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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>Dichotomy of neutralizing antibody, B cell and T cell responses to SARS-CoV-2 vaccination and protection in healthy adults</strong> -
<div>
Heterogeneity in SARS-CoV-2 vaccine responses is not understood. Here, we identify four patterns of live-virus neutralizing antibody responses: individuals with hybrid immunity (with confirmed prior infection); rare individuals with low responses (paucity of S1-binding antibodies); and surprisingly, two further groups with distinct serological repertoires. One group - broad responders - neutralize a range of SARS-CoV-2 variants, whereas the other - narrow responders - neutralize fewer, less divergent variants. This heterogeneity does not correlate with Ancestral S1-binding antibody, rather the quality of the serological response. Furthermore, IgDlowCD27-CD137+ B cells and CCR6+ CD4+ T cells are enriched in broad responders before dose 3. Notably, broad responders have significantly longer infection-free time after their third dose. Understanding the control and persistence of these serological profiles could allow personalized approaches to enhance serological breadth after vaccination.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.24.541920v1" target="_blank">Dichotomy of neutralizing antibody, B cell and T cell responses to SARS-CoV-2 vaccination and protection in healthy adults</a>
</div></li>
<li><strong>Longitudinal host transcriptional responses to SARS-CoV-2 infection in adults with extremely high viral load</strong> -
<div>
Current understanding of viral dynamics of SARS-CoV-2 and host responses driving the pathogenic mechanisms in COVID-19 is rapidly evolving. Here, we conducted a longitudinal study to investigate gene expression patterns during acute SARS-CoV-2 illness. Cases included SARS-CoV-2 infected individuals with extremely high viral loads early in their illness, individuals having low SARS-CoV-2 viral loads early in their infection, and individuals testing negative for SARS-CoV-2. We could identify widespread transcriptional host responses to SARS-CoV-2 infection that were initially most strongly manifested in patients with extremely high initial viral loads, then attenuating within the patient over time as viral loads decreased. Genes correlated with SARS-CoV-2 viral load over time were similarly differentially expressed across independent datasets of SARS-CoV-2 infected lung and upper airway cells, from both in vitro systems and patient samples. We also generated expression data on the human nose organoid model during SARS-CoV-2 infection. The human nose organoid-generated host transcriptional response captured many aspects of responses observed in the above patient samples while suggesting the existence of distinct host responses to SARS-CoV-2 depending on the cellular context, involving both epithelial and cellular immune responses. Our findings provide a catalog of SARS-CoV-2 host response genes changing over time.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.24.542181v1" target="_blank">Longitudinal host transcriptional responses to SARS-CoV-2 infection in adults with extremely high viral load</a>
</div></li>
<li><strong>Vascular Endothelial-derived SPARCL1 Exacerbates Viral Pneumonia Through Pro-Inflammatory Macrophage Activation</strong> -
<div>
Inflammation upon infectious lung injury is a double-edged sword: while tissue-infiltrating immune cells and cytokines are necessary to control infection, these same factors often aggravate injury. Full appreciation of both the sources and targets of inflammatory mediators is required to facilitate strategies to maintain antimicrobial effects while minimizing off-target epithelial and endothelial damage. Recognizing that the vasculature is centrally involved in tissue responses to injury and infection, we observed that pulmonary capillary endothelial cells (ECs) exhibit dramatic transcriptomic changes upon influenza injury punctuated by profound upregulation of Sparcl1. Endothelial deletion and overexpression of SPARCL1 implicated this secreted matricellular protein in driving key pathophysiologic symptoms of pneumonia, which we demonstrate result from its effects on macrophage polarization. SPARCL1 induces a shift to a pro-inflammatory "M1-like" phenotype (CD86+CD206-), thereby increasing associated cytokine levels. Mechanistically, SPARCL1 acts directly on macrophages in vitro to induce the pro-inflammatory phenotype via activation of TLR4, and TLR4 inhibition in vivo ameliorates inflammatory exacerbations caused by endothelial Sparcl1 overexpression. Finally, we confirmed significant elevation of SPARCL1 in COVID-19 lung ECs in comparison with those from healthy donors. Survival analysis demonstrated that patients with fatal COVID-19 had higher levels of circulating SPARCL1 protein compared to those who recovered, indicating the potential of SPARCL1 as a biomarker for prognosis of pneumonia and suggesting that personalized medicine approaches might be harnessed to block SPARCL1 and improve outcomes in high-expressing patients.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.25.541966v1" target="_blank">Vascular Endothelial-derived SPARCL1 Exacerbates Viral Pneumonia Through Pro-Inflammatory Macrophage Activation</a>
</div></li>
<li><strong>The landscape of biomedical research</strong> -
<div>
The number of publications in biomedicine and life sciences has rapidly grown over the last decades, with over 1.5 million papers now published every year. This makes it difficult to keep track of new scientific works and to have an overview of the evolution of the field as a whole. Here we present a 2D atlas of the entire corpus of biomedical literature, and argue that it provides a unique and useful overview of the life sciences research. We base our atlas on the abstract texts of 21 million English articles from the PubMed database. To embed the abstracts into 2D, we use a large language model PubMedBERT, combined with t-SNE tailored to handle samples of our size. We use our atlas to study the emergence of the Covid-19 literature, the evolution of the neuroscience discipline, the uptake of machine learning, and the distribution of gender imbalance in academic authorship. Furthermore, we present an interactive web version of our atlas that allows easy exploration and will enable further insights and facilitate future research.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.10.536208v2" target="_blank">The landscape of biomedical research</a>
</div></li>
<li><strong>Learning virus genotype-fitness landscape in embedding space</strong> -
<div>
Predicting the SARS-CoV-2 epidemic and “immune escape” mutations remain crucial problems. We present a theoretical framework called Phenotype-Embedding (P-E) theorem and prove that the virus fitness can calculate by selecting appropriate sequence embedding under the VAE framework. Starting from the P-E theorem and based on a modified Transformer model, we obtain a calculable quantitative relationship between “immune escape” mutations and the fitness of the virus lineage and plot a genotype-fitness landscape in the embedded space. We accurately calculated the viral fitness and basic replication number (R0) using only the sequence data of SARS-CoV-2 spike protein. In addition, our model can simulate viral neutral evolution and spatio-temporal selection, decipher the effects of epistasis and recombination, and more accurately predict viral mutations associated with immune escape. Our work provides a theoretical framework for constructing genotype-phenotype landscapes and a paradigm for the interpretability of deep learning in virus evolution research.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.02.09.527693v2" target="_blank">Learning virus genotype-fitness landscape in embedding space</a>
</div></li>
<li><strong>Modeling spatial intercellular communication and multilayer signaling regulations using stMLnet</strong> -
<div>
Multicellular organisms require intercellular and intracellular signaling to coordinately regulate different cell functions. Although many methods of cell-cell communication (CCC) inference have been developed, they seldom account for both the intracellular signaling responses and global spatial information. The recent advancement of spatial transcriptomics (ST) provides unprecedented opportunities to better decipher CCC signaling and functioning. In this paper, we propose an ST-based multilayer network method, stMLnet, for inferring spatial intercellular communication and multilayer signaling regulations by quantifying distance-weighted ligand-receptor signaling activity based on diffusion and mass action models and mapping it to intracellular targets. We benchmark stMLnet with existing methods using simulation data and 8 real datasets of cell type-specific perturbations. Furthermore, we demonstrate the applicability of stMLnet on six ST datasets acquired with four different technologies (e.g., seqFISH+, Slide-seq v2, MERFIS and Visium), showing its effectiveness and reliability on ST data with varying spatial resolutions and gene coverages. Finally, stMLnet identifies positive feedback circuits between alveolar epithelial cells, macrophages, and monocytes via multilayer signaling pathways within a COVID-19 microenvironment. Our proposed method provides an effective tool for predicting multilayer signaling regulations between interacting cells, which can advance the mechanistic and functional understanding of spatial CCCs.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.06.27.497696v2" target="_blank">Modeling spatial intercellular communication and multilayer signaling regulations using stMLnet</a>
</div></li>
<li><strong>The impact of RSV/SARS-CoV-2 co-infection on clinical disease and viral replication: insights from a BALB/c mouse model</strong> -
<div>
RSV and SARS-CoV-2 are prone to co-infection with other respiratory viruses. In this study, we use RSV/SARS-CoV-2 co-infection to evaluate changes to clinical disease and viral replication in vivo. To consider the severity of RSV infection, effect of sequential infection, and the impact of infection timing, mice were co-infected with varying doses and timing. Compared with a single infection of RSV or SARS-CoV-2, the co-infection of RSV/SARS-CoV-2 and the primary infection of RSV followed by SARS-CoV-2 results in protection from SARS-CoV-2-induced clinical disease and reduces SARS-CoV-2 replication. Co-infection also augmented RSV replication at early timepoints with only the low dose. Additionally, the sequential infection of RSV followed by SARS-CoV-2 led to improved RSV clearance regardless of viral load. However, SARS-CoV-2 infection followed by RSV results in enhanced SARS-CoV-2-induced disease while protecting from RSV-induced disease. SARS-CoV-2/RSV sequential infection also reduced RSV replication in the lung tissue, regardless of viral load. Collectively, these data suggest that RSV and SARS-CoV-2 co-infection may afford protection from or enhancement of disease based on variation in infection timing, viral infection order, and/or viral dose. In the pediatric population, understanding these infection dynamics will be critical to treat patients and mitigate disease outcomes.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.24.542043v1" target="_blank">The impact of RSV/SARS-CoV-2 co-infection on clinical disease and viral replication: insights from a BALB/c mouse model</a>
</div></li>
