Indonesian Reticulated Constrictor Strikes

"During the search the team found a giant python, measuring seven metres in length which we suspected had preyed on the victim."

"The victim's body was not destroyed when we found her inside the snake, meaning that she had only been recently swallowed whole."

"The [search] team captured the snake."

Local police statement, Jambi province, Sumatra Island, Indonesia

 

"They are constrictors, so what they do is coil their body around you. They will give you a hug of death."

"The top and bottom jaw of a snake is connected by ligaments, it's quite flexible. They can swallow prey larger than the size of their head."

Matjam Rusli, snake conservationist, director of the Indonesia Herpetofauna Foundation

Reticulated pythons are believed to be able to reach over 10 metres in length  Getty Images

"Most cases are cases of farmers working in rubber and cacao plantations in Sumatra and Sulawesi, most cases occur at night", explained Indonesian snake expert Djoko Iskandar, professor at Randung Institute of Technology. Extremely long such reptiles only are capable of successfully preying on adult humans, he added. 

 

Deforestation deprives snakes of their natural habitat and sources of food; one factor cited by experts as a cause of the increasing frequency of fatal encounters between constrictors and humans. Such encounters are becoming more common in the country, given encroachment on the environment snakes depend upon.

A local women, employed as a tree tapper on an Indonesian rubber plantation, 54-year-old Jahrah, left her home Sunday morning and failed to return. When her work day was concluded and she still had not arrived back home that afternoon, her husband alerted the locals and set out to find what had happened to his wife.

He discovered his missing wife's sandals, jacket, head scarf and knife lying on the forest floor but she was nowhere about. The following morning a party searching for Jahrah (who according with Indonesian social culture is identified by only one name) encountered a heavily bloated snake, The reptile was put to death by the search team, then went on to slice open its stomach and there they discovered the unfortunate woman's remains, perfectly intact.

 

iStock

 

Generally, non-venomous pythons are not known to attack humans. Instead they feed on smaller animals, securing their victims with a nonvenomous bite prior to suffocating them to death through construction, before swallowing them whole. Then they rest, immobile, as digestion begins. On occasion, as with the case in this instance, they will also prey on humans.

Snake conservationist Nathan Rusli believes it was a reticulated python that was responsible, the only reptile species living in the Sumatran province of Jambi sufficiently large to consume an adult human. Incidents such as this are considered rare in their once-a-year occurrence. Understandably, for the victims and their families, once-a-year events such as this are once too often.

Reticulated pythons are the longest snakes in the world. Photo: Shutterstock

Rescuers Having A Whale Of A Time

"We could get a really good bird's-eye view. We knew exactly how the gear was through the mouth."

"There was a buoy on the left side, or the port side of the animal, through the mouth and then on the right side, there was a line protruding -- trailing much behind the animal much behind the buoy."

"That rope in the mouth would prevent the animal from successfully foraging so it was being impacted that way."

"The rope can continue to wear into the flesh and sometimes be ingested. So it can be definitely a lethal situation."

"It complicated things significantly because not only were we worried about the animals [accompanying whales following the larger, injured whale] getting entangled in that trailing gear from being so close to the whale, also how they would react once we started working to remove the gear."

"They [travel companions] do travel together and often you'll get the same animals travelling together. Why they chose to continue with this animal when it was under duress and entangled? We don't know."

"The animal reacted to that tension and did a spy-hop up and a backflip ... it actually just popped all the line out. So, the plan worked perfectly."

Paul Cottrell, Pacific marine mammal rescue lead, Fisheries and Oceans Canada

Rescuers work to save an entangled humpback whale in B.C. waters on Oct. 21, 2022. (Department of Fisheries and Oceans & McGill Drone Imaging Department)

 

A whale rescued from entanglement in fishing gear, a situation that was becoming increasingly dangerous for the preservation of the whale's life. And observant and concerned witnesses to its plight were ultimately responsible in their alerts to fisheries authorities that this huge mammal needed human intervention, as soon as possible, led to its rescue from a slow and agonizing death by starvation. This is the story behind a ten-metre-long humpback whale in British Columbia's Strait of Georgia.

It took a lot of patience, observation and a rescue plan, along with the help of a team of experts, a drone, a satellite tag, and above all concerned ciizens as well as the whale's acrobatic twist to release it from an unhappy fate. The immense whale was accompanied by a group of companion whales that were swimming by its side the entire period of its travail and rescue.

 

A humpback whale entangled in fishing gear off B.C.'s West Coast was rescued with the help of a team of experts and an acrobatic twist from the captive itself

 

Calls began arriving at Fisheries and Oceans Canada last Thursday, revolving about the plight of a whale caught in fishing line, and pulling along a yellow buoy. A full day was spent by would-be rescuers trying to locate the whale. It took another day before a whale-watching crew happened to spot and track the animal off the Gulf Island of Texada. Officials were finally able to place a satellite tag on the trailing gear. "So that was huge. Then we could relax a little bit because we would be able to find the animal by the satellite tag", explained Mr. Cottrell.

Tag guiding them, the rescue team was enabled to make a convergence on the animal and with the use of a drone have a closer look at precisely the manner of its 'capture' by the trailing rope. At that juncture they understood there was roughly 90 metres of polysteel rope and with it the buoy and prawn fishing gear. The abrasive rope had caught in the whale's mouth and had begun wearing away its flesh.  The three other humpback whales swimming alongside the trapped animal, added another dimention of caution to the attempted rescue plan.

