Elsevier study: At what point does click-bait susceptibility become a mental health disorder?

17 Nov

Shahram Heshmat Ph.D. wrote in the Psychology Today article, 5 Patterns of Compulsive Buying: How do you know you have an addiction?

About 6% of the U.S. population can be said to have compulsive buying behavior with 80% of compulsive buyers being women. Many women have been socialized from a very young age to enjoy shopping with their mothers and friends (Workman & Paper, 2010). However, compulsive buying is likely to increase for men with the evolution of digital commerce. It is much faster and easier now to find what you are looking for.
Compulsive buying is similar to behavioral addiction, such as binge eating and gambling (Lawrence et al., 2014). Compulsive spending frequently co-occurs with other mental illnesses like depression, anxiety, and eating disorders. Unlike other addictions, which take hold in the teens, spending addictions mostly develop in the 30s when people achieve financial independence.
Compulsive buying is not listed as an addiction in the DSM-5. However, the impulse problem appears to share certain characteristics common in addictive disorders (Black, 2012).
1. Impulse purchase. Compulsive buyers often purchase things on impulse that they can do without. And they often try to conceal their shopping habits…. Compulsive buyers may develop into hoarders later in life after their products have accumulated with time (Mueller, 2007).
2. Buyers high. Compulsive shoppers experience a rush of excitement when they buy. The euphoric experience is not from owning something but from the act of buying it…. And this excitement can become addictive.
3. Shopping to dampen unpleasant emotions. Compulsive shopping is an attempt to fill an emotional void, like loneliness, lack of control, or lack of self-esteem. Often, a negative mood, such as an argument or frustration triggers an urge to shop. However, the decrease in negative emotions is temporary and it is replaced by an increase in anxiety or guilt (Donnelly et al., 2016).
4. Guilt and remorse. Purchases are followed by feelings of remorse. They feel guilty and irresponsible for purchases that they perceive as indulges. The result may be a vicious cycle, that is, negative feeling fuel another “fix,” purchasing something else.
5. The pain of paying. Paying with cash is more painful than paying with credit cards (Ariely and Kreisler, 2017). The main psychological force of credit cards is that they separate the pleasure of buying from the pain of paying. Credit cards seduce us into thinking about the positive aspects of a purchase. In fact, CBD is only prevalent in developed countries where there is a system of credit and a consumer culture. https://www.psychologytoday.com/intl/blog/science-choice/201806/5-patterns-compulsive-buying

See, Compulsive Shopping https://www.investopedia.com/terms/c/compulsive-shopping.asp and Compulsive Spending / Shopping https://www.goodtherapy.org/learn-about-therapy/issues/compulsive-shopping

Science Daily reported the Elsevier study: At what point does click-bait susceptibility become a mental health disorder?

A new study in Comprehensive Psychiatry, published by Elsevier, found that one third of a group of patients seeking treatment for buying-shopping disorder (BSD) also reported symptoms of addictive online shopping. These patients tended to be younger than the others in the study sample, experienced greater levels of anxiety and depression, and were likely to exhibit a higher severity of BSD symptoms.
“It really is time to recognize BSD as separate mental health condition and to accumulate further knowledge about BSD on the Internet,” explained lead investigator Astrid Müller, MD, PhD, Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany. At present, BSD is not categorized as a separate mental health condition; it is characterized as “other specified impulse control disorder” in the recently released 11th revision of the International Classification of Diseases.
BSD is a cross-national problem that afflicts an estimated five percent of the population. It is characterized by extreme preoccupation with and craving for buying and/or shopping, as well as irresistible and identity-seeking urges to possess consumer goods. Patients with BSD buy more consumer goods than they can afford, need, or use. Their excessive purchasing serves to regulate emotions, e.g., to get pleasure, relief from negative feelings or cope with self-discrepancy. In the long run, the recurrent breakdown in self-control leads to extreme distress, psychiatric comorbidity, familial discord, clutter due to pathological hoarding of goods, and indebtedness and/or deception and embezzlement to enable continued spending despite insufficient finances.
As e-commerce has gained increasing popularity as a primary method for buying and shopping for goods over the past decade, a need has developed for mental health experts to explore whether traditional BSD manifests differently in the online retail market. The Internet offers a vast variety of shopping information and simultaneous access to many online stores, thereby meeting expectations for immediate reward, emotional enhancement, and identity gain.
Previous studies showed that certain Internet-specific aspects of buying and shopping, such as availability, anonymity, accessibility, and affordability, contribute to the development of an online subtype of BSD. However, there is a paucity of studies investigating addictive online shopping as a phenotype of BSD related to the problematic use of the Internet. This study, which analyzed data from earlier studies reporting on 122 treatment-seeking patients, is among the first to quantify and explore the phenomenon of online shopping in BSD diagnosed-patients…. https://www.sciencedaily.com/releases/2019/11/191114100911.htm

Citation:

At what point does click-bait susceptibility become a mental health disorder?
Date: November 14, 2019
Source: Elsevier
Summary:
A new study found that one third of a group of patients seeking treatment for buying-shopping disorder (BSD) also reported symptoms of addictive online shopping. These patients tended to be younger than the others in the study sample, experienced greater levels of anxiety and depression, and were likely to exhibit a higher severity of BSD symptoms.
Journal Reference:
Astrid Müller, Sabine Steins-Loeber, Patrick Trotzke, Birte Vogel, Ekaterini Georgiadou, Martina de Zwaan. Online shopping in treatment-seeking patients with buying-shopping disorder. Comprehensive Psychiatry, 2019; 94: 152120 DOI: 10.1016/j.comppsych.2019.152120

Here is the press release from Elsevier:

At what point does click-bait susceptibility become a mental health disorder?
One third of patients seeking treatment for buying-shopping disorder report symptoms of online shopping addiction, according to a new study published in Comprehensive Psychiatry

Philadelphia, November 13, 2019
A new study in Comprehensive Psychiatry, published by Elsevier, found that one third of a group of patients seeking treatment for buying-shopping disorder (BSD) also reported symptoms of addictive online shopping. These patients tended to be younger than the others in the study sample, experienced greater levels of anxiety and depression, and were likely to exhibit a higher severity of BSD symptoms.
“It really is time to recognize BSD as separate mental health condition and to accumulate further knowledge about BSD on the Internet,” explained lead investigator Astrid Müller, MD, PhD, Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany. At present, BSD is not categorized as a separate mental health condition; it is characterized as “other specified impulse control disorder” in the recently released 11th revision of the International Classification of Diseases.
BSD is a cross-national problem that afflicts an estimated five percent of the population. It is characterized by extreme preoccupation with and craving for buying and/or shopping, as well as irresistible and identity-seeking urges to possess consumer goods. Patients with BSD buy more consumer goods than they can afford, need, or use. Their excessive purchasing serves to regulate emotions (e.g., to get pleasure, relief from negative feelings or cope with self-discrepancy). In the long run, the recurrent breakdown in self-control leads to extreme distress, psychiatric comorbidity, familial discord, clutter due to pathological hoarding of goods, and indebtedness and/or deception and embezzlement to enable continued spending despite insufficient finances.
As e-commerce has gained increasing popularity as a primary method for buying and shopping for goods over the past decade, a need has developed for mental health experts to explore whether traditional BSD manifests differently in the online retail market. The Internet offers a vast variety of shopping information and simultaneous access to many online stores, thereby meeting expectations for immediate reward, emotional enhancement, and identity gain.
Previous studies showed that certain Internet-specific aspects of buying and shopping, such as availability, anonymity, accessibility, and affordability, contribute to the development of an online subtype of BSD. However, there is a paucity of studies investigating addictive online shopping as a phenotype of BSD related to the problematic use of the Internet. This study, which analyzed data from earlier studies reporting on 122 treatment-seeking patients, is among the first to quantify and explore the phenomenon of online shopping in BSD diagnosed-patients.
Dr. Müller added, “We hope that our results showing that the prevalence of addictive online shopping among treatment-seeking patients with BSD will encourage future research addressing the distinct phenomenological characteristics, underlying features, associated comorbidity, and specific treatment concepts.”
Notes for editors
The article is “Online shopping in treatment-seeking patients with buying-shopping disorder,”by Astrid Müller, Sabine Steins-Loeber, Patrick Trotzke, Birte Vogel, Ekaterini Georgiadou, and Martina de Zwaan (https://doi.org/10.1016/j.comppsych.2019.152120). It appears in Comprehensive Psychiatry, volume 94 published by Elsevier.
This study is published open access and can be downloaded by following the DOI link above.
Full text of the article is available to credentialed journalists upon request. Contact Eileen Leahy at +1 732 238 3628or hmsmedia@elsevier.com to obtain copies. Journalists wishing to speak to the authors should contact Astrid Müller at mueller.astrid@mh-hannover.de.
About Comprehensive Psychiatry
Comprehensive Psychiatry is an open access, peer-reviewed journal that publishes on all aspects of psychiatry and mental health with a mission to disseminate cutting-edge knowledge in order to improve patient care and advance the understanding of mental illness. The Journal aims to publish high quality papers with a particular emphasis on the clinical implications of the work including an improved understanding of psychopathology.
About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray’s Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. http://www.elsevier.com
Media contact
Eileen Leahy
Elsevier
+1 732 238 3628
hmsmedia@elsevier.com

Dr. April Benson wrote in Compulsive Shopping Treatment Overview:

As with most other addictive, impulse control, or compulsive disorders, there is a wide range of effective treatment options: drug treatment, individual, group, and couples therapy, counseling for compulsive buying, Debtors Anonymous, and Simplicity Circles can all be effective. The choice of what form or forms of compulsive shopping treatment to use with a particular person is a complex decision that goes well beyond the scope of this overview. For further information about making treatment decisions, consult my own writings, the For Therapists page of this website, as well as the bibliographic references at the end of each chapter in I Shop, Therefore I Am: Compulsive Buying and the Search for Self.
Psychotropic medications, including antidepressants, mood stabilizers, and opiod antagonists have been used to treat compulsive buying, with varying effectiveness. For further details, see McElroy and Goldsmith-Chapter 10 of I Shop, Therefore I Am and in Benson, April L. and Gengler, Marie. “Treatment of Compulsive Buying,” in Handbook of Addictive Disorders: A Practical Guide to Diagnosis and Treatment Handbook, Robert Coombs, (ed.), Wiley (2004).
Group therapy for compulsive buyers has been reported since the late 1980s. At least five different forms of group therapy have been utilized with this population. My own group compulsive shopping treatment model is an amalgam of three things: useful techniques from existing models; didactic and experiential material used in group treatment for Borderline Personality Disorder; and material I’ve found effective in my clinical practice. A study of the efficacy of this model has been submitted for publication to the Journal of Groups in Addiction and Recovery and two additional papers, one about the model itself, and the second, a case illustration of the model, will appear in Volume 8, Number 1, of the Journal of Groups in Addiction and Recovery (2013).
There are chapters about two of the existing group therapy models in my book, I Shop, Therefore I Am and I describe all five in detail in Benson, April L. and Gengler, Marie. “Treatment of Compulsive Buying,” in Handbook of Addictive Disorders: A Practical Guide to Diagnosis and Treatment Handbook, Robert Coombs, (ed.), Wiley (2004).
Couples therapy for compulsive buying is an extremely important treatment modality, because couples act as a financial unit and generally blend income as well as spending. Money issues are an intrinsic part of marriage and are often a source of intense and pervasive friction that can seep into other aspects of the relationship. Couples therapy is indicated when the compulsive spending problem can’t be dealt with adequately on an individual basis. Olivia Mellan, the country’s foremost expert in this area, discusses the treatment in Chapter 15, “Overcoming Overspending in Couples”, of I Shop, Therefore I Am.
How Does Compulsive Shopping Treatment Work?
Compulsive shopping treatment targets the specific problem and creates an action plan to stop the behavior. Targeted counseling for this problem alters the negative actions of compulsive buying and concurrently works toward healing the underlying emotions, although less emphasis is placed on exploring the emotional significance of compulsive buying than in traditional individual psychotherapy. The major premise of compulsive shopping treatment is the idea that insight alone will not stop the behavior. All stages in the compulsive buying cycle must be identified: the triggers, the feelings, the dysfunctional thoughts, the behaviors, the consequences of the behavior, as well as the meaning of the compulsive buying. Creating and using a spending plan is a cornerstone of compulsive shopping treatment. More information about compulsive buying counseling can be found in Karen McCall’s chapter “Financial Recovery Counseling”, as well as in my treatment chapter in Handbook of Addictive Disorders: A Practical Guide to Diagnosis and Treatment Handbook, Robert Coombs, (ed.), Wiley (2004).
Debtors Anonymous (D.A.) can be a powerful tool in recovery from compulsive buying, especially for compulsive buyers who have problems with debt. D.A. sees debting as a disease similar to alcoholism that can be cured with solvency, which means abstinence from any new debt. Since individuals are trying to control their lives with addictive debting, D.A. offers a regimented program of surrender and recovery, a program with a spiritual emphasis. Individual debtors work through the steps of the program with a sponsor, a more experienced member of the group, using newly acquired tools in conjunction with the steps. How Debtors Anonymous and psychotherapy can work synergistically is the topic of Kellen and Levine’s chapter of I Shop, Therefore I Am….. https://www.shopaholicnomore.com/complusive-shopping-treatment/

