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Tag: Surgery

  • Doctor charged in connection with Matthew Perry’s death is expected to plead guilty

    Doctor charged in connection with Matthew Perry’s death is expected to plead guilty

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    LOS ANGELES — One of two doctors charged in the investigation of the death of Matthew Perry is expected to plead guilty Wednesday in a federal court in Los Angeles to conspiring to distribute the surgical anesthetic ketamine.

    Dr. Mark Chavez, 54, of San Diego, signed a plea agreement with prosecutors in August and would be the third person to plead guilty in the aftermath of the “Friends” star’s fatal overdose last year.

    Prosecutors offered lesser charges to Chavez and two others in exchange for their cooperation as they go after two targets they deem more responsible for the overdose death: another doctor and an alleged dealer that they say was known as “ketamine queen” of Los Angeles.

    Chavez is free on bond after turning over his passport and surrendering his medical license, among other conditions.

    His lawyer Matthew Binninger said after Chavez’s first court appearance on Aug. 30 that he is “incredibly remorseful” and is “trying to do everything in his power to right the wrong that happened here.”

    Also working with federal prosecutors are Perry’s assistant, who admitted to helping him obtain and inject ketamine, and a Perry acquaintance, who admitted to acting as a drug messenger and middleman.

    The three are helping prosecutors in their prosecution of Dr. Salvador Plasencia, charged with illegally selling ketamine to Perry in the month before his death, and Jasveen Sangha, a woman who authorities say sold the actor the lethal dose of ketamine. Both have pleaded not guilty and are awaiting trial.

    Chavez admitted in his plea agreement that he obtained ketamine from his former clinic and from a wholesale distributor where he submitted a fraudulent prescription.

    After a guilty plea, he could get up to 10 years in prison when he is sentenced.

    Perry was found dead by his assistant on Oct. 28. The medical examiner ruled ketamine was the primary cause of death. The actor had been using the drug through his regular doctor in a legal but off-label treatment for depression that has become increasingly common.

    Perry began seeking more ketamine than his doctor would give him. About a month before the actor’s death, he found Plasencia, who in turn asked Chavez to obtain the drug for him.

    “I wonder how much this moron will pay,” Plasencia texted Chavez. The two met up the same day in Costa Mesa, halfway between Los Angeles and San Diego, and exchanged at least four vials of ketamine.

    After selling the drugs to Perry for $4,500, Plasencia asked Chavez if he could keep supplying them so they could become Perry’s “go-to.”

    Perry struggled with addiction for years, dating back to his time on “Friends,” when he became one of the biggest stars of his generation as Chandler Bing. He starred alongside Jennifer Aniston, Courteney Cox, Lisa Kudrow, Matt LeBlanc and David Schwimmer for 10 seasons from 1994 to 2004 on NBC’s megahit sitcom.

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  • An Ultrathin Graphene Brain Implant Was Just Tested in a Person

    An Ultrathin Graphene Brain Implant Was Just Tested in a Person

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    In 2004, Andre Geim and Konstantin Novoselov at the University of Manchester in England achieved a breakthrough when they isolated graphene for the first time. A flat form of carbon made up of a single layer of atoms, graphene is the thinnest known material—and one of the strongest. Hailed as a wonder material, it won Geim and Novoselov a Nobel Prize in physics in 2010.

    Twenty years later, graphene is finally making its way into batteries, sensors, semiconductors, air conditioners, and even headphones. And now, it’s being tested on people’s brains.

    This morning, surgeons at the University of Manchester temporarily placed a thin, Scotch-tape-like implant made of graphene on the patient’s cortex—the outermost layer of the brain. Made by Spanish company InBrain Neuroelectronics, the technology is a type of brain-computer interface, a device that collects and decodes brain signals. InBrain is among several companies, including Elon Musk’s Neuralink, developing BCIs.

    “We are aiming to have a commercial product that can do brain decoding and brain mapping and could be used in a variety of disorders,” says Carolina Aguilar, InBrain’s CEO and cofounder.

    Brain mapping is a technique used to help plan brain surgeries. When taking out a brain tumor, for instance, surgeons place electrodes on the brain to determine the location of motor and speech function in the brain so that they can safely remove the tumor without affecting the patient’s ability to move or speak.

    During today’s surgery, the implant was installed for 79 minutes. The patient was already undergoing brain surgery to have a tumor removed and consented to the experiment. In that time, researchers observed that the InBrain device was able to differentiate between healthy and cancerous brain tissue with micrometer-scale precision.

    The University of Manchester is the site of InBrain’s first-in-human study, which will test the graphene device in up to 10 patients who are already undergoing brain surgery for other reasons. The goal of the study, which is funded by the European Commission’s Graphene Flagship project, is to demonstrate the safety of graphene in direct contact with the human brain.

    David Coope, the neurosurgeon who performed the procedure, says the InBrain device is more flexible than a conventional electrode, allowing it to better conform to the surface of the brain. “From a surgical perspective, it means we can probably put it in places where we would find it difficult to put an electrode,” he says. The mainstay electrodes used for brain mapping are disks of platinum iridium set in silicon. “So they’re reasonably stiff,” Coope says.

    By contrast, the InBrain device is a transparent sheet that sits on the brain’s surface. Half the thickness of a human hair, it contains 48 tiny decoding graphene electrodes measuring just 25 micrometers each. The company is developing a second type of implant that penetrates the brain tissue and can deliver precise electrical stimulation.

    The surface device alone can be used for brain mapping, but Aguilar says the company is also integrating the two devices and plans to eventually test them together as a treatment for neurological disorders such as Parkinson’s disease.

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    Emily Mullin

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  • Find More Pictures of Her Here>>

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  • ‘Shoot me up with a big one’: A timeline of the last days of Matthew Perry

    ‘Shoot me up with a big one’: A timeline of the last days of Matthew Perry

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    LOS ANGELES — The arrest of five people in the overdose death of Matthew Perry has revealed key details about the final days of the “Friends” star, most of them spent in the throes of an addiction to the surgical anesthetic ketamine.

    Perry would die at age 54 on Oct. 28 after telling his assistant to shoot him up “with a big one.” Drawn from unsealed federal court documents and a medical examiner’s investigation, here’s a chronological look at the end of Perry’s life.

    September 30 — Perry and his live-in personal assistant, Kenneth Iwamasa, met at their home in the Pacific Palisades neighborhood of Los Angeles with Dr. Salvador Plasencia. Perry had been receiving ketamine treatments for depression — an increasingly common off-label use — from his regular doctor, but wasn’t able to get as much as he wanted. Plasencia texted a doctor friend in San Diego, Mark Chavez, who agreed to obtain ketamine for him.

    “I wonder how much this moron will pay,” Plasencia texted Chavez. The two met up the same day in Costa Mesa, halfway between Los Angeles and San Diego and exchanged at least four vials of ketamine.

    Plasencia returned to Perry’s house, where Iwamasa paid him $4,500 in cash for the vials. Plasencia gave Perry two injections of ketamine, and instructed Iwamasa on how to give the injections to the actor. Plasencia texted Chavez that the experience “felt like a bad movie.”

    October 2 — Iwamasa texted Plasencia saying he wanted to buy not just injection sessions, but to be left with more vials of ketamine, referring to it in agreed-upon code as “dr pepper.” Plasencia appeared, gave Perry the injections, and left behind the vials of the anesthetic.

    October 4 — Iwamasa injected Perry himself for the first time. He texted the doctor that he had found “the sweet spot” to put the needle into his boss, but that trying different spots on Perry had led to them running out, and they needed more. Plasencia texted Chavez asking if he could keep supplying the drug so they could become Perry’s “go-to.”

    October 6 — Iwamasa told Plasencia they were running low, and needed more. Plasencia went to Perry’s house and sold him one or more vials.

    October 8 — In a late night meetup at a Santa Monica shopping plaza, Plasencia sold Iwamasa four vials of ketamine for $6,000 in cash.

    October 10 — Iwamasa drove Perry to a public parking lot in Long Beach, where they met up with the doctor. He sold them more ketamine, and gave an injection to Perry while the actor sat in a car. On the same day, Iwamasa sought even more of the drug from an additional source of ketamine, reaching out to Erik Fleming, an acquaintance of Perry.

    October 11 — Fleming messaged Iwamasa that he can get ketamine from a woman he knows. “It’s unmarked but it’s amazing – he take one and try it and I have more if he likes,” Fleming wrote. The woman, Jasveen Sangha, was known to her customers as the “Ketamine Queen.” Fleming texted Iwamasa that she only deals “with high end and celebs. If it were not great stuff she’d lose her business.”

