Covid lockdowns did no favors to Americans’ mental health, but many psychologists are occupied by other matters. Consider the transformation of the American Psychological Association, which, over the past two years, has committed itself—and the field of psychology along with it—to identity politics.
The association’s recently released Racial Equity Action Plan is just the latest installment. The APA’s makeover appears to have accelerated during the riots in the summer of 2020. That June, the APA asked for feedback from its members as to how it might use “the power of psychology” to address the “pandemic of racism.” In April 2021, the APA released its Equity, Diversity, and Inclusion Framework, a document laden with concepts from critical race theory and enjoining members to “embed [equity, diversity, and inclusion] throughout all aspects of our work.”
The trend continued throughout last year. In October 2021, the APA passed a resolution on “Advancing Health Equity” that “centered on race / ethnicity as the key driver of health inequities.” The association now appears resolute on using the term “people of the global majority”—explained as “an alternative collective term for people of color that does not center Whiteness”—and avers that “health inequities compound the risks to people of color because of climate change.” It paired this resolution with an official apology to nonwhite people.
The Racial Equity Action Plan deepens the organization’s political commitments. It begins with a section on “knowledge production,” stating that the APA intends to “influence the profession to center racially-conscious community engaged scholarship and promote research that utilizes innovative, culturally-informed methodologies.” The plan provides some examples, such as “indigenous healing, eastern medicine, and faith-based practices.”
In another section, simply titled “Health,” the APA states that it intends to “influence curriculum development to incorporate qualitative, participatory, and socially engaged research, concepts of liberation psychology, systemic racism, and population health into the psychology curriculum across all levels of training.” This will affect not only psychology curriculum and training but research, funded by the National Institutes of Health, the National Science Foundation, and others.
A later section of the plan returns to the subject of training future psychologists. The association seeks to “improve psychology graduate education and training [by including] diverse, non-Western cultural perspectives” and impose “racial equity practices for entry and completion of training requirements.” These training requirements include admissions, degree requirements, and continuing education. The APA also intends to “promote epistemological justice by centering . . . non-Western cultural perspectives.”
The APA’s influence does not end with the universities. The organization also plans to prepare all “preschool to higher education students to think critically about identity, community, and civics.” Schools will be given “resources and policies designed to raise awareness about all aspects of privilege.” One wonders how any of this “applies the best available psychological science to benefit society and improve lives,” as stated on the association’s DEI initiatives website.
It will cause great mental harm to teach children that some people are privileged, while others are not, that some are oppressed, while others are the oppressors—and that these categories are defined by the color of one’s skin.
Mason Goad is a research associate at the National Association of Scholars.
Mount Sinai researchers have published results that show encouraging therapeutic options for patients with the blood cancer multiple myeloma after first-line treatment with bispecific antibodies fails. Bispecific antibodies are a type of antibody that can bind to two different antigens at the same time—they are meant to enhance the immune system's destruction of tumor cells.
While new T cell-based immunotherapies, or "T-cell redirection" therapies, such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies have revolutionizedcancer treatment, doctors still need to determine what second-line treatments (also known as salvage therapy) are effective after a patient relapses. In the August 26 online edition ofBlood Advances, Mount Sinai researchers report that sequential use of different T-cell redirection therapies in these multiple myeloma patients is possible and could lead to good patient outcomes and survival.
In a retrospective analysis, researchers identified 58 multiple myeloma patients who participated in a bispecific antibodies clinical trial at Mount Sinai and underwent salvage therapy due to relapse. Patients were followed for an average of 30.5 months after the end of the trial and underwent an average of two salvage therapies over that period.
Nineteen patients received T-cell redirection therapy as a first salvage therapy, and the rest received a non-T-cell redirection therapy, such as chemotherapy. Thirty-two percent of patients who underwent T-cell redirection therapy as a first salvage therapy needed to undergo a second salvage therapy due to relapse or nonresponse to therapy. In a significant contrast, 79 percent of the patients treated with a non-T-cell redirection therapy needed to undergo a second salvage therapy. Some of this group of patients had T-cell redirection therapy as their second salvage therapy, resulting in a total of 28 patients who received T-cell redirection as either a first salvage therapy or second salvage therapy.