Your success and happiness lies in you. Resolve to keep happy, and your joy and you shall form an invincible host against difficulties.
Helen Keller

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART ©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©

Dr. Wilda ©
https://drwilda.com/

Cincinnati Children’s Hospital Medical Center study: Screen-based media associated with structural differences in brains of young children

10 Nov

Andrew Stevensen wrote in the Sydney Morning Herald article, The screens that are stealing childhood:

Australians have smartphones and tablet computers gripped in their sweaty embrace, adopting the new internet-enabled technology as the standard operating platform for their lives, at work, home and play.
But it is not only adults who are on the iWay to permanent connection. As parents readily testify, many children don’t just use the devices, they are consumed by them.
”These devices have an almost obsessive pull towards them,” says Larry Rosen, professor of psychology at California State University and author of iDisorder: Understanding Our Obsession with Technology and Overcoming its Hold on Us.
”How can you expect the world to compete with something like an iPad3 with a high-definition screen, clear video and lots of interactivity? How can anything compete with that? There’s certainly no toy that can.
”Even old people like me can’t stop themselves from tapping their pocket to make sure their iPhone is there. Imagine a teenager, even a pre-teen, who’s grown up with these devices attached at the hip 24/7 and you end up with what I think is a problem.”
The technology has been absorbed so comprehensively that the jury on the potential impact on young people is not just out, it’s yet to be empanelled.
”The million-dollar question is whether there are risks in the transfer of real time to online time and the answer is that we just don’t know,” says Andrew Campbell, a child and adolescent psychologist….
Authoritative standards on appropriate levels of use are limited. The American Academy of Paediatrics recommends parents discourage TV for children under two and limit screen time for older children to less than two hours a day.
The guidelines, says Professor Rosen, are ”ludicrous” but the need for them and constant communication with young people about technology and how they use it, remains. ”It’s no longer OK to start talking to your kids about technology when they’re in their teens. You have to start talking to them about it as soon as you hand them your iPhone or let them watch television or Skype with grandma,” he says.
He suggests a ratio of screen time to other activities of 1:5 for very young children, 1:1 for pre-teens and 5:1 for teenagers. Parents should have weekly talks with their children from the start, looking for signs of obsession, addiction and lack of attention. http://www.smh.com.au/technology/technology-news/the-screens-that-are-stealing-childhood-20120528-1zffr.html

See, Technology Could Lead to Overstimulation in Kids http://www.educationnews.org/parenting/technology-could-lead-to-overstimulation-in-kids/

Science Daily reported in Screen-based media associated with structural differences in brains of young children:

A new study documents structural differences in the brains of preschool-age children related to screen-based media use.
The study, published in JAMA Pediatrics, shows that children who have more screen time have lower structural integrity of white matter tracts in parts of the brain that support language and other emergent literacy skills. These skills include imagery and executive function — the process involving mental control and self-regulation. These children also have lower scores on language and literacy measures.
The Cincinnati Children’s Hospital Medical Center study assessed screen time in terms of American Academy of Pediatrics (AAP) recommendations. The AAP recommendations not only take into account time spent in front of screens but also access to screens, including portable devices; content; and who children are with and how they interact when they are looking at screens.
“This study raises questions as to whether at least some aspects of screen-based media use in early childhood may provide sub-optimal stimulation during this rapid, formative state of brain development,” says John Hutton, MD, director of the, Reading & Literacy Discovery Center at Cincinnati Children’s and lead author of the study. “While we can’t yet determine whether screen time causes these structural changes or implies long-term neurodevelopmental risks, these findings warrant further study to understand what they mean and how to set appropriate limits on technology use….” https://www.sciencedaily.com/releases/2019/11/191104112918.htm

Citation:

Screen-based media associated with structural differences in brains of young children
Date: November 4, 2019
Source: Cincinnati Children’s Hospital Medical Center
Summary:
A new study documents structural differences in the brains of preschool-age children related to screen-based media use.

Journal Reference:
John S. Hutton, Jonathan Dudley, Tzipi Horowitz-Kraus, Tom DeWitt, Scott K. Holland. Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children. JAMA Pediatrics, 2019; e193869 DOI: 10.1001/jamapediatrics.2019.3869

Here is the press release from Cincinnati Children’s Hospital Medical Center:

Screen-based media associated with structural differences in brains of young children
by Cincinnati Children’s Hospital Medical Center

The study, published in JAMA Pediatrics, shows that children who have more screen time have lower structural integrity of white matter tracts in parts of the brain that support language and other emergent literacy skills. These skills include imagery and executive function—the process involving mental control and self-regulation. These children also have lower scores on language and literacy measures.
The Cincinnati Children’s Hospital Medical Center study assessed screen time in terms of American Academy of Pediatrics (AAP) recommendations. The AAP recommendations not only take into account time spent in front of screens but also access to screens, including portable devices; content; and who children are with and how they interact when they are looking at screens.
“This study raises questions as to whether at least some aspects of screen-based media use in early childhood may provide sub-optimal stimulation during this rapid, formative state of brain development,” says John Hutton, MD, director of the, Reading & Literacy Discovery Center at Cincinnati Children’s and lead author of the study. “While we can’t yet determine whether screen time causes these structural changes or implies long-term neurodevelopmental risks, these findings warrant further study to understand what they mean and how to set appropriate limits on technology use.”
Among the AAP recommendations:
• For children younger than 18 months, avoid use of screen media other than video-chatting. Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they’re seeing.
• For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
• Designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms.
• Higher ScreenQ scores were associated with lower brain white matter integrity, which affects organization and myelination—the process of forming a myelin sheath around a nerve to allow nerve impulses to move more quickly—in tracts involving language executive function and other literacy skills.
“Screen-based media use is prevalent and increasing in home, childcare and school settings at ever younger ages,” says Dr. Hutton. “These findings highlight the need to understand effects of screen time on the brain, particularly during stages of dynamic brain development in early childhood, so that providers, policymakers and parents can set healthy limits.”
________________________________________
Explore further
New studies measure screen-based media use in children https://medicalxpress.com/news/2018-05-screen-based-media-children.html
________________________________________
Journal information: JAMA Pediatrics
Provided by Cincinnati Children’s Hospital Medical Center https://medicalxpress.com/news/2019-11-screen-based-media-differences-brains-young.html

There is something to be said for Cafe Society where people actually meet face-to-face for conversation or the custom of families eating at least one meal together. Time has a good article on The Magic of the Family Meal http://content.time.com/time/magazine/article/0,9171,1200760,00.html See, also Family Dinner: The Value of Sharing Meals http://www.ivillage.com/family-dinner-value-sharing-meals/6-a-128491
Perhaps, acting like the power is out from time to time and using Helen Robin’s suggestions is not such a bad idea.

Related:

Two studies: Social media and social dysfunction https://drwilda.com/2013/04/13/two-studies-social-media-and-social-dysfunction/

Common Sense Media report: Kids migrating away from Facebook
https://drwilda.com/tag/the-impact-of-social-media-use-on-children/

Is ‘texting’ destroying literacy skills https://drwilda.com/2012/07/30/is-texting-destroying-literacy-skills/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART ©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Rensselaer Polytechnic Institute and Yale School of Medicine study: Living skin can now be 3D-printed with blood vessels included

2 Nov

Debra Stang wrote in the Heathline article, Skin Graft, which was Medically reviewed by Catherine Hannan, MD on May 30, 2017:

What is a skin graft?
Skin grafting is a surgical procedure that involves removing skin from one area of the body and moving it, or transplanting it, to a different area of the body. This surgery may be done if a part of your body has lost its protective covering of skin due to burns, injury, or illness.
Skin grafts are performed in a hospital. Most skin grafts are done using general anesthesia, which means you’ll be asleep throughout the procedure and won’t feel any pain.
Why are skin grafts done?
A skin graft is placed over an area of the body where skin has been lost. Common reasons for a skin graft include:
• skin infections
• deep burns
• large, open wounds
• bed sores or other ulcers on the skin that haven’t healed well
• skin cancer surgery
Types of skin grafts
There are two basic types of skin grafts: split-thickness and full-thickness grafts.
Split-thickness grafts
A split-thickness graft involves removing the top layer of the skin — the epidermis — as well as a portion of the deeper layer of the skin, called the dermis. These layers are taken from the donor site, which is the area where the healthy skin is located. Split-thickness skin grafts are usually harvested from the front or outer thigh, abdomen, buttocks, or back.
Split-thickness grafts are used to cover large areas. These grafts tend to be fragile and typically have a shiny or smooth appearance. They may also appear paler than the adjoining skin. Split-thickness grafts don’t grow as readily as ungrafted skin, so children who get them may need additional grafts as they grow older.
Full-thickness grafts
A full-thickness graft involves removing all of the epidermis and dermis from the donor site. These are usually taken from the abdomen, groin, forearm, or area above the clavicle (collarbone). They tend to be smaller pieces of skin, as the donor site from where it’s harvested is usually pulled together and closed in a straight-line incision with stitches or staples.
Full-thickness grafts are generally used for small wounds on highly visible parts of the body, such as the face. Unlike split-thickness grafts, full-thickness grafts blend in well with the skin around them and tend to have a better cosmetic outcome…. https://www.healthline.com/health/skin-graft#types
See, Skin Graft Ruka Shimizu and Kazuo Kishi* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335647/
Tyler Lacoma wrote in What is 3D printing? Here’s everything you need to know:
3D printing is a manufacturing process that creates a three dimensional object by incrementally adding material until the object is complete (this contrasts with subtractive manufacturing techniques such as carving or milling, in which an object is created by selectively removing parts from a piece of raw material). A 3D printer is simply a machine that can take a digital 3D model and turn it into a tangible 3D object via additive manufacturing. While these printers come in many forms, they all have three basic parts….
It’s hard to find a sector that hasn’t been affected by 3D printing. Manufacturing processes around the world have adopted 3D printing techniques to help solve their problems and improve efficiency. When used in mass production, 3D printing tends to be cheaper than any other method. When used to create prototypes, it’s typically the fastest option. But that’s just the beginning! Check just a few of the incredible ways that 3D printing is currently being used.
 Shoes: Companies like Feetz and 3D Shoes manufacture 3D-printed shoes on demand, with plenty of customization options. Bigger brands are getting into the business, too!
 Houses: Yes, we are printing 3D houses now, too! In fact, manufacturer Apis Ctor has developed a house that can be printed and painted in 24 hours.
 Healthcare materials: Common, disposable healthcare objectives, like sample cups, now often come from 3D printing systems. In the prosthetics world, 3D printing is used to create customized prosthetics for individual’s unique bodies and requirements. Advanced systems are even creating 3D skin grafts made out of biological ink.
 Custom ordering: At home or work and feeling left out of the 3D printing business? Thousands of printing companies now offer 3D printing where you specify objects, materials, and place your order online.
 Set Design: Set design and prop-making have fully embraced 3D printing as a far cheaper, faster way to create very specific props for today’s shows and theater. Think how much easier it is to create an alien environment when you can draw, program, and print a usable version of even the most outlandish or historical objects in no time at all! https://www.digitaltrends.com/computing/what-is-3d-printing/