    October 12 — Plasencia went to Perry’s house, where he was paid $21,000 in cash, some of it owed to him for previous ketamine buys. While there he injected Perry. The actor immediately froze up and his blood pressure spiked. The assistant said the doctor told him, “let’s not do that again.”

    October 13 — Perry got a sample of Sangha’s ketamine and tried it. He and Iwamasa would ask for 25 vials of it, for which he would pay $5,500. Fleming dropped it off at Perry’s house a day later.

    On or around Oct. 20 — Perry received his last legal ketamine treatment from his regular physician, according to what a woman close to him whose name was redacted in official documents told medical examiner’s investigators. The woman said his previous doctor had given him treatments every other day, but his new doctor said Perry was doing well, his depression was managed, and he no longer needed so many treatments. The woman would tell investigators that she had believed Perry had been sober for 19 months and there had been no relapse.

    Around October 24 — Perry talked to the unidentified woman for the last time. She told investigators he had been in good spirits.

    October 25 — Iwamasa asked Fleming for another 25 vials of ketamine. After picking up $6,000 from Perry, Fleming picked up the ketamine from Sangha, who told him her own source is known as “Master Chef.” Meanwhile, Iwamasa gave Perry at least six shots of ketamine.

    October 26 — Iwamasa again gave Perry at least six shots of ketamine.

    October 27 — The assistant again gave the actor at least six shots of ketamine. With the supply coming from Fleming and Sangha, Perry and Iwamasa had been out of touch with Plasencia for about two weeks. Plasencia would text Iwamasa saying he had more to offer: “I know you mentioned taking a break. I have been stocking up.”

    About 8:30 a.m. — Acting at Perry’s direction, using syringes from Plasencia and ketamine from Sangha, Iwamasa gave Perry an injection.

    About 11 a.m. — Perry played pickleball, according to what Iwamasa told medical examiner’s investigators later in the day, though many elements of that initial story changed in his later talks to prosecutors.

    About 12:45 p.m. — Iwamasa gave Perry his second shot of the day, and the actor began watching a movie.

    Shortly before 1:30 p.m. — Iwamasa gave Perry his third and final injection of the day while Perry sat at his backyard jacuzzi. “Shoot me up with a big one,” Iwamasa remembered Perry telling him. The assistant then left to run errands.

    About 4 p.m. — Iwamasa returned home to find Perry face down in the jacuzzi. He jumped in, pulled Perry to the steps and called 911. Paramedics arrived minutes later and declared Perry dead. Coroner’s investigators would say ketamine was the primary cause of his death, with drowning a secondary cause.

    ___

    Iwamasa has pleaded guilty to conspiracy to distribute Ketamine. Fleming has pleaded guilty to distributing ketamine resulting in death. Both are cooperating with prosecutors.

    Chavez has agreed to plead guilty to conspiracy to distribute the drug. Plasencia and Sangha, the two main targets of the investigation, have pleaded not guilty to multiple felony counts.

    Plasencia’s lawyer Stefan Sacks said Thursday that everything his client did was in Perry’s best medical interest. Sangha’s attorney declined comment.

    Attorneys for the other three men did not respond to multiple messages seeking comment from The Associated Press.

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  • Widespread global tech outage disrupts flights, banks, hospitals and media outlets

    Widespread global tech outage disrupts flights, banks, hospitals and media outlets

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    FRANKFURT, Germany — A global technology outage caused by a faulty software update grounded flights, knocked banks and media outlets offline, and disrupted hospitals, small businesses and other services on Friday, highlighting the fragility of a digitized world dependent on just a handful of providers.

    The trouble with the update issued by cybersecurity firm CrowdStrike and affecting computers running Microsoft Windows was not a hacking incident or cyberattack, according to CrowdStrike, which apologized and said a fix was on the way.

    But hours later, the disruptions continued — and escalated.

    Long lines formed at airports in the U.S., Europe and Asia as airlines lost access to check-in and booking services at a time when many travelers are heading away on summer vacations. Hospitals and doctors’ offices had problems with their appointment systems, and cancelled non-urgent surgeries. Several TV stations in the U.S. were also prevented from airing local news early Friday.

    Saskia Oettinghaus, a member of the German Olympic diving team, was among those stuck at the Berlin Airport.

    “We are on our way to Paris for the Olympic Games and now we are at a standstill here for the time being,” Oettinghaus said.

    Other athletes and spectators traveling to Paris were delayed, as were their uniforms and accreditations, but Games organizers said disruptions were limited and didn’t affect ticketing or the torch relay.

    “This is a very, very uncomfortable illustration of the fragility of the world’s core internet infrastructure,” said Ciaran Martin, a professor at Oxford University’s Blavatnik School of Government and former Head of Britain’s National Cyber Security Centre.

    Cyber expert James Bore said real harm would be caused by the outage because systems people have come to rely on at critical times are not going to be available. Hospitals, for example, will struggle to sort out appointments and those who need care may not get it — and it will lead to deaths, he said.

    “All of these systems are running the same software,” Bore said. “We’ve made all of these tools so widespread that when things inevitably go wrong — and they will, as we’ve seen — they go wrong at a huge scale.”

    The head of Germany’s IT security agency, Claudia Plattner, said that “the problems will last some time — we can’t expect a very quick solution.” A forecast for when exactly all systems will be up and running is difficult, but “it won’t be hours,” she added.

    Microsoft spokesperson Frank X. Shaw confirmed in an emailed statement that “a CrowdStrike update was responsible for bringing down a number of Windows systems globally.” Earlier, the company had posted on the social media platform X that it was working to “alleviate impact” and that they were “observing a positive trend in service availability.”

    During an interview on NBC’s “Today Show” Friday, CrowdStrike CEO George Kurtz apologized for the outage, saying the company was “deeply sorry for the impact that we’ve caused to customers, to travelers, to anyone affected by this, including our companies.”

    “We know what the issue is” and are working to remediate it, Kurtz said.

    “It was only the Microsoft operating system” that was affected, though it didn’t happen on every Microsoft Windows system, he said.

    The Austin, Texas-based company’s shares were down nearly 10% in early trading Friday.

    A recording playing on its customer service line said, “CrowdStrike is aware of the reports of crashes on Microsoft ports related to the Falcon sensor,” referring to one of its products used to block online attacks.

    Meanwhile, governments and companies across the world scrambled to respond.

    The White House said President Joe Biden was briefed on the outage and his team has been touch with the company and other impacted entities.

    New Zealand’s acting prime minister, David Seymour, said on X that officials in the country were “moving at pace to understand the potential impacts,” adding that he had no information indicating it was a cybersecurity threat.

    The issue was causing “inconvenience” for the public and businesses, he added.

    On the Milan stock exchange, the FTSE MIB index of blue-chip Italian stocks could not be compiled for an hour, though trading continued.

    Major delays reported at airports grew on Friday morning, with most attributing the problems in booking systems of individual airlines.

    In the U.S., airlines United, American and Delta said that at least some flights were resuming after severe disruptions, though delays would persist.

    Airlines and railways in the U.K. were also affected, with longer than usual waiting times.

    In Germany, Berlin-Brandenburg Airport halted flights for several hours due to difficulties in checking in passengers, while landings at Zurich airport were suspended and flights in Hungary, Italy and Turkey disrupted.

    The Dutch carrier KLM said it had been “forced to suspend most” of its operations.

    Amsterdam’s Schiphol Airport warned that the outage was having a “major impact on flights” to and from the busy European hub. The chaotic morning coincided with one of the busiest days of the year for Schiphol.

    Widespread problems were reported at Australian airports, where lines grew and some passengers were stranded as online check-in services and self-service booths were disabled — although flights were still operating. Meanwhile, passengers stood in long lines at Rome’s Leonardo Da Vinci airport after flights were cancelled following a global power outage.

    In New England, the outage led to delays at airports and for some hospitals to cancel appointments.

    At Mass General Brigham, the largest health care system in Massachusetts, all scheduled non-urgent surgeries, procedures, and medical visits were cancelled Friday because of the outage, according to a spokesperson. Emergency departments remain open and care for patients in the hospital has not been impacted.

    While the outages were being experienced worldwide, Australia appeared to be severely affected by the issue. Disruption reported on the site DownDetector included the banks NAB, Commonwealth and Bendigo, and the airlines Virgin Australia and Qantas, as well as internet and phone providers such as Telstra.