 

In the commotion that ensued during the rescue attempt two of the whales remained steadfastly beside the trapped animal and the rescue boats. Such encounters by rescuers with companion animals, particularly of this size are rare. Mr. Cottrell explained that in over fifty rescues, this was the first such event he had been involved in, working around a group this large. But the rescue team thought of their plan and the team began cutting the line away from one side of the whale's mouth with the thought of attempting to slide out the remaining rope from the opposite side.

Drone monitoring the operation from above, as the whales followed so the drivers of the boats could react should any behavioural change occur, the team spent four hours painstakingly clearing half the entanglement before putting a cautious amount of tension on the opposite side. And then the whale went into action with an impressive acrobatic, twisting motion to free itself from the rope. Then, with the help of the drone the liberators watched the whale and its companions swim off together.

An entangled humpback whale was surrounded by other whales as rescuers worked to save it on Oct. 21, 2022. (Department of Fisheries and Oceans & McGill Drone Imaging Department)

The Bitter Club of 'Involuntary Celibate' Men

"I first detail the type of subordination incels argue they experience -- a social bias in favour of attractive people they call lookism."

"[According to incels Wiki, 'lookism' is defined as a prejudice or discrimination based on one's appearance.]"

"[They claim their physical deficiencies, disadvantaged by] Lookism [is what makes women dismiss them]." 

“They label themselves as victims, they see themselves as victims. They are ‘victimized’ by women in society and they think that the main reason why they’re victims is this form of social bias called ‘lookism,’ and they talk about lookism quite a bit.”

“These guys are not just sad, lonely people who are upset with themselves and maybe sexually frustrated because they’re still virgins. These are guys who want women treated like property, talk about murdering women, talk about stalking women, talk about completely removing women’s rights, celebrate things like the Taliban victory in Afghanistan because it was a loss for women . . . celebrate things like the overturning of Roe v Wade."

“So, they’re not just guys who are sad and lonely and looking for love. They are really guys who are aggressively misogynistic and want to see women harmed physically and socially."

"They’re all over the planet and they’re a diverse group of men."

 Michael Halpin, assistant professor, department of sociology and social anthropology, Dalhousie University

Sociology professor Michael Halpin completed one of the largest studies thus far on the Incel movement. The Signal

"I get zero matches on Tinder with professional photographs, the most disgusting subhuman folks want nothing to do with me."

"This is despite me maintaining acceptable hygiene and well above-average physical fitness, and having impeccable etiquette."

"I am an absolute grotesque sub-human."

Incel community member 

"Wrist size is important .. wrist correlates almost perfectly with frame, and  you need a strong natural frame to be considered a 'real man'."

Incel community member

"Incels simultaneously situate themselves as failed hopeless losers while celebrating, encouraging and participating in violence against women."

"This paper analyzes weaponized subordination, wherein men strategically use their perceived subordinate masculine status to legitimate their degradation of women. The paper draws on a qualitative analysis of 9,062 comments made on a popular involuntary celibate (“incel”) discussion board. Incels are an online community of men who define themselves by their inability to participate in heterosexual sex/relationships. Incel forums are characterized by self-loathing, anger, and misogyny, with several incels having committed murders (e.g., Elliot Rodger)."

Newly published study

A study recently published in Sociologists for Women in Society based its conclusions partially on the examination of some 9,000 comments that were posted by men identifying themselves as 'involuntarily celibate'. The comments were posted on a popular incel discussion board where men feel free to post their ideas of their state of being and that subordinate masculinity entitles them and legitimizes the degradation of women through male supremacy.

The very term itself describing the emotional attitudes of men who feel themselves to have been unfairly judged as insufficiently masculine and attractive to women was first spoken of by a Canadian university student in the 1990s who initiated the online community on behalf of "anybody of any gender who was lonely, had never had sex or who hadn't had a relationship in a long time". On the site people were free to discuss their personal experiences.

By 2000 she was no longer involved in the website. The incel community was gradually led by extremists gathering to discuss hatred of women on the fora now mostly populated by men of all types and persuasions and backgrounds who view themselves as being "ugly, genetic trash" whose domination by other men and rejection by women has left them in a state of self-loathing, anger and misogyny, according to the study.

The study's author, Michael Halpin, analyzed the discourse he sought out on line for a deeper understanding of the incel justification of their misogyny. There is a penchant for incels to describe their poor self-image in emasculated terms such as "Manlets" for feminine-looking men of short physical stature, "jawlets" for men with weak jawlines, "wristlets" for those with small wrists, and "lanklets" for tall men with slender frames.

 

Their physical deficiencies, disadvantaged by 'lookism' is the primary focus, they believe, leading women to dismiss them, according to Dr. Halpin; a massive inferiority complex which the men then project onto women. The most infamous man associated with 'involuntary celibacy' is Elliot Rodger for violently murdering six people in Isla Vista, California. He is referred to within the incel community by some of its members as "Saint Elliot", given praise for stabbing three men to death and shooting three women, and another male student.

 

Done there, he drove through the city shooting at pedestrians and striking others with his car, finally committing suicide with a gun, shooting himself in the head. He left a 137-page manifesto and YouTube video recounting his search for vengeance against those responsible for women rejecting him.

Getty Images

Remain ... Vigilant

"Our findings suggest that immune imprinting by prior antigenic exposure may pose a greater challenge [than currently appreciated]."

Bivalent Vaccine efficacy study

"No one is saying don't get boosted. The concern that I have is if you talk up these bivalent boosters as being some kind of super strong shield ... that encourages people to believe they've got amazingly strong protection against infection..."

"My message for the general public is: Don't drop your guard just because you've been boosted."

John F. Moore, professor of microbiology and immunology, Weill Cornell Medicine, New York

Getty Images

 

It would seem that despite being lauded for super efficacy by its manufacturers, the new bivalent COVID-19 vaccine boosters  may not deliver the ant5icipated level of protection against Omicron mutations after all. On the other hand, in the glass-half-full category, the bivalent shots, offering similar protection to the original vaccine formulas previously rolled out in the early stages of the pandemic, do offer at the very least the same protection level against serious outcomes once infected; fewer hospitalizations, less health impact and fewer deaths.

Two new studies, both small involving a total of 73 individuals between them, have the status of pre-prints, not yet accepted for publication in any respected medical journal following assessment by peer scientists for accuracy. The authors of the studies consider a phenomenon called "immunological imprinting" as a possible impediment to full Omicron subvariant efficacy; the immune system has a habit of locking onto and responding to the initial version of the virus either through vaccination or infection.

Columbia University and University of Michigan researchers responsible for the first study, compared Pfizer and Moderna's bivalent boosters targeting both the original SARS-CoV-2 strain along with Omicron's BA.4/BA.5 strains against the original vaccine formulations. Three to five weeks following booster shots no "discernibly superior" difference was found between the level of virus neutralizing antibodies in the blood of people receiving the revamped vaccine as a fourth shot in comparison to those who received the original vaccine formations.

"To disappointment, the bivalent vaccine did not show superiority over the original vaccine", observed co-author David D. Ho, professor of microbiology and immunology at Columbia. A Beth Israel Deaconess Medical Center in Boston team arrived at similar findings when they studied the responses of 15 people who received the original mRNA boosters and 18 others who received the bivalent boosters.

Some of those studied had two to four prior COVID-19 vaccine doses while a third of participants experienced a confirmed COVID-19 infection during the Omicron surge. Both boosters were seen to increase antibody responses; however, a "modest and non-significant trend" favoured the bivalent shot. Pfizer, on the other hand, issued a press release with their data finding that individuals who received its bivalent shot showed a "substantial increase" in neutralizing antibodies against Omicron BA.4 and BA.5 in the first seven days after receiving a booster dose.

The Moderna vaccine approved in Canada is different than the one tested in the two new studies. The version approved in Canada was designed to target Omicron BA.1, since eclipsed by BA.4 and BA.5. Moderna researchers reported, in a study published in the New England Journal of Medicine that a fourth dose of their BA.1-targeting booster elicited a "superior antibody response" against Omicron in comparison to a booster dose of its older vaccine, including against the BA.4 and 5 subvariants,.

The role of the neutralizing antibodies in assessment is to infer how well vaccines work. Little available public data is thus far available on how efficacious the revamped boosters are at preventing severe illness and hospitalization, even while immunologists anticipate they will be of help in thwarting severe outcomes.

"For those who are saying, 'See, see, I told you so', I would say, let's stand down a little bit and wait for some cleaner data to come out, because these studies can't be used to support really one argument or another", cautioned Dr. DeeptaBhattachary7a, professor of immunology at University of Arizona.

Getty Images

"[Millions of people have already had three, even four shots of the original vaccine] so there's a potential for imprinting, a preferential revving up of the immune response to whatever the person was originally exposed to."

"Bottom line. Until more data are available, regard the bivalent booster as equivalent to a booster which augments and broadens immunity, without specific anti-BA.5 properties."

Dr. Eric Topol, professor of medicine, Scripps Research

Extracorporeal Membrane Oxygenation Therapy

"We already knew that ICU survivors can suffer mental health impacts from the trauma of invasive treatments, living with new physical limitations and dealing with long recovery times."

"We suspected ECMO [extracorporeal membrane oxygenation] survivors can suffer mental health impacts from the trauma of invasive treatments, living with new physical limitations and dealing with long recovery times."

"We suspected ECMO survivors would be at greater risk of mental health impacts because they are sedated and ventilated for longer and often face a more challenging recovery. But we didn't have clear data until now."

Study lead author Dr. Shannon Fernando, critical care physician, Lakeridge Health, The Ottawa Hospital/University of Ottawa

"We suddenly have a lot more ECMO survivors because of COVID-19."

\"We need to make sure they have the mental health support they need to recover and survive."

Dr. Kwadwo Kyeremanteng, co-senior author, scientist, critical care doctor, The Ottawa Hospital

 

"The use of ECMO has grown worldwide, particularly in the context of the COVID-19 pandemic, where ECMO has been used for refractory respiratory failure in cases of severe COVID-19,."

"Given the severity of illness found among patients receiving ECMO, its invasive nature, as well as the prolonged duration of therapy and recovery that is often required among those who survive ... survivors after ECMO may be at even greater risk of downstream mental health morbidity than other survivors of critical illness."

Research Study conclusion

MedPageToday

During the SARS-CoV-2 pandemic extracorporeal membrane oxygenation (ECMO)  became the life support of last resort. This extreme treatment aided some critically ill patients to evade succumbing when they were on the brink of death, bringing them back to life. This advanced therapeutic form of life support is proving to be costly in mental health outcomes for some patients, a message highlighted in a new study resulting from research carried out by Ottawa scientists.

 

Published in JAMA this week, the study found survivors of ECMO experienced a 24 percent elevated rate of mental health diagnoses following discharge, in comparison to other intensive care unit survivors. The extreme form of life-saving therapy temporarily replaces the heart and lungs of patients undergoing heart or respiratory failure, and is in use at five Ontario medical centres, including the University of Ottawa Heart Institute.

 

Use of ECMO has grown worldwide in response to the COVID-19 pandemic in addressing record numbers of extremely ill patients who present with severe respiratory failure. Ontario had twice as many patients at one point on ECMO as during the pre-pandemic period. Typically, the procedure was undertaken on an infrequent basis in reflection of limits on who might qualify and would be seen to benefit from its use.

 

ECMO is extremely invasive which accounts for its use on younger patients, with roughly 50 to 65 percent of those who receive the treatment surviving. Most of those survivors are alive five years after receiving the treatment. Researchers from The Ottawa Hospital, the Institut du Savoir Montfort, ICES and the University of Ottawa studied the health records of all ICU survivors in Ontario between April 2010 and March of 2020. 642 ECMO survivors were matched with 3,820 ICU survivors with similar characteristics inclusive of age, sex, mental health history, severity of illness and length of stay.

 

Of the ECMO survivors, 37 percent were diagnosed with a new mental health condition, identified as depression, anxiety and traumatic disorders, representing a 24 percent higher rate of new mental health conditions than other ICU survivors. Earlier research led by Dr. Fernando found survivors of ICU at higher risk of suicide and self-harm following discharge. In the study on ECMO patients, further heightened suicide and self-harm risk was not seen, but the research recommends a greater focus on patients discharged from ICU and particularly those who received ECMO treatment. 

"Patients will need help long after they leave the ICU", commented Dr. Fernando. Patients in his care during the recovery period after ECMO treatment often described to him nightmares and recurring thoughts in keep with post-traumatic-stress disorders. "It became clear it was exceedingly common", he explained.

"As care providers, we can tell our patients that it's common to struggle with your mental health after an ICU admission."

"ICU survivors need to realize that they often face months or years of recovery and families and health care providers need to support them."

Dr. Peter Tanuseputro, physician-scientist, The Ottawa Hospital

Photo by Dr. Yoanna Skrobik/Supplied /PST

Hello, Are You Woke Yet?

"A lack of access to menstrual products in men's toilet rooms has raised concerns regarding washroom equity."

"[Under proposed regulations employers will be required to provide menstrual products] in each toilet room. [One product dispenser] is assumed to be purchased for each toilet room, regardless of gender, across all work sites under the control of large business employers in the federal jurisdiction."

"[In addition  to the dispensers government would also] require one covered container for the disposal of menstrual products to be installed in every toilet compartment, in women's, men's and gender-0neutral toilet rooms."

"Therefore, these covered containers would be added to all toilet compartments [stalls] in men's toilet rooms across the federal jurisdiction."

"[The proposed regulations will improve sanitation and help] build a more inclusive Canada."

Government of Canada

Kevin Hiebert with the advocacy group Changing the Flow based in the Region of Waterloo in Ontario, says the groups directly impacted by lack of access to period products should lead the discussion on how to get menstrual equity right. (Mike Stewart/Associated Press)

Yes, this is what consumes the Liberal government of Justin Trudeau. Live and let live just won't cut it. Very special arrangements must now be made into law to address 'equity' and provide the transgendered who represent 0.2 of Canada's population with considerate comfort. The balance of the population not needful of that kind of 'comfort' may find themselves accommodating a government move to see that there is free and ample menstruation products available to that vanishingly small component of the population, courtesy of the taxpayer and those who must purchase their own hygiene products

 

Four government departments -- the Ministries of Development, Indigenous Services, Natural Resources and Transport Canada -- are sponsoring this inspired move to improve hygiene and accommodate transgender individuals in federally regulated workplaces. Employers under the proposed regulations would be required to see that menstrual products are freely available in bathrooms, whether designated for male or female use. 

The proposed new regulations, according to government, will result in a more inclusive atmosphere for individuals who have moved from their natal birth identification to the gender of their choice. This is a private process, individual determination of how one wishes to conduct their lives as far as gender is concerned. Why it has become a matter of public display and attention requiring the entire population to fall into place behind the delicate subject of gender choice is puzzling indeed.

Within the wider public many women are and will continue to be uneasy about sharing bathroom space with a man living as a woman and the reverse is also a reality; many men will feel extremely uncomfortable in the presence of a woman now living as a man, in their midst while in the process of performing normal evacuations. 

But the proposed regulations are to become a government-sponsored instrument that will result in more worker productivity, an increase in workplace safety, the improvement of employees' physical and psychological health, a reduction in discrimination against 2SLGBTQ1+ communities while impacting positively on Indigenous workers and disproportionately benefit the poor. Gender-based discrimination will be addressed by this initiative resulting in increased fairness and equality. All this to be achieved by mandating menstrual product dispensers be placed in each men's washroom

According to government estimates the full cost of the regulations would come in at $116.6 million stretching from 2024 to 2033. Details such as estimates of how costly the purchase of the products and their installation [containers for disposal], represents part of the total cost. Thoroughly thought out and justified by the dire need to provide former women now living as men with female menstrual products. Meant as well to be used by anyone who requires them. Another free benefit for government workers.

The products will be there, widely available for the select few that will take advantage of their presence as a bonus salute to their newly-acquired status, while the majority of workers will no doubt become accustomed to the presence of these products which the larger balance of employees may find their presence peculiar, even annoying in the presumption that they are needed at all. In that perhaps it would be more useful to assign singular toilet stalls separate and apart from others for the specific use of individuals requiring these menstrual products to begin with?

The 2021 Census of Population included for the first time a question on gender and the precision of "at birth" on the sex question, allowing all cisgender, transgender and non-binary individuals to report their gender.

Canada is the first country to collect and publish data on gender diversity from a national census.

Of the nearly 30.5 million people in Canada aged 15 and older living in a private household in May 2021, 100,815 were transgender (59,460) or non-binary (41,355), accounting for 0.33% of the population in this age group.

The proportions of transgender and non-binary people were three to seven times higher for Generation Z (born between 1997 and 2006, 0.79%) and millennials (born between 1981 and 1996, 0.51%) than for Generation X (born between 1966 and 1980, 0.19%), baby boomers (born between 1946 and 1965, 0.15%) and the Interwar and Greatest Generations (born in 1945 or earlier, 0.12%).

Over time, the acceptance and understanding of gender and sexual diversity has evolved. Further, there has been social and legislative recognition of transgender, non-binary and LGBTQ2+ people in general. Younger generations may be more comfortable reporting their gender identity than older generations.

In May 2021, the Canadian population aged 15 and older had an average age of 48.0 years. In comparison, the transgender population had an average age of 39.4 years, while the non-binary population had an average age of 30.4 years.

Just under 1 in 100 young adults aged 20 to 24 were non-binary or transgender (0.85%).

Nova Scotia (0.48%), Yukon (0.47%) and British Columbia (0.44%) had the highest proportions of transgender and non-binary people aged 15 and older among provinces and territories.

Victoria (0.75%), Halifax (0.66%) and Fredericton (0.60%) had the most gender diversity among Canadian large urban centres.

Just over half of non-binary people aged 15 and older (52.7%) lived in one of Canada's six largest urban centres: Toronto (15.3%), Montréal (11.0%), Vancouver (10.8%), Ottawa–Gatineau (5.6%), Edmonton (5.4%) and Calgary (4.5%).

Nearly 1 in 6 non-binary people aged 15 and older (15.5%) lived in the downtown core of a large urban centre. This share was more than twice that of transgender people (7.0%) and over three times higher than that of cisgender people (4.7%).

Statistics Canada

 

Under Ottawa's proposed regulations, employers would be required to provide menstrual products in women’s, men’s, and gender-neutral toilet rooms. Photo by DEREK RUTTAN/London Free Press files

To Boost Or Not To Boost, That is the Question

"Laboratory data suggest these updated vaccines provide increased protection against currently circulating variants."

"If you received your last COVID-19 vaccine [more than two months] ago, I encourage you to join me and get your updated vaccine now."

Dr. Rochelle Walensky, head, U.S. Centers for Disease Control and Prevention

Dr. Rochelle Walensky is isolating at home. Tom Williams/CQ-Roll Call, Inc./Getty Images   

"I would be lying to you if [I said] it doesn't keep me up at night worrying that there is a certain chance that we may have to deploy another booster -- at least for a portion of the population, perhaps older individuals -- before next September, October."

"I'm not saying that's what's going to happen, but it's what keeps me up at night, because we see how fast this virus is evolving."

Helen Branswell,  head, U.S. Food and Drug Administration vaccine operations

"I'm seeing the pushback and mocking everywhere."

"The anti-vax  community has effectively weaponized early statements from public health officials about transmission, which could have been better."

"And, yes, Omicron changed the picture. But the data are clear; Unvaccinated die more, and are hospitalized more, and have worse outcomes."

"I think this has made misinformation and ideological spin more persuasive. The personal risk/ benefit analysis has shifted."

"With the rise in complacency and the belief that the boosters are just 'extra' which is the wrong framing, even slight hesitancy seems more likely to translate into inaction."

Dr. Timothy Caulfield, professor of law, University of Alberta

The elderly in any given population [individuals over age 65], those with serious medical conditions such as chronic lung disease "where even a mild infection could land them in hospital", and the immuno-compromised should sensibly be vaccinated for optimal protection with the new bivalent boosters, infectious diseases specialist Dr. Paul Offit -- at Children's Hospital of Philadelphia, a vaccine adviser to the FDA -- has argued.

New fuel in the controversy over whether people should continue receiving new and updated vaccines has arisen with the public disclosure that the head of the very agency in the U.S. in charge of disease control has tested positive for COVID-19, a month following her vaccination with one of the newly-approved COVID-19 vaccines. Immunologists and other medical personnel are now concerned that the latest news may cast doubt on the usefulness and efficacy in the public mind of the vaccines altogether.

Even before the news that Dr Rochelle Walensky had been infected, albeit with what has been described as a 'mild' case of COVID, a growing surge of public opinion reflects skepticism over the new bivalent vaccines, designed to target both the Omicron and original strains of SARS-CoV-2. Not to be overlooked, however, is that the infection's symptoms are evidencing as mild. "That is what the vaccine is supposed to do in 2022", noted Al Tompkins of the Poynter Institute.

Dr. Walensky was administered her bivalent COVID booster on September 22 and that she became infected afterward is not unusual; such breakthrough incidents have been well documented. That her symptoms of COVID have been mild and her recovery anticipated to be quicker, both those positives are a result of the booster elevating her resistance to COVID, while not completely protecting her against its onset. 

Anticipating a surge in cases as winter approaches, both American and Canadian public health agencies encourage their populations to take the initiative to protect themselves from harsher infection impacts requiring hospitalization, and in the elderly, more deaths. The health agencies are focused on broadening immunity across all age groups, but particularly those of the most vulnerable; the elderly, those with chronic health conditions and the immune-impaired. 

The modified boosters have been designed to contain a broader strain of the virus for immune protection against both circulating and future COVID variants "although given the unpredictable nature of the ongoing evolution of SARS-Co-2 this is uncertain at this time", cautioned Health Canada. Despite being up to date on COVID shots and masking during a World Health summit last week in Berlin, Dr. Walensky contracted COVID even though she masked at all times during the two-day meeting, other than for publicly speaking and while eating.

