Another Sudanese Conflict

"This is a huge country, very diverse ... I think it will be a nightmare for the world."

"This is not a war between an army and small rebellion."

"It is almost like two armies – well trained and well armed." 

Former Sudanese Prime Minister Abdalla Hamdok

 

"[There was a recently noticeable change in the sides' attitudes; they appeared more open to negotiations, and were saying they would accept] some form of talks".

"The word 'negotiations' or 'talks' was not there in their discourse in the first week or so."

U.N. special representative in Sudan, Volker Perthes 

"I'm afraid that one day I'm asleep and I wake up to a bomb falling on my house."

"That's my deepest fear right now. That's all that I think of. That's why I can't sleep at night."

Khalid, resident of Khartoum

People gather to ride a truck to flee outside Khartoum, during clashes between the paramilitary Rapid Support Forces and the army, in Khartoum, Sudan April 28, 2023. REUTERS/ Stringer

"The current fighting has forced us to stop almost all of our activities in West Darfur."

"We are incredibly worried about the impact this violence is having on people who have already lived through waves of violence in the previous years."

Sylvain Perron, MSF’s deputy operations manager for Sudan

In 2003 there was wholesale carnage in the area of Darfur, an African farming community. There were disagreements between the Arab pastoralists and the farmers of Darfur. The Muslim-majority Arab-led government of the day under president Omar al-Bashir unleashed a no-holds-barred conflict on the farming communities of ethnic minorities, with military helicopters dropping bombs and the Janjaweed Arab mounted militias attacking the largely helpless farming communities who fled in terror.

 

Horrendous war crimes were committed and al-Bashir was found guilty along with his top general of war crimes and crimes against humanity.  An estimated 300,000 people were slaughtered, and millions were left homeless.

At the present time, Sudan's military had a shared custody of the country with the leader of the Rapid Support Forces militia which had grown out of the Janjaweed. Both General Abdel-Fattah Burhan who leads the Sudanese military and General Mohammed Hamdan Dagalo leader of the Rapid Support Forces (RSF) ended their temporary power sharing arrangement over the issue of elections for a civilian government promised after the previous one had been deposed.

 

Their disagreement turned into a violent power struggle with the third largest African country on the continent now engaged in a war that has killed hundreds of its people, wounded many thousands and caused the migration of over 75,000 people seeking haven from the conflict elsewhere in neighbouring countries, while foreign governments have taken emergency measures to evacuate their citizens to safety out of the country.

 

A number of temporary truces and ceasefires have come and gone, with other African and Arab nations, the UN and US acting as mediators between the adversaries in efforts to persuade them to reach an agreement and cease hostilities. The capital Khartoum has become a war zone. The truces are tentative and quickly breached, while in the interim tens of thousands flee elsewhere for safety. Evacuations by land, sea and air have come to an abrupt standstill, as the violence continues and escalates.

 

European, Asian and African nationals prepare to board a ship to Saudi Arabia, at Port Sudan, Sudan April 28, 2023. REUTERS/Ibrahim Mohammed Ishak

 

The military's warplanes bombed the RSF in upscale neighbourhoods in Khartoum on Friday while classes were reported as well around the headquarters of the military, the Republican Palace and the area close to the Khartoum international airport. Since the conflict erupted on April 15, these are areas that have become flashpoints. In Khartoum's sister city Omdurman, explosions have been noted as well.

In Khartoum, medical workers report that medical personnel have been abducted by the RSF to treat their wounded fighters. A voice note was shared on a chat group for Sudanese health care workers giving warning to wear civilian clothing, not medical uniforms, and to conceal any identification that would list their profession, should RSF fighters stop them on the street.

A Sudanese-American infectious disease physician at the University of Nebraska, working with community health leaders in Sudan shared the stories of five doctors she knows who were taken from the streets of Khartoum by the RSF since the fighting began. One of the abducted doctors forcibly taken to an unknown location described seeing dozens of wounded fighters, a stockpile of medical supplies and two other kidnapped doctors working on the fighters.

His days there were spent treating fighters with gunshot wounds, burns and other injuries, before they were finally released. Neither the military nor the militia have been able to strike a conclusive blow against the other to this point. World powers struggle to convince them to set aside the violence. An East African nation bloc has arranged an initiative for the two sides to hold talks, promoted by the African Union, the United States, the United Arab Emirates, Saudi Arabia and the United Nations.

 

While denying that he has an ambitions to attain power for himself, General Burhan insists that General Dagalo "wants to rule Sudan, seize its resources and magnify his wealth". He has ruled out speaking and engaging in negotiations with Dagalo while accusing him of orchestrating a rebellion against the state.

This image grab taken from AFPTV video footage on April 28, 2023, shows an aerial view of black smoke rising over Khartoum. (AFPTV/AFP)

AI Chatbot Medical-Educational Toolbox

"Patients with cirrhosis and/or liver cancer and their caregivers often have unmet needs and insufficient knowledge about managing and preventing complications of their disease."

"We found ChatGPT -- while it has limitations -- can help empower patients and improve health literacy for different populations."

"More research is still needed to better examine the tool in patient education, but we believe ChatGPT to be a very useful adjunctive tool for physicians -- not a replacement -- but adjunctive tool that provides access to reliable and accurate health information that is easy for many to understand."

"We hope that this can help physicians to empower patients and improve health literacy for patients facing challenging conditions such as cirrhosis and liver cancer."

Brennan Spiegel, director of Health Services Research, Cedars-Sinai Medical Center, Los Angeles

"The complexity of care required for this patient population makes patient empowerment with knowledge about their disease crucial for optimal outcomes."

"While there are currently online resources for patients and caregivers, the literature available is often lengthy and difficult for many to understanding, highlighting the limited options for this group."