<li><strong>Within-host SARS-CoV-2 viral kinetics informed by complex life course exposures reveals different intrinsic properties of Omicron and Delta variants</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The emergence of successive SARS-CoV-2 variants of concern (VOC) during 2020-22, each exhibiting increased epidemic growth relative to earlier circulating variants, has created a need to understand the drivers of such growth. However, both pathogen biology and changing host characteristics - such as varying levels of immunity - can combine to influence replication and transmission of SARS-CoV-2 within and between hosts. Disentangling the role of variant and host in individual-level viral shedding of VOCs is essential to inform COVID-19 planning and response, and interpret past epidemic trends. Using data from a prospective observational cohort study of healthy adult volunteers undergoing weekly occupational health PCR screening, we developed a Bayesian hierarchical model to reconstruct individual-level viral kinetics and estimate how different factors shaped viral dynamics, measured by PCR cycle threshold (Ct) values over time. Jointly accounting for both inter-individual variation in Ct values and complex host characteristics - such as vaccination status, exposure history and age - we found that age and number of prior exposures had a strong influence on peak viral replication. Older individuals and those who had at least five prior antigen exposures to vaccination and/or infection typically had much lower levels of shedding. Moreover, we found evidence of a correlation between the speed of early shedding and duration of incubation period when comparing different VOCs and age groups. Our findings illustrate the value of linking information on participant characteristics, symptom profile and infecting variant with prospective PCR sampling, and the importance of accounting for increasingly complex population exposure landscapes when analysing the viral kinetics of VOCs.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.17.23290105v1" target="_blank">Within-host SARS-CoV-2 viral kinetics informed by complex life course exposures reveals different intrinsic properties of Omicron and Delta variants</a>
</div></li>
<li><strong>Primary Care Post-COVID syndrome Diagnosis and Referral Coding</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Introduction - Guidelines for diagnosing and managing Post-COVID syndrome have been rapidly developed. Consistency of the application of these guidelines in primary care is unknown. Electronic health records provide an opportunity to review the use of codes relating to Post-COVID syndrome. This paper explores the use of primary care records as a surrogate uptake measure for NICEs rapid guideline managing the long-term effects of COVID-19 by measuring the use of Post-COVID syndrome diagnosis and referral codes in the pathway. Method - With the approval of NHS England we used routine clinical data from the OpenSafely-EMIS/-TPP platforms. Counts of Post-COVID syndrome diagnosis and referral codes were generated from a cohort of all adults, establishing numbers of diagnoses and referrals following diagnosis. The relationship between Post-COVID syndrome diagnosis and referral codes was explored with reference to NICEs rapid guideline. Results - Of over 45 million patients, 69,220 (0.15%) had a Post-COVID syndrome diagnostic code, and 67,741 (0.15%) had a referral code. 78% of referral codes did not have an associated diagnosis code. 79% of diagnosis codes had no subsequent referral code. Only 18,633 (0.04%) had both. There were higher rates of both diagnosis and referral in those who were more deprived, female and some ethnic groups. Discussion - This study demonstrates variation in diagnosis and referral coding rates for Post-COVID syndrome across different patient groups. The results, with limited crossover of referral and diagnostic codes, suggest only one type of code is usually recorded. Recording one code limits the use of routine data for monitoring Post-COVID syndrome diagnosis and management, but suggests several areas for improvement in coding. Post-COVID syndrome coding, particularly diagnosis coding, needs to improve before administrators and researchers can use it to evaluate care pathways.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.23.23289798v1" target="_blank">Primary Care Post-COVID syndrome Diagnosis and Referral Coding</a>
</div></li>
<li><strong>Psychiatric hospital admissions and linkages to ambulatory services in the Western Cape Province of South Africa (2015-2022): trends, risk factors, the impact of the COVID-19 pandemic and possible opportunities for intervention</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
In recent years, hospital managers have reported increasing numbers of psychiatric hospital admissions in the Western Cape Province of South Africa, driven by poverty and substance use. We aimed to examine this trend, and the impact of the COVID-19 pandemic, as well as assess factors associated with linkage to ambulatory services following hospital discharge and repeat psychiatric admissions. Using electronic health data from the Provincial Health Data Centre, a consolidated routine service database, all psychiatric hospital admissions in the Western Cape public sector from 2015 to 2022 were analyzed, stratified by hospital level. Mixed effects logistic regression was used in this cohort study to determine the factors associated with successful linkage to ambulatory services within 30 days following hospital discharge, and repeat psychiatric admission within 30 and 90 days. We found that psychiatric hospital admissions, particularly at the district/acute level, were increasing prior to 2020 and an increasing proportion of diagnoses were substance related. 40% of admissions at the district level had not been seen at a primary health care facility in the year before the admission. Male patients and those with substance use disorders were less likely to be successfully linked to outpatient services following discharge. Successful linkage was one of the most protective factors against readmission within 90 days with an adjusted odds ratio of 0.76 (95%CI 0.73-0.79) and 0.45 (95%CI 0.42-0.49) at district/acute and specialized hospitals respectively. Improving linkage to ambulatory services by mental health patients post-discharge is likely to avert hospital readmissions.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.17.23290107v1" target="_blank">Psychiatric hospital admissions and linkages to ambulatory services in the Western Cape Province of South Africa (2015-2022): trends, risk factors, the impact of the COVID-19 pandemic and possible opportunities for intervention</a>
</div></li>
<li><strong>Posttraumatic stress disorder symptom trajectories in a 16-month COVID-19 pandemic period</strong> -
<div>
In the aftermath of mass trauma, posttraumatic stress disorder (PTSD) symptoms follow prototypical trajectories of resilience, recovery, or chronic distress. The coronavirus disease 2019 (COVID-19) pandemic represented an unheralded opportunity to better understand heterogeneous trajectories of PTSD symptoms across a prolonged period of social disruption and stress. We tracked the PTSD symptoms of trauma-exposed individuals in the U.S., sought to identify population-based variability in PTSD symptom trajectories, and understand what, if any, early pandemic experiences would predict their membership in one trajectory over others. As part of a large-scale longitudinal study of U.S. residents during the pandemic, participants who reported at least one potentially traumatic event in their lifetime (N = 1206) at Wave 1 (April 2020) were included in the current study. PTSD symptoms were assessed with the PTSD Checklist for DSM-5 at four time points extending to July 2021. Latent growth mixture modeling was used to identify heterogeneous symptom trajectories. Trajectory membership was regressed on baseline demographics and experiences from the early stage of the pandemic as measured by the Epidemic-Pandemic Impacts Inventory. Four trajectories (Resilient [73%], Recurring [13.3%], Recovering [8.3%], and Chronic [5.5%] were identified. Age, trauma load, and early pandemic experiences (emotional/physical health problems and positive changes) were each significant predictors of trajectory membership. Predictors primarily differentiated the Resilient from each of the other three trajectories. Distinct PTSD symptom trajectories during the COVID-19 pandemic point to the need for targeted efforts helping those at most risk for ongoing distress.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/wpjgm/" target="_blank">Posttraumatic stress disorder symptom trajectories in a 16-month COVID-19 pandemic period</a>
</div></li>
<li><strong>Experiences, impacts and mental health functioning during a COVID-19 outbreak and lockdown: Data from a diverse New York City sample of college students</strong> -
<div>
In March 2020, New York City (NYC) experienced an outbreak of coronavirus disease 2019 (COVID-19) which resulted in a 78-day mass confinement of all residents other than essential workers. The aims of the current study were to (1) document the breadth of COVID-19 experiences and their impacts on college students of a minority-serving academic institution in NYC; (2) explore associations between patterns of COVID-19 experiences and psychosocial functioning during the prolonged lockdown, and (3) explore sex and racial/ethnic differences in COVID-19-related experiences and mental health correlates. A total of 909 ethnically and racially diverse students completed an online survey in May 2020. Findings highlight significant impediments to multiple areas of students’ daily life during this period (i.e., home life, work life, social environment, and emotional and physical health) and a vast majority reported heightened symptoms of depression and generalized anxiety. These life disruptions were significantly related to poorer mental health. Moreover, those who reported the loss of a close friend or loved one from COVID-19 (17%) experienced significantly more psychological distress than counterparts with other types of infection-related histories. Nonetheless, the majority (96%) reported at least one positive experience since the pandemic began. Our findings add to a growing understanding of COVID-19 impacts on psychological health and contribute the important perspective of the North American epicenter of the pandemic during the time frame of this investigation. We discuss how the results may inform best practices to support students’ well-being and serve as a benchmark for future studies of US student populations facing COVID-19 and its aftermath.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/nyght/" target="_blank">Experiences, impacts and mental health functioning during a COVID-19 outbreak and lockdown: Data from a diverse New York City sample of college students</a>
</div></li>
<li><strong>Information bias of vaccine effectiveness estimation due to informed consent for national registration of COVID-19 vaccination: estimation and correction using a data augmentation model</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Registration in the Dutch national COVID-19 vaccination register requires consent from the vaccinee. This causes misclassification of non-consenting vaccinated persons as being unvaccinated. We quantified and corrected the resulting information bias in the estimation of vaccine effectiveness (VE). Methods: National data were used for the period dominated by the SARS-CoV-2 Delta variant (11 July to 15 November 2021). VE ((1-relative risk)*100%) against COVID-19 hospitalization and ICU admission was estimated for individuals 12-49, 50-69, and ≥70 years of age using negative binomial regression. Anonymous data on vaccinations administered by the Municipal Health Services were used to determine informed consent percentages and estimate corrected VEs by iterative data augmentation. Absolute bias was calculated as the absolute change in VE; relative bias as uncorrected / corrected relative risk. Results: A total of 8,804 COVID-19 hospitalizations and 1,692 COVID-19 ICU admissions were observed. The bias was largest in the 70+ age group where the non-consent proportion was 7.0% and observed vaccination coverage was 87%: VE of primary vaccination against hospitalization changed from 75.5% (95% CI 73.5-77.4) before to 85.9% (95% CI 84.7-87.1) after correction (absolute bias -10.4 percentage point, relative bias 1.74). VE against ICU admission in this group was 88.7% (95% CI 86.2-90.8) before and 93.7% (95% CI 92.2-94.9) after correction (absolute bias -5.0 percentage point, relative bias 1.79). Conclusions: VE estimates can be substantially biased with modest non-consent percentages for registration of vaccination. Data on covariate specific non-consent percentages should be available to correct this bias.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.23.23290384v1" target="_blank">Information bias of vaccine effectiveness estimation due to informed consent for national registration of COVID-19 vaccination: estimation and correction using a data augmentation model</a>
</div></li>