Resources:

Medical Applications of 3D Printing https://www.fda.gov/medical-devices/3d-printing-medical-devices/medical-applications-3d-printing
3D printing in medicine: How the technology is increasingly being used to save lives https://binged.it/2WJ7WsA

3D Printing in Medicine: The Best Applications in 2019                                https://all3dp.com/2/3d-printing-in-medicine-the-best-applications/

Science Daily reported the Rensselaer Polytechnic Institute study: Living skin can now be 3D-printed with blood vessels included

Researchers at Rensselaer Polytechnic Institute have developed a way to 3D print living skin, complete with blood vessels. The advancement, published online today in Tissue Engineering Part A, is a significant step toward creating grafts that are more like the skin our bodies produce naturally.
“Right now, whatever is available as a clinical product is more like a fancy Band-Aid,” said Pankaj Karande, an associate professor of chemical and biological engineering and member of the Center for Biotechnology and Interdisciplinary Studies (CBIS), who led this research at Rensselaer. “It provides some accelerated wound healing, but eventually it just falls off; it never really integrates with the host cells.”
A significant barrier to that integration has been the absence of a functioning vascular system in the skin grafts.
Karande has been working on this challenge for several years, previously publishing one of the first papers showing that researchers could take two types of living human cells, make them into “bio-inks,” and print them into a skin-like structure. Since then, he and his team have been working with researchers from Yale School of Medicine to incorporate vasculature.
In this paper, the researchers show that if they add key elements — including human endothelial cells, which line the inside of blood vessels, and human pericyte cells, which wrap around the endothelial cells — with animal collagen and other structural cells typically found in a skin graft, the cells start communicating and forming a biologically relevant vascular structure within the span of a few weeks. You can watch Karande explain this development here.
“As engineers working to recreate biology, we’ve always appreciated and been aware of the fact that biology is far more complex than the simple systems we make in the lab,” Karande said. “We were pleasantly surprised to find that, once we start approaching that complexity, biology takes over and starts getting closer and closer to what exists in nature.”
Once the Yale team grafted it onto a special type of mouse, the vessels from the skin printed by the Rensselaer team began to communicate and connect with the mouse’s own vessels.
“That’s extremely important, because we know there is actually a transfer of blood and nutrients to the graft which is keeping the graft alive,” Karande said.
In order to make this usable at a clinical level, researchers need to be able to edit the donor cells using something like the CRISPR technology, so that the vessels can integrate and be accepted by the patient’s body.
“We are still not at that step, but we are one step closer,” Karande said.
“This significant development highlights the vast potential of 3D bioprinting in precision medicine, where solutions can be tailored to specific situations and eventually to individuals,” said Deepak Vashishth, the director CBIS. “This is a perfect example of how engineers at Rensselaer are solving challenges related to human health….” https://www.sciencedaily.com/releases/2019/11/191101111556.htm

Citation:

Living skin can now be 3D-printed with blood vessels included
Development is significant step toward skin grafts that can be integrated into patient’s skin
Date: November 1, 2019
Source: Rensselaer Polytechnic Institute
Summary:
Researchers have developed a way to 3D print living skin, complete with blood vessels. The advancement is a significant step toward creating grafts that are more like the skin our bodies produce naturally.

Journal Reference:
Tânia Baltazar, Jonathan Merola, Carolina Motter Catarino, Catherine Bingchan Xie, Nancy Kirkiles-Smith, Vivian Lee, Stéphanie Yuki Kolbeck Hotta, Guohao Dai, Xiaowei Xu, Frederico Castelo Ferreira, W Mark Saltzman, Jordan S Pober, Pankaj Karande. 3D bioprinting of a vascularized and perfusable skin graft using human keratinocytes, (..). Tissue Engineering Part A, 2019; DOI: 10.1089/ten.TEA.2019.0201

Here is the press release from Rensselaer Polytechnic Institute:

November 1, 2019
Living Skin Can Now be 3D-Printed With Blood Vessels Included
Development is significant step toward skin grafts that can be integrated into patient’s skin

TROY, N.Y. — Researchers at Rensselaer Polytechnic Institute have developed a way to 3D print living skin, complete with blood vessels. The advancement, published online today in Tissue Engineering Part A, is a significant step toward creating grafts that are more like the skin our bodies produce naturally.
“Right now, whatever is available as a clinical product is more like a fancy Band-Aid,” said Pankaj Karande, an associate professor of chemical and biological engineering and member of the Center for Biotechnology and Interdisciplinary Studies (CBIS), who led this research at Rensselaer. “It provides some accelerated wound healing, but eventually it just falls off; it never really integrates with the host cells.”
A significant barrier to that integration has been the absence of a functioning vascular system in the skin grafts.
Karande has been working on this challenge for several years, previously publishing one of the first papers showing that researchers could take two types of living human cells, make them into “bio-inks,” and print them into a skin-like structure. Since then, he and his team have been working with researchers from Yale School of Medicine to incorporate vasculature.
In this paper, the researchers show that if they add key elements — including human endothelial cells, which line the inside of blood vessels, and human pericyte cells, which wrap around the endothelial cells — with animal collagen and other structural cells typically found in a skin graft, the cells start communicating and forming a biologically relevant vascular structure within the span of a few weeks.
Watch Karande explain this development:
“As engineers working to recreate biology, we’ve always appreciated and been aware of the fact that biology is far more complex than the simple systems we make in the lab,” Karande said. “We were pleasantly surprised to find that, once we start approaching that complexity, biology takes over and starts getting closer and closer to what exists in nature.”
Once the Yale team grafted it onto a special type of mouse, the vessels from the skin printed by the Rensselaer team began to communicate and connect with the mouse’s own vessels.
“That’s extremely important, because we know there is actually a transfer of blood and nutrients to the graft which is keeping the graft alive,” Karande said.
In order to make this usable at a clinical level, researchers need to be able to edit the donor cells using something like the CRISPR technology, so that the vessels can integrate and be accepted by the patient’s body.
“We are still not at that step, but we are one step closer,” Karande said.
“This significant development highlights the vast potential of 3D bioprinting in precision medicine, where solutions can be tailored to specific situations and eventually to individuals,” said Deepak Vashishth, the director CBIS. “This is a perfect example of how engineers at Rensselaer are solving challenges related to human health.”
Karande said more work will need to be done to address the challenges associated with burn patients, which include the loss of nerve and vascular endings. But the grafts his team has created bring researchers closer to helping people with more discrete issues, like diabetic or pressure ulcers.
“For those patients, these would be perfect, because ulcers usually appear at distinct locations on the body and can be addressed with smaller pieces of skin,” Karande said. “Wound healing typically takes longer in diabetic patients, and this could also help to accelerate that process.”
At Rensselaer, Karande’s team also includes Carolina Catarino, doctoral student in chemical and biological engineering. The Yale team includes Tania Baltazar, a postdoctoral researcher who previously worked on this project at Rensselaer; Dr. Jordan Pober, a professor of immunobiology; and Mark Saltzman, a professor of biomedical engineering.
This work was supported by a grant from the National Institutes of Health.
CONTACT
Reeve Hamilton
Director of Media Relations and Communications
(518) 833-4277
hamilr5@rpi.edu
For general inquiries: newsmedia@rpi.edu
ABOUT RENSSELAER POLYTECHNIC INSTITUTE
Founded in 1824, Rensselaer Polytechnic Institute is America’s first technological research university. Rensselaer encompasses five schools, 32 research centers, more than 145 academic programs, and a dynamic community made up of more than 7,900 students and more than 100,000 living alumni. Rensselaer faculty and alumni include more than 145 National Academy members, six members of the National Inventors Hall of Fame, six National Medal of Technology winners, five National Medal of Science winners, and a Nobel Prize winner in Physics. With nearly 200 years of experience advancing scientific and technological knowledge, Rensselaer remains focused on addressing global challenges with a spirit of ingenuity and collaboration.

Jeff Kerns wrote in A Look at the Future of Medical 3D Printing, Part 1: Science fiction continues to become reality as 3D printing cuts deeper into the medical industry:

Available Soon
Unveiled at the Radiological Society of North America’s 2017 show, Stratasys unveiled 3D-printed anatomical structures, including disease pathologies that mimic the look and feel of biological parts to accelerate guidance, testing, and education. Engineered in conjunction with top researchers and manufacturers, service initially includes fully functional bone and heart models, with vascular structures expected in early 2018. This technology will eliminate restrictions associated with research on animal, mannequin, or cadaver models—BioMimics effectively mirrors intricacies of both soft tissue and hard bones via multi-material 3D printing.
These are only models, so regulations are fewer than if you were 3D printing the actual organs to go into a patient. While there are recently published reviews describing the use of 3D printing to produce bones, ears, windpipes, jawbones, cells, blood vessels, and more, it will take time before this technology is common practice. An estimate published by the U.S. National Library of Medicine National Institute of Health says that we are less than 20 years from a fully functioning printable heart.
However, it should be cautioned that despite recent significant and exciting medical advances involving 3D printing, notable scientific and regulatory challenges remain, and the most transformative applications for this technology will need time to evolve.
In our next installment, the future of 3D printing tissues, organs, and custom pharmaceuticals will be discussed. Many professionals say 3D printing is getting a lot of hype, but it will be a long time before we start seeing 3D-printed organs. However, the fact that they seem to be saying “It will take a long time,” and not “This will never happen,” is exciting enough. Also, the idea that we may see printed bone and tissue earlier than when organ printing was predicted make it hard not to justify the hype around this technology.
But for the time being, we’ll just need to keep eating right and exercising.
https://www.machinedesign.com/3d-printing/look-future-medical-3d-printing-part-1

Exploration is the engine that drives innovation. Innovation drives economic growth. So let’s all go exploring.
Edith Widder

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Lancet study: Insufficient evidence that medicinal cannabinoids improve mental health

30 Oct

The National Institute on Drug (NIH) Abuse article What is medical marijuana?

The term medical marijuana refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions. The U.S. Food and Drug Administration (FDA) has not recognized or approved the marijuana plant as medicine.
However, scientific study of the chemicals in marijuana, called cannabinoids, has led to two FDA-approved medications that contain cannabinoid chemicals in pill form. Continued research may lead to more medications.
Because the marijuana plant contains chemicals that may help treat a range of illnesses and symptoms, many people argue that it should be legal for medical purposes. In fact, a growing number of states have legalized marijuana for medical use.
Why isn’t the marijuana plant an FDA-approved medicine?
The FDA requires carefully conducted studies (clinical trials) in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication. So far, researchers haven’t conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its cannabinoid ingredients) outweigh its risks in patients it’s meant to treat.
Read more about the various physical, mental, and behavioral effects of marijuana in our Marijuana DrugFacts.
Medical Marijuana Laws and Prescription Opioid Use Outcomes
A new study underscores the need for additional research on the effect of medical marijuana laws on opioid overdose deaths and cautions against drawing a causal connection between the two. Early research suggested that there may be a relationship between the availability of medical marijuana and opioid analgesic overdose mortality. In particular, a NIDA-funded study published in 2014 found that from 1999 to 2010, states with medical cannabis laws experienced slower rates of increase in opioid analgesic overdose death rates compared to states without such laws.1
A 2019 analysis, also funded by NIDA, re-examined this relationship using data through 2017. Similar to the findings reported previously, this research team found that opioid overdose mortality rates between 1999-2010 in states allowing medical marijuana use were 21% lower than expected. When the analysis was extended through 2017, however, they found that the trend reversed, such that states with medical cannabis laws experienced an overdose death rate 22.7% higher than expected.2 The investigators uncovered no evidence that either broader cannabis laws (those allowing recreational use) or more restrictive laws (those only permitting the use of marijuana with low tetrahydrocannabinol concentrations) were associated with changes in opioid overdose mortality rates.
These data, therefore, do not support the interpretation that access to cannabis reduces opioid overdose. Indeed, the authors note that neither study provides evidence of a causal relationship between marijuana access and opioid overdose deaths. Rather, they suggest that the associations are likely due to factors the researchers did not measure, and they caution against drawing conclusions on an individual level from ecological (population-level) data. Research is still needed on the potential medical benefits of cannabis or cannabinoids.
Read more in our Marijuana Research Report. https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine

Resources:

Marijuana medical benefits – large review finds very few https://www.skepticalraptor.com/skepticalraptorblog.php/marijuana-medical-benefits-large-review/

Marijuana and Cannabinoids | NCCIH
https://nccih.nih.gov/health/marijuana

Science Daily reported the Lancet study: Insufficient evidence that medicinal cannabinoids improve mental health:

Meta-analysis finds inadequate evidence that cannabinoids relieve depression, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis.
The most comprehensive analysis of medicinal cannabinoids and their impact on six mental health disorders — combining 83 studies including 3,000 people — suggests that the use of cannabinoids for mental health conditions cannot be justified based on the current evidence. This is due to a lack of evidence for their effectiveness, and because of the known risks of cannabinoids.
The new findings, published in The Lancet Psychiatry journal, find insufficient evidence medicinal cannabinoids improve disorders overall or their symptoms, although there is a very low quality evidence that pharmaceutical tetrahydrocannabinol (THC) may lead to a small improvement in symptoms of anxiety in individuals with other medical conditions, such as chronic pain or multiple sclerosis.
Medicinal cannabinoids include medicinal cannabis and pharmaceutical cannabinoids, and their synthetic derivatives, THC and cannabidiol (CBD). Around the world, these are increasingly being made available for medicinal purposes (e.g. in the United States, Australia, and Canada), including for the treatment of mental health disorders. However, there are concerns around the adverse effects of this availability, as there is a large body of evidence indicating that non-medicinal cannabis use can increase the occurrence of depression, anxiety, and psychotic symptoms.
Professor Louisa Degenhardt of the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney, Australia, and lead author of the study says: “Our findings have important implications in countries where cannabis and cannabinoids are being made available for medical use. There is a notable absence of high-quality evidence to properly assess the effectiveness and safety of medicinal cannabinoids compared with placebo, and until evidence from randomised controlled trials is available, clinical guidelines cannot be drawn up around their use in mental health disorders.”
She continues: “In countries where medicinal cannabinoids are already legal, doctors and patients must be aware of the limitations of existing evidence and the risks of cannabinoids. These must be weighed when considering use to treat symptoms of common mental health disorders. Those who decide to proceed should be carefully monitored for positive and negative mental health effects of using medicinal cannabinoids.”
This study follows The Lancet Series on Drug Use, which includes a paper on cannabis where the authors assess the current and possible future public health impacts of the legalisation of cannabis production, sale, and use in the Americas. They summarise the overall evidence on medicinal use of cannabinoids, regulation, and how medicinal use may have affected recreational use.
The authors set out to examine the available evidence for all types of medicinal cannabinoids. They included all study designs and investigated the impact on remission from and symptoms of six mental health disorders in adults: depression, anxiety, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, post-traumatic stress disorder (PTSD), and psychosis.
They included published and unpublished studies between 1980 and 2018 and included 83 eligible studies, 40 of which were randomised controlled trials (RCTs) (the others were open-label trials, where participants knew which treatment they were taking). Of the 83 studies, 42 looked at depression (including 23 RCTs), 31 looked at anxiety (17 RCTs), eight looked at Tourette syndrome (two RCTs), three were on ADHD (one RCT), 12 were on PTSD (one RCT), and 11 were on psychosis (six RCTs).
In most RCTs examining depression and anxiety, the primary reason for cannabinoid use was for another medical condition such as chronic non-cancer pain or multiple sclerosis. In the studies looking at the other four disorders, the cannabinoid was used to treat the mental health disorder. Few randomised controlled trials examined the role of pharmaceutical CBD or medicinal cannabis; most looked at THC, with or without CBD.
The authors found that pharmaceutical THC (with or without CBD) improved anxiety symptoms among individuals with other medical conditions (seven studies of 252 people), though this may have been due to improvements in the primary medical condition. The authors suggest further research should explicitly study the effects of cannabinoids on anxiety and depression…. https://www.sciencedaily.com/releases/2019/10/191028213912.htm

Citation:

Insufficient evidence that medicinal cannabinoids improve mental health
Date: October 28, 2019
Source: The Lancet
Summary:
The most comprehensive analysis of medicinal cannabinoids and their impact on six mental health disorders — combining 83 studies including 3,000 people — suggests that the use of cannabinoids for mental health conditions cannot be justified based on the current evidence. This is due to a lack of evidence for their effectiveness, and because of the known risks of cannabinoids.

Journal Reference:
Nicola Black, Emily Stockings, Gabrielle Campbell, Lucy T Tran, Dino Zagic, Wayne D Hall, Michael Farrell, Louisa Degenhardt. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. The Lancet Psychiatry, 2019; DOI: 10.1016/S2215-0366(19)30401-8

Here is the press release from the Lancet:

NEWS RELEASE 28-OCT-2019

The Lancet Psychiatry: Insufficient evidence that medicinal cannabinoids improve mental health

Meta-analysis finds inadequate evidence that cannabinoids relieve depression, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis
THE LANCET
Meta-analysis finds inadequate evidence that cannabinoids relieve depression, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis.
The most comprehensive analysis of medicinal cannabinoids and their impact on six mental health disorders – combining 83 studies including 3,000 people – suggests that the use of cannabinoids for mental health conditions cannot be justified based on the current evidence. This is due to a lack of evidence for their effectiveness, and because of the known risks of cannabinoids.
The new findings, published in The Lancet Psychiatry journal, find insufficient evidence medicinal cannabinoids improve disorders overall or their symptoms, although there is a very low quality evidence that pharmaceutical tetrahydrocannabinol (THC) may lead to a small improvement in symptoms of anxiety in individuals with other medical conditions, such as chronic pain or multiple sclerosis.
Medicinal cannabinoids include medicinal cannabis and pharmaceutical cannabinoids, and their synthetic derivatives, THC and cannabidiol (CBD). Around the world, these are increasingly being made available for medicinal purposes (e.g. in the United States, Australia, and Canada), including for the treatment of mental health disorders. However, there are concerns around the adverse effects of this availability, as there is a large body of evidence indicating that non-medicinal cannabis use can increase the occurrence of depression, anxiety, and psychotic symptoms.
Professor Louisa Degenhardt of the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney, Australia, and lead author of the study says: “Our findings have important implications in countries where cannabis and cannabinoids are being made available for medical use. There is a notable absence of high-quality evidence to properly assess the effectiveness and safety of medicinal cannabinoids compared with placebo, and until evidence from randomised controlled trials is available, clinical guidelines cannot be drawn up around their use in mental health disorders.” [1]
She continues: “In countries where medicinal cannabinoids are already legal, doctors and patients must be aware of the limitations of existing evidence and the risks of cannabinoids. These must be weighed when considering use to treat symptoms of common mental health disorders. Those who decide to proceed should be carefully monitored for positive and negative mental health effects of using medicinal cannabinoids.” [1]
This study follows The Lancet Series on Drug Use, which includes a paper on cannabis where the authors assess the current and possible future public health impacts of the legalisation of cannabis production, sale, and use in the Americas. They summarise the overall evidence on medicinal use of cannabinoids, regulation, and how medicinal use may have affected recreational use. [2]
The authors set out to examine the available evidence for all types of medicinal cannabinoids. They included all study designs and investigated the impact on remission from and symptoms of six mental health disorders in adults: depression, anxiety, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, post-traumatic stress disorder (PTSD), and psychosis.
They included published and unpublished studies between 1980 and 2018 and included 83 eligible studies, 40 of which were randomised controlled trials (RCTs) (the others were open-label trials, where participants knew which treatment they were taking). Of the 83 studies, 42 looked at depression (including 23 RCTs), 31 looked at anxiety (17 RCTs), eight looked at Tourette syndrome (two RCTs), three were on ADHD (one RCT), 12 were on PTSD (one RCT), and 11 were on psychosis (six RCTs).
In most RCTs examining depression and anxiety, the primary reason for cannabinoid use was for another medical condition such as chronic non-cancer pain or multiple sclerosis. In the studies looking at the other four disorders, the cannabinoid was used to treat the mental health disorder. Few randomised controlled trials examined the role of pharmaceutical CBD or medicinal cannabis; most looked at THC, with or without CBD.
The authors found that pharmaceutical THC (with or without CBD) improved anxiety symptoms among individuals with other medical conditions (seven studies of 252 people), though this may have been due to improvements in the primary medical condition. The authors suggest further research should explicitly study the effects of cannabinoids on anxiety and depression.
Pharmaceutical THC (with or without CBD) worsened negative symptoms of psychosis (one study, 24 people) and did not significantly affect any other primary outcomes for the mental health disorders examined. It also increased the number of people who had adverse events (ten studies; 1,495 people) and withdrawals due to adverse events (11 studies; 1,621 people) compared with placebo across all mental health disorders examined.
The study highlights the limited evidence and the low quality of the evidence that exists around using cannabinoids for treatment of mental health conditions. There is a need for high-quality research to understand the effects of different cannabinoids on a range of outcomes for people with mental health disorders.
Professor Degenhardt says: “Cannabinoids are often advocated as a treatment for various mental health conditions. Countries that allow medicinal cannabinoid use will probably see increased demand for such use. Clinicians and consumers need to be aware of the low quality and quantity of evidence for the effectiveness of medicinal cannabinoids in treating mental health disorders and the potential risk of adverse events. Given the likely interest but scant evidence to guide patient and clinician decisions around cannabinoids for mental health, there is an urgent need for randomised controlled trials to inform whether there are benefits of cannabinoids for these indications.” [1]
The authors highlight that their analysis and conclusions are limited by the small amount of available data, small study sizes, and the differences in findings between small studies. There is no recommended approach for addressing these issues in systematic reviews, but they tried to minimise them by keeping the focus of the review narrow. They also note that most studies are based on pharmaceutical cannabinoids, rather than medicinal cannabis, but plant products are most often used by those taking cannabinoids for medicinal purposes in the USA.
In a related Comment article, Professor Deepak Cyril D’Souza of Yale University School of Medicine, USA, says: “The process of drug development in modern medicine is to first demonstrate efficacy and safety in clinical trials before using the drug clinically. With cannabinoids, it seems that the cart (use) is before the horse (evidence). For cannabinoids to be used in the treatment of psychiatric disorders they should be tested in RCTs and subjected to the same regulatory approval process as other prescription medications.”
###
NOTES TO EDITORS
This study was funded by Australian Therapeutic Goods Administration, the Commonwealth Department of Health, Australia, Australian National Health and Medical Research Council and the US National Institutes of Health. It was conducted by researchers from the National Drug and Alcohol Research Centre, UNSW, the University of Brisbane, Australia and King’s College London, UK.
The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf if you have any questions or feedback, please contact The Lancet press office pressoffice@lancet.com
[1] Quote direct from author and cannot be found in the text of the Article.
[2] Paper available here (begins page 29): http://www.thelancet-press.com/embargo/EMBARGOED-druguseseries.pdf
A press release for this report is also available.
Peer-reviewed / Meta-analysis / People
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

The Centers for Disease Control and Addiction wrote in Marijuana: How Can It Affect Your Health?

Marijuana is the most commonly used illegal drug in the United States, with 37.6 million users in the past year,1 and marijuana use may have a wide range of health effects on the body and brain. Click on the sections below to learn more about how marijuana use can affect your health.
ADDICTION
About 1 in 10 marijuana users will become addicted. For people who begin using before the age of 18, that number rises to 1 in 6. 1-3
Some of the signs that someone might be addicted include:
• Unsuccessful efforts to quit using marijuana.
• Giving up important activities with friends and family in favor of using marijuana.
• Using marijuana even when it is known that it causes problems fulfilling everyday jobs at home, school or work.4
People who are addicted to marijuana may also be at a higher risk of other negative consequences of using the drug, such as problems with attention, memory, and learning. Some people who are addicted need to smoke more and more marijuana to get the same high. It is also important to be aware that the amount of tetrahydrocannabinol (THC) in marijuana (i.e., marijuana potency or strength) has increased over the past few decades. The higher the THC content, the stronger the effects on the brain. In addition, some methods of using marijuana (e.g., dabbing, edibles) may deliver very high levels of THC to the user.5 Researchers do not yet know the full extent of the consequences when the body and brain (especially the developing brain) are exposed to high concentrations of THC or how recent increases in potency affect the risk of someone becoming addicted. 5
References
1. Lopez-Quintero, C, et al. (2011). Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend. 115(1-2): p. 120-30.
2. Hall, W, Degenhardt L. (2009). Adverse health effects of non-medical cannabis use. Lancet. 374(9698): p. 1383-91.
3. Budney, AJ, Sargent JD, and Lee, DC. (2015). Vaping cannabis (marijuana): parallel concerns to e-cigs? Addiction. 110(11): p. 1699-704.
4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
5. National Institute on Drug Abuse. Is marijuana addictive?external icon (2017) Rockville, MD: National Institutes of Health, National Institute on Drug Abuse.
BRAIN HEALTH
Marijuana use directly affects the brain — specifically the parts of the brain responsible for memory, learning, attention, decision making, coordination, emotions, and reaction time.1
What are the short-term effects of marijuana on the brain?
Heavy users of marijuana can have short-term problems with attention, memory, and learning, which can affect relationships and mood.
What are the long-term effects of marijuana on the brain?
Marijuana also affects brain development. When marijuana users begin using as teenagers, the drug may reduce attention, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions.
Marijuana’s effects on these abilities may last a long time or even be permanent. This means that someone who uses marijuana may not do as well in school and may have trouble remembering things. 1-3
The impact depends on many factors and is different for each person. It also depends on the amount of tetrahydrocannabinol (THC) in marijuana (i.e., marijuana potency or strength), how often it is used, the age of first use, and whether other substances (e.g., tobacco and alcohol) are used at the same time.
Marijuana and the developing brain
Developing brains, like those in babies, children, and teenagers are especially susceptible to the hurtful effects of marijuana. Although scientists are still learning about these effects of marijuana on the developing brain, studies show that marijuana use by mothers during pregnancy may be linked to problems with attention, memory, problem-solving skills, and behavior problems in their children. 3-7
References
1. Batalla A, Bhattacharyya S, Yücel M, et al. (2013). Structural and functional imaging studies in chronic cannabis users: a systematic review of adolescent and adult findings. PloS One. 8(2):e55821. doi:10.1371/journal.pone.0055821.
2. Filbey, FM, et al., Long-term effects of marijuana use on the brain. (2014) Proc Natl Acad Sci USA. 111(47): p. 16913-8.
3. Goldschmidt, L, et al. (2002). Richardson, Effects of prenatal marijuana exposure on child behavior problems at age 10. Neurotoxicol Teratol. 22(3): p. 325-36.
4. Fried, PA, Watkinson, B, and Gray, R. Differential effects on cognitive functioning in 9- to 12-year olds prenatally exposed to cigarettes and marihuana. Neurotoxicol Teratol, 1998. 20(3): p. 293-306.
5. Leech, SL, et al., (1999). Prenatal substance exposure: effects on attention and impulsivity of 6-year-olds. Neurotoxicol Teratol. 21(2): p. 109-18.
6. Goldschmidt, L, et al., (2008) Prenatal marijuana exposure and intelligence test performance at age 6. J Am Acad Child Adolesc Psychiatry. 47(3): p. 254-63.
7. El Marroun, H, et al., (2011). Intrauterine cannabis exposure leads to more aggressive behavior and attention problems in 18-month-old girls. Drug Alcohol Depend. 118(2-3): p. 470-4.
CANCER
Marijuana and cannabinoids (the active chemicals in marijuana that cause drug-like effects throughout the body, including the central nervous system and the immune system). The main active cannabinoid in marijuana is delta-9-THC. Another active cannabinoid is cannabidiol (CBD), which may relieve pain and lower inflammation without causing the “high” of delta-9-THC. Although marijuana and cannabinoids have been studied with respect to managing side effects of cancer and cancer therapies, there are no ongoing clinical trials of marijuana or cannabinoids in treating cancer in people.9 Studies so far have not shown that cannabinoids help control or cure the disease.2 And like many other drugs, marijuana can cause side effects and complications.
Relying on marijuana alone as treatment or for managing side effects while avoiding or delaying conventional medical care for cancer may have serious health consequences.2
How can marijuana affect symptoms of cancer?
Studies of man-made forms of the chemicals found in the marijuana plant can be helpful in treating nausea and vomiting from cancer chemotherapy.1 Studies have found that marijuana can be helpful in treating neuropathic pain (pain caused by damaged nerves).1
At this time, there is not enough evidence to recommend that patients inhale or ingest marijuana as a treatment for cancer-related symptoms or side effects of cancer therapy.
Is there a link between marijuana and cancer?
Smoked marijuana delivers THC and other cannabinoids to the body, but it also delivers harmful substances to users and those close by, including many of the same substances found in tobacco smoke, which are harmful to the lungs and cardiovascular system.3
Researchers have found limited evidence of an association between current, frequent, or chronic marijuana smoking and testicular cancer (non-seminoma-type).4
Because marijuana plants come in different strains with different levels of active chemicals, it can make each user’s experience very hard to predict. More research is needed to understand the full impact of marijuana use on cancer.
References
1. National Academies of Sciences E, and Medicine. (2017). The health effects of cannabis and cannabinoids: Current state of evidence and recommendations for researchexternal icon. Washington, D.C.
2. National Cancer Institute. (2017). Cannabis and Cannabinoids (PDQ®)–Patient Versionexternal icon. Rockville, MD: National Institutes of Health, National Cancer Institute.
3. U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General pdf icon[PDF – 36MB]external icon. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
4. Gurney, J, et al. (2015). Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 15: p. 897.
CHRONIC PAIN
Even though pain management is one of the most common reasons people use medical marijuana in the U.S., there is limited evidence that marijuana works to treat most types of chronic pain.
A few studies have found that marijuana can be helpful in treating neuropathic pain (pain caused by damaged nerves). 1 However, more research is needed to know if marijuana is any better or any worse than other options for managing chronic pain.
References
1. National Academies of Sciences E, and Medicine. (2017). The health effects of cannabis and cannabinoids: Current state of evidence and recommendations for researchexternal icon. Washington, D.C.
HEART HEALTH
Using marijuana makes the heart beat faster.1 It could also lead to increased risk of stroke and heart disease. 2-6 However, most of the scientific studies linking marijuana to heart attacks and strokes are based on reports from people who smoked it. Smoked marijuana delivers THC and other cannabinoids to the body, but it also delivers harmful substances to users and those close by, including many of the same substances found in tobacco smoke, which are harmful to the lungs and cardiovascular system. 3 So it’s hard to separate the effects of the compounds in marijuana on the cardiovascular system from the hazards posed by the irritants and other chemicals contained in the smoke. More research is needed to understand the full impact of marijuana use on the circulatory system to determine if marijuana use leads to higher risk of death from these causes.
References
1. Sidney, S. (2002) Cardiovascular consequences of marijuana use. J Clin Pharmacol. 42(11 Suppl): p. 64S-70S.
2. Wolff, V, et al. (2013). Cannabis-related stroke: myth or reality? Stroke. 44(2): p. 558-63.
3. Wolff, V, et al. (2015). Characteristics and Prognosis of Ischemic Stroke in Young Cannabis Users Compared With Non-Cannabis Users. J Am Coll Cardiol. 66(18): p. 2052-3.
4. Franz, CA and Frishman, WH. (2016) Marijuana Use and Cardiovascular Disease. Cardiol Rev. 24(4): p. 158-62.
5. Rumalla, K, Reddy, AY, and Mittal, MK. (2016). Recreational marijuana use and acute ischemic stroke: A population-based analysis of hospitalized patients in the United States. J Neurol Sci. 364: p. 191-6.
6. Rumalla, K, Reddy, AY, and Mittal, MK. (2016). Association of Recreational Marijuana Use with Aneurysmal Subarachnoid Hemorrhage. J Stroke Cerebrovasc Dis. 25(2): p. 452-60.
LUNG HEALTH
How marijuana affects lung health is determined by how it’s consumed. In many cases, marijuana is smoked in the form hand-rolled cigarettes (joints), in pipes or water pipes (bongs), in bowls, or in blunts—emptied cigars that have been partly or completely refilled with marijuana. Smoked marijuana, in any form, can harm lung tissues and cause scarring and damage to small blood vessels. 1-2 Smoke from marijuana contains many of the same toxins, irritants, and carcinogens as tobacco smoke. 3 Smoking marijuana can also lead to a greater risk of bronchitis, cough, and phlegm production. 4-8 These symptoms generally improve when marijuana smokers quit.9-10
Secondhand marijuana smoke
The known health risks of secondhand exposure to cigarette smoke—to the heart or lungs, for instance—raise questions about whether secondhand exposure to marijuana smoke poses similar health risks. While there is very little data on the health consequences of breathing secondhand marijuana smoke, there is concern that it could cause harmful health effects, including among children.
Recent studies have found strong associations between those who said there was someone in the home who used marijuana or a caretaker who used marijuana and the child having detectable levels of THC — the psychoactive ingredient in marijuana. 5,11 Children exposed to the psychoactive compounds in marijuana are potentially at risk for negative health effects, including developmental problems for babies whose mothers used marijuana while pregnant. 8 Other research shows that marijuana use during adolescence can impact the developing teenage brain and cause problems with attention, motivation, and memory.12
References
1. Tashkin, DP. (2013) Effects of marijuana smoking on the lung. Ann Am Thorac Soc. 10(3): p. 239-47.
2. Moir, D, et al. (2008). A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two machine smoking conditions. Chem Res Toxicol. 21(2): p. 494-502.
3. U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General pdf icon[PDF – 36MB]external icon. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
4. Aldington, S, et al., Effects of cannabis on pulmonary structure, function and symptoms. Thorax, 2007. 62(12): p. 1058-63.
5. Moore, C, et al. (2011). Cannabinoids in oral fluid following passive exposure to marijuana smoke. Forensic Sci Int. 212(1-3): p. 227-30.
6. Tan, WC, et al. (2009). Marijuana and chronic obstructive lung disease: a population-based study. CMAJ. 180(8): p. 814-20.
7. Taylor, DR, et al. (200). The respiratory effects of cannabis dependence in young adults. Addiction. 95(11): p. 1669-77.
8. National Academies of Sciences E, and Medicine. (2017). The health effects of cannabis and cannabinoids: Current state of evidence and recommendations for researchexternal icon. Washington, D.C.
9. Hancox, RJ, et al. (2015). Effects of quitting cannabis on respiratory symptoms. Eur Respir J, 2015. 46(1): p. 80-7.
10. Tashkin, DP, Simmons MS, and Tseng, CH. (2012). Impact of changes in regular use of marijuana and/or tobacco on chronic bronchitis. COPD. 9(4): p. 367-74.
11. Wilson KM, Torok MR, Wei B, et al. (2017). Detecting biomarkers of secondhand marijuana smoke in young children. Pediatr Res. 81:589–592.
12. Broyd, SJ, et al. (2016). Acute and Chronic Effects of Cannabinoids on Human Cognition-A Systematic Review. Biol Psychiatry. 79(7): p. 557-67.
MENTAL HEALTH
Marijuana use, especially frequent (daily or near daily) use and use in high doses, can cause disorientation, and sometimes cause unpleasant thoughts or feelings of anxiety and paranoia. 1
Marijuana users are significantly more likely than nonusers to develop temporary psychosis (not knowing what is real, hallucinations and paranoia) and long-lasting mental disorders, including schizophrenia (a type of mental illness where people might see or hear things that aren’t really there). 2
Marijuana use has also been linked to depression and anxiety, and suicide among teens. However, it is not known whether this is a causal relationship or simply an association.
References
1. National Academies of Sciences E, and Medicine. (2017). The health effects of cannabis and cannabinoids: Current state of evidence and recommendations for researchexternal icon. Washington, D.C.
2. Volkow ND, Swanson JM, Evins AE, et al. (2016). Effects of cannabis use on human behavior, including cognition, motivation, and psychosis: a review. JAMA Psychiatry. 73(3):292-297. doi:10.1001/jamapsychiatry.2015.3278.
POISONING
Edibles, or food and drink products infused with marijuana and eaten, have some different risks than smoking marijuana, including a greater risk of poisoning. Unlike smoked marijuana, edibles can:
• Take from 30 minutes to 2 hours to take effect. So some people eat too much, which can lead to poisoning and/or serious injury.
• Cause effects that last longer than expected depending on the amount, the last food eaten, and medications or alcohol used at the same time.
• Be very difficult to measure. The amount of THC, the active ingredient in marijuana, is very difficult to measure and is often unknown in edible products. Many users can be caught off-guard by the strength and long-lasting effects of edibles.
It is also important to remember that marijuana affects children differently than adults. Since marijuana has become legal in some states, children have accidentally eaten marijuana products that looked like candy and treats, which made them sick enough to need emergency medical care. 3
If you use marijuana products, keep them in childproof containers and out of the reach of children. For additional questions, you can contact your health care provider, your health department, the Poison Helplineexternal icon at 1-800-222-1222, or 911 if it’s an emergency.
RISK OF USING OTHER DRUGS
The concept of marijuana as a “gateway drug”—where using marijuana leads a person to use other drugs—generates a lot of disagreement. Researchers haven’t found a definite answer yet. 1-2 However, most people who use marijuana do not go on to use other, “harder” drugs. 1
It is important to remember that people of any age, sex, or economic status can become addicted to marijuana or other drugs. Things that can affect the likelihood of substance use include:
• Family history.
• Having another mental health illness (such as anxiety or depression).
• Peer pressure.
• Loneliness or social isolation.
• Lack of family involvement.
• Drug availability.
• Socioeconomic status. 2
References
1. National Institute on Drug Abuse. Is marijuana a gateway drug? (2017). Rockville, MD: National Institutes of Health, National Institute on Drug Abuse.
2. Robertson EB, David SL, Rao SA. (2003) Preventing Drug Use Among Children and Adolescents. A Research-Based Guide for Parents, Educators, and Community Leaders pdf icon[PDF-725KB]external icon. National Institute on Drug Abuse, 2nd edn. NIH Publication no. 04-4212 (A). Bethesda, MD: US Department of Health and Human Services.
3. Colorado Department of Public Health and Environment (2017) Monitoring Health Concerns Related to Marijuana in Colorado: 2016external icon.
Reference
1. Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Healthexternal icon. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
2. Batalla A, Bhattacharyya S, Yücel M, et al. (2013). Structural and functional imaging studies in chronic cannabis users: a systematic review of adolescent and adult findings. PloS One. 8(2):e55821. doi:10.1371/journal.pone.0055821. https://www.cdc.gov/marijuana/health-effects.html

THE JURY IS OUT ON THE MEDICAL USES OF MARIJUANA.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Columbia University’s Mailman School of Public Health: Aspirin may halve air pollution harms

27 Oct

Yvette Brazier in the article, Uses, benefits, and risks of aspirin, which was reviewed by Justin Choi, MD, wrote:

Aspirin, or acetylsalicylic acid (ASA), is commonly used as a pain reliever for minor aches and pains and to reduce fever. It is also an anti-inflammatory drug and can be used as a blood thinner.
People with a high risk of blood clots, stroke, and heart attack can use aspirin long-term in low doses.
Aspirin contains salicylate, which derives from willow bark. Its use was first recorded around 400 BCE, in the time of Hippocrates, when people chewed willow bark to relieve inflammation and fever.
It is often given to patients immediately after a heart attack to prevent further clot formation and cardiac tissue death.
Fast facts on aspirin
Here are some key points about aspirin. More detail is in the main article.
• Aspirin is one of the most widely used medications in the world.
• It comes from salicylate, which can be found in plants such as willow trees and myrtle.
• Aspirin was the first non-steroidal anti-inflammatory drug (NSAID) to be discovered.
• It interacts with a number of other drugs, including warfarin and methotrexate.
What is aspirin?
Aspirin has a range of uses, including the treatment of pain and inflammation and reduction of blood clotting.
Aspirin is a non-steroidal anti-inflammatory drug (NSAID).
NSAIDs are medications with the following effects:
• Analgesic: Relieves pain without anesthesia or loss of consciousness
• Antipyretic: Reduces a fever
• Anti-inflammatory: Lowers inflammation when used in higher doses
Non-steroidal means they are not steroids. Steroids often have similar benefits, but they can have unwanted side effects.
As analgesics, NSAIDs tend to be non-narcotic. This means they do not cause insensibility or stupor. Aspirin was the first NSAID to be discovered…. https://www.medicalnewstoday.com/articles/161255.php

Another use for aspirin is to reduce the harm caused by pollution.

Science Daily reported in Aspirin may halve air pollution harm:

A new study is the first to report evidence that nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin may lessen the adverse effects of air pollution exposure on lung function. The team of researchers from the Columbia Mailman School of Public Health, Harvard Chan School of Public Health, Boston University School of Medicine published their findings in the American Journal of Respiratory and Critical Care Medicine.
The researchers analyzed a subset of data collected from a cohort of 2,280 male veterans from the greater Boston area who were given tests to determine their lung function. The average age of participants was 73 years. The researchers examined the relationship between test results, self-reported NSAID use, and ambient particulate matter (PM) and black carbon in the month preceding the test, while accounting for a variety of factors, including the health status of the subject and whether or not he was a smoker. They found that the use of any NSAID nearly halved of the effect of PM on lung function, with the association consistent across all four weekly air pollution measurements from same-day to 28 days prior to the lung function test.
Because most of the people in the study cohort who took NSAIDs used aspirin, the researchers say the modifying effect they observed was mainly from aspirin, but add that effects of non-aspirin NSAIDs are worthy of further exploration. While the mechanism is unknown, the researchers speculate that NSAIDs mitigate inflammation brought about by air pollution.
“Our findings suggest that aspirin and other NSAIDs may protect the lungs from short-term spikes in air pollution,” says first and corresponding author Xu Gao, PhD, a post-doctoral research scientist in the Department of Environmental Health Sciences at the Columbia Mailman School. “Of course, it is still important to minimize our exposure to air pollution, which is linked to a host of adverse health effects, from cancer to cardiovascular disease.”
“While environmental policies have made considerable progress toward reducing our overall exposure to air pollution, even in places with low levels of air pollution, short-term spikes are still commonplace,” says senior author Andrea Baccarelli, MD, PhD, chair of the Department of Environmental Health Sciences at the Columbia Mailman School. “For this reason, it is important to identify means to minimize those harms.”
An earlier study by Baccarelli found that B vitamins may also play a role in reducing the health impact of air pollution…. https://www.sciencedaily.com/releases/2019/10/191002165233.htm

Citation:

Aspirin may halve air pollution harms
Date: October 2, 2019
Source: Columbia University’s Mailman School of Public Health
Summary:
A new study is the first to report evidence that nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin may lessen the adverse effects of air pollution exposure on lung function. The researchers found that the use of any NSAID nearly halved of the effect of PM on lung function, with the association consistent across all four weekly air pollution measurements from same-day to 28 days prior to the lung function test.

Journal Reference:
Xu Gao, Brent Coull, Xihong Lin, Pantel Vokonas, Joel Schwartz, Andrea A Baccarelli. Nonsteroidal Anti-Inflammatory Drugs Modify the Effect of Short-Term Air Pollution on Lung Function. American Journal of Respiratory and Critical Care Medicine, 2019; DOI: 10.1164/rccm.201905-1003LE

Here is the press release from Columbia:

Aspirin may prevent air pollution harms

by Columbia University’s Mailman School of Public Health

A new study is the first to report evidence that nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin may lessen the adverse effects of air pollution exposure on lung function. The team of researchers from the Columbia Mailman School of Public Health, Harvard Chan School of Public Health, Boston University School of Medicine published their findings in the American Journal of Respiratory and Critical Care Medicine.
The researchers analyzed a subset of data collected from a cohort of 2,280 male veterans from the greater Boston area who were given tests to determine their lung function. The average age of participants was 73 years. The researchers examined the relationship between test results, self-reported NSAID use, and ambient particulate matter (PM) and black carbon in the month preceding the test, while accounting for a variety of factors, including the health status of the subject and whether or not he was a smoker. They found that the use of any NSAID nearly halved of the effect of PM on lung function, with the association consistent across all four weekly air pollution measurements from same-day to 28 days prior to the lung function test.
Because most of the people in the study cohort who took NSAIDs used aspirin, the researchers say the modifying effect they observed was mainly from aspirin, but add that effects of non-aspirin NSAIDs are worthy of further exploration. While the mechanism is unknown, the researchers speculate that NSAIDs mitigate inflammation brought about by air pollution.
“Our findings suggest that aspirin and other NSAIDs may protect the lungs from short-term spikes in air pollution,” says first and corresponding author Xu Gao, Ph.D., a post-doctoral research scientist in the Department of Environmental Health Sciences at the Columbia Mailman School. “Of course, it is still important to minimize our exposure to air pollution, which is linked to a host of adverse health effects, from cancer to cardiovascular disease.”
“While environmental policies have made considerable progress toward reducing our overall exposure to air pollution, even in places with low levels of air pollution, short-term spikes are still commonplace,” says senior author Andrea Baccarelli, MD, Ph.D., chair of the Department of Environmental Health Sciences at the Columbia Mailman School. “For this reason, it is important to identify means to minimize those harms.”
An earlier study by Baccarelli found that B vitamins may also play a role in reducing the health impact of air pollution.
________________________________________
Explore further
Pain medications linked to higher cardiovascular risks in patients with osteoarthritis
________________________________________
More information: Xu Gao et al, Nonsteroidal Anti-Inflammatory Drugs Modify the Effect of Short-Term Air Pollution on Lung Function, American Journal of Respiratory and Critical Care Medicine (2019). DOI: 10.1164/rccm.201905-1003LE
Journal information: American Journal of Respiratory and Critical Care Medicine
Provided by Columbia University’s Mailman School of Public Health
236 shares

The National Institute of Environmental Health Sciences (NIH) site has good basic information about air pollution.

