The world's first routine vaccine programme against malaria has started in Cameroon, in a move projected to save thousands of children's lives across Africa. From a report: The symbolic first jab was given to a baby girl named Daniella at a health facility near Yaounde on Monday. Every year 600,000 people die of malaria in Africa, according to the World Health Organization (WHO). Children under five make up at least 80% of those deaths. Cameroon is offering the RTS,S vaccine free of charge to all infants up to the age of six months old.

Patients require a total of four doses. Health officials say these will be given at the same time as other routine childhood vaccines to make it easier for parents. It comes after successful pilot campaigns in Kenya, Ghana and Malawi - where the vaccine caused a 13% drop in malaria deaths in children of eligible age, says Unicef. The jab is known to be effective in at least 36% of cases, according to US researchers, meaning it could save over one in three lives. While the rollout is undoubtedly a relief and a life-saver, its relatively low efficacy rate means that it is not a "silver bullet," argues Willis Akhwale at End Malaria Council Kenya.

Slashdot reader quonset writes: After decades of study and testing, a potential vaccine for cancer may be on the horizon. Dr. Thomas Wagner, founder of Orbis Health Solutions, is using the body's own immune system to fight the disease, with each shot personalized to the patient, according to ABC News.
From the article: Typically, cancer cells evade a person's immune system because it is recognized as that person's cells. Wagner developed a tumor lysate particle only (TLPO) vaccine that uses a person's tumor cells to identify particular parts that are then presented back in the body using the vaccine in a way that can stimulate their immune system to gain the ability to detect these cancer cells like an infection, allowing the immune system to fight the cancer itself.

"People used to ask me the question, 'When will there be a cure for cancer?' And I've been doing this for 60 years and I could never answer that question," Wagner said. "Until recently, until the last three or four or five years." Wagner believes this type of cancer treatment could be a key to finding the long-awaited cure for cancer, all cancers, if paired with early detection.

Wagner's TLPO cancer vaccine has been tested in hundreds of patients with advanced forms of melanoma in Phase 2 clinical trials. The most recent data presented at an academic conference showed nearly 95% of people given only the vaccine were still alive three years after starting treatment and 64% were still disease-free. Among the most advanced forms of melanoma, disease-free survival after three years for people with stage III disease was 60% in the vaccine-only group, compared to about 39% in the placebo group. Disease-free survival for those with stage IV disease was about 68% in the vaccine-only group, and zero in the placebo group.

The most common side effects were redness or pain at the injection site, fever and fatigue after the injection – similar to other vaccines that stimulate an immune response.

Based on this data and other studies, the U.S. Food and Drug Administration has greenlit Wagner's vaccine to start a Phase 3 clinical trial. It will be a three-year endeavor with a goal to enroll 500 people and is planned to launch sometime this year, Riley Polk, president of Orbis Health Solutions, told WLOS, an ABC News affiliate in Asheville, North Carolina.
Polk's own father was told there were no treatment options left for his lung cancer, according to the article. That was more than 10 years ago, and "His father opted to try Wagner's cancer vaccine and lived 10 more years before dying from something unrelated to cancer." Polk gives ABC News this quote.

"You can tell me a lot of things, but you can't tell me [the vaccine] doesn't work."

"It's ridiculous just how virulent some of these bacteria get over time," says Dwayne Roach, assistant professor of bacteriophages, infectious disease and immunology at San Diego State University.

But now CNN says doctors are fighting multi-drug-resistant superbugs with "nature's oldest predators — tiny tripod-looking viruses called phages designed to find, attack and gobble up bacteria." The microscopic creatures have saved the lives of patients dying from superbug infections and are being used in clinical trials as a potential solution to the growing problem of antibiotic resistance...

In labs around the country, phage scientists are taking research and discovery to the next level... [Yale scientists] are busy mapping which phages and antibiotics are most symbiotic in the fight against a pathogen. Roach's San Diego State lab is investigating the body's immune response to phages while developing new phage purification techniques to prepare samples for intravenous use in patients. Currently, clinical trials are underway to test the effectiveness of phages against intractable urinary tract infections, chronic constipation, joint infections, diabetic foot ulcers, tonsillitis and the persistent, reoccurring infections that occur in patients with cystic fibrosis. The chronic infections common in cystic fibrosis are typically due to various strains of drug-resistant Pseudomonas aeruginosa — the same pathogen responsible for Horton's ear infection and the artificial tears outbreak.

A number of labs are developing libraries of phages, stockpiled with strains found in nature that are known to be effective against a particular pathogen. In Texas, a new facility is taking that a step further — speeding up evolution by creating phages in the lab. "Rather than just sourcing new phages from the environment, we have a bioreactor that in real time creates billions upon billions of phages," said Anthony Maresso, associate professor at Baylor College of Medicine in Houston. "Most of those phages won't be active against the drug-resistant bacteria, but at some point there will be a rare variant that has been trained, so to speak, to attack the resistant bacteria, and we'll add that to our arsenal," Maresso said. "It's a next-generation approach on phage libraries." Maresso's lab published a study last year on the treatment of 12 patients with phages customized to each patient's unique bacterial profile. It was a qualified success: The antibiotic-resistant bacteria in five patients were eradicated, while several more patients showed improvements.

