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Could a supplement be as effective as exercise at protecting health? – Medical News Today

New research suggests that a common dietary supplement, glucosamine, may help reduce overall death risk to a similar degree as regular exercise.

Two researchers from West Virginia University (WVU), in Morgantown, recently found that individuals who took glucosamine/chondroitin one of the most common kinds of glucosamine supplements on a daily basis for at least 1 year saw a 39% reduction in mortality from all causes of death and a 65% reduction in the likelihood of death from cardiovascular disease.

The study appears in the Journal of the American Board of Family Medicine.

However, Dr. Dana King, the lead author of the study and chair of Family Medicine at WVU, does not advise people to replace exercise with the supplement.

Thats not what we suggest, King explains. Keep exercising. But the thought that taking a pill would also be beneficial is intriguing.

Glucosamine/chondroitin, a combination of two natural compounds found in cartilage, is widely used to help with osteoarthritis and joint pain. During 20202024, the global glucosamine market is expected to grow by $229.19 million, according to Technavio, a global technology research and advisory company.

While the supplement is popular, however, several clinical trials have failed to show that it provides a significant improvement in pain.

Still, the National Institutes of Health (NIH) report that oral glucosamine supplements are likely safe when taken correctly by adults.

In their study, Dr. King and Jun Xiang, a health data analyst at WVU, assessed data from 16,686 adults who had completed the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2010. All of the participants were at least 40 years old.

NHANES was designed to be an ongoing assessment of the health and nutrition status of people throughout the United States. Screeners interview participants at their homes, and later, NHANES staff members perform examinations in mobile centers to collect health and nutrition data.

The WVU study was particularly interested in participants who had taken glucosamine/chondroitin for at least 365 days before their interviews. Among the participants, 658, or nearly 4%, had taken glucosamine/chondroitin for a year or longer.

When Dr. King and Xiang merged the NHANES data with 2015 mortality figures, they found that there had been 3,366 deaths among the participants and that 674 deaths had resulted from cardiovascular disease, the leading cause of death in the U.S.

The authors caution that the 39% reduction in all-cause mortality and 65% reduction in death from cardiovascular disease that they observed among the participants who took glucosamine/chondroitin may have a simple explanation: People who use supplements may generally take more care with their health and be healthier overall.

However, the researchers stress that they did control for variables such as age, race, sex, education, and the frequency of exercise, making the simple explanation less likely.

Once we took everything into account, the impact was pretty significant.

Dr. Dana King

Dr. King became curious about glucosamine/chondroitin, which he takes, after learning that every member of his local cyclists club also took the supplement.

I thought, Well, I wonder if this is really helpful. Thats how I got curious about it, Dr. King says.

Previous studies, including one from 2019 and another from 2012, had likewise demonstrated an association between the intake of glucosamine supplements and a reduction in rates of cardiovascular mortality.

One group of researchers hypothesize that glucosamine/chondroitin may lower systemic inflammation in healthy individuals with overweight, which could account for the supplements effects on mortality rates.

The WVU team cautions that theirs was an epidemiological study, not a clinical trial confirming the link between longevity and glucosamine/chondroitin use requires further research. However, Dr. King considers the results so far encouraging.

In my view, King says, its important that people know about this, so they can discuss the findings with their doctor and make an informed choice.

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Could a supplement be as effective as exercise at protecting health? - Medical News Today

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How Scientists Are Identifying Ways to Prevent the Next Pandemic – The Wire Science

People wearing protective face masks walk in Bangkok, Thailand March 2, 2020. Photo: Reuters/Chalinee Thirasupa

New Delhi: How to prevent the next pandemic? As 2021 begins with COVID-19 continuing its global spread, scientists have spotlighted three approaches to at least reduce the risk of pandemic potential diseases screening animals, reducing land-use change and improving health infrastructure.

There can be no one answer to the question at the centre of an anxious debate across a world coping with COVID-19 and wondering what will happen if another one comes, but the global scientific community has been working on multiple tracks to ensure that humankind is better prepared.

Following several multidisciplinary studies in 2020, scientists now firmly believe a perfect storm for an outbreak with pandemic potential is created by the combined forces of land-use change, high population density and the presence of interfaces between wildlife and domestic animals.

We are only as strong as our weakest link given our globally connected society, Krutika Kuppalli, an expert in emerging infectious diseases affiliated with the Stanford University School of Medicine in the US, told PTI.

Manuel Ruiz, wildlife veterinarian at Montana State University in the US, added that one of the best ways to prevent the next pandemic is to sample animals across the world to characterise potential pathogens.

Instead of spending money to curb outbreaks once they occurred, we could invest in reforestation and in trying to change the way we interact with wildlife, and alter our level of land-use change, Ruiz said.