<li><strong>Emotional overeating affected nine in ten female students during the COVID-19 University closure: A cross-sectional study in France</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objectives: To estimate the proportion of female university students reporting overeating (EO) in response to emotions during the COVID-19 university closures, and to investigate social and psychological factors associated with this response to stress. Design: Online survey gathered sociodemographic data, alcohol/drugs use disorders, boredom proneness and impulsivity using validated questionnaires, and EO using the Emotional Overeating Questionnaire (EOQ) assessing eating in response to six emotions (anxiety, sadness, loneliness, anger, fatigue, happiness), whose structure remains to be determined. Participants: Sample of 302 female students from Rennes University, France. Main Outcome Measure: Frequencies of emotional overeating. Analysis: The frequency of emotional overeating was expressed for each emotion as percentages. Exploratory Factor analyses (EFA) were used to determine EOQ structure and provide an index of all EOQ items used for further analysis. Linear regression models were used to explore relationships between EO and others covariates. Results: Nine in ten participants reported intermittent EO in the last 28 days, mostly during 6 to 12 days, in response to Anxiety (75.5%), Sadness (64.5%), Happiness (59.9%), Loneliness (57.9%), Tiredness (51.7%), and to a lesser extent to Anger (31.1%). EFA evidenced a one-factor latent variable reflecting “Distress-Induced Overeating” positively correlated with internal boredom proneness, tobacco use, attentional impulsivity, inability to resist emotional cues, and loss of control over food intake, and negatively with age and well-being. EO was unrelated to body mass index or substance abuse. Conclusion and Implications: Nine in ten female students reported emotional overeating during the COVID-19 university closure. This response to stress was related to eating tendencies typical of young women, but also to personality/behavioral patterns such as boredom and impulsivity proneness. Better understanding of the mechanisms underlying EO in response to stress and lack of external/social stimulation would improve preventive interventions.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.17.23290100v1" target="_blank">Emotional overeating affected nine in ten female students during the COVID-19 University closure: A cross-sectional study in France</a>
</div></li>
<li><strong>Wastewater Surveillance for SARS-CoV-2 in an Atlanta, Georgia Jail: A study of the feasibility of wastewater monitoring and correlation of building wastewater and individual testing results.</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background Wastewater-based surveillance (WBS) on an institutional level was implemented during the COVID-19 pandemic, including carceral facilities. In this study of a mega-jail, we examined the relationship between COVID-19 diagnostic test results from jail residents and the PCR signal for SARS-CoV-2 detection in weekly samples of jail wastewater over a 28-week period. Methods This study in a Georgia Jail (average population ~2,700) was conducted October 2021-May 2022. Weekly on-site wastewater samples were collected (Moore Swabs) and tested for SARS-CoV-2 RNA using RTqPCR. The source of wastewater was identified using a tracer dye. The jail offered residents rapid antigen testing at entry. We conducted periodic mass screenings via RT-PCR of nasal swabs. We aggregated individual test data, calculated the Spearman correlation coefficient, and performed logistic regression to examine the relationship between the strength of the SARS-CoV-2 PCR signal (Ct value) in wastewater and the proportion of the jail population that tested positive for COVID-19. Results Overall, 3770 individual nasal specimens were collected; 3.4% were COVID-positive. Weekly diagnostic test positivity ranged from 0%-29.5%. Dye tests demonstrated that a single wastewater collection point was sufficiently representative of the jails aggregate viral load. Twenty-five wastewater samples were collected. RT-qPCR Ct values for wastewater samples with SARS-CoV-2 RNA ranged from 28.1-39.9. A strong inverse correlation was observed between diagnostic test positivity and Ct value (r= -0.67, p &lt; 0.01). Conclusion WBS was shown to be an effective strategy for surveilling COVID-19 in a large jail. Strong partnerships with the jail administration are essential to the success of WBS surveillance.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.17.23290000v1" target="_blank">Wastewater Surveillance for SARS-CoV-2 in an Atlanta, Georgia Jail: A study of the feasibility of wastewater monitoring and correlation of building wastewater and individual testing results.</a>
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<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Investigation of the Effect on Cognitive Skills of COVID-19 Survivors</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Other: green walking and intelligence gam<br/><b>Sponsors</b>:   Bayburt University;   Karadeniz Technical University<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Conducting Clinical Trials of the Medicine “Rutan Tablets 0.1g” No. 10 in the Complex Therapy of COVID-19</strong> - <b>Condition</b>:   Patients With COVID-19<br/><b>Interventions</b>:   Drug: The drug “Rutan 0.1”.;   Other: Basic treatment<br/><b>Sponsor</b>:   Research Institute of Virology, Ministry of Health of the Republic of Uzbekistan<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of Safety, Tolerability, Reactogenicity, Immunogenicity of Baiya SARS-CoV-2 Vax 2 as a Booster for COVID-19</strong> - <b>Conditions</b>:   COVID-19 Vaccine;   COVID-19<br/><b>Interventions</b>:   Biological: 50 μg Baiya SARS-CoV-2 Vax 2;   Other: Placebo<br/><b>Sponsor</b>:   Baiya Phytopharm Co., Ltd.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Effect of Special Discharge Training in the COVID-19</strong> - <b>Condition</b>:   COVID-19 Pneumonia<br/><b>Intervention</b>:   Other: COVID-19 Discharge Education<br/><b>Sponsor</b>:   Kilis 7 Aralik University<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Physiotherapy in Mutated COVID-19 Patients</strong> - <b>Condition</b>:   COVID-19 Pandemic<br/><b>Intervention</b>:   Behavioral: Physiotherapy<br/><b>Sponsor</b>:   Giresun University<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Studying the Efficiency of the Natural Preparation Rutan in Children in the Treatment of COVID-19, ARVI</strong> - <b>Condition</b>:   COVID-19 Respiratory Infection<br/><b>Interventions</b>:   Drug: Rutan 25 mg;   Other: Control group<br/><b>Sponsor</b>:   Research Institute of Virology, Ministry of Health of the Republic of Uzbekistan<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Pilot Study Evaluating the Efficacy of the Vielight Neuro RX Gamma in the Treatment of Post COVID-19 Cognitive Impairment</strong> - <b>Condition</b>:   Post COVID-19 Cognitive Impairment<br/><b>Interventions</b>:   Device: Vielight Neuro RX Gamma active device;   Device: Vielight Neuro RX Gamma sham device<br/><b>Sponsor</b>:   Vielight Inc.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>To Explore the Regulatory Effect of Combined Capsule FMT on the Levels of Inflammatory Factors in Peripheral Blood of Patients With COVID-19 During Treatment.</strong> - <b>Conditions</b>:   Fecal Microbiota Transplantation;   COVID-19 Infection<br/><b>Intervention</b>:   Procedure: Fecal microbiota transplantation<br/><b>Sponsor</b>:   Shanghai 10th People’s Hospital<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Use of a Hypochlorous Acid Spray Solution in the Treatment of COVID-19 Patients : COVICONTROL Study .</strong> - <b>Condition</b>:   SARS CoV 2 Infection<br/><b>Interventions</b>:   Other: Spray with Hypochlorous Acid Group;   Other: Spray with Placebo Group<br/><b>Sponsor</b>:   University of Monastir<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Telerehabilitation Program and Detraining in Patients With Post-COVID-19 Sequelae</strong> - <b>Condition</b>:   COVID-19 Acute Respiratory Distress Syndrome<br/><b>Intervention</b>:   Other: Telerehabilitation program<br/><b>Sponsor</b>:   Campus docent Sant Joan de Déu-Universitat de Barcelona<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Phase 3 Study of Novavax Vaccine(s) as Booster Dose After mRNA Vaccines</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: NVX-CoV2373;   Biological: SARS-CoV-2 rS antigen/Matrix-M Adjuvant<br/><b>Sponsor</b>:   Novavax<br/><b>Active, not recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 Vaccine Uptake Amongst Underserved Populations in East London</strong> - <b>Conditions</b>:   COVID-19;   Influenza;   Vaccination Refusal<br/><b>Intervention</b>:   Device: Patient Engagement tool<br/><b>Sponsors</b>:   Queen Mary University of London;   Social Action for Health<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>REVERSE-Long COVID-19 With Baricitinib Pilot Study</strong> - <b>Condition</b>:   Post-Acute COVID-19 Syndrome<br/><b>Intervention</b>:   Drug: Baricitinib 4 MG<br/><b>Sponsors</b>:   Vanderbilt University Medical Center;   Emory University;   University of California, San Francisco;   University of Minnesota;   Vanderbilt University;   Yale University<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Dose Exploration Intramuscular/Intravenous Prophylaxis Pharmacokinetic Exposure Response Study</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: AZD3152;   Other: Placebo<br/><b>Sponsor</b>:   AstraZeneca<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study to Assess Safety, Reactogenicity and Immunogenicity of the repRNA(QTP104) Vaccine Against SARS-CoV-2(COVID-19)</strong> - <b>Conditions</b>:   COVID-19;   SARS-CoV-2<br/><b>Interventions</b>:   Biological: QTP104 1ug;   Biological: QTP104 5ug;   Biological: QTP104 25ug<br/><b>Sponsor</b>:   Quratis Inc.<br/><b>Active, not recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Optimizing the Cas13 antiviral train: cargo and delivery</strong> - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in 2020 highlighted the need for rapid, widespread responses against infectious disease. One such innovation uses CRISPR-Cas13 technology to directly target and cleave viral RNA, thereby inhibiting replication. Due to their programmability, Cas13-based antiviral therapies can be rapidly deployed to target emerging viruses, in comparison with traditional therapeutic development that takes at least 12-18 months, and often…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>In silico design and evaluation of a novel therapeutic agent against the spike protein as a novel treatment strategy for COVID-19 treatment</strong> - CONCLUSIONS: In silico studies can provide a good opportunity to study viral proteins and new drugs or compounds since they do not need direct exposure to infectious agents or equipped laboratories. The suggested therapeutic agent should be further characterized in vitro and in vivo.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>CD24-Siglec interactions in inflammatory diseases</strong> - CD24 is a small glycosylphosphatidylinositol (GPI)-anchored glycoprotein with broad expression in multiple cell types. Due to differential glycosylation, cell surface CD24 have been shown to interact with various receptors to mediate multiple physiological functions. Nearly 15 years ago, CD24 was shown to interact with Siglec G/10 to selectively inhibit inflammatory response to tissue injuries. Subsequent studies demonstrate that sialylated CD24 (SialoCD24) is a major endogenous ligand for…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A linear B-cell epitope close to the furin cleavage site within the S1 domain of SARS-CoV-2 Spike protein discriminates the humoral immune response of nucleic acid- and protein-based vaccine cohorts</strong> - CONCLUSIONS: Understanding the exact function of antibodies recognizing amino acid region 657-671 of SARS-CoV-2 Spike glycoprotein and why nucleic acid-based vaccines elicit different responses from protein-based ones will be helpful for future vaccine design.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Impacts of pregnancy and menopause on COVID-19 severity: A systematic review and meta-analysis of 4.6 million women</strong> - CONCLUSIONS: Pregnancy and menopause are protective and risk factors for severe COVID-19, respectively. The protective role of pregnancy on COVID-19 is minimal and could be counteracted or masked by prepregnancy or pregnancy comorbidities. The administration of estrogen and progesterone may prevent severe COVID-19.