"There's a lot of approaches right now that are happening in parallel," Roach said. "Do we engineer phages? Do we make a phage cocktail, and then how big is the cocktail? Is it two phages or 12 phages? Should phages be inhaled, applied topically or injected intravenously? There's a lot of work underway on exactly how to best do this...." Genetically engineering phages would allow scientists to target each person's unique mix of antibiotic-resistant pathogens instead of searching sewage, bogs, ponds, the bilge of boats and other prime breeding grounds for bacteria to find just the right phage for the job.

Along with phage libraries, genetic engineering is also a key to churning out phages in mass, to distribute on a wider scale. In Russia and the country of Georgia, where phage therapy has been used for decades, patients can buy phage cocktails off the shelf in pharmacies.

Private equity firms are increasingly buying hospitals across the US, and when they do, patients suffer, according to two separate reports. Specifically, the equity firms cut corners, slash services, lay off staff, lower quality of care, take on substantial debt, and reduce charity care, leading to lower ratings and more medical errors, the reports collectively find. ArsTechnica: Last week, the financial watchdog organization Private Equity Stakeholder Project (PESP) released a report delving into the state of two of the nation's largest hospital systems, Lifepoint and ScionHealth -- both owned by private equity firm Apollo Global Management. Through those two systems, Apollo runs 220 hospitals in 36 states, employing around 75,000 people. The report found that some of Apollo's hospitals were among the worst in their respective states, based on a ranking by The Lown Institute Hospital Index. The index ranks hospitals and health systems based on health equity, value, and outcomes, PESP notes. The hospitals also have dismal readmission rates and government rankings.

The Center for Medicare and Medicaid Services (CMS) ranks hospitals on a one- to five-star system, with the national average of 3.2 stars overall and about 30 percent of hospitals at two stars or below. Apollo's overall average is 2.8 stars, with nearly 40 percent of hospitals at two stars or below. The other report, a study published in JAMA late last month, found that the rate of serious medical errors and health complications increases among patients in the first few years after private equity firms take over. The study examined Medicare claims from 51 private equity-run hospitals and 259 matched control hospitals. Specifically, the study, led by researchers at Harvard University, found that patients admitted to private equity-owned hospitals had a 25 percent increase in developing hospital-acquired conditions compared with patients in the control hospitals. In private equity hospitals, patients experienced a 27 percent increase in falls, a 38 percent increase in central-line bloodstream infections (despite placing 16 percent fewer central lines than control hospitals), and surgical site infections doubled.

Cancer deaths in the United States are falling, with four million deaths prevented since 1991, according to the American Cancer Society's annual report. At the same time, the society reported that the number of new cancer cases had ticked up to more than two million in 2023, from 1.9 million in 2022. The New York Times: Cancer remains the second leading cause of death in the United States, after heart disease. Doctors believe that it is urgent to understand changes in the death rate, as well as changes in cancer diagnoses. The cancer society highlighted three chief factors in reduced cancer deaths: declines in smoking, early detection and greatly improved treatments. Breast cancer mortality is one area where treatment had a significant impact. In the 1980s and 1990s, metastatic breast cancer "was regarded as a death sentence," said Donald Berry, a statistician at the University of Texas MD Anderson Cancer Center and an author of a new paper on breast cancer with Sylvia K. Plevritis of Stanford University and other researchers (several authors of the paper reported receiving payments from companies involved in cancer therapies).

The paper, published Tuesday in JAMA, found that the death rate from breast cancer had fallen to 27 per 100,000 women in 2019 from 48 per 100,000 in 1975. That includes metastatic cancer, which counted for nearly 30 percent of the reduction in the breast cancer death rate. Breast cancer treatment has improved so much that it has become a bigger factor than screening in saving lives, said Ruth Etzioni, a biostatistician at the Fred Hutchinson Cancer Center. Death rates have even declined among women in their 40s, who generally did not have regular mammograms, said Dr. Mette Kalager, a professor of medicine at the University of Oslo and Oslo University Hospital, "indicating a substantial effect of treatment," she said.

An anonymous reader quotes a report from the New York Times: In an unmarked laboratory stationed between the campuses of Harvard and the Massachusetts Institute of Technology, a splinter group of scientists is hunting for the next billion-dollar drug. The group, bankrolled with $500 million from some of the wealthiest families in American business, has created a stir in the world of academia by dangling seven-figure paydays to lure highly credentialed university professors to a for-profit bounty hunt. Its self-described goal: to avoid the blockages and paperwork that slow down the traditional paths of scientific research at universities and pharmaceutical companies, and discover scores of new drugs (at first, for cancer and brain disease) that can be produced and sold quickly.