    National news outlets — including public broadcaster ABC and Sky News Australia — were unable to broadcast on their TV and radio channels for hours. Some news anchors went on air online from dark offices, in front of computers showing “blue screens of death.”

    Hospitals in several countries also reported problems.

    Britain’s National Health Service said the outage caused problems at most doctors’ offices across England. NHS England said in a statement said the glitch was affecting the appointment and patient record system used across the public health system.

    Some hospitals in northern Germany canceled all elective surgery scheduled for Friday, but emergency care was unaffected.

    Shipping was disrupted too: A major container hub in the Baltic port of Gdansk, Poland, the Baltic Hub, said it was battling problems resulting from the global system outage.

    ___

    Kurtenbach reported from Bangkok and Graham-McLay from Wellington, New Zealand. Associated Press journalists around the world contributed.

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  • Elon Musk’s Neuralink Is Ready to Implant a Second Volunteer

    Elon Musk’s Neuralink Is Ready to Implant a Second Volunteer

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    A second person will soon receive Neuralink’s experimental brain implant, according to Elon Musk, the company’s cofounder.

    In a video update on Wednesday, Musk said the surgery is planned to take place in “the next week or so.” The company is making changes to the surgical procedure and placement of the device to avoid problems that arose with its first participant, whose implant partially detached from the brain a few weeks after surgery.

    Neuralink is developing a brain-computer interface, or BCI, which uses a person’s brain signals to control an external device. Its first product, dubbed Telepathy, aims to help paralyzed people operate a computer using just their thoughts. Musk has said Neuralink is working on a second product, called Blindsight, to provide artificial vision to people who are blind.

    “A way to think about the Neuralink device is kind of like a Fitbit or an Apple Watch with tiny wires or electrodes,” Musk said in the video, which was livestreamed on his social media platform, X. In the short term, the Neuralink device is meant to help people with disabilities, but Musk said his long-term goal is to use BCI technology “to mitigate the civilizational risk of AI by having a closer symbiosis between human intelligence and digital intelligence.”

    For now, the company is running an early feasibility study to evaluate the safety and functionality of its device in people with paralysis. As part of the study, Noland Arbaugh became the first person to get Neuralink’s brain implant in January. Arbaugh is paralyzed from the shoulders down due to a swimming accident that occurred in 2016.

    Neuralink’s coin-sized implant sits in the skull and has 64 flexible wire threads thinner than a human hair that extend into the brain tissue. Each thread contains 16 electrodes that collect intended movement signals from neurons.

    At first, the device was functioning as it should. Arbaugh was able to use a cursor just by thinking about it, allowing him to play video games, email friends, and browse the Internet. But a few weeks after the surgery, the implant started to malfunction and Arbaugh lost control of the cursor.

    In a May blog post on its website, Neuralink said a number of threads had retracted from Arbaugh’s brain, resulting in a net decrease in the number of effective electrodes. In response, Neuralink modified its neural recording algorithm to be more sensitive and improved how it translates neural signals into cursor movements.

    Arbaugh is back to using a computer with his brain, although just 15 percent of the implant’s threads are still working, according to Neuralink executives. In an interview with WIRED, Arbaugh said the device has given him back a sense of independence.

    Still, Neuralink is trying to avoid the same issues with its second study participant. “We really want to make sure that we make as much progress as possible between each Neuralink patient,” Musk said Wednesday.

    During the video update, company executives acknowledged that air was trapped inside Arbaugh’s skull after surgery, which could have contributed to the threads coming out. Matthew MacDougall, Neuralink’s head of neurosurgery, said the company is taking steps to eliminate this air pocket in its second volunteer. It also plans to insert the threads deeper into the brain tissue and track the movement of those threads.

    “You may think the most obvious mitigation for threads that pulled out of the brain is to insert them deeper. We think so too, and so we’re going to broaden the range of depths at which we insert threads,” MacDougall said.

    In addition, the company’s surgeons plan to “sculpt the surface of the skull” to minimize the gap under the implant so that it sits flush with the normal contour of the skull. This, MacDougall said, should “minimize the gap under the implant” and “put it closer to the brain and eliminate some of the tension on the threads.”

    Musk said he hopes to implant Neuralink’s device in the “high single digits” of study participants this year. (A listing by Neuralink on ClinicalTrials.gov says the company plans to enroll three participants in its current study.)

    He added that Neuralink is working on a next-generation implant that has 128 threads, each with eight electrodes per thread, a change that he says will “potentially double the bandwidth if we are accurate with the placement of the threads.” Musk didn’t provide a timeline on when that device will be ready to test in people.

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    Emily Mullin

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  • Kyiv hit with heaviest bombardment in months

    Kyiv hit with heaviest bombardment in months

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    KYIV, Ukraine — The sky was crystal clear as Oksana Femeniuk took her daughter to Ukraine’s largest children’s hospital for routine dialysis.

    Around 10 a.m, air-raid sirens blared. Sixteen-year old Solomiia was undergoing the treatment that required her to sit still for up to five hours and could not be interrupted. Her mother had to flee to the hospital’s basement shelter without her.

    Hurtling toward them at 435 to 497 miles per hour was a Russian Kh-101 cruise missile, according to Ukraine’s security service, the United Nations and open-source investigators. Using painstaking trial and error, Russia has modified the weapon over the last year to defeat Ukraine’s air defense systems by flying at low altitude and hugging terrain, according to military analysts.

    Minutes later the world turned black. Neither the patient nor her mother would remember the moment the missile struck. But they remember the chaos that ensued after regaining consciousness: Femeniuk thought she would choke from the fumes. Solomiia woke to find the ceiling crumpled over her small body.

    In an operating room in the next building, pediatric surgeon Oleh Holubchenko had been preparing to operate on an infant with a congenital facial defect. Covered in shrapnel wounds, he realized that the blast wave had catapulted him to the other side of the operating room.

    The toll of Russia’s heaviest bombardment of Kyiv in almost four months — one of the deadliest of the war — shows the devastating human cost of Russia’s improved targeting tactics.

    The hospital’s director general, Volodymyr Zhovnir, stood at the scene of the explosion, eclipsed by the towering building with shattered windows. No children died, thank God, he said, but they lost a dear colleague, Dr. Svitlana Lukianchuk.

    Lukianchuk was hurrying along the children and parents from the toxicology building, which would later be destroyed, to the shelter. She returned to empty out more rooms. and then, the explosion, Femeniuk remembers.

    Solomiia was born with chronic renal failure, making hemodialysis part of her life.

    After the full-scale invasion, Femeniuk left her three children and husband behind in the small village near Rivne, in western Ukraine, to live in the capital so the girl could access the treatment she needs.

    Leaving her daughter during the air raid was a difficult decision. But the 34-year old mother had to project strength, she said. Her daughter was being brave by staying, knowing she could not interrupt her treatment. Femeniuk could not reveal to her daughter that she was actually terrified.

    As the air-raid siren blared, the girl was on her phone watching videos. Given how long dialysis can take, she tends to get bored.

    She awoke to find the ceiling in front of her eyes and the head doctor tending to her covered in blood and on her knees.

    The girl’s first impulse was to put her hands up to the ceiling to keep tons of concrete and debris from crushing her small body. She was trapped with a few other patients and hospital staff, and they were safely pulled out of the rubble.

    “The first thing I thought about was my mom, if she is alive or not. Then I thought: ‘Am I alive or not?’” she said, her fingers painted with small flowers, fidgeting as she spoke. Mother and daughter recounted their experience from the Kyiv City Children’s Clinical Hospital, where Solomiia was transferred.

    In the shelter, the exit was blocked and the fire blazing outside soon invaded the small space. Femeniuk called her husband, telling him she didn’t know if she would survive and she didn’t know if Solomiia was still alive.

    Eventually, those taking shelter managed to push their way out and to their horror they realized that the very building they had been in, that some of their children had been in, was hit. Femeniuk began picking up pieces of rubble in panic, calling out her daughter’s name. Then she saw the nurse who had been assisting them, covered in blood.

    Solomiia had been evacuated after the blast, the nurse said. She was safe.

    Meanwhile, in the operating room, it took Holubchenko fifteen minutes to realize that he was covered in shrapnel wounds. The doctor was too busy evacuating patients, starting with the 5-month old whose surgery was eventually completed elsewhere.

    “My colleagues and I who were in the operating room received shrapnel wounds to the body, the face, back, arms and legs,” he said. “There are glass windows in the operating room, the doors. All of it was just blown off, all destroyed.”

    In the hospital ward, he looked out to the street from a shattered window.

    “There used to be a wall here,” he said.

    When he went outside and realized the toxicology building had collapsed, his mind reverted to the times he would have consultations with patients there and check-ups. Now half the building was caved in.

    But he didn’t dwell on the thought for long and joined a line of volunteers, health workers and emergency crews removing debris, piece by piece.

    “Everyone wanted to do something,” he said.

    The assault hit seven of the city’s 10 districts. The strike on the Okhmatdyt children’s hospital, where 627 children were being cared for at the time, drew ire from Ukrainian officials and the international community. Two adults were killed, including a female doctor, and 50 were injured.

    Russia denied responsibility for the hospital strike, insisting it doesn’t attack civilian targets in Ukraine despite abundant evidence to the contrary, including AP reporting. Moscow insisted it was a Ukrainian air defense missile that struck the hospital.

    Artem Starosiek, the founder of the Ukainian group Molfar, which analyzes events based on open-source evidence, said there were overwhelming signs of Russia’s culpability. The missile used in the attack bears the characteristics of the Kh-101, he said, pointing to the shape of the body, tail and location of the wings, he said.

    That it was a clear blue day also played an important role, he said. Launching the modified missile during a sunny day is optimal for the weapon’s optoelectronic system to recognize the target correctly, he said.

    “The force of the warhead’s explosion is important; an air-defense missile could not have caused such consequences,” he said.

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    By SAMYA KULLAB – Associated Press

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  • Are We Polar Bears in a Jungle?  | NutritionFacts.org

    Are We Polar Bears in a Jungle?  | NutritionFacts.org

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    Rather than being some kind of disorder or a failure of willpower, weight gain is largely a normal response by normal people to an abnormal situation.

    It’s been said that “Nothing in biology makes sense except in the light of evolution.” The known genetic contribution to obesity may be small, but, in a certain sense, you could argue that it’s all in our genes. The excess consumption of available calories may be hardwired into our DNA. We were born to eat.

    Throughout human history and beyond, we existed in survival mode—in unpredictable scarcity. We’ve been programmed with a powerful drive to eat as much as we can while we can and just store the rest for later. Food availability could never be taken for granted, so those who ate more at the moment and were best able to store more fat for the future might better survive subsequent shortages to pass along their genes. So, generation after generation, millennia after millennia, those with lesser appetites may have died out, while those who gorged may have selectively lived long enough to pass along their genetic predisposition to eat and store more calories. That may be how we evolved into such voracious calorie-conserving machines. Now that we’re no longer living in such lean times, though, we’re no longer so lean ourselves.

    What I just described is the “thrifty gene” concept proposed in 1962. As I discuss in my video The Thrifty Gene Theory: Survival of the Fattest, it suggests that obesity is the result of a “‘mismatch’ between the environment in which humans evolved and our modern environment”—like being a polar bear in a jungle. All that fur and fat may have given polar bears an edge in the Arctic but would be decidedly disadvantageous in the Congo. Similarly, a propensity to pack on the pounds may have been a plus in prehistoric times but can turn into a liability when our scarcity-sculpted biology is plopped down into the land of plenty. So, it’s not gluttony or sloth. Obesity may simply be “a normal response to an abnormal environment.”

    Much of our physiology is finely tuned to stay within a narrow range of upper and lower limits. If we get too hot, we sweat; if we get too cold, we shiver. Our body has mechanisms to keep us in balance. In contrast, our bodies have had little reason to develop an upper limit to the accumulation of body fat. In the beginning, there may have been evolutionary pressures to keep lithe and nimble in the face of predation, but thanks to things like weapons and fire, we haven’t had to outrun as many saber-toothed tigers for about two million years or so. This may have left our genes with the one-sided selection pressures to binge on every morsel in sight and stockpile as many calories as possible in our bodies.

    What was once adaptive is now a problem—or at least so says the thrifty gene hypothesis that originated more than half a century ago. It “provides a simple and elegant explanation for the modern obesity epidemic and was quickly embraced by scientists and lay people alike.” Although the researcher, James Neel, later distanced himself from the original proposal, the basic premise, despite remaining mostly theoretical, is still “largely accepted” by the scientific community, and the implications are profound.

    In 2013, the American Medical Association voted to classify obesity as a disease (going against the advice of its own Council on Science and Public Health). Not that it necessarily matters what we call it, but disease implies dysfunction. Bariatric drugs and surgery are not correcting an anomaly in human physiology. Our bodies are just doing what they were designed to do in the face of excess calories. Rather than being some sort of disorder, weight gain is largely “a normal response by normal people to an abnormal environment.” As you can see below and at 4:12 in my video, more than 70 percent of Americans are now overweight. It’s normal. 

    “A body gaining weight when excess calories are available for consumption is behaving normally. Efforts to curtail such weight gain with drugs [or surgery] are not efforts to correct an anomaly in human physiology, but rather to deconstruct and reconstruct its normal operations at the core.”

    If weight gain is largely a normal response by normal people to an abnormal situation, what exactly is that abnormal situation? Calorie-Rich-And-Processed Foods. (I’ll let you work out the acronym.) That’s the topic we’ll turn to next.

    This is the third in an 11-video series on the history of the obesity epidemic. If you missed the first two, see The Role of Diet vs. Exercise in the Obesity Epidemic and The Role of Genes in the Obesity Epidemic.

    There are eight more coming up. See the related posts below.

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    Michael Greger M.D. FACLM

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  • Israel maintains a shadowy hospital for Gaza detainees. Critics allege mistreatment

    Israel maintains a shadowy hospital for Gaza detainees. Critics allege mistreatment

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    JERUSALEM — Patients lying shackled and blindfolded on more than a dozen beds inside a white tent in the desert. Surgeries performed without adequate painkillers. Doctors who remain anonymous.

    These are some of the conditions at Israel’s only hospital dedicated to treating Palestinians detained by the military in the Gaza Strip, three people who have worked there told The Associated Press, confirming similar accounts from human rights groups.

    While Israel says it detains only suspected militants, many patients have turned out to be non-combatants taken during raids, held without trial and eventually returned to war-torn Gaza.

    Eight months into the Israel-Hamas war, accusations of inhumane treatment at the Sde Teiman military field hospital are on the rise, and the Israeli government is under growing pressure to shut it down. Rights groups and other critics say what began as a temporary place to hold and treat militants after Oct. 7 has morphed into a harsh detention center with too little accountability.

    The military denies the allegations of inhumane treatment and says all detainees needing medical attention receive it.

    The hospital is near the city of Beersheba in southern Israel. It opened beside a detention center on a military base after the Oct. 7 Hamas attack on Israel because some civilian hospitals refused to treat wounded militants. Of the three workers interviewed by AP, two spoke on condition of anonymity because they feared government retribution and public rebuke.

    “We are condemned by the left because we are not fulfilling ethical issues,” said Dr. Yoel Donchin, an anesthesiologist who has worked at Sde Teiman hospital since its earliest days and still works there. “We are condemned from the right because they think we are criminals for treating terrorists.”

    The military this week said it formed a committee to investigate detention center conditions, but it was unclear if that included the hospital. Next week Israel’s highest court is set to hear arguments from human rights groups seeking to shut it down.

    Israel has not granted journalists or the International Committee of the Red Cross access to the Sde Teiman facilities.

    Israel has detained some 4,000 Palestinians since Oct. 7, according to official figures, though roughly 1,500 were released after the military determined they were not affiliated with Hamas. Israeli human rights groups say the majority of detainees have at some point passed through Sde Teiman, the country’s largest detention center.

    Doctors there say they have treated many who appeared to be non-combatants.

    “Now we have patients that are not so young, sick patients with diabetes and high blood pressure,” said Donchin, the anesthesiologist.

    A soldier who worked at the hospital recounted an elderly man who underwent surgery on his leg without pain medication. “He was screaming and shaking,” said the soldier.

    Between medical treatments, the soldier said patients were housed in the detention center, where they were exposed to squalid conditions and their wounds often developed infections. There was a separate area where older people slept on thin mattresses under floodlights, and a putrid smell hung in the air, he said.

    The military said in a statement that all detainees are “reasonably suspected of being involved in terrorist activity.” It said they receive check-ups upon arrival and are transferred to the hospital when they require more serious treatment.

    A medical worker who saw patients at the facility in the winter recounted teaching hospital workers how to wash wounds.

    Donchin, who largely defended the facility against allegations of mistreatment but was critical of some of its practices, said most patients are diapered and not allowed to use the bathroom, shackled around their arms and legs and blindfolded.

    “Their eyes are covered all the time. I don’t know what the security reason for this is,” he said.

    The military disputed the accounts provided to AP, saying patients were handcuffed “in cases where the security risk requires it” and removed when they caused injury. Patients are rarely diapered, it said.

    Dr. Michael Barilan, a professor at the Tel Aviv University Medical School who said he has spoken with over 15 hospital staff, disputed accounts of medical negligence. He said doctors are doing their best under difficult circumstances, and that the blindfolds originated out of a “fear (patients) would retaliate against those taking care of them.”

    Days after Oct. 7, roughly 100 Israelis clashed with police outside one of the country’s main hospitals in response to false rumors it was treating a militant.

    In the aftermath, some hospitals refused to treat detainees, fearful that doing so could endanger staff and disrupt operations. They were already overwhelmed by people wounded during the Hamas attack and expecting casualties to rise from an impending ground invasion.

    As Israel pulled in scores of wounded Palestinians to Sde Teiman, it became clear the facility’s infirmary was not large enough, according to Barilan. An adjacent field hospital was built from scratch.

    Israel’s Health Ministry laid out plans for the hospital in a December memo obtained by AP.

    It said patients would be treated while handcuffed and blindfolded. Doctors, drafted into service by the military, would be kept anonymous to protect their “safety, lives and well-being.” The ministry referred all questions to the military when reached for comment.

    Still, an April report from Physicians for Human Rights-Israel, drawing on interviews with hospital workers, said doctors at the facility faced “ethical, professional and even emotional distress.” Barilan said turnover has been high.

    Patients with more complicated injuries have been transferred from the field hospital to civilian hospitals, but it has been done covertly to avoid arousing the public’s attention, Barilan said. And the process is fraught: The medical worker who spoke with AP said one detainee with a gunshot wound was discharged prematurely from a civilian hospital to Sde Teiman within hours of being treated, endangering his life.

    The field hospital is overseen by military and health officials, but Donchin said parts of its operations are managed by KLP, a private logistics and security company whose website says it specializes in “high-risk environments.” The company did not respond to a request for comment.

    Because it’s not under the same command as the military’s medical corps, the field hospital is not subject to Israel’s Patients Rights Act, according to Physicians for Human Rights-Israel.

    A group from the Israeli Medical Association visited the hospital earlier this year but kept its findings private. The association did not respond to requests for comment.

    The military told AP that 36 people from Gaza have died in Israel’s detention centers since Oct. 7, some of them because of illnesses or wounds sustained in the war. Physicians for Human Rights-Israel has alleged that some died from medical negligence.

    Khaled Hammouda, a surgeon from Gaza, spent 22 days at one of Israel’s detention centers. He does not know where he was taken because he was blindfolded while he was transported. But he said he recognized a picture of Sde Teiman and said he saw at least one detainee, a prominent Gaza doctor who is believed to have been there.

    Hammouda recalled asking a soldier if a pale 18-year-old who appeared to be suffering from internal bleeding could be taken to a doctor. The soldier took the teenager away, gave him intravenous fluids for a few hours, and then returned him.

    “I told them, ‘He could die,’” Hammouda said. “‘They told me this is the limit.’”

    ___

    AP writer Sarah El Deeb in Beirut contributed to this report.

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  • Illness took away her voice. AI created a replica she carries in her phone

    Illness took away her voice. AI created a replica she carries in her phone

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    PROVIDENCE, R.I. — The voice Alexis “Lexi” Bogan had before last summer was exuberant.

    She loved to belt out Taylor Swift and Zach Bryan ballads in the car. She laughed all the time — even while corralling misbehaving preschoolers or debating politics with friends over a backyard fire pit. In high school, she was a soprano in the chorus.

    Then that voice was gone.

    Doctors in August removed a life-threatening tumor lodged near the back of her brain. When the breathing tube came out a month later, Bogan had trouble swallowing and strained to say “hi” to her parents. Months of rehabilitation aided her recovery, but her speech is still impaired. Friends, strangers and her own family members struggle to understand what she is trying to tell them.

    In April, the 21-year-old got her old voice back. Not the real one, but a voice clone generated by artificial intelligence that she can summon from a phone app. Trained on a 15-second time capsule of her teenage voice — sourced from a cooking demonstration video she recorded for a high school project — her synthetic but remarkably real-sounding AI voice can now say almost anything she wants.

    She types a few words or sentences into her phone and the app instantly reads it aloud.

    “Hi, can I please get a grande iced brown sugar oat milk shaken espresso,” said Bogan’s AI voice as she held the phone out her car’s window at a Starbucks drive-thru.

    Experts have warned that rapidly improving AI voice-cloning technology can amplify phone scams, disrupt democratic elections and violate the dignity of people — living or dead — who never consented to having their voice recreated to say things they never spoke.

    It’s been used to produce deepfake robocalls to New Hampshire voters mimicking President Joe Biden. In Maryland, authorities recently charged a high school athletic director with using AI to generate a fake audio clip of the school’s principal making racist remarks.

    But Bogan and a team of doctors at Rhode Island’s Lifespan hospital group believe they’ve found a use that justifies the risks. Bogan is one of the first people — the only one with her condition — who have been able to recreate a lost voice with OpenAI’s new Voice Engine. Some other AI providers, such as the startup ElevenLabs, have tested similar technology for people with speech impediments and loss — including a lawyer who now uses her voice clone in the courtroom.

    “We’re hoping Lexi’s a trailblazer as the technology develops,” said Dr. Rohaid Ali, a neurosurgery resident at Brown University’s medical school and Rhode Island Hospital. Millions of people with debilitating strokes, throat cancer or neurogenerative diseases could benefit, he said.

    “We should be conscious of the risks, but we can’t forget about the patient and the social good,” said Dr. Fatima Mirza, another resident working on the pilot. “We’re able to help give Lexi back her true voice and she’s able to speak in terms that are the most true to herself.”

    Mirza and Ali, who are married, caught the attention of ChatGPT-maker OpenAI because of their previous research project at Lifespan using the AI chatbot to simplify medical consent forms for patients. The San Francisco company reached out while on the hunt earlier this year for promising medical applications for its new AI voice generator.

    Bogan was still slowly recovering from surgery. The illness started last summer with headaches, blurry vision and a droopy face, alarming doctors at Hasbro Children’s Hospital in Providence. They discovered a vascular tumor the size of a golf ball pressing on her brain stem and entangled in blood vessels and cranial nerves.

    “It was a battle to get control of the bleeding and get the tumor out,” said pediatric neurosurgeon Dr. Konstantina Svokos.

    The 10-hour length of the surgery coupled with the tumor’s location and severity damaged Bogan’s tongue muscles and vocal cords, impeding her ability to eat and talk, Svokos said.

    “It’s almost like a part of my identity was taken when I lost my voice,” Bogan said.

    The feeding tube came out this year. Speech therapy continues, enabling her to speak intelligibly in a quiet room but with no sign she will recover the full lucidity of her natural voice.

    “At some point, I was starting to forget what I sounded like,” Bogan said. “I’ve been getting so used to how I sound now.”

    Whenever the phone rang at the family’s home in the Providence suburb of North Smithfield, she would push it over to her mother to take her calls. She felt she was burdening her friends whenever they went to a noisy restaurant. Her dad, who has hearing loss, struggled to understand her.

    Back at the hospital, doctors were looking for a pilot patient to experiment with OpenAI’s technology.

    “The first person that came to Dr. Svokos’ mind was Lexi,” Ali said. “We reached out to Lexi to see if she would be interested, not knowing what her response would be. She was game to try it out and see how it would work.”

    Bogan had to go back a few years to find a suitable recording of her voice to “train” the AI system on how she spoke. It was a video in which she explained how to make a pasta salad.

    Her doctors intentionally fed the AI system just a 15-second clip. Cooking sounds make other parts of the video imperfect. It was also all that OpenAI needed — an improvement over previous technology requiring much lengthier samples.

    They also knew that getting something useful out of 15 seconds could be vital for any future patients who have no trace of their voice on the internet. A brief voicemail left for a relative might have to suffice.

    When they tested it for the first time, everyone was stunned by the quality of the voice clone. Occasional glitches — a mispronounced word, a missing intonation — were mostly imperceptible. In April, doctors equipped Bogan with a custom-built phone app that only she can use.

    “I get so emotional every time I hear her voice,” said her mother, Pamela Bogan, tears in her eyes.

    “I think it’s awesome that I can have that sound again,” added Lexi Bogan, saying it helped “boost my confidence to somewhat where it was before all this happened.”

    She now uses the app about 40 times a day and sends feedback she hopes will help future patients. One of her first experiments was to speak to the kids at the preschool where she works as a teaching assistant. She typed in “ha ha ha ha” expecting a robotic response. To her surprise, it sounded like her old laugh.

    She’s used it at Target and Marshall’s to ask where to find items. It’s helped her reconnect with her dad. And it’s made it easier for her to order fast food.

    Bogan’s doctors have started cloning the voices of other willing Rhode Island patients and hope to bring the technology to hospitals around the world. OpenAI said it is treading cautiously in expanding the use of Voice Engine, which is not yet publicly available.

    A number of smaller AI startups already sell voice-cloning services to entertainment studios or make them more widely available. Most voice-generation vendors say they prohibit impersonation or abuse, but they vary in how they enforce their terms of use.

    “We want to make sure that everyone whose voice is used in the service is consenting on an ongoing basis,” said Jeff Harris, OpenAI’s lead on the product. “We want to make sure that it’s not used in political contexts. So we’ve taken an approach of being very limited in who we’re giving the technology to.”

    Harris said OpenAI’s next step involves developing a secure “voice authentication” tool so that users can replicate only their own voice. That might be “limiting for a patient like Lexi, who had sudden loss of her speech capabilities,” he said. “So we do think that we’ll need to have high-trust relationships, especially with medical providers, to give a little bit more unfettered access to the technology.”

    Bogan has impressed her doctors with her focus on thinking about how the technology could help others with similar or more severe speech impediments.

    “Part of what she has done throughout this entire process is think about ways to tweak and change this,” Mirza said. “She’s been a great inspiration for us.”

    While for now she must fiddle with her phone to get the voice engine to talk, Bogan imagines an AI voice engine that improves upon older remedies for speech recovery — such as the robotic-sounding electrolarynx or a voice prosthesis — in melding with the human body or translating words in real time.

    She’s less sure about what will happen as she grows older and her AI voice continues to sound like she did as a teenager. Maybe the technology could “age” her AI voice, she said.

    For now, “even though I don’t have my voice fully back, I have something that helps me find my voice again,” she said.

    ___

    The Associated Press and OpenAI have a licensing and technology agreement that allows OpenAI access to part of AP’s text archives.

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  • Town Meeting OKs budget, local option taxes in first night

    Town Meeting OKs budget, local option taxes in first night

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    MARBLEHEAD — Town Meeting approved local meals and rooms taxes in its opening night, but technological hiccups ultimately forced the meeting to pause after Article 26, leaving the back-half of the warrant for night two on Tuesday.

    A smattering of technical issues plagued the opening of Town Meeting, causing it to take more than an hour to move through procedural articles. Issues ranged from audio cutting out in the overflow chamber outside of the middle school’s auditorium and video projector issues that prevented the timely display of the articles being voted on. The issues were finally ironed out by about 8:40 p.m., nearly two hours in.

    The meeting also saw the successful launch and use of an electronic clicker system for vote tracking, which showed that Town Meeting opened with more than 800 people when a vote of 704 to 97 was tallied to close out Article 6. More than an hour later, a narrow, three-vote margin was tabulated in 20 seconds with no need for further verification or manual tallying.

    Dozens of Marblehead union employees lined the entrance to the auditorium at Veterans Middle School prior to the start of the meeting, calling for a restoration of prior cuts that took place to balance prior budgets.

    “There’s no more room to cut that budget,” said Jonathan Heller, co-chairperson of the Marblehead Education Association. “They’ve been able to bridge between a reduced budget and level-service budget. That’s what we’re hoping this town will approve tonight, to get us back to level budget at first.”

    The unions were quiet during the meeting, however, with a brief comment from Terri Tauro, president of the Marblehead Municipal Employees Union, on an indefinitely postponed article on the police contract. 

    “I’d like to start with a shout-out to our town employees,” Tauro said. “Marblehead’s town employees educate your children and keep them safe. We keep your power on, plow the snow, and care for your aging parents. 

    “For many of us, the wages we make working for the town are far less than what it would take to live in the town,” Tauro said. “It may soon be that our wages won’t cover living in this state. Massachusetts is, after all, the fourth most expensive state in this country to live.”

    The first articles to receive substantial debate were 24 and 25, two measures to add meals and lodging taxes, with each factoring in generating about $200,000 in revenue for the budget passed in Article 26. 

    Debate also focused on the reported 261 short-term rental units that exist and are presently untaxed in Marblehead, a group of property owners that one resident Monday night suggested would put the town’s only two hotels at a competitive disadvantage.

    Carolyn Pyburn, of Gilbert Heights Road, sought instead to lower the 6% proposed for the rooms tax down to 4%. That vote failed by a razor-thin margin of 391 to 394 — a result that arrived within 20 seconds with the new voting method.

    “This is another no-brainer,” said Albert Jordan, a Roosevelt Avenue resident, of the rooms tax. “There’s 351 communities in Massachusetts, and most of them are doing this.”

    Peter Conway, an Orchard Street resident, raised another issue with the tax: That many rooms are paid for in advance.

    “You can’t go back to the guests who’ve made a contract with you,” Conway said of hotels. “To be fair, that would have to be put off until at least the fall to give the businesses the chance to reach out to people.”

    Article 24, the meals tax, passed 515 to 294. The main vote for the rooms tax, after the failed amendment, was 469 to 345. The budget then passed 611 to 63 after a series of votes on individual departments and appropriations that reflected similar approval margins.

    The meeting was adjourned following the budget, leaving articles 27 through 53 for night two, Tuesday, beginning at 7 p.m.

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    By Dustin Luca | Staff Writer

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  • She was too sick for a traditional transplant. So she received a pig kidney and a heart pump

    She was too sick for a traditional transplant. So she received a pig kidney and a heart pump

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    NEW YORK — Doctors have transplanted a pig kidney into a New Jersey woman who was near death, part of a dramatic pair of surgeries that also stabilized her failing heart.

    Lisa Pisano’s combination of heart and kidney failure left her too sick to qualify for a traditional transplant, and out of options. Then doctors at NYU Langone Health devised a novel one-two punch: Implant a mechanical pump to keep her heart beating and days later transplant a kidney from a genetically modified pig.

    Pisano is recovering well, the NYU team announced Wednesday. She’s only the second patient ever to receive a pig kidney — following a landmark transplant last month at Massachusetts General Hospital – and the latest in a string of attempts to make animal-to-human transplantation a reality.

    This week, the 54-year-old grasped a walker and took her first few steps.

    “I was at the end of my rope,” Pisano told The Associated Press. “I just took a chance. And you know, worst case scenario, if it didn’t work for me, it might have worked for someone else and it could have helped the next person.”

    Dr. Robert Montgomery, director of NYU Langone Transplant Institute, recounted cheers in the operating room as the organ immediately started making urine.

    “It’s been transformative,” Montgomery said of the experiment’s early results.

    But “we’re not off the hook yet,” cautioned Dr. Nader Moazami, the NYU cardiac surgeon who implanted the heart pump.

    “With this surgery I get to see my wife smile again,” Pisano’s husband Todd said Wednesday.

    Other transplant experts are closely watching how the patient fares.

    “I have to congratulate them,” said Dr. Tatsuo Kawai of Mass General, who noted that his own pig kidney patient was healthier overall going into his operation than NYU’s patient. “When the heart function is bad, it’s really difficult to do a kidney transplant.”

    More than 100,000 people are on the U.S. transplant waiting list, most who need a kidney, and thousands die waiting. In hopes of filling the shortage of donated organs, several biotech companies are genetically modifying pigs so their organs are more humanlike, less likely to be destroyed by people’s immune system.

    NYU and other research teams have temporarily transplanted pig kidneys and hearts into brain-dead bodies, with promising results. Then the University of Maryland transplanted pig hearts into two men who were out of other options, and both died within months.

    Mass General’s pig kidney transplant last month raised new hopes. Kawai said Richard “Rick” Slayman experienced an early rejection scare but bounced back enough to go home earlier this month and still is faring well five weeks post-transplant. A recent biopsy showed no further problems.

    Pisano is the first woman to receive a pig organ — and unlike with prior xenotransplant experiments, both her heart and kidneys had failed. She went into cardiac arrest and had to be resuscitated before the experimental surgeries. She’d gotten too weak to even play with her grandchildren. “I was miserable,” the Cookstown, New Jersey, woman said.

    A failed heart made her ineligible for a traditional kidney transplant. But while on dialysis, she didn’t qualify for a heart pump, called a left ventricular assist device or LVAD, either.

    “It’s like being in a maze and you can’t find a way out,” Montgomery explained — until the surgeons decided to pair a heart pump with a pig kidney.

    With emergency permission from the Food and Drug Administration, Montgomery chose an organ from a pig genetically engineered by United Therapeutics Corp. so its cells don’t produce a particular sugar that’s foreign to the human body and triggers immediate organ rejection.

    Plus a tweak: The donor pig’s thymus gland, which trains the immune system, was attached to the donated kidney in hopes that it would help Pisano’s body tolerate the new organ.

    Surgeons implanted the LVAD to power Pisano’s heart on April 4, and transplanted the pig kidney on April 12. There’s no way to predict her long-term outcome but she’s shown no sign of organ rejection so far, Montgomery said. And in adjusting the LVAD to work with her new kidney, Moazami said doctors already have learned lessons that could help future care of heart-and-kidney patients.

    Special “compassionate use” experiments teach doctors a lot but it will take rigorous studies to prove if xenotransplants really work. What happens with Pisano and Mass General’s kidney recipient will undoubtedly influence FDA’s decision to allow such trials. United Therapeutics said it hopes to begin one next year.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Capital Region chef receives kidney transplant

    Capital Region chef receives kidney transplant

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    ALBANY, N.Y. (NEWS10) — The family of a beloved Capital Region chef and philanthropist shared an update on his health. Yono Purnomo received a kidney from a living donor on Tuesday.

    Purnomo had been on a months-long search for a kidney after being diagnosed with end stage renal failure in 2023. NEWS10’s Trishna Begam interviewed the restauranteur about his health and how dialysis multiple times a day changed his life.

    His surgery took place Tuesday morning at New York City’s Presbyterian Hospital. He and his donor are both recovering. Purnomo’s family said both are doing well, and they thank everyone for their continued support and prayers.

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    Courtney Ward

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  • Unbelievable facts

    Unbelievable facts

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    The surgery is called orthognathic surgery. It’s a long haul, usually over 3 years, and…

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  • Red Sox pitcher Lucas Giolito to undergo right elbow surgery, potentially ending his season

    Red Sox pitcher Lucas Giolito to undergo right elbow surgery, potentially ending his season

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    FORT MYERS, Fla. — Boston Red Sox pitcher Lucas Giolito will undergo right elbow surgery on Tuesday, potentially ending his first season with the team before it even begins.

    Manager Alex Cora confirmed the development to reporters on Monday. The decision comes after Giolito traveled to Alabama last week to get a second opinion from Dr. Jeffrey R. Dugas.

    “Lucas is having surgery tomorrow. The extent of it, we don’t know yet. We know it’s with the ligament,” manager Alex Cora said. “So we’ll know more tomorrow when they go in. The type of surgery, we don’t know yet.”

    Giolito, who signed a $38.5 million, two-year deal with the Red Sox, made two starts in spring training. He tossed a pair of scoreless innings in his first outing before reporting discomfort in the elbow after getting tagged for four runs and three walks in 2 1/3 innings against Minnesota on March 1.

    This will be the second major right-elbow surgery for the 29-year-old Giolito. The right-hander had Tommy John surgery on Aug. 31, 2012, less that two months after Washington made him the top overall pick in the 2012 amateur draft.

    Giolito reached the majors in 2016 with Washington. He was an All-Star in 2019 while pitching for the Chicago White Sox and has been reliable during his big-league career, throwing at least 160 innings in five of the last six seasons.

    ___

    AP MLB: https://apnews.com/MLB

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  • WTF Fun Fact 13694 – History of the Chainsaw

    WTF Fun Fact 13694 – History of the Chainsaw

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    The history of the chainsaw, a tool linked with forestry and tree felling, has its roots in surgical practice. Specifically, it aided in childbirth.

    Medical Origins of the Chainsaw

    The initial conception of the chainsaw was far removed from the lumber yards. Invented by Scottish doctors John Aitken and James Jeffray, it was designed to address a specific challenge in childbirth. According to the 1785 edition of “Principles Of Midwifery, Or Puerperal Medicine,” this crude yet innovative device was intended for use in symphysiotomy procedures. They widen the pubic cartilage and remove obstructive bone. The goal is to facilitate the delivery process when the baby becomes stuck in the birth canal.

    This “flexible saw,” as it was described, allowed for the precise cutting away of flesh, cartilage, and bone. Despite its gruesome application, the invention was a medical breakthrough. It also offered a new solution to a life-threatening dilemma faced by mothers and babies.

    The Chainsaw Through History

    The chainsaw’s medical use continued into the 19th century, with the development of the osteotome by German physician Bernhard Heine in 1830. This device, further refined the concept of the chainsaw for surgical purposes. “The Lancet London” described it as comprising two plates that contained a toothed wheel operated by a handle to cut through bone and tissue.

    However, the narrative of the chainsaw took a significant turn at the start of the 20th century, moving beyond the confines of the operating room to the great outdoors.

    Birth of the Modern Chainsaw

    The transformation of the chainsaw into a tool for woodcutting began earnestly in the late 19th and early 20th centuries. Patents filed in 1883 for the Chain Sawing Machine and in 1906 for the Endless Chain Saw laid the groundwork for its application in producing wooden boards and felling giant redwoods. By 1918, Canadian James Shand patented the first portable chainsaw. This marked a new era for the chainsaw’s use in forestry.

    Andreas Stihl subsequently developed and patented the electric chainsaw in 1926. Then came the gas-powered model in 1929. This made the tool more accessible and efficient for logging activities. These early models were large and required two men to operate. They set the stage for post-World War II advancements that made chainsaws lighter and more user-friendly, allowing single-person operation.

    — WTF fun facts

    Source: “Why were chainsaws invented?” — BBC Science Focus

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    WTF

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  • SENIOR LOOKOUT: Dealing with hearing loss can stave off dementia

    SENIOR LOOKOUT: Dealing with hearing loss can stave off dementia

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    Hearing loss is one of the most common conditions affecting older adults. According to the National Institute on Deafness and Other Communication Disorders, one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing.

    The effect of hearing loss on an older person can be devastating. Having trouble hearing can make it hard to understand and follow a doctor’s advice. Hearing doorbells and alarms becomes difficult. Having conversations becomes hard. This can be frustrating, embarrassing and at worse, dangerous.

    But, these are not the only problems that can follow hearing loss.

    In a study that tracked 639 adults for nearly 12 years, a Johns Hopkins research team found that mild hearing loss doubled dementia risk. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.

    There are options to help with hearing loss, but first you need to detect its occurrence. Here are some questions based on a tool for hearing loss. If you answer yes to three or more of these questions you could have a hearing problem and you should check with your doctor. Do you:

    Sometimes feel embarrassed when you meet new people because you struggle to hear?

    Feel frustrated when talking to members of your family because you have difficulty hearing them?

    Have difficulty hearing when someone speaks in a whisper?

    Feel restricted or limited by a hearing problem?

    Attend religious services less often than you would like because of hearing problem?

    Argue with family members because of hearing problem?

    Have trouble hearing the TV or radio at levels that are loud enough for others?

    Believe that any difficulty with your hearing limits your personal or social life?

    Have trouble hearing family or friends when you are together in a restaurant? Or when visiting friends, relatives, or neighbors?

    Hearing loss can happen for a number of different reasons. Hearing loss might be a genetic trait or may be caused by illness or injury. Another reason for hearing loss is having been exposed to extended periods of loud noise. Many construction workers, farmers, musicians, airport workers, and people in the armed forces are subject to hearing loss.

    There are ways to address hearing loss. You must determine what works best for you and your circumstances. Here are a few ways to counteract hearing loss:

    Hearing aids. They make sounds louder. Often things will sound different than you are used to, which can make getting use to a hearing aid difficult. You may need to try a number of hearing aids before you find the one that works for you.

    Cochlear implants. These are small electronic devices surgically implanted in the inner ear. These implants are for people whose hearing loss is severe.

    Assistive listening device. These include amplifying devices for the telephone, or cell phone. They can also be helpful in places of worship, theaters, and auditoriums.

    Lip reading. People who use this method pay close attention to others when they talk, by watching how the speaker’s mouth moves.

    Hearing aids and other devices are rarely covered by insurance, and they are not inexpensive. But, the cost to the individual with hearing loss is much more in loss of quality of life.

    SeniorCare keeps a list of organizations that assist with hearing aids and other hearing assistance devices. To learn more, call SeniorCare at 978-281-1750 or TTY: 978-282-1836 and ask to speak with an information and referral specialist.

    Tracy Arabian is the communications officer at SeniorCare Inc., a local agency on aging that serves Gloucester, Beverly, Essex, Hamilton, Ipswich, Manchester-by-the-Sea, Rockport, Topsfield and Wenham.

    Tracy Arabian is the communications officer at SeniorCare Inc., a local agency on aging that serves Gloucester, Beverly, Essex, Hamilton, Ipswich, Manchester-by-the-Sea, Rockport, Topsfield and Wenham.

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    Senior Lookout | Tracy Arabian

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  • South Korea orders striking doctors to return to work as their walkouts burden hospital operations

    South Korea orders striking doctors to return to work as their walkouts burden hospital operations

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    SEOUL, South Korea — South Korea on Wednesday officially ordered thousands of striking doctors to return to work immediately, a step that could lead to legal punishments if the doctors don’t end their walkouts, which have caused numerous cancellations of surgeries and other treatments at hospitals.

    About 7,800 medical interns and residents in South Korea have walked off their jobs this week to protest the government’s push to recruit more medical students.

    Officials say they want to increase the nationwide medical school admissions cap by 2,000 from next year to brace for South Korea’s rapidly aging population. But doctors’ groups have refuted the plan, saying universities aren’t ready to offer quality education to that many students. They also say the government’s plan would lead to increased public medical expenses since it lacks measures for how to raise low medical fees in some key professions.

    The 2,000 additional admissions “is a nonsensical figure,” the Korean Intern Residents Association said in a statement Tuesday. “We hope the government will rethink its plan and formulate a policy that reflects the voices of trainee doctors.”

    Junior doctors typically support senior doctors during surgeries and treat patients in hospitals. Their joint walkouts have burdened hospital operations. The Health Ministry said Wednesday that authorities have received 58 public complaints over the walkouts, mostly regarding indefinite delays of surgeries and cancellations of other medical treatments.

    The government on Wednesday accused the trainee doctors of putting their rights before the lives of patients.

    “The fundamental responsibility of medical personnel is caring for the lives and health of the people. I would say once again that any collective action that threatens this cannot be justified,” Vice Health Minister Park Min-soo told reporters.

    Park said as of Tuesday night about 8,820 out of the country’s 13,000 trainee doctors have submitted resignations to their hospitals. None of their resignations has been approved, but about 7,810 of the doctors have left their work sites, Park said.

    Park said the government issued an official order for most of the striking doctors to return to work.

    South Korea’s medical law allows the government to issue such back-to-work orders to doctors and other medical personnel when there are concerns about public health. If they refuse to abide by the order, they could face up to three years in prison or 30 million won ($22,480) in fines, a punishment that would also lead to the revocation of their medical licenses, according to the law.

    Park didn’t detail possible punishments but said the government would enforce the law in a principled manner. He called for dialogue with the striking doctors.

    Trainee doctors said the government’s return-to-work order was intimidation and must be withdrawn immediately.

    To deal with the trainee doctors’ walkouts, the government has opened military hospitals to the public, extended the operating hours of public medical institutions and had emergency medical treatment centers stay open around the clock. But observers say if the walkouts are prolonged or joined by senior doctors, that could cause major disruptions in South Korea’s overall medical service.

    South Korea has a total of 140,000 doctors. The Korea Medical Association said it plans to hold rallies to support the trainees but hasn’t determined whether to launch strikes.

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  • South Korean doctors walk out to protest medical training push, causing surgery cancellations

    South Korean doctors walk out to protest medical training push, causing surgery cancellations

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    SEOUL, South Korea — South Korean trainee doctors collectively walked off their jobs Tuesday to protest a government push to recruit more medical students, triggering cancellations of surgeries and other medical treatments at hospitals.

    The Health Ministry urged them to return to work immediately, saying they must not endanger the lives of patients to fight the government.

    As of Monday night, more than half of the 13,000 medical interns and residents in South Korea had submitted resignations, according to the Health Ministry, and 1,630 left their work sites. None of the resignations have been accepted so far.

    More junior doctors are expected to follow suit. Under a decision made by their association last week, trainee doctors at the country’s five major hospitals were supposed to walk off collectively on Tuesday.

    At the center of the dispute is a recent government announcement that universities would admit 2,000 more medical students starting from next year, from the current 3,058. The government says it aims to add up to 10,000 doctors by 2035 to address what it calls a shortage of doctors exacerbated by the country’s fast-aging population.

    South Korea’s doctor-to-patient ratio is among the lowest in the developed world, particularly in essential but low-paying professions like pediatrics and emergency departments, and in rural areas.

    Many doctors rejected the plan, saying that schools won’t be able to handle so many new students and that the funding is more urgently needed to raise medical fees. Some argue that having too many doctors could also lead to unnecessary medical treatments due to increased competition.

    “Because of a bungled policy that ignores reality on the ground, I can fold up my dream of becoming a specialist in the pediatric emergency department without any regrets,” Park Dan, head of the Korean Intern Residents Association, wrote on Facebook on Monday, after submitting his resignation to Seoul’s Severance Hospital. “I have no intention of returning to work.”

    The doctors’ protests have failed to generate public support, with a survey suggesting about 75% of South Koreans support the government’s push to train more doctors. Their critics argue that doctors are mainly worried their incomes would drop if there were more doctors.

    “I think trainee doctors are fighting for their own interests,” said Seo Hong Soon, a 74-year-old housewife, speaking on Tuesday near Seoul National University Hospital. “We want them to remember the Hippocratic oath and make concessions. We hope they will put their duty before money.”

    Most of South Korea’s 13,000 trainee doctors work at its 100 teaching hospitals, assisting senior doctors during surgery and treating inpatients. If their walkouts are prolonged or joined by senior doctors, that could cause disruptions at those hospitals and in South Korea’s overall medical service, observers say.

    South Korea has a total of 140,000 doctors. The Korea Medical Association said Monday it plans to hold rallies to support the trainees but hasn’t determined whether to launch strikes.

    At Seoul’s Asan Medical Center, a nurse said it’s unclear how long senior doctors could keep performing surgeries and other treatments without the assistance of junior doctors. The nurse, who requested anonymity citing the sensitivity of the issue, said that trainees typically handle skin incision and disinfection during surgeries at the direction of senior doctors and manage data on hospital computers.

    She said her hospital plans to delay admissions for some cancer patients and to release inpatients early. Other Asan hospital officials said Tuesday that an unspecified number of junior doctors didn’t come to work but noted some were still working. They said the hospital is rearranging planned surgery schedules based on the conditions of patients.

    Vice Health Minister Park Min-soo said authorities have received 34 public complaints related to the walkouts, 25 of them over the cancellation of surgeries. Other cases include hospitals refusing to treat patients and canceling planned medical treatments.

    “If you leave your patients to oppose a government policy despite knowing what your collective action would cause, that will never be justified,″ Park said. “We appeal to trainee doctors to return to patients. An act of endangering the lives of patients to express your opinions is something that you must not do.”

    Lee Geon-ju, head of an association of lung cancer patients, posted a YouTube message calling for doctors and government officials to end their squabbling.

    “For whatever reasons, doctors must not neglect patients to prevent them from failing to receive urgent surgeries and other treatments,” said Lee, who called himself a terminally ill cancer patient.

    ___

    Associated Press video journalist Yong Jun Chang contributed to this report.

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  • Clues to early onset colorectal cancer found in microbiome of Hispanic patients

    Clues to early onset colorectal cancer found in microbiome of Hispanic patients

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    Nina Sanford, M.D., Chief of Gastrointestinal Radiation Oncology Service, UT Southwestern Medical Center

    Most people have a screening colonoscropy around age 50, however recent research has uncovered a rise in early onset colorectal cancer in patients younger than 50.

    What can be causing this increase?

    Dr. Sanford and colleagues at UT Southwestern Medical Center have found a clue in the microbiome of colorectal patients of Hispanic ethnicity, recently published in the Journal of Immunotherapy and Precision Oncology.

    “The increasing incidence of early-onset colorectal cancer, defined as a diagnosis of CRC in patients aged less than 50 years, has become a growing concern over the last four decades.This trend is particularly associated with rectal tumors, with notable racial and ethnic disparities in presentation and outcome.For instance, Black individuals have the highest EOCRC incidence and mortality rates, whereas Hispanic patients, despite overall lower overall incidence, tend to be diagnosed at younger ages compared to non-Hispanic White individuals.”

    For a copy of the full paper and interviews, please contact Lori Soderbergh.

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    UT Southwestern Medical Center

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