Early on in the present pandemic, it became clear that efforts applying scientific approaches to prevent the next big outbreak could cost countries way less than the expenditures they have meted out to control Covid-19.

A study published in July in the journal Science estimated that COVID-19 may likely cost the global economy between $8.1 and 15.8 trillion. It added that preventing major outbreaks could be 500 times cheaper than the expenditures meted out to curb the ongoing pandemic

According to Ruiz, detecting or classifying every single pathogen in the worlds wildlife would be close to impossible, but new methods using machine learning algorithms can be used to generate a catalogue of pathogens from which the animal host and place where the next outbreak may happen could be predicted.

One such international collaborative project that came into the spotlight in 2020 was USAIDs PREDICT, which aimed to strengthen global capacity for the detection of new viruses with pandemic potential.

Working with over 30 countries and screening more than 1,64,000 animals and people, the project has detected nearly 100 novel viruses globally, including the Bombali ebolavirus and the deadly Marburg virus.

The PREDICT project by the US has created this big dataset of viruses circulating in bats and other wildlife. And even now we know only a small proportion of the potential pathogens circulating out there, Ruiz, who studies the transmission of diseases from bats to humans, told PTI.

Also Read: Why Preparations for the Next Pandemic Must Begin Now

Pathogens and viruses

As several studies in the past have highlighted, bats have unique super immune systems, enabling them to carry viruses such as the Nipah virus and SARS-CoV-2 without being infected. These pathogens can however jump or spill over to humans and cause new diseases in them when they make close contact with the flying mammals.

Disease ecologist Abi T. Vanak from the Ashoka Trust For Research In Ecology And The Environment (ATREE) in Bengaluru added that projects such as PREDICT, which scan the horizon for new pathogens, can help identify groups that have pandemic potential in the future.

From surveillance, we can find out the longevity of the viruses outside the host. Some wont even last for few minutes. Some can last for days, Vanak told PTI.

This influences how often a virus can jump from an animal and cause an outbreak in humans.

As these pathogens spill over under very specific conditions, scientists have also unravelled the role played by land-use change in contributing to new outbreaks from animals to humans known as zoonotic diseases.

A major research in this domain, published in the journal Nature in August, analysed mammal and bird species across the world, and found that songbirds, bats, and rodents have the highest potential for spreading new diseases to humans.

Land-use change is acting as a kind of ecological filter and these species that do get through the filter are those that carry more pathogens, Rory Gibb, a co-author of this study from University College London, told PTI.

In several studies published in 2020, parts of India were classified as potential hotspots from where the next pandemic may emerge, partly due to increased rates of land-use change in the country.

Commenting on this observation, Virat Jolli, director of the New Delhi-based organisation Biodiversity and Environmental Sustainability (BEST), said the risk of new pandemic-potential diseases jumping from rodents, bats, and birds, were particularly high in India, especially in the Western Ghats.

The forest areas of Western Ghats, in his view, are under pressure because of plantation, overgrazing and human settlements.

Forest fragmentation for mining, road, and railways projects may lead to the emergence of new diseases, Jolli warned.

The buffer area of 10 kilometres around the protected area should in no way be reduced or altered, he added.

Multidisciplinary approach

Since unravelling the when and the where of the next pandemic is a complex question, scientists have also made strides in applying a multidisciplinary approach to predict the emergence of new outbreaks.

In a study, published in April in the journal PLOS, Vanak and his team for the first time applied a co-production model to predict how the tick-borne Kyasanur forest disease (KFD) a viral haemorrhagic fever endemic to south India was triggered by factors including land-use change.

The co-production approach brings together different forms of knowledge and expertise from scientists and a wide range of stakeholders to try to understand and address a key problem.

It became much clearer from similar studies in 2020 that collaborative research involving experts from across disciplines is the way forward.

Diseases dont exist in individual animals theyre part of an ecosystem. Sampling an animal for viruses and analysing them is just one part of the puzzle. We need virologists talking to public health experts, social scientists, ecologists and epidemiologists, Vanak added.

Another major study, which took a multidisciplinary approach to predict global hotspots where the next pandemic could emerge, was published in November in the journal One Health.

It analysed where wildlife-human interfaces intersected with areas of poor health infrastructure and globalised cities, and also pointed to parts of India as potential hotspots.

Michael Walsh, study co-author from the Prasanna School of Public Health, Manipal University, agreed the Western Ghats, as well as northeastern parts of the country, have broad areas of risk.

Instead of focusing on specific species, more resources could be invested in improving human health infrastructure in these regions, Walsh told PTI.

While parts of Kerala and Tamil Nadu fall under these hotspots, he said these states are not in the highest tier of risk because they have quite good health infrastructure relative to other states.

Ruiz believes some parts of India are potential hotspots not because lots of viruses are circulating there but because these have high rates of land-use change and these are also places with high-density of human populations.