Braggadocio from start-ups is de rigueur, and plenty of ex-academics have started biotechnology companies, hoping to strike it rich on their one big discovery. This group, rather boastfully named Arena BioWorks, borrowing from a Teddy Roosevelt quote, doesn't have one singular idea, but it does have a big checkbook. "I'm not apologetic about being a capitalist, and that motivation from a team is not a bad thing," said the technology magnate Michael Dell, one of the group's big-money backers. Others include an heiress to the Subway sandwich fortune and an owner of the Boston Celtics. The wrinkle is that for decades, many drug discoveries have not just originated at colleges and universities, but also produced profits that helped fill their endowment coffers. The University of Pennsylvania, for one, has said it earned hundreds of millions of dollars for research into mRNA vaccines used against Covid-19. Under this model, any such windfall would remain private. [...]

The five billionaires backing Arena include Michael Chambers, a manufacturing titan and the wealthiest man in North Dakota, and Elisabeth DeLuca, the widow of a founder of the Subway chain. They have each put in $100 million and expect to double or triple their investment in later rounds. In confidential materials provided to investors and others, Arena describes itself as "a privately funded, fully independent, public good." Arena's backers said in interviews that they did not intend to entirely cut off their giving to universities. Duke turned down an offer from Mr. Pagliuca, an alumnus and board member, to set up part of the lab there. Mr. Dell, a major donor to the University of Texas hospital system in his hometown, Austin, leased space for a second Arena laboratory there. [Stuart Schreiber, a longtime Harvard-affiliated researcher who quit to be Arenaâ(TM)s lead scientist] said it would require years -- and billions of dollars in additional funding -- before the team would learn whether its model led to the production of any worthy drugs. "Is it going to be better or worse?" Dr. Schreiber said. "I don't know, but it's worth a shot."

In order to reach places like Alpha Centauri this century, we'll need to utilize gram-scale spacecraft that rely on directed-energy propulsion. To that end, NASA has selected the Swarming Proxima Centauri project for Phase I development as part of this year's NASA Innovative Advanced Concepts (NIAC) program. According to Universe Today, Swarming Proxima Centauri is "a collaborative effort between Space Initiatives Inc. and the Initiative for Interstellar Studies (i4is) led by Space Initiative's chief scientist Marshall Eubanks." From the report: According to Eubanks, traveling through interstellar space is a question of distance, energy, and speed. At a distance of 4.25 light-years (40 trillion km; 25 trillion mi) from the Solar System, even Proxima Centauri is unfathomably far away. To put it in perspective, the record for the farthest distance ever traveled by a spacecraft goes to the Voyager 1 space probe, which is currently more than 24 billion km (15 billion mi) from Earth. Using conventional methods, the probe accomplished a maximum speed of 61,500 km/h (38,215 mph) and has been traveling for more than 46 years straight.

In short, traveling at anything less than relativistic speed (a fraction of the speed of light) will make interstellar transits incredibly long and entirely impractical. Given the energy requirements this calls for, anything other than small spacecraft with a maximum mass of a few grams is feasible. [...] In contrast, concepts like Breakthrough Starshot and the Proxima Swarm consist of "inverting the rocket" -- i.e., instead of throwing stuff out, stuff is thrown at the spacecraft. Instead of heavy propellant, which constitutes the majority of conventional rockets, the energy source for a lightsail is photons (which have no mass and move at the speed of light). But as Eubanks indicated, this does not overcome the issue of energy, making it even more important that the spacecraft be as small as possible. "Bouncing photons off of a laser sail thus solves the speed-of-stuff problem," he said. "But the trouble is, there is not much momentum in a photon, so we need a lot of them. And given the power we are likely to have available, even a couple of decades from now, the thrust will be weak, so the mass of the probes needs to be very small -- grams, not tons."

Their proposal calls for a 100-gigawatt (GW) laser beamer boosting thousands of gram-scale space probes with laser sails to relativistic speed (~10-20% of light). They also proposed a series of terrestrial light buckets measuring a square kilometer (0.386 mi2) in diameter to catch the light signals from the probes once they are well on their way to reaching Proxima Centauri (and communications become more difficult). By their estimates, this mission concept could be ready for development around midcentury and could reach Proxima Centauri and its Earth-like exoplanet (Proxima b) by the third quarter of this century (2075 or after). [...] Eubanks and his colleagues hope that the development of a coherent swarm of robotic probes will have applications closer to home. Swarm robotics is a hot field of research today and is being investigated as a possible means of exploring Europa's interior ocean, digging underground cities on Mars, assembling large structures in space, and providing extreme weather tracking from Earth's orbit. Beyond space exploration and Earth observation, swarm robotics also has applications in medicine, additive manufacturing, environmental studies, global positioning and navigation, search and rescue, and more.

