Category Archives: Genetic Medicine

Covid-19 is having a disastrous effect on the South African economy that had already entered into recession, the Reserve Bank expects GDP to shrink by 6% adding pressure to the already high 2019 unemployment rate of 29.1% with an estimated loss of an additional one million jobs, taking the country to 7.7 million unemployed.

The lockdown will lead to a significant reduction in tax revenue at a time government has had to prioritise unplanned spending towards healthcare and economic support measures for disaster relief efforts, pushing the already high debt to GDP ratio of 62% to unsustainable levels.

SAs growth prospects are grim with the country facing a very real human catastrophe. Governments short-term policies are all focused on Covid-19 mitigation and disaster relief within the very limited means of state finances.

What will urgently be required post-Covid-19 is a clear and coherent economic policy where government can, through targeted interventions, achieve rapid socioeconomic development that has been elusive to date. Its clear that new regenerative thinking is required that seeks to provide long-term sustainability, is resistant to external shocks such as global economic markets and climate change and is based on maximising our abundant human and natural resources.

SA will need policy along the lines of Roosevelts New Deal that helped lift the US out of the Great Depression by putting people to work building social infrastructure and the Marshall Plan designed to rebuild Europe after World War II. What would this sort of policy look like for SA? Would it be an extension of business as usual? Or is it an opportunity to innovate out of the ashes of the old and chart a course for the much-vaunted African Renaissance?

In his acceptance speech to the African Union in Feb 2020, President Cyril Ramaphosa said we have trained our sights on supporting green growth on the continent, and on ensuring that the continent takes advantage of the opportunities presented by the green transition. This includes new industries in energy, materials engineering, the circular economy, sustainable agriculture and clean production.

The time to implement this vision of advancing inclusive green economic growth and sustainable development has come. We boldly need to step into this green future and design systems that allow us to live within our economic and ecological limits. We can achieve this by setting our sights on genuinely transformative economic growth and the potential of a plant that has been naturalised and traded in Africa for a thousand years.

President Ramaphosa talked about this in his 2020 State of the Nation Address, acknowledging that cannabis farming happens throughout the country, pledging to open up and regulate the commercial use of hemp products, providing opportunities for small-scale farmers. Cannabis offers an opportunity unprecedented in South Africas history since the discovery of gold on the Witwatersrand in 1886 as South Africas much-maligned and excluded green gold, with massive potential to birth a new sunrise industry to lift us out of economic recession, poverty and unemployment.

Globally, cannabis has a long history as one of the mainstays and drivers of early industrialisation, providing fibre for ropes and canvas for sails that powered maritime trade to help build the global market that exists today, as well as textiles for clothing and an important role in medicinal apothecaries.

It was South Africas colonial government that nominated Indian hemp to be listed as a dangerous drug by the League of Nations in the mid 1920s followed by the banning of industrial hemp as the result of a corporate agenda of nefarious interests in the US in the mid 1930s. It has been illegal for the past 80 years in most parts of the world for its narcotic properties while the industrial capacity continued to contribute to the economies of China, India and parts of Europe.

Currently, more than 30 countries have legal cannabis for medical use and a growing number of states in the US and other countries are legalising or tolerating cannabis for recreational use, including South Africa where the Constitutional Court ruled in September 2018 that it was legal to cultivate and use cannabis in the privacy of your own home and gave Parliament two years to amend legislation.

Today, the global medical and recreational cannabis market is growing from an estimated $9.6-billion in 2017 to a projected market value of $57-billion-plus by 2027. These estimates exclude existing and potential new markets for industrial cannabis for which little information is available.

The potential for cannabis in South Africa is enormous. The country has drought-resistant acclimatised genetic strains that have naturalised over hundreds of years, combined with tens of thousands of existing farmers who are familiar with the crop and how to grow it. The potential value chain is being explored by the Department of Trade and Industry and the Department of Agriculture, which have been tasked with finalising an agro-processing masterplan by the end of June.

What is not clear is whether SA will base its future cannabis industry regulations on the existing resource base and farmers or follow the western model of narcotic levels in the plant for which our country would have to import genetics, and is considerably behind the curve by global standards.