Depth and duration of response to the first bispecific antibodies treatment did not predict response to the second T-cell redirection therapy, indicating that even if patients did not respond to an initial T-cell redirection therapy, there may still be an option to effectively treat with a second course. The overall response rate of the 19 patients who transitioned from the initial bispecific antibodies to T-cell redirection therapy as a first salvage therapy was 84 percent, compared to 49 percent in those who received other types of therapies.
"As the clinical use and advancement of T-cell redirection therapies continue to grow, effective strategies are needed to manage outcomes for patients who relapse or are unresponsive to this initial treatment," said senior author Samir Parekh, MD, Director of Translational Research in Myeloma, co-leader of the Cancer Clinical Investigation program at The Tisch Cancer Institute, and a member of the Icahn Genomics Institute at the Icahn School of Medicine at Mount Sinai. "This study shows patients relapsing after initial bispecific antibodies therapy can benefit from a second bispecific antibody or CAR-T cell therapy."
Studies are underway to understand how T cells function after initial T-cell redirection therapy and how they are activated in sequential bispecific antibodies and CAR-T cell treatments. "Future clinical trials incorporating sequential combinations of T-cell redirection therapy will build upon these findings to further develop treatment guidelines and improve long-term outcomes for multiple myeloma patients," Dr. Parekh said.
More information: Tarek H Mouhieddine et al, Sequencing T-cell redirection therapies leads to deep and durable responses in relapsed/refractory myeloma patients, Blood Advances (2022). DOI: 10.1182/bloodadvances.2022007923
Though chemotherapy can be lifesaving, the cancer treatment often leaves patients suffering from debilitating side effects, including cognitive impairments in processing speed, memory, executive function and attention. Dubbed "chemo brain," these lingering symptoms can dramatically impact patients' quality of life long after they have completed their cancer treatments.
Currently, there are no FDA-approved drugs to mitigate these deficits. In breakthrough findings, renowned Saint Louis University pain researcher Daniela Salvemini, Ph.D., and her team have uncovered some of the molecular events that happen whenchemotherapydrugs cause these deficits. More promising still, they've found that an already-approved FDA drug designed to treat multiple sclerosis also appears to work to reduce chemotherapy-related cognitive impairment (CRCI).
A growing need
The National Cancer Institute (NCI) expects cancer survivorship to reach 21. 7 million by 2029. As survivorship advances, the need to address chemotherapy's severe, long-lasting neurotoxic side effects is increasing.
CRCI is a major neurotoxic side effect of chemotherapy, affecting more than 50% of patients treated with widely used chemotherapy drugs, including taxanes like Paclitaxel and platinum-based agents like Cisplatin. These drugs are widely used as part of standard treatment for numerous cancers, including head and neck, testicular, colon, breast, ovarian and non-small cell lung cancers.
When assessed by neuropsychological tests, up to 75% percent of patients treated with chemotherapy for cancers outside the nervous system reported cognitive deficits.
Salvemini, who is the William Beaumont professor of pharmacology and physiology and Chair of the department at Saint Louis University, says CRCI profoundly affects patient quality of life.
"Our current understanding of the mechanisms underlying CRCI and their impact on cognition is limited due to the multifactorial origins of CRCI," said Salvemini, who is also director of the Henry and Amelia Nasrallah Center for Neuroscience at SLU and a fellow of the Saint Louis Academy of Science. "A better understanding of these mechanisms is essential for developing new therapies and improving survivors' quality of life."