Researchers have designed an app to reduce the impact of tinnitus, an often debilitating condition that manifests via a ringing sound or perpetual buzzing. The Guardian reports: While there is no cure, there are a number of ways of managing the condition, including cognitive behavioural therapy (CBT). This helps people to reduce their emotional connection to the sound, allowing the brain to learn to tune it out. However, CBT can be expensive and difficult for people to access. Researchers have created an app, called MindEar, that provides CBT through a chatbot with other approaches such as sound therapy. "What we want to do is empower people to regain control," said Dr Fabrice Bardy, the first author of the study from the University of Auckland -- who has tinnitus.

Writing in the journal Frontiers in Audiology and Otology, Bardy and colleagues report how 28 people completed the study, 14 of whom were asked to use the app's virtual coach for 10 minutes a day for eight weeks. The other 14 participants were given similar instructions with four half-hour video calls with a clinical psychologist. The participants completed online questionnaires before the study and after the eight-week period. The results reveal six participants given the app alone, and nine who were also given video calls, showed a clinically significant decrease in the distress caused by tinnitus, with the extent of the benefit similar for both groups. After a further eight weeks, a total of nine participants in both groups reported such improvements.

In the coming months, Walmart will be expanding its drone delivery program in Texas to reach an 1.8 million additional households in the Dallas-Fort Worth area. The expansion will be completed within the year. The Verge reports: The retailer says its drone deliveries now cover 75 percent of the population in the Dallas-Fort Worth metro area, all thanks to partnerships with drone startups Wing and Zipline. Walmart launched its drone delivery program with Zipline and DroneUp in Arkansas in 2021 before expanding it to more states in 2022. The newly expanded service in Texas allows customers living within 10 miles of a participating Walmart to get items delivered to their homes via drone.

Since there is a weight limit, customers can only have smaller products like cold medicine, birthday candles, and even a carton of eggs delivered. Walmart says deliveries arrive in 30 minutes or less, with some reaching customers' doorsteps in as fast as 10 minutes. In 2023, Walmart partnered with Wing, which is owned by Google's parent company Alphabet, to deliver to 60,000 more homes in the Dallas-Fort Worth area from two different stores. But this marks its biggest expansion yet, adding 30 more towns and municipalities within the Texas metroplex. The program also now uses drones from both Wing and Zipline to make deliveries in the area, both of which are approved by the Federal Aviation Administration to fly drones "without a dedicated observer being able to see the drone at all times." You can check to see if deliveries are available for your address on the Wing and Zipline websites.

An anonymous reader quotes a report from Reuters: Consumer Reports has found that plastics retain a "widespread" presence in food despite the health risks, and called on regulators to reassess the safety of plastics that come into contact with food during production. The non-profit consumer group said on Thursday that 84 out of 85 supermarket foods and fast foods it recently tested contained "plasticizers" known as phthalates, a chemical used to make plastic more durable. It also said 79% of food samples in its study contained bisphenol A (BPA), another chemical found in plastic, and other bisphenols, though levels were lower than in tests done in 2009.

Consumer Reports said none of the phthalate levels it found exceeded limits set by U.S. and European regulators. It also said there was no level of phthalates that scientists confirm is safe, but that does not guarantee the safety of foods you eat. Phthalates and bisphenols can disrupt the production and regulation of estrogen and other hormones, potentially boosting the risk of birth defects, cancer, diabetes, infertility, neurodevelopmental disorders, obesity and other health problems. Among tested supermarket foods, Annie's Organic Cheesy Ravioli contained the most phthalates in nanograms per serving, 53,579, followed by Del Monte sliced peaches and Chicken of the Sea pink salmon.

An anonymous reader quotes a report from VICE News: Last week border officials in the Punjab region of India revealed they intercepted 107 drug-carrying drones sent by smuggling gangs last year over the border from Pakistan, the highest number on record. Most were carrying heroin or opium from Pakistan to be dropped and received by collaborators in the Punjab, notorious for having India's worst levels of opiate addiction. Last year the head of a police narcotics unit in Lahore, a city in Pakistan which borders the Punjab, was dismissed after he was suspected of running a drug trafficking gang sending drones over to India. But the use of cheap flying robots instead of humans to smuggle drugs across borders is a worldwide phenomenon. [...]

[D]rones will likely become an everyday part of drug dealing too, according to Peter Warren Singer, author of multiple books on national security and a Fellow at think tank New America, with legit medicines due to be delivered by drone in the U.S. later this year and maybe in the U.K. too. "We are just scraping the surface of what is possible, as drone deliveries become more and more common in the commercial world, it will be the same with delivery of illicit goods. In our book, Burn-In, we explain how a future city will see drones zipping about delivering everything from groceries and burritos to drugs, both prescribed by a doctor or bought off a dealer. Drones have traditionally been used by governments and corporations for what are known as the "3 D's" jobs that are too dull, dirty, or dangerous for humans. For criminals, it is the same, except add in another D: Dependable. A drone doesn't steal the product and can't be arrested or snitch if caught."