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effect of voluntary human mobility restrictions on vector-borne diseases during the COVID-19 pandemic in Japan: A descriptive epidemiological study using a national database (2016 to 2021)</strong> - The coronavirus disease 2019 (COVID-19) pandemic not only encouraged people to practice good hygiene but also caused behavioral inhibitions and resulted reduction in both endemic and imported infectious diseases. However, the changing patterns of vector-borne diseases under human mobility restrictions remain unclear. Hence, we aimed to investigate the impact of transborder and local mobility restrictions on vector-borne diseases through a descriptive epidemiological study. The analysis was…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effect of P2Y12 Inhibitors on Organ Support-Free Survival in Critically Ill Patients Hospitalized for COVID-19: A Randomized Clinical Trial</strong> - CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of critically ill participants hospitalized for COVID-19, treatment with a P2Y12 inhibitor did not improve the number of days alive and free of cardiovascular or respiratory organ support. The use of the P2Y12 inhibitor did not increase major bleeding compared with usual care. These data do not support routine use of a P2Y12 inhibitor in critically ill patients hospitalized for COVID-19.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immunosuppressants exert differential effects on pan-coronavirus infection and distinct combinatory antiviral activity with molnupiravir and nirmatrelvir</strong> - CONCLUSIONS: Different immunosuppressants have distinct effects on coronavirus replication, with 6-TG, MPA, tofacitinib and filgotinib possessing pan-coronavirus antiviral activity. The combinations of MPA, 6-TG, tofacitinib and filgotinib with antiviral drugs exerted an additive or synergistic antiviral activity. Thus, these findings provide an important reference for optimal management of immunocompromised patients infected with coronaviruses.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Myricetin possesses the potency against SARS-CoV-2 infection through blocking viral-entry facilitators and suppressing inflammation in rats and mice</strong> - CONCLUSION: Our findings showed that myricetin inhibited HCoV-229E and SARS-CoV-2 replication in vitro, blocked SARS-CoV-2 virus entry facilitators and relieved inflammation through the RIPK1/NF-κB pathway, suggesting that this flavonol has the potential to be developed as a therapeutic agent against COVID-19.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Promoting cognitive health: a virtual group intervention for community-living older adults</strong> - CONCLUSIONS: The synchronous virtual group intervention was shown to be feasible for the elderly in the community who participated in the study.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SARS-CoV-2 RBD and Its Variants Can Induce Platelet Activation and Clearance: Implications for Antibody Therapy and Vaccinations against COVID-19</strong> - The COVID-19 pandemic caused by SARS-CoV-2 virus is an ongoing global health burden. Severe cases of COVID-19 and the rare cases of COVID-19 vaccine-induced-thrombotic-thrombocytopenia (VITT) are both associated with thrombosis and thrombocytopenia; however, the underlying mechanisms remain inadequately understood. Both infection and vaccination utilize the spike protein receptor-binding domain (RBD) of SARS-CoV-2. We found that intravenous injection of recombinant RBD caused significant…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>HSPA5 Promotes Attachment and Internalization of Porcine Epidemic Diarrhea Virus through Interaction with the Spike Protein and the Endo-/Lysosomal Pathway</strong> - Porcine epidemic diarrhea virus (PEDV) has caused huge economic losses to the global pig industry. The swine enteric coronavirus spike (S) protein recognizes various cell surface molecules to regulate viral infection. In this study, we identified 211 host membrane proteins related to the S1 protein by pulldown combined with liquid-chromatography tandem mass spectrometry (LC-MS/MS) analysis. Among these, heat shock protein family A member 5 (HSPA5) was identified through screening as having a…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of the Inhibition Potency of Nirmatrelvir against Main Protease Mutants of SARS-CoV-2 Variants</strong> - SARS-CoV-2 continues to pose a threat to public health. Main protease (M^(pro)) is one of the most lucrative drug targets for developing specific antivirals against SARS-CoV-2 infection. By targeting M^(pro), peptidomimetic nirmatrelvir is able to inhibit viral replication of SARS-CoV-2 and reduce the risk for progression to severe COVID-19. However, multiple mutations in the gene encoding M^(pro) of emerging SARS-CoV-2 variants raise a concern of drug resistance. In the present study, we…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Culture and pandemic control at cross-roads: navigating the burial guidelines for COVID-19-related deaths in a Ghanaian setting</strong> - CONCLUSIONS: Insensitivity to socio-cultural practices compromised the implementation of the COVID-19 pandemic control interventions, particularly, the COVID-19-related death and burial protocols. Some compromises that were not sanctioned by the protocols were reached to allow health officials and families respectfully bury their dead. These findings call for the need to prioritize the incorporation of sociocultural practices in future pandemic prevention and management strategies.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rational Design of Covalent Kinase Inhibitors by an Integrated Computational Workflow (Kin-Cov)</strong> - Covalent kinase inhibitors (CKIs) hold great promise for drug development. However, examples of computationally guided design of CKIs are still scarce. Here, we present an integrated computational workflow (Kin-Cov) for rational design of CKIs. The design of the first covalent leucine-zipper and sterile-α motif kinase (ZAK) inhibitor was presented as an example to showcase the power of computational workflow for CKI design. The two representative compounds, 7 and 8, inhibited ZAK kinase with…</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>It Was More Than a #DeSaster</strong> - Ron DeSantis’s botched campaign launch suggests that he’s no Trump-killer. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/it-was-more-than-a-desaster">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why Masha Gessen Resigned from the PEN America Board</strong> - A conversation about balancing free-speech commitments in an era of war. - <a href="https://www.newyorker.com/news/q-and-a/why-masha-gessen-resigned-from-the-pen-america-board">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What Is Biden’s Endgame in the Debt-Ceiling Standoff?</strong> - The Administration is examining all its options to avoid a technical default should there be no agreement by the “X-Date.” - <a href="https://www.newyorker.com/news/our-columnists/what-is-bidens-endgame-in-the-debt-ceiling-standoff">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>E. Jean Carroll Discusses Trump’s Comeuppance</strong> - Since losing a civil case to the journalist, who accused him of sexual abuse and defamation, Trump has doubled down on his attacks. - <a href="https://www.newyorker.com/news/daily-comment/e-jean-carroll-discusses-trumps-comeuppance">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What Is a Weed?</strong> - The names we call plants say more about us than they do about the greenery that surrounds us. - <a href="https://www.newyorker.com/news/our-local-correspondents/what-is-a-weed">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>What was Succession actually trying to tell us?</strong> -
<figure>
<img alt="Photo collage of the actors in the HBO show “Succession” against a backdrop of cartoon symbols of wealth, including a helicopter, a private jet, and diamonds." src="https://cdn.vox-cdn.com/thumbor/_PpFBVWadVEv6uN5yY1RytTXBQI=/94x0:1534x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72315004/SuccessionFinal2.0.jpg"/>
<figcaption>
Vox/Photos by: Macall B. Polay, David Russell, Graeme Hunter/HBO
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Real headlines and “wealth consultants” helped weave an unseemly portrait of wealth in America.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cJAjKm">
<em><strong>Note: This article contains spoilers for several episodes from all four seasons of </strong></em><strong>Succession</strong><em><strong>. </strong></em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1kkaW4">
Early in <em>Succession</em>’s first season, professional simp Tom Wambsgans told his punching-bag-slash-protegé Greg Hirsch that he’ll show him how to be rich, as if it’s a skill to practice and absorb. They’re outsiders — Tom (Matthew Macfadyen) married into the Roy family, while Greg (Nicholas Braun) is a mere cousin, initially prodded into the Roys’ business not by ambition but by his mother. He had only recently wormed his way into the family’s affairs. They’re in awe of the glittering world of billionaires almost within their grasp, with little idea of the misery and humiliation in store.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="keFzhS">
Over the past four seasons, <em>Succession, </em>which airs its final episode on HBO on Sunday, May 28, has shown its audience not only how to be rich but the way extreme wealth and power can be a pestilence that subtly rots everything it touches.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TVXzc1">
Without moralizing, <em>Succession</em> carefully built its case over the years, charting the slow unraveling of the Roy family as it chased ever-higher heights of power. The show was a <a href="https://www.folger.edu/blogs/shakespeare-and-beyond/of-roys-and-kings-the-shadow-of-succession/">Shakespearean tragedy</a>, a car wreck that gained a huge, rubber-necking audience: The Roys, the magnates pulling the strings at media conglomerate Waystar-Royco, ate, dressed, and lived well, but they were not well. They and their social circle existed in a walled garden, surrounded by an underclass of household servants, bodyguards, drivers, and assistants who oiled the machine of their elegant lifestyle. But their fear of losing even a scrap of power further isolated them even from the people they claimed to love. Their riches didn’t just make them powerful or self-absorbed — they made them paranoid. Far from being satisfied with their lot in life, they hunched over in a defensive position, beset with gnawing anxiety over all the precious things others were jealously trying to take from them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nnPGTL">
<em>Succession</em>’s portrayal of the secluded halls of power was deeply cynical, and its allure at times was purely voyeuristic, but it’s hard to deny the show’s realism. <em>Succession</em>’s world — its aesthetics and plotlines, its characters’ grand motivations and little tics — mirrored real-life billionaires and the circles they run in. Under showrunner Jesse Armstrong, the show employed a squad of wealth consultants to ensure the accuracy of the writing on the <a href="https://podcasts.apple.com/us/podcast/recode-media/id1080467174?i=1000613973724">nitty-gritty of the media business</a> (like whether it’s possible that a CEO of a large conglomerate could hide <a href="https://www.nytimes.com/2019/08/04/business/media/hbo-succession-business.html">significant debt from shareholders</a>) and how the wealthy behave (they <a href="https://twitter.com/variety/status/1303392660426637312">never wear coats</a> because they’re always transported directly from one destination to another). They wear Patek Philippe watches, which can run well north of $100,000, casually take helicopter rides out of New York to throw around a baseball, relish eating <a href="https://www.eater.com/2018/11/21/18101843/ortolans-bird-napkin-billions-succession">illegal avian delicacies</a>, and have <a href="https://youtu.be/qMLkgWqibLc?t=72">no idea what a gallon of milk</a> costs. Many popular TV shows have portrayed the lives of the wealthy as glitzy and glamorous, but few have so deftly used the real symbols and language of wealth to tell a story of greed and abuse of power that’s also a microcosm of a society suffering under the weight of an increasingly unequal, undemocratic economic landscape.