If the novel coronavirus had emerged in a rural village which wasnt a transport hub like Wuhan, probably the virus may have died off there, Ruiz added.

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How Scientists Are Identifying Ways to Prevent the Next Pandemic - The Wire Science

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Weed and Seven Benadryl: The Wild Lengths COVID Docs Are Taking to Get Sleep – The Daily Beast

One emergency medicine doctor at a New York City hospital has lost count of the number of sleep medicines shes tried since the coronavirus took over her life in February.

First it was temazepam and then trazodone, though even tripling her initial 50 mg dose didnt help. Shes been prescribed two different antidepressants, and tried medical marijuana.

One night, she said, she took seven Benadryl.

And my doctor was like, What happened? And I was like, I didnt sleep, said the emergency medicine doctor, who spoke to The Daily Beast on the condition of anonymity because she didnt want her employer to find out she sees a psychiatrist or takes medication.

Her newest cocktail: a combination of Ativan, melatonin, and high blood pressure medicines. But there are still days, she said, when she drags herself into work on no sleep at all. It absolutely affects how I do my job, said the doctor.

For a while, I was terrified of sleeping.

Emergency medicine doctor in New York

Of course, getting to sleep isnt even half the battle. Even when her medicines work and she can drift off, she finds herself woken up by a surge of adrenaline a few hours later.

And then there are the night terrors.

For a while, I was terrified of sleeping, she told The Daily Beast. I didnt even want to take my medicine to go to sleep, because youd just have really bad dreams of your patients dying and you couldnt save them.

Since the coronavirus went from curiosity to pandemic, frontline health-care workers tasked with caring for the hundreds of thousands of patients passing through their clinics, emergency departments, and hospitals have been mired in sleep disorders and insomnia. One study of New York City health-care workers treating COVID patients this spring showed that 75 percent of respondents had at least some insomnia and that, on average, they were sleeping less than six hours each night.

And then theres just so much death.

Dr. Jessi Gold

Now, as the second wave of the virus pummels the United States, experts say that percentage is likely much higherand that the arrival of a vaccine, while encouraging, offers little in the way of a respite.

Its a crisis, said Dr. Jessi Gold, a psychiatrist at Washington University in St. Louis who specializes in the mental health of health-care workers.

Pretty much no one is sleeping, she added. And that makes sense, because if you think of sleep as a symptom of acute stress, well, this job is in many ways an accumulation of traumas. Theres the anxiety of, Am I going to get sick? Am I going to get my partner or my children or someone else sick? Gold said.

And then theres just so much death.

In the short term, these sleep issues have severe consequences for the profession, according to Gold, who likens working on little sleep to drunk driving. But other doctors say the long-term consequences are perhaps even more dire.

Were never going to be the same again, said Dr. Tsion Firew, an assistant professor of emergency medicine at Columbia University Medical Center in New York City.

In May, Firew, who is also struggling with insomnia but does not take prescription sleep aids, co-authored a study that found more than half of frontline health-care workers during COVID were experiencing anxiety and depression.

The best medicine for someone who is going through a mental trauma, you advise the person or patient or find a way to avoid the trauma so they can begin the healing, she said. But for us, were still in it. Weve lost our friends, our colleagues, and some of us have lost our family members. So its going to be a thing thats going to haunt us forever.

For some health-care workers, seeing colleagues finally receiving the vaccine was one of the first bright spots since the pandemic began.

Its just nonstop terror, unfortunately.

Dr. Tsion Firew

This week, there happens to be some optimism, said Dr. Vignesh Doraiswamy, a hospitalist at Ohio State University Medical Center. Doraiswamy said he sleeps between five and six hours a night, but hasnt yet resorted to prescription medications.

But he and other health-care workers said that the vaccines slow rollout and the rising number of new cases and deathsand the crushing impact on hospital capacityvastly overshadowed the hope for relief.

The next couple of weeks are going to be even tougher, Firew told The Daily Beast, adding, Its very difficult to fathom what might happen with the holidays and people traveling and just peoples complacency. And once you see the number of cases rising, the next thing that happens is the wave of the dead. So its just nonstop terror, unfortunately.

One Bay Area geriatrician, who spoke to The Daily Beast on the condition of anonymity because she, too, didnt want her employer to know about her usage of sleep medicines, said trazodone didnt work.

Neither did CBD or CBD with THC, the antidepressant duloxetine, melatonin, Sleepytime tea, or obsessive knitting and watching Star Wars.

The two anti-anxiety meds shes on now, she said, help sometimes. But on Friday night, she still found herself awake at 4 a.m., replaying a PCR test shed given to a symptomatic patient that afternoon. The patient, she said, was confused and kept taking off their mask. And with the second wave limiting PPE yet again, shed been using the same N95 mask for a week. She felt like shed been exposed, and she wondered if shed brought the virus home to her partner and his son.