The cannabis value chain is based on the components of the plant that have economic potential: the seed offers food and oil that is high in essential fatty acids that will noticeably improve the diet of SAs poor, resulting in improved cognitive performance and boosted immune systems. In addition, the plant can be used to produce both ethanol and biofuel that could potentially feed directly into the energy and plastic sectors. The stalk offers two main agro-processing streams, the outer layer that can be stripped providing one of the longest fibres known to humanity to be used for an extensive range of consumer and industrial textiles. The inner part of the stalk is known as hurd and is used in the paper, automotive and building industries. The flower and most controversial part of the plant is where the medicinal and recreational benefits lie.

There is very little economic data available for an integrated cannabis model as the plant and its benefits have been suppressed for such a long time. Early estimates for a co-operative farming and agro-processing model based on empowering small farmers as a strategy to regenerate rural economies indicate considerable economic potential.

An agricultural co-operative hub model of 20,000 hectares supported by an estimated 10,000 small farmers, each farming two hectares and employing an additional agricultural labourer per hectare would create 30,000 jobs. The processing hub would house a series of decortication technologies required to process up to 50,000 tons of fibre and 120,000 tons of hurd employing 150 plant and support workers.

The potential income per farmer per hectare is dependent on bio-region, climatic conditions and seed strains. Conservative estimates indicate that per hectare, stalk biomass is worth R50,000, fibre R18,000, seed R155,000 and cannabinoids R100,000. Average income per hectare is about R175,000, generating revenue of R350,000 for a small farmer on two hectares and revenue of R3.5-billion per co-operative hub farming 20,000 hectares. Ten hubs farming 200,000 hectares could potentially generate R35-billion in revenue. Additional added value from developing finished products still needs to be determined.

There are also noteworthy climate crisis mitigation benefits to cannabis farming and the possibility to access climate funding to roll out an industrial cannabis strategy. Cannabis sequesters up to 10,000 tons of carbon per hectare, where one co-operative hub could sequester up to 200 million tons of carbon.

The objective is to develop a multi-billion-rand industrialised cannabis value chain that enables the empowerment of small-scale farmers and the development of agro-processing co-operative hubs that focus on developing the following value chains:

Seed

The seed can be processed into food with a focus on preventative healthcare to boost the diet of the poor in the form of hemp hearts, the inside of the seed, or protein powder made from crushing the seed shell. Both are extremely high in proteins and omega essential fatty acids. The seed can also be cold pressed into an oil for human consumption.

Bio-fuel and plastic

The seed can be cold pressed into oil, the whole plant can be processed for fuel through a pyrolysis process or converted into ethanol by a fermentation process. There is also huge potential for an eco-friendly bio-plastics industry that will start to reverse land and sea plastic pollution.

Building

The inner part of the stalk, the hurd, can be processed into hempcrete for building houses that are stronger, fire- and moisture-proof and more durable. Communities can grow and build their own homes transforming the governments housing programme from handouts to skills development and empowerment. The hurd can also be processed into eco-friendly insulation and pressed fibre-board similar to existing wood-based options.

Textiles

The outer part of the stalk, the bast fibres, can be used to make textiles that are extremely versatile and used for a wide variety of applications from accessories, shoes and furniture, to home furnishings.

Paper

Paper is made from either the hurd or bast fibre. Industrial cannabis/hemp paper is a valuable alternative to conventional paper made from trees, and could provide a more renewable source for much of the worlds paper needs one acre of hemp can produce as much paper as four to 10 acres of trees over a 20-year cycle. Hemp stalks grow in four months, whereas trees take at least 20 years.

Medicine

Cannabis medicines were once the most commonly used medicines in the world until the 1920s and were listed in the US Pharmacopoeia until the mid-1930s. Today medical cannabis is playing an increasingly significant role and offers potentially cheap healthcare solutions for a variety of ailments that can directly contribute to primary and preventative health care on a community level and pharmaceutical medicines for specific conditions.

There are also substantial opportunities to develop new technologies for modern processing and to adapt or use existing technologies lying dormant in the country such as the R100-million DTI-funded fibre processing plant near Winterton.

In order to rapidly develop the economic potential of cannabis in SA, innovative world-leading legislative changes will be required to create the enabling conditions to rapidly unlock cannabis markets where:

The existing Constitutional Court ruling for Responsible Adult Use needs to be expanded as it excludes all people without access to private land from cultivating cannabis and therefore access to cannabis so as to include the ability to cultivate, extract, process, manufacture and sell cannabis-based products for recreational use, along the same lines that alcohol and tobacco are currently regulated so as to be inclusive.

Covid-19 provides South Africa with the economic and social necessity to draw on all its available resources to ensure a resilient recovery and to make policy decisions that work towards rapidly regenerating our society and economy. The countrys long history of illicit cannabis production and export puts us in a strong position to develop a local cannabis market that unlocks the entire value chain, stimulates economic growth and generates substantial tax revenue for the fiscus.

The rapid introduction of far-reaching, proactive and empowering legislation is required to create the conditions to allow cannabis the possibility to restore the dignity of ordinary people, creating jobs for meaningful work, to grow and manufacture their own food, fuel, fibre, shelter and medicine in a green sustainable way. DM

Nicholas Heinamann is an African cannabis activist, policy strategist, and consultant. He is the co-ordinator of the SA Cannabis Lobby group, a partnership of the Cannabis Industry Development Council, WC, and Afristar Foundation. Afristar is a South African PBO that develops projects and strategies promoting Regenerative Futures focused on a nature-based economy. He has been lobbying cannabis as the Peoples Plant since 1996 and the role it can play to alleviate poverty and deal with the environmental, energy, food, water and climate crisis the world is facing.

Please note you must be a Maverick Insider to comment. Sign up here or if you are already an Insider.

Continue reading here:
Cannabis cultivation could be a key economic driver for reconstruction after Covid-19 - Daily Maverick

Prevention and management of postoperative recurrence (POR) is a controversial field in Crohns disease. The aim of this survey was to report common practice in real-life settings.An 11-question survey was distributed among gastroenterologists attending the 14th European Crohns and Colitis Organisation (ECCO) congress.Postoperative endoscopy to assess recurrence was routinely performed within 12months by 87% of respondents. Forty-six percent of clinicians reported to maintain endoscopic assessment in routine follow-up even after first negative colonoscopy. Most respondents (60%) considered starting postoperative immunoprophylaxis in nave patients if one or more known risk factors were present. The number of risk factors was an important driver for prescribing biologics over immunosuppressants for 60% of respondents.In case of fistulizing phenotype, perianal disease, or concomitant colonic involvement, the majority of physicians reported to start an immediate prophylaxis in 85, 98 and 88% of patients, respectively. A significant percentage of clinicians were more prone to an endoscopy-driven treatment in long-standing disease after failure of thiopurines (51%) and elderly (43%).Endoscopy within the first year after surgery to assess POR has become routine in most centres. The high rate of early prophylaxis with expensive biologics despite missing solid evidence highlights the need for more randomized trials.

PubMed

Read the original here:
The prevention and management of Crohns disease postoperative recurrence: results from the Y-ECCO/ClinCom 2019 Survey. - Physician's Weekly

Doctors talk about what they would have liked to know about the progression of the illness a month ago when they started treating severe cases. In other news: rationing care, viral loads and the life span of the virus.

The New York Times:What Doctors On The Front Lines Wish Theyd Known A Month AgoJust about a month ago, people stricken with the new coronavirus started to arrive in unending ranks at hospitals in the New York metropolitan area, forming the white-hot center of the pandemic in the United States. Now, doctors in the region have started sharing on medical grapevines what it has been like to re-engineer, on the fly, their health care systems, their practice of medicine, their personal lives. Doctors, if you could go back in time, what would you tell yourselves in early March? (Dwyer, 4/14)

The New York Times:What Disease Are We Treating?: Why Coronavirus Is Stumping Many DoctorsDoctors say the coronavirus is challenging core tenets of medicine, leading some to abandon long-established ventilator protocols for certain patients. But other doctors warn this could be dangerous. (Stein and Tiefenthaler, 4/14)

Stat:Who Gets The Last Ventilator? Pondering The Unthinkable Amid Covid-19The patient was around 80, an immigrant from the Dominican Republic, his medical record filled with the accumulations and erosions of old age. His blood pressure was high, his spinal cord narrowing to a pinch. He had a history of alcohol addiction, but was no longer drinking. A prostate cancer had been burned out with radiation, and he had yearly appointments to make sure it wasnt coming back. He had type 2 diabetes. (Boodman, 4/14)