Alexander Kuo, medical director, Liver Transplantation Medicine, Cedars-Sinai

"ChatGPT has [been] shown able to provide professional, yet highly comprehensible responses."

"However, this is one of the first studies to examine the ability of ChatGPT to answer clinically oriented, disease-specific questions correctly and compare its performance to [that of] physicians and trainees."

Yee Hui Yeo, clinical fellow, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai

A new Cedars-Sinai study found ChatGPT—while it has limitations—can help empower patients and improve health literacy for different populations. Photo by Getty.

 

According to a new study reflecting research out of Cedars-Sinai Medical Center in Los Angeles, published in the journal Clinical and Molecular Hepatology, ChatGPT, an artificial intelligence platform, has the potential of improving the prognosis of patients suffering from cirrhosis and liver cancer. The chatbot as controversial as it has been to date, could become a valuable tool, providing patients with knowledge of lifestyle and treatment information, conveyed in easily understood terms.

 

MedPageToday

Of the 3,500 Canadians diagnosed with liver cancer in 2022, approximately 1,650 of the total are thought to have died of the disease in that same year. Liver cancer's five-year net survival rate is just 22 percent. Representing the end-stage form of liver disease, Cirrhosis is a major risk factor for liver cancer; and both conditions require an extensive litany of therapies, difficult for some patients to manage on their own.

ChatGPT (chat generative pre-trained transformer) are becoming popular for personalized education purposes resulting from their capacity to respond to user prompts with human-quality responses that are drawn from vast databases. The health-care industry has already understood the usefulness of the software through its ability to compose basic medical reports and respond correctly to questions commonly appearing on medical school exams.

The research team in testing ChatGPT's cirrhosis and liver cancer knowledge, presented the chatbot with 164 frequently asked questions divided into five categories: basic knowledge, diagnosis, treatment, lifestyle or preventive medicine. The results were studied and graded by two liver transplant specialists, according to whom ChatGPT answered roughly 77 percent of questions correctly, with high accuracy levels in over 90 percent of questions of varying categories.

The liver specialists who graded the answers however, found that 75 percent of responses relating to basic knowledge, treatment and lifestyle categories were correct, yet fell short in adequacy. In that the proportion of responses "mixed with correct and incorrect data", worked out to: basic knowledge (22 percent); diagnosis (33 percent); diagnosis (33 percent); treatment (25 percent); lifestyle (18 percent); and preventive medicine (50 percent). 

 

It was established that while the software succeeded in offering useful advice to patients and caregivers dealing with cirrhosis and liver cancer, the study clarified that superior information is given from a doctor directly. Peter Lee, corporate vice president at Microsoft had an essay published in The New England Journal of Medicine, addressing the issue. He contended that society faced a choice whether to use ChatGPT in the health-care industry. 

The software has already demonstrated its value to the health-care industry with its ability to compose basic medical reports. GETTY

"We can try to slow down or shut down this technology, because we don't understand the risks completely."

"A second argument is more fatalist, saying: 'It's unstoppable. We might as well give it a try."

"A third choice, which I think is the only rational one, but it has to be made intentionally, is to think hard about how to integrate this technology into our lives so that we can be accomplishing things that neither humans nor AI alone can do."

"I'm hoping the medical community and the public will choose that third option."

Peter Lee, Microsoft corporate vice-president, research and incubation

Spring Allergies and Probiotics

"Hay fever affects performance, productivity and quality of life. For the people who suffer badly, it's no joke."

"For some time now, we've known that the gut microbiome of food-allergic people is different from that of those who don't have those allergies."

"We now have similar findings when it comes to hay fever and the bacteria that colonize our nasal passages."

"People with diverse bacteria in their nasal lining seem to be at lower risk of hay fever. Those with less diverse bacteria seem to be at higher risk."

"[It's never too early to start an anti-hay-fever diet.] You need to give the bacteria time to respond, and your immune system time to calm down."

Professor Adam Fox, consultant pediatric allergist, Guy's and St. Thomas' hospitals

"Our genes haven't changed in the past two decades, but allergies have risen and are continuing to do so."

"What's changed? Our food environment. Food can play a very important part in calming inflammation."

"[Children raised on anti-inflammatory diets are less likely to develop allergies in the first place, while] what you eat can certainly decrease your symptoms, too."

Shilpa Ravella, gastroenterologist, assistant professor of medicine, Columbia University Medical Center

 

"Vitamin C also acts as a natural antihistamine, which can be found in foods such as citrus fruits, broccoli, peppers, chili, kale and rocket."

"[It is, however, easily destroyed by heat and light], so trying to cook these as little as possible will help to retain more potency."

Eve Kalinik, nutritional therapist

Hay fever is a misery in the spring, leading to red eyes and sneezing. Caused by the inhalation of grass or tree pollen granules which are processed by the immune system, Hay fever is a dreaded spring event. With a genetic predisposition to developing an allergy to these plants, a risk that an inappropriate response will develop to release a chemical called histamine is highly likely. No cures for allergies exist and they're difficult to treat.

However, a growing body of studies suggest an alternative method may exist for tackling symptoms; through diet and dietary supplements. The journal Nature Microbiology published results of a study comparing nasal microbiomes of 55 hayfever-plagued adults with those of 205 healthy volunteers, finding hay-fever sufferers had a narrower range of bacteria in their noses and 17-times more of a particular kind: Streptococcus salivarius A situation that can drive the inflammation that haunts hay-fever sufferers.