</p>
<hr class="p-entry-hr" id="oexic3"/>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3gQ3Uo">
On <em>Succession</em>, as in real life, rich people have easily, and often catastrophically, meddled in politics and society. It showed us how easily the wealthy misapprehend the magnitude of their power, using it to force obedience and invade the lives of others while never contemplating whether it came with obligation. They used the potent combination of wealth and influence to avoid the consequences of scandal and regulation whenever convenient, and frittered away hundreds of millions on vanity art projects and political campaigns, even to sway narratives about presidential elections. In one episode in season 3, the Roys attended an exclusive political conference where a group of rich donors and business leaders hand-pick the next Republican presidential nominee after the current president has announced he’s not running again, in part because he’s so beaten down by attacks against him by ATN — the Roys’ news network. Logan Roy (Brian Cox), the family’s malignant patriarch, favored whoever was most beneficial to his business interests.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7YUCE8">
Such private gatherings are where real billionaires also whisper their political desires, throwing their considerable cash behind one candidate or another. Political mega-donors like <a href="https://www.nytimes.com/2022/02/07/technology/peter-thiel-facebook.html">Peter Thiel</a>, Ken Griffin, Mike Bloomberg, and George Soros (and formerly <a href="https://www.vox.com/the-goods/23458837/sam-bankman-fried-ftx-sbf-downfall-explained">Sam Bankman-Fried</a>) have undeniably helped shape which politicians make it onto the ballot and what pro-industry, anti-regulation policies these candidates support. The amount of “dark money” in politics — political spending where the donor isn’t disclosed — continues to soar, exceeding <a href="https://www.opensecrets.org/news/2021/03/one-billion-dark-money-2020-electioncycle/">$1 billion</a> in the 2020 federal elections. The ultra-rich, being as well-connected as they are, involve themselves not only in elections but in <a href="https://www.vox.com/recode/23274476/abortion-rights-billionaire-donors">heated political issues</a> and even weigh in on <a href="https://www.cnbc.com/2022/10/24/how-googles-former-ceo-eric-schmidt-helped-write-ai-laws-in-washington-without-publicly-disclosing-investments-in-ai-start-ups.html">White House policy</a>. Billionaires pour their money into politicians and social causes for a variety of stated reasons, but their interference leads to basically one result: Their power grows, and often, so does their net worth.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Y5ovZI">
The Roys’ most obvious inspiration were the Murdochs, who own a global media empire that includes right-wing network Fox News (though the show also contains <a href="https://www.hbo.com/succession/article/jesse-armstrong-shares-the-inspiration-for-the-roy-family">dribbles of the Redstones</a>, the media family behind Paramount Global, and others). ATN was Fox’s fictional twin, as was underscored in this season’s election episode when the network spread disinformation and a narrative of anti-establishment distrust that helps Jeryd Mencken, the show’s caricature of Donald Trump, become president. The core drama of the show — a bitter struggle between siblings to take over the company their father built — was drawn from the real <a href="https://www.nytimes.com/interactive/2019/04/03/magazine/rupert-murdoch-fox-news-trump.html">succession fight among the Murdoch children</a>, particularly Elisabeth, Lachlan, and James Murdoch. This feud of two brothers and a sister was dramatized across <em>Succession</em>’s four seasons: The Roys constantly scrabbled to move up the ranks, or at least to not tumble from them. Not despite their wealth but because of it, defensiveness was their default state of being.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yLofoy">
Even in the small details, <em>Succession</em> was injected with references and homages to the Murdochs and others — Logan Roy’s idea of buying up a raft of local TV stations in season one was a page out of a <a href="https://www.hollywoodreporter.com/news/general-news/fox-buy-three-local-tv-stations-350-million-1252596/">Murdoch playbook</a>. Logan stood on boxes of paper to give a speech to ATN employees in an early season four episode, just as Murdoch reportedly did for a <a href="https://twitter.com/sarahellison/status/1642863126201655296">speech in the Wall Street Journal newsroom</a>. Logan Roy’s direct line to the US president, however, feels tame compared to <a href="https://www.washingtonpost.com/lifestyle/2023/05/19/succession-logan-roy-rupert-murdoch-fox-atn/">Rupert Murdoch’s coziness with world leaders</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9M2n0p">
But for all their wealth and power, <em>Succession</em> argued, the Roys were never a happy family. Logan, who set the tone for the rest of the family’s moods and behaviors, flew into a rage at any hint that he was being insulted — and was always grinding his teeth at the unease that someone, somewhere, might not be giving him his due respect. (Think: Elon Musk, a frequently impulsive, blustering tech billionaire, who has increasingly spouted off on his perceived persecution in the media, despite his <a href="https://www.vox.com/the-goods/23585251/elon-musk-tesla-trial-verdict">history</a> of doing or saying things that affect his company, shareholders, and the public at large.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nRzeJc">
Logan Roy was a billionaire who founded a giant media conglomerate; one would think his self-evident accomplishments would be enough to appease his ego. Yet Logan was petty, thin-skinned, and reactive to every slight. He delayed announcing a Waystar successor — just as Rupert Murdoch, now 92 years old, has — because he could never bear the thought of giving up power. Instead, he spent his last years viciously fighting off any perceived threat to his throne.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="F2B8zj">
It’s hard not to see the parallels, too, between <a href="https://www.vox.com/culture/2019/9/15/20864545/succession-season-2-episode-6-argestes-recap-logan-pierce-cruises">Waystar’s cruise line</a> sexual harassment coverup and Rupert Murdoch’s biggest scandal: His newspapers had been hacking the phones of politicians and celebrities, including those of the British royal family. Under parliamentary testimony, Murdoch’s son James admitted that he’d <a href="https://www.latimes.com/world/europe/la-fg-british-scandal-murdoch-20150611-story.html">received an email</a> about the phone hacking after <a href="https://www.theguardian.com/media/2011/sep/06/james-murdoch-phone-hacking-email">initially denying</a> he had been aware of it. Did Rupert know? In the end, other senior members of the paper took the fall, some being arrested, one senior editor serving a prison sentence, and many other staff resigning or being fired. Murdoch’s company also paid an undisclosed amount in damages — but no one in the family was personally punished beyond financial and reputational damage.
</p>
<hr class="p-entry-hr" id="2Eq2VY"/>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cTDO8O">
In a eulogy for Logan in the <a href="https://www.vox.com/tv/23730196/succession-season-4-episode-9-funeral-protests-election">penultimate episode of the series</a>, Ewan (James Cromwell) spoke of the meagerness his brother brought out in others. He had a stinginess of spirit befitting someone forced to aggressively defend his scarce resources — not someone with billions in assets. Not someone whose son cruelly dangled the prospect of a million-dollar reward to a groundskeeper’s young child at a family baseball game in the show’s first episode.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1USS0k">
Such unkindness was the least of the damage the Roys wreaked on the less-privileged people around them, whose suffering they barely even register. Kendall (Jeremy Strong) accidentally killed a cater-waiter while high and on a reckless pursuit for more drugs; an ATN employee shot himself at work because he couldn’t bear the workplace harassment he faced; the cruise scandal revealed that in incidents involving violence or abuse against workers at Waystar, the victims were labeled <a href="https://www.nytimes.com/2021/10/14/arts/television/succession-season-3-review.html">“No Real Person Involved”</a> — as in, not high enough in the ranks to merit much of a response. Later, when Waystar came under scrutiny for their cruise misdeeds, Shiv (Sarah Snook) manipulated a sexual harassment victim into silence. They carelessly left a trail of casualties in their wake, brushing the destruction aside as collateral damage for their all-important need for more power, and for their father’s praise. Perhaps it’s not surprising that Armstrong included a <a href="https://www.independent.co.uk/arts-entertainment/tv/news/succession-logan-ghislaine-maxwell-robert-death-b2317606.html">nod to Ghislane Maxwell</a> in the show, invoking a figure who has become a notorious example of powerful men and women abusing vulnerable people.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="C0wesC">
Yet, in a real sense, the Roys saw themselves as mistreated and maligned. Connor (Alan Ruck), the eldest son, was a libertarian who frequently railed against taxation. His family reins him in not because they disagreed with his stance but because it lacked subtlety. Quietly reducing their taxes was what they hired accountants and financial advisers for. (During Logan’s wake this season, Waystar CFO Karl Muller, played by David Rasche, unironically opined that burning the Gauguin paintings Logan kept in a Swiss vault would be ideal for avoiding taxes and collecting insurance money.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HC4oFy">
The Roys’ particular brand of meagerness has been well-documented in real life. The actual billionaires of US society pay incredibly little in taxes compared to the average middle- and low-income American. A <a href="https://www.propublica.org/article/the-secret-irs-files-trove-of-never-before-seen-records-reveal-how-the-wealthiest-avoid-income-tax">ProPublica analysis</a> of billionaires’ tax records in 2021 showed that the 25 richest Americans paid a tax rate of about 3.4 percent, while the median American household paid about 14 percent of their annual wages in federal taxes. Billionaires often argue that <a href="https://www.latimes.com/business/story/2019-08-15/billionaires-oppose-taxes">tax breaks for them benefit everyone</a>, freeing up capital that can be reallocated to charitable causes, to their innovative companies, to creating jobs. <em>Succession</em> gave us the sense that the truth is far more avaricious.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oxJGCU">
In <em>The Wealth Hoarders</em>, author Chuck Collins — director of the program on Inequality and the Common Good at the Institute for Policy Studies, as well as the heir to the Oscar Mayer fortune — offers an insider’s view of the mentality of high-net-worth individuals, who consider it sacrilege not to hold onto their wealth. Give away the interest generated from your assets, sure, but to chip away at the principal is “class suicide,” as one rich person suggested to Collins. The wealth management industry — sometimes called the <a href="https://www.icij.org/inside-icij/2021/06/how-the-worlds-richest-defend-their-wealth-with-help-from-a-dedicated-industry/">wealth defense industry</a> — has ballooned in the past few decades, consisting of an army of professionals paid hefty sums to ensure that the Roys of the world never have to give too much away, whether it’s by using obscure tax loopholes or taking advantage of <a href="https://www.vox.com/the-goods/2023/1/4/23413342/us-tax-havens-billionaires-wealthy">trusts and tax havens</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9wbV07">
Armstrong’s subtle messaging about the Roys’ vague discontent isn’t some moralistic fable about wealth; the uber-rich often report being perplexingly dissatisfied and uneasy about their financial state. Having “enough” money tends to be relative. Millionaires <a href="https://www.ft.com/content/b2e56c96-1f32-11e9-a46f-08f9738d6b2b">worry about being able to retire</a>. A famous 2011 <a href="https://www.theatlantic.com/business/archive/2011/03/surveying-the-super-rich/71841/">Boston College survey</a> of extremely rich American households — whose average net worth was $78 million — revealed that multi-millionaires generally aren’t content with their fortunes, with one respondent saying he wouldn’t feel secure until he had $1 billion. Psychologist Robert A. Kenny, who helped create the survey, told the Atlantic, “Sometimes I think that the only people in this country who worry more about money than the poor are the very wealthy.” One wealth adviser told the New York Times in a 2017 article about the <a href="https://www.nytimes.com/2017/11/07/your-money/wealth-anxiety-money.html">anxieties of the ultra-rich</a>: “They never do feel they have enough. It takes some coaxing to get them to <em>spend</em> money.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j9Nmro">
Ewan gave his grandson Greg some trenchant wisdom in the first season, before he’d begun to be corrupted by his association with the Roys. “One of the symptoms of an approaching nervous breakdown is the belief that one’s work is ever so important,” Ewan said, quoting the philosopher Bertrand Russell. That’s been the essence of the entire show: a wealthy family teetering on the edge of a nervous breakdown. As the show comes to a close, it’s closer to the precipice than ever.