The public is largely unaware of the extent to which infection protection through COVID vaccines ebbs as time goes on. Unvaccinated 12- to 64-year-olds according to a new study from the Washington State Department of Health, were almost twice as likely to be infected with COVID and three times more likely to be hospitalized with COVID than people with at least two doses of vaccine. In the group 65-uears and up, unvaccinated individuals were 4.5 times more likely than the immunized to die.

The Venerable BMI Quotient Called Into Question

"The BMIs [body mass index] do get fairly high, but our complications remain reasonable. I don't think it's a reason to turn people away [from knee joint replacement]."

"All the cartilage is completely gone [with end-stage degenerated joints]. Even a lay person looking at this joint [with the eroded bone, inflammation, red tissue, scar tissue] if it was open would say, 'Wow, that looks painful." 

"...Unless you've had this [degenerative joint disease] or seen people like this, you can't even imagine."

"Obviously if you're putting more load through that joint, it gets worn and torn sooner."

Dr.Harman Chaudhry, orthopedic surgeon, Sunnybrook Holland Orthopedic and Arthritic Centre

"The best marker of adiposity will have the strongest association with mortality."

"We need to shift the way we're thinking about fat away from sheer quantity toward distribution, which seems more physiologically relevant."

Guillaume Pare, professor of pathology and molecular medicine, McMaster University

"[It's not often the case that people accumulate fat in one place and not the other; either the hips or the waist.] The two go together."

"The simple message should be not to accumulate too much fat, wherever it goes."

Keith Frayn, emeritus professor of human metabolism, University of Oxford

When it comes to health, one measurement doesn't tell the whole story.iStock (2); Everyday Health

The ratio of weight to height has been used by doctors, insurance companies, statisticians and the World Health Organization for a half century as a guide in assessing overweight and obesity. Its viability as a tool to fully comprehend overweight and obese people's health score is now coming under scrutiny, with some health professionals damning it as inaccurate and misleading, recommending it is past time to put it to rest and use an alternate measurement scale.

Some argue that the BMI was formulated as a measurement of weightedness based on white males of European descent, making it an inappropriate tool as a generalized system for other racial and ethnic groups. Its use to arbitrarily disqualify heavier physiques from joint replacement, along with other life-altering 'elective' surgeries is increasingly being questioned. 

 

 

"BMI has now become the organizing principle of a massively sprawling surveillance system and the default tool in society's arsenal in the 'war on obesity'", two Harvard academics wrote in MedPage Today. "And the consequences are dangerous", they concluded. Missed diagnoses occurring when doctors inadvertently assume the person's complaints or symptoms are merely a reflection of weight and the indiscriminate recording of an individual's BMI which can be totally irrelevant.

The BMI measurement of acquired fat fails to account for bone or muscle or frame size, while overestimating a fat condition. Nor does it consider the deposition of where the fat is located. Where it is now well known that belly fat is more harmful than fat accumulated around hips, Waist-to-hip ratio, according to a McMaster University professor, is superior to and should replace the BMI.

A massive meta-analysis involving over ten million people enrolled in a total of 239 studies across four continents --Asia, Australia and New Zealand, Europe and North America -- found overweight and obesity defined by the BMI associated with higher rates of death from any cause, including coronary heart disease, stroke and cancer in each global region studied; results published in the Lancet.

Critics point out that one size does not fit all; the BMI does not represent an optimal measurement of adiposity (fat); the formula in their opinion is scientifically illogical "There is no physiological reason to square a person's height" argued British mathematician Keith Devlin. The waist is crucially ignored in the formula at a time when it is cautioned that visceral fat that wraps about internal abdominal organs is particularly unhealthy, raising the risk of Type 2 diabetes and heart disease.

Waist to hip ratio (WHR) is now promoted as a more reliable prediction of an early death. An analysis by Dr. Guillaume Pare and former student Irfan Khan was produced an abstract at a European diabetes conference finding waist-hip ratio more reliably predicts early death than BMI. Mortality risk, they found, was lowest for those with the lowest WHR, rising steadily with increasing WHR.

Waist circumference divided by hip circumference, according to the World Health Organization, means a healthy WHR is 0,.9 or lower for men, 0.85 of less for women. A 2015 study of 40,000 Americans found nearly half classed as overweight according to their BMI, with 29 percent classed as obese and 15 percent with severe obesity were cardio-metabolically healthy; risk of diabetes and heart disease low, based on markers such as cholesterol, blood glucose and blood pressure. Over 30 percent of normal weight subjects were metabolically unhealthy.

Two of the world's largest groups of bariatric surgeons published new guidelines recently, the first in 30 years, calling for expanding eligibility for weight loss surgery to reconfigure the gut and digestive system controlling how many calories people can consume at any given time, and absorb. New standards are less restrictive, yet based still on BMI rather than factors such as fatty liver disease or high cholesterol.

Complex surgery is required in replacing knees and hips in people with severe obesity where potential complications require a risk-benefit discussion. People are unable to straighten their legs, bend their knees, experience trouble in and out of cars; pain disturbs their sleep leaving them depressed and with mood changes from lack of sleep. Surgery can make the difference between a normal life and being in a wheelchair. Yet patients are turned down for surgery, dismissed with a recommendation that they lose weight to qualify for surgery.

BMI range	Classification	Risk of poor health
less than 18.5	underweight	high
18.5–24.9	normal weight	low
25.0–29.9	overweight	low to moderate
30.0–34.9	obese class I (moderately obese)	high
35.0–39.9	obese class II (severely obese)	very high
40 or greater	obese class III (extremely obese)	extremely high

Genomic Impacts on the Human Immune System

"When the Black Death swept through northern Africa and Eurasia in the mid-fourteenth century, it killed up to half of the human populations there, reshaped history — and potentially changed the course of human evolution."

"A study published on 19 October in Nature¹ suggests that lingering scars from the bubonic plague, which was caused by the bacterium Yersinia pestis, can be found in genes involved in the modern human immune system. Four DNA variants in particular seem to have become more common after the Black Death, and might have contributed to survival."

Genes that might have aided survival during the Black Death are now linked to autoimmune disorders.  Nature

“Diseases and epidemics like the Black Death leave impacts on our genomes, like archeology projects to detect."

"This is a first look at how pandemics can modify our genomes but go undetected in modern populations. These genes are under balancing selection — what provided tremendous protection during hundreds of years of plague epidemics has turned out to be autoimmune related now."

"A hyperactive immune system may have been great in the past but in the environment today it might not be as helpful."

Hendrik Poinar, Professor of Anthropology, McMaster University 

"Our genome today is a reflection of our whole evolutionary history [as we adapt to different germs]", senior author Luis Barreiro explained of the conclusions reached by a team of scientists for a study published in the journal Nature. As example, some pathogens such as those behind the bubonic plague had a large impact on current-day immune systems. Current populations were left a biological legacy -- which helped our ancestors survive the Black Death, the end result being that it may make us more susceptible to some diseases encountered today.

 

In the 14th century, the Black Death represented the single most deadly event in recorded history as it spread relentlessly throughout Europe, the Middle East and northern Africa, in the process eradicating up to 30 to 50 percent of the population. Dr. Barreiro and colleagues at the University of Chicago, McMaster University in Hamilton, Ontario and the Pasteur Institute in Paris examined ancient DNA samples from bones of over 200 people from London and Denmark who had perished over a period of roughly100 years before, during and following the Black Death sweeping through the region.

 

Four genes which -- depending on the variant identified -- either protected against -- or increased susceptibility to -- the bacteria that caused bubonic plague; most often transmitted by the bite of an infected flea. What had assisted people in Medieval times was found to have led to problems generations following -- raising the frequency of mutations detrimental in modern times. 

 

Crohn's disease, rheumatoid arthritis and lupus represent certain autoimmune disorders, for example, found to have an association with some of the same genetic variants identified as protective against the plague. In diseases of this kind the immune system that defends the body against disease and infection attacks the body's own healthy tissues. "A hyperactive immune system may have been great in the past but in the environment today it might not be as helpful", explained Hendrik Poinar, anthropology professor at McMaster, another of the study's senior authors.

 

Although past research sought to examine how the Black Death affected the human genome, Dr. Barreiro is convinced that theirs represents the first demonstration that the Black Death held an important place in the evolution of the human immune system. The narrow time window associated with the event is a unique aspect of the study. Leading to a question: Will the COVID-19 pandemic leave a large impact on human evolution? Since the death rate is so much lower and the majority of people who died in the current pandemic already had borne children, Dr. Barreiro does not think that to be the case.

 

It is the fact that an anticipated appearance of more deadly pandemics in the future that may continue to shape humanity at the most basic level of the immune system function, that may go on to shape the future.

"The team focused on genes related to immunity and found four DNA variants that seemed to have been selected for during the Black Death in samples from both the United Kingdom and Denmark. One variant affected the expression of a gene called ERAP2. People with the variant produce a full-length version of an RNA molecule that encodes the ERAP2 protein; those who lack it make a shorter version of the RNA."

Nature

Bored? Get Smart!

"Boredom is sort of an emotional dashboard light that goes off saying like: 'Hey, you're not on track'."

"[Boredom is a warning sign that says, it's] really necessary."

"I think boredom gets a bad rap that's not deserved. [Boredom] is linked to a lot of what most of us want out of life, like living a rich, fulfilling, interesting, meaningful life."

"Boredom is just one sort of helpful signal -- maybe unwanted signal -- that helps us get there."

Erin Westgate, social psychologist, University of Florida

Getty Images

 

Dr. Westgate and colleagues found in a 2021 study that participants were led by boredom toward sadistic behaviour. One experiment with bored participants viewing a mundane 20-minute video showed them to be more likely to do something that it was presumed none had ever considered doing before. They took to shredding maggots with names the researchers gave them to 'humanize' the maggots in the minds of the study participants: Toto, Tifi and Kiki.

 

A psychological play to appeal to their consciences that failed to produce desired results, under the influence of boredom for some of the participants. Of 67 study participants who had watched the boring video, a dozen, representing 18 percent of the total, dropped a maggot into a coffee grinder. Just one out of 62 study participants in another group viewing an interesting documentary turned to shredding a maggot. Although the study participants had no knowledge of this, the maggots didn't mind that the grinding machine was faked.

 

A link was proven between boredom and various types of bad behaviour ranging from online trolling, to bullying in the classroom, to verbal and physical abuse by members of the military toward one another in other experiments. Boredom, it was confirmed, does not always make people surrender to our meaner instincts; it merely calls upon us to take action whether it is deigned to be good or bad. When good alternatives are present boredom also can convince people to perform good deeds.

 

In conclusion it seemed that research pointed in the direction that boredom appears to motivate people to search for novelty situations to staunch the boredom and raise interest levels. Having distractions to entice one away from boredom can often mean resorting to favoured topics having the effect of moving distant from feeling bored. Ten adults were placed in an fMRI brain scanner to measure brain activity as they watched either a clip from the nature documentary Planet Earth, a video of two men hanging laundry, or a static image.

This experiment initiated by James Danckert, a cognitive neuroscientist at the University of Waterloo and his colleagues, featured  the boring laundry video, the documentary or the men hanging laundry, spurred the brain's default mode network to activation; a constellation of brain regions active during internal thought, similar to someone's mind wandering. The anterior insular cortex, a region of the brain believed to signal something important happening in the outside world, shut down as a result of the boring video.

When personal agency is temporarily withdrawn people are most likely to be bored, and that often occurs at work or in school where situations arise where less autonomy presents and fewer options to remedy the emotion are present. Boredom is the mind's way of informing us that something is not quite right, but what to do about it, is not a feature of boredom. It is up to the individual to find useful measures to defeat boredom.

James Danckert, speaks pf people automatically trying to dispel boredom by turning to an iPhone for interest; yet he points out that decision is not particularly meaningful and could lead to a return to boredom. In the search of alternatives more meaningful, he recommends scrutinizing goals, large and small. Boredom, and the search for relief from it, is an essential part of our human experience points out Dr.Danckert. 

Ethics of Organ Retrieval : 'Dead Donor Rule'

"There is growing interest in adopting NRP [normothermic regional perfusion] in Canada [for organ transplant retrieval operations]."

"Knowing how stakeholder perspectives on NRP could impact trust in donation will allow for the development of policy that responds to these perspectives."

"Reanimation of the donor's brain may result in harm to the donor should they regain sentience."

Research paper, journal BMJ Open        

"We know that, after about 30 minutes of having someone on an NRP pump, their heart will actually start beating again, spontaneously, to the degree that the pump can be turned off."

"Potentially -- it's pretty unlikely we think -- potentially there could be restoration of brain activity or even brain function."

"And the concern there is, of course, if brain function is restored to the point where someone becomes conscious, they might be capable of experiencing pain, and that obviously would be a serious threat to donor safety."

"I think prudence demands that we start with abdominal."

Dr. Charles Weijer, professor of medicine and philosophy, Western University

"[By restarting circulation, even artificially, NRP undermines the validity of the definition of circulatory death because] the patient is, in fact, successfully resuscitated,"

"The patient is now dead by brain death criteria -- due to actions taken by the physicians procuring the organs."

American College of Physicians

The medial transplant community in Canada is in preparation mode for the 'anticipated adoption' of a new method of collecting organs for transplant involving restoring warm blood flow to vital organs. Including to the point of restarting the heart sheer moments following someone having been declared officially dead. Known as normathermic regional perfusion (NRP), the procedure is legal in some jurisdictions while outlawed in others. Medical ethicists seem split in their opinion whether the process invalidates the declaration of death.

The focus is on whether the procedure violates the widely accepted dead donor role where there must be the assurance that organs only be taken from dead patients. Researchers are scrutinizing the literature on the ethics of using NRP through conducting in-depth interviews and focus groups with organ recipients, deceased organ donors; family members, donation agencies and transplant surgeons, along with other health professionals involved directly in the donation procedure.

Once a prospective donor was declared officially brain-dead, a decision based on loss of any detectable brain activity and function, organs were only then removed. In brain death the body is maintained on life support, heart beating and pushing blood through the organs, until such time that the organs can be retrieved. A process to remove organs from 'controlled circulatory death' donors -- people not brain dead, but without recovery prospects, the decision was made to withdraw life support; a process recognized since 2006.

 

Once the heart stops and the obligatory five-minute 'no touch' period passes to ensure the heart has permanently ceased beating after the removal of life support, organ procurement proceeds. Starved of oxygen and nutrients during the dying process and the mandated wait period, organs can become unsuitable for transplant or may take longer to recover once set within the recipient than "if they'd been getting blood throughout", explained Toronto nephrologist Dr. Jeffrey Schiff, president, Canadian Society of Transplantation.

Following death, with NRP the donor is immediately connected through cannulas placed within large blood vessels, to a machine funneling their blood into a device that adds oxygen and removes carbon dioxide, then pumps it back into the body. During this process major arteries supplying blood to the brain are clamped and tied off in prevention of brain 'reanimation', a process called "regional" perfusion where doctors can restore blood flow to the abdomen only when target organs are abdominal such as kidneys, liver and pancreas. It is thoraco-abdominal NRP which also resuscitates the heart that becomes the problem.

Perfused for about 60 minutes the body is then weaned from the pump when doctors can assess the viability of the heart pumping inside the body. Several ethical concerns are raised, beginning with the post-mortem reversal of what was intended to be recognized as permanent circulatory death. As well the death donor rule is challenged by NRP, where the donor cannot be made dead to obtain their organs; where organ retrieval as well cannot cause death. 

In the article published in BMJ Open, Dr. Weijer and his colleagues explore the uncertainty over whether the surgical techniques used in prevention of brain reperfusion can with absolute confidence rule out collateral blood flow to the brain. Separately, in an earlier article produced by the same team, continuous brain monitoring in critical care and transplant medicine was called for during NRP to exclude "brain reanimation."

In abdominal NRP, flow of oxygenated blood above the diaphragm is far less likely to result, ruling out the heart beginning to once again beat. Jurisdictions look at the use of this technology differently where, for example Australia outlaws NRP while it is pernitted in the United Kingdom and Spain.

Surgical instruments used in a kidney transplant in 2016. The agency that oversees organ allocation, the United Network for Organ Sharing, is under scrutiny after a report documented loss and waste of donated organs, often because of problems transporting the organs. Molly Riley/AP

"During NRP, the deceased body is ethically manipulated using technology to permit organ recovery, but the body remains dead."

New York University bioethicist Arthur Caplan, American Journal of Transplantation