New findings
In her most recent paper, "Sphingosine-1-Phosphate Receptor 1 Activation in the Central Nervous System Drives Cisplatin-Induced Cognitive Impairments," published Sept. 1, 2022, in the Journal of Clinical Investigation, Salvemini and her team present the first evidence that chemotherapy alters an important cellular pathway called sphingolipid metabolism in critical areas of the brain linked to cognitive function.
Salvemini notes that in the central nervous system, Cisplatin increases levels of the potent signaling molecule sphingosine-1-phosphate (S1P), which contributes to the development of CRCI through activation of S1P receptor subtype 1 (S1PR1) on astrocytes and S1PR1-driven mitochondrial dysfunction and neuroinflammatory processes. Mechanistically, she says the team revealed that cisplatin-induced S1P formation is mediated by the toll-like receptor 4.
Their findings bridge the gaps in understanding the molecular mechanisms underlying CRCI and identify a novel target for therapeutic intervention with functional S1PR1 antagonists. Importantly, S1PR1 antagonists do not interfere with the efficacy of chemotherapy as they and others have shown in previous work and can also block tumor cell growth, inflammation and metastasis.
"Our findings are fascinating since two functional S1PR1 antagonists are already FDA-approved for treating multiple sclerosis," Salvemini said. "Repurposing these drugs to prevent CRCI would be a groundbreaking shift towards enhancing patient quality of life in cancer treatment."
In previous studies, Salvemini pioneered research on a treatment for neuropathic pain that could provide the first alternative to ineffective steroids and addictive opioids. Work from Salvemini's lab established that altered S1PR1 signaling in the central nervous system in response to chemotherapy also contributes to chemotherapy-induced neuropathic pain, another central neurotoxicity of cancer treatment. This work fueled two ongoing NCI clinical trials to test the potential use of Gilenya, a drug approved to treat multiple sclerosis, to prevent neuropathic pain in patients with breast cancer treated with Paclitaxel.
"Our work is very translational," Salvemini said. "We try to understand the mechanisms at the molecular level, identify the targets, work with our chemists to make new drugs to target that specific pathway, test it, and then take the necessary steps to move along this compound until it is ready to be studied in a clinical trial."
More information: Silvia Squillace et al, Sphingosine-1-phosphate receptor 1 activation in the central nervous system drives cisplatin-induced cognitive impairment, Journal of Clinical Investigation (2022). DOI: 10.1172/JCI157738
Franklin, Tenn.-based Community Health Systems is being sued in Florida federal court for alleged violations of the Worker Adjustment and Retraining Notification Act.
The lawsuit, filed Aug. 29 by a former employee, alleges CHS and ShorePoint Health Venice (Fla.), which is owned by CHS, didn't provide workers with written notice required by the WARN Act before terminating their employment in August. The plaintiff, who was laid off from ShorePoint Health Venice, is bringing the action on behalf of herself and about 600 other former employees seeking to recover damages.
CHS ended some services, including emergency services, at ShorePoint Health Venice last month and plans to close the hospital on Sept. 22. The lawsuit alleges CHS and ShorePoint terminated employees on Aug. 29 without providing the 60 days advance written notice required by the WARN Act.
"Defendants' purported commitment to keep the … plaintiff and the putative class members 'employed,' on paper at least, by not officially terminating them until November 22, 2022, changes nothing because the … plaintiff and putative class members were told to no longer show up for work and they are no longer paid by defendants," the complaint states.
Employers can claim an exemption from the written notice requirement for "unforeseeable business circumstance," but the plaintiff alleges CHS and ShorePoint knew the mass layoff was imminent in April or sooner.
The lawsuit is seeking 60 days of wages, salary, commissions, bonuses, accrued pay for vacation and personal days, pension, 401(k) contributions, health insurance and other fringe benefits for the plaintiff and putative class members. The suit is also seeking payment for medical expenses incurred during the 60-day period following termination that would have been covered and paid under the defendants' health insurance plans.
Texas Gov.Greg Abbott (R) said rape victims in the state can prevent pregnancies by using emergency contraception pills such as Plan B, The Dallas Morning News reported Friday.