</p></li>
<li><strong>The year’s scariest horror film is The Zone of Interest</strong> -
<figure>
<img alt="A family picnic on the bank of a river." src="https://cdn.vox-cdn.com/thumbor/2nQGgkv_xvclqh0x__EdTMDoqUs=/160x0:1120x720/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72314940/zone.0.jpg"/>
<figcaption>
A peaceful scene from <em>The Zone of Interest</em>, the year’s best horror film. | A24
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Jonathan Glazer’s new film dismantles simple cliches about the banality of evil.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VeKXt5">
<em>The Zone of Interest</em>, Jonathan Glazer’s first film in 10 years, is ostensibly based on a book: Martin Amis’s stomach-churning 2014 novel of the same name. But understanding the movie’s formal and thematic genius requires looking at it differently: as a sidelong horror-film adaptation of Hannah Arendt’s 1963 <em>Eichmann in Jerusalem</em>, one that goes way beyond that book’s well-worn idea of the “banality of evil.” That phrase, lifted from <em>Eichmann</em>’s subtitle, furnishes most people’s entire Arendt knowledge base: the idea that evil presents itself not as a devil with horns and a pitchfork, but in seemingly egoless, “mediocre” men like Adolf Eichmann, architect of the <a href="https://encyclopedia.ushmm.org/content/en/article/final-solution-overview">Final Solution</a>, who carry out unspeakable atrocities.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6l2SiK">
That’s not wrong, but it’s much too simple, verging on cliche — ironic, given Arendt’s warnings. In her reporting on Eichmann’s trial, Arendt noted how he spoke only in “stock phrases and self-invented cliches,” the kinds of euphemisms that Arendt said indicated a refusal to think for oneself. In this, Eichmann was a true company man; the Third Reich was notorious for inventing language and speech codes that made following the rules seem inevitable. The Nazi Sprachregelung<em>, </em>or its particular bureaucratic vocabulary, was euphemistic in the extreme. Killing became “dispatching”; forced migration became “resettlement”; the mass murder of the Jews became Eichmann’s “final solution.” When you call what you’re doing to millions of your neighbors “special treatment,” you don’t have to think about what it really is. You might even start to enjoy the challenge of doing it more officially.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qbX51H">
This Sprachregelung is all over <em>The Zone of Interest</em>, in part because its characters don’t talk about murder or genocide, but also because Glazer — whose previous film was the brilliantly unsettling <a href="https://www.vox.com/culture/2020/8/5/21352779/she-dies-tomorrow-review"><em>Under the Skin</em></a><em> —</em> replicates the characters’ internal distance through the movie’s images and sounds. The result is unsettling in the extreme. It takes a few minutes of watching to realize what, precisely, you’re looking at, and the nauseating shock at that moment packs a stronger punch than any horror movie I’ve seen this year. Here is the sunny, flower-filled, orderly front garden, in front of a well-appointed and tidy home in which a large, cheerful family lives. But wait; just beyond the yard is a tall gray cement fence with barbed wire on top, and smokestacks visible in the distance.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dHCLqT">
On the other side of the garden wall is Auschwitz.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="16GJhu">
The home is occupied by the notorious extermination camp’s commandant, Rudolf Höss (a real man, played here by Christian Friedel), his wife Hedwig (<a href="https://www.vox.com/culture/2016/12/29/14089486/toni-erdmann-review-maren-ade-sandra-huller-peter-simonischek">Sandra Hüller</a>), their large brood of children, and a few servants, at least one of whom seems to be Jewish. <em>The Zone of Interest</em> keeps the Höss family in the foreground. We see them on a picnic, having family dinners, spending time playing in the garden, enjoying their greenhouse and their pool. Hedwig is a nurturing mother and hospitable housekeeper.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vYl3PK">
While they live out their lives in their happy house, we watch with horror. Smartly, Glazer gives us only the most minimal amount of character background; this is emphatically not a movie where there’s a “good Nazi” to root for. Instead, it shows how the whole Nazi system was designed to ensure that nobody could be good. We’re hearing the Hösses talk about life in the foreground. But there’s an ambient noise in <em>The Zone of Interest</em>, akin to the hum of a white noise machine — except in this case it’s omnipresent, the sound of furnaces in the distance, laced with occasional gunshots and howls. To hear what’s going on in the house, we have to tune them out a little. I hope we can’t.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Iy48MN">
The characters, however, have. Höss and his colleagues have been deeply formed by the regime in which they’ve made their careers, in which Nazi ideology is encoded in its language and systems. (They speak with awe and obedience of Himmler and of Hitler — and, of course, of Eichmann.) Höss has made a name for himself as an executor of efficient systems: “His particular strength is turning theory into practice,” a letter that a colleague writes about him explains. The practice of killing, that is.
</p>
<div class="c-float-right">
<aside id="YDqLVy">
<q>The characters in <em>The Zone of Interest</em> know exactly what’s happening; they’ve just, essentially, dissociated</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UyrrTn">
It would be inexcusable and deadly wrong to say that <em>The Zone of Interest</em> is about people living in blissful ignorance about what’s going on just over the garden wall. They know exactly what’s happening; they’ve just, essentially, dissociated. Höss talks about gassing thousands of Jews as if it’s an interesting problem to be solved, but it’s his job. What’s more chilling is that his family knows. Hedwig — who proudly tells her mother she’s been nicknamed the “queen of Auschwitz” — admires a fur coat that arrives in a shipment brought in by a prisoner, trying on the lipstick she finds in the pocket. She warns the Jewish girl who works in the house that she could “have my husband spread your ashes” across the fields. She speaks with her visiting mother about whether a former neighbor of theirs, a Jewish woman her mother cleaned for, is “in there.” There’s a tinge of revenge, the feeling that if she is, she probably deserves it because she was probably plotting Bolshevik nonsense in days gone by.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PKKZ3E">
Perhaps the most telling scene comes when two of the young sons are playing in the backyard. The older locks the younger in the greenhouse — and then makes noises of gassing at him. The only family member who seems unable to ignore the horror of what’s happening is the baby, who screams whenever the ovens light up.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HkIVDP">
The sound design in <em>The Zone of Interest</em> is so extraordinarily effective that it’s easy to miss what the film is doing on a visual level. The scenes of familial bliss take place in a beautiful garden or a comfortable home, but they’re shot with a severity that belies the setting; this is a world gone flat, a paean to a fascist dream of life properly lived, yet all surfaces and no depths. To live such a life would require a hollowing out, an ability to continually ignore one’s senses — those ovens smell awful, but Hedwig never indicates she can smell them at all — until they more or less cease functioning. The insistent bright ugliness gives way occasionally to something shocking (a few black-and-white segments reversed into photonegative, or a shot of a flower that fades to blood-red), all the better to remind us that none of this is beautiful, and we ought to be horrified.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eJPrso">
Introducing her book <em>The Life of the Mind </em>by writing about her Eichmann observations again, Arendt could have been writing about the Hösses. She was “struck by the manifest shallowness” in Eichmann, which made it “impossible to trace the uncontestable evil of his deeds to any deeper level of roots or motives.” In fact, she wrote, while his deeds were monstrous, she saw that “the doer — at least the very effective one now on trial — was quite ordinary, commonplace, and neither demonic nor monstrous.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fd6hse">
What is monstrous is the insistently abstracted language the Hösses and other Nazis use in order to avoid thought, especially contrasted with the wordless screams that Mica Levi has worked into the score. Höss is praised for his advances in “KL practice” (KL standing for Konzentrationslager, or concentration camp); we watch him deep in conversation about circular burn chambers that can more efficiently exterminate. “Burn, cool, unload, reload, continuously!” the designer tells him. We watch rooms full of Nazi commandants applaud news of the beginning of the “mass deportation” of Hungarian Jews, with 25 percent “retained for labor.” Nobody says exactly what they mean.