Liam O'Shea, senior research fellow for organized crime and policing at defense and security thinktank RUSI, said drones were at the moment of limited value to wholesale traffickers and organized criminal gangs because of their range and the weight they can carry. "It makes sense that smugglers would seek to use drones. They are cheap and easy to acquire. They also lower the risks involved in some transactions, as smugglers do not have to be physically present during transactions. They offer opportunities for smuggling in areas where previous routes were too risky, such as prisons and over securitized borders. "I expect them to be of greater value to smaller players and distributors dealing with smaller quantities. Wholesale drug traffickers will still need to use routes that facilitate smuggling at higher volume or using drones to make multiple trips, which entails risks of detection. That may well change as improvements in technology improve drones' carrying capacity and crime groups are better able to access drones with greater capacity."

An anonymous reader quotes a report from Interesting Engineering: Marking a significant advancement in medical science, the world's first partial heart transplant has achieved the expected outcome after over a year of research efforts. Carried out by Duke Health, the patient, a young individual, now exhibits functioning valves and arteries that are growing in tandem with the transplant, as initially expected by the medical team. In spring 2022, doctors carried out the procedure on a baby who needed a new heart valve. Before, they used non-living valves, which didn't grow with the child. This meant the child needed frequent replacements, and the surgeries had a 50 percent chance of being deadly. The new procedure avoids these problems, according to the team.

Babies with serious heart valve problems face a tough challenge because there aren't any implants that can grow with them. So, these babies end up needing new implants over and over until they're big enough for an adult-sized valve. It's a problem that doesn't have a solution yet. Duke Health doctors, leading a study published in the Journal of the American Medical Association, discovered that the innovative valve collection method used in the partial heart transplant resulted in two properly functioning valves and arteries that are growing along with the child, resembling natural blood vessels. "This publication is proof that this technology works, this idea works, and can be used to help other children," said Joseph W. Turek, first author of the study and Duke's chief of pediatric cardiac surgery, in a statement. The research also notes that the new procedure requires less immunosuppressant medication, reducing potential long-term side effects.

It also facilitates a "domino transplant" method, where one donor heart benefits multiple patients, potentially doubling the number of hearts available for children with heart disease by utilizing previously unused hearts and valves.

An anonymous reader quotes a report from Ars Technica: ChatGPT is still no House, MD. While the chatty AI bot has previously underwhelmed with its attempts to diagnose challenging medical cases -- with an accuracy rate of 39 percent in an analysis last year -- a study out this week in JAMA Pediatrics suggests the fourth version of the large language model is especially bad with kids. It had an accuracy rate of just 17 percent when diagnosing pediatric medical cases. The low success rate suggests human pediatricians won't be out of jobs any time soon, in case that was a concern. As the authors put it: "[T]his study underscores the invaluable role that clinical experience holds." But it also identifies the critical weaknesses that led to ChatGPT's high error rate and ways to transform it into a useful tool in clinical care. With so much interest and experimentation with AI chatbots, many pediatricians and other doctors see their integration into clinical care as inevitable. [...]

For ChatGPT's test, the researchers pasted the relevant text of the medical cases into the prompt, and then two qualified physician-researchers scored the AI-generated answers as correct, incorrect, or "did not fully capture the diagnosis." In the latter case, ChatGPT came up with a clinically related condition that was too broad or unspecific to be considered the correct diagnosis. For instance, ChatGPT diagnosed one child's case as caused by a branchial cleft cyst -- a lump in the neck or below the collarbone -- when the correct diagnosis was Branchio-oto-renal syndrome, a genetic condition that causes the abnormal development of tissue in the neck, and malformations in the ears and kidneys. One of the signs of the condition is the formation of branchial cleft cysts. Overall, ChatGPT got the right answer in just 17 of the 100 cases. It was plainly wrong in 72 cases, and did not fully capture the diagnosis of the remaining 11 cases. Among the 83 wrong diagnoses, 47 (57 percent) were in the same organ system.

Among the failures, researchers noted that ChatGPT appeared to struggle with spotting known relationships between conditions that an experienced physician would hopefully pick up on. For example, it didn't make the connection between autism and scurvy (Vitamin C deficiency) in one medical case. Neuropsychiatric conditions, such as autism, can lead to restricted diets, and that in turn can lead to vitamin deficiencies. As such, neuropsychiatric conditions are notable risk factors for the development of vitamin deficiencies in kids living in high-income countries, and clinicians should be on the lookout for them. ChatGPT, meanwhile, came up with the diagnosis of a rare autoimmune condition. Though the chatbot struggled in this test, the researchers suggest it could improve by being specifically and selectively trained on accurate and trustworthy medical literature -- not stuff on the Internet, which can include inaccurate information and misinformation. They also suggest chatbots could improve with more real-time access to medical data, allowing the models to refine their accuracy, described as "tuning."

fahrbot-bot shares a report from The Guardian: Scientists have discovered an entirely new class of antibiotic that appears to kill one of three bacteria considered to pose the greatest threat to human health because of their extensive drug-resistance. Zosurabalpin defeated highly drug-resistant strains of Carbapenem-resistant Acinetobacter baumannii (Crab) in mouse models of pneumonia and sepsis, and was being tested in human trials. Crab is classified as a priority 1 critical pathogen by the World Health Organization, alongside two other drug-resistant forms of bacteria -- Pseudomonas aeruginosa and Enterobacteriaceae.