According to NIH:

Air pollution is a mixture of natural and man-made substances in the air we breathe. It is typically separated into two categories: outdoor air pollution and indoor air pollution.
Outdoor air pollution involves exposures that take place outside of the built environment. Examples include:
• Fine particles produced by the burning of fossil fuels (i.e. the coal and petroleum used in energy production)
• Noxious gases (sulfur dioxide, nitrogen oxides, carbon monoxide, chemical vapors, etc.)
• Ground-level ozone (a reactive form of oxygen and a primary component of urban smog)
• Tobacco Smoke
Indoor air pollution involves exposures to particulates, carbon oxides, and other pollutants carried by indoor air or dust. Examples include:
• Gases (carbon monoxide, radon, etc.)
• Household products and chemicals
• Building materials (asbestos, formaldehyde, lead, etc.)
• Outdoor indoor allergens (cockroach and mouse dropping, etc.)
• Tobacco smoke
• Mold and pollen
In some instances, outdoor air pollution can make its way indoors by way of open windows, doors, ventilation, etc.
What health effects are linked to air pollution?
Over the past 30 years, researchers have unearthed a wide array of health effects which are believed to be associated with air pollution exposure. Among them are respiratory diseases (including asthma and changes in lung function), cardiovascular diseases, adverse pregnancy outcomes (such as preterm birth), and even death.
In 2013, the World Health Organization concluded that outdoor air pollution is carcinogen to humans.
How can I reduce my risk for air pollution exposure?
Indoor air pollution can be reduced by making sure that a building is well-ventilated and cleaned regularly to prevent the buildup of agents like dust and mold. Occupants would also be wise to remove any known pollutants and or irritants (aerosols, stringent cleaning supplies, etc.) whenever possible.
Outdoor air pollution exposures can be reduced by checking one’s Air Quality Index (AQI), avoiding heavy traffic when possible, and avoiding secondhand tobacco smoke…. https://www.niehs.nih.gov/health/topics/agents/air-pollution/index.cfm

As with any medical procedure, before beginning a medical regime, a competent medical practitioner must be consulted.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Yale University study: Class bias in hiring based on few seconds of speech

24 Oct

Roland G. Fryer wrote in the Education Next article, “Acting White”:

“Go into any inner-city neighborhood, and folks will tell you that government alone can’t teach kids to learn.They know that parents have to parent, that children can’t achieve unless we raise their expectations and turn off the television sets and eradicate the slander that says a black youth with a book is acting white.”
—Barack Obama, Keynote Address, Democratic National Convention, 2004

Acting white was once a label used by scholars, writing in obscure journals, to characterize academically inclined, but allegedly snobbish, minority students who were shunned by their peers.
Now that it has entered the national consciousness—perhaps even its conscience—the term has become a slippery, contentious phrase that is used to refer to a variety of unsavory social practices and attitudes and whose meaning is open to many interpretations, especially as to who is the perpetrator, who the victim.
I cannot, in the research presented here, disentangle all the elements in the dispute, but I can sort out some of its thicker threads. I can also be precise about what I mean by acting white: a set of social interactions in which minority adolescents who get good grades in school enjoy less social popularity than white students who do well academically.
My analysis confirms that acting white is a vexing reality within a subset of American schools. It does not allow me to say whose fault this is, the studious youngster or others in his peer group. But I do find that the way schools are structured affects the incidence of the acting-white phenomenon. The evidence indicates that the social disease, whatever its cause, is most prevalent in racially integrated public schools. It’s less of a problem in the private sector and in predominantly black public schools.
With findings as potentially controversial as these, one wants to be sure that they rest on a solid base. In this regard, I am fortunate that the National Longitudinal Study of Adolescent Health (Adhealth) provides information on the friendship patterns of a nationally representative sample of more than 90,000 students, from 175 schools in 80 communities, who entered grades 7 through 12 in the 1994 school year. With this database, it is possible to move beyond both the more narrowly focused ethnographic studies and the potentially misleading national studies based on self-reported indicators of popularity that have so far guided the discussion of acting white.
The Meaning of the Phrase
Though not all scholars define acting white in precisely the same way, most definitions include a reference to situations where some minority adolescents ridicule their minority peers for engaging in behaviors perceived to be characteristic of whites. For example, when psychologist Angela Neal-Barnett in 1999 asked some focus-group students to identify acting-white behavior, they listed actions that ranged from speaking standard English and enrolling in an Advanced Placement or honors class to wearing clothes from the Gap or Abercrombie & Fitch (instead of Tommy Hilfiger or FUBU) and wearing shorts in winter!
Only some of these behaviors have a direct connection to academic engagement. However, as the remarks of Barack Obama, who would later win a seat in the United States Senate, suggest, it is the fact that reading a book or getting good grades might be perceived as acting white that makes the topic a matter of national concern. Indeed, negative peer-group pressure has emerged as a common explanation for the black-white achievement gap, a gap that cannot be explained away by differences in demographic characteristics alone. If minority students today deliberately underachieve in order to avoid social sanctions, that by itself could explain why the aca¬demic performance of 17-year-old African Americans, as measured by the National Assessment of Educational Progress (NAEP), has deteriorated since the late 1980s, even while that of nine-year-olds has been improving. It may also help us understand the shortage of minority students in most elite colleges and universities… https://www.educationnext.org/actingwhite/

See, A Study in Blackness: What is ‘Acting Black’? https://atlantablackstar.com/2016/07/01/a-study-in-blackness-what-is-acting-black/

PHYS ORG reported in Study shows class bias in hiring based on few seconds of speech:

Candidates at job interviews expect to be evaluated on their experience, conduct, and ideas, but a new study by Yale researchers provides evidence that interviewees are judged based on their social status seconds after they start to speak.
The study, to be published in the Proceedings of the National Academy of Sciences, demonstrates that people can accurately assess a stranger’s socioeconomic position—defined by their income, education, and occupation status—based on brief speech patterns and shows that these snap perceptions influence hiring managers in ways that favor job applicants from higher social classes.
“Our study shows that even during the briefest interactions, a person’s speech patterns shape the way people perceive them, including assessing their competence and fitness for a job,” said Michael Kraus, assistant professor of organizational behavior at the Yale School of Management. “While most hiring managers would deny that a job candidate’s social class matters, in reality, the socioeconomic position of an applicant or their parents is being assessed within the first seconds they speak—a circumstance that limits economic mobility and perpetuates inequality.”
The researchers based their findings on five separate studies. The first four examined the extent that people accurately perceive social class based on a few seconds of speech. They found that reciting seven random words is sufficient to allow people to discern the speaker’s social class with above-chance accuracy. They discovered that speech adhering to subjective standards for English as well as digital standards—i.e. the voices used in tech products like the Amazon Alexa or Google Assistant—is associated with both actual and perceived higher social class. The researchers also showed that pronunciation cues in an individual’s speech communicate their social status more accurately than the content of their speech.
The fifth study examined how these speech cues influence hiring. Twenty prospective job candidates from varied current and childhood socioeconomic backgrounds were recruited from the New Haven community to interview for an entry-level lab manager position at Yale. Prior to sitting for a formal job interview, the candidates each recorded a conversation in which they were asked to briefly describe themselves. A sample of 274 individuals with hiring experience either listened to the audio or read transcripts of the recordings. The hiring managers were asked to assess the candidates’ professional qualities, starting salary, signing bonus, and perceived social class based solely on the brief pre-interview discussion without reviewing the applicants’ job interview responses or resumes.
The hiring managers who listened to the audio recordings were more likely to accurately assess socioeconomic status than those who read transcripts, according to the study. Devoid of any information about the candidates’ actual qualifications, the hiring managers judged the candidates from higher social classes as more likely to be competent for the job, and a better fit for it than the applicants from lower social classes. Moreover, they assigned the applicants from higher social classes more lucrative salaries and signing bonuses than the candidates with lower social status…. https://phys.org/news/2019-10-class-bias-hiring-based-seconds.html

Citation:

Class bias in hiring based on few seconds of speech
Date: October 21, 2019
Source: Yale University
Summary:
Candidates at job interviews expect to be evaluated on their experience, conduct, and ideas, but a new study provides evidence that interviewees are judged based on their social status seconds after they start to speak.

Journal Reference:
Michael W. Kraus et al. Evidence for the reproduction of social class in brief speech. PNAS, 2019 DOI: 10.1073/pnas.1900500116

Here is the press release from Yale:

Yale study shows class bias in hiring based on few seconds of speech

YALE UNIVERSITY
New Haven, Conn. — Candidates at job interviews expect to be evaluated on their experience, conduct, and ideas, but a new study by Yale researchers provides evidence that interviewees are judged based on their social status seconds after they start to speak.
The study, to be published in the Proceedings of the National Academy of Sciences, demonstrates that people can accurately assess a stranger’s socioeconomic position — defined by their income, education, and occupation status — based on brief speech patterns and shows that these snap perceptions influence hiring managers in ways that favor job applicants from higher social classes.
“Our study shows that even during the briefest interactions, a person’s speech patterns shape the way people perceive them, including assessing their competence and fitness for a job,” said Michael Kraus, assistant professor of organizational behavior at the Yale School of Management. “While most hiring managers would deny that a job candidate’s social class matters, in reality, the socioeconomic position of an applicant or their parents is being assessed within the first seconds they speak — a circumstance that limits economic mobility and perpetuates inequality.”
The researchers based their findings on five separate studies. The first four examined the extent that people accurately perceive social class based on a few seconds of speech. They found that reciting seven random words is sufficient to allow people to discern the speaker’s social class with above-chance accuracy. They discovered that speech adhering to subjective standards for English as well as digital standards — i.e. the voices used in tech products like the Amazon Alexa or Google Assistant — is associated with both actual and perceived higher social class. The researchers also showed that pronunciation cues in an individual’s speech communicate their social status more accurately than the content of their speech.
The fifth study examined how these speech cues influence hiring. Twenty prospective job candidates from varied current and childhood socioeconomic backgrounds were recruited from the New Haven community to interview for an entry-level lab manager position at Yale. Prior to sitting for a formal job interview, the candidates each recorded a conversation in which they were asked to briefly describe themselves. A sample of 274 individuals with hiring experience either listened to the audio or read transcripts of the recordings. The hiring managers were asked to assess the candidates’ professional qualities, starting salary, signing bonus, and perceived social class based solely on the brief pre-interview discussion without reviewing the applicants’ job interview responses or resumes.
The hiring managers who listened to the audio recordings were more likely to accurately assess socioeconomic status than those who read transcripts, according to the study. Devoid of any information about the candidates’ actual qualifications, the hiring managers judged the candidates from higher social classes as more likely to be competent for the job, and a better fit for it than the applicants from lower social classes. Moreover, they assigned the applicants from higher social classes more lucrative salaries and signing bonuses than the candidates with lower social status.
“We rarely talk explicitly about social class, and yet, people with hiring experience infer competence and fitness based on socioeconomic position estimated from a few second of an applicant’s speech,” Kraus said. “If we want to move to a more equitable society, then we must contend with these ingrained psychological processes that drive our early impressions of others. Despite what these hiring tendencies may suggest, talent is not found solely among those born to rich or well-educated families. Policies that actively recruit candidates from all levels of status in society are best positioned to match opportunities to the people best suited for them.”
###
Kraus co-authored the paper with graduate students Brittany Torrez and Jun Won Park, and research associate Fariba Ghayebi.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

William Julius Wilson wrote in The Declining Significance of Race:

One of the basic arguments of The Declining Signi½cance of Race is that there has been a deepening economic schism as reflected in a widening gap between lower-income and higher-income black families. In light of more recent data, not only has the family income gap between poorer and better-off African Americans continued to widen, but the situation of the bottom ½fth of black families has deteriorated since 1975 (see Table 1). In 2007, 45.6 percent of all poor blacks had incomes below 50 percent of the poverty line.28Overall, poor black families fell below the poverty line by an average of $9,266 in 2007, a depth of poverty exceeding that of all other racial/ ethnic groups in the United States.29 Regardless of the reversal of the relative income gains of younger educated blacks reported in the previous section, the gap between the haves and have-nots in the African American population continues to grow…. https://dash.harvard.edu/bitstream/handle/1/8052151/Wilson-DecliningSignificanceRevised.pdf?sequence=1

It is politically expedient from certain elites to emphasize race because it relieves them of their class bias.

“I shall always be a flower girl to Professor Higgins, because he always treats me as a flower girl, and always will; but I know I can be a lady to you, because you always treat me as a lady, and always will.”
George Bernard Shaw, Pygmalion

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

University of British Columbia study: New DNA ‘clock’ could help measure development in young children

19 Oct

Rachel Nuwer wrote in the Scientific American article, Programming a DNA Clock: Engineers have created a DNA-based chemical “oscillator,” opening the door to molecular computing:

Nature is a master at constructing biological machines and circuits, including the ones that maintain the body’s internal clock, copy genes or help cells move. Now human engineers are learning to design and synthesize novel biochemical devices such as nanoscale factories, biological circuits and even molecular computers.
This work has so far relied mostly on using existing cellular components (enzymes, for example), but some researchers prefer to start from scratch. For these “molecular programmers,” DNA is the coding language of choice, and crafting circuits and machines to rival those found in nature is the ultimate goal. Recently they took a big step closer by creating the first oscillator—a molecular clock—made solely of DNA.
This milestone achievement, reported last December in Science, shows that DNA is not simply a passive carrier of genetic information. Instead it is a molecule that—even on its own—“is capable of complex behavior,” says senior author David Soloveichik, an electrical and computer engineer at the University of Texas at Austin. Building a DNA oscillator is a biological engineering feat in itself and would likely be integral for potential breakthroughs in synthetic biology, such as controlling the timing of events in artificial cells, scheduling the release of drugs and synchronizing molecular computers.
To create the device, Soloveichik, Niranjan Srinivas, then a doctoral candidate at the California Institute of Technology, and their colleagues built a DNA compiler—a series of algorithms that allows a programmer to issue molecule-building instructions without having to get into the nitty-gritty biochemistry. Software translates those instructions into DNA sequences that are synthesized and mixed together. The strands then self-assemble into molecular machines.
Using its compiler, the team programmed a prototype DNA oscillator that generates repeating patterns of “ticks” and “tocks.” In principle, Soloveichik says, the same formula can be used to produce more complex behavior, such as changing the clock’s speed in response to chemical signals. These clocks could eventually lead to chemical computation—after all, some of the first mechanical computers were simply sophisticated clocks…. https://www.scientificamerican.com/article/programming-a-dna-clock/

Scientists have been studying and designing DNA Clocks. See, DNA clock helps to get measure of people’s lifespans https://www.sciencedaily.com/releases/2015/01/150130092913.htm

Ricki Lewis, PhD wrote A New Biological Aging Clock: Ribosomal DNA:

A new biological clock could be put to good use. “Determining biological age is a central step to understanding fundamental aspects of aging as well as developing tools to inform personal and public health choices. We have hopes that the ribosomal clock will provide new insights into the impact of the environment and personal choices on long-term health,” said Dr. Lemos.
• assessing the effects of cancer treatments on biological aging, perhaps through a cheek swab test
• detecting how environmental exposures like pollution or factors such as lack of exercise or malnutrition affect biological aging
• determining the age structure of a natural population, perhaps through feces analyses
• estimating the age of a stray cat or dog. The animal shelter deemed our new cat Milton as 3, based on his teeth. Might his rDNA provide a more accurate assessment? This approach could be extended to checking the age of humans.
• manufacturers of cosmetics and skin care products can combine rDNA with SPF measurements to dole out dollops customized to how long a customer has until wrinkles appear…. https://blogs.plos.org/dnascience/2019/03/28/a-new-biological-aging-clock-ribosomal-dna/

The University of British Columbia studied the use of a DNA clock to measure development in young children.

Science Daily reported in New DNA ‘clock’ could help measure development in young children:

Scientists have developed a molecular “clock” that could reshape how pediatricians measure and monitor childhood growth and potentially allow for an earlier diagnosis of life-altering development disorders.
The research, published this week in PNAS, describes how the addition of chemical tags to DNA over time can potentially be used to screen for developmental differences and health problems in children.
The study was led by researchers at BC Children’s Hospital, the University of British Columbia (UBC) and the University of California, Los Angeles. It is the first study to describe a method specifically designed for children, called the Pediatric-Buccal-Epigenetic (PedBE) clock, which measures chemical changes to determine the biological age of a child’s DNA.
Small chemical changes to DNA, known as epigenetic changes, alter how genes are expressed in certain tissues and cells. Some of these changes happen as a person ages and others may be in response to a person’s environment or life experiences.
In adults, these patterns of epigenetic changes are well established. They can be used to accurately predict a person’s age from a DNA sample or, if a person’s epigenetic age differs from their actual age, it can point differences in health, including age-related diseases and early mortality.
“We have a good idea how these DNA changes occur in adults, but until now we didn’t have a tool that was specific for children,” says Dr. Michael Kobor, senior author of study. “These DNA changes occur at very different rates in kids and so we adapted this technique for younger ages….”
The PedBE clock was developed using DNA methylation profiles from 1,032 healthy children whose ages ranged from a few weeks old to 20 years. The researchers found 94 different sites in the genome that, when tested together, could accurately predict a child’s age to within about four months. The team also found that children who spent longer in the womb showed an accelerated rate of DNA change by three months, demonstrating that this tool could be used to indicate an infant’s developmental stage. The analysis can be done cheaply and efficiently on cells collected from a cheek swab.
“This powerful and easy-to-use tool could be used by clinicians to identify why some children aren’t meeting early milestones and potentially diagnose children with developmental disorders earlier in life,” says Dr. Lisa McEwen, first author on the study. “This would enable doctors and pediatricians to intervene sooner in a child’s life leading to better outcomes for kids.”
In a small pilot study, the researchers also found that children with autism spectrum disorder (ASD) showed a higher PedBE “age” than those considered to be developing typically, suggesting that the clock could be used to screen for ASD…. https://www.sciencedaily.com/releases/2019/10/191015140253.htm

Citation:

New DNA ‘clock’ could help measure development in young children
Date: October 15, 2019
Source: University of British Columbia
Summary:
Scientists have developed a molecular ‘clock’ that could reshape how pediatricians measure and monitor childhood growth and potentially allow for an earlier diagnosis of life-altering development disorders.

Journal Reference:
Lisa M. McEwen, Kieran J. O’Donnell, Megan G. McGill, Rachel D. Edgar, Meaghan J. Jones, Julia L. MacIsaac, David Tse Shen Lin, Katia Ramadori, Alexander Morin, Nicole Gladish, Elika Garg, Eva Unternaehrer, Irina Pokhvisneva, Neerja Karnani, Michelle Z. L. Kee, Torsten Klengel, Nancy E. Adler, Ronald G. Barr, Nicole Letourneau, Gerald F. Giesbrecht, James N. Reynolds, Darina Czamara, Jeffrey M. Armstrong, Marilyn J. Essex, Carolina de Weerth, Roseriet Beijers, Marieke S. Tollenaar, Bekh Bradley, Tanja Jovanovic, Kerry J. Ressler, Meir Steiner, Sonja Entringer, Pathik D. Wadhwa, Claudia Buss, Nicole R. Bush, Elisabeth B. Binder, W. Thomas Boyce, Michael J. Meaney, Steve Horvath, Michael S. Kobor. The PedBE clock accurately estimates DNA methylation age in pediatric buccal cells. Proceedings of the National Academy of Sciences, 2019; 201820843 DOI: 10.1073/pnas.1820843116

Here is the press release from the University of British Columbia:

New DNA “clock” could help measure development in young children
October 15, 2019
Scientists have developed a molecular “clock” that could reshape how pediatricians measure and monitor childhood growth and potentially allow for an earlier diagnosis of life-altering development disorders.
The research, published this week in PNAS, describes how the addition of chemical tags to DNA over time can potentially be used to screen for developmental differences and health problems in children.
The study was led by researchers at the University of British Columbia (UBC), BC Children’s Hospital, and the University of California, Los Angeles. It is the first study to describe a method specifically designed for children, called the Pediatric-Buccal-Epigenetic (PedBE) clock, which measures chemical changes to determine the biological age of a child’s DNA.
Small chemical changes to DNA, known as epigenetic changes, alter how genes are expressed in certain tissues and cells. Some of these changes happen as a person ages and others may be in response to a person’s environment or life experiences.
In adults, these patterns of epigenetic changes are well established. They can be used to accurately predict a person’s age from a DNA sample or, if a person’s epigenetic age differs from their actual age, it can point differences in health, including age-related diseases and early mortality.
“We have a good idea how these DNA changes occur in adults, but until now we didn’t have a tool that was specific for children,” says Dr. Michael Kobor, a UBC professor in the department of medical genetics, investigator at BC Children’s Hospital and senior study author. “These DNA changes occur at very different rates in kids and so we adapted this technique for younger ages.”
Dr. Kobor is also an investigator at the Centre for Molecular Medicine and Therapeutics, the Canada Research Chair in Social Epigenetics and the Sunny Hill BC Leadership Chair in Child Development.
The PedBE clock was developed using DNA methylation profiles from 1,032 healthy children whose ages ranged from a few weeks old to 20 years. The researchers found 94 different sites in the genome that, when tested together, could accurately predict a child’s age to within about four months. The team also found that children who spent longer in the womb showed an accelerated rate of DNA change by three months, demonstrating that this tool could be used to indicate an infant’s developmental stage. The analysis can be done cheaply and efficiently on cells collected from a cheek swab.
“This powerful and easy-to-use tool could be used by clinicians to identify why some children aren’t meeting early milestones and potentially diagnose children with developmental disorders earlier in life,” says Dr. Lisa McEwen, lead study author who completed this research as a UBC PhD candidate in Dr. Kobor’s lab. “This would enable doctors and pediatricians to intervene sooner in a child’s life leading to better outcomes for kids.”
In a small pilot study, the researchers also found that children with autism spectrum disorder (ASD) showed a higher PedBE “age” than those considered to be developing typically, suggesting that the clock could be used to screen for ASD.
“The fact that our pediatric clock was able to distinguish between typically developing children and those with autism in this small experiment demonstrates the powerful potential of this tool,” says Dr. Kobor. “Although more research is needed to confirm this, these results show that the PedBE clock could be an important factor in evaluating how children develop.”
The researchers made the tool freely available along with the publication of this study so other research teams are able to use and experiment with the tool right away.
A version of this story originally appeared on the BC Children’s Hospital website. https://www.med.ubc.ca/news/new-dna-clock-could-help-measure-development-in-young-children/
Richard Harris wrote about potential uses of DNA diagnosis in A Boy’s Mysterious Illness Leads His Family On A Diagnostic Odyssey https://www.npr.org/sections/health-shots/2019/10/16/769462793/a-boys-mysterious-illness-leads-his-family-on-a-diagnostic-odyssey

The most beautiful thing we can experience is the mysterious. It is the source of all true art and science.
Albert Einstein

Where information leads to Hope. © Dr. Wilda.com
Dr. Wilda says this about that ©
Blogs by Dr. Wilda:
COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/
Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/
Dr. Wilda ©
https://drwilda.com/