</p>
<div class="c-float-right">
<aside id="0k14oD">
<q>To see others as sub-human, worthy of prejudice or slavery or torture or extermination, we need to be coached through some mental gymnastics</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BXuBHH">
Arendt wrote that the Nazi Sprachregelung introduced a degree of separation between the users and reality, making the horrors of Hitler’s ideas, as Arendt put it, “somehow palatable.” Another way to say this is that humans are capable of great cruelties and monstrosities, but we’re also creatures of compassion and empathy. To see others as sub-human, worthy of prejudice or slavery or torture or extermination, we need to be coached through some mental gymnastics. We need words that disconnect us from reality, that put a layer of remove between us and them, between action and thought. Between our humanity and what we are capable of.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ghhmsc">
The effect of watching <em>The Zone of Interest</em> ought, I think, to make us feel a mounting horror — and then, from there, to make us think, an act Arendt was always writing about. In the <em>Life of the Mind </em>introduction, she argued that the antidote to the thoughtless cruelty of the autocratic systems around us might be thinking: “Might the problem of good and evil, our faculty of telling right from wrong, be connected with our faculty of thought?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Q6n58J">
Maybe, she wrote. “Could this activity be among the conditions that make men abstain from evildoing or even actually ‘condition’ them against it?” she asks. In other words, could learning to think, to avoid cliched thought and stock phrases, train us out of complacency? Could being shocked and horrified and made profoundly uncomfortable, left without easy language, perpetuate a moral good?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6fY795">
What Glazer does with <em>The Zone of Interest</em> is give the audience just a taste of that shock, and then force us into thinking. He never shows the atrocities outright — not to pique our curiosity but because we do not want to see them. To depict it would be, in its own way, an atrocity. Instead, he adds a visual and aural layer of abstraction in order to let us test ourselves, to see if we are, perhaps, the sort of people willing to be in their place now.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9zoAZQ">
“The dividing line,” Arendt wrote, “between those who want to think, and therefore have to judge by themselves, and those who do not, strikes across all social and cultural or educational differences.” All that seems clear right now, at this point in history, is this question is eternally worth facing.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BbCqQD">
The Zone of Interest<em> premiered at the Cannes Film Festival in May and will be distributed later in 2024 by A24.</em>
</p></li>
<li><strong>Want to try Wegovy or Ozempic? Get ready to fight with your health insurer.</strong> -
<figure>
<img alt="Boxes of the diabetes drug Ozempic rest on a pharmacy counter on April 17, 2023, in Los Angeles." src="https://cdn.vox-cdn.com/thumbor/Gw6CqrPyIarcY_H6F9WUvUoxErQ=/0x0:4589x3442/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72314897/GettyImages_1482908413.0.jpg"/>
<figcaption>
Wegovy and Ozempic could address one of the most pressing health crises in the US — and yet the country’s health system seems to be actively discouraging their use. | Mario Tama/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Can the US afford to cover this next generation of weight-loss drugs? Can it afford not to?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MC71ms">
<a href="https://www.vox.com/science-and-health/23584679/ozempic-wegovy-semaglutide-weight-loss-obesity">A new generation of weight-loss drugs</a> presents an opportunity to improve the health of millions of Americans — and a challenge for the nation’s health care system that will have to figure out how to afford them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ANocC3">
The demand for these drugs is proving to be extraordinary. Last week, Novo Nordisk <a href="https://www.statnews.com/2023/05/19/weight-loss-wegovy-novo-nordisk-pauses-ads/?utm_campaign=morning_rounds&amp;utm_medium=email&amp;_hsmi=259228806&amp;_hsenc=p2ANqtz--KUcMCOFymRu6dPCTb-uvFBgwXPYHUZ0qICMrpFbxB0t8m7cYRNOrOM_3KaT1v4iZGD_J9o9yOzERBUreL6p9eHM1xCg&amp;utm_content=259228806&amp;utm_source=hs_email">announced</a> it would temporarily stop advertising <a href="https://www.vox.com/science-and-health/23584679/ozempic-wegovy-semaglutide-weight-loss-obesity">Wegovy</a>, a diabetes medication that was approved for weight loss in 2021, to prevent high demand from leading to a shortage. Its sister drug with the same active ingredient, <a href="https://www.vox.com/videos/2023/3/14/23638717/ozempic-wegovy-weight-loss-semaglutide-hormones-glp1">Ozempic</a>, is not approved for weight loss but is in high demand for off-label use. And the market is only expected to grow: Eli Lilly has <a href="https://www.goodmorningamerica.com/wellness/story/popular-diabetes-drug-mounjaro-fda-approved-weight-loss-98882665#:~:text=The%20FDA%20approved%20Ozempic%20in,for%20people%20who%20are%20obese.">asked</a> the FDA to approve another diabetes drug, Mounjaro, for use in losing weight.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vUVOmt">
The public health opportunity could also be significant. <a href="https://www.healthsystemtracker.org/chart-collection/how-have-costs-associated-with-obesity-changed-over-time/#Share%20of%20adults%20who%20are%20overweight%20or%20obese,%202011-2021">One in three US adults</a>, more than 85 million people, are considered obese; another one in three are considered overweight. Obesity is a risk factor for various chronic health conditions — like hypertension, heart disease, diabetes, and so on — that are among the most common causes of death in the United States, and the treatments for these diseases are costly. Medical costs associated with obesity exceed $250 billion annually, according to <a href="https://icer.org/wp-content/uploads/2022/03/ICER_Obesity_Final_Evidence_Report_and_Meeting_Summary_102022.pdf">the Institute for Clinical and Economic Review</a> (ICER).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cPP0JZ">
If these drugs can help people shed weight, and early indications are they’re very effective in doing that, that should help them avert those chronic conditions too. And indeed, <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/obesity-drug-brings-heart-health-benefit-alongside-weight-loss-study-2023-05-19/?utm_campaign=KHN%3A%20First%20Edition&amp;utm_medium=email&amp;_hsmi=259281710&amp;_hsenc=p2ANqtz-_OXhJPE0CiycV85ZBproJV2iseWM2xBfpYD9jNTz4HXnARs_YgapOvJ6b1dk4KI2kZW8svdpfQrSoBwHxrH5olr1_PlA&amp;utm_content=259281710&amp;utm_source=hs_email">preliminary research findings</a> suggest Wegovy improves patients’ heart health, which could help to avoid costlier medical problems down the road. The new treatments have the added advantage of relative ease of use, compared to other obesity treatments like gastric bypass surgery. You can take an injection once a week instead of going under the knife. (Although, unlike a one-time surgery, you may need to take those injections in perpetuity.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UGc1m4">
The American health care system has seen blockbuster drugs — treatments that are wildly profitable for pharmaceutical companies — before. But this is a special case: drugs that are meant to be taken over the long term to address conditions that affect more than half of the US population.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KvgaQz">
Not everyone who is obese or overweight is unhealthy, or interested in losing weight, and doctors likely won’t think the medication is appropriate for everyone. Even so, the potential number of people eligible is big enough that, even if the vast majority never fill a prescription, the weight-loss drugs could quickly become among the most common drugs in America, and the most expensive for insurers to cover. ICER estimated if just 0.1 percent of the potential patient population for Wegovy were to receive a prescription, the cost would be significant enough to drive up premiums for private plans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dWvDm2">
But the US health system isn’t built to help a vast population take advantage of a very expensive drug, even one with these potential long-term benefits. And that raises questions about whether patients who might benefit and are interested will even be able to afford them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8Wz1gC">
Having health insurance doesn’t mean your plan will cover every drug on the market. Insurers make decisions, based on both clinical benefit and cost, about whether to cover different drugs, what restrictions to place on that coverage, and how much patients have to pay for them out of pocket. So far, drugs like Wegovy and Ozempic are usually excluded from people’s insurance coverage. Medicare and Medicaid generally do not include weight-loss drugs. Employer health plans, which cover half of the country’s population, typically don’t cover weight-loss drugs either, and are demanding documentation from patients and doctors to justify a Wegovy or Ozempic prescription.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qeoTGx">
In other words, we have new treatments that address one of the most pressing health crises in the country — and yet our health system seems to be actively discouraging their use. What gives?
</p>
<h3 id="q7Mfl5">
Why health insurers typically aren’t covering Wegovy and Ozempic right now
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZKSpX8">
Wegovy, Ozempic, and their peers are ushering in a new era of obesity treatment. Historically, being overweight or obese has been characterized as largely a personal failure and the result of poor lifestyle choices. But most of the medical community already treats weight issues as a biological problem, with behavior as just one component. The public has gradually been coming around to the same view.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3ovnSO">
The ability to take an injection once a week and see significant weight loss is another step toward treating obesity like any other disease, with the potential to improve health and prevent serious and costly medical conditions later in life. According to <a href="https://icer.org/wp-content/uploads/2022/03/ICER_Obesity_Final_Evidence_Report_and_Meeting_Summary_102022.pdf">ICER</a>, the patients in the clinical trials that evaluated Wegovy as a weight-loss treatment saw about a 15 percent reduction in weight after one year compared to people in the placebo arm of the trials.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jp7eKL">
That amount of weight loss can result in meaningful health benefits. According to <a href="https://www.cdc.gov/healthyweight/losing_weight/index.html#:~:text=Even%20a%20modest%20weight%20loss,blood%20cholesterol%2C%20and%20blood%20sugars.">the Centers for Disease Control and Prevention</a>, even a 5-10 percent reduction in body weight can lead to improved blood pressure, cholesterol, and blood sugar. A small Mayo Clinic study <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/obesity-drug-brings-heart-health-benefit-alongside-weight-loss-study-2023-05-19/?utm_campaign=KHN%3A%20First%20Edition&amp;utm_medium=email&amp;_hsmi=259281710&amp;_hsenc=p2ANqtz-_OXhJPE0CiycV85ZBproJV2iseWM2xBfpYD9jNTz4HXnARs_YgapOvJ6b1dk4KI2kZW8svdpfQrSoBwHxrH5olr1_PlA&amp;utm_content=259281710&amp;utm_source=hs_email">estimated</a> that patients saw a reduction in their likelihood of a heart attack or stroke after taking Wegovy for a year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="l4DBAQ">
Those improvements should let people live longer and save the health system money. According to <a href="https://www.healthsystemtracker.org/chart-collection/how-have-costs-associated-with-obesity-changed-over-time/#Share%20of%20adults%20who%20are%20overweight%20or%20obese,%202011-2021">the Peterson-KFF Health System Tracker</a>, people enrolled in large employer health plans who are diagnosed with obesity have significantly higher annual health care costs compared to people who are not: about $12,600 versus $4,700 in 2021.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hw4FZj">
But those benefits can only be realized for most people if their insurer covers the drug. Wegovy currently has a list price between $800 and $1,000 a month, or between $10,000 and $12,000 a year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1FIa8d">
Even in the age of the Affordable Care Act, insurers still have a lot of leeway in deciding which prescription drugs to cover. <a href="https://www.wsj.com/articles/workers-want-ozempic-for-weight-loss-few-employers-want-to-pay-for-it-215fb5c1?st=gcto7w14k64ctxe&amp;utm_source=Sailthru&amp;utm_medium=email&amp;utm_campaign=VoxCare%205/25/23">According to the Wall Street Journal</a>, less than half of large firms (those with more than 5,000 employees) cover weight-loss drugs under their health plan. For smaller shops, the share is even lower, less than 20 percent. Medicaid and Medicare, which insure <a href="https://www.kff.org/other/state-indicator/total-population/?dataView=1&amp;currentTimeframe=0&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D">about 35 percent of the population</a> combined, don’t cover them either, even though obese patients are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337412/">more likely to be covered by those programs</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yxdso2">
Right now, employer health plans are pushing back against the high demand they are seeing for these treatments. Experts say that they don’t expect those attitudes to change until the prices come down or cheaper alternatives come onto the market.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MzZ2uV">
“Until there are, coverage that’s offered through an employer’s health insurance plan may be limited to individuals who are in extreme need of these drugs,” Jennifer Chang, an expert at the Society for Human Resource Management, told me, “versus just as a means of losing weight.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6gTtkE">
David Dillon, a health actuary at Lewis &amp; Ellis, explained how this might look in practice. When doctors prescribe Wegovy for weight loss and patients submit their claim, insurers may ask the doctor for information from annual well visits or blood labs that indicate the person is at risk of developing diabetes. The Wall Street Journal <a href="https://www.wsj.com/articles/workers-want-ozempic-for-weight-loss-few-employers-want-to-pay-for-it-215fb5c1?st=gcto7w14k64ctxe">reported</a> that patients are already receiving that kind of request from their health insurer, and some are having their claims denied.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aE97F2">
Most health insurers do cover gastric bypass surgery, which could in theory be more cost-effective because it’s a one-and-done procedure rather than a prolonged medication regimen. But they also require patients and doctors to meet a long list of criteria before covering that version of obesity treatment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eryydC">
Medicare, meanwhile, is actually <a href="https://www.ncoa.org/article/obesity-treatment-and-medicare-a-guide-to-understanding-coverage">prohibited by law</a> from covering weight-loss drugs under the legislation passed in 2003 that created its prescription drug benefit. Legislation has been proposed in the past to eliminate that exclusion, and drug makers are pushing again for lawmakers to repeal it with these new obesity drugs coming onto the market. Coverage of those drugs could impose significant costs to the program (as much as $27 billion every year) but could also potentially yield long-term cost savings.