Antibiotic-resistant infections pose an urgent threat to human health -- particularly those caused by a large group of bacteria known as Gram-negative bacteria, which are protected by an outer shell containing a substance called lipopolysaccharide (LPS). "LPS allows bacteria to live in harsh environments, and it also allows them to evade attack by our immune system," said Dr Michael Lobritz, the global head of infectious diseases at Roche Pharma Research and Early Development in Basel Switzerland, which developed the new drug. No new antibiotic for Gram-negative bacteria have been approved in more than 50 years.

Roche had previously identified Zosurabalpin as capable of blocking the growth of A baumannii but it was not clear how it worked, or if it would be effective in animals with Crab-related infections. Through a series of experiments published in Nature, Prof Daniel Kahne at Harvard University in Cambridge, US, and colleagues showed that the drug prevented LPS from being transported to the outer membrane of the bacterium, killing it. They also found that Zosurabalpin considerably reduced levels of bacteria in mice with Crab-induced pneumonia and prevented the death of those with Crab-related sepsis. While [Lobritz] stressed that this molecule alone would not solve the public health threat of antimicrobial resistant infections, the discovery could lay the foundations for future efforts to drug the same transport system in other bacteria.

"This year has been a major turning point in American health care," reports USA Today, "and patients can anticipate several major developments in the new year," including the beginning of a CRISPR "revolution" and "a new reckoning with drug prices that could change the landscape of the U.S. health care system for decades to come." Health care officials expect 2024 to bring a wave of innovation and change in medicine, treatment and public health... Many think 2024 could be the year more people have the tools to follow through on New Year's resolutions about weight loss. If they can afford them and manage to stick with them, people can turn to a new generation of remarkably effective weight-loss drugs, also called GLP-1s, which offer the potential for substantial weight loss...

In 2023, mental health issues became among the nation's most deadly, costly and pervasive health crises... The dearth of remedies has also paved the way for an unsuspecting class of drugs: psychedelics. MDMA, a party drug commonly known as "ecstasy," could win approval for legal distribution in 2024, as a treatment for post-traumatic stress disorder. Another psychedelic, a ketamine derivative eskatemine, sold as Spravato, was approved in 2019 to treat depression, but it is being treated like a conventional therapy that must be dosed regularly, not like a psychedelic that provides a long-lasting learning experience, said Matthew Johnson, an expert in psychedelics at Johns Hopkins University. MDMA (midomafetamine capsules) would be different, as the first true psychedelic to win FDA approval.

In a late-stage trial of patients with moderate or severe post-traumatic stress disorder, close to 90% showed clinically significant improvements four months after three treatments with MDMA and more than 70% no longer met the criteria for having the disorder, which represented "really impressive results," according to Matthew Johnson, an expert in psychedelics at Johns Hopkins University in Maryland. Psilocybin, known colloquially as "magic mushrooms," is also working its way through the federal approval process, but it likely won't come up before officials for another year, Johnson said. Psychedelics are something to keep an eye on in the future, as they're being used to treat an array of mental health issues: eskatimine for depression, MDMA for PTSD and psilocybin for addiction. Johnson said his research suggests that psychedelics will probably have a generalizable benefit across many mental health challenges in the years to come.
2024 will also be the first year America's drug-makers face new limits on how much they can increase prices for drugs covered by the federal health insurance program Medicare.

In 2021, Philips pulled its popular sleep apnea machines and ventilators off the shelves after discovering that an industrial foam built into the devices to reduce noise could release toxic particles and fumes into the masks worn by patients. "But as Philips publicly pledged to send out replacements, supervisors inside the company's headquarters near Pittsburgh were quietly racing to manage a new crisis that threatened the massive recall and posed risks to patients all over again," reports ProPublica. "Tests by independent laboratories retained by Philips had found that a different foam used by the company -- material fitted inside the millions of replacement machines -- was also emitting dangerous chemicals, including formaldehyde, a known carcinogen."

"Though Philips has said the machines are safe, ProPublica and the Pittsburgh Post-Gazette obtained test results and other internal records that reveal for the first time how scientists working for the company grew increasingly alarmed and how infighting broke out as the new threat reached the highest levels of the Pittsburgh operation. The findings also underscore an unchecked pattern of corporate secrecy that began long before Philips decided to use the new foam." From the report: The company had previously failed to disclose complaints about the original foam in its profitable breathing machines, a polyester-based polyurethane material that was found to degrade in heat and humidity. Former patients and others have described hundreds of deaths and thousands of cases of cancer in government reports. After the introduction of the new foam in 2021, this one made of silicone, the company again held back details about the problem from the public even as it sent out replacement machines with the new material to customers around the world.