In Texas, abortions are banned and do not include exceptions for rape or incest.
Late last month, a so-called “trigger law” went into effect following the Supreme Court’s overturning of Roe v. Wade earlier this year. The trigger law makes it a felony to perform an abortion in the state with narrow exceptions when the pregnant person’s life is at risk.
“We want to support those victims, but also those victims can access health care immediately, as well as to report it,” Abbott told The Dallas Morning News and KXAS-TV’s “Lone Star Politics” in a segment obtained by the Morning News that will air on Sunday.
“By accessing health care immediately, they can get the Plan B pill that can prevent a pregnancy from occurring in the first place,” he added.
Plan B is an oral contraceptive that is taken within 72 hours of unprotected sex or a “contraceptive accident” to prevent pregnancy, according to the product’s website. The pill prevents an egg from being released from the ovary to prohibit fertilization.
In the dark hours before dawn, there’s no busier place than the Hunts Point produce market in The Bronx, where throngs of chefs, grocers and deli owners jockey each morning to snag the plumpest peaches and leafiest lettuce.
Once fentanyl reaches the market, traffickers move it to nearby apartments where the drug gets chopped up and packaged into small glassine envelopes. The drugs are then sold on the streets of the city — and up and down the East Coast.
“It comes in with the produce,” said Bridget Brennan, who heads the city’s Office of the Special Narcotics Prosecutor, noting that densely packed fentanyl bricks, hidden in box trucks and 18-wheelers, travel by highways from the border with Mexico to the Great Lakes region before coming east.
Fentanyl is so potent that a dose just 2 milligrams in size — the same size as the powder next to the penny above — can prove fatal.Drug Enforcement Administration
“The drugs are offloaded in New Jersey and then into The Bronx, where they are milled into glassines. The mills pump out millions of these glassines and they get distributed all over the country.”
Packaging operations inside apartments close to Hunts Point are staffed mostly by Dominican laborers decked out in full face masks, gloves and protective clothing to prevent them from being poisoned by the powerful narcotic, Brennan said.
“It tends to be an apartment in The Bronx with eight guys sitting around a big table working around the clock.”
Huge amounts of fentanyl are moved from the border to Hunts Point produce market, where it is easily hidden among produce and legitimate salespeople (seen here), then moved to nearby apartments where it’s cut up for distribution.Bloomberg via Getty Images
They produce powder versions of the drug and press it into pills that look just like oxycodone, she said.
The fake oxy tablets are known as “blues” — 30 milligram pills so potent they are typically cut into halves or quarters, Brennan said. The amount of the drug can range from .02 to 5.1 milligrams, according to the Drug Enforcement Administration. While the agency says a dose as small as two milligrams can be enough to induce a fatal overdose, 42 percent of the pills the DEA tested had that much or more.
Oxy users, said Brennan, “think they know what they’re getting because they’re used to purchasing pills online. But sometimes it’s pure fentanyl.”
Hunts Point spokesman Robert Leonard said the market was “highly regulated by a number of city, state and federal agencies — including on-site presences. … Our market is committed to providing over 4,000 workers and thousands of customers who come into our market daily with a safe and law-abiding environment. …This includes cooperating fully with all levels of law enforcement.”
Fentanyl, which is manufactured by the cartels in Mexico, has become a plague in America amid the current border crisis, sources said.
A cache of fentanyl displayed by anti-narcotic officers. So potent — and risky — is the drug that some dealers brand their packets with terms like “Overdose” and “Game of Death.”
“It’s quite frankly a tsunami of death that is crashing into the United States over our southern border,” Collin County Sheriff Jim Skinner told The Post of the thousands of pounds of the drug smuggled into the US.
Cartels are taking advantage of the wave of migrants surging over the border, experts said.
Special Narcotics prosecutor Bridget G. Brennan has chronicled the elaborate fentanyl processing and distribution operation set up near Hunts Point, which she said is mostly staffed by Dominican laborers.Richard Harbus
“Ninety percent of our resources are tied up processing immigrants,” said Brandon Judd, president of the national Border Patrol union. “The cartels exploit that border patrol agents are tied up. That means the border is wide open for them.”
The production of fentanyl begins in China, where a network of underground labs batch up “precursor” chemicals needed to manufacture the drug. Those include the two most common ingredients of fentanyl: N-phenethylpiperidone and 4-anilino-N-phenethylpiperidine.
The Jalisco New Generation cartel in Guadalajara is one of the main drug operations in Mexico manufacturing fentanyl from precursors in China. Cartels are exploiting weaknesses at the border to get the drug into the US, experts said.CJNG
The US and China have both banned these and other components, but they continue to be made. In 2020, a reporter for NPR identified three suspected suppliers — in Shanghai and two provinces: Ningxia, in the north central mountains, and Hebei, near Beijing.
The compounds are then shipped to Mexico, where two notorious cartels — the Sinaloa gang in Culiacan, and the Jalisco New Generation cartel in Guadalajara — produce the bulk of the fentanyl consumed in the US, according to the DEA.
The drugs are smuggled over the border at crossings in Texas and New Mexico, according to Brennan, then trucked north on highway 25 toward Denver before heading east toward Chicago on Interstate 80.
Detained migrants and asylum seekers at a US border crossing — one of many such entry points where fentanyl enters the country before being trucked north and east.USA TODAY NETWORK/Sipa USA
Though some shipments get seized, many more get through, in part because drug-sniffing dogs, who are capable of detecting opioids, have not been trained to identify fentanyl — for their own safety. The drug can be absorbed through the mucus membranes in dog’s noses, killing them just by getting too close to it.
Rand Henderson, the sheriff of Montgomery County, a suburb of Houston that’s been hit hard by fentanyl overdoses, said the smaller sizes of fentanyl bundles make it difficult to stop the trafficking.
“It’s not like moving bundles of marijuana,” he said. “These are much smaller bricks that are measured in pounds.”
Box trucks and 18-wheelers transport bricks of fentanyl from the border to the Great Lakes region and then New York City.Bloomberg via Getty Images
Illegal fentanyl use in the US surged starting in 2015. Before then, in the early days of fentanyl, recreational users were mostly anesthesiologists who sedated surgery patients with the drug.
The drug took off because it was cheaper than heroin and became much more readily available, experts say. Even now, a single dose of fentanyl can cost as little as $2.
“It’s absolutely cheaper,” Henderson said. “Think about making something in a lab using these cheap chemicals. You have a room that it can be made in versus an organic product that you have to grow, like poppies, so you need a field, workers, water. You have to harvest it and package it. You don’t have any of that with fentanyl.”
A bag of fentanyl pills hidden within a dog costume illustrates both the elaborate — and disarmingly simple — methods dealers will employ to get their product to market.
It’s also much more profitable for dealers. According to one DEA estimate a kilo of fentanyl costing about $4,000 wholesale could reap as much as $1.2 million in revenue — whereas $4,000 of wholesale heroin might bring in just $60,000. More than one million pills can be made from a single kilo of raw fentanyl.
And experts said New York City has become a center for fentanyl distribution — not just because of its excellent connection to roadways — but because of recent bail reforms.
The change in bail requirements, which went into effect in January 2020 under Gov. Andrew Cuomo, mandated that non-violent and low-level drug offenders, including those accused of possession, were to be freed without cash bail.
Jose Jorge was arrested for pushing fentanyl on NYC streets but was sprung amid the city’s lax bail laws.Erik Thomas/NY Post
Moments after his release, the 47-year-old infamously crowed, “Cuomo for president!”
Brennan’s office also recorded him on a wire saying fentanyl overdoses were “good for business,” because they prove the potency of his product. (Some dealers even stamp their products with morbid names like “Overdose” and “Game of Death,” Brennan said.) Jorge was ultimately arrested and is now serving a nine-year sentence, for criminal sale of a controlled substance,at Auburn state prison.