Stat:How Much Of The Coronavirus Does It Take To Make You Sick?Infectious respiratory diseases spread when a healthy person comes in contact with virus particles expelled by someone who is sick usually through a cough or sneeze. The amount of particles a person is exposed to can affect how likely they are to become infected and, once infected, how severe the symptoms become. The amount of virus necessary to make a person sick is called the infectious dose. Viruses with low infectious doses are especially contagious in populations without significant immunity. (Hogan, 4/14)

CIDRAP:Study Finds Evidence Of COVID-19 In Air, On Hospital SurfacesA study published late last week in Emerging Infectious Diseases found a wide distribution of COVID-19 virus genetic material on surfaces and in the air about 4 meters (13 feet) from patients in two hospital wards in Wuhan, China, posing a risk to healthcare workers. While the findings of the environmental sampling study do not indicate the amount of live virus, if any, or precisely determine the distance of aerosol transmission, the authors say that they confirm that the virus spreads in aerosols in addition to large respiratory droplets. (Soucheray, 13)

Go here to read the rest:
Some Ironclad Best Medical Practices Tossed Out The Window In Face Of COVID-19's Chaotic Destruction - Kaiser Health News

Courtesy of UC Davis Health

UC Davis scientists Marcelo Prado and Katie Zegarski load samples onto trays that will then be placed into a machine to test for coronavirus. It's one example of the vast research ongoing across the UC system to study the coronavirus.

UC Davis scientists Marcelo Prado and Katie Zegarski load samples onto trays that will then be placed into a machine to test for coronavirus. It's one example of the vast research ongoing across the UC system to study the coronavirus.

Researchers at universities across California are playing a major role in the global effort to find a cure and slow down the spread of the novel coronavirus.

The University of California, with five medical centers and major research capacity on its 10 campuses, is well-positioned to contribute to that effort, while private universities like Stanford University, with its ownresearch departments and medical school, are also working to understand and treat the disease.

With non-essential research suspended, many scientists are focused almost exclusively on fighting the virus and are doing so in a variety of ways. Doctors are working to increase the capacity to test individuals for coronavirus while also evaluating drugs to determine if they can be used as effective treatments. Virologists are studying the genetics of the virus to learn more about how it spreads and attacks human cells. There are also more niche efforts, such as a project at UC Berkeley that intends to use artificial intelligence to combat the virus.

There is an urgent need for scientists to learn as much as possible about the virus and slow its spread. Globally, the toll from the coronavirus has surpassed 116,000 deaths, according to a Johns Hopkins University tracker. That includes more than 300 deaths in California.

One of the leading sites for coronavirus research in California is at UC Davis, wheremany researchers have been studying the virus nonstop since February. Thats when the universitys medical center treated the patient who had the first diagnosed case of community spread coronavirus in the United States, meaning the patient, who had not traveled to countries where the virus was common at that time, had been infected from someone in the community.

Researchers took samples from that patient and used them to investigate the virus and begin developing their own in-house test.

The university was equipped to study the virus because of its range of research and medical centers, said Angela Haczku, who, as the associate dean for translational research at UC Daviss School of Medicine, oversees the universitys coronavirus research. The School of Medicine collaborated with the universitys Center for Immunology and Infectious Diseases and the universitys primate research center to create their own tests. The universitys primate center, where experiments are conducted using non-human primates, could also eventually be used to test and develop potential vaccines, officials said.

UC Davis began in-house testing March 19 and is now using an automated testing system that has the potential to produce more than 1,000 tests daily, Haczku said. There is a shortage of coronavirus testing nationally, and experts say that expanding testing would make it easier to slow the spread of the virus since doctors would have a better idea of who is infected.

The automated testing at UC Davis is made possible through a robot called the Roche Diagnostics cobas 6800 System. The machine, which is the size of an SUV, is already producing 400 tests a day for patients at UC Davis Health and that number could increase to up to 1,400 tests daily.

Haczku said she has dedicated almost all of her time over the past month to coronavirus-related research focused on expanding testing and on clinical trials, which involve testing drugs on patients to learn if they can work as effective treatments. UC Davis is currently conducting clinical trials of two drugs: remdesivir, an antiviral drug that was previously tested on patients with Ebola, and sarilumab, which treats arthritis.

Haczkus days start with 7 a.m. meetings with other School of Medicine administrators and end around midnight after connecting with research collaborators in Asia.

Seeing what this virus does to people, there is a motivation to work fast, she said.

Courtesy of UC Davis Health

A scientist at UC Davis tests a patient sample for coronavirus.

The other four University of California medical centers at UCLA, UC San Diego, UCSF and UC Irvine are also either doing their own in-house testing of the coronavirus or plan to soon. The five medical centers hope to combine resources, such as patient databases, to develop better testing and clinical trial capabilities, but they first need to get approval from a UC Institutional Review Board, Haczku said. Institutional Review Boards are regulatory committees that oversee research involving humans to make sure the research is ethical.

Globally, more than 200 clinical trials of different drugs are underway. One of those trials involves all five of the UC campuses with medical centers. They are among dozens of universities conducting a trial of remdesivir, an antiviral drug that scientists believe has potential to be a treatment for the virus. Stanford University is also participating in that trial. In clinical trials, drugs are administered to patients who give consent to participate in the trial after learning about any potential risks.

Dr.Bruce Aylward of the World Health Organization in February called remdesivir the one drug right now that we think may have real efficacy. President Donald Trump has also touted remdesivir, saying in March that the drug seems to have a very good result having to do with this virus.

However, remdesivir is not yet an approved treatment of COVID-19, the disease the virus causes. The Food and Drug Administration has authorized its use in emergency situations for some coronavirus patients, including the first United States patient who was diagnosed with coronavirus and the UC Davis patient who was diagnosed with the first community-acquired case of the virus in the U.S. UC Davis doctors in February gave the drug to that patient, who recovered after receiving remdesivir and has since been discharged, though doctors have warned against drawing conclusions about the drug based on a single patients experience.

Doctors will get a better sense of whether the drug is effective through the clinical trials. Patients will be eligible to be enrolled in the clinical trial if they test positive for COVID-19 and if they are being treated at one of the testing sites, such as one of the UC medical centers or Stanford.

Patients will be randomly assigned to receive either remdesivir or a placebo. The National Institutes of Health, the federal agency that is sponsoring the trial, will analyze results from the different testing sites and determine whether the drug is effective, said Dr. Neera Ahuja, who along with Dr. Kari Nadeau is one of two Stanford doctors conducting the trial.

A major advantage of the study, Ahuja said, is that if remdesivir proves to be ineffective, doctors can continue with the same trial infrastructure and easily switch to testing another drug. Thats because the study has an adaptive trial design, which is meant to make a trial more efficient by allowing changes to the study while it is ongoing.

And so unlike some of the other industry-sponsored trials where its just one drug and thats all they have, we can phase from one to the next to the next until we hopefully find something effective and then be able to hopefully fast track it to FDA approval, Ahuja told EdSource.

Remdesivir is far from the only drug being studied to fight the coronavirus.

Researchers at UC San Franciscos Quantitative Sciences Bioinstitute are looking into dozens of other drugs that could attack the virus in a different way.

While drugs like remdesivir seek to destroy the viruss own proteins, researchers at the Quantitative Sciences Bioinstitute have identified drugs that could potentially treat the virus by blocking it from interacting with proteins in human cells that the virus relies on to survive.

Theres a lot of work ongoing where people are trying to target the viral proteins, which is great. Were taking a different track, Nevan Krogan, the director of the institute, said at a virtual town hall in March.

So far, they have identified 69 drugs that could target the human proteins, including 27 that are FDA-approved.

The reason scientists are studying so many different drugs is because the current coronavirus is new to scientists and there is still much they dont know about it.

Virologists like Mike Buchmeier at UC Irvines Center for Virus Research are attempting to address that dilemma by studying exactly how the virus is spreading.

Buchmeier, who specializes in researching coronaviruses, has been researching the virus since it was discovered in China in December. Officially called SARS-CoV-2, it is a new strain of coronavirus, which is part of a large family of viruses that commonly infect many animals, including cats, cattle and bats.

In rare cases, such as with the current virus, coronaviruses can spread from animals to humans and then spread to other people, according to the Centers for Disease Control and Prevention. Health experts believe the new strain of coronavirus likely originated in bats and first spread from animals to humans at a seafood and meat market in Wuhan, China, where the outbreak began.