One of the devices was the DreamStation 2, a newly released continuous positive airway pressure, or CPAP, machine promoted as one of the company's primary replacements. Federal regulators were alerted to the concern more than two years ago but said in a news release at the time that the company was carrying out additional tests on the foam and that patients should keep using their replacements until more details were available. The Food and Drug Administration has not provided new information on the test results since then, and it is still unclear whether the material is safe. That leaves millions of people in the United States alone caught in the middle, including those with sleep apnea, which causes breathing to stop and start through the night and can lead to heart attacks, strokes and sudden death.

The new foam isn't the only problem: An internal investigation at Philips launched in the months after the recall found that water was condensing in the circuitry of the DreamStation 2, creating a new series of safety risks. "Loss of therapy, thermal events, and shock hazards," the investigation concluded. The FDA issued an alert about overheating last month, warning that the devices could produce "fire, smoke, burns, and other signs of overheating" and advising patients to keep the machines away from carpet, fabric and "other flammable materials." Philips has said that customers could continue using the devices if they followed safety instructions. ...

An anonymous reader quotes a report from Bloomberg, written by Naomi Kresge: In the early days of the Covid-19 pandemic, hundreds of scientists from all over the world banded together in an open-source effort to develop an antiviral that would be available for all. They could never have anticipated the many roadblocks they would face along the way, including the Russian invasion of Ukraine, which made refugees out of a group of Kyiv chemists who were doing important work for the project. The group, which called itself Covid Moonshot, hasn't given up on its effort to introduce a more affordable, patent-free treatment for the virus. Their open-source Covid antiviral, now funded by Wellcome, is on track to be ready for human testing within the next year and a half, according to Annette von Delft, a University of Oxford scientist and one of the Moonshot group's leaders. More early discovery work on a range of potential inhibitors for other viruses is also still going on and being funded by a US government grant.

"It's a bit like a proof of concept," von Delft says, for bringing a patent-free experimental drug into the clinic, a model that could be repurposed as a tool to fight neglected tropical diseases or antimicrobial resistance, or prepare for future pandemics. "Can we come up with a strategic model that can help those kinds of compounds with less of a business case along?" Of course, there was definitely a business case for a Covid antiviral, and some of the biggest drugmakers rushed to develop them. In 2022, Pfizer Inc.'s Paxlovid was one of the world's best-selling medicines with $18.9 billion in revenue. Demand has since cratered for the pill, which needs to be given shortly after infection and can't be taken alongside a number of other commonly prescribed medicines. Analysts expect the Paxlovid revenue to plunge just shy of $1 billion this year.

However, there is still a need for a better Covid antiviral, particularly in countries where access to the Pfizer pill is limited, according to von Delft. Covid cases have surged again this holiday season, with the rise of a new variant called JN.1 reminding us that the virus is still changing to evade the immunity we've built up so far. Just before Christmas, UK authorities said about one in every 24 people in England and Scotland had the disease. An accessible antiviral could help people return to work more quickly, and it could also be tested as a potential treatment for long Covid. "We know from experience in viral disease that there will be resistance variants evolving over time," von Delft said. "We'll need more than one."

"I'm optimistic about the world's climate progress," Bill Gates wrote this week — but he also explained why.

"In 2024 and beyond, I predict we will see lots of new innovations coming into the marketplace — even in very complicated areas like nuclear. The climate crisis can feel overwhelming, but I find it easier to stay optimistic when you focus on all the progress we're making. If the world continues to prioritize funding innovation, I'm hopeful we can make good progress on our climate goals."

And elsewhere Gates writes that "AI is about to supercharge the innovation pipeline." My work has always been rooted in a core idea: Innovation is the key to progress. It's why I started Microsoft, and it's why Melinda and I started the Gates Foundation more than two decades ago. Innovation is the reason our lives have improved so much over the last century. From electricity and cars to medicine and planes, innovation has made the world better. Today, we are far more productive because of the IT revolution. The most successful economies are driven by innovative industries that evolve to meet the needs of a changing world.

My favorite innovation story, though, starts with one of my favorite statistics: Since 2000, the world has cut in half the number of children who die before the age of five. How did we do it? One key reason was innovation. Scientists came up with new ways to make vaccines that were faster and cheaper but just as safe. They developed new delivery mechanisms that worked in the world's most remote places, which made it possible to reach more kids. And they created new vaccines that protect children from deadly diseases like rotavirus.

In a world with limited resources, you have to find ways to maximize impact. Innovation is the key to getting the most out of every dollar spent. And artificial intelligence is about to accelerate the rate of new discoveries at a pace we've never seen before.

