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€œDespite a new wave which began on 25 buy generic baclofen July which Viet Nam is now also in the process of bringing under effective control, it is side effects baclofen 10mg tablets globally recognized that Viet Nam demonstrated one of the world’s most successful responses to the COVID-19 pandemic between January and April 16. After that date, no cases of local transmission were recorded for 99 consecutive days.There were less than 400 cases of infection across the country during that period, most of them imported, and zero deaths, a remarkable accomplishment considering the country’s population of 96 million people and the fact that it shares a 1,450 km land border with China.Long-term planning pays offKamal Malhotra is the UN Resident Coordinator in Viet Nam. , by UN Viet Nam/Nguyen Duc HieuViet Nam’s success has drawn international attention because of its early, proactive, response, led buy generic baclofen by the government, and involving the whole political system, and all aspects of the society. With the support of theWorld Health Organization (WHO) and other partners, Viet Nam had already put a long-term plan in place, to enable it to cope with public health emergencies, building on its experience dealing with previous disease outbreaks, such as SARS, which it also handled remarkably well.Viet Nam’s successful management of the COVID-19 outbreak so far can, therefore, be at least partly put down to the its investment during “peacetime”. The country has now demonstrated that preparedness to deal with infectious disease is a key ingredient for protecting people and securing public health in times of pandemics such as buy generic baclofen COVID-19.As early as January 2020, Viet Nam conducted its first risk assessment, immediately after the identification of a cluster of cases of “severe pneumonia with unknown etiology” in Wuhan, China.

From the time that the first two COVID-19 cases were confirmed in Viet Nam in the second half of January 2020, the government started to put precautionary measures into effect by strengthening entry-screening measures and extending the Tết (Lunar New Year) holiday for schools. © UNICEFTeachers and students were able to return to school in Lao Cai, Viet Nam, in May.By 13 February 2020, the number of cases had climbed to 16 with limited local transmission detected in a village near the capital city, Hanoi. As this had the potential to cause a further spread of the virus in Viet Nam, the country implemented a targeted three-week village-wide buy generic baclofen quarantine, affecting 11,000 people. There were then no further local cases for three weeks.But Viet Nam had simultaneously developed its broader quarantine and isolation policy to control COVID-19. As the next wave began in early March, through an imported case from the UK, the government knew that it was crucial to contain virus transmission as fast as possible, in order also to safeguard its economy.Viet Nam therefore closed its borders and suspended international flights from mainland China in February, buy generic baclofen extending this to UK, Europe, the US and then the rest of the world progressively in March, whilst requiring all travelers entering the country, including its nationals, to undergo 14-day mandatory quarantine on arrival.This helped the authorities keep track of imported cases of COVID-19 and prevent further local transmission which could have then led to wider community transmission.

Both the military and local governments were mobilized to provide testing, meals and amenity services to all quarantine facilities which remained free during this period.No lockdown requiredWhile there was never a nationwide lockdown, some restrictive physical distancing measures were implemented throughout the country. On 1 April 2020, the Prime Minister issued a nationwide buy generic baclofen two week physical distancing directive, which was extended by a week in major cities and hotspots. People were advised to stay at home, non-essential businesses were requested to close, and public transportation was limited.Such measures were so successful that, by early May, following two weeks without a locally confirmed case, schools and businesses resumed their operations and people could return to regular routines. Green One UN House, the home of most UN agencies in Viet Nam, remained open throughout this period, with the Resident Coordinator, WHO Representative and approximately 200 UN staff and consultants physically in the office throughout this period, to provide vital support to the Government and people of Viet Nam.Notably, the Vietnamese public had been exceptionally compliant with government directives and advice, partly as a result of trust built up thanks to real time, transparent communication from the Ministry of Health, supported by the WHO and other UN agencies. Innovative methods buy generic baclofen were used to keep the public informed and safe.

For instance, regular text updates were sent by the Ministry of Health, on preventive measures and COVID-19’s symptoms. A COVID-19 song was released, with lyrics raising public awareness of the disease, which later went viral on social media with a dance challenge on Tik Tok initiated by Quang Dang, a local celebrity. buy generic baclofen. UN Viet Nam/Nguyen Duc HieuYoung people in Viet Nam take part in International Youth Day 2020 festivities in June. Protecting the vulnerableStill, challenges remain to ensure buy generic baclofen that the people across the country, especially the hardest hit people, from small and medium-sized enterprises (SMEs) and poor and vulnerable groups, are well served by an adequately resourced and effectively implemented social protection package. The UN in Viet Nam is keen to help the government support clean technology-based SMEs, with the cooperation of international financial institutions, which will need to do things differently from the past and embrace a new, more inclusive and sustainable, perspective on growth.Challenges remainAs I write, Viet Nam stands at a critical point with respect to COVID-19.

On 25 July, 99 days after being COVID-free in terms of local transmission, a new case was confirmed in Da Nang, a well-known tourist destination. Hundreds of thousands of people flocked to the city and surrounding region over the summer.The government is once again demonstrating its serious commitment to containing local buy generic baclofen virus transmission. While there have been a few hundred new local transmission cases and 24 deaths, all centered in a major hospital in Danang (sadly, all the deaths were of people with multiple pre-conditions) aggressive contact tracing, proactive case management, extensive quarantining measures and comprehensive public communication activities are taking place.I am confident that the country will be successful in its efforts to once again successfully contain the virus, once more over the next few weeks.”The Review Committee will advise whether any amendments to the International Health Regulations (IHR) are necessary to ensure it is as effective as possible, WHO Director General Tedros Adhanom Ghebreyesus told journalists. He said the COVID-19 pandemic has been “an acid test” for many countries, organizations buy generic baclofen and the treaty. “Even before the pandemic, I have spoken about how emergencies such as the Ebola outbreak in eastern DRC (the Democratic Republic of the Congo) have demonstrated that some elements of the IHR may need review, including the binary nature of the mechanism for declaring a public health emergency of international concern,” said Mr.

Tedros. Interaction with pandemic panel The IHR Review buy generic baclofen Committee will hold its first meeting on 8 and 9 September. The committee will also interact with two other entities, exchanging information and sharing findings. They are the Independent Panel for Pandemic Preparedness and Response, established last month to evaluate global response to the COVID-19 pandemic, and the Independent Oversight Advisory Committee for the WHO Health Emergencies Programme buy generic baclofen. It is expected that the committee will present a progress report to the World Health Assembly, WHO’s decision-making body, at its resumed session in November.

The Assembly buy generic baclofen comprises delegations from WHO’s 194 member States who meet annually in May. A truncated virtual session was held this year due to the pandemic. The committee will present its full report to the Assembly in 2021. Committed to ending COVID-19 The IHR was first adopted in 1969 and is legally-binding on buy generic baclofen 196 countries, including all WHO Member States. It was last revised in 2005.

The treaty outlines rights and obligations for countries, including the requirement to report public health events, as well as the criteria to determine whether or not a particular event constitutes a buy generic baclofen “public health emergency of international concern”. Mr. Tedros underscored WHO’s commitment to ending the pandemic, “and to working with all countries to learn from it, and to ensure that together we build the healthier, safer, fairer world that we want.” Invest in mental health WHO is also buy generic baclofen shining light on the pandemic’s impact on mental health at a time when services have suffered disruptions. For example, Mr. Tedros said lack of social interaction has affected many people, while others have experienced anxiety and fear.

Meanwhile, some mental health facilities have been closed and converted buy generic baclofen to COVID-19 treatment facilities. Globally, close to one billion people are living with a mental disorder. In low- and middle-income countries, more than three-quarters buy generic baclofen of people with mental, neurological and substance use disorders do not receive treatment. World Mental Health Day is observed annually on 10 October, and WHO and partners are calling for a massive scale-up in investments. The UN buy generic baclofen agency also will host its first-ever global online advocacy event on mental health where experts, musicians and sports figures will discuss action to improve mental health, in addition to sharing their stories.

Global fight against polio continues The milestone eradication of wild poliovirus in Africa does not mean the disease has been defeated globally, Mr. Tedros reminded journalists. WHO announced on Tuesday that the continent has been declared free of the virus, which can cause paralysis, after no cases were reported for four years “We still have a lot of work to do to eradicate polio buy generic baclofen from the last two countries where it exists. Afghanistan and Pakistan,” he said. Mr.

Tedros also congratulated Togo, which on Wednesday celebrated the end of sleeping sickness as a public health problem. The disease, officially known as human African Trypanosomiasis, is spread by tsetse flies and is fatal without treatment..

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NCHS Data see this website Brief No baclofen blood sugar. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated baclofen blood sugar with an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2).

Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is “the permanent cessation baclofen blood sugar of menstruation that occurs after the loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status.

The age range selected for this analysis reflects the focus on midlife sleep health. In this baclofen blood sugar analysis, 74.2% of women are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal. Keywords.

Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a baclofen blood sugar 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 baclofen blood sugar. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend baclofen blood sugar by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no baclofen blood sugar longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for baclofen blood sugar Figure 1pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble falling asleep four times or more in baclofen blood sugar the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 baclofen blood sugar. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, baclofen blood sugar 2015image icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had baclofen blood sugar a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data baclofen blood sugar table for Figure 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or baclofen blood sugar more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 baclofen blood sugar. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image baclofen blood sugar icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual baclofen blood sugar cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 3pdf icon.SOURCE baclofen blood sugar. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group baclofen blood sugar who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 baclofen blood sugar. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories.

Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status.

A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. €.

2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?.

€Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?. €Trouble falling asleep.

Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone.

Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option.

Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454.

2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50.

2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N.

Perimenopause. From research to practice. J Women’s Health (Larchmt) 25(4):332–9.

2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society.

J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International.

SUDAAN (Release 11.0.0) [computer software]. 2012. Suggested citationVahratian A.

Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286. Hyattsville, MD.

National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J.

Blumberg, Ph.D., Associate Director for Science.

NCHS Data buy generic baclofen Brief No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep buy generic baclofen is associated with an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2).

Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is buy generic baclofen “the permanent cessation of menstruation that occurs after the loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status.

The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women are premenopausal, 3.7% are perimenopausal, and 22.1% are buy generic baclofen postmenopausal. Keywords.

Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, buy generic baclofen on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 buy generic baclofen. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend by menopausal status buy generic baclofen (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their buy generic baclofen last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data buy generic baclofen table for Figure 1pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women buy generic baclofen aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 buy generic baclofen. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend buy generic baclofen by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago buy generic baclofen or less.

Women were premenopausal if they still had a menstrual cycle. Access data table buy generic baclofen for Figure 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage buy generic baclofen of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 buy generic baclofen. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p buy generic baclofen <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a buy generic baclofen menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for buy generic baclofen Figure 3pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women buy generic baclofen. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 buy generic baclofen. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories.

Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status.

A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. €.

2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?.

€Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?. €Trouble falling asleep.

Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone.

Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option.

Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454.

2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50.

2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

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Baclofen is used for

The yearly influenza season threatens baclofen is used for to make the COVID-19 pandemic doubly deadly, but I believe that this isn’t inevitable.There are two commonly https://www.voiture-et-handicap.fr/buy-baclofen-usa/ given vaccines – the pneumococcal vaccine and the Hib vaccine – that protect against bacterial pneumonias. These bacteria complicate both influenza and COVID-19, often leading to death. My examination of disease trends and vaccination rates leads me to believe that broader use of the pneumococcal and Hib vaccines could baclofen is used for guard against the worst effects of a COVID-19 illness.I am an immunologist and physiologist interested in the effects of combined infections on immunity. I have reached my insight by juxtaposing two seemingly unrelated puzzles. Infants and children get SARS-CoV-2, the virus that causes COVID-19, but very rarely become hospitalized or baclofen is used for die.

And case numbers and death rates from COVID-19 began varying greatly from nation to nation and city to city even before lockdowns began. I wondered why.One night I woke up with a possible answer. Vaccination rates baclofen is used for. Most children, beginning at age two months, are vaccinated against numerous diseases. Adults less baclofen is used for so.

And, both infant and adult vaccination rates vary widely across the world. Could differences in the rates of vaccination against one or more diseases account for baclofen is used for differences in COVID-19 risks?. As someone who had previously investigated other pandemics such as the Great Flu Pandemic of 1918-19 and AIDS, and who has worked with vaccines, I had a strong background for tracking down the relevant data to test my hypothesis.Pneumococcal Vaccination Rates Correlate With Lower COVID-19 Cases and DeathsI gathered national and some local data on vaccination rates against influenza, polio, measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis (DTP), tuberculosis (BCG), pneumococci and Haemophilus influenzae type B (Hib). I correlated them with COVID-19 case rates and death rates for 24 nations that had experienced their COVID-19 outbreaks at about the same time. I controlled for factors such as percentage of the population who were baclofen is used for obese, diabetic or elderly.I found that only pneumococcal vaccines afforded statistically significant protection against COVID-19.

Nations such as Spain, Italy, Belgium, Brazil, Peru and Chile that have the highest COVID-19 rates per million have the poorest pneumococcal vaccination rates among both infants and adults. Nations with the lowest rates of COVID-19 – Japan, Korea, Denmark, Australia and New Zealand – have the highest rates of pneumococcal vaccination among both infants and adults.A baclofen is used for recent preprint study (not yet peer-reviewed) from researchers at the Mayo Clinic has also reported very strong associations between pneumococcal vaccination and protection against COVID-19. This is especially true among minority patients who are bearing the brunt of the coronavirus pandemic. The report also suggests that other vaccines, or combinations of vaccines, such as Hib and MMR may also provide protection.These results are important because in the U.S., childhood vaccination against pneumococci – which protects against Streptococcus baclofen is used for pneumoniae bacteria – varies by state from 74% to 92%. Although the CDC recommends that all adults 18-64 in high risk groups for COVID-19 and all adults over the age of 65 get a pneumococcal vaccination, only 23% of high-risk adults and 64% of those over the age of 65 do so.Similarly, although the CDC recommends at all infants and some high-risk adults be vaccinated against Haemophilus influenzae type B (Hib), only 80.7% of children in the U.S.

And a handful of immunologically compromised adults have been. Pneumococcal and Hib baclofen is used for vaccination rates are significantly lower in minority populations in the U.S. And in countries that have been hit harder by COVID-19 than the U.S.Based on these data, I advocate universal pneumococcal and Hib vaccination among children, at-risk adults and all adults over 65 to prevent serious COVID-19 disease.Left. Combined rates of childhood and adult (over 65) pneumococcal vaccination (out of a baclofen is used for possible 200). Right.

Cases (per million) population of COVID-19 at about 90 days into the pandemic for 24 nations. Nations with baclofen is used for high pneumococcal vaccination rates have low COVID-19 case rates. (Credit. CC BY-SA)How Pneumococcal Vaccination Protects Against COVID-19Protection against serious baclofen is used for COVID-19 disease by pneumococcal and Hib vaccines makes sense for several reasons. First, recent studies reveal that the majority of hospitalized COVID-19 patients, and in some studies nearly all, are infected with streptococci, which causes pneumococcal pneumonias, Hib or other pneumonia-causing bacteria.

Pneumococcal and Hib vaccinations should protect coronavirus patients from these infections and thus significantly cut the risk of serious pneumonia.I also found that pneumococcal, Hib and possibly rubella vaccines may confer baclofen is used for specific protection against the SARS-CoV-2 virus that causes COVID-19 by means of “molecular mimicry.”Molecular mimicry occurs when the immune system thinks one microbe looks like another. In this case, proteins found in pneumococcal vaccines and, to a lesser degree, ones found in Hib and rubella vaccines as well look like several proteins produced by the SARS-CoV-2 virus.Two of these proteins found in pneumococcal vaccines mimic the spike and membrane proteins that permit the virus to infect cells. This suggests pneumococcal vaccination may prevent SARS-CoV-2 infection. Two other baclofen is used for mimics are the nucleoprotein and replicase that control virus replication. These proteins are made after viral infection, in which case pneumococcal vaccination may control, but not prevent, SARS-CoV-2 replication.Either way, these vaccines may provide proxy protection against SARS-CoV-2 infection that we can implement right now, even before we have a specific virus vaccine.

Such protection may not be complete baclofen is used for. People might still suffer a weakened version of COVID-19 but, like most infants and children, be protected against the worst effects of the infection.Fighting Influenza-related Pneumonias During the COVID-19 PandemicWhile the specific protection these other vaccines confer against COVID-19 has not yet been tested in a clinical trial, I advocate broader implementation of pneumococcal and Hib vaccination for one additional, well-validated reason.Pneumococcal and Hib pneumonias – both caused by bacteria – are the major causes of death following viral influenza. The influenza virus rarely causes death baclofen is used for directly. Most often, the virus makes the lungs more susceptible to bacterial pneumonias, which are deadly. Dozens of studies around the world have demonstrated that increasing rates of pneumococcal and Hib vaccination dramatically lowers influenza-related pneumonias.Similar studies demonstrate that the price of using these vaccines is balanced by savings due to lower rates of influenza-related hospitalizations, intensive care unit admissions and deaths.