Buchmeiers current research, he said in an interview, involves studying the viruss RNA, a single stranded genetic material. (Many viruses have RNA instead of the double stranded DNA genetic material.) Having that information helps Buchmeier and other scientists understand the virus because they can use the genetic material to trace the origins of the virus and how it has spread. The genetic material also allows Buchmeier to better understand how the virus causes damage in humans.

And then we can use that to think about what would be a suitable vaccine, Buchmeier said.

Elsewhere across universities in California, other efforts are underway in response to the virus. For example, UC Berkeley is one of the hosts of a new artificial intelligence research consortium that is seeking research proposals that offer ways to fight the coronavirus.

The consortium, called the C3.ai Digital Transformation Institute, was created by California-based artificial intelligence company C3.ai and will be managed and hosted by UC Berkeley and the University of Illinois at Urbana-Champaign. One of the institutes co-directors is Shankar Sastry, a professor of engineering and computer science at UC Berkeley.

Early results from the research wont be available until June, but the work of other artificial intelligence companies internationally may provide a glimpse into how the technology can be used to fight the virus.

For example, the United Kingdom-based artificial intelligence company Exscientia has a collection of thousands of drugs and is using its technology to try to determine which ones can potentially treat COVID-19. Exscientia plans to use its drug-screening technology to quickly mine through the drugs and identify molecules that may be effective in fighting the coronaviruss proteins and enzymes. The company then hopes to use that information to repurpose one of the existing drugs to treat coronavirus patients.

The Berkeley institute is calling for a wide range of proposals to combat the virus, such as using machine learning to design new drugs or incentivize behavior that mitigates the spread of the virus, like social distancing.

Given the urgency of the challenge, the institute accelerated its timeline by putting out the first call for research proposals in March and asked for the proposals to be submitted by May 1. Awards will be distributed by June, but researchers who submit their proposals by April 15 could be notified of awards earlier than that.

The institute also plans to use a peer-review process that is less rigorous than is customary so it can further expedite the project and share results with the public as soon as possible. The consortium plans to start disseminating results via public forums in June. What wed like to do here is to provide for a certain adventurousness. We wont be afraid to have even a substantial fraction of the research projects fail, he said.

Sastry added that he views the institute as something that could be an intermediary between the computer science world and the public health field.I feel theres a huge new subject of academic inquiry here. And so I think that to have an intermediary between information technologies and all these societal systems, I think thats the intellectual turf of this institute. Thats really a prime excitement to me, Sastry said.

Go here to see the original:
California university researchers join the global race to fight coronavirus - EdSource

TUESDAY, April 14, 2020 (HealthDay News) -- Teenagers who use marijuana to fall asleep may be setting themselves up for insomnia later in life, a new study suggests.

It is widely known that many people rely on marijuana as a sleep aid. In a 2018 survey of 1,000 marijuana users in Colorado, 74% reported that they use it to fall asleep.

Still, there is little evidence to suggest that marijuana use actually results in sleep improvements. "There's a lot of research on sleep and cannabis, but it's a little mixed," explained study co-author Evan Winiger, a graduate student in behavioral genetics, psychology and neuroscience at the University of Colorado, in Boulder.

In the study, Winiger and his colleagues analyzed the sleep habits and history of marijuana use among 1,882 teens from Colorado. To get at the potential genetic components of marijuana use and sleep disturbances, all of the participants were twins.

The results showed that roughly one-third of the participants who started using marijuana before age 18 had insomnia later in life. Only 20% of the other participants -- who either never became regular marijuana users or started their use at age 18 or older -- had insomnia in adulthood.

The teenage marijuana users were also more likely to experience a particularly detrimental type of sleep called "short sleep," or sleeping less than six hours per night. Short sleep is associated with various chronic health issues, including heart disease, asthma and arthritis, according to the U.S. Centers for Disease Control and Prevention.

Ten percent of those who regularly used marijuana in their teenage years said they were short sleepers in adulthood, compared to only 5% of those who never used, the findings showed.

There are a few theories as to why marijuana may affect sleep, but no absolute answers. The primary view, according to sleep experts, is that marijuana influences your circadian rhythm, the system that tells the body when to sleep and when to wake up.

Since the study participants were twins -- some identical and some fraternal -- the authors were able to tease out whether the associations between marijuana use and sleep problems were genetic.

The investigators identified that some of the same genes that influenced whether people started using marijuana early in their life also played a role in the likelihood of later sleep problems.