Factors of lifestyle can come into play even though allergies are genetically-inherited conditions. Allergies that include hay fever are inflammatory conditions which some foods like meals containing sugary or processed ingredients can make cellular swelling worse. The Mediterranean diet as example of an anti-inflammatory therapy, can help to prevent and can alleviate hay fever in that it contains fresh fruits and vegetables, whole grains, fish and olive oil.

 

Apples are a good source of anti-inflammatories, as are onions which are both anti-inflammatory and contain as well the polyphenol quercetin, which acts as an antihistamine. Fermented foods like live yogurt, kimchee, kefir and sauerkraut are also linked to lower inflammation and higher diversity of gut bacteria. and while the science of probiotics is still in its infancy it shows great promise also in the area of treating allergies.

A study led by scientists at the National Institute of Integrative Medicine in Melbourne, Australia, gave the probiotic formula NC-Seasonal-Biotic to hay-fever sufferers in 2022. The finding was that it significantly reduced symptoms compared with a placebo group. In ten to 12 weeks, the noses of the volunteers ran less, their eyes were less itchy, and they slept better and felt less irritable.

Experts recommend liquid probiotics such as Symprove and BetterVits Probiotic Complex, instead of the powdered varieties.

"Hay fever is an overreaction of your immune system to pollen. If your immune system is already sensitive because of irritation in your gut, then it's highly reactive."

"If it's calm, it stands a better chance of reacting healthily to pollen."

"It's a challenge for a powdered [probiotic] product to deliver live bacteria into the gut [so opt for liquid probiotics instead]."

Dr. Simon Gaisford, professor of pharmaceutics, UCL

Love Fried Foods? Feeling Anxious?

"Here we revealed that fried food consumption, especially fried potato consumption, is strongly associated with a higher risk of anxiety and depression symptoms."

"Western dietary patterns have been unfavourably linked with mental health."

"However, the long-term effects of habitual fried food consumption on anxiety and depression and underlying mechanisms remain unclear."

Study Researchers, Hangzhou, China 

"[The research] irritates me in many ways. To suggest that there is one single cause of depression is absolute nonsense."

"[A very legitimate study was used to collect data] and then the researchers take this data and they analyze it to see what they can squeeze out of it."

"The takeaway is that if you raise zebra fish, don't let them swim in acrylamide-laced water."

McGill University chemistry Professor Joe Schwarcz

"It's an interesting study, but it doesn't change what was already known -- that a diet based on plenty of vegetables, fruit, nuts, seeds, pulses and moderate amounts of other foods is associated with better mental and physical health."

"Caution should be used when using animal models which only show 'anxiety-like' symptoms."

"[Toasted bread and coffee are also significant sources of acrylamide]."

Dr. Duane Mellor, senior lecturer, registered dietitian, Aston University, Birmingham, England 

"I've worked in a hospital setting for over a decade  helping people who experience severe depression."

"French fries don't land people in hospital."

Professor Jonathan Stea, clinical psychologist, University of Calgary adjunct assistant professor

Go ahead, eat that french fry. Photo by Getty Images

It isn't entirely unusual for research papers to be published, as was this study that saw publication in peer-reviewed journal, PNAS (the Proceedings of the National Academy of Sciences) conducted by researchers from Hangzhou, China, whose results face criticism. Where 140,728 subjects who took part in  he U.K. Biobank, a biomedical database and research resource replete with genetic, health and lifestyle information from a half-million U.K. participants, which gained critical and often controversial rebuttals from other scientists.

 

And this study seemed to hit all the right buttons for unfavourable feedback in its contention that the study concludes with that consumption of too many fried foods could lead to depression. "It may be that depressed people are more likely to eat French fries as a comfort food", responded Dr. Joel Shulkin. Yet this is a widely circulated study purporting to reveal that those who consume a plenitude of French fires face a higher risk of anxiety and depression.

 

Males, according to the study results, were seen to be particularly susceptible. The working hypothesis of the study is that enthusiasts of fried foods are exposed to acrylamide, a chemical which forms through a chemical reaction when plant-based and other foods are fried, roasted or baked, and most particularly at high temperatures. During frying, amino acids and sugars in the food react, giving foods a toasty crust and flavour -- the entire point of the process -- that appeals to the human palate.

 

The researchers focused on whether an association between frequent fried food ingestion and depression existed. Their study first looked at humans, then zebra fish. Biobank humans were followed for an average of 11 years. Those who reported eating more than one serving a day of fried foods had a 12 percent higher risk of anxiety and a seven percent higher risk of depression, compared to those who did not indulge.

 

The browner the surface of the food being fried, the higher the level of acrylamide will be present.  It is not entirely clear what risk acrylamide poses to humans, according to the U.S. Food and Drug Administration. However, it is classified as "likely to be carcinogenic to humans", by the U.S. Environmental Protection Agency.

The Chinese study authors in another, separate study reported long-term exposure to acrylamide led to anxiety-and depressive-like behaviours in adult zebra fish. Exposure made the fish less sociable, spending more time in dark zones and more time at the bottom of the tank, an indication of anxiety. The researchers identified symptoms of oxidative stress, a condition caused by an overabundance of tissue-damaging free radicals, along with cerebral inflammation in the fish.

The study subjects who consumed fried foods were likelier to be smokers, to have a higher body mass index and lower income and education levels: "Factors that are likely affecting mental health and that cannot be completely excluded in the analysis", stated Gunger Kihnie, professor of nutrition and food science at University of Reading.

According to Professor Schwarcz, it is possible that acrylamide is neurotoxic, since anything causing inflammation can affect all cells, including neurons. In view of cancer risks, people should reduce their intake of acrylamide. The level present in fries, suggests the professor, can be reduced by soaking the potatoes first in water, draining, then frying.

French Fries   Getty Images

Group A Streptococcus : Invasive Group A Streptococcal Disease (iGAS)

"Group A Strep (GAS) is a common bacterium that causes infections including strep throat. If strep goes untreated or under-treated, it can lead to invasive group A strep. It gets more serious if it invades the blood or spinal fluid and can result in flesh-eating disease and toxic shock that sometimes leads to death." Among symptoms to be on the lookout for are:

• Skin becomes red, warm, swollen, or very painful soon after an injury or surgery
• Fever and chills, muscle aches, nausea, and vomiting, followed 24 to 48 hours later by low blood pressure, increased heart rate, or rapid breathing

Toxic shock can lead to organ failure and death, according to the Centers for Disease Control.

WebMD

Doctors are seeing an increase in the number of patients experiencing an invasive form of group A strep. The illness is common but can be serious when bacteria spreads to the blood or deep tissue, and needs to be treated quickly.   CBC

 

"Researchers also recently reported on 2022 surges in iGAS in France and Denmark, while the U.S. Centers for Disease Control and Prevention (CDC) said cases this year have 'remained high in children in some areas of the country even after respiratory viruses decreased in those areas'."

"The CDC noted an added wrinkle: An ongoing shortage of liquid amoxicillin, which is often prescribed to children to treat early, milder group A strep infections."

"That common antibiotic has also been on Health Canada's tier three shortage list since mid-November, which refers to shortages 'that have the greatest potential impact on Canada's drug supply and health-care system'."

"A spokesperson for Health Canada told CBC News that there are signals the supply is improving, though overall demand remains higher than normal, which could impact supply at some pharmacies."

CBC News

In Ontario four children died, infected with invasive group A streptococcal bacteria in the past 6 months given a spike in cases of the sometimes-deadly disease. The deaths of these four children alongside deaths of 92 adults in the same period is reflective of a trend around the world -- a rise in cases of Invasive Group A Streptococcal Disease (iGAS). Reported cases of iGAS increased by 52 percent during the recent fall and winter strep season.

Group A Streptococcus is a bacterium found commonly in the nose, throat and on the skin. Many people carry the bacterium without it ever becoming active. Once invasive, it has the potential to cause severe illnesses, including necrotizing fasciitis (flesh-eating disease), meningitis and streptococcal toxic shock syndrome. Countries around the globe have reported spikes in iGAS in recent months and now Ontario has joined them.

Between October 2022 and March 31 in comparison to the same period in the five years before the pandemic higher rates of iGAS infections among all age groups were reported in Ontario. People over 65 are the most severely affected. Cases among children are rising, but deaths have not exceeded past years'. Very young children, pregnant women, those with weakened immune systems and people over 60 are considered at the greatest risk of developing invasive group A strep.

 

The vast majority of cases of iGAS require hospitalization. Among children, those between ages one and four had a higher percentage of severe outcomes than before the pandemic. Children under one and over four years of age had fewer severe outcomes than before the pandemic. While rates of serious outcomes for those over age 65 was higher in the past six months than during the average pre-pandemic year.

 

Seniors who were hospitalized had a death rate of 22.1 percent in comparison to17.8 percent in a pre-pandemic year. Higher rates of iGAS in Ontario, across Canada and elsewhere in the world were reported during a period where viral illnesses, including influenza and respiratory syncytial virus (RSV) spiked, and COVID-19 continues to circulate. In addition, long-term health issues can plague people who survive iGAS. 

 

Fever, headaches, confusion and a decreased level of consciousness during a strep infection signal a shift to a more serious disease level. "Those constellations of symptoms usually should ring an alarm bell", cautioned Dr. Donald Vinh, an infectious disease specialist with McGill University. In rare instances, GAS infection can lead to invasive GAS, which can cause life-threatening conditions, such as necrotizing fasciitis, streptococcal toxic shock syndrome and other severe infections, as well as post-immune mediated diseases, such as poststreptococcal glomerulonephritis, acute rheumatic fever and rheumatic heart disease.

 

Woman checking her child's fever. Credit: MART PRODUCTION

"Streptococcus pyogenes, also known as Group A Streptococcus, is a group of Gram-positive bacteria which can be carried in human throats or skin; it is responsible for more than 500 000 deaths annually worldwide."

"Transmission occurs by close contact with an infected person and can be passed on through coughs, sneezes, or contact with a wound."

"GAS infection commonly causes mild illnesses such as tonsillitis, pharyngitis, impetigo, cellulitis and scarlet fever. GAS infections are easily treated with antibiotics, and a person with a mild illness stops being contagious after 24 hours of treatment."

"GAS is considered a common cause of bacterial pharyngitis in school-aged children and may also affect younger children. The incidence of GAS pharyngitis usually peaks during winter months and early spring. Outbreaks in kindergartens and schools are common. GAS pharyngitis is diagnosed by rapid antigen tests (Rapid Strep) or bacterial culture and is treated with antibiotics and supportive care. Good hand hygiene and general personal hygiene can help control transmission."

World Health Organization

Fasten Those (Inflight) Seatbelts!

"Airports like London Heathrow deem that the person hasn't died [while a passenger on a flight] until the port authority doctor certifies the death. Only a licensed physician can pronounce death; otherwise it is deemed 'apparent'."

"If possible, passengers are displaced, but remember, most flights are full. Or, if possible, the body is relocated."

"The body is covered with a blanket up to the neck, the seat is reclined, eye shades are used, the seat belt is fastened, and pillows are used for padding."

Flight Captain Doug Morris, Air Canada Pilot

An airplane passes in front of the setting sun in London. A flight does not always divert if someone expires onboard (Press Association)

There were thousands of medical emergencies (that emanated from millions of passenger flights) in three years of which 0.3 percent culminated in death during a flight, according to a 2013 report in the New England Journal of Medicine on "Outcomes of Medical Emergencies on Commercial Airline Flights". That 0.3 percent was broken down to specify that out of 36 identified 'airline' deaths, 30 occurred during flight, capturing people ranging in age from a one-month-old baby to a 92-year-old.

Air Canada Captain Doug Morris published a book titled This Is Your Captain Speaking: Stories From The Flight Deck. He pointed out, among other things, that people travel for many reasons, the most common among which is for leisure and for business. But there are also people for whom a flight can represent issues of health and mortality. Those who fly somewhere in search of medical care, or who return home to spend their final days where they plan to breathe their last.

People live, people die, and occasionally they die while flying somewhere on a commercial flight that is shared by hundreds of other people. People who are suddenly confronted by a dire medical emergency among the passengers that results in death. The reaction is horror, fear and sometimes panic. People take death very seriously; their own, and that of others in proximity to themselves in particular. Flight crews are not completely unaware of the risks involved in their positions that can call upon them to administer defibrillators.

Abstract:  In-flight Deaths During Commercial Air Travel  How Big Is the Problem?

"Do passenger deaths occur during commercial air travel? If so, how often and from what causes? We reviewed information reported to the International Air Transport Association on in-flight deaths that occurred during commercial air travel for the eight years between 1977 and 1984. Of the 120 airlines in the International Air Transport Association, 42 carriers reported deaths during these eight years. A total of 577 in-flight deaths were recorded, for a reported average of 72 deaths per year. Deaths occurred at average rates of 0.31 per million passengers, 125 per billion passenger-kilometers, and 25.1 per million departures. The majority of those who died were men (66%, 382/577) and middle-aged (mean age, 53.8 years). Most of the individuals (77%, 399/515) reported no health problems prior to travel. Physicians aboard the aircrafts offered medical assistance for 43% (247/577) of the deaths. More than half of the deaths (56%, 326/577) seemed to be related to cardiac problems. Sudden unexpected cardiac death was the cause of death in 63% (253/399) of the apparently healthy people and seems to be the major cause of death during air travel. These observations support the initiation of programs to train cabin personnel in the skills of basic cardiopulmonary resuscitation and in the use of automatic external defibrillators."

JAMA Network   April 1, 1988

In one instance, a 62-year-old man died on a flight from Los Angeles to Albuquerque in 2014. The reaction of the flight crew was less than noble, in refusing to use a defibrillator in reflection of the man's hairy chest. More recently a woman in her 60s died en route to Manchester from Tenerife. Such events, though rare, are morbid events causing no lack of consternation from all involved.

Even though it might seem obvious from close inspection by a member of a flight crew that someone has suddenly died on board, legally and medically the expired are not held to be technically dead unless and until an authorized medical practitioner examines the person and confirms death has occurred. In such unlikely events as an onboard, inflight death, often passengers who happen to be medical doctors can intervene. 

The International Air Transport Association's non-binding protocols anticipate that cabin crew may be prepared to perform cardiopulmonary resuscitation for 30 minutes at the least when circumstances such as turbulence allow the opportunity for the deceased to be placed on the floor. Everyone must wear seat belts however, during periods of severe turbulence, including the dead, and for obvious reasons; a body left unsecured has the potential to bang about the interior of a plane, becoming a potentially lethal flying object itself.

When these situations arise, the plane becomes unlikely to reach a scheduled destination on time. Captain Morris, in writing of his experiences with an in-flight live consultation service helping to determine whether an on-board medical emergency requires flight diversion, indicates that presumed deaths do qualify for flight diversion.

"I have diverted to a few places under their recommendation, but I've also kept the flight going most times, based on their expert findings."

"The service is a saviour for everyone because there is nothing easy about 'pulling over to the side of the road', in an airliner."

Air Canada Captain Doug Morris

 

 

The Scorpion's Deadly Nest

"Jewry is unqualifiedly a racial association and not a religious association ..."

"Its influence will bring about the racial tuberculosis of the people."

"Antisemitism on purely emotional grounds will find its ultimate expression in the form of pogroms. Rational antisemitism, however, must lead to a systematic legal position and elimination of the special privileges which Jews hold ... Its final objective must unswervingly be the removal of the Jews altogether."

"Only a government of national vitality is capable of doing both, and never a government of national impotence."

Adolf Hitler, Vienna, 1919

Adolf Hitler (front row, far left) served on the western front in World War I and during the course of the war was twice decorated for service, wounded, and temporarily blinded in a mustard gas attack. He used his veteran status in later election campaigns.  National Archives and Records Administration, College Park, MD

The architect of the Second World War and the state-sponsored killing machine that was the Holocaust was born in 1889 in an Austrian town on the border with Germany. His parents' household was authoritarian, his father a quick-tempered, strict Austrian customs official. It was Adolf Hitler's mother who indulged their son. But this man who brought the world to conflict and massive death counts inherited personality traits from his father. As a boy he was moody and dissatisfied, lazy and disinterested in studies, he left school at age 16, his ambition was to become a fine-arts painter.

He planned to attend the Vienna Academy of Art in 1907 but his application, based on samples of his painting, led him to fail the entrance examination. For the next five years he lived in Vienna, in men's hostels, shabbily dressed, attempting to eke out a living by selling sketches at local cafes and taverns. The few private art galleries who consented to buy some of his paintings for resale, were mostly owned by Jews.

By his own account of the beginning of his severe antisemitism it was while he still lived in Vienna before moving to Munich in 1913 at age 24. It was in his hometown that he first heard composer Richard Wagner's music, an influential cultural icon whose antisemitism impressed Hitler. While living in Vienna the Viennese versions of racism and antisemitism blamed Jews for all the tribulations faced by non-Jews. The popular mayor of Vienna proclaimed to Hitler's admiration: "Greater Vienna must not turn into Greater Jerusalem".

Vienna had been home to Jews since the middle of the 12th century although in 1512 the inner city was proclaimed off limits to Jews and they were ghettoized, then expelled in 1570 by Emperor Leopold 1, who once economic interests prevailed invited Jews to return, eventually to achieve full civil rights enabling Jews to own property in the city, and attend universities, all of which brought a wave of Jewish immigration to the city. By 1907 the tide had turned when Jews from Eastern Europe and Russia fleeing pogroms flooded Vienna and antisemitism became rampant.

The prevailing opinion was that all Jews were dangerously different from the non-Jewish population of Vienna. Yet this was a time when Hitler as a youth appeared to get on well with Jews. Mein Kampf on the other hand, sees Hitler highlight "The visual instruction of the Vienna streets performed invaluable services as I wandered blindly, then viewed the population with open eyes". He saw "an apparition in a black caftan and black hair locks. Is this a Jew? was my first thought ... but the longer I stared at this foreign face, scrutinizing feature for feature, the more my first question assumed a new form: Is this a German?"

In the first World War he volunteered for the German Army although the Austrian military found him physically unfit for military service. He served on the Western Front, in France and Belgium as a dispatch runner carrying orders on foot or by bicycle. Wounded in 1915, he served with distinction winning the Iron Cross First Class in 1918. He was recommended for this honour by a Jewish officer named Hugo Guttman. Yet Germany lost that war, and Hitler began to blame Jews for that outcome.

"There is no making pacts with Jews; there can only be the hard: either-or. I, for my part, decided to go into politics", he wrote in1924. The largest and most largely Jewish political party in the Weimar Republic was the Social Democrats. Right-wing Freikorps units consisting mostly of World War I veterans blamed Germany's defeat on Jews.

Awe-Inspiring Visions of Sunsets and Sunrises

"[People can] experience these bumps in awe and aesthetic appraisal and beauty [when looking a a sunset or sunrise]."

"We have, as Western populations, become very disconnected from the natural world."

"When you see something vast and overwhelming or something that produces this feeling of awe, your own problems can feel diminished and so you don't worry so much about them."

Alex Smalley, doctoral candidate, University of Exeter, Britain

"Everything that you see, it's a function of many, many scattering [atmospheric filtering of light] events."

"The sunlight hits the first particle it encounters in the atmosphere, then that particle shines or reflects that incoming light onto the particle next to it."

"This is just going on a multitude number of times before that light ultimately reaches your eyes."

"They [sunsets] are very ephemeral. If you watch them, they change over the order of minutes."

Steve Coffidi, meteorologist, University of Oklahoma

 

According to research results, sunsets constitute the most beautiful fleeting weather phenomenon in a day with people finding sunrises and sunsets to represent the most beautiful, awe-inspiring of all weather conditions.This, from a study published by British researchers. According to whom people preferred sunsets and sunrises over storms, rainbows, clear blue skies or nightscapes.

 

Spending time in nature under clear blue skies has been demonstrated through research as capable of boosting mental health. In addition to which, the new research suggests, viewing a sunset or sunrise can provide an additional emotional boost. The surprising element here is that this emotional expression prevails even when viewing sunsets in paintings or screen savers the effect is similar. 

 

Sunlight takes a direct path through the atmosphere to the ground when it is paused overhead during daytime. Its position moves tangential to the ground when it rises or sets, and the pathway from sun to ground is thus lengthened, introducing various colour palettes. Sunlight strikes more molecules in the air as the pathway lengthens. Molecules like oxygen and nitrogen are thousands of times smaller than incoming visible wavelengths from the sun as it emits electromagnetic energy.

As the particles scatter, the sun's visible energy changes in direction with shorter wavelengths, like blue and purples removed from vision and longer wavelengths; orange and rad pass more freely to the ground, emitting those iconic sunset and sunrise colours. Summer is not the best time to view these phenomena with the interference of increased air pollution in the atmosphere.

 

During late fall and winter, viewing of sunrises or sunsets are optimal, when the air is cleaner, drier and less humid. Clouds can assist in sunrise enhancement by reflecting sunlight to the ground, seen with more high-altitude clouds, to capture light from the sun before it hits the atmosphere to undergo major filtering. In the presence of higher cirrus or altocumulus clouds rather than low-level clouds, brilliant reds, oranges and scarlet sunsets often occur.

People, asserts Mr. Smalley, respond to digital stimuli of nature; screen savers as example, testing people's emotions. Immersive technology can transport people's imaginations to places around the world. More positive emotions, moods and a strengthening of cognitive functions are often experienced when people physically spend time in nature, can also occur in viewing beautiful photographs of sunrises and sunsets.

Health Report for Canada's Chief Public Health Officer

"Fundamental changes in our socioeconomic structures are needed to rebuild our relationships with each other and with our planet."

"Collectively, we have a deep appreciation for Indigenous Peoples' close and continuing relationship to the land and waters that we live upon and we are committed to a lifelong learning journey toward becoming good guests here."

"Canadian public health actions should focus on] decolonization, justice and equity [above all]."

"Health systems should be independently governed or at least arm's length from government structures to be free of fear of repercussions."

What We Heard: Perspectives on Climate Change and Public Health in Canada

Dr.Theresa Tam, Chief Public Health officer, Health Canada

Health Canada commissioned a report and what emerged was a paper written by three individuals, identifying as "white settlers", some 72 pages in length. It was commissioned for the purpose of studying and detailing "impacts of climate change on the health and well-being of people living in Canada". For their report the three authors surveyed thirty public health experts and academics for inclusion and perspective.

 

Warming climate does in fact have an impact on health in Canada; an example of which is an expanded range for disease-carrying mosquitoes increasing potentially the number of people who may be exposed to diseases normally associated with more tropical climates than Canada's; as example, malaria, dengue fever and West Nile virus. Despite which the report lists no condition or infectious illness that might pose a risk in Canada, with linkage to climate change.

The report features instead disparate opinions by Canadian public health professionals focusing on "less tangible determinants", equating with "legal, colonial and racist factors". Which led the report to include opinions and explanations and recommendations such as these:

• "If we don't address capitalism, if we don't address colonialism, racism, the patriarchy, etcetera, we're going to tread water for a long time until we eventually drown."
• "It's really about the foundations of our society, the capitalist system, the culture of extraction -- and we need to change that. How do we do that?"
• "[The concept of] liberty and individualism advances the individual over the collective; it says 'as long as I get what I want, bugger you', and it leads to a huge number of problems, and it undermines the collective process."

The views of 30 Canadian public health officials and academics considered to "have some understanding of the role of public health systems", were distilled in the report. Many of these individuals exist at top levels in the Canadian public health establishment and include three Canada Research chairs. All of the 30 representatives were asked in focus groups or one-on-one interviews: "What roles should the public health system play and why?"

Climate change and poor public health, the report concludes, are caused by many of the same issues: "White supremacy, capitalism, colonialism and racism". Yet another theme posited that public health officials should be more "courageous" to insist on policy typically considered outside their purview be included, which would encompass the promotion of "low meat" diets, designs of housing projects and advocating against extraction and use of fossil fuels.

One respondent stated: "Practically speaking, a lot of public health people want to be making the connections, but they are literally not given the mandate or the permission to because it's not seen to be within their box." There is an admission in the report that public or official pushback to this manner of "speaking out" may result from health agencies, recommending these bodies be insulated against avenues of accountability.

One report respondent stated a belief that "Public health is under attack in some provinces ... and there's this climate change denial that we all know is being fuelled by the fossil fuel sector. So, my worry is that with public health that we won't actually be able to get out there and do what we need to do."

There was a near-unanimous pronouncement in the report that public health agencies should receive increased funding, even at the expense of the primary heath care system; if public health has more money to improve society and fight climate change, the rational goes, fewer people would be going to hospital. "Not only would the primary health-care system require less funding but staff would be less overwhelmed in their duties, especially as health issues related to climate change intensify", reads the report.

NOTICE: This is not a chapter of Lewis Carroll's "Through The Looking Glass".

The report concludes that climate change and poor public health are caused by many of the same things: “White supremacy, capitalism, colonialism, and racism.” Photo by Public Health Agency of Canada

Help Yourself Find and Reach Goals

"...It pops when you point out that it's the perfect fresh start."

"The season -- Easter, Passover, Ramadan -- pick your renewal holiday."

"All of the religions have it pegged, but in regular life without religious prompting we can use it, too." 

Katy Milkman, professor, Wharton School

Oscar Wong -- Getty Images

 

The Wharton School, University of Pennsylvania -- produced a study that shows what is called the 'fresh start effect' has a particular draw in spring. One experiment they conducted had subjects urged to save for retirement making use of different 'temporal landmarks'. They had the option of saving right then and now or to select a future date, like New Year's, a birthday or the first day of spring.

When several months elapsed, it was seen that people who focused on saving on their birthdays or at spring onset, had managed to save 20 to 30 percent more than the other selected groups. There is a fairly universal belief that the turn of a new year is the right time to decide to make changes in one's life, but some studies have clarified that New Year's resolutions have a tendency to fade; by April and May the resolutions draw little attention from those who claimed them.

New research suggests that it is spring, itself a time of global renewal and inspiration, that would represent the best time to turn one's mind to changes and goals. Sometimes stale old habits become more amenable to change and the adoption of new habits when the world itself is doing just that; having shed winter and welcomed spring with all its promises of new life, that particular natural event can act as a spur to action for people, as well.

Professor Milkman, the author of How to Change: The Science of Getting from Where You Are to Where You Want to Be, subscribes to the theory that motivation can 'wax and wane', providing the reason why fresh beginnings pair well with a single action relating to an inner need to keep people committed to identifying and adapting themselves to new perspectives.

She suggests that spring is the optimum time to think about enrolling in a savings plan with automatic deductions; to sign up for a fitness class or gym membership. There are other recommendations she makes that could be useful to the individual looking for new meaning in their lives and how best to express and acknowledge that it's time to make a fresh start in motivating themselves to achieve satisfaction in life. For example; start small:

• Place a notebook on your night table, use it to write down your thoughts and concerns;
• Commit to scheduling a physical, mammogram or dental appointment;
• Plan a trip for a happiness boost through an interesting vacation;
• Organize passwords, begin using a financial planning app;
• Put together a home library of all the books you've ever meant to read and read them;
• Commit yourself to more home meal preparations using wholesome food
• Get invested in a good leisure exercise routine.

Invest in a little introspection. Identify what is important to you. Plan to pay attention to those elements that classify as meaningful in your life. If achievement is your goal, make certain you have planned in a way that will make it possible for you to reach your goals. Identify what you find pleasure in doing, and what gives you the most satisfaction in your working and leisure life.

• What do you really think of yourself and your method of living life to its fullest?
• Who or what matters most to you?
• What are your deepest-held values?
• How is success defined in  your mind?
• What makes your life worth living?

Carefully write down your answers and engage in some deep introspection on whether your goals are within reach. And be aware that goals and satisfaction in life at some points in your life may change and with that change your own direction in gaining the control you want to have of your life must adapt to alterations. Be honest with yourself, and be practical.

boonchai wedmakawand

Plant Communication

"An idyllic field of flowers can be a noisy place. It's just that we can't hear the sounds."

"Our findings suggest the world around us is full of plant sounds, and that these sounds contain information -- for example, about water scarcity or injury."

"We assume that in nature the sounds emitted by plants are detected by creatures nearby, such as bats, rodents, various insects, and possibly also other plants -- that can hear the high frequencies and derive relevant information." 

Lilach Hadany, School of Plant Sciences and Food Security, Wise Faculty of Life Sciences, Tel Aviv University

House plant enthusiast Drew Beaudoin is surprised to learn plants emit sounds. (Katerina Georgieva/CBC)

Scientists in Israel discovered that plants voice their discomfort and distress due to drought, neglect or disease. The human ear cannot detect these sounds that are high-pitched emergency signals of distress. But they recorded the sounds of tomato, tobacco, wheat, corn and cactus making occasional ultrasonic popping noises which the researchers likened to bubble wrap. Plants ramp these sounds up when they're suffering stress. The findings were published in the journal Cell.

 

Famously, other, previous studies showed that plants respond positively and tend to thrive when exposed to music and to being gently spoken to. Now, science brings us the news that plants also communicate in their very particular biological way that nature has endowed them with; plant speech. Water scarcity or injury provoke plants to distress they aurally broadcast.

The research team placed plants in an acoustic box that was placed in an isolated basement with no background sound. Microphones capable of recording sounds at frequencies of 20 to 250 kilohertz were placed four inches from each plant.The plants were then subjected to different treatments; some left unwatered for five days; others had their stems cut, and a control group was left intact. 

Subsequent recordings showed sounds were emitted by the plants at frequencies of 40-80 kilohertz. Unstressed plants produced barely one click every hour on average; the stressed plants emitted dozens of sounds every hour. The maximum frequency detected by a human adult is roughly15 kilohertz.

Noises were emitted by water-sressed plants before they were visibly dehydrated. The researchers found it was possible to identify the distressed plant along with the type of stress being experienced. A dehydrated tomato plant made a different pattern of clicks as compared to a dehydrated cactus. Happy plants on the other hand, had a tendency to be quiet.

The potential for monitoring plants to determine whether they are struggling, based on their noises is a potential for a new type of agricultural program the research team envisions emerging from this research. Sound recordings could conceivably be used in irrigation monitoring crop hydration to help distribute water more efficiently.

Tel Aviv University professor Lilach Hadany, right, led the study, working with Prof. Yossi Yovel, left. (Tel Aviv University)

Nature's Cull

"There are enough red flags that we're beholden to prepare."

"If the virus spills over into new species, it always gains an opportunity to mutate and adapt even further."

"So this is really an unprecedented level of viral activity for H5N1."

Dr.Samira Mubareka, infectious disease specialist, clinician scientist, Sunnybrook Research Institute/University of Toronto

 

"The spillover of these viruses from wild birds to mammals could cause a potentially devastating pandemic if the H5N1 viruses mutate into forms that can spread efficiently among the mammalian species."

Research study, Canadian Food Inspection Agency, published in Emerging Microbes & Infections journal

There have been fewer than a dozen Asian influenza cases confirmed among humans identified globally since 2020. Even among those no instances have been identified of H5N1 passing from human to human. Public health agencies are involved in closely watching how the highly pathogenic avian influenza H5N1 is evolving, a heightened level of alertness, the impetus of which can be traced to the still-and-ever-presence of the previous SARS-CoV-2 pathogen that upended the world community in a massive infection and fatality rate.

First identified in 1996, H5N1 had manifested itself in 2020 with a new type that was detected in late 2021 in North America. Since that date, the virus has decimated huge flocks of both wild and domesticated birds, the result of which has been millions of poultry deaths in Canada alone, from infection and from preventive culls. Dr. Mubareka advised that what has partially captured the attention of scientists is the range of species being infected by the virus.

The first Canadian case was identified in a pet dog earlier this month, among the hundreds of confirmed cases in wild skunks, foxes, mink and other mammals dating to the beginning of 2021. Farmers in Ontario and Quebec have been bracing for a potential wave of cases with the return of migratory birds (bringing the infectious virus with them). Public health agencies throughout Europe, Canada and the United States feel for the time being that risk to humans of contagion is low. There is no risk associated with consumption of cooked birds.

 

 

Scientists with the Canadian Food Inspection Agency working at a laboratory in Winnipeg where cases of H5N1 are confirmed and genetically sequenced, studied cases in 40 different wild mammals, the researchers finding the virus had undergone some "critical mutations". The critical mutations referred to by the researchers involved that part of the virus that allowed it to replicate; similar findings were reported globally.The scientists found in 17 percent of the cases changes advantaging the virus  to replicate in humans.

On the other hand, the researchers also found that the virus had not developed a preference to lock on to receptors in a human nose, mouth and throat -- the target of an influenza virus, key to human infection. Multiple surveillance networks set to monitor and track the influenza virus have been installed by the Public Health Agency of Canada, which claims to take the situation "very seriously". Its recent experience with COVID-19 aided it in building H5N1-specific plans across government departments.

The 27 member states of the European Union agreed to implement a bird flu vaccine strategy, with Mexico, Egypt and China on a list of countries inoculating chickens against H5N1. Targeted vaccination could help to prevent poultry losses and reduce the spread of the virus, advised Shayan Sharif, professor and acting dean at the Ontario Veterinary College, concerned at the possibility that the virus may mutate to become more dangerous to humans and eventually transmit human-to-human.