In the baclofen is used for context of COVID-19, lowering rates of influenza-related hospitalizations and ICU admissions would free up resources to fight the coronavirus, independent of any effect these vaccines might have on SARS-CoV-2 itself. In my opinion, that is a winning scenario.In short, we need not wait for a SARS-CoV-2 vaccine to slow down COVID-19.I believe that we can and should act now by fighting the coronavirus with all the tools at our disposal, including influenza, Hib, pneumococcal and perhaps rubella vaccinations.Preventing pneumococcal and Hib complications of influenza and COVID-19, and perhaps proxy-vaccinating against SARS-CoV-2 itself, helps everyone. Administering these already available and well-tested pneumococcal and Hib vaccines baclofen is used for to people will save money by freeing up hospital beds and ICUs. It will also improve public health by reducing the spread of multiple infections and boost the economy by nurturing a healthier population.Robert Root-Bernstein is a Professor of Physiology at Michigan State University. This article was originally published on The Conversation under a Creative Commons liscense Read the original here.This story appeared in the November 2020 issue as "Bacteria and the Brain." Subscribe to Discover magazine for more stories like this.It’s not always easy to convince people that the human gut is a sublime and wondrous place worthy of special attention.

Sarkis Mazmanian discovered that soon after arriving at Caltech for his first faculty job 14 baclofen is used for years ago, when he explained to a local artist what he had in mind for the walls outside his new office.The resulting mural greets visitors to the Mazmanian Lab today. A vaguely psychedelic, 40-foot-long, tube-shaped colon that’s pink, purple and red snakes down the hallway. In a panel next to it, fluorescent yellow and green bacteria explode out of a deeply inflamed baclofen is used for section of the intestinal tract, like radioactive lava from outer space.The mural is modest compared with what the scientist has been working on since. Over the last decade or so, Mazmanian has been a leading proponent of the idea that the flora of the human digestive tract has a far more powerful effect on the human body and mind than we thought — a scientific effort that earned him a $500,000 MacArthur Fellowship “Genius Grant” in 2012. Since then, Mazmanian and a small but growing cadre of fellow microbiologists baclofen is used for have amassed a tantalizing body of evidence on the microbiome’s role in all kinds of brain disorders, including schizophrenia, Alzheimer’s disease, Parkinson’s disease and depression.But the results they’ve seen in autism could, in the end, prove the most transformative.

Autism affects about 1 in 59 children in the U.S., and involves profound social withdrawal, communication problems, and sometimes anxiety and aggression. The causes of the brain disorder have remained speculative. Now, Mazmanian and other researchers are finding that autism may be inextricably linked to — or even caused by — irregularities in the gut microbiome.A Biology StoryAt 47, Mazmanian — with his shaved head, flannel shirt and skinny jeans — resembles a young, urban hipster on his way to write at the baclofen is used for local café. Originally, literary life was his plan. Born in Lebanon to two Armenian refugees, neither of whom had more than a baclofen is used for first-grade education, Mazmanian landed in the class of an energetic high school English teacher in California’s San Fernando Valley, where his family first settled.

The teacher recognized his gift for language and encouraged him to pursue a career in literature. Mazmanian enrolled baclofen is used for at UCLA in 1990, planning to major in English.Everything changed when he took his first biology class. Hunched over his new, thick textbook in the library, reading about basic biological concepts like photosynthesis, Mazmanian felt a vast new world opening up to him.Sarkis Mazmanian, shown in front of a mural that celebrates the human gut, is part of a group of microbiologists researching the effects of the digestive tract on a range of disorders. (Credit. Caltech)“For the first time in my life, I wanted to turn the page and baclofen is used for see where the story was going to go,” he says.

€œI think I decided that minute to become a scientist.”Mazmanian was most fascinated by the idea that tiny organisms, invisible to the naked eye, could function as powerful, self-contained machines — powerful enough to take over and destroy the human body. After graduating with a degree in microbiology, Mazmanian joined a UCLA infectious diseases lab and began studying bacteria that cause staph infections.As his dissertation defense approached, Mazmanian read a one-page commentary penned by a prominent microbiologist, highlighting the fact that our intestines are teeming with baclofen is used for hundreds, if not thousands, of different species of bacteria. But it was still largely unknown what they are and how they affect the human body.When Mazmanian dug further, he found that no one had yet answered what seemed to him to be the most obvious question. Why would the human immune system, designed to attack and destroy foreign invaders, allow hundreds of species of bacteria to live and thrive in our guts unmolested?. To him, the bacteria’s survival baclofen is used for implied that we had evolved to coexist with them.

And if that were so, he reasoned, there must be some benefit to both the microbes and the human body — a symbiotic relationship. But what was it? baclofen is used for. Gut InvadersMazmanian set out to study the link between gut microbes and the immune system. As a postdoctoral researcher, baclofen is used for he joined the lab of Harvard University infectious disease specialist Dennis Kasper.To start, Mazmanian examined how the immune systems of germ-free mice — lab mice completely protected, starting at birth, from all microbes — differed from those of mice with either few or normal levels of microbes. He expected this initial census would be just a first step in a long and arduous quest for scientific pay dirt.

But when he went to examine a printout of his results in the lab, he realized immediately he might already be onto something big. The germ-free mice had a 30 to 40 percent reduction in a specific type of immune cell known as helper T-cells.This colorized close-up of a mouse’s gut reveals the tight relationship between the gut microbe Bacteroides fragilis (red) and baclofen is used for the epithelial surface of the colon (blue). (Credit. Caltech)Since helper T-cells play a key role in coordinating attacks against invading pathogens, the finding suggested that the immune systems of the germ-free baclofen is used for mice were far less robust than those found in peers with normal levels of microbes.“That was exciting, right?. € Mazmanian recalls.

€œObviously I baclofen is used for repeated it and tested it in a number of different ways. Then I asked the next question. €˜Can I restore the [immune] function in an adult animal?. €™â€‰â€Mazmanian colonized baclofen is used for the guts of the immunocompromised, germ-free mice with microbes from standard lab mice. After receiving the fecal transplant, their T-cell counts shot up.

Within a month, their numbers were identical to mice raised outside the germ-free bubble.Resolving to identify baclofen is used for the microorganisms causing this transformation, Mazmanian resorted to trial and error. One by one, he added strains of bacteria found in the guts of mice to the guts of germ-free mice.He got nowhere with the first five or six species he examined. Then, simply because it was convenient, he decided to test one more that was readily baclofen is used for available in his lab. Mazmanian’s adviser, Kasper, had been studying a gut microbe called Bacteroides fragilis. When Mazmanian implanted one of Kasper’s specimens into the gut of his germ-free mice, the results were dramatic.

The T-cell numbers baclofen is used for spiked to normal. Eventually, Mazmanian demonstrated he could reproduce this effect simply by adding a single molecule that these bacteria produce, called polysaccharide A, to their guts.“There was no logic in the choice whatsoever,” Mazmanian recalls. €œ[B. Fragilis] was available, it came from the gut.” In other words, he got lucky.Mazmanian dug deeper and discovered that the biggest impact B. Fragilis had was on the population of a subtype of helper T-cells called regulatory, or suppressor, T-cells.

These cells play a key role in preventing the immune system from attacking its host body, protecting against autoimmune or inflammatory diseases. It was the first time any scientist had demonstrated that a single compound from a single microbe could reverse a specific problem with the immune system.To Mazmanian, the finding, published in 2005 in the journal Cell, alluded to new approaches to treating a wide array of autoimmune, inflammatory and allergic disorders. What if it were possible to help a faulty immune system by tweaking a patient’s microbiome?. It was with this exploration in mind that he arrived in Pasadena in 2006 to set up his lab at Caltech.A Convenient CollaborationA few years later, Mazmanian was having lunch on campus with neuroscientist and colleague Paul Patterson. Patterson had been preoccupied with a mystery that had, for years, confounded those studying autism in humans.

When pregnant mothers have a severe infection in the second trimester, their babies are much more likely to develop autism.As Mazmanian tells it, Patterson was a man of few words, and at lunch Mazmanian was “going on and on” about his own work.“You know,” Patterson interjected thoughtfully, “I think kids with autism have GI issues.”Patterson recalled reading that something like 60 percent of children with autism had some form of clinical GI problem, such as bloating, constipation, flatulence or diarrhea. Was it possible, he wondered, that there was a microbiome connection?. As they talked, Mazmanian’s excitement grew.A few years earlier, Patterson had discovered that when he exposed pregnant mice to pathogens like the influenza virus, they gave birth to pups that grew up more likely to be startled by loud noises, to shy away from social contact and to groom themselves repetitively — symptoms that resemble those of autism. Patterson was in the process of comparing the brains of these autism-mimicking mice with their neurotypical cousins to see if he could detect any differences that might explain how the maternal immune system was somehow interfering with the pups’ brain development.Mazmanian had a suggestion. The next time Patterson sacrificed one of his autistic mice to study their brains, what if he set the intestines aside for his colleague down the hall?.

When the guts arrived in Mazmanian’s lab, he found that the intestines of the neurotypical mice looked normal. But the guts of the autism-mimicking offspring were almost uniformly inflamed. Could it be that the microbiome was the cause of this inflammation?. And could that, in turn, be somehow connected to the behavioral symptoms?. Throughout the winter and spring of 2012, Mazmanian and Patterson continued their conversation.

Mazmanian found distinct differences in the microbiomes of the mice. And, they noticed, the mice with the features of autism had leaky gut syndrome, an increased permeability of the gut lining that can allow pathogens and allergens to leach out. This condition had also been reported in children with autism.So Mazmanian and Patterson turned their attention outside the gut. They took blood samples to see if any gut microbes, or the compounds they produce, were circulating in the rest of the body. They homed in on one molecule in particular, called 4-ethylphenyl sulfate, which was roughly 45 times as abundant in the mice that had symptoms of autism.

And it looked familiar. Structurally, it was almost identical to a molecule recently found to be significantly elevated in human children with autism.It was enough to take the next step. Every day for three weeks, Mazmanian injected the molecule, harvested from the mice with autism-like symptoms, directly into the bloodstream of 5-week-old normal lab mice (the age at which the autistic mice normally developed leaky gut). Then Mazmanian and his team gave them a series of behavioral tests. The mice were far more easily startled and were less comfortable in large empty spaces than their untreated peers, indications of an increase in anxiety-related behaviors commonly seen in the mice with autism-like symptoms.

The researchers published their results in Cell in 2013.Though surprising, the data made sense in some ways. Many drug companies rely on small-molecule drugs that can be taken orally, but still manage to cross the blood-brain barrier and affect behavior. It seemed entirely possible that small molecules, created by bacteria in the gut, could enter the bloodstream and reach the brain. And they don’t even have to leak out of the gut to do so.Of Mice and MenPatterson died in 2014, at age 70, just six months after the publication of the duo’s groundbreaking Cell paper. Around the same time, a series of parallel experiments in a clinic hundreds of miles away was already paving the way forward.

While Patterson and Mazmanian had been working in mice, Rosa Krajmalnik-Brown, a microbiologist at Arizona State University, had teamed up with Jim Adams, who directs the university’s autism and Asperger’s research program, to study humans.The researchers were conducting a detailed analysis of the microbiome of human autism patients and found that the bacteria were far less diverse in the children with autism. Notably, several important species involved in the digestion of carbohydrates were severely depleted.Krajmalnik-Brown and Adams launched a preliminary trial to test the effects of fecal transplants on 18 children between the ages of 7 and 16 with severe autism, who also had severe GI issues. The researchers administered powerful antibiotics to kill off the microbiomes of the children and followed them with a bowel cleanse. They then replaced the microbes with transplanted flora taken from the guts of healthy neurotypical adult volunteers.The results were better than anyone could have expected. The procedure resulted in a large reduction in GI symptoms and increased the diversity of bacteria in the children’s guts.

But more significantly, their neurological symptoms were reduced. At the onset of the study in 2017, an independent evaluator found 83 percent of participants had severe autism. Two years after the initial trial, only 17 percent were rated as severely autistic. And 44 percent were no longer on the autism scale.“[My child] did a complete 180,” says Dana Woods, whose then-7-year-old son Ethan enrolled in the initial study five years ago. €œHis ability to communicate is so much different now.

He’s just so much more present. He’s so much more aware. He’s no longer in occupational therapy. He’s no longer in speech therapy. After the study, he tested two points away from a neurotypical child.”In their first report on the trial in 2017, the team highlighted a number of distinct changes in the microbiome after the transplants, in particular a surge in the populations of three types of bacteria.

Among them was a four-fold increase in Bifidobacterium, a probiotic organism that seems to play a key role in the maintenance of a healthy gut.But figuring out what was happening on a cellular level — to really look inside some guts — would require another vehicle. The ASU team needed Mazmanian’s mice.“At the end of the day, what we care about is healing people and how the microbiome affects people,” explains Krajmalnik-Brown. €œThat’s why we work with people. But with mice you can do things that are more mechanistic.”The Great Mouse Detective(Credit. Caltech)Together, Krajmalnik-Brown, Mazmanian and their collaborators would uncover some tantalizing new insights that go a long way to solving the mystery.

In May 2019, the team published another high-profile paper in Cell, after they transplanted stool samples from Krajmalnik-Brown’s severely autistic patients into the guts of Mazmanian’s germ-free mice. The offspring of these mice showed the autism-like symptoms, such as repetitive and compulsive behavior.This time, the team dug even deeper into the biochemical processes playing out in the brain, looking not just at behavior but at the chemicals involved in creating it. The mice that developed autism-like behaviors had measurably lower levels of two substances called taurine and 5-aminovaleric acid (5AV). When they dug into the literature, the team learned that these two substances are known to mimic activity of a key signaling agent in the brain called gamma-aminobutyric acid (GABA) — a neurotransmitter that other studies have found is deficient in the brains of children with autism.What’s more, some have speculated that the tendency of children with autism to experience sensory overstimulation may stem from the inability to tamp down overexcited neurons. A lack of GABA could lead to just that.The scientists next orally administered high levels of taurine and 5AV to pregnant mice with the autistic children’s microbiomes.

When their pups were born, the researchers continued to feed the young the substances until they reached adulthood. Compared with untreated animals, the second-generation mice had significantly fewer behavioral symptoms. Taurine reduced repetitive behavior, as measured by marble burying, increased the level of social interaction, and relieved anxiety. Mice administered 5AV were more active and social.“We healed humans with behavioral problems,” says Krajmalnik-Brown. €œ[And we] transferred some of those deficits and behaviors to mice — basically the opposite.

It’s huge.”Mazmanian hopes to take the next step in the months ahead.“I can flip a switch, turn on a light, I know that switch turns on that light. I don’t know the circuit, I don’t know where the wire is,” Mazmanian says. €œExactly how that’s happening … we just don’t understand that.”This most recent study, by itself, hardly proves that dysregulated microbiomes cause the brain disorder — a point that plenty of other scientists skeptical of Mazmanian’s work are happy to make.“The paper made a big splash, but trying to model psychiatric-related human conditions in mice, in my view, is a little bit of a stretch,” says Sangram Sisodia, a neurobiologist at the University of Chicago who studies the microbiome. €œA mouse with autism?. €Nor was that the only criticism.

Several researchers have suggested that the group didn’t give proper attention to one of their tests ­— one whose results conflicted with their thesis ­— while others found flaws in the statistical methods they used to assess their results. Mazmanian downplays these criticisms, but agrees the work is not yet conclusive.Meanwhile, the ASU trial has also engendered skepticism, mainly due to its tiny sample size, the lack of a control group and the methods by which the children were assessed for autism severity. Krajmalnik-Brown and Adams say they stand by their results, but agree more research is needed. In recent months, they have launched two new studies that will address these issues.Adams insists the work is already changing lives. €œWe followed up with every one of our 18 participants,” he says, referring to the children who received fecal transplants.

€œSure enough, we found that most of the GI benefits had remained. And family after family said their child just slowly, steadily continued making more improvement.” They published the update in Scientific Reports in spring 2019.“I’m not ready to say the case is closed,” says Mazmanian. €œHealthy skepticism is a good thing. I believe the preclinical data, I believe the mouse data. But there’s a lot of studies that still need to be done.” A Healthy Gut, A New OutlookEthan Woods had GI issues and symptoms of autism until researchers introduced new microbes to his gut.

His mother says the treatment changed everything. (Credit. Dana Woods)Prior to his fecal transplant at age 7, Ethan Woods suffered from chronic and severe diarrhea, constipation and cramping, symptoms so extreme that to his mother, Dana, he sounded like “a bit like a woman in labor when he was trying to have a bowel movement.” “It was just awful watching your child go through this,” she says, explaining that when she enrolled her autistic son in the Arizona State study, her “only goal was to fix his gut.”Remarkably, Ethan’s agony began to disappear just a few weeks into the trial. But that was not the most dramatic difference. Before the transplant, Ethan’s speech was drawn out and slow, his language skills rudimentary.

He seemed to live in his own bubble. He had frequent outbursts. For as long as Dana could remember, her mornings with Ethan had been marked by arguing, fighting, pushing and anger. But then one morning, something shocking happened.“He woke me up one morning with his face right in my face with this big smile and he said, ‘Morning, Mom!. €™â€‰â€ she recalls.

€œAnd he was just excited and happy and ready to go about his day with this big smile. It choked me up to the point where I teared up because I had never experienced a happy kid in the morning.”Later, Ethan carried over an iPad and opened an app with a talking cat that repeats back the words children speak aloud. He played back a video recording of himself from just a few weeks earlier.“[He] looks me in the eye and says, ‘Mom, why did I talk like that?. What is wrong with me?. €™ And as soon as he did that, I caught my breath.

I had to compose myself and say, ‘I don’t know. But do you feel better?. Do you feel different?. Why do you think?. €™â€‰â€Ethan’s communication skills had already begun to improve.

Within a year of the study, his speech therapist graduated him from speech therapy because he had met all his goals.“He went from one end of the rainbow all the way to the other end of the rainbow,” she says. €œPrior to the study, I was very afraid. My biggest fear was ‘how is he going to navigate the world when I’m not here?. €™ And I think I have a lot of hope now that he is going to be OK now on his own.”There’s something strange about the female orgasm, something that scientists have been unable to explain. Biological functions are normally discussed in terms of evolutionary pressure, or reproductive advantage.

If a biological trait improves your chances of having more offspring, then it’s more likely to stick around in your species. The male orgasm makes perfect sense — ejaculate contains the genetic material that’s necessary for making babies. But the female orgasm has been harder to nail down. Fertilization doesn’t depend on it, and “fun” isn’t exactly in the pantheon of evolutionary explanations.Researchers that study how the female orgasm relates to reproductive success have two main options — either ask people invasive questions about their most personal moments, or to find a way to stick probes in or on them during said moments. Neither of these approaches have resulted in the kind of “wet lab” research that’s the gold standard for biological understanding.What we do know, despite widespread cultural discomfort with talking openly about sex and pleasure, is that there appears to be significant sexual dysfunction in American society.

Back in 2014, researchers from the Kinsey Institute, the preeminent U.S. Academy for the study of sex and relationships, said as much. In a survey of nearly 3,000 people, they found that men, straight or gay, orgasmed 85 percent of the time during consensual sexual encounters. Lesbian women orgasmed less often, 75 percent of the time, while straight women fared worst with just a 60 percent chance of orgasm. Other studies have shown that something like 10-15 percent of women experience lifelong anorgasmia, meaning they’ve never experienced orgasm.

A further 40 percent of women report some kind of inability to reach orgasm in the past year.The orgasm gap is hard to explain. Some think that it comes down to straight men’s finesse, or lack thereof, citing the difference between straight and lesbian satisfaction. Indeed, it makes sense that knowing your way around the territory would help. But for many couples this isn’t a helpful revelation, since the emotional maturity necessary to teach sexual dexterity is often out of reach. Shortcut to SatisfactionLuckily, we live in an era of Silicon Valley disruption, which has even started lapping at the shores of sex research.

Technologist Liz Klinger is at the forefront of this transition. She and her team have built a platform that lets people become citizen scientists of sex —without ever having to get out from between the sheets.About a decade ago, Klinger’s company, Lioness, released what they billed as the first “smart vibrator,” a sex toy that could actually learn about you. The final product was a far cry from the first prototype, which was much more laboratory object than sex toy.The “test device was this whole mess of wires, with a hard connection. We had to physically send it to our beta testers, who used it and sent it back,” recalls Klinger. The researchers would download the data collected by the toy’s four sensors — temperature, motion, acceleration and pressure — and compile it into a chart that represented arousal and orgasm, as told through the story of pelvic-floor muscle contractions.It was an immediate success for sex partners who needed ways to talk about pleasure in a more objective way.

Klinger recalled that when she got the first beta-test couple on the phone, “the wife was like ‘holy crap, we finally were able to talk about these things that I’ve had a lot of trouble talking about.’ It turned out that she wanted more foreplay, and he didn’t know quite that that meant. He’d spend more time, but it just didn’t match up, you know?. € With the company’s signature offering in hand — a chart of sexual arousal over time — Klinger found that couples could have a conversation “without the subtext of ‘oh, you’re not good enough, or I don’t like you enough,’ on the husband’s part and ‘I’m so tired of talking about this’ on the wife’s part,” she says. The chart “can change people’s perceptions of their own experiences, and how they talk about them with others.”Doing the Deed — For ScienceThis spring, the company has launched a research platform dubbed Lioness 2.0 — a new optional service that, unsurprisingly, their data-obsessed users have greeted with open arms. Now, instead of simply using the toy to understand themselves better, Lioness owners can opt in to the kinds of hands-on studies that are necessary for a deeper understanding of sex and pleasure.

So far, the company is working with Nigeria’s Society for Family Health to study how pleasure changes with menopause across age, race and orientation, as well as with the U.S.’s Center for Genital Health and Education to explore the role of pelvic floor muscles in orgasm.Pani Farvid, a professor of applied psychology at The New School in New York City, has some reservations about the platform. €œI really like what they’re trying to do, but there could be more added to make it a bit more comprehensive. My concern is that there's a misconception that sex is just about the orgasm, that it’s just physiological and that pleasure just has to do with the genitals.” From where she’s sitting, “that’s a very mechanical view of sexuality.” If the Lioness is helping to equalize the orgasm gap, or helping people understand their bodies better, “I think that's great,” says Farvid. €œBut as a critical sexologist, I'm interested in delving deeper into what these practices mean.” If sex is hyper-focused on orgasm, to exclusion of everything else, she cautions that these norms “have real-life negative impacts on people's sex lives and their sense of themselves.”At this point, knee-deep in an era of data collection that was once the sole purview of white-coat-wearing scientists, it’s old news that we need to be careful with what our technology is doing to us. No tool can serve as a cure-all, even if it comes loaded with a neat app and some space-age sensors.

What it can offer, though, is the opportunity to start a conversation, and the chance to take a long, honest look at something about yourself — whether it’s the number of steps you take every day, or the way you want to be touched.Wondering how to keep your glasses from fogging up when your mask is on?. Look no further. If we've learned one thing throughout the COVID-19 pandemic, it's the importance of wearing a mask. Countless studies have shown over the past eight months that wearing a protective barrier over your nose and mouth — whether it's a standard-issue surgical mask or an N95 respirator — can significantly decrease the odds of catching and transmitting disease. What's more, some research shows that masking up can reduce the severity of an infection if a masked person does contract COVID-19.

But while masks are potentially lifesaving, they can be uncomfortable, often changing your breathing patterns and fogging up your glasses when breath escapes through the top of the mask. Among people who choose not to wear a mask to prevent the spread of COVID-19, many cite discomfort as a key reason why.Wesley Wilson, a tumor immunologist in Pennsylvania, knows how annoying it can be when your glasses are fogging up. He says fogging is “definitely a problem” among his hospital colleagues, who need to wear protective goggles and surgical masks while on the job. Fortunately, they've also picked up a few helpful hacks for keeping their vision clear while wearing a mask with glasses.#1. Use Tape“If you have to keep your mask on for hours, tape works like a charm,” Wilson says.

This especially applies to healthcare professionals in his practice who are required to keep their masks on at all times, except during lunch. €œIf you're putting on your mask and taking it off a lot, tape probably isn't practical — but two small pieces of tape on the cheeks keep the mask fitted closer to your face, and the hot air out of your glasses,” he says.#2. Fit the Mask to Your FaceWhile some air leakage is to be expected, wearing a mask that fits securely to your face will prevent glass fogging and filter the virus more effectively since less air is coming in or out. Find surgical masks or N95s that come with a nose bridge, a small, flexible piece of metal or plastic that allows the mask to more closely fit the contours of your face. Nose bridges can be sewn inside masks or affixed to the front.Read More.

Why It Feels Like You Can't Breathe Inside Your Face Mask#3. Adjust Your MaskAccording to the American Academy of Ophthalmology, a minor adjustment in how you wear your mask could be enough to prevent fog as well. Simply pull the mask over your nose and rest your glasses on top of your face mask. As long as the mask is fitted close to your face, this should prevent hot air from slipping out.#4. Spray Your GlassesA former ice hockey player, Wilson says the protective visor under his helmet would often fog with hot air while he was on the ice during games.

Like an ocean diver, he would use de-misting solution or a defogging spray (such as this one) to keep his visor free of fog. The same concept applies to eyeglass fog caused by masking, he says. €œYou can either buy a spray or you can make your own with either shaving cream or soap and water,” says Wilson. €œWiping some shaving cream on your glasses and then wiping it off will coat them with a similar surface-tension altering compound that prevents fog.”With the COVID-19 pandemic showing no signs of stopping, there’s a lot of responsibility on people to wear face masks while out in public. But even if you do wear a mask, you might not be wearing it properly.   According to CDC guidelines, face masks are meant to cover both the nose and the mouth and fit securely under the chin.

While most people who mask-up do wear them correctly, that’s not always the case. Some people prefer to wear their masks pulled down so it only covers their mouth, leaving their nose exposed. But this can defeat a key purpose of wearing a mask. Research from several scientists have demonstrated that the nose is highly vulnerable to COVID-19 infection.  Wearing a mask helps slow the spread of COVID-19 by preventing the transmission of droplets and aerosols that are produced when a person breathes, talks, coughs or sneezes. The CDC says this is a primary way the virus spreads.

Nasal Negligence     In April, an international team of researchers determined that the nose is a key entry point for SARS-CoV-2, the virus that causes COVID-19. Their work, which was published in the journal Nature Medicine, explained that nasal cells in particular contain high levels of the proteins that SARS-CoV-2 attaches to in order to enter the body. The proteins are called ACE2 and TMPRSS2. €¯â€¯â€¯â€¯â€¯â€¯â€¯ To track down the protein pathways for the virus, the researchers examined tissue samples from donors that included lung, eye, nasal, intestinal, heart, kidney and liver cells. Waradon Sungnak, an immunologist at the Wellcome Sanger Institute and the lead author of the study, explained that the researchers examined the nose cells somewhat as an afterthought, and did not anticipate them to be so important.

Because the nose is a main pathway for the virus, Sungnak says it's a possible explanation for why COVID-19 spread so efficiently early in the pandemic.  “The expression of these viral entry factors are high in the nose,” Sungnak says. €œSo, it’s a very easy place for the virus to get in and then once it gets in, a place to replicate. So if there’s any way for you to block that from happening, I think it’s worth it. So, for me, it doesn’t really make sense if you’re putting on a mask, to not be putting a barrier on the nose.” COVID-19 Gateway  Another study, published in Cell in July, pointed to the importance of protecting the nose. A team tracked how the coronavirus entered the lungs and where the initial site of infection was.

The researchers mapped surface receptors in the airways to determine which areas contained the most ACE2 proteins. They determined that the highest concentrations of these proteins are located in are in the nose, instead of the deep lungs as they had anticipated. After exposing tissue samples to SARS-CoV-2, the team determined that the nose was the most fertile infection point of the entire respiratory system. Read next. Why It Feels Like You Can't Breathe Inside Your Face Mask — and What to Do About ItStudy author Richard Boucher, a pulmonary researcher at the University of North Carolina in Chapel Hill, says that the findings are consistent with the way the nose is used by the body as a filtration device, to both draw in and trap viruses.

While in the nose, the viruses can be “micro-aspirated,” or breathed into the lungs through tiny droplets of body fluids. Once in the lungs, the virus replicates itself using the cells there. Boucher says micro-aspiration is more common among older people and those with medical conditions. As a result, these populations are more likely to have viruses like COVID-19 impact their lower respiratory system, which includes airways and lungs. Younger or healthier people, in contrast, are more likely to have the virus remain in their nasal passages, which means they'll experience milder symptoms such as runny noses or sneezing.

Boucher says it’s clear that protecting the nose is extremely important to protecting the lungs and respiratory tract from COVID-19. Based on the findings of his study, wearing a mask underneath the nose is completely ineffective in protecting someone’s respiratory system.    “It may in fact be bad because it gives you a false sense of protection,” Boucher says. €œYou may go into circumstances that are not so wise, but you think you’re protected so you’ll take the risk. So, in one sense it’s the worst of all worlds. It’s ineffective, but it may deceive you into thinking you’re protected.” .

The yearly influenza season threatens to make the buy generic baclofen COVID-19 pandemic doubly deadly, but I believe that this isn’t inevitable.There are two commonly given vaccines – the pneumococcal vaccine and the Hib vaccine – that protect against bacterial pneumonias. These bacteria complicate both influenza and COVID-19, often leading to death. My examination of disease trends and vaccination rates leads me to believe that broader use of the pneumococcal and Hib vaccines could guard against the worst effects of a buy generic baclofen COVID-19 illness.I am an immunologist and physiologist interested in the effects of combined infections on immunity. I have reached my insight by juxtaposing two seemingly unrelated puzzles.

Infants and children get SARS-CoV-2, the virus that causes COVID-19, but very rarely become buy generic baclofen hospitalized or die. And case numbers and death rates from COVID-19 began varying greatly from nation to nation and city to city even before lockdowns began. I wondered why.One night I woke up with a possible answer. Vaccination rates buy generic baclofen.

Most children, beginning at age two months, are vaccinated against numerous diseases. Adults less so buy generic baclofen. And, both infant and adult vaccination rates vary widely across the world. Could differences in the rates of buy generic baclofen vaccination against one or more diseases account for differences in COVID-19 risks?.

As someone who had previously investigated other pandemics such as the Great Flu Pandemic of 1918-19 and AIDS, and who has worked with vaccines, I had a strong background for tracking down the relevant data to test my hypothesis.Pneumococcal Vaccination Rates Correlate With Lower COVID-19 Cases and DeathsI gathered national and some local data on vaccination rates against influenza, polio, measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis (DTP), tuberculosis (BCG), pneumococci and Haemophilus influenzae type B (Hib). I correlated them with COVID-19 case rates and death rates for 24 nations that had experienced their COVID-19 outbreaks at about the same time. I controlled for factors such buy generic baclofen as percentage of the population who were obese, diabetic or elderly.I found that only pneumococcal vaccines afforded statistically significant protection against COVID-19. Nations such as Spain, Italy, Belgium, Brazil, Peru and Chile that have the highest COVID-19 rates per million have the poorest pneumococcal vaccination rates among both infants and adults.

Nations with the lowest rates of COVID-19 – Japan, Korea, Denmark, Australia and New Zealand – have the highest rates of pneumococcal vaccination among both infants and adults.A recent buy generic baclofen preprint study (not yet peer-reviewed) from researchers at the Mayo Clinic has also reported very strong associations between pneumococcal vaccination and protection against COVID-19. This is especially true among minority patients who are bearing the brunt of the coronavirus pandemic. The report also suggests that other vaccines, or combinations of vaccines, such as Hib and MMR may also provide protection.These results are important because in the U.S., childhood vaccination against pneumococci – which protects against Streptococcus pneumoniae bacteria – buy generic baclofen varies by state from 74% to 92%. Although the CDC recommends that all adults 18-64 in high risk groups for COVID-19 and all adults over the age of 65 get a pneumococcal vaccination, only 23% of high-risk adults and 64% of those over the age of 65 do so.Similarly, although the CDC recommends at all infants and some high-risk adults be vaccinated against Haemophilus influenzae type B (Hib), only 80.7% of children in the U.S.

And a handful of immunologically compromised adults have been. Pneumococcal and buy generic baclofen Hib vaccination rates are significantly lower in minority populations in the U.S. And in countries that have been hit harder by COVID-19 than the U.S.Based on these data, I advocate universal pneumococcal and Hib vaccination among children, at-risk adults and all adults over 65 to prevent serious COVID-19 disease.Left. Combined rates of childhood and adult (over 65) pneumococcal vaccination buy generic baclofen (out of a possible 200).

Right. Cases (per million) population of COVID-19 at about 90 days into the pandemic for 24 nations. Nations with high buy generic baclofen pneumococcal vaccination rates have low COVID-19 case rates. (Credit.

CC BY-SA)How Pneumococcal buy generic baclofen Vaccination Protects Against COVID-19Protection against serious COVID-19 disease by pneumococcal and Hib vaccines makes sense for several reasons. First, recent studies reveal that the majority of hospitalized COVID-19 patients, and in some studies nearly all, are infected with streptococci, which causes pneumococcal pneumonias, Hib or other pneumonia-causing bacteria. Pneumococcal and Hib vaccinations should protect coronavirus patients from these infections and thus significantly cut the risk of serious buy generic baclofen pneumonia.I also found that pneumococcal, Hib and possibly rubella vaccines may confer specific protection against the SARS-CoV-2 virus that causes COVID-19 by means of “molecular mimicry.”Molecular mimicry occurs when the immune system thinks one microbe looks like another. In this case, proteins found in pneumococcal vaccines and, to a lesser degree, ones found in Hib and rubella vaccines as well look like several proteins produced by the SARS-CoV-2 virus.Two of these proteins found in pneumococcal vaccines mimic the spike and membrane proteins that permit the virus to infect cells.

This suggests pneumococcal vaccination may prevent SARS-CoV-2 infection. Two other mimics are the nucleoprotein and replicase that control virus replication buy generic baclofen. These proteins are made after viral infection, in which case pneumococcal vaccination may control, but not prevent, SARS-CoV-2 replication.Either way, these vaccines may provide proxy protection against SARS-CoV-2 infection that we can implement right now, even before we have a specific virus vaccine. Such protection may not be buy generic baclofen complete.

People might still suffer a weakened version of COVID-19 but, like most infants and children, be protected against the worst effects of the infection.Fighting Influenza-related Pneumonias During the COVID-19 PandemicWhile the specific protection these other vaccines confer against COVID-19 has not yet been tested in a clinical trial, I advocate broader implementation of pneumococcal and Hib vaccination for one additional, well-validated reason.Pneumococcal and Hib pneumonias – both caused by bacteria – are the major causes of death following viral influenza. The influenza virus rarely causes buy generic baclofen death directly. Most often, the virus makes the lungs more susceptible to bacterial pneumonias, which are deadly. Dozens of studies around the world have demonstrated that increasing rates of pneumococcal and Hib vaccination dramatically lowers influenza-related pneumonias.Similar studies demonstrate that the price of using these vaccines is balanced by savings due to lower rates of influenza-related hospitalizations, intensive care unit admissions and deaths.

In the context of COVID-19, lowering rates of influenza-related hospitalizations and ICU admissions would free up resources to fight the coronavirus, independent buy generic baclofen of any effect these vaccines might have on SARS-CoV-2 itself. In my opinion, that is a winning scenario.In short, we need not wait for a SARS-CoV-2 vaccine to slow down COVID-19.I believe that we can and should act now by fighting the coronavirus with all the tools at our disposal, including influenza, Hib, pneumococcal and perhaps rubella vaccinations.Preventing pneumococcal and Hib complications of influenza and COVID-19, and perhaps proxy-vaccinating against SARS-CoV-2 itself, helps everyone. Administering these already available and well-tested pneumococcal and Hib vaccines to people will save money by freeing up hospital beds and ICUs buy generic baclofen. It will also improve public health by reducing the spread of multiple infections and boost the economy by nurturing a healthier population.Robert Root-Bernstein is a Professor of Physiology at Michigan State University.

This article was originally published on The Conversation under a Creative Commons liscense Read the original here.This story appeared in the November 2020 issue as "Bacteria and the Brain." Subscribe to Discover magazine for more stories like this.It’s not always easy to convince people that the human gut is a sublime and wondrous place worthy of special attention. Sarkis Mazmanian discovered that soon after arriving at Caltech for his first faculty job 14 years ago, when he explained to a local artist what he had in mind for the walls outside buy generic baclofen his new office.The resulting mural greets visitors to the Mazmanian Lab today. A vaguely psychedelic, 40-foot-long, tube-shaped colon that’s pink, purple and red snakes down the hallway. In a panel next to it, fluorescent yellow and green bacteria explode out of a deeply inflamed section of the intestinal tract, like radioactive lava from outer space.The buy generic baclofen mural is modest compared with what the scientist has been working on since.

Over the last decade or so, Mazmanian has been a leading proponent of the idea that the flora of the human digestive tract has a far more powerful effect on the human body and mind than we thought — a scientific effort that earned him a $500,000 MacArthur Fellowship “Genius Grant” in 2012. Since then, Mazmanian and a small but growing cadre of fellow microbiologists have amassed a buy generic baclofen tantalizing body of evidence on the microbiome’s role in all kinds of brain disorders, including schizophrenia, Alzheimer’s disease, Parkinson’s disease and depression.But the results they’ve seen in autism could, in the end, prove the most transformative. Autism affects about 1 in 59 children in the U.S., and involves profound social withdrawal, communication problems, and sometimes anxiety and aggression. The causes of the brain disorder have remained speculative.

Now, Mazmanian and other researchers are finding that autism may be inextricably linked to — or even caused by — buy generic baclofen irregularities in the gut microbiome.A Biology StoryAt 47, Mazmanian — with his shaved head, flannel shirt and skinny jeans — resembles a young, urban hipster on his way to write at the local café. Originally, literary life was his plan. Born in buy generic baclofen Lebanon to two Armenian refugees, neither of whom had more than a first-grade education, Mazmanian landed in the class of an energetic high school English teacher in California’s San Fernando Valley, where his family first settled. The teacher recognized his gift for language and encouraged him to pursue a career in literature.

Mazmanian enrolled at UCLA in buy generic baclofen 1990, planning to major in English.Everything changed when he took his first biology class. Hunched over his new, thick textbook in the library, reading about basic biological concepts like photosynthesis, Mazmanian felt a vast new world opening up to him.Sarkis Mazmanian, shown in front of a mural that celebrates the human gut, is part of a group of microbiologists researching the effects of the digestive tract on a range of disorders. (Credit. Caltech)“For the first time in my life, I wanted to turn the page and see where the story was going to go,” he says buy generic baclofen.

€œI think I decided that minute to become a scientist.”Mazmanian was most fascinated by the idea that tiny organisms, invisible to the naked eye, could function as powerful, self-contained machines — powerful enough to take over and destroy the human body. After graduating with a degree in microbiology, Mazmanian joined a UCLA infectious diseases lab and began studying bacteria that cause staph infections.As his dissertation defense approached, Mazmanian read a one-page commentary penned by a prominent microbiologist, highlighting the fact that our intestines are teeming with hundreds, if not thousands, of different species of buy generic baclofen bacteria. But it was still largely unknown what they are and how they affect the human body.When Mazmanian dug further, he found that no one had yet answered what seemed to him to be the most obvious question. Why would the human immune system, designed to attack and destroy foreign invaders, allow hundreds of species of bacteria to live and thrive in our guts unmolested?.

To him, the bacteria’s survival implied that we had evolved to coexist with them buy generic baclofen. And if that were so, he reasoned, there must be some benefit to both the microbes and the human body — a symbiotic relationship. But what was it? buy generic baclofen. Gut InvadersMazmanian set out to study the link between gut microbes and the immune system.

As a postdoctoral researcher, he joined the lab of Harvard University infectious disease specialist Dennis Kasper.To start, Mazmanian examined how the immune systems of germ-free mice — lab mice completely protected, starting at birth, from all buy generic baclofen microbes — differed from those of mice with either few or normal levels of microbes. He expected this initial census would be just a first step in a long and arduous quest for scientific pay dirt. But when he went to examine a printout of his results in the lab, he realized immediately he might already be onto something big. The germ-free mice had a 30 to 40 percent reduction in a specific type of immune cell buy generic baclofen known as helper T-cells.This colorized close-up of a mouse’s gut reveals the tight relationship between the gut microbe Bacteroides fragilis (red) and the epithelial surface of the colon (blue).

(Credit. Caltech)Since helper T-cells play a key role in coordinating attacks against invading pathogens, the finding suggested that the immune systems of the germ-free mice were far less robust than those found in peers with normal levels buy generic baclofen of microbes.“That was exciting, right?. € Mazmanian recalls. €œObviously I repeated it and tested it in a number buy generic baclofen of different ways.

Then I asked the next question. €˜Can I restore the [immune] function in an adult animal?. €™â€‰â€Mazmanian colonized the guts of the buy generic baclofen immunocompromised, germ-free mice with microbes from standard lab mice. After receiving the fecal transplant, their T-cell counts shot up.

Within a month, their numbers were identical to mice buy generic baclofen raised outside the germ-free bubble.Resolving to identify the microorganisms causing this transformation, Mazmanian resorted to trial and error. One by one, he added strains of bacteria found in the guts of mice to the guts of germ-free mice.He got nowhere with the first five or six species he examined. Then, simply because it was convenient, he decided to test one more that was readily buy generic baclofen available in his lab. Mazmanian’s adviser, Kasper, had been studying a gut microbe called Bacteroides fragilis.

When Mazmanian implanted one of Kasper’s specimens into the gut of his germ-free mice, the results were dramatic. The T-cell buy generic baclofen numbers spiked to normal. Eventually, Mazmanian demonstrated he could reproduce this effect simply by adding a single molecule that these bacteria produce, called polysaccharide A, to their guts.“There was no logic in the choice whatsoever,” Mazmanian recalls. €œ[B.

Fragilis] was available, it came from the gut.” In other words, he got lucky.Mazmanian dug deeper and discovered that the biggest impact B. Fragilis had was on the population of a subtype of helper T-cells called regulatory, or suppressor, T-cells. These cells play a key role in preventing the immune system from attacking its host body, protecting against autoimmune or inflammatory diseases. It was the first time any scientist had demonstrated that a single compound from a single microbe could reverse a specific problem with the immune system.To Mazmanian, the finding, published in 2005 in the journal Cell, alluded to new approaches to treating a wide array of autoimmune, inflammatory and allergic disorders.

What if it were possible to help a faulty immune system by tweaking a patient’s microbiome?. It was with this exploration in mind that he arrived in Pasadena in 2006 to set up his lab at Caltech.A Convenient CollaborationA few years later, Mazmanian was having lunch on campus with neuroscientist and colleague Paul Patterson. Patterson had been preoccupied with a mystery that had, for years, confounded those studying autism in humans. When pregnant mothers have a severe infection in the second trimester, their babies are much more likely to develop autism.As Mazmanian tells it, Patterson was a man of few words, and at lunch Mazmanian was “going on and on” about his own work.“You know,” Patterson interjected thoughtfully, “I think kids with autism have GI issues.”Patterson recalled reading that something like 60 percent of children with autism had some form of clinical GI problem, such as bloating, constipation, flatulence or diarrhea.

Was it possible, he wondered, that there was a microbiome connection?. As they talked, Mazmanian’s excitement grew.A few years earlier, Patterson had discovered that when he exposed pregnant mice to pathogens like the influenza virus, they gave birth to pups that grew up more likely to be startled by loud noises, to shy away from social contact and to groom themselves repetitively — symptoms that resemble those of autism. Patterson was in the process of comparing the brains of these autism-mimicking mice with their neurotypical cousins to see if he could detect any differences that might explain how the maternal immune system was somehow interfering with the pups’ brain development.Mazmanian had a suggestion. The next time Patterson sacrificed one of his autistic mice to study their brains, what if he set the intestines aside for his colleague down the hall?.

When the guts arrived in Mazmanian’s lab, he found that the intestines of the neurotypical mice looked normal. But the guts of the autism-mimicking offspring were almost uniformly inflamed. Could it be that the microbiome was the cause of this inflammation?. And could that, in turn, be somehow connected to the behavioral symptoms?.

Throughout the winter and spring of 2012, Mazmanian and Patterson continued their conversation. Mazmanian found distinct differences in the microbiomes of the mice. And, they noticed, the mice with the features of autism had leaky gut syndrome, an increased permeability of the gut lining that can allow pathogens and allergens to leach out. This condition had also been reported in children with autism.So Mazmanian and Patterson turned their attention outside the gut.

They took blood samples to see if any gut microbes, or the compounds they produce, were circulating in the rest of the body. They homed in on one molecule in particular, called 4-ethylphenyl sulfate, which was roughly 45 times as abundant in the mice that had symptoms of autism. And it looked familiar. Structurally, it was almost identical to a molecule recently found to be significantly elevated in human children with autism.It was enough to take the next step.

Every day for three weeks, Mazmanian injected the molecule, harvested from the mice with autism-like symptoms, directly into the bloodstream of 5-week-old normal lab mice (the age at which the autistic mice normally developed leaky gut). Then Mazmanian and his team gave them a series of behavioral tests. The mice were far more easily startled and were less comfortable in large empty spaces than their untreated peers, indications of an increase in anxiety-related behaviors commonly seen in the mice with autism-like symptoms. The researchers published their results in Cell in 2013.Though surprising, the data made sense in some ways.

Many drug companies rely on small-molecule drugs that can be taken orally, but still manage to cross the blood-brain barrier and affect behavior. It seemed entirely possible that small molecules, created by bacteria in the gut, could enter the bloodstream and reach the brain. And they don’t even have to leak out of the gut to do so.Of Mice and MenPatterson died in 2014, at age 70, just six months after the publication of the duo’s groundbreaking Cell paper. Around the same time, a series of parallel experiments in a clinic hundreds of miles away was already paving the way forward.

While Patterson and Mazmanian had been working in mice, Rosa Krajmalnik-Brown, a microbiologist at Arizona State University, had teamed up with Jim Adams, who directs the university’s autism and Asperger’s research program, to study humans.The researchers were conducting a detailed analysis of the microbiome of human autism patients and found that the bacteria were far less diverse in the children with autism. Notably, several important species involved in the digestion of carbohydrates were severely depleted.Krajmalnik-Brown and Adams launched a preliminary trial to test the effects of fecal transplants on 18 children between the ages of 7 and 16 with severe autism, who also had severe GI issues. The researchers administered powerful antibiotics to kill off the microbiomes of the children and followed them with a bowel cleanse. They then replaced the microbes with transplanted flora taken from the guts of healthy neurotypical adult volunteers.The results were better than anyone could have expected.

The procedure resulted in a large reduction in GI symptoms and increased the diversity of bacteria in the children’s guts. But more significantly, their neurological symptoms were reduced. At the onset of the study in 2017, an independent evaluator found 83 percent of participants had severe autism. Two years after the initial trial, only 17 percent were rated as severely autistic.

And 44 percent were no longer on the autism scale.“[My child] did a complete 180,” says Dana Woods, whose then-7-year-old son Ethan enrolled in the initial study five years ago. €œHis ability to communicate is so much different now. He’s just so much more present. He’s so much more aware.

He’s no longer in occupational therapy. He’s no longer in speech therapy. After the study, he tested two points away from a neurotypical child.”In their first report on the trial in 2017, the team highlighted a number of distinct changes in the microbiome after the transplants, in particular a surge in the populations of three types of bacteria. Among them was a four-fold increase in Bifidobacterium, a probiotic organism that seems to play a key role in the maintenance of a healthy gut.But figuring out what was happening on a cellular level — to really look inside some guts — would require another vehicle.

The ASU team needed Mazmanian’s mice.“At the end of the day, what we care about is healing people and how the microbiome affects people,” explains Krajmalnik-Brown. €œThat’s why we work with people. But with mice you can do things that are more mechanistic.”The Great Mouse Detective(Credit. Caltech)Together, Krajmalnik-Brown, Mazmanian and their collaborators would uncover some tantalizing new insights that go a long way to solving the mystery.

In May 2019, the team published another high-profile paper in Cell, after they transplanted stool samples from Krajmalnik-Brown’s severely autistic patients into the guts of Mazmanian’s germ-free mice. The offspring of these mice showed the autism-like symptoms, such as repetitive and compulsive behavior.This time, the team dug even deeper into the biochemical processes playing out in the brain, looking not just at behavior but at the chemicals involved in creating it. The mice that developed autism-like behaviors had measurably lower levels of two substances called taurine and 5-aminovaleric acid (5AV). When they dug into the literature, the team learned that these two substances are known to mimic activity of a key signaling agent in the brain called gamma-aminobutyric acid (GABA) — a neurotransmitter that other studies have found is deficient in the brains of children with autism.What’s more, some have speculated that the tendency of children with autism to experience sensory overstimulation may stem from the inability to tamp down overexcited neurons.