</p>
<h3 id="WZoN3M">
Why employer health plans might not invest in people’s long-term health
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hPOUAR">
This is one of the ways in which the US health system’s reliance on employer-sponsored insurance fails us. Most working-age adults are covered by the company that employs them. The priority for the company’s health plan is to try to keep costs as low as possible in the short term, to avert premium increases.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IqUNL5">
“We have a much more mobile workforce now. Not many folks are staying 20 to 30 years in the same role,” Chang said. “Those long-term benefits might not be a part of their thinking because they are thinking short-term, immediate results versus the long game.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PnBEke">
That’s because in the modern economy, employment is often a short-term proposition. <a href="https://www.bls.gov/news.release/tenure.nr0.htm">The average tenure for a job</a> in the United States these days is about four years.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="V7qwcw">
“Because people often switch jobs and health insurers, there isn’t always an incentive to pay upfront for a drug that may generate health benefits and cost reductions in the future,” said Larry Levitt, executive vice president at the health policy think tank KFF.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ors221">
Compounding that problem is that these weight-loss drugs currently appear to be overpriced compared to their value, even if that value is real. Based on ICER’s assessment of Wegovy’s long-term health benefits, the drug provides a value commensurate to between $7,500 and $9,800 per year. But the medicine’s list price is currently above $17,000 and, even when accounting for <a href="https://www.vox.com/2023/5/10/23709448/what-are-pbms-pharmacy-benefit-managers-bernie-sanders">rebates paid by drug makers to health plans</a>, the average annual cost is still higher (about $13,000) than its expected value.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RrKhc4">
One thing experts are watching is whether, in the future, the federal government determines weight-loss drugs should be classified as preventive medicine. Health plans are <a href="https://www.kff.org/womens-health-policy/fact-sheet/preventive-services-covered-by-private-health-plans/">required to cover certain preventive services</a> recommended by expert panels under the ACA. (That is, if the preventive medicine provision survives <a href="https://www.vox.com/policy-and-politics/2022/9/7/23341076/obamacare-reed-oconnor-prep-supreme-court-braidwood-becerra-affordable-care-act">an ongoing legal challenge</a>.) This would make it easier for patients to access the drugs — and much, much more costly for insurers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1ItztO">
That is the health system the United States has built. Drug makers that patent a novel treatment are given a monopoly and broad discretion to set whatever prices they want for their products. Insurers have some leverage to bring those prices down in negotiations, but they will also resort to restricting coverage to moderate their costs. And because employer plans can expect to cover a given patient for only a few years, they are incentivized to keep costs low in the short term without paying much mind to the potential for long-term savings by averting chronic health problems.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Kbi45x">
It is a situation driven by the peculiar structure of US health care. A breakthrough weight-loss treatment is going to present a cost challenge to other developed countries, where obesity rates have been rising for years, too. But those countries don’t face the same cost pressures.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aYzT5j">
In the UK, for example, a month’s supply of Wegovy <a href="https://www.cbsnews.com/news/ozempic-wegovy-weight-loss-uk-semaglutide-fraction-of-what-americans-pay/">costs about $100</a> instead of more than $1,000 — a reflection of the National Health Service’s assessment of the value it will provide. Novo Nordisk also knows it can drive a harder bargain in the US with its more laissez-faire market, <a href="https://www.pbs.org/newshour/economy/do-other-countries-piggyback-o">reducing the need</a> to try to extract as much revenue as possible from Britain. And the UK has adopted <a href="https://www.independent.co.uk/news/health/wegovy-available-online-nhs-weight-loss-b2296055.html">prescription criteria</a> for all patients based on that assessment, with the drug prioritized for people who have specific health conditions, such as high blood pressure, diabetes or prediabetes, heart disease, and even sleep apnea.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mQad5P">
So there will be some limits on coverage for weight-loss drugs and experts in the UK do expect some frustration among patients as a result. But that country is making a holistic assessment of the value these drugs can provide and setting costs and access accordingly.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XRhCVf">
In the US, meanwhile, your ability to take Wegovy or Ozempic or whatever comes next depends on the whims of your employer’s health plan — with little consideration for how it may affect your long-term health.
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Glorious Grace claims the Madras Race Club Cup</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rasputin and Pride’s Angel shine</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Spain takes action against racism after Vinícius case but punishing fans remains a challenge</strong> - No one has ever gone to trial in Spain for racially abusing a player, and despite the unprecedented attention prompted by the recent Vinícius case, it may not be easy to get fans to start paying for their actions in court.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IPL 2023: Dhoni takes someone else’s trash and makes it treasure, says Matthew Hayden</strong> - Dhoni’s tactical genius has played a big part in Chennai Super King reaching their 10th IPL final.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>WTC winners to get $1.6 million prize money</strong> - The tournament prize money is the same as that for the inaugural World Test Championship Final in 2019-21</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Andhra Pradesh’s first wild orchidarium to come up in Visakhapatnam soon</strong> - A first look at the beautifully designed orchidarium by the AP Forest Department in Visakhapatnam which houses wild orchid species of the Eastern Ghats. It is that is coming up as part of the newly developed Eastern Ghats Biodiversity Centre</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Congress kept everything pending in Palamuru, BRS turned it green: Niranjan Reddy</strong> - Minister blames cases filed by Congress leaders for delay in completion of PRLIS</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Kejriwal to meet Chief Minister K Chandrasekhar Rao on Saturday</strong> - Delhi Chief Minister trying to mobilise support to his opposition to the recent Ordinance by the Centre on Delhi civil servants</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>State-level inauguration of Pouradhwani on May 28</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>‘Live’ Malayalam movie review: A loud, weak take on the relevant issue of fake news</strong> - Director V. K. Prakash and scriptwriter S. Sureshbabu take up a valid and relevant subject, but on-screen it often translates into a rather loud melodrama</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Russian rocket attack on Ukraine hospital kills two</strong> - More than 20 people were injured in the attack on a medical facility in the eastern city of Dnipro.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine war: Wagner may be smuggling weapons from Mali - US</strong> - The private Russian military group could be using African states to procure mines and other weapons.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Olivier Vandecasteele: Belgian aid worker freed in exchange for Iranian diplomat</strong> - Olivier Vandecasteele and Assadollah Assadi are flying home under a deal brokered by Oman.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Turkey election: What five more years of Erdogan would mean</strong> - President Erdogan is tipped to win Turkey’s presidential vote after a deeply divisive election.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Channel migrants tragedy: Five French soldiers accused of failing to help</strong> - Five French soldiers are accused of failing to help during the incident when 27 people died.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Dealmaster: Lenovo’s ThinkPad doorbusters top Memorial Day deals</strong> - Savings on laptops, blenders, sports watches, headphones, and more for Memorial Day. - <a href="https://arstechnica.com/?p=1942166">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rocket Report: Europe has a rocket problem, FAA testing safety of methane</strong> - “SpaceX continues to totally redefine the world’s access to space.” - <a href="https://arstechnica.com/?p=1940862">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Neuralink says it has the FDA’s OK to start clinical trials</strong> - Company isn’t enrolling patients yet, but it has cleared a major hurdle. - <a href="https://arstechnica.com/?p=1942466">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The curious case of the brie made from nuts that caused a multi-state outbreak</strong> - Health officials cracked the case starting with just two cases. - <a href="https://arstechnica.com/?p=1942447">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>People in Old Testament Jerusalem suffered from widespread dysentery, study finds</strong> - Study results indicate “long-term presence” of <em>Giardia</em> parasite in Near East populations. - <a href="https://arstechnica.com/?p=1941246">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A pun walks into a room and kills 10 people…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Pun in. Ten dead.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/sirpunsalot69"> /u/sirpunsalot69 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13s4zxn/a_pun_walks_into_a_room_and_kills_10_people/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13s4zxn/a_pun_walks_into_a_room_and_kills_10_people/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I can picture in my mind a world without war, a world without hate</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
And I can picture us attacking that world, because they’d never expect it.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/brockstopher"> /u/brockstopher </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13rwnsm/i_can_picture_in_my_mind_a_world_without_war_a/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13rwnsm/i_can_picture_in_my_mind_a_world_without_war_a/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>An octopus slinks into a dark room with a gun in each arm.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He hears a soft chuckle coming from the corner. “You’re one short, my friend,” says the cat as he steps into view.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/DaddyDomThaddeus"> /u/DaddyDomThaddeus </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13ro3c0/an_octopus_slinks_into_a_dark_room_with_a_gun_in/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13ro3c0/an_octopus_slinks_into_a_dark_room_with_a_gun_in/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Linda and Martha are talking. “Have you heard of the Bechdel Test?” asks Linda.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Yes,” answers Martha. “My boyfriend told me about it.”
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/wimpykidfan37"> /u/wimpykidfan37 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13rz6si/linda_and_martha_are_talking_have_you_heard_of/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13rz6si/linda_and_martha_are_talking_have_you_heard_of/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why is American beer like having sex in a canoe?</strong> - <!-- SC_OFF --></p>
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Because it’s fucking close to water.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Canuck647"> /u/Canuck647 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13s4xdp/why_is_american_beer_like_having_sex_in_a_canoe/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13s4xdp/why_is_american_beer_like_having_sex_in_a_canoe/">[comments]</a></span></p></li>
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