, Noorie Hyun, Neal D. Freedman, Lisa L. Kahle, Philip E. Castle, Barry I. Graubard, and Anil K. Chaturvedi. CANCER; Published Online: August 8, 2022 (DOI: 10.1002/cncr.34390).

URL Upon Publicationhttp://doi.wiley.com/10.1002/cncr.34390

Editorial: “Sex disparities in cancer: an ongoing quest.” Jingqin R. Luo and Graham A. Colditz. CANCER; Published Online: August 8, 2022 (DOI: 10.1002/cncr.34389).

URL Upon Publicationhttp://doi.wiley.com/10.1002/cncr.34389

https://www.eurekalert.org/news-releases/960689

Oil-based systems show promise for eradicating salmonella on food production machinery

 Recent outbreaks of food-borne Salmonella have been associated with chocolate and peanut butter. Although Salmonella cannot grow in either of these low-water foods, the cells survive, becoming more resistant to heat treatment, which has contributed to recent outbreaks. New research published in Applied and Environmental Microbiology suggests that oil formulations with food-grade organic acids can kill dried Salmonella on stainless steel surfaces.

"Cleaning and sanitation of manufacturing environments are critical for a safe food supply," said lead author Lynne McLandsborough, Ph.D., a professor of food science at University of Massachusetts Amherst. However, water-based cleaning is rarely used in processing peanut butter, because it promotes microbial growth. "Also, as anyone who has baked peanut butter cookies can tell you, peanut butter and water do not mix, and cleanup with water is challenging," said McLandsborough.

Instead, manufacturers often remove residual peanut butter from manufacturing systems using heated oil, followed by overnight cooling and application of flammable alcohol-based sanitizing agents.

In the study, McLandsborough and collaborators dried Salmonella on stainless steel surfaces at controlled relative humidity. They then covered the dried bacteria with various oils with organic acids, varying the acid type, concentration, contact time and treatment temperature to identify highly antimicrobial formulations.

By using peanut oil mixed with acetic acid at a concentration about half that of household vinegar and applying heat, "killing was much greater than expected, indicating a synergistic effect," said McLandsborough. "Our results show that acidified oils could be used as an effective means of sanitation in low-moisture food processing facilities, where water-based cleaning can be challenging."

"To our knowledge, using oils as a carrier of organic acids is a novel approach to delivering antimicrobial compounds against food-borne pathogens," said McLandsborough. The research may thus lead to adaptation of oil-based systems for industrial cleaning, for example, of machinery for processing chocolate and peanut butter, said McLandsborough. "That would enable more frequent cleaning, boosting the safety of these products."


Story Source:

Materials provided by American Society for MicrobiologyNote: Content may be edited for style and length.


Journal Reference:

  1. Mrinalini Ghoshal, Shihyu Chuang, Ying Zhang, Lynne McLandsborough. Efficacy of Acidified Oils against Salmonella in Low-Moisture EnvironmentsApplied and Environmental Microbiology, 2022; DOI: 10.1128/AEM.00935-22