A lack of GABA could lead to just that.The scientists next orally administered high levels of taurine and 5AV to pregnant mice with the autistic children’s microbiomes. When their pups were born, the researchers continued to feed the young the substances until they reached adulthood. Compared with untreated animals, the second-generation mice had significantly fewer behavioral symptoms. Taurine reduced repetitive behavior, as measured by marble burying, increased the level of social interaction, and relieved anxiety.

Mice administered 5AV were more active and social.“We healed humans with behavioral problems,” says Krajmalnik-Brown. €œ[And we] transferred some of those deficits and behaviors to mice — basically the opposite. It’s huge.”Mazmanian hopes to take the next step in the months ahead.“I can flip a switch, turn on a light, I know that switch turns on that light. I don’t know the circuit, I don’t know where the wire is,” Mazmanian says.

€œExactly how that’s happening … we just don’t understand that.”This most recent study, by itself, hardly proves that dysregulated microbiomes cause the brain disorder — a point that plenty of other scientists skeptical of Mazmanian’s work are happy to make.“The paper made a big splash, but trying to model psychiatric-related human conditions in mice, in my view, is a little bit of a stretch,” says Sangram Sisodia, a neurobiologist at the University of Chicago who studies the microbiome. €œA mouse with autism?. €Nor was that the only criticism. Several researchers have suggested that the group didn’t give proper attention to one of their tests ­— one whose results conflicted with their thesis ­— while others found flaws in the statistical methods they used to assess their results.

Mazmanian downplays these criticisms, but agrees the work is not yet conclusive.Meanwhile, the ASU trial has also engendered skepticism, mainly due to its tiny sample size, the lack of a control group and the methods by which the children were assessed for autism severity. Krajmalnik-Brown and Adams say they stand by their results, but agree more research is needed. In recent months, they have launched two new studies that will address these issues.Adams insists the work is already changing lives. €œWe followed up with every one of our 18 participants,” he says, referring to the children who received fecal transplants.

€œSure enough, we found that most of the GI benefits had remained. And family after family said their child just slowly, steadily continued making more improvement.” They published the update in Scientific Reports in spring 2019.“I’m not ready to say the case is closed,” says Mazmanian. €œHealthy skepticism is a good thing. I believe the preclinical data, I believe the mouse data.

But there’s a lot of studies that still need to be done.” A Healthy Gut, A New OutlookEthan Woods had GI issues and symptoms of autism until researchers introduced new microbes to his gut. His mother says the treatment changed everything. (Credit. Dana Woods)Prior to his fecal transplant at age 7, Ethan Woods suffered from chronic and severe diarrhea, constipation and cramping, symptoms so extreme that to his mother, Dana, he sounded like “a bit like a woman in labor when he was trying to have a bowel movement.” “It was just awful watching your child go through this,” she says, explaining that when she enrolled her autistic son in the Arizona State study, her “only goal was to fix his gut.”Remarkably, Ethan’s agony began to disappear just a few weeks into the trial.

But that was not the most dramatic difference. Before the transplant, Ethan’s speech was drawn out and slow, his language skills rudimentary. He seemed to live in his own bubble. He had frequent outbursts.

For as long as Dana could remember, her mornings with Ethan had been marked by arguing, fighting, pushing and anger. But then one morning, something shocking happened.“He woke me up one morning with his face right in my face with this big smile and he said, ‘Morning, Mom!. €™â€‰â€ she recalls. €œAnd he was just excited and happy and ready to go about his day with this big smile.

It choked me up to the point where I teared up because I had never experienced a happy kid in the morning.”Later, Ethan carried over an iPad and opened an app with a talking cat that repeats back the words children speak aloud. He played back a video recording of himself from just a few weeks earlier.“[He] looks me in the eye and says, ‘Mom, why did I talk like that?. What is wrong with me?. €™ And as soon as he did that, I caught my breath.

I had to compose myself and say, ‘I don’t know. But do you feel better?. Do you feel different?. Why do you think?.

€™â€‰â€Ethan’s communication skills had already begun to improve. Within a year of the study, his speech therapist graduated him from speech therapy because he had met all his goals.“He went from one end of the rainbow all the way to the other end of the rainbow,” she says. €œPrior to the study, I was very afraid. My biggest fear was ‘how is he going to navigate the world when I’m not here?.

€™ And I think I have a lot of hope now that he is going to be OK now on his own.”There’s something strange about the female orgasm, something that scientists have been unable to explain. Biological functions are normally discussed in terms of evolutionary pressure, or reproductive advantage. If a biological trait improves your chances of having more offspring, then it’s more likely to stick around in your species. The male orgasm makes perfect sense — ejaculate contains the genetic material that’s necessary for making babies.

But the female orgasm has been harder to nail down. Fertilization doesn’t depend on it, and “fun” isn’t exactly in the pantheon of evolutionary explanations.Researchers that study how the female orgasm relates to reproductive success have two main options — either ask people invasive questions about their most personal moments, or to find a way to stick probes in or on them during said moments. Neither of these approaches have resulted in the kind of “wet lab” research that’s the gold standard for biological understanding.What we do know, despite widespread cultural discomfort with talking openly about sex and pleasure, is that there appears to be significant sexual dysfunction in American society. Back in 2014, researchers from the Kinsey Institute, the preeminent U.S.

Academy for the study of sex and relationships, said as much. In a survey of nearly 3,000 people, they found that men, straight or gay, orgasmed 85 percent of the time during consensual sexual encounters. Lesbian women orgasmed less often, 75 percent of the time, while straight women fared worst with just a 60 percent chance of orgasm. Other studies have shown that something like 10-15 percent of women experience lifelong anorgasmia, meaning they’ve never experienced orgasm.

A further 40 percent of women report some kind of inability to reach orgasm in the past year.The orgasm gap is hard to explain. Some think that it comes down to straight men’s finesse, or lack thereof, citing the difference between straight and lesbian satisfaction. Indeed, it makes sense that knowing your way around the territory would help. But for many couples this isn’t a helpful revelation, since the emotional maturity necessary to teach sexual dexterity is often out of reach.

Shortcut to SatisfactionLuckily, we live in an era of Silicon Valley disruption, which has even started lapping at the shores of sex research. Technologist Liz Klinger is at the forefront of this transition. She and her team have built a platform that lets people become citizen scientists of sex —without ever having to get out from between the sheets.About a decade ago, Klinger’s company, Lioness, released what they billed as the first “smart vibrator,” a sex toy that could actually learn about you. The final product was a far cry from the first prototype, which was much more laboratory object than sex toy.The “test device was this whole mess of wires, with a hard connection.

We had to physically send it to our beta testers, who used it and sent it back,” recalls Klinger. The researchers would download the data collected by the toy’s four sensors — temperature, motion, acceleration and pressure — and compile it into a chart that represented arousal and orgasm, as told through the story of pelvic-floor muscle contractions.It was an immediate success for sex partners who needed ways to talk about pleasure in a more objective way. Klinger recalled that when she got the first beta-test couple on the phone, “the wife was like ‘holy crap, we finally were able to talk about these things that I’ve had a lot of trouble talking about.’ It turned out that she wanted more foreplay, and he didn’t know quite that that meant. He’d spend more time, but it just didn’t match up, you know?.

€ With the company’s signature offering in hand — a chart of sexual arousal over time — Klinger found that couples could have a conversation “without the subtext of ‘oh, you’re not good enough, or I don’t like you enough,’ on the husband’s part and ‘I’m so tired of talking about this’ on the wife’s part,” she says. The chart “can change people’s perceptions of their own experiences, and how they talk about them with others.”Doing the Deed — For ScienceThis spring, the company has launched a research platform dubbed Lioness 2.0 — a new optional service that, unsurprisingly, their data-obsessed users have greeted with open arms. Now, instead of simply using the toy to understand themselves better, Lioness owners can opt in to the kinds of hands-on studies that are necessary for a deeper understanding of sex and pleasure. So far, the company is working with Nigeria’s Society for Family Health to study how pleasure changes with menopause across age, race and orientation, as well as with the U.S.’s Center for Genital Health and Education to explore the role of pelvic floor muscles in orgasm.Pani Farvid, a professor of applied psychology at The New School in New York City, has some reservations about the platform.

€œI really like what they’re trying to do, but there could be more added to make it a bit more comprehensive. My concern is that there's a misconception that sex is just about the orgasm, that it’s just physiological and that pleasure just has to do with the genitals.” From where she’s sitting, “that’s a very mechanical view of sexuality.” If the Lioness is helping to equalize the orgasm gap, or helping people understand their bodies better, “I think that's great,” says Farvid. €œBut as a critical sexologist, I'm interested in delving deeper into what these practices mean.” If sex is hyper-focused on orgasm, to exclusion of everything else, she cautions that these norms “have real-life negative impacts on people's sex lives and their sense of themselves.”At this point, knee-deep in an era of data collection that was once the sole purview of white-coat-wearing scientists, it’s old news that we need to be careful with what our technology is doing to us. No tool can serve as a cure-all, even if it comes loaded with a neat app and some space-age sensors.

What it can offer, though, is the opportunity to start a conversation, and the chance to take a long, honest look at something about yourself — whether it’s the number of steps you take every day, or the way you want to be touched.Wondering how to keep your glasses from fogging up when your mask is on?. Look no further. If we've learned one thing throughout the COVID-19 pandemic, it's the importance of wearing a mask. Countless studies have shown over the past eight months that wearing a protective barrier over your nose and mouth — whether it's a standard-issue surgical mask or an N95 respirator — can significantly decrease the odds of catching and transmitting disease.

What's more, some research shows that masking up can reduce the severity of an infection if a masked person does contract COVID-19. But while masks are potentially lifesaving, they can be uncomfortable, often changing your breathing patterns and fogging up your glasses when breath escapes through the top of the mask. Among people who choose not to wear a mask to prevent the spread of COVID-19, many cite discomfort as a key reason why.Wesley Wilson, a tumor immunologist in Pennsylvania, knows how annoying it can be when your glasses are fogging up. He says fogging is “definitely a problem” among his hospital colleagues, who need to wear protective goggles and surgical masks while on the job.

Fortunately, they've also picked up a few helpful hacks for keeping their vision clear while wearing a mask with glasses.#1. Use Tape“If you have to keep your mask on for hours, tape works like a charm,” Wilson says. This especially applies to healthcare professionals in his practice who are required to keep their masks on at all times, except during lunch. €œIf you're putting on your mask and taking it off a lot, tape probably isn't practical — but two small pieces of tape on the cheeks keep the mask fitted closer to your face, and the hot air out of your glasses,” he says.#2.

Fit the Mask to Your FaceWhile some air leakage is to be expected, wearing a mask that fits securely to your face will prevent glass fogging and filter the virus more effectively since less air is coming in or out. Find surgical masks or N95s that come with a nose bridge, a small, flexible piece of metal or plastic that allows the mask to more closely fit the contours of your face. Nose bridges can be sewn inside masks or affixed to the front.Read More. Why It Feels Like You Can't Breathe Inside Your Face Mask#3.

Adjust Your MaskAccording to the American Academy of Ophthalmology, a minor adjustment in how you wear your mask could be enough to prevent fog as well. Simply pull the mask over your nose and rest your glasses on top of your face mask. As long as the mask is fitted close to your face, this should prevent hot air from slipping out.#4. Spray Your GlassesA former ice hockey player, Wilson says the protective visor under his helmet would often fog with hot air while he was on the ice during games.

Like an ocean diver, he would use de-misting solution or a defogging spray (such as this one) to keep his visor free of fog. The same concept applies to eyeglass fog caused by masking, he says. €œYou can either buy a spray or you can make your own with either shaving cream or soap and water,” says Wilson. €œWiping some shaving cream on your glasses and then wiping it off will coat them with a similar surface-tension altering compound that prevents fog.”With the COVID-19 pandemic showing no signs of stopping, there’s a lot of responsibility on people to wear face masks while out in public.

But even if you do wear a mask, you might not be wearing it properly.   According to CDC guidelines, face masks are meant to cover both the nose and the mouth and fit securely under the chin. While most people who mask-up do wear them correctly, that’s not always the case. Some people prefer to wear their masks pulled down so it only covers their mouth, leaving their nose exposed. But this can defeat a key purpose of wearing a mask.

Research from several scientists have demonstrated that the nose is highly vulnerable to COVID-19 infection.  Wearing a mask helps slow the spread of COVID-19 by preventing the transmission of droplets and aerosols that are produced when a person breathes, talks, coughs or sneezes. The CDC says this is a primary way the virus spreads. Nasal Negligence     In April, an international team of researchers determined that the nose is a key entry point for SARS-CoV-2, the virus that causes COVID-19. Their work, which was published in the journal Nature Medicine, explained that nasal cells in particular contain high levels of the proteins that SARS-CoV-2 attaches to in order to enter the body.

The proteins are called ACE2 and TMPRSS2. €¯â€¯â€¯â€¯â€¯â€¯â€¯ To track down the protein pathways for the virus, the researchers examined tissue samples from donors that included lung, eye, nasal, intestinal, heart, kidney and liver cells. Waradon Sungnak, an immunologist at the Wellcome Sanger Institute and the lead author of the study, explained that the researchers examined the nose cells somewhat as an afterthought, and did not anticipate them to be so important. Because the nose is a main pathway for the virus, Sungnak says it's a possible explanation for why COVID-19 spread so efficiently early in the pandemic.  “The expression of these viral entry factors are high in the nose,” Sungnak says.

€œSo, it’s a very easy place for the virus to get in and then once it gets in, a place to replicate. So if there’s any way for you to block that from happening, I think it’s worth it. So, for me, it doesn’t really make sense if you’re putting on a mask, to not be putting a barrier on the nose.” COVID-19 Gateway  Another study, published in Cell in July, pointed to the importance of protecting the nose. A team tracked how the coronavirus entered the lungs and where the initial site of infection was.

The researchers mapped surface receptors in the airways to determine which areas contained the most ACE2 proteins. They determined that the highest concentrations of these proteins are located in are in the nose, instead of the deep lungs as they had anticipated. After exposing tissue samples to SARS-CoV-2, the team determined that the nose was the most fertile infection point of the entire respiratory system. Read next.

Why It Feels Like You Can't Breathe Inside Your Face Mask — and What to Do About ItStudy author Richard Boucher, a pulmonary researcher at the University of North Carolina in Chapel Hill, says that the findings are consistent with the way the nose is used by the body as a filtration device, to both draw in and trap viruses. While in the nose, the viruses can be “micro-aspirated,” or breathed into the lungs through tiny droplets of body fluids. Once in the lungs, the virus replicates itself using the cells there. Boucher says micro-aspiration is more common among older people and those with medical conditions.

As a result, these populations are more likely to have viruses like COVID-19 impact their lower respiratory system, which includes airways and lungs. Younger or healthier people, in contrast, are more likely to have the virus remain in their nasal passages, which means they'll experience milder symptoms such as runny noses or sneezing. Boucher says it’s clear that protecting the nose is extremely important to protecting the lungs and respiratory tract from COVID-19. Based on the findings of his study, wearing a mask underneath the nose is completely ineffective in protecting someone’s respiratory system.    “It may in fact be bad because it gives you a false sense of protection,” Boucher says.

€œYou may go into circumstances that are not so wise, but you think you’re protected so you’ll take the risk. So, in one sense it’s the worst of all worlds. It’s ineffective, but it may deceive you into thinking you’re protected.” .

Baclofen sds

October is Mental Health Awareness Month and World baclofen sds Mental Health Day https://www.voiture-et-handicap.fr/buy-baclofen-usa/ takes place on 10 October 2020. This year, the COVID-19 pandemic has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of people’s experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the virus.1–3 Job losses, financial and housing insecurity, the challenges of working from home, home schooling, restricted access to health and social care services and social isolation coupled with reduced support and contact with family and baclofen sds friends have all impacted people’s well-being. There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care. These factors have significant potential for negative repercussions on the mental health and well-being of healthcare staff.4 5 There have been reports of high levels of stress, depression and even suicides,6 and long-term effects include a higher risk for post-traumatic stress disorder or moral injury.5Healthcare organisations need to plan for the inevitable consequence of this pandemic and baclofen sds ensure that resources are in place for their workers.

Screening for mental health issues and treatment, including counselling, should be made available. In addition, nurses and baclofen sds other healthcare staff should be encouraged to reflect on their experiences and consider how to implement self-care strategies that will enhance their well-being. This includes staying informed of the current data and information and being aware of the risks to themselves and others while caring for patients with the virus. By monitoring and enacting strategies to reduce stress and develop support systems, staff can minimise longer-term impacts.4Whether organisational support and self-care monitoring have achieved better mental health outcomes for healthcare workers is, as yet, unknown. Research across the globe is underway not baclofen sds only related to the virus itself but also to the mental health consequences of the pandemic.

We do not yet know the extent of the issues or how best to support healthcare providers. In order baclofen sds to better understand the issues and to support nurses at this time, evidence-based nursing will focus our social media to mental health issues during the month of October. We will highlight and share relevant resources and information and encourage discussion of the key challenges facing healthcare workers.During October, we will showcase the experiences of four key groups—patients, nurses, students and informal carers and families. Be sure to log into evidence-based nursing each week for the following blogs:October baclofen sds 4. Impact of COVID-19 on patient mental health.October 11.

Impact of COVID-19 on nurses’ mental health and.Twitter Chat on Wednesday October 14 at baclofen sds 20:00 UK time.Oct. 18. Impact of COVID-19 on student nursing.Oct. 25. Impact of COVID-19 on informal carers and families.A PhD is a globally recognised postgraduate degree and typically the highest degree programme awarded by a University, with students usually required to expand the boundaries of knowledge by undertaking original research.

The purpose of PhD programmes of study is to nurture, support and facilitate doctoral students to undertake independent research to expected academic and research standards, culminating in a substantial thesis and examined by viva voce. In this paper—the first of two linked Research Made Simple articles—we explore what the foundations of a high-quality PhD are, and how a Doctoral candidate can develop a study which is published here successful, original and impactful.Foundations of a ‘good’ PhD studySupervision and supportCentral to the development and completion of a good PhD is the supervisory relationship between the student and supervisor. The supervisor guides the student by directing them to resources and training to ensure continuous learning, provides opportunity to engage with experts in the field, and facilitates the development of critical thinking through questioning and providing constructive criticism.1The support needs of students will be different, so a flexible yet quality assured approach to PhD research training is required. A good supervisory team (usually includes at least two postdoctoral academics) provide experienced guidance and mentorship and will offer students academic support, with regular meetings and timely feedback on written submissions, will assist the student to develop a peer network and help them access research communities relative to their field. Effective supervision has beneficial outcomes for students, including encouraging a positive work ethic and influencing engagement in a stimulating environment, allowing students to pursue their own ideas with educated encouragement.

The quality of the supervisory relationship can impact greatly on the PhD experience and ultimately sets the student on the road to producing excellent Doctoral work.1An environment that promotes personal and professional development is further aided by positive peer interactions. If students feel part of a community and have contact with others also working on doctoral studies, there is the scope for peer compassion and understanding during both challenging and rewarding periods. Students who access personal and professional support and guidance through mentoring models during their studies are more likely to succeed. These models include one-to-one peer mentoring or activities for example journal discussion or methods learning groups. Often, groups of students naturally come together and give each other support and advice about research process expectations and challenges, and offer friendship, and guidance.2 Given the usefulness of different types of mentoring models, all can create a supportive and collaborative environment within a PhD programme of study, to minimise working in isolation and enable students to achieve their greatest potential.Characteristics of a good study.

Originality and theoretical underpinningA PhD should make an original contribution to knowledge. Originality can be achieved through the study design, the nature or outcomes of the knowledge synthesis, or the implications for research and/or practice.3 Disciplinary variation, however, influences the assessment of originality. For example, originality in science, technology, engineering and mathematics subjects is often inferred if the work is published/publishable, in comparison to intellectual originality in the social sciences.4 Although PhD originality assumes different nuances in different contexts, there is a general acceptance across disciplines that there should be evidence of the following within the thesis:An interplay between old and new—any claims of originality are developed from existing knowledge and practices.There are degrees of originality, relating to more than one aspect of the thesis.Any claims for originality are accompanied by clear articulation of significance.A good PhD should be also underpinned by theoretical and/or conceptual frameworks (that include philosophical and methodological models) that give clarity to the approach, structure and vision of the study.5 These theoretical and conceptual frameworks can explain why the study is pertinent and how the research addresses gaps in the literature.6 Table 1 provides a distinction of what construes theoretical and conceptual frameworks.View this table:Table 1 Characteristics of theoretical and conceptual frameworks7Theoretical/conceptual frameworks must align with the research question/aims, and the student must be able to articulate how conceptual/theoretical framework were chosen. Key points for consideration include:Are the research questions/aim and objectives well defined?. What theory/theories/concepts are being operationalised?.

How are the theories/concepts related?. Are the ontological and epistemological perspectives clearly conveyed and how do they relate to theories and concepts outlined?. What are the potential benefits and limitations of the theories and concepts outlined?. Are the ways the theories/concepts are outlined and being used original?. A PhD thesis (and demonstrable in viva) must be able to offer cohesion between the choice of research methods that stems from the conceptual/theoretical framework, the related ontological and epistemological decisions, the theoretical perspective and the chosen methodology (table 2).

PhD students must be able to articulate the methodological decisions made and be critical of methods employed to answer their research questions.View this table:Table 2 Relationship between research paradigms, perspectives, methodologies and methods.8 9ConclusionIn summary, we offer considerations of what the foundations of a good PhD should be. We have considered some of the key ingredients of quality PhD supervision, support and research processes and explored how these will contribute to the development of a study that leads to student success and which makes a valuable contribution to the evidence base. In the next paper, we will look in more detail at the assessment of the PhD through the submission of a thesis and an oral viva..

October is buy generic baclofen Mental Health Awareness Month and World Mental address Health Day takes place on 10 October 2020. This year, the COVID-19 pandemic has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of people’s experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the virus.1–3 Job losses, financial and housing buy generic baclofen insecurity, the challenges of working from home, home schooling, restricted access to health and social care services and social isolation coupled with reduced support and contact with family and friends have all impacted people’s well-being.

There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care. These factors have significant potential for negative buy generic baclofen repercussions on the mental health and well-being of healthcare staff.4 5 There have been reports of high levels of stress, depression and even suicides,6 and long-term effects include a higher risk for post-traumatic stress disorder or moral injury.5Healthcare organisations need to plan for the inevitable consequence of this pandemic and ensure that resources are in place for their workers. Screening for mental health issues and treatment, including counselling, should be made available.

In addition, nurses and other healthcare staff should be encouraged to reflect on their experiences and consider how to implement self-care buy generic baclofen strategies that will enhance their well-being. This includes staying informed of the current data and information and being aware of the risks to themselves and others while caring for patients with the virus. By monitoring and enacting strategies to reduce stress and develop support systems, staff can minimise longer-term impacts.4Whether organisational support and self-care monitoring have achieved better mental health outcomes for healthcare workers is, as yet, unknown.

Research across the globe is underway not only related to the virus itself but also to the buy generic baclofen mental health consequences of the pandemic. We do not yet know the extent of the issues or how best to support healthcare providers. In order to better understand the issues and to support nurses at this time, evidence-based buy generic baclofen nursing will focus our social media to mental health issues during the month of October.

We will highlight and share relevant resources and information and encourage discussion of the key challenges facing healthcare workers.During October, we will showcase the experiences of four key groups—patients, nurses, students and informal carers and families. Be sure buy generic baclofen to log into evidence-based nursing each week for the following blogs:October 4. Impact of COVID-19 on patient mental health.October 11.

Impact of COVID-19 on nurses’ mental health and.Twitter Chat on Wednesday October 14 at buy generic baclofen 20:00 UK time.Oct. 18. Impact of COVID-19 on student nursing.Oct.

25. Impact of COVID-19 on informal carers and families.A PhD is a globally recognised postgraduate degree and typically the highest degree programme awarded by a University, with students usually required to expand the boundaries of knowledge by undertaking original research. The purpose of PhD programmes of study is to nurture, support and facilitate doctoral students to undertake independent research to expected academic and research standards, culminating in a substantial thesis and examined by viva voce.

In this paper—the first of two linked Research Made Simple articles—we explore what the foundations of a high-quality PhD are, and how a Doctoral candidate can develop a study which is successful, original and impactful.Foundations of a ‘good’ PhD studySupervision and supportCentral to the development and completion of a good PhD is the supervisory relationship between https://www.voiture-et-handicap.fr/buy-baclofen-usa/ the student and supervisor. The supervisor guides the student by directing them to resources and training to ensure continuous learning, provides opportunity to engage with experts in the field, and facilitates the development of critical thinking through questioning and providing constructive criticism.1The support needs of students will be different, so a flexible yet quality assured approach to PhD research training is required. A good supervisory team (usually includes at least two postdoctoral academics) provide experienced guidance and mentorship and will offer students academic support, with regular meetings and timely feedback on written submissions, will assist the student to develop a peer network and help them access research communities relative to their field.

Effective supervision has beneficial outcomes for students, including encouraging a positive work ethic and influencing engagement in a stimulating environment, allowing students to pursue their own ideas with educated encouragement. The quality of the supervisory relationship can impact greatly on the PhD experience and ultimately sets the student on the road to producing excellent Doctoral work.1An environment that promotes personal and professional development is further aided by positive peer interactions. If students feel part of a community and have contact with others also working on doctoral studies, there is the scope for peer compassion and understanding during both challenging and rewarding periods.

Students who access personal and professional support and guidance through mentoring models during their studies are more likely to succeed. These models include one-to-one peer mentoring or activities for example journal discussion or methods learning groups. Often, groups of students naturally come together and give each other support and advice about research process expectations and challenges, and offer friendship, and guidance.2 Given the usefulness of different types of mentoring models, all can create a supportive and collaborative environment within a PhD programme of study, to minimise working in isolation and enable students to achieve their greatest potential.Characteristics of a good study.

Originality and theoretical underpinningA PhD should make an original contribution to knowledge. Originality can be achieved through the study design, the nature or outcomes of the knowledge synthesis, or the implications for research and/or practice.3 Disciplinary variation, however, influences the assessment of originality. For example, originality in science, technology, engineering and mathematics subjects is often inferred if the work is published/publishable, in comparison to intellectual originality in the social sciences.4 Although PhD originality assumes different nuances in different contexts, there is a general acceptance across disciplines that there should be evidence of the following within the thesis:An interplay between old and new—any claims of originality are developed from existing knowledge and practices.There are degrees of originality, relating to more than one aspect of the thesis.Any claims for originality are accompanied by clear articulation of significance.A good PhD should be also underpinned by theoretical and/or conceptual frameworks (that include philosophical and methodological models) that give clarity to the approach, structure and vision of the study.5 These theoretical and conceptual frameworks can explain why the study is pertinent and how the research addresses gaps in the literature.6 Table 1 provides a distinction of what construes theoretical and conceptual frameworks.View this table:Table 1 Characteristics of theoretical and conceptual frameworks7Theoretical/conceptual frameworks must align with the research question/aims, and the student must be able to articulate how conceptual/theoretical framework were chosen.

Key points for consideration include:Are the research questions/aim and objectives well defined?. What theory/theories/concepts are being operationalised?. How are the theories/concepts related?.

Are the ontological and epistemological perspectives clearly conveyed and how do they relate to theories and concepts outlined?. What are the potential benefits and limitations of the theories and concepts outlined?. Are the ways the theories/concepts are outlined and being used original?.

A PhD thesis (and demonstrable in viva) must be able to offer cohesion between the choice of research methods that stems from the conceptual/theoretical framework, the related ontological and epistemological decisions, the theoretical perspective and the chosen methodology (table 2). PhD students must be able to articulate the methodological decisions made and be critical of methods employed to answer their research questions.View this table:Table 2 Relationship between research paradigms, perspectives, methodologies and methods.8 9ConclusionIn summary, we offer considerations of what the foundations of a good PhD should be. We have considered some of the key ingredients of quality PhD supervision, support and research processes and explored how these will contribute to the development of a study that leads to student success and which makes a valuable contribution to the evidence base.

In the next paper, we will look in more detail at the assessment of the PhD through the submission of a thesis and an oral viva..

Baclofen and cerebral palsy

A new study led baclofen and cerebral palsy by UC Davis MIND Institute researchers found a distinct DNA methylation signature in https://www.voiture-et-handicap.fr/buy-baclofen-usa/ the cord blood of newborns who were eventually diagnosed with autism spectrum disorder (ASD). This signature mark spanned DNA regions and genes linked to early fetal neurodevelopment. The findings may hold clues baclofen and cerebral palsy for early diagnosis and intervention. Cord blood DNA sample might hold the key to early ASD diagnosis“We found evidence that a DNA methylation signature of ASD exists in cord blood with specific regions consistently differentially methylated,” said Janine LaSalle, lead author on the study and professor of microbiology and immunology at UC Davis.The study published Oct.

14 in Genome Medicine also identified sex-specific epigenomic signatures that support the developmental and sex-biased roots of ASD.The U.S baclofen and cerebral palsy. Centers for Disease Control and Prevention (CDC) estimates that one in 54 children are diagnosed with ASD, a complex neurological condition linked to genetic and environmental factors. It is much more prevalent baclofen and cerebral palsy in males than females.The role of the epigenome in DNA functioningThe epigenome is a set of chemical compounds and proteins that tell the DNA what to do. These compounds attach to DNA and modify its function.

One such compound is CH3 (known as the methyl group) that could lead to DNA methylation. DNA methylation can change the activity baclofen and cerebral palsy of a DNA segment without changing its sequence. Differentially methylated regions (DMRs) are areas of DNA that have significantly different methylation status. The epigenome compounds do not change the DNA baclofen and cerebral palsy sequence but affect how cells use the DNA's instructions.

These attachments are sometimes passed on from cell to cell as cells divide. They can also be passed down from baclofen and cerebral palsy one generation to the next. The neonatal epigenome has the potential to reflect past interactions between genetic and environmental factors during early development. They may also influence future health outcomes.Finding factors in fetal cord blood that might predict autismThe researchers studied the development of 152 children born to mothers enrolled in the MARBLES and EARLI studies.

These mothers had baclofen and cerebral palsy at least one older child with autism and were considered at high risk of having another child with ASD. When these children were born, the mothers’ umbilical cord blood samples were preserved for analysis. At 36 months, these children got diagnostic and developmental assessments baclofen and cerebral palsy. Based on these, the researchers grouped the children under “typically developing” (TD) or “with ASD.”The researchers also analyzed the umbilical cord blood samples taken at birth from the delivering mothers.

They performed whole-genome sequencing of these blood samples to baclofen and cerebral palsy identify an epigenomic signature or mark of ASD at birth. They were checking for any patterns of DNA-epigenome binding that could predict future ASD diagnosis.They split the samples into discovery and replication sets and stratified them by sex. The discovery set included samples from 74 males (39 TD, 35 ASD) and 32 females (17 TD, 15 ASD). The replication baclofen and cerebral palsy set was obtained from 38 males (17 TD, 21 ASD) and eight females (3TD, 5 ASD).Using the samples in the discovery set, the researchers looked to identify specific regions in the genomes linked to ASD diagnosis.

They tested the DNA methylation profiles for DMRs between ASD and TD cord blood samples. They mapped the DMRs to genes and assessed them in gene function, tissue expression, chromosome location and overlap baclofen and cerebral palsy with prior ASD studies. They later compared the results between discovery and replication sets and between males and females.Cord blood to reveal insights into genes related to ASDThe researchers identified DMRs stratified by sex that discriminated ASD from TD cord blood samples in discovery and replication sets. They found that seven regions baclofen and cerebral palsy in males and 31 in females replicated, and 537 DMR genes in males and 1762 DMR genes in females replicated by gene association.

These DMRs identified in cord blood overlapped with binding sites relevant to fetal brain development. They showed brain and embryonic expression and X chromosome baclofen and cerebral palsy location and matched with prior epigenetic studies of ASD.“Findings from our study provide key insights for early diagnosis and intervention,” LaSalle said. €œWe were impressed by the ability of cord blood to reveal insights into genes and pathways relevant to the fetal brain.”The researchers pointed out that these results will require further replication before being used diagnostically. Their study serves as an important proof of principle that the cord blood methylome is informative about future ASD risk.

The co-authors on this study are Charles E baclofen and cerebral palsy. Mordaunt, Julia M. Jianu, Benjamin I baclofen and cerebral palsy. Laufer, Yihui Zhu, Hyeyeon Hwang, Keith W.

Dunaway, Sally Ozonoff, Irva Hertz-Picciotto and Rebecca baclofen and cerebral palsy J. Schmidt of UC Davis MIND Institute. Kelly M. Bakulski of University of Michigan, Ann Arbor baclofen and cerebral palsy.

Jason I. Feinberg, Heather baclofen and cerebral palsy E. Volk and M. Daniele Fallin baclofen and cerebral palsy of Johns Hopkins University.

Kristen Lyall of Drexel University. Lisa A. Croen of baclofen and cerebral palsy Kaiser Permanente Northern California. And Craig J.

Newschaffer of Pennsylvania baclofen and cerebral palsy State University.Article. Mordaunt et al. (2020). Cord blood DNA methylome in newborns later diagnosed with autism spectrum disorder reflects early dysregulation of neurodevelopmental and X-linked genes, Genome Medicine, doi.

Https://doi.org/10.1186/s13073-020-00785-8If you survive COVID-19, you may have something else to fear, and it has nothing to do with how sick you were. Doctors are often unable to identify why some patients are COVID-19 long-haulersFor some people — and there seems to be no consistent reason — symptoms can last and last, sometimes for months. The name many of these patients call themselves is “long-haulers,” but it does not begin to describe the confusion, anxiety and distress that long-term COVID-19 patients endure.“It’s scary for them,” said Nicholas Kenyon, a UC Davis Health professor and leading pulmonary and critical care expert. €œThey want to know, ‘Why am I still out of breath?.

Why am I still tired and coughing after months?. Am I ever going to get better?. €™â€The answer for them is not clear, and certainly not simple. That’s because even defining the problem is not simple.There are no precise statistics on the number of long-haul patients — people who, in theory, have recovered from the worst impacts of the coronavirus, tested negative, but still have symptoms that can last for weeks or months.

The Journal of the American Medical Association in a recent article, as well as a study from a team of British scientists, estimate about 10% of COVID-19 patients become long-haulers. That’s in line with what UC Davis Health is seeing, Kenyon said.But it’s hard to quantify because it’s hard to define the length of time that lingering symptoms fit the long-haul COVID category.“Even after a month, it gets frightening,” Kenyon said. €œPeople ask, ‘What’s wrong with me?. €™â€No limits to who long-haul COVID affectsLong-term COVID-19 appears to affect every kind of patient — from people who were hospitalized with severe COVID-19 to those with very mild bouts who recovered at home.

It appears in regions with both high rates and low rates of COVID-19 infections. It attacks people who were battling other conditions before contracting COVID-19 and people who were completely healthy. And it hits both the old and the young.“What’s new is this is affecting some people who are quite young who were very healthy and never had other illnesses.” — Nicholas Kenyon“We’ve seen this in patients across the gamut, and there does not appear to be any clear connections in the cause,” Kenyon said. €œWhat’s new is this is affecting some people who are quite young who were very healthy and never had other illnesses.”It is not uncommon, Kenyon said, for patients who were hospitalized for a long time — whatever the reason — to take months to get back to feeling normal.

But even those COVID-19 patients are inconsistent. Most recover on a steady, if sometimes slow, upward line, but some have symptoms that persist for months.“We have experience helping people who were hospitalized with other severe viral infections, but this disease is so new, there is still much to learn,” he said. €œWe don’t know why a few hospitalized patients continue to have symptoms and others don’t. We aren’t even exactly clear what all the symptoms are.”Common symptoms of long-haul COVID-19The list of symptoms is long, wide and inconsistent.

For some people, they are nothing like the original symptoms they had when they first were infected by COVID-19. The most common include:CoughingOngoing, sometimes debilitating, fatigueBody achesJoint painShortness of breathLoss of taste and smell — even if this did not occur during the height of their illnessDifficulty sleepingHeadachesBrain fogThat last one is among the most confounding. Patients report being unusually forgetful, confused or unable to concentrate even enough to watch TV.Many long-haul COVID-19 patients battle exhaustion and a range of other symptoms“That sort of brain fog can happen to people who were in an intensive care unit for a length of time, but it is relatively rare,” Kenyon said. €œBut this is happening to all sorts of patients, including people who had mild cases and were not hospitalized.”Symptoms for long-haulers are not uniform.

Some report severe chest pain along with more general body aches. Others have chills and sweats or gastrointestinal issues. Some people have reported feeling better for days or even weeks then relapsing.For others, it’s a case of just not feeling like themselves.“There are patients who can go for a run and test completely normal,” Kenyon said. €œBut they still don’t feel right.

They aren’t back to their old selves, but we can’t fully define what’s wrong. Telling a patient who feels bad that they are fine and there is nothing we can identify is not a decent answer for them, or for us.”Trying to explain long-haul COVID-19The problem for patients and experts trying to help is the same one that physicians and infectious disease experts face with COVID-19 in general — it’s so new that science is only beginning to grasp it. And long-haulers have only recently gotten the attention of some experts who were first engaged with trying to slow the pandemic or care for dangerously ill patients.The vast majority of long-haulers test negative for COVID-19 and there is no specific test to give them for lasting symptoms of the coronavirus, said Nam Tran, an associate clinical professor of pathology and laboratory medicine and senior director of clinical pathology in charge of COVID-19 testing at UC Davis Health.“There are patients who can go for a run and test completely normal. But they still don’t feel right … Telling a patient who feels bad that they are fine and there is nothing we can identify is not a decent answer for them, or for us.”— Nicholas Kenyon“Unfortunately, we don’t know enough about the virus to test for its lingering effects,” Tran said.

€œThere are questions about why their fatigue goes on and on, and science just hasn’t solved them yet. We’re all learning in real time.”The most common theories about long-term COVID-19 patients include the hypotheses that the virus remains in their bodies in some small form, or that their immune systems continue to overreact even though the infection has passed.“The idea that the virus is somehow persisting has been discussed,” Kenyon said. €œThis doesn’t mean the virus is growing or that we can test for it, but this might mean their bodies are reacting to it or it’s still triggering ongoing inflammation.”Some infectious disease experts, including Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, have speculated that long-term COVID-19 might be a form of what is called chronic fatigue syndrome, or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Unfortunately for long-haulers, ME/CFS is not well understood, either.What is being done to help COVID-19 long-haulers?.

As with many other COVID-19 issues, it’s hard just knowing how long some of the symptoms might last when the disease was identified barely 10 months ago. Learning how to treat these patients also requires time.“First, we have to discover what we can about the disease and how to treat it,” Kenyon said. €œThat takes time and experience. Then we all have to share the information with other physicians and the public.

We don’t have that system of sharing in place yet for long-haulers.”Early in the pandemic, pulmonary care chiefs around the U.S. Gathered virtually on Sunday evenings to talk about caring for patients and to share information to help each other progress. Kenyon said he’d like to see something like that resume to discuss caring for long-term COVID-19 patients.“It may not seem to be as much of an emergency as in the first days of the pandemic, but this is just as important,” he said. €œBecause of the pandemic, we don’t have some of our usual routes of communication, like in-person meetings and conferences.”Also, because the disease is so new, much of the information about long-haul COVID-19 cases and care is anecdotal.

That is changing, however, and UC Davis Health is working to bring its expertise together to help patients.“These people need our help,” Kenyon said. €œWe don’t want anyone to have to go step-by-step through each symptom or to go through a list of referrals to find out what’s happening to them. We are uniquely set up to care for these patients, and we will.”.

A new study led by UC Davis MIND Institute researchers found a distinct DNA methylation signature in the cord blood of buy generic baclofen newborns who were eventually diagnosed with autism spectrum disorder https://www.voiture-et-handicap.fr/buy-baclofen-usa/ (ASD). This signature mark spanned DNA regions and genes linked to early fetal neurodevelopment. The findings may hold clues for early diagnosis and buy generic baclofen intervention.

Cord blood DNA sample might hold the key to early ASD diagnosis“We found evidence that a DNA methylation signature of ASD exists in cord blood with specific regions consistently differentially methylated,” said Janine LaSalle, lead author on the study and professor of microbiology and immunology at UC Davis.The study published Oct. 14 in Genome Medicine also identified sex-specific epigenomic signatures that support the developmental and sex-biased buy generic baclofen roots of ASD.The U.S. Centers for Disease Control and Prevention (CDC) estimates that one in 54 children are diagnosed with ASD, a complex neurological condition linked to genetic and environmental factors.

It is buy generic baclofen much more prevalent in males than females.The role of the epigenome in DNA functioningThe epigenome is a set of chemical compounds and proteins that tell the DNA what to do. These compounds attach to DNA and modify its function. One such compound is CH3 (known as the methyl group) that could lead to DNA methylation.

DNA methylation can change the activity of a DNA segment without buy generic baclofen changing its sequence. Differentially methylated regions (DMRs) are areas of DNA that have significantly different methylation status. The epigenome compounds buy generic baclofen do not change the DNA sequence but affect how cells use the DNA's instructions.

These attachments are sometimes passed on from cell to cell as cells divide. They can buy generic baclofen also be passed down from one generation to the next. The neonatal epigenome has the potential to reflect past interactions between genetic and environmental factors during early development.

They may also influence future health outcomes.Finding factors in fetal cord blood that might predict autismThe researchers studied the development of 152 children born to mothers enrolled in the MARBLES and EARLI studies. These mothers had buy generic baclofen at least one older child with autism and were considered at high risk of having another child with ASD. When these children were born, the mothers’ umbilical cord blood samples were preserved for analysis.

At 36 months, these buy generic baclofen children got diagnostic and developmental assessments. Based on these, the researchers grouped the children under “typically developing” (TD) or “with ASD.”The researchers also analyzed the umbilical cord blood samples taken at birth from the delivering mothers. They performed whole-genome sequencing of buy generic baclofen these blood samples to identify an epigenomic signature or mark of ASD at birth.

They were checking for any patterns of DNA-epigenome binding that could predict future ASD diagnosis.They split the samples into discovery and replication sets and stratified them by sex. The discovery set included samples from 74 males (39 TD, 35 ASD) and 32 females (17 TD, 15 ASD). The replication set was obtained from 38 males (17 TD, 21 ASD) and eight females (3TD, 5 ASD).Using the samples in the discovery set, the researchers looked to identify specific regions in the buy generic baclofen genomes linked to ASD diagnosis.

They tested the DNA methylation profiles for DMRs between ASD and TD cord blood samples. They mapped the DMRs to genes and assessed them in gene function, tissue expression, chromosome location and overlap with buy generic baclofen prior ASD studies. They later compared the results between discovery and replication sets and between males and females.Cord blood to reveal insights into genes related to ASDThe researchers identified DMRs stratified by sex that discriminated ASD from TD cord blood samples in discovery and replication sets.

They found that seven regions in males and 31 in females replicated, and 537 DMR genes in males and 1762 DMR genes in females buy generic baclofen replicated by gene association. These DMRs identified in cord blood overlapped with binding sites relevant to fetal brain development. They showed brain and embryonic expression and X chromosome location and matched with prior epigenetic studies of ASD.“Findings from our study provide key insights for early diagnosis and intervention,” buy generic baclofen LaSalle said.

€œWe were impressed by the ability of cord blood to reveal insights into genes and pathways relevant to the fetal brain.”The researchers pointed out that these results will require further replication before being used diagnostically. Their study serves as an important proof of principle that the cord blood methylome is informative about future ASD risk. The co-authors on this study are Charles buy generic baclofen E.

Mordaunt, Julia M. Jianu, Benjamin buy generic baclofen I. Laufer, Yihui Zhu, Hyeyeon Hwang, Keith W.

Dunaway, Sally Ozonoff, Irva Hertz-Picciotto and Rebecca buy generic baclofen J. Schmidt of UC Davis MIND Institute. Kelly M.

Bakulski of University of Michigan, Ann buy generic baclofen Arbor. Jason I. Feinberg, Heather buy generic baclofen E.

Volk and M. Daniele Fallin of Johns buy generic baclofen Hopkins University. Kristen Lyall of Drexel University.

Lisa A. Croen of Kaiser Permanente buy generic baclofen Northern California. And Craig J.

Newschaffer of buy generic baclofen Pennsylvania State University.Article. Mordaunt et side effects baclofen 10mg tablets al. (2020).

Cord blood DNA methylome in newborns later diagnosed with autism spectrum disorder reflects early dysregulation of neurodevelopmental and X-linked genes, Genome Medicine, doi. Https://doi.org/10.1186/s13073-020-00785-8If you survive COVID-19, you may have something else to fear, and it has nothing to do with how sick you were. Doctors are often unable to identify why some patients are COVID-19 long-haulersFor some people — and there seems to be no consistent reason — symptoms can last and last, sometimes for months.

The name many of these patients call themselves is “long-haulers,” but it does not begin to describe the confusion, anxiety and distress that long-term COVID-19 patients endure.“It’s scary for them,” said Nicholas Kenyon, a UC Davis Health professor and leading pulmonary and critical care expert. €œThey want to know, ‘Why am I still out of breath?. Why am I still tired and coughing after months?.

Am I ever going to get better?. €™â€The answer for them is not clear, and certainly not simple. That’s because even defining the problem is not simple.There are no precise statistics on the number of long-haul patients — people who, in theory, have recovered from the worst impacts of the coronavirus, tested negative, but still have symptoms that can last for weeks or months.

The Journal of the American Medical Association in a recent article, as well as a study from a team of British scientists, estimate about 10% of COVID-19 patients become long-haulers. That’s in line with what UC Davis Health is seeing, Kenyon said.But it’s hard to quantify because it’s hard to define the length of time that lingering symptoms fit the long-haul COVID category.“Even after a month, it gets frightening,” Kenyon said. €œPeople ask, ‘What’s wrong with me?.

€™â€No limits to who long-haul COVID affectsLong-term COVID-19 appears to affect every kind of patient — from people who were hospitalized with severe COVID-19 to those with very mild bouts who recovered at home. It appears in regions with both high rates and low rates of COVID-19 infections. It attacks people who were battling other conditions before contracting COVID-19 and people who were completely healthy.

And it hits both the old and the young.“What’s new is this is affecting some people who are quite young who were very healthy and never had other illnesses.” — Nicholas Kenyon“We’ve seen this in patients across the gamut, and there does not appear to be any clear connections in the cause,” Kenyon said. €œWhat’s new is this is affecting some people who are quite young who were very healthy and never had other illnesses.”It is not uncommon, Kenyon said, for patients who were hospitalized for a long time — whatever the reason — to take months to get back to feeling normal. But even those COVID-19 patients are inconsistent.

Most recover on a steady, if sometimes slow, upward line, but some have symptoms that persist for months.“We have experience helping people who were hospitalized with other severe viral infections, but this disease is so new, there is still much to learn,” he said. €œWe don’t know why a few hospitalized patients continue to have symptoms and others don’t. We aren’t even exactly clear what all the symptoms are.”Common symptoms of long-haul COVID-19The list of symptoms is long, wide and inconsistent.

For some people, they are nothing like the original symptoms they had when they first were infected by COVID-19. The most common include:CoughingOngoing, sometimes debilitating, fatigueBody achesJoint painShortness of breathLoss of taste and smell — even if this did not occur during the height of their illnessDifficulty sleepingHeadachesBrain fogThat last one is among the most confounding. Patients report being unusually forgetful, confused or unable to concentrate even enough to watch TV.Many long-haul COVID-19 patients battle exhaustion and a range of other symptoms“That sort of brain fog can happen to people who were in an intensive care unit for a length of time, but it is relatively rare,” Kenyon said.

€œBut this is happening to all sorts of patients, including people who had mild cases and were not hospitalized.”Symptoms for long-haulers are not uniform. Some report severe chest pain along with more general body aches. Others have chills and sweats or gastrointestinal issues.

Some people have reported feeling better for days or even weeks then relapsing.For others, it’s a case of just not feeling like themselves.“There are patients who can go for a run and test completely normal,” Kenyon said. €œBut they still don’t feel right. They aren’t back to their old selves, but we can’t fully define what’s wrong.

Telling a patient who feels bad that they are fine and there is nothing we can identify is not a decent answer for them, or for us.”Trying to explain long-haul COVID-19The problem for patients and experts trying to help is the same one that physicians and infectious disease experts face with COVID-19 in general — it’s so new that science is only beginning to grasp it. And long-haulers have only recently gotten the attention of some experts who were first engaged with trying to slow the pandemic or care for dangerously ill patients.The vast majority of long-haulers test negative for COVID-19 and there is no specific test to give them for lasting symptoms of the coronavirus, said Nam Tran, an associate clinical professor of pathology and laboratory medicine and senior director of clinical pathology in charge of COVID-19 testing at UC Davis Health.“There are patients who can go for a run and test completely normal. But they still don’t feel right … Telling a patient who feels bad that they are fine and there is nothing we can identify is not a decent answer for them, or for us.”— Nicholas Kenyon“Unfortunately, we don’t know enough about the virus to test for its lingering effects,” Tran said.