I worry about the effects it has on my overall wellbeing and my longevity in the profession, she said. I thought I had things treated better once I made this medication switch, but as things have come up again, its reared its ugly head. And all the medication in the world isnt going to change the external circumstances.

Sleep disorders were never rare among doctors and nurses in emergency medicine and other specialities with shifts that vary from morning to night, Gold noted. Whats different now, she said, is the sheer volume of health-care workers experiencing them and just how resistant these disorders have become to treatment.

Sleep is hard to treat. Period. Exclamation point, Gold said. Sleep in general is hard to manage. And then if you throw in a significant stressor like COVIDI tell a lot of people that its hard to drug the situation out of them. That doesnt mean that medication cant help, but it does mean if the stressor is still there, its still there. I dont have the ability to do an Eternal Sunshine of the Spotless Mind.

Sometimes, I wish I did.

What haunts Doraiswamy most when hes lying awake in his bed at night are the conversations. Hes asked people in their twenties if they have a living will or if theyve thought about what it means to be put on a breathing tube. Hes told countless children that their parents wont make it through the night.

Elderly couples always break my heart, he said. The number of times Ive had to tell someone in their eighties that your loved ones not doing well and were doing the best we can, but probably its not enough... And never did I think Id be having those conversations over the phone.

The emergency medicine doctor in New York who resorted to trying seven Benadryl said she often finds herself replaying the deaths of two men, both non-English-speakers, who died early in the pandemic.

Youre telling them its going to be fine, its going to be fine. But you know its not going to be fine, she recalled. I knew that I was lying to them. And they both passed away in the ER, not in a room. There was no dignity in that.

Without an effective sleep regime, she said, she and her colleagues at the hospital have more or less given up on sleeping well, and instead turned to coffee to stay awake. But even that had an unexpected side effect: now many of her colleagues, she said, have gastric ulcers. On Sunday, one doctor she works with went for a second endoscopy. She also has symptoms of an ulcer, she said, but it hasnt been diagnosed.

No time to get an endoscopy, she wrote in a text message to The Daily Beast. Im your typical bad patient doctor.

And this points to a grim irony, Gold said. Although doctors and nurses know more about medication and treatment, theyre often reluctant to seek treatment themselves, especially when it comes to issues of behavioral health like anxiety, depression and, of course, the insomnia currently gripping the profession.

There is a ton of stigma in general about mental health in medicine and this culture of stoicism and a fear that if you look weak it will affect your job, Gold said.

This is a huge problem as the pandemic continues to pummel the people charged with blunting its impact. The same study showing high rates of insomnia among New York health-care workers this spring indicated that nearly 60 percent were experiencing acute stress, often a precursor to post-traumatic stress disorder. In April, an emergency medicine doctor and an emergency medical technician, both of whom had worked on the frontlines of the pandemic in New York, died by suicide.

Unfortunately, just in the medical field, it sometimes takes courage to seek care. Its not like its easy to talk about, the way you talk about your high blood pressure or diabetes, said Firew, who had been a colleague of the emergency medicine doctor who died.

Thats why, the other New York emergency doctor said, even when she hasnt slept at all, she drags through the day at work, rather than call in sick. And when she decided to see a psychiatrist for her sleep issues, she said, she went to extreme lengths to make sure there wouldnt be a record, choosing a therapist who kept paper and not electronic files.

Despite the fact that shes drowning in more than $300,000 of medical school debt, she also pays for her visits with cash rather than go through her insurer.

Theres all this HIPAA stuff, but lets be real, they read your charts, and God forbid you come in with an elbow dislocation and they see that your last visit was with a psychiatrist, she said. You dont want that to be read.

Gold said that while fears like this are widespread, theyre only partly based in reality. The stigma is real, she said, but the idea that theyll ding your license or you'll lose your job, most of that is lore.

Still Gold said that seeking professional help, even under the table, is a best-case scenario. Because of these fears, many doctors wont seek medical interventions at all, or will end up self-prescribing.

Medication might not be ideal, but you have to sleep, she said. And Id rather they ask me for help than turn to prescribing themselves benzos or opioids, because that would be a problem.

Read more:
Weed and Seven Benadryl: The Wild Lengths COVID Docs Are Taking to Get Sleep - The Daily Beast

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Covid-19 Update Precision Medicine Software market: Poised to Garner Maximum Revenues by 2027 with major key players in the market Syapse, Allscripts,…

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Covid-19 Update Precision Medicine Software market: Poised to Garner Maximum Revenues by 2027 with major key players in the market Syapse, Allscripts,...