Brennan said she remains baffled as to the “massive overcorrection” on bail, which was partly meant to lower the state’s prison populations. “No prosecutors were consulted,” she said. “No judges were consulted.”
Some of the 5,000 brightly-colored fentanyl pills recently discovered by border patrol agents strapped to a suspect’s leg. The pills’ small size and high potency translate into big profits for traffickers — upwards of $1.2 million per kilogram.Twitter / @CBPPortDirNOG
Brennan’s office has found that 78 percent of the overdose deaths in New York are linked to fentanyl. In the first two quarters of last year, 1,233 people in the city died of an OD, according to the NYC Health Department — up from 965 over the same period in 2020.
“Because drug packaging is imprecise, users are playing Russian roulette,” her office stated in its 2021 annual report.
Prosecutors continue to worry about how aggressively fentanyl is being marketed — particularly to kids. On Tuesday, the DEA put out a statement warning about brightly colored “rainbow” fentanyl pills and powder made to look like sidewalk chalk. The new form is “a deliberate effort by drug traffickers to drive addiction amongst kids and young adults,” said Anne Milgram, the agency’s administrator.
“Fentanyl is the single deadliest drug threat our nation has ever encountered,” she said in a statement.
Law enforcement officials display a massive seizure of fentanyl, which is responsible for 78 percent of all overdose deaths in New York City.
“I never thought in my career that I would see a drug that would trump methamphetamines,” added Henderson. Fentanyl, he said, has “been turned into a weapon of mass destruction.”
One former cop is upset about the lack of government funding to help law enforcement stop the flow of the drug.
“Our federal agents, they need more resources to interdict more fentanyl,” said Robert Almonte, a security consultant who worked as a narcotics investigator with the El Paso police for 25 years.
Despite major fentanyl busts such as this one, drug agents say not enough funding is available to stem the drug’s flow on the US-Mexico border.
“They need the technology to detect it coming across in commercial trucks. This is a crisis and we are not treating it as a crisis. I’m frustrated and angry and I think that every American should be.”
Almonte, however, did note one encouraging development.
At a meeting in Washington DC last month with the DEA, agents vowed to do more to cut off the supply of precursor chemicals from China into Mexico, he said.
“My hat goes off to the DEA,” he said. “Without those chemicals the cartels can’t produce fentanyl — or meth for that matter.”
“Fentanyl is the biggest threat to our national security,” he added.
“People are dying by the thousands and we are not doing enough to stop it from coming across the border. We’re not recognizing the gravity of the situation.”
NY Post
1. China: The production of fentanyl begins in China, where a network of underground labs batch up “precursor” chemicals needed to manufacture the drug. The US and China have both banned these and other components, but they continue to be made.
2. Mexico: Drug organizations including the Sinaloa cartel and the Jalisco New Generation cartel use precursor chemicals from China to manufacture fentanyl, which is cheaper and more profitable than heroin. One kilo of fentanyl can reap as much as $1.2 million compared to $60k from the same amount of heroin.
3. The Border: The flow of migrants over the US-Mexico border under Biden’s open-door policies has overwhelmed guards who have little time to check for small bricks of heroin, which make their way to NYC in box trucks and 18-wheelers.
4. En Route to NYC: “There’s a convergence of highways going north to Massachusetts and Connecticut, New Jersey, Pennsylvania and Long Island,” said Bridget Brennan, who heads the city’s Office of the Special Narcotics Prosecutor, noting that densely packed fentanyl bricks travel from the border to the Great Lakes region before coming east.
5. Destination NYC: Hunts Point produce market in The Bronx is a hub for the lethal drug, which gets smuggled into the city amid boxes of fruits and vegetables. Bricks of fentanyl are then moved to nearby apartments where laborers produce a powder version and press the drug into pills that look just like oxycodone, which are then sold on the streets of NYC.