€œThere are questions about why their fatigue goes on and on, and science just hasn’t solved them yet. We’re all learning in real time.”The most common theories about long-term COVID-19 patients include the hypotheses that the virus remains in their bodies in some small form, or that their immune systems continue to overreact even though the infection has passed.“The idea that the virus is somehow persisting has been discussed,” Kenyon said. €œThis doesn’t mean the virus is growing or that we can test for it, but this might mean their bodies are reacting to it or it’s still triggering ongoing inflammation.”Some infectious disease experts, including Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, have speculated that long-term COVID-19 might be a form of what is called chronic fatigue syndrome, or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Unfortunately for long-haulers, ME/CFS is not well understood, either.What is being done to help COVID-19 long-haulers?. As with many other COVID-19 issues, it’s hard just knowing how long some of the symptoms might last when the disease was identified barely 10 months ago. Learning how to treat these patients also requires time.“First, we have to discover what we can about the disease and how to treat it,” Kenyon said.

€œThat takes time and experience. Then we all have to share the information with other physicians and the public. We don’t have that system of sharing in place yet for long-haulers.”Early in the pandemic, pulmonary care chiefs around the U.S.

Gathered virtually on Sunday evenings to talk about caring for patients and to share information to help each other progress. Kenyon said he’d like to see something like that resume to discuss caring for long-term COVID-19 patients.“It may not seem to be as much of an emergency as in the first days of the pandemic, but this is just as important,” he said. €œBecause of the pandemic, we don’t have some of our usual routes of communication, like in-person meetings and conferences.”Also, because the disease is so new, much of the information about long-haul COVID-19 cases and care is anecdotal.

That is changing, however, and UC Davis Health is working to bring its expertise together to help patients.“These people need our help,” Kenyon said. €œWe don’t want anyone to have to go step-by-step through each symptom or to go through a list of referrals to find out what’s happening to them. We are uniquely set up to care for these patients, and we will.”.

How much baclofen

Shutterstock The how much baclofen U.S. Department of Health and Human Services State Opioid Response (SOR) recently awarded the state of how much baclofen Ohio $96.2 million.The program provides community support, psychosocial services, and access to lifesaving, evidence-based medication to treat opioid-use disorders. The state will use the funding to continue and expand its current programs.“While our country works to combat the COVID-19 pandemic, we cannot lose sight of the opioid epidemic that continues to also take the lives of too many in our state,” U.S. Rep.

Tim Ryan (D-OH), said. €œFor those who struggle with substance use disorders and mental illness, COVID-19 has worsened existing conditions and created new struggles across our state and nation. For us to fight back, we need sufficient resources to address the root causes of the opioid epidemic. I’m proud to have used my position on the House Appropriations Committee to ensure Northeast Ohio – and so many other communities across Ohio – get the funding we need.

This sizable grant is a big step towards ensuring communities like ours will not only be able to help those who are suffering but for us to put an end to this tragic opioid epidemic once and for all.”This is the first round of SOR funding..

Shutterstock The U.S buy generic baclofen. Department of Health and Human Services State Opioid Response (SOR) recently awarded the state of Ohio $96.2 million.The program provides community support, psychosocial services, and access to lifesaving, evidence-based medication to treat buy generic baclofen opioid-use disorders. The state will use the funding to continue and expand its current programs.“While our country works to combat the COVID-19 pandemic, we cannot lose sight of the opioid epidemic that continues to also take the lives of too many in our state,” U.S. Rep. Tim Ryan (D-OH), said.

€œFor those who struggle with substance use disorders and mental illness, COVID-19 has worsened existing conditions and created new struggles across our state and nation. For us to fight back, we need sufficient resources to address the root causes of the opioid epidemic. I’m proud to have used my position on the House Appropriations Committee to ensure Northeast Ohio – and so many other communities across Ohio – get the funding we need. This sizable grant is a big step towards ensuring communities like ours will not only be able to help those who are suffering but for us to put an end to this tragic opioid epidemic once and for all.”This is the first round of SOR funding..

Oral baclofen

Under the Paperwork Reduction Act of oral baclofen 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the burden estimate or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden. Comments on the collection(s) of information must be received by the OMB desk officer by November 23, 2020.

Written comments and recommendations for the proposed oral baclofen information collection should be sent within 30 days of publication of this notice to www.reginfo.gov/​public/​do/​PRAMain. Find this particular information collection by selecting “Currently under 30-day Review—Open for Public Comments” or by using the search function. To obtain copies of a supporting statement and any related forms for the proposed collection(s) summarized in this notice, you may make your request using one of following.

1. Access CMS' website address at https://www.cms.gov/​Regulations-and-Guidance/​Legislation/​PaperworkReductionActof1995/​PRA-Listing.html. 2.

Call the Reports Clearance Office at (410) 786-1326. Start Further Info William Parham at (410) 786-4669. End Further Info End Preamble Start Supplemental Information Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C.

3501-3520), federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. The term “collection of information” is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party.

Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires federal agencies to publish a 30-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice that summarizes the following proposed collection(s) of information for public comment.

1. Type of Information Collection Request. Revision of a currently approved collection without change.

Title of Information Collection. Hospice Quality Reporting Program. Use.

The Hospice Item Set (HIS) is a standardized, patient-level data collection tool developed specifically for use by hospices. It is currently used for the collection of quality measure data pertaining to the Hospice Quality Reporting Program (HQRP). Since April 1, 2017, hospices have been using the HIS V2.00.0 which specifies the collection of data items that support eight National Quality Forum (NQF) endorsed Quality Measures (QMs) and an additional measure pair for hospice.

All Medicare-certified hospice providers are required to submit HIS admission and discharge records to CMS for each patient admission and discharge. The HIS contains data elements that are used by the CMS to calculate these measures and also allows CMS to collect quality data from hospices in compliance with Section 3004 of the Affordable Care Act. The information collection request was revised to remove Section O of the HIS discharge assessment now that we proposed to replace it with the claims-based Hospice Visits in the Last Days of Life quality measure.

Form Number. CMS-10390 (OMB control number. 0938-1153).

State, Local, or Tribal Governments, Private Sector (not-for-profit institutions). Individuals or households. Number of Respondents.

Total Annual Hours. 636,312. (For policy questions regarding this collection contact Cindy Massuda at (410) 786-0652.) Start Signature Dated.

October 20, 2020. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs.

End Signature End Supplemental Information [FR Doc. 2020-23541 Filed 10-22-20. 8:45 am]BILLING CODE 4120-01-PStart Preamble Health Resources and Services Administration (HRSA), Department of Health and Human Services.

Notice. In compliance with the requirement for opportunity for public comment on proposed data collection projects of the Paperwork Reduction Act of 1995, HRSA announces plans to submit an Information Collection Request (ICR), described below, to the Office of Management and Budget (OMB). Prior to submitting the ICR to OMB, HRSA seeks comments from the public regarding the burden estimate, below, or any other aspect of the ICR.

Comments on this ICR should be received no later than December 15, 2020. Submit your comments to paperwork@hrsa.gov or mail the HRSA Information Collection Clearance Officer, Room 14N136B, 5600 Fishers Lane, Rockville, MD 20857. Start Further Info To request more information on the proposed project or to obtain a copy of the data collection plans and draft instruments, email paperwork@hrsa.gov or call Lisa Wright-Solomon, the HRSA Information Collection Clearance Officer at (301) 443-1984.

End Further Info End Preamble Start Supplemental Information When submitting comments or requesting information, please include the Start Printed Page 65834information request collection title for reference. Information Collection Request Title. Survey of Eligible Users of the National Practitioner Data Bank, OMB No.

0915-0366—Reinstatement With Change. Abstract. HRSA plans to survey the users National Practitioner Data Bank (NPDB).

The purpose of this survey is to assess the overall satisfaction of the eligible users of the NPDB. This survey will evaluate the effectiveness of the NPDB as a flagging system, source of information, and its use in decision making. Furthermore, this survey will collect information from organizations and individuals who query the NPDB to understand and improve their user experience.

This survey is a reinstatement of the 2012 NPDB survey with some changes. Need and Proposed Use of the Information. The survey will collect information regarding the participants' experiences of querying and reporting to the NPDB, perceptions of health care practitioners with reports, impact of NPDB reports on organizations' decision-making, and satisfaction with various NPDB products and services.

The survey will also be administered to health care practitioners that use the self-query service provided by the NPDB. The self-queriers will be asked about their experiences of querying, the impact of having reports in the NPDB on their careers and health care organizations' perceptions, and their satisfaction with various NPDB products and services. Understanding self-queriers' satisfaction and their use of the information is an important component of the survey.

Proposed changes to this ICR include the following. 1. In the proposed entity survey, there are 37 modules and 258 questions.

From the previous 2012 survey, there are 15 deleted questions and 13 new questions in addition to proposed changes to 12 survey questions. 2. In the proposed self-query survey, there are 22 modules and 88 questions.

From the previous 2012 survey, there are 5 deleted questions and 5 new questions in addition to proposed changes to two survey questions. Likely Respondents. Eligible users of the NPDB will be asked to complete a web-based survey.

Data gathered from the survey will be compared with previous survey results. This survey will provide HRSA with the information necessary for research purposes and for improving the usability and effectiveness of the NPDB. Burden Statement.

Burden in this context means the time expended by persons to generate, maintain, retain, disclose or provide the information requested. This includes the time needed to review instructions, to develop, acquire, install and utilize technology and systems for the purpose of collecting, validating and verifying information, processing and maintaining information, and disclosing and providing information, to train personnel and to be able to respond to a collection of information, to search data sources, to complete and review the collection of information, and to transmit or otherwise disclose the information.

Access CMS' buy generic baclofen website address https://www.voiture-et-handicap.fr/buy-baclofen-usa/ at https://www.cms.gov/​Regulations-and-Guidance/​Legislation/​PaperworkReductionActof1995/​PRA-Listing.html. 2. Call the Reports Clearance Office at (410) 786-1326. Start Further Info William Parham at (410) buy generic baclofen 786-4669.

End Further Info End Preamble Start Supplemental Information Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. The term “collection of information” is defined buy generic baclofen in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party.

Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires federal agencies to publish a 30-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting buy generic baclofen the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice that summarizes the following proposed collection(s) of information for public comment. 1.

Type of Information Collection buy generic baclofen Request. Revision of a currently approved collection without change. Title of Information Collection. Hospice Quality buy generic baclofen Reporting Program.

Use. The Hospice Item Set (HIS) is a standardized, patient-level data collection tool developed specifically for use by hospices. It is currently used for the buy generic baclofen collection of quality measure data pertaining to the Hospice Quality Reporting Program (HQRP). Since April 1, 2017, hospices have been using the HIS V2.00.0 which specifies the collection of data items that support eight National Quality Forum (NQF) endorsed Quality Measures (QMs) and an additional measure pair for hospice.

All Medicare-certified hospice providers are required to submit HIS admission and discharge records to CMS for each patient admission and discharge. The HIS contains data elements that are used by the CMS to calculate these measures and also allows CMS to collect quality data from hospices in compliance with buy generic baclofen Section 3004 of the Affordable Care Act. The information collection request was revised to remove Section O of the HIS discharge assessment now that we proposed to replace it with the claims-based Hospice Visits in the Last Days of Life quality measure. Form Number.

CMS-10390 (OMB buy generic baclofen control number. 0938-1153). Frequency. On Occasion buy generic baclofen.

Affected Public. State, Local, or Tribal Governments, Private Sector (not-for-profit institutions). Individuals or households buy generic baclofen. Number of Respondents.

4,688. Total Annual buy generic baclofen Responses. 1,328,417. Total Annual Hours.

636,312. (For policy questions regarding this collection contact Cindy Massuda at (410) 786-0652.) Start Signature Dated. October 20, 2020. William N.

Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. End Signature End Supplemental Information [FR Doc. 2020-23541 Filed 10-22-20. 8:45 am]BILLING baclofen and magnesium CODE 4120-01-PStart Preamble Health Resources and Services Administration (HRSA), Department of Health and Human Services.

Notice. In compliance with the requirement for opportunity for public comment on proposed data collection projects of the Paperwork Reduction Act of 1995, HRSA announces plans to submit an Information Collection Request (ICR), described below, to the Office of Management and Budget (OMB). Prior to submitting the ICR to OMB, HRSA seeks comments from the public regarding the burden estimate, below, or any other aspect of the ICR. Comments on this ICR should be received no later than December 15, 2020.

Submit your comments to paperwork@hrsa.gov or mail the HRSA Information Collection Clearance Officer, Room 14N136B, 5600 Fishers Lane, Rockville, MD 20857. Start Further Info To request more information on the proposed project or to obtain a copy of the data collection plans and draft instruments, email paperwork@hrsa.gov or call Lisa Wright-Solomon, the HRSA Information Collection Clearance Officer at (301) 443-1984. End Further Info End Preamble Start Supplemental Information When submitting comments or requesting information, please include the Start Printed Page 65834information request collection title for reference. Information Collection Request Title.

Survey of Eligible Users of the National Practitioner Data Bank, OMB No. 0915-0366—Reinstatement With Change. Abstract. HRSA plans to survey the users National Practitioner Data Bank (NPDB).

The purpose of this survey is to assess the overall satisfaction of the eligible users of the NPDB. This survey will evaluate the effectiveness of the NPDB as a flagging system, source of information, and its use in decision making. Furthermore, this survey will collect information from organizations and individuals who query the NPDB to understand and improve their user experience. This survey is a reinstatement of the 2012 NPDB survey with some changes.

Need and Proposed Use of the Information. The survey will collect information regarding the participants' experiences of querying and reporting to the NPDB, perceptions of health care practitioners with reports, impact of NPDB reports on organizations' decision-making, and satisfaction with various NPDB products and services. The survey will also be administered to health care practitioners that use the self-query service provided by the NPDB. The self-queriers will be asked about their experiences of querying, the impact of having reports in the NPDB on their careers and health care organizations' perceptions, and their satisfaction with various NPDB products and services.

Understanding self-queriers' satisfaction and their use of the information is an important component of the survey. Proposed changes to this ICR include the following. 1. In the proposed entity survey, there are 37 modules and 258 questions.

From the previous 2012 survey, there are 15 deleted questions and 13 new questions in addition to proposed changes to 12 survey questions. 2. In the proposed self-query survey, there are 22 modules and 88 questions. From the previous 2012 survey, there are 5 deleted questions and 5 new questions in addition to proposed changes to two survey questions.

Likely Respondents. Eligible users of the NPDB will be asked to complete a web-based survey. Data gathered from the survey will be compared with previous survey results. This survey will provide HRSA with the information necessary for research purposes and for improving the usability and effectiveness of the NPDB.

Burden Statement. Burden in this context means the time expended by persons to generate, maintain, retain, disclose or provide the information requested. This includes the time needed to review instructions, to develop, acquire, install and utilize technology and systems for the purpose of collecting, validating and verifying information, processing and maintaining information, and disclosing and providing information, to train personnel and to be able to respond to a collection of information, to search data sources, to complete and review the collection of information, and to transmit or otherwise disclose the information. The total annual burden hours estimated for this Information Collection Request are summarized in the table below.

Total Estimated Annualized Burden HoursForm nameNumber of respondentsNumber of responses per respondentTotal responsesAverage burden per response (in hours)Total burden hoursNPDB Users Entities Respondents15,000115,0000.253,750NPDB Self-Query Respondents2,00012,0000.10200Total17,00017,0003,950 HRSA specifically requests comments on (1) the necessity and utility of the proposed information collection for the proper performance of the agency's functions, (2) the accuracy of the estimated burden, (3) ways to enhance the quality, utility, and clarity of the information to be collected, and (4) the use of automated collection techniques or other forms of information technology to minimize the information collection burden. Start Signature Maria G. Button, Director, Executive Secretariat. End Signature End Supplemental Information [FR Doc.

2020-22964 Filed 10-15-20. 8:45 am]BILLING CODE 4165-15-P.

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€œThe support provided by these counsellors will complement the peer work and drought support provided by our Farm Gate Counsellors and Drought Counsellors.”Rural counsellor Samara Byrne said she wants young people to know there are people you can turn to when feeling overwhelmed with life or feeling like a burden on others. €œWe are here for you and here to listen if you are feeling distressed, buy generic baclofen anxious or a burden to loved ones. The service https://www.voiture-et-handicap.fr/buy-baclofen-usa/ is easily accessible through the Mental Health Line.

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A NSW Premier’s Priority, this is a whole-of-government commitment to transforming the way we identify and support anyone impacted by suicide.If you, or someone you know, is thinking about suicide or experiencing a personal crisis or distress, please seek help immediately in a life-threatening situation by calling 000 or seek support though one of these services:Lifeline 13 11 14Suicide Call Back Service 1300 659 467NSW Mental Health Line 1800 011 511.

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