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Wildlife, land-use change and health infra: Scientists identify ways of preventing next pandemic – The Tribune

New Delhi, January 4

How to prevent the next pandemic? As 2021 begins with COVID-19 continuing its global spread, scientists have spotlighted three approaches to at least reduce the risk of pandemic potential diseases screening animals, reducing land-use change and improving health infrastructure.

There can be no one answer to the question at the centre of an anxious debate across a world coping with COVID-19 and wondering what will happen if another one comes but the global scientific community has been working on multiple tracks to ensure that humankind is better prepared.

Following several multidisciplinary studies in 2020, scientists now firmly believe aperfectstorm for an outbreak with pandemic potential is created by the combined forces of land-use change, high population density and the presence of interfaces between wildlife and domestic animals.

Weare only as strong as our weakestlinkgiven our globally connected society, Krutika Kuppalli, an expert in emerging infectious diseases affiliated with theStanford University School of Medicine in the US,told PTI.

Manuel Ruiz, wildlife veterinarian at Montana State University in the US, added that one of the best ways to prevent the next pandemic was tosampleanimals across the world to characterise potential pathogens.

Instead of spending money to curb outbreaks once they occurred,wecould invest in reforestation and in trying to change the way we interact with wildlife, and alter our level of land-use change, Ruiz said.

Earlier in the pandemic, it became clear that efforts applying scientific approaches to prevent the next big outbreak could cost countries way less than the expenditures they have meted out to control COVID-19.

A study published in July in the journal Science estimated that COVID-19 may likely cost the global economy between $8.1 and 15.8 trillion. It added that preventing major outbreaks could be 500 times cheaper than the expenditures meted out to curb the ongoing pandemic.

According to Ruiz, detecting or classifying every single pathogen in the worlds wildlife would be close to impossible but new methods using machine learning algorithms can be used to generate a catalogue of pathogens from which the animal host and place where the next outbreak may happen could be predicted.

One such international collaborative project that came into the spotlight in 2020 was USAIDs PREDICT, which aimed tostrengthen global capacity for the detection of new viruses with pandemic potential.

Working with over 30 countries and screening more than 1,64,000 animals and people, the project has detected nearly 100 novel viruses globally, including the Bombali ebolavirus and thedeadlyMarburg virus.

The PREDICT project by the US has created this big dataset of viruses circulating in bats and other wildlife. And even now we know only a small proportion of the potential pathogens circulating out there, Ruiz, who studies the transmission of diseases from bats to humans, told PTI.

As several studies in the past have highlighted, bats have unique super immune systems, enabling them to carry viruses such as the Nipah virus and the SARS-CoV-2 without being infected. These pathogens can however jump or spill over to humans and cause new diseases in them when they make close contact with the flying mammals.

Disease ecologist Abi T Vanak from theAshoka Trust for Research In Ecology And The Environment(ATREE) in Bengaluru added that projects such as PREDICT, which scan the horizon for new pathogens, can help identify groups that have pandemic potential in the future.

From surveillance, we can find out the longevity of the viruses outside the host. Some wont even last for a few minutes. Some can last for days, Vanak told PTI.

This influences how often a virus can jump from an animal and cause an outbreak in humans.

As these pathogens spill over under very specific conditions, scientists have also unravelled the role played by land-use change in contributing to new outbreaks from animals to humans known as zoonotic diseases.

A major research in this domain, published in the journal Nature in August, analysed mammal and bird species across the world, and found that songbirds, bats, and rodents have the highest potential for spreading new diseases to humans.

Land-use change is acting as a kind of ecological filterand these species that do get through the filter are those that carry more pathogens, Rory Gibb, a co-author of this study from University College London, told PTI.

In several studies published in 2020, parts of India were classified as potential hotspots from where the next pandemic may emerge, partly due to increased rates of land-use change in the country.

Commenting on this observation, Virat Jolli, director of the New Delhi-based organisation Biodiversity and Environmental Sustainability(BEST), said the risk of new pandemic-potential diseases jumping from rodents, bats, and birds, were particularly high in India, especially in the Western Ghats.

The forest areas of Western Ghats, in his view, are under pressure because of plantation, overgrazing and human settlements.

Forest fragmentation for mining, road, and railways projects may lead to the emergence of new diseases, Jolli warned.

The buffer area of 10 kilometres around the protected area should in no way be reduced or altered, he added.

Since unravelling the when and the where of the next pandemic is a complex question, scientists have also made strides in applying a multidisciplinary approach to predict the emergence of new outbreaks.

In a study, published in April in the journal PLOS, Vanak and his team for the first time applied a co-production model to predict how the tick-borneKyasanur forest disease(KFD)a viral haemorrhagic fever endemic to south Indiawas triggered by factors including land-use change.

The co-production approach brings together different forms of knowledge and expertise fromscientists and a wide range of stakeholders to try to understand and address a key problem.

It became much clearer from similar studies in 2020 that collaborative research involving experts from across disciplines is the way forward.

Diseases dont exist in individual animalstheyre part of an ecosystem. Sampling an animal for viruses and analysing them is just one part of the puzzle. We need virologists talking to public health experts, social scientists, ecologists and epidemiologists, Vanak added.

Another major study, which took a multidisciplinary approach to predict global hotspots where the next pandemic could emerge, was published in November in the journal One Health.

It analysed where wildlife-human interfaces intersected with areas of poor health infrastructure and globalised cities, and also pointed to parts of India as potential hotspots.

Michael Walsh, study co-author from the Prasanna School of Public Health, Manipal University, agreed the Western Ghats, as well as northeastern parts of the country, havebroadareas of risk.

Instead of focusing on specific species, more resources could be invested in improving human health infrastructure in these regions, Walsh told PTI.

While parts of Kerala and Tamil Nadu fall under these hotspots, he said these statesarenot in the highest tier of risk because they have quite good health infrastructure relative to other states.

Ruiz believes some parts of India are potential hotspotsnotbecause lots of viruses are circulating there but because these have high rates of land-use change and these are also places with high-density of human populations.

If the novel coronavirus had emerged in a rural village which wasnt a transport hub like Wuhan, probably the virus may have died off there, Ruiz added. PTI

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Wildlife, land-use change and health infra: Scientists identify ways of preventing next pandemic - The Tribune

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Do we have to age? – The Guardian

When the biologist Andrew Steele tells people his thoughts on ageing that we might one day cure it as if it were any other disease they are often incredulous and sometimes hostile. Once, at a friends wedding, he left a group of guests mildly incensed for suggesting that near-future humans might live well into their 100s. A similar thing happens at dinner parties, where the responses are more polite but no less sceptical. He understands the reaction. We think of ageing as an inescapable fact of life were born, we grow old, so it goes. Thats been the narrative for thousands of years, he says, on a video call. But what if it didnt have to be?

Steele began professional life as a physicist. As a child, he was fascinated by space, the way many scientists are. But he has spent the past three years researching a book about biogerontology, the scientific study of ageing, in which he argues the case for a future in which our lives go on and on. Steele considers ageing the greatest humanitarian issue of our time. When he describes growing old as the biggest cause of suffering in the world, he is being earnest. Ageing is this inevitable, creeping thing that happens, he says. He is wearing a button-down shirt and, at 35, a look of still-youthful optimism. Were all quite blind to its magnitude. But what do people die of? Cancer. Heart disease. Stroke. These things all occur in old people, and they primarily occur because of the ageing process.

Steele defines ageing as the exponential increase in death and suffering with time, and he thinks it would be helpful to finally grapple with this raw quantity of suffering. The human risk of death doubles every seven or eight years. We tend to breeze through the first five or six decades of life relatively unscathed, health-wise. Maybe we wake up at 50 with an ache, or slightly sagging skin, but still we are generally considered unlucky if we discover a tumour or develop arthritis or suffer heart problems. The death of a 50-year-old from disease is a premature death.

But at some point in our 60s a kind of cliff edge appears, and often we have no choice but to stumble over it. Easy movements become hard. We begin to lose our hearing and our sight. Frustrating and embarrassing things start to happen. Why cant I feel the tips of my toes? What on earth has happened to my hip? The body has worked tirelessly for years, and the cumulative internal effects of that action the problematic buildup of aged, senescent cells; the dangerous mutations of other cells; the steady decline of the immune system; the general wearing-down of the bodys structures suddenly predispose us to a variety of age-related diseases: cancer, cardiovascular disease, hypertension, dementia. A 10-year-olds risk of death is 0.00875%. At 65, the risk has risen to 1%. By the time we turn 92 we have a one in five chance of dying that year. For decades we are mostly fine, Steele says, and then, all of a sudden, were not.

The dream of anti-ageing medicine, Steele writes in his book, Ageless: The New Science of Getting Older Without Getting Old, is treatments that would identify the root causes of dysfunction as we get older, then slow their progression or reverse them entirely. These root causes are what biogerontologists call hallmarks. Cancer isnt a hallmark of ageing, Steele says now. But its caused by several of the hallmarks of ageing. If scientists can address those hallmarks, we can come up with treatments that slow down the whole ageing process, deferring diseases into the future.

The hope isnt that we get to live longer for the sake of it, it is that we live longer in good health. Some people call this longevity; Steele refers to increasing a persons healthspan. Theres this misconception when you talk to people about treating ageing, he says. They imagine theyre going to live longer but in a state of terrible decrepitude, that youre going to extend their 80s and 90s so theyre sat in a care home for 50 years. That doesnt make sense from a logical perspective or a practical one.

I say, What would be the point?

Exactly!

Its just more pain

Nobody would want it, he says. Then he raises an eyebrow. Its surprising that people would actually think scientists would want that.

Humans have been searching for a cure for ageing for thousands of years. Herodotus wrote of the Fountain of Youth in the 5th century BC; countless people have made lengthy, futile quests for life-extending elixirs. Until recently, very little was known about why we age and how. For a long time, scientists looked at it and thought, Oh God, this is going to be some immeasurably complex process that we cant possibly hope to study in a lab, Steele says, which dissuaded research. Until the 1960s, it was generally accepted that our role on this Earth was to produce children, and that once wed succeeded in that undertaking, our bodies, fulfilled of function, would be left to slowly fade.

But in the past three decades biogerontological research has accelerated, and recent successes have sparked excitement. A 2015 study, published by the Mayo Clinic, in the US, found that using a combination of existing drugs dasatinib, a cancer medicine, and quercetin, which is sometimes used as a dietary suppressant to remove senescent cells in mice reversed a number of signs of ageing, including improving heart function. A 2018 study that used the same drugs found that the combination slowed or partially reversed the ageing process in older mice. In another study, the drug spermidine extended the lifespans of mice by 10%, and studies using the drug rapamycin have extended the healthspans of mice, worms and flies, though it comes with problematic side-effects, including the suppression of the immune system and the loss of hair. Last year, scientists in Texas transplanted stem cells from young mice into elderly ones, adding three months to their average lifespans, which in equivalent human terms could be worth more than a decade.

To Steele this is all thrilling. The pace of change has been dizzying, he says of recent developments. Though it is the fact that human trials have begun that excites him most. After the success in mice, the first trial aimed at removing senescent cells in humans began in 2018, and others are ongoing. A more recent study found that a combination of hormones and drugs appears to help rejuvenate the thymus, which contributes to the immune system but degenerates rapidly with age. Next year, a landmark trial will begin to investigate whether metformin, a drug used to treat diabetes, might in fact delay the development or progression of age-related chronic diseases such as heart disease, cancer and dementia.

In Ageless, Steele writes, This collection of evidence is tantalising, and foreshadows a future where ageing will be treated. He also writes: This future may not be far away. When I ask him what he means by not far away, exactly, he smiles. Scientists are rightly sceptical, he says, but its important to say that a lot of significant breakthroughs could happen in the lifespan of people alive today.

I ask, Can you be more specific?

Eventually, he says, I think we are very likely to have a drug that treats ageing in the next 10 years.

Steele believes we will be hopelessly unlucky if scientists dont make a breakthrough within that time, given how many human trials are in progress or upcoming. And although these breakthroughs wont result in treatments that extend our lives by 100 years, they will give us enough extra time to ensure were alive for subsequent breakthroughs, subsequent treatments, subsequent additions in lifespan and so on. Our lives will be extended not all in one go but incrementally one year, another year, suddenly were 150. In Ageless, Steele talks of a generation of people that grows up expecting to die but, thanks to an accumulation of new treatments, each more effective than the last, just doesnt. One after another, he writes, lifesaving medical breakthroughs will push their funerals further and further into the future.

What Steele is talking about isnt immortality; people will continue to die. Science wont help if, looking down at your phone, you walk out into the road and get hit by a car. Or if you fall off a ladder and break your neck. Or if you are unlucky enough to be hit by a missile in a war zone. Or if you contract a virulent infectious disease that has no vaccine. But it will result in lifespans that are significantly longer than what we currently consider normal.

I ask if Steele expects there to someday be lots of 150-year-olds wandering around, as healthy as 20-year-olds.

Yes, he says, if it all works.

I say, 200-year-olds playing football in the park?

Why not? he says. The trouble is, saying were going to have 150-year-olds walking around looking like 20-year-olds, its weird. It sounds sci-fi. It sounds a bit creepy. Ultimately, I dont want this because I want to have a load of 150-year-olds looking like 20-year-olds, I want it because those 150-year-olds wont have cancer, they wont have heart disease, they wont be struggling with arthritis. Theyll still be playing with their grandkids, their great-grandkids even. Its about the health and lifestyle benefits.

When Steele brings up his work with people, the question he gets asked most often is: What about overpopulation? He has a go-to answer he thinks highlights the ridiculousness of the question. Imagine were staring down the barrel of 15bn people on Earth, he says. There are lots of ways to try and tackle that problem. Would one of them be: invent ageing?

That he is asked this question so frequently frustrates him. More so, he is bothered by the implication that what he is suggesting is somehow weird or inhuman or unholy, rather than ultimately helpful for society. If Id just written a book about how were going to cure childhood leukaemia using some amazing new medicine, he says, literally nobody would be like, But isnt that going to increase the global population?

He shakes his head.

What Im saying is, Here is an idea that could cure cancer, heart disease, stroke Curing any one of those things would get you plaudits. But as soon as you suggest a potentially effective way of dealing with them altogether, suddenly youre some mad scientist who wants to overpopulate us into some terrible environmental apocalypse?

Steele considers this a major hurdle in biogerontologys potential success our incredible bias toward the status quo of ageing as an inevitable process, and our inability to accept it as preventable. If we lived in a society where there was no ageing, and suddenly two-thirds of people started degenerating over decades, started losing their strength, started losing their mental faculties, and then succumbing to these awful diseases, it would be unthinkable. And of course, wed set to work trying to cure it.

He makes reference to the pandemic. The coronavirus exemplifies the problem we have in terms of funding science, in trying to confront these kinds of challenges. Because its so acute, because it all of a sudden appeared on the scene and the entire global economy was dragged to a halt, we see this very clear, current, present need to do something about it. And yet if you look at ageing, or even climate change, these are slow-moving disasters, and so theyre easy to miss. It is not lost on him that ageing-related drugs might have reduced the impact of the coronavirus, given it is a disease that is particularly life-threatening among older populations. To this end, he thinks biogerontology will eventually dramatically change the role of medicine, from being primarily reactive to primarily preventive. Weve somehow unintentionally drifted into this state in society where we end up treating endpoints, almost in a state of panic, at the last minute, he says, rather than preventing them beforehand.

Steele considers Ageless a call to arms, and is hopeful it presents enough evidence to finally convince the public as well as regulators, who currently dont define ageing as a disease, which makes it difficult to receive support for trials that ageing is a problem to be fixed. There is a kneejerk reaction to biogerontology, just because it sounds strange, he says. We place ageing research in this separate category socially, morally, ethically, even scientifically. When, actually, its just an extension of the normal goals of modern medicine.

Writing a book on ageing, it turns out, is a good way to make you reappraise your own lifestyle. These days, Steele is running more than he used to, and he has begun to watch what and how much he eats. Its not like I was ever a massive couch potato, he says. But, equally, I have tried to optimise things. In the absence of anti-ageing drugs, he suggests we all do the same. It seems that a lot of the sort of basic health advice that everyone can recite do some exercise, dont be overweight, try to eat a broad range of foods, dont smoke all that stuff basically slows down the ageing process.

I tell him Ive spoken to people who are taking several unproven supplements a day, hoping to eke out a few more years, and of others who, ahead of the trial, are already taking the experimental drug metformin.

Given that Im in my 30s, he says, I think the case against metformin is stronger than the case for. The evidence is suggestive, but its not conclusive. And theres a spectrum. There are people who are experimenting with senolytics. There was the case of the biotech CEO who went to Colombia and had gene therapy. But the data in humans just isnt there. He adds: The same is true of so many of these supplements and health foods. If any of these things did have a substantial effect, wed know about it.

When I ask him what he thinks of the anti-ageing industry all of those creams and serums that promise rejuvenation, our modern-day elixirs he says, Id like to completely obviate it. If the breakthroughs do come, they are likely to significantly change the structure of our time on Earth. We are used to the three-act life: we are young and learn, we are middle-aged and work, we are old and retire. But what happens if we live another 100 years? Might we go back to school at 60, or switch careers at 105 or, at 40, decide to take some kind of 20-year soul-searching hiatus, knowing well have a century or more to do other things having returned from whatever wilderness we had run away to?

And what about death? At one point during our conversation, I ask Steele if he imagines a time when dying becomes a choice. He thinks the question is overblown. Because death is inevitable people have rationalised it as something that drives life, or gives life meaning, or adds some sort of poetry to the human condition, he says. But I think, broadly speaking, death is bad. If there was less death in the world, I think most people would agree that was a good thing. And though my passion for treating ageing isnt driven by reducing the amount of death, its driven by reducing ill health in later life, its driven by conquering disease, its driven by getting rid of suffering, if theres less death as a side-effect? I dont think thats a bad thing.

Ageless: The New Science of Getting Older Without Getting Old by Andrew Steele is published by Bloomsbury at 20. Buy it from guardianbookshop.com for 17.40

The root causes of ageing are called hallmarks. Treat these and you slow ageing.

1. Genomic instability As we age, we accumulate genetic damage. Simply, over time, our DNA gets mangled. It is thought that if scientists can find a way to repair that damage, they will then be able impact the ageing process.

2. Cellular senescence The longer we live, the more chance we have of experiencing a build-up of senescent (old) cells, which tend to hang around in the body and can contribute to the onset of age-related diseases.

3. Mitochondrial dysfunction Mitochondria are organelles that generate the energy our cells need to power necessary biochemical reactions. It has been found that mitochondrial dysfunction can accelerate ageing.

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Do we have to age? - The Guardian

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