The study was the first to identify such a link, according to Winiger. "There's not a lot of research on the overlapping genetics between these domains," he said.

The findings were published recently in the journal Sleep.

The limitations of the study, some acknowledged by the authors and others not, include the fact that the results were based on self-reported information, which could be prone to bias and memory errors, according to Bhanuprakash Kolla, a psychiatrist and neurologist at the Mayo Clinic in Rochester, Minn.

In addition to the self-reporting bias, Kolla noted that "the authors did not account for the possible use of other substances, such as tobacco and alcohol, which can also influence sleep."

Winiger and his team did account for some possibly contradicting variables, such as prior diagnoses of depression or anxiety. They adjusted the results to control for those variables, as depression and anxiety disorders are known to have an effect on sleep.

Dr. Nathaniel Watson, a former president of the American Academy of Sleep Medicine and a professor of neurology at the University of Washington, thinks that the full story of marijuana and sleep has not yet been told.

Watson said that widespread legalization of marijuana will allow researchers to study it in more controlled environments, like a clinical trial. He thinks that future studies may show that marijuana does have some potential benefits for sleep, but there is not enough evidence to come to a conclusion either way.

"Nonetheless, this is an impressive study," Watson said. "It adds to our growing understanding of the relationship between cannabis and sleep."

More information

Head to the Sleep Foundation for tips on better sleep.

SOURCES: Evan Winiger, graduate student, behavioral genetics, psychology & neuroscience, University of Colorado, Boulder; Bhanuprakash Kolla, M.D., psychiatrist and neurologist, Mayo Clinic, Rochester, Minn.; Nathaniel Watson, M.D., former president, American Academy of Sleep Medicine, and professor of neurology, University of Washington, Seattle; Dec. 2, 2019, Sleep

Here is the original post:
Using Pot to Help You Sleep? It Could Backfire - HealthDay

As the world watches and wonders when coronavirus pandemic stay-at-home orders and social distancing measures might end, some hope antibody tests might help provide a solution.

Antibody tests also known as serology tests arent meant to diagnose active coronavirus infections. Rather, they check for proteins in the immune system, known as antibodies, through a blood sample. Their presence means a person was exposed to the virus and developed antibodies against it, which may mean that person has at least some immunity although experts are not sure how strong the immunity may be or even how long it will last.

In contrast, diagnostic testing, so far, has mostly used a laboratory technique known as a polymerase chain reaction test or a PCR test. These tests can diagnose active infections through a sample usually from a nose swab that is then tested for viral genetic material.

Here are five questions and answers about Covid-19 and antibody testing.

Within a period of a week or so, were going to have a rather large number of [antibody] tests that are available, Dr. Anthony Fauci, the director of the National Institute of Allergy & Infectious Diseases, told CNN on Friday.

But that doesnt mean theyre ready now.

The US Food and Drug Administration has not approved any antibody tests for the coronavirus, but one test made by Cellex Inc. has been granted emergency use authorization. Other companies have also created their own versions under a new FDA policy implemented last month that makes it easier for companies to manufacture and distribute antibody tests.

However, the FDA tightened up the new policy and now says it will review data on lab tests that claim they can detect Covid-19 antibodies, according to Scott Becker, the CEO of the Association of Public Health Laboratories, who told CNN he was on a call with FDA officials Tuesday morning when the matter was discussed.

Since the FDA issued the policy, more than 90 developers have come forward with antibody tests, the agency said.

Under the new policy, tests can be used and distributed once the manufacturer has informed the FDA that the test has been validated, but the companies cannot make the claim that the agency has validated the tests.

The FDA has cautioned that these serology tests should not be used as the sole basis to diagnose or exclude [coronavirus] infection or to inform infection status and has asked manufacturers to report possible concerns over the test.

Without FDA approval, these tests dont undergo the rigorous process usually required to prove accuracy, and this has raised concerns.

Becker has called many of the tests crappy. His association represents 125 state, county and municipal public health labs in the United States. Those labs, along with private labs, would be responsible for running the tests.

But Becker initially said his labs wouldnt use the tests that are on the market because hes concerned about inaccurate results that might mean people mistakenly believe theyre immune to coronavirus and can return to work or stop social distancing.

It could be quite dangerous, Becker said.

Becker said he shared his concerns about the quality of antibody tests with the US Department of Health and Human Services Dr. Brett Giroir and FDA Commissioner Dr. Stephen Hahn.

Becker confirmed to CNN that Hahn told him and members of his association that the National Cancer Institute (NCI) would begin reviewing data from the tests that are on the market to see if they return correct results. B

Giroir said checking these tests for accuracy will be a priority, but acknowledged not all of the available tests will be of sound quality.

There is a very consolidated effort between the FDA, CDC, NIH to validate some of the [antibody] tests that are on the market right now And we have reason to believe that not all of them are going to perform well, he said at a White House press briefing last week. Were going to be very careful to make sure that when we tell you youre likely immune from the disease that test really said that.

Besides indicating some level of immunity, the presence of Covid-19 antibodies could help identify those who have been infected but never realized they had the disease. Early research shows a large number of people may have had mild symptoms or no symptoms at all and this group might be spreading the coronavirus more than previously thought.

There may be many people out there, and I suspect there are a fair amount, that have been infected, were asymptomatic and didnt know it, Fauci recently said on NBC News Today Show in response to why antibody tests are important.

The National Institutes of Health announced Friday it is recruiting up to 10,000 volunteers to take part in a study on how many Americans have been infected with Covid-19 and are not aware of it.

These crucial data will help us measure the impact of our public health efforts now and guide our COVID-19 response moving forward, Fauci said in a statement.

Knowing exactly who has antibodies can also help with Covid-19 treatment. Clinical trials using convalescent plasma a process that takes the antibodies from someone who has recovered from Covid-19 and injects them into a person who is sick are currently underway.

How can you possibly know who to get [antibodies] from if they havent been tested? If youre talking about trying to scale [convalescent plasma] up as a real therapy, youre going to have to do mass testing to figure out who might be a donor, Dr. Celine Gounder, a professor of medicine and infectious diseases at NYU School of Medicine, told CNN.

Those with Covid-19 antibodies might have immunity against the disease but its unclear how strong the immune response might be or for how long.

If we look at MERS coronavirus, we would see people who would have an antibody response for maybe 10 months, maybe a year, Dr. Maria van Kerkhove, the World Health Organization technical lead for the Covid-19 response, told CNN. Even there, we didnt know if that conferred protection. So for this particular virus [Covid-19], the answer is we dont know yet, but those studies are being done.

The immunity afforded by Covid-19 can be thought of as providing bridging protection until we have an effective vaccine available, said Dr. William Schaffner, an infectious disease specialist at Vanderbilt, in an email to CNN.

Even then, the vaccine may have to be given annually, Schaffner said, pointing out that without concrete data, its all just speculation.

The answer may also depend on the characteristics of the virus, which we still dont know, said Dr. Bala Hota, a professor of infectious diseases and the associate medical officer for Rush University Medical Center in Chicago.

Some of the factors are how much variation we can expect to see in the genetic profile of infecting strains of the novel coronavirus Since the virus is so new, we dont have the data yet, he said in an email to CNN.

Determining who has some level of immunity through antibody testing could help people feel safer about returning to work.

New York Gov. Andrew Cuomo, whose state has more reported coronavirus cases than any other, is looking to antibody tests for restarting life in a city that has been brought to a halt by the virus.

New York has developed its own antibody testing regimen approved by its department of health for use within the state and is working with the FDA to bring it to scale, he said last week on social media.

We cannot restart life as we knew it without testing, Cuomo tweeted.

Former FDA Commissioner Dr. Scott Gottlieb helped devise an action plan on how to reopen the country and antibody testing plays a crucial role.

The initiative suggests the tests will have important implications for peoples ability to return to work, especially in health care settings but it also points out the many unknowns about these tests, including some pretty big ones: What does a positive test actually mean in terms of someones protection level? And just how accurate are they?

As those issues are addressed and testing capacity expands, the performance of these tests improve making it easier for the federal and state governments to establish criteria for testing and to prioritize who gets them, according to the plan. Antibody testing could also provide important data for modeling and predicting future Covid-19 outcomes.

Fauci said at a briefing that antibody tests can reveal how widespread the coronavirus is in the US: And by the time we have to face whats going to happen with this going back to normality, we will have in place the capability of identifying, isolating, contact tracing so that it never gets out of hand.

Read more from the original source:
What are antibody tests and what do they mean for the coronavirus pandemic? - KRDO