One of the biggest impacts so far is on creating new medicines. Drug discovery requires combing through massive amounts of data, and AI tools can speed up that process significantly. Some companies are already working on cancer drugs developed this way. But a key priority of the Gates Foundation in AI is ensuring these tools also address health issues that disproportionately affect the world's poorest, like AIDS, TB, and malaria. We're taking a hard look at the wide array of AI innovation in the pipeline right now and working with our partners to use these technologies to improve lives in low- and middle-income countries...

I feel like a kid on Christmas morning when I think about how AI can be used to get game-changing technologies out to the people who need them faster than ever before. This is something I am going to spend a lot of time thinking about next year.
Gates notes that researchers are already exploring questions like "Can AI combat antibiotic resistance?"

Scientists have developed a vibrating pill that, when swallowed before eating, can create a feeling of fullness. The Guardian reports: The research, which has yet to be carried out in humans, shows that after 30 minutes of activity by the Vibes pill, pigs ate on average almost 40% less food in the following half hour than they did without the device, and gained weight more slowly. The Vibes name is an acronym derived from the pill's full title -- Vibrating Ingestible BioElectronic Stimulator. The work in pigs suggests the vibrations activate stretch receptors in the stomach, simulating the presence of food. This results in signals being sent to the hypothalamus in the brain via the vagus nerve, increasing levels of various hormones that give rise to a feeling of fullness and decreasing those that result in feelings of hunger.

"We envision the Vibes pill being ingested on a relatively empty stomach 20 to 30 min before anticipated meals to trigger the desired sensation of satiety early in the meal,â the team write, adding that when produced at scale, the cost of the pills is expected to be in the cents to one dollar range. The vibrations, which are powered by a battery encased in the swallowed capsule, can be triggered when stomach acid dissolves a membrane around the pill, or by a timer. The researchers say the pills, which are about the size of a large vitamin tablet, offer a non-invasive, temporary therapy, without the need for weight-loss surgery, and exit the body with other solid waste -- meaning in humans they are flushed down the toilet. However they suggest it could be possible to develop pills that are implanted, or stay in the stomach, to reduce the need for people to repeatedly take them, should they require continuing therapy. Further reading: Man Reports PillCam Stuck In His Gut For Over 12 Weeks

In 2005, the reclassification of pseudoephedrine to behind-the-counter status led to widespread use of oral phenylephrine in OTC decongestants, despite evidence of its ineffectiveness. Randy Hatton, a clinical professor in the College of Pharmacy at the University of Florida, and his colleague worked to bring this issue to the FDA's attention, revealing loopholes in the regulatory process for older OTC drugs. Hatton writes in an opinion piece for Scientific American: Before the FDA required that drugs had to be proven effective, it determined whether OTC drugs were effective through expert panels that reviewed existing data. These OTC monographs establish what older OTC ingredients can be marketed without FDA approval. The oral decongestant monograph panel reviewed a few published studies and multiple unpublished studies for phenylephrine. Of the unpublished studies, only four studies showed oral phenylephrine was effective, while seven showed it was no better than placebo. We requested copies of all evidence used by the nasal decongestant review panel via a Freedom of Information Act request and performed a systematic review and meta-analysis ourselves. [...]

The FDA has multiple regulatory processes for different types of medicinal compounds. People are perhaps most familiar with the New Drug Application process, which leads to clinical trials for prescription drug approvals. However, many OTC or nonprescription drugs are regulated differently. In fact, a law passed in 1951, the Durham-Humphrey Amendment to the 1938 Food, Drug, and Cosmetic Act, created the categories of prescription and nonprescription drugs. In 1962, the act was amended again so that drugs had to be shown to be effective, hence the requirement for well-done clinical trials. But what about the drugs that were approved before 1962? This is the loophole that some OTC drugs fall through. For prescription drugs, FDA tried to address pre-1962 approvals through a review of over 3,000 prescription drugs. Most of those drugs have now been reviewed and addressed, but there are still unapproved prescription drugs on the market today, such as an extended-release form of oral nitroglycerin. For nonprescription drugs, FDA established the OTC monograph process 10 years after the 1962 amendment to the Food, Drug, and Cosmetic Act, which required products not proven effective to be reconsidered. FDA formed advisory panels grouping hundreds of ingredients into 26 categories based on the products' uses. After gathering all available information, both published and unpublished, from manufacturers, the advisory panels issued final reports to FDA about whether these ingredients were GRASE (generally recognized as safe and effective), not GRASE, or inconclusive. GRASE ingredients can be used in nonprescription drugs without FDA approval if the use matches the monograph. "The oral phenylephrine example shows that FDA needs more funding to look at these old drugs," concludes Hatton. "We need public funds to support independent researchers who want to examine these products objectively. The government should be able to spend millions to save consumers billions on ineffective products. Companies that market these products have no incentive to prove they don't work. Nonprescription drugs must be effective -- not just safe."