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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>A nine-year investigