The Bleak Hopelessness and Despair of Suicide

"People can have a cognitive shutdown or blank, as any of us do, when we can't remember things during times of extreme stress."
"[Having a three-digit hotline would] facilitate people's access to care at times when they are in dire need."
Madelyn Gould, psychiatrist, Columbia University

Suicide prevention phone numbers and red mock tombstones designating some of the more than 1,000 people who took their lives by suicide in Washington state in 2017 are displayed on a grassy area in March 2019, in Olympia, Wash. (Ted S. Warren/Associated Press)

"People tell you how they feel every day at every moment [on line]. People don't realize that they are putting out these signals. The beauty of AI is that it's all training data. We don't know who anyone is. We're not reading stuff. Everything is just converted to numbers. It's very clinical and non-invasive."
"You can't always prevent suicide, but it is valuable to know who is at risk and who is not at risk."
"The more we're trained to help our friends, the more power we have. Research can't be the magic answer. We still have to interact."
"I'm excited about the next couple of years. We will go from 'We built it' to 'This is what we are going to do with it'."
"In science, you can be on the frontier, or you can be in the application. In psychiatry, there's a big need for application. I think there's room for tools that do something different. It's exciting when you find something that you think is true, and  you can build something that hasn't been built before."
Zachary Kaminsky, molecular biologist, researchers, Royal Ottawa Mental Health Centre

In the United States the issue of suicides is of such concern that Congress, intending to help in the nation's growing suicide epidemic pushed for a three-digit number for the national suicide prevention hotline, in the hopes of saving lives. Seconds count in responding to people's extreme emotional distress, dialling 911 proved of little help and the current 11-digit U.S. national hotline number eluded desperate people's memory at times of high emotional stress.

Canada is struggling with a similar situation where on a daily basis people feel hopeless enough to commit suicide, at the estimated rate of 11 individuals daily, with 100,000 attempting to kill themselves every year. And so, the 9-8-8 innovation dialing code for the national suicide prevention hotline that went into effect at the turn of the year has attracted the attention of activists attempting to persuade government authorities to follow suit in Canada with its 988 Campaign for Canada.

Now, a researcher with the Royal Ottawa Mental Health Centre, formerly with Johns Hopkins University, has conducted novel research in artificial intelligence and the detection of suicidal ideation. Artificial intelligence capable of assessing millions of social media posts to isolate words or images to send up a red flag identifying thoughts of suicide. Adolescents whose growing incidence of suicide horrifies society, often disclose suicide risk factors on social media rather than speak to family or doctors.

In June, 2018, food writer Hadley Tomicki is accompanied by his daughter Kira as he takes a picture of a mural of Anthony Bourdain in Santa Monica, Calif. The culinary celebrity and documentarian killed himself on June 8, just a few weeks before his 62nd birthday.  Chris Pizzello/The Associated Press

By transforming data into a mathematical score, artificial intelligence has the capacity to aid in suicide prevention, according to Dr. Kaminsky, the DIFD Mach-Gaensslen chair in suicide prevention research at The Royal's institute of mental health research. In the recent space of ten months, five University of Ottawa students committed suicide, shocking the university, the city and health care providers. According to Algonquin College, a 2010 survey of students at the college saw 11 percent reporting having considered suicide within a previous 12 month-period.

People have a tendency to place their most candid thinking and personal information on social media. The question was, how to make  use of the information in hopes of preventing suicides. Reading hundreds of thousands of posts represented an impossible task. Which led Dr.Kaminsky to the thought that artificial intelligence could be trained to recognize words and patterns of words and then automatically respond; through an algorithm that might send a suicidal person information on counselling, as an example.

Dr. Zachary Kaminsky  Tony Caldwell/Postmedia

Prevention campaigns in schools or neighbourhoods could be deployed through an AI system used to discover 'hot spots' for suicidal thinking. AI has the potential to isolate the ten percent of the general population thinking of suicide from the 0.5 percent that tend to act on their thoughts. Dr.Kaminsky points out that predictions linked to individuals cannot ever be failsafe; false negatives will always occur.

The researcher's two-year initial study scanned Twitter accounts from English-speakers worldwide. Tests screened for words like 'burden, loneliness, stress, depression, insomnia, anxiety', and 'hopelessness'.  Words specifically selected since researchers acknowledged they were related to feelings experienced by suicidal people who often think of themselves as a burden to others, as an example.

Machine learning results in artificial intelligence reaching beyond the initial words to identify patterns and networks of other associated words such as 'love', a commonly-used word among people thinking of suicide, distressed through the breakdown of romantic relationships. Math is used to allocate each Twitter feed with multiple scores, capable of plotting a year's worth of scores rather than a year's worth of tweets, and in the process illustrating patterns of thought.

Some people, noted Dr.Kaminsky, tend to feel better once they tweet about suicide, whereas some people tend to feel worse. A large, sympathetic response from within a social network has the potential to help people feel better about themselves. The algorithm has been tested solely on Twitter but the technique can lend itself for use with other social media, based on images rather than words.

Suzanne and Raymond Rousson point to a collage of photographs of their son, Sylvain, at their home south of Ottawa. Sylvain killed himself last January. He was 27.

Preserving Wild Animal Populations From Extinction

"[Reporting the results of four visits to Mong La] the wildlife trafficking capital of the world [the writers] observed 42 bags of scales, 32 whole skins, 15 fetuses or pangolin parts in wine, and 27 whole pangolins for sale."
Global Ecology and Conservation

"If we heed the warning not only will we protect human life but we could actually save species like pangolins."
Peter Kights, CEO, WildAid

"The problem is not the animals, it's that we get in contact with them."
Sara Platto, professor, animal behaviour, Jianghan University, Wuhan

"If the illegal animal trade was at the root of this outbreak, it is going to be really difficult to trace, and I suspect most of the evidence is gone already – destroyed or spread out across the black market." 
"People aren't going to want to talk, because of the consequences [of the illegal trade and consequent penalties." 
Texas A&M University virologist Benjamin Neuman

Wildlife such as the pangolin, a scaly ant-eating mammal, could be the b eneficiaries of the recent coronavirus outbreak, which is believed to have begun with the consumption of wild meats.  Getty Images

Pangolin meat, characterized as "dark with a sticky, stringy texture" is a sought-after dinner table delicacy in some areas of the world. There are claims that pangolin scales which cover the body of the small creatures -- keratin, like human fingernails, and rhinoceros horns are useful in treating a wide range of ailments, from infertility to rheumatoid arthritis making them a sought-after ingredient in traditional medicine and folk remedies.

It is difficult to change cultures, all the more so when they have the staying power and influence of tradition. That the South China Morning Post reported in 2018: "There is no scientific evidence showing that pangolin scales are effective as a treatment" may appeal to rational intelligence is expected, but at the same time there is nothing either rational or intelligent in beliefs based on faith in tradition.

Two continents, Africa and Asia, play host to eight species of pangolin, all known to be vulnerable or critically endangered. Despite being considered a protected species through international trade law, a million of their number has been trafficked in the past decade, according to the World Wildlife Fund. A short while ago, 9,500 kilograms of pangolin scales were seized by officials from shipping containers in Nigeria, representing a likely 20,000 animals taken from the wild.

A trade ban has been in place since 2017, and shipments such as that violate the ban, an occurrence that is becoming more common, representing organized criminal networks expanding their business from ivory to pangolins. Scientists, in view of the current epidemic of COVID-19 and the new and growing threat of zoonotics -- viruses leaping from wild animals to humans -- suspect pangolins may have been the source of the new coronavirus.

Nature recently reported "So far, the closest match to the human coronavirus has been found in a bat in China's Yunnan province". The quote above from the journal Global Ecology and Conservation, represents a finding by researchers Vincent Nijman, Ming Xia Zhang and Chris Shepherd when they took stock of what was popularly for sale at the Mong La wildlife market, located on the border of southwestern China and Shan State in Myanmar where pangolin wine is seen for sale.

The researchers had estimated that pangolin products were valued at close to a million a year sold in Myanmar, but fetched much higher prices once the forbidden goods crossed into China "where prices of pangolins and their parts have risen considerably over the last decade". The World Wildlife Fund estimates the value of wild species trafficking as a whole to be roughly $20 million in annual value.

The timid, scaly pangolin is thought to be among the most highly poached mammals in the world. The animal had been implicated in the coronavirus outbreak earlier in the month by researchers at the South China Agricultural University. According to the experts there, pangolins appear to be the intermediary in the virus jump to humans, but "the mystery is far from solved", reported Nature.

"I do think the government has seen the toll it takes on [the] national economy and society is much bigger than the benefit that wild-eating business rings", observed Jeff He, China director at the International Fund for Animal Welfare. In a move to halt the spread of the coronavirus, officials in China have issued an order to ban all consumption of wild animal meat, inclusive of pangolins, peacocks, civets, turtles and badgers.

Should such an order be brought into permanent legislation, after the emergency fears of viral contamination leading to COVID-19 infection, it would repesent a great leap forward for the preservation of animal species now threatened with extinction resulting from the voracious appetite in China for exotic animal species, but it would require a commitment on the part of the government to expunge this particular tradition from its cuisine and pharmacological culture.

Pangolins, the most trafficked mammal in the world after humans, could be the cause of the coronavirus outbreak.

(photo credit: Wikimedia Commons)

Immoral Sadistic Behaviour Has Consequences

"The prison van might as well have been a spaceship, because it put me into a whole new world. I liken it to arriving in North Korea."

"The sights, smells, sounds, the language the other prisoners speak was all alien to me. Most middle-class prisoners will come across as slightly different to the rest. They're not of the villainous nature, they probably speak slightly differently, they probably, don't understand the language."

"[Then, about six months in, clients will reach their] realization point -- when the adrenalin stops pumping. You've realized this is your home now, and then the enormity hits you, and t he stress you put on your family. That's a massive low point."

"It took me about two weeks to get through. It happens with everybody. I get calls from concerned relatives."

Steve Dagworthy, 44, financial broker, founder, Prison Consultants, U.K.

"When I went in, I kept looking to the guards for guidance on what you do and when you do it, and quickly found out that that was absolutely the wrong thing to do."

"It's typical for people who are sentenced to long terms in prison to despair. But what eventually happens is that your former life falls away. So it's not 'what am I missing -- my girlfriend, my family/' Instead, it's: 'On Tuesdays I play the sports league', or 'on Thursdays I go watch a movie in the library'."

"You develop a different life in there. The first six months are really hard. The last six months are also really hard. But the ten years in between, they're really not that bad."

 David Parker, prison consultant, U.S.

Law enforcement officers stand at the entrance to the Alderson Federal Prison Camp where Martha Stewart turned herself in October 8, 2004   Getty Images

These are voices of men who have committed white collar crimes, been charged with criminal offences, had court dates, were convicted and then incarcerated. Experiencing your freedom taken away is a shock to anyone. Likely those thought of as forming the criminal class for any kind of societal offense feel disconnected from the world, from their lives, from everything familiar to them, but people of the middle-class who consider themselves generally law-abiding who may have strayed just never imagine that they will commit a crime and face the punishment that accompanies conviction.

Steve Dagworthy, a white-collar worker, middle class, married with two children erred on the wrong side of legal behaviour. He describes his total ignorance of how prison inmates behave, regulated by what he terms "cell etiquette". Which are rules that inmates are expected to recognize and respect. An example being whoever first takes up residence in a prison cell is entitled to the preferred bottom bunk. His lawyers, representing his best interests purportedly, informed him of nothing related to prison life.

When he witnessed bloody knife fights between prisoners he was appalled and no doubt frightened of those who inserted "shivs" within the handles of toothbrshes. He was incarcerated in 2009, and released three years later, serving three years of a sentence. And when he was once again a free man he founded the United Kingdom's first jail-time advice service, teaching wealthy clients how they must adapt to a new style of life in prison, among inmates incarcerated for a wide variety of crimes and coming from mostly backgrounds that partially explain their crimes.

This is a far different type of service than most people could conceive of. It is one aimed directly toward the moneyed upper-middle-class who have abused their privileges through illegal activities of one kind or another. It was revealed this week that Harvey Weinstein the once-powerful Hollywood film producer found guilty this week of some of the charges laid against him of sexual impropriety with a wide number of women who finally stepped forward to reveal his crimes, has seen fit to hire a prison consultant. The man faces up to 25 years in prison for third-degree rape.

Speculation is that in exchange for thousands, the consultant will proceed to tutor Mr. Weinstein on surviving life in prison as a  highly recognizable sex offender, someone who will be viewed as despicable among the prison population. The advice will be wide-ranging, from how best to interact with the other inmates in whatever prison he ends up in, to the broader issue of how his long, empty days as a prisoner can be 'enriched'. Presumably, what kind of prison activities he can take advantage of to fill in the blank hours of his new life.

At his age and with the condition of his health, a long prison sentence is a fairly good substitute for a death sentence. Temporarily at least, he will be held at Rikers Island, a New York jail notorious for overcrowding, gang brutality and allegations of human rights violations. Conditions so brutal that municipal politicians have committed to shutting it down. Eventually. It is not Mr. Dagworthy who has been hired by Weinstein to advise him, but if he were, he would begin by informing the man that the first six months he will spend in prison will be full of fear and bewilderment.

 Clients of this former prisoner-turned-mentor are advised to find something that will occupy them but to leave a distance between themselves and jobs in the prison that have the potential to place them in awkward positions. Working in the prison kitchen, as an example, might result in someone asking for extra food. "As soon as you get involved in that, then  you're known, and you succumb to the professional prisoners who are there to try to get something from you or bully you", he advises, drawing on his personal experience.

As for Mr. Parker and his experience and advice... He states that someone like Weinstein would need to show respect toward those in prison with him. The relationship a prisoner establishes with fellow inmates is critically important to their well-being, far more so than  any relationship that can be established with guards, who should be kept at arm's length to avoid accusations of currying favour.
And with Mr. Weinstein's particular case where he will be vulnerable to the actions of other prisoners who may take exception to the presence of an infamous rapist among them, he will likely be placed in protective custody.

There have been instances, points out Mr. Parker, when such notorious prisoners have been beaten to death by fellow inmates. There have been instances where once-powerful men who have been accused, charged and convicted of serial rapes have committed suicide, even those who have been placed on a 'preventive' death watch. However, there are two sides to protective custody; one is fairly obvious; to ensure that other inmates are unable to violently attack another inmate held in low esteem. 

And, needless to say the other side of the coin is a curtailment of whatever 'freedom' is available in a prison setting.There is no win-win for someone of this man's ilk. Having committed despicable crimes time and again and bearing no consequences, the times simply caught up with him in a new era of female empowerment, and now there are due consequences. For Mr. Weinsein, dire consequences.

Weinstein arrives at New York City Criminal Court for the continuation of this trial on January 24, 2020 in New York City.

Getty Images/Jeenah Moon

Preserving Heirlooms

"The seed vault is the backup in the global system of conservation to secure food security on Earth."

"We need to preserve this biodiversity, this crop diversity, to provide healthy diets and nutritious foods, and for providing farmers, especially smallholders, with sustainable livelihoods so that they can adapt to new conditions."

Stefan Schmitz, executive director, Crop Trust, Bonn

Journalists and cameramen walk under a gust of cold wind near the entrance of the Svalbard Global Seed Vault that was officially opened near Longyearbyen on February 26, 2008.Larsen, Hakon Mosvold/AFP/Getty Images

Cherokee Nation

Cherokee Nation seeds destined for the Svalbard Global Seed Vault

"It was the recognition of the vulnerability of the world’s gene banks that sparked the idea of establishing a global seed vault to serve as a backup storage facility. The purpose of the Vault is to store duplicates [backups] of seed samples from the world’s crop collections."
"Permafrost and thick rock ensure that the seed samples will remain frozen even without power. The Vault is the ultimate insurance policy for the world’s food supply, offering options for future generations to overcome the challenges of climate change and population growth. It will secure, for centuries, millions of seeds representing every important crop variety available in the world today. It is the final back up."

Crop Trust

There are a good many well organized, dedicated seed banks around the world, where heritage seeds are banked and maintained, and for many the purpose is to supply small-hold farmers and people living in poverty around the world with seeds to grow their own crops. Located in areas around the world from North America, Asia, sub-Saharan Africa, Central America, India and Oceania, among others, research and collection and distribution helps to ensure that seeds to produce grains and vegetables to feed the world will never be lost.

An employee of the Potato International Centre (CIP) in Lima, handles seeds of potatoes and sweet potatoes being cultivated at the Centre. January 25th, 2008. Seeds of these tubercules were sent to the Svalbard Global Seed Vault (SISV) in Norway. ERNESTO BENAVIDES/AFP/Getty Images

One of many interesting seed banks is maintained in a special vault in the Arctic meant to preserve seeds for rice, wheat and assorted food staples, where a million varieties are preserved. This place is the Svalbard Global Seed Vault, built into a mountainside and designed as a storage facility, with its goal to protect the integrity of vital crop seeds should cataclysms of nuclear war or plant pathogens strike the world order when it becomes imperative to safeguard global food supplies.

Crop Diversity Trust

Boxes of seeds stored deep inside the mountain in the Svalbard Global Seed Vault.

It is also called the "doomsday vault", and was built in 2008 by the government of Norway on the island of Spitsbergen in the Svalbard archipelago located between Norway and the North Pole under the auspices of the global Food Trust. This week, the vault was opened to receive seeds from 30 gene banks including seeds from India, Mali and Peru, alongside Britain's Royal Botanical Gardens' banked seeds from Highgrove, Prince Charles' private estate.

At one time, an estimated 7,000 different plants were cultivated around the world. However, according to agricultural experts, at the present time about 60 percent of food comes from three main crops; maize, wheat and rice, a focus lacking in diversity to the extent that should each of those crops -- which use a diminishing number of seed types, lacking diversity -- fall victim to an overwhelming challenge due to climate change, vulnerable mono-seed harvests may fail.

Statistics warn that one in nine people around the globe -- according to the United Nations' World Food Programme -- go to bed hungry. According to scientists, erratic weather patterns could threaten both the quality and quantity of food available on a broad scale. Norway recently completed an $11 million upgrade to the building which had been constructed as a safe food vault at Svalbard in reflection of the preservation qualities of the Arctic cold.

And then it was discovered during a period of inclement weather in the form of an unexpected thaw of permafrost, that the doomsday vault had been compromised by meltwater entering the tunnel vestibule. The good news part in the alarming bad news story is that none of the seeds received water damage.

This photo March 1, 2016 shows a man carrying one of the newly arrived boxes containing seeds from Japan and USA into the international gene bank Svalbard Global Seed Vault (SGSV), outside Longyearbyen on Spitsbergen, Norway. HEIKO JUNGE/NTB Scanpix/AFP via Getty Images

 

 

 

 

A Worthy Cause 

Wilson stands outside his home and watches young kangaroos as they feed and drink, in his front yard in New South Wales, Australia, on January 28, 2020.

Jorge Silva/Reuters 

"We had way too many animals in the house and around the house so we really couldn't go -- we decided we were going to stay and fight."
"At three o'clock it was a beautiful summer's day, by four o'clock it was midnight. You couldn't see any more than 20 yards and then the firestorm came through and pretty much burned everything."
"It was a horrible thing -- the whole bush has been burnt. It's been vaporized -- it's Vietnam is what it looks like."
"It's not until after the fires when it really hits you how close you were to dying but at the time you are too busy trying to put the fire out."
"We didn't have children ourselves; this is what we spend our time doing. We think it's worthy -- a worthy cause -- looking after our babies no matter what they are, whether they are kangaroos, echidnas or wombats."
Julie Willis, Wytaliba, New South Wales, Australia

Julie Willis, an animal carer, feeds orphaned kangaroo joeys, in an area of her home designated for the pre-release of kangaroos, in the community of Wytaliba, New South Wales, Australia January 28, 2020. REUTERS/Jorge Silva

The Wytaliba home of Gary Wilson and Julie Willis, a house built of cypress-pine, has doubled as a wildlife sanctuary for a quarter of a century. The small community in Wytaliba, New South Wales, originally a commune built in the 1970s, saw a bushfire sweep through the area on November 8. Several of the people living in Wytaliba lost their lives. Gary Wilson and Julie Willis decided not to evacuate their timber home in view of the fact that they were giving life and haven to orphaned baby animals, mostly joeys.

An orphaned kangaroo joey Julie Willis rescued- January 28, 2020.

Jorge Silva/Reuters

They spent an exhausting fourteen hours using fire extinguishers, water pumps and a sprinkler system to put out burning embers falling from the bushfire through the sky onto the roof of their home. It was hard work, but they had executed a determined plan of action and with Lady Fortune on their side, managed to keep the fire at bay, although everything around them was consumed by the ravaging flames.

REUTERS/Jorge Silva

They felt little option left to them but to act as they did, to preserve the lives of the dozen marsupials hanging from fabric pouches in their living room. Along with nursing the orphans kangeroos that they had earlier nurtured, now full grown, as well as other wildlife that had long left their care, and have returned to the house searching for refuge from the flames.

Most animals, explained Willis, like possums, gliders, echidnas, lizards and many birds were unable to flee the fires that overtook their flight. Fires that she described as more fierce than any she had ever before seen.

This year's bushfire season, fierce and prolonged in Australia, has killed 33 people and demolished an estimated billion native animals since the fires began back in September, destroying 2,500 homes and seeing over 11.7 million hectares of tinder-dry bushland razed. Fallout from the monstrous fires continues, with food scarcity and water tainted with ash devastating local wildlife, increasing the number of boarders at the Wytaliba home.

Wilson and Willis have gone from rescuing joeys after their mothers have been struck by vehicles, to hosting an increasing number of orphans whom the raging fires created. The joeys are fed a particular milk formula every two-to-four hours and will eventually be released back into the wild. For now, it's Julie Willis, Gary Wilson and the tiny refugees living in the off-the-grid home, surrounded by scorched bush and burnt-out vehicles.

Orphaned kangaroo joeys that were rescued during the bushfire season sit in cloth pouches hung in the living room of partners Gary Wilson and Julie Willis's home, in the community of Wytaliba, New South Wales, Australia, on January 28, 2020.

Jorge Silva/Reuters

Spare No Efforts in Cardiopulmonary Resuscitation Following Cardiac Arrest in the Elderly -- Though Doomed to Fail

"It's a common scenario. And it's not going to have a good outcome."
"She was trying to die, and it was only a matter of time before she arrested again."
"Should CPR even have been started for this patient?"
Dr.Kei Ouchi, emergency physician, researcher, Brigham and Women's Hospital

"Many of us in daily practice have the perception that we regularly do resuscitations that are futile from the inception."
"We wanted to examine that."
Dr.Patrick Druwe, physician, Ghent University Hospital, Belgium

"The big ethics discussion has been around, 'When do we stop'?"
"Only recently have there been discussions about, 'When do we start it'?"
Dr.Monique Starks, cardiologist, Duke University School of Medicine, North Carolina

James Steinberg

Recently, an international network was organized by a team led by Dr.Patrick Druwe at Ghent University, for the purpose of surveying health care professionals in Europe, Japan, Israel and the United States. A study, published in The Journal of the American Geriatrics Society considered CPR for adults over 80 who had experienced out-of-hospital cardiac arrest.

The results of the study shone a spotlight on a number of issues, none very favourable, respecting physician reaction to elderly patients in cardiac arrest. The survival rates were dismal; an outcome reported previously in the medical literature. What the study pointed out was how frequently health care professionals automatically support resuscitation, despite knowing beforehand through experience that the outcome will have poor results. Results though well known to the health community are not shared with the general public.

Roughly 600 clinicians, half of whom were paramedics and emergency technicians, the remainder representing emergency physicians and nurses, were tasked with recalling their most recent patient    aged 80 or more who had undergone CPR. The question put to them was whether they were in agreement with beginning cardiopulmonary resuscitation, and did they feel certain that resuscitation should not have been started, or were they uncertain?

Of the patients in the specific age category suffering cardiac arrest and immediately subjected to CPR,  a mere two percent survived and were able to leave hospital. Despite which over half the clinicians felt CPR was appropriate in those instances, while only 18.5 percent felt it inappropriate. A minority of patients have a 'shockable' rhythm in cardiac arrest, where the heart is moving but abnormally and it is not pumping blood effectively.

With the use of CPR, along with a defibrillator to shock the heart, circulation can be restored and the patient's life saved. Most patients, however, have non-shockable rhythms; their hearts show electrical activity, despite which they aren't pumping at all, and in these instances survival rates tend to fall sharply.  Age increases the proportion of cardiac arrests involving non-shockable rhythms.

Over 40 percent of the cases of cardiac arrest followed by CPR had been 'unwitnessed', which is to say rescuers had no idea how long the patients had been in arrest -- when reality is that the odds of successful resuscitation become increasingly diminished ten percent with each minute that passes while in cardiac arrest. Of the elderly patients with non-shockable rhythms and unwitnessed arrests, none survived hospitalization.

Irrespective of which, 44 percent of the clinicians taking part in the study felt those efforts under those circumstances, to be appropriate. Bleak outcomes following CPR for out-of-hospital cardiac arrest at advanced ages has been documented by other research, even though improvements have been seen in resuscitation results where hospitalized patients have better rates of survival.

Bruce Ayres / Getty Images

The Life-Saving Exploits of Old Cat

"In the past few days my line was always busy. Each day I received hundreds of requests and had to visit 20 to 30 households."
"They [the household pets] were all very scared and stressed. Some cats were extremely short of food and water."
"Of course I'm scared [of contracting the coronavirus], but just by thinking that the cats would starve to death if we didn't go, I can't just leave them there."
"The volunteers on our team, me included, have saved more than 1,000 pets since Jan. 25."
"My conservative estimate is that around 5,000 are still trapped, and they may die of starvation in the coming days."
Lao Mao, veterinarian, on-line pet community Wuhan Pet Life

"I never met their owners in person or had any deeper interactions. They trusted me and gave their keys to me, and I need to be responsible and repay their trust."
"Honestly, it is tiring. Of course I'm afraid. But if I dare to leave my house for work, I can leave my house for this as well."
"I see them as my own kittens, and treat this as a serious task."
Yang Ying, 50, Wuhan Pet Life management team

"In Beijing, Tianjin, Shandong, Heilongjiang, Hebei, Wuhan, Shanxi, Shanghai there are reports of local government orders for street dog culling out of fear that the animals might transmit the coronavirus."
"According to the World Health Organization, there is no evidence that pet dogs or cats can be infected with the virus, and medical experts in China have spoken out against blaming dogs and cats for spreading the illness. Humane Society International urges pet owners around the world not to abandon their pets as a response to this outbreak."
"In the meantime, animal advocates in China are rescuing abandoned pets and informing the public that dogs and cats do not pose a risk. Humane Society International has been supporting Chinese groups in coordinating public education efforts since the Wuhan coronavirus broke out."Humane Society International (HSI)

One man claimed that his pet cat (pictured) was buried alive when his house was disinfected while he was being quarantined in hospital because of the coronavirus outbreak

Wuhan Pet Life is operated as an online resource for pet owners by 43-year-old veterinarian Shuai Lihua who has earned the fond nickname 'Old Cat' (Lao Mao) from his many admirers. Working with him are six volunteers. And he and his volunteers have responded to a desperate situation that has developed for household pets left alone during the coronairus quarantine that has locked down Wuhan, the capital city of 11-million inhabitants in Hubei province, the epicentre of China's COVID-19 epidemic.

He and his rescue squad have managed to save several thousand pets from starvation when their owners, under quarantine have been unable to return to look after their pets' welfare. According to Lao Mao, about 20,000 animals have been left at home alone with no one to care for them, once the quarantine was tightened on the city on January 23 -- at a time when many of its residents had left to visit with family during Chinese Lunar New Year, an annual custom in China.

Travel curbs left people unable to return to their city of Wuhan, leaving their pets stranded. Owner of a pet hospital, Lao Mao is familiar with animal rescue, he has been doing just that for the past 13 years. So he decided he would do what he could to help in the situation, once he began receiving calls from frantic animal owners stranded and unable to return home. Lao Mao and his rescue team have saved thousands of pets so far, 99 percent of which were cats, 0.5 percent dogs, the remainder rabbits and hamsters.

There were too many cats to be accommodated, once  his home became crowded with the rescues, leaving the veterinarian with little choice but to leave sufficient food and water for each of the cats in their homes for a calculated month. In most instances the rescues were successful, but there were cases when the team discovered they were too late on arrival. Kittens had starved to death, or cats had perished following a difficult labour.

There were many times when Lao Mao, not possessing a key to gain entrance to a home, had to fend for himself to gain often awkward, difficult, and no doubt illegal, access. For the most part, however, pet owners were able to get their keys delivered to him, or they sent their password to him for their homes' locks. It is the high volume of rescues that places him at risk, however, of the coronavirus that has killed over a thousand people nationwide thus far and infected 80,000.

The feeding and care of these  temporarily adopted cats is complicated in a city where private vehicles remain banned as a critical measure of the quarantine. The owner of a cat who eventually contacted Lao Mao for help on February 3 had planned his return home for January 27. According to his calculations, he would be safe leaving food until the day of return. "When I went there to fill food and water for the cat, it stuck very close to me. It drank water for more than 10 seconds when usually cats just drink for two to three seconds", explained Old Cat.

A woman carrying a dog in the Chinese city of Wuhan on January 22.

Getty Images

Run For Your Life!

"As clinicians are meeting with patients in the new year, making a goal-oriented exercise training recommendation—such as signing up for a marathon or fun-run—may be a good motivator for our patients to keep active."
"Our study highlights the importance of lifestyle modifications to slow the risks associated with aging, especially as it appears to never be too late as evidenced by our older, slower runners."
"Our study shows it is possible to reverse the consequences of aging on our blood vessels with real-world exercise in just six months. These benefits were observed in overall healthy individuals across a broad age range and their marathon times are suggestive of achievable exercise training in novice participants."
"Almost everyone benefited. And those people whose arteries needed the most help benefited the most [through the study trials]." 
Dr. Charlotte Manisty (UCL Institute of Cardiovascular Science & Barts Heart Centre)

University College London

A newly published study has found that training for and completing a marathon ran can impact arteries, leaving them more flexible, healthy and biologically younger than they had been before the training and marathon run. The effects were that immediate; the completion of a first marathon was sufficient to rejuvenate a major artery; a monumental plus for heart health, along with overall health condition.

Arteries carry oxygenated blood from the heart. When the arteries are  healthy and pliable they expand and contract as blood pulses through them at a steady flow. They become compromised with age, beginning to stiffen and blood starts to crowd against the inflexible walls of the blood vessels, causing blood pressure to rise and organs requiring an even, gentle blood stream, such a the brain can be deleteriously affected.

There has been past research hinting that exercise could have the potential to alter arterial stiffening related to encroaching age. Older athletes as an example, tend to have relatively supple arteries. What hasn't been clear is whether sedentary people, beginning to exercise, can still improve the health of their arteries. The new study, published in The Journal of the American College of Cardiology, was the result of researchers at University College London setting out to answer that question.

Getty Images

They did so, along with other institutions, by tracking arteries of people new to an exercise routine, singling out first-time entrants in the London Marathon, new to the sport of running, Over 200 of these men and women, most of them in their middle-age, all accustomed to a sedentary lifestyle, were contacted by the researchers, six months before the Marathon.

None of the group of participants who had completed health and fitness tests and a scan of their aortas, showed any signs of heart disease or other serious health problems. Most of the runners began preferred marathon-training programs, jogging several times weekly. Some experienced injuries or other health concerns and saw fit to drop out, but ultimately, 136 men and women completed the race, their average time of 4.5 hours for the men and 5.5 hours for the women.

Post-race they returned to the laboratory to have their initial pre-race tests repeated. Their aortas proved more flexible, their arteries appearing to have shed the equivalent of almost four years of gradual stiffening, in functional terms. Older male runners and those whose finishing times had been slower, turned out to show the mos marked improvements, which did not depend on changes in fitness or weight which had been negligible throughout training and the actual run.

The only issue that had impacted on the beneficial outcome appears to be that they all had maintained their training and had gone on to complete the race. "The benefits of exercise are undeniable.
Keeping active reduces your risk of having a heart attack or stroke and cuts your chances of an early death. As the old mantra goes, 'If exercise were a pill, it would be hailed as a wonder drug'", said Professor Metin Avkiran of the British Heart Foundation (BHF), which funded the study,

Over the course of every week, adults should do a minimum of either:

• 150 minutes moderate-intensity exercise, such as brisk walking, doubles tennis or cycling
• 75 minutes vigorous exercise, such as running, football or rugby

People should also do strengthening activities - such as push-ups, sit-ups or lifting and carrying - at least two times a week to give muscles a good workout.

Getty Images    Lead researcher Dr Charlotte Manisty said: "People with known heart disease or other medical conditions should speak to their doctor first.
"But for most people, the benefits of taking up exercise far outweigh any risk."

 

Preserving Fine Motor Function in Brain Surgery

"The violin is my passion. I've been playing since I was ten years old. The thought of losing my ability to play was heartbreaking."
"Being a musician himself, Professor Ashkan understood my concerns. He and the team at King's went out of their way to plan the operation -- from mapping my brain to planning the position I needed to be in to play."
"Thanks to them, I'm hoping to be back with my orchestra very soon."
"[Doctors told me], 'Your tumor is on the right-hand side, so it will not affect your right-hand side, it will affect your left-hand side'. And I'm just like, 'Oh, hang on, this is my most important part. My job these days is playing the violin'."
Dagmar Turner, British violinist

"[The operation had forced his team to consider the] finer details [of violin playing]. Length of the string, pressure on the string, all those fast movements moving from one string to another."
"So that is what was unusual for us."
"We perform around four hundred resectons, tumour removals, each year, which often involves rousing patients to carry out language tests, but this was the first time I've had a patient play an instrument [during surgery]."
"We knew how important the violin is to Dagmar, so it was vital that we preserved function in the delicate areas of her brain that allowed her to play."
"We managed to remove over 90 percent of the tumour, including all areas suspicious of aggressive activity, while retaining full function of her left hand."
Dr.Keyoumars Ashkan, neurosurgeon, King's College Hospital, London

Dagmar Turner recently played her violin during brain surgery in London. "The violin is my passion," she said in a statement. "I've been playing since I was 10 years old."

King's College Hospital NHS Foundation Trust/Screen shot by NPR

Unusual, and rare that a musician would actually play their instrument during surgery, enabling surgeons to map the brain to distinguish which area would be affected through surgery so that steps could be taken to carefully avoid disturbing the area in question for the purpose of retaining the artist's ability to continue performing. There have been a few previous instances of neurosurgery that set about to produce a result very similar to that of this 53-year-old violinist who was determined to retain her ability to play a violin.

The surgery scheduled for DagmarTurner at King's College Hospital, London was to remove a tumour on her right frontal lobe. Which left her with the fear that post-surgery her ability to play her beloved violin might be compromised. As a member of the Isle of Wight Symphony Orchestra she was intent on doing all that was possible to make certain that no damage to the area controlling fine movement of the left hand -- a requirement for skilled, intricate violin playing -- would occur.

She discussed her fears with lead surgeon Keyoumars Ashkan and out of that discussion came the plan of action. As an accomplished pianist himself, Dr.Ashkan was compassionately invested in doing whatever he could to preserve Ms.Turner's left-hand neural controls. It was agreed that she would be awakened from a general anesthetic so she could play her violin once the team had conducted the craniotomy -- opening the skull. It took two hours with Ms.Turner playing all the while for her brain to be meticulously mapped.

While she played scales and improvised melodies and music compositions from memory, the parts of the lobe to be preserved for its necessity in controlling the left hand, were precisely identified. The violinist had been diagnosed with a large, slow-growing tumour, a grade-2 glioma, in 2013. During a public performance she had suffered a seizure. The tumour was identified as benign, but once it began to aggressively take on size despite radiotherapy, the decision was taken to remove it.

The surgical team had inserted a tiny electrical probe, activating it to determine whether it disrupted Ms.Turner's ability to playi with the understanding the surgeons could remove tissue where activation would not affect her playing ability. The procedure was repeatedly followed as the tumour was removed. Surgery was pronounced successful, following which Ms.Turner returned home in three days' time. Within two and a half weeks, she was able once again to take up her place with the orchestra.

After surgeons removed a tumor from Dan Fabbio's brain in 2017, they gave him his saxophone — to see whether he'd retained his ability to play. A year after his surgery, Fabbio is back to work full time as a music teacher.

YouTube/Screenshot by NPR 

The Global Imperative of Improving Road Safety Conditions

"These are real people, not statistics. I am not a statistic."
"I was involved in a road crash that totally changed my life and I continue to bear the consequences."
Bright Oyways, Association for Safe International Road Travel, Kenya

This is a health issue that we know the cure for. We could avoid the kind of senseless deaths that are taking place but we don't have the political will."
"We are doing something wrong. Maybe we aren't making enough noise."
Rochele Sobel, founder, Association for Safe International Road Travel (ASIRT), U.S.

"Somehow society has accepted [traffic deaths and injuries] as the cost of living in our society these days."
"We call it an accident. It is not an accident."
Chana Widawski, Families for Safe Streets, New York

"We have invented the leading cause of death for our children and young people."
"Why have we accepted for so long a transport system that is killing so many people? It doesn't have to be like that."
"Road traffic deaths and injuries can be prevented. The key is political will. The key is the head of state decides to make this an important priority on his or her agenda."
Etienne Krug, director, social determinants of health, World Health Organization

"Why should we have a completely different acceptable-risk level in road safety?:
"From an ethical standpoint we are saying that no one should be killed or suffer a lifelong injury in road traffic."
"We can't build a road system based on the belief that everyone is perfect. No other system is built like that."
Maria Krafft, head, traffic safety, Swedish Transport Administration

Mikael Ullen    Representatives and participants from more than 80 countries at the 3rd Global Ministerial Conference on Road Safety taking place in Stockholm, Sweden.

Traffic safety, and road accidents take lives and create injuries that will change peoples' lives forever. An instant is all it takes for a driver to lose control of a vehicle, for attention to waver, for a driver to fail to notice oncoming traffic, or warning signs. Then there is the issue of driver impairment, whether alcohol or drugs are involved. The fact that so many people drive with their minds elsewhere than on the road, impulsively responding to a cellphone, irrespective of whether it's hand-held or secured, represents yet another potential danger.

Careless driving, speeding, can end up in an accident where a driver, passengers or those in another vehicle are killed or injured. Then there are traffic deaths involving people on bicycles, motorcycles, or pedestrians. Whatever the cause the damage to human health and life is irreparable. When the organization Mothers Against Drunk Driving began their campaign against carnage on the roads from impaired drivers the issue was simply ignored as though this was a societal ill that had to be accepted, despite road-safety driving laws.

That group's tireless campaigning made society take a second look at what they were accepting as inevitable, tarnishing the lens of impaired driving perception, and making it a focus of an unacceptable cause of too many road deaths. MADD's campaign had great dividends; society no longer accepts that this is an offshoot of the love affair with driving, that a responsibility comes with driving, and drinking while under the influence is not to be tolerated. But then, nor is speeding, or inattention.

Except that people are prone to both, and everyone not only makes errors of judgement, such as running an orange/red light, or failing to stop at an intersection, or allowing attention on the road to wander, because we are, after all, only human, and may live to regret what we may cause. On the other hand, traffic-law enforcement and municipal and state/provincial road and highway infractions would be lessened if more careful attention were to be given to urging caution on the road by mandating adequate speed limits in people-vulnerable areas.

Seven-thousand four-hundred shoes, each pair representing one of the road crash victims who die every day.

Statistics tell us that every day around the world a toll of 3,700 deaths take place in traffic accidents. Sweden, Norway and a handful of other countries have taken practical steps to reduce those numbers substantially; if they can reduce road deaths on their highways, it can be done anywhere with enough political resolve. Figures tell us that in 2016, there were 1.36-million traffic-related deaths worldwide. These deadly crashes now represent the leading cause of death for children and young people between the ages of five and 29, globally.

This week, the third annual Global Ministerial Conference on Road Safety took place in Stockholm, its purpose to gather national representatives with a view to agreeing pursue a new commitment in reducing traffic deaths and serious injuries by fifty percent within the decade. It is a startling fact that the issue of mounting traffic-related deaths receives relatively little public attention -- until and unless such an accident occurs to you or someone you know and care for.

The representative of the organization Families for Safe Streets explained their pursuit of personal stories of traffic tragedies that have persuaded them to make use of civil disobedience as an attention gathering tool in their agenda to strive for changes to make streets safer. While global issues such as climate change capture peoples' attention, one much closer to home and infinitely more imminent and destructive for the moment, is little-noticed.

"Where is the sense of  urgency for road crashes?" was the rhetorical question lobbed by Egyptian youth activist Omnia el Omrahi, comparing how fixated and how swiftly the world has focused its attention on the novel coronavirus out of Wuhan, China. Sweden's pilot project of Vision Zero has amply demonstrated what can be done with the determination of the public and local civic administrations. Reducing speed limits to 30 kilometres/h is feasible in areas where vulnerable populations interact with traffic to prevent traffic deaths.

Many urban neighbourhoods have introduced 30 km/h speed limits in school districts and urban neighbourhoods, but many more need to focus on doing just that in the interests of child safety. Sweden continues to aim for its goal of zero traffic deaths, while in Norway, Oslo recorded one traffic death in 2019, and no pedestrian deaths whatever. Canada's traffic death count has recently been diminished, yet remains double at least that of many countries in Europe where road design and traffic safety remain high priorities.

Sweden operates a safe system approach to traffic based on the concept of human error, recognizing it as a vulnerability that no one should suffer throughout their life as a result of sustaining a serious injury. Road systems were designed traditionally on the theory that no one should make errors in a complex system where the risks are well understood. But driving a vehicle and adhering to such a standard makes little sense when no other enterprise engages with public safety in such an offhand manner.

Highways are best divided where speed limits exceed 80 km/h. Technology such as geo-fencing, to control speed limits for vehicles such as delivery trucks, re[resemts yet another safety-related initiative. Along with speed limits not to exceed 30 km/h anywhere pedestrians and traffic share public space.

Photo: Vibhu Mishra:  Emergency services respond to a car accident in New York City, United States. Prompt response and medical assistance can help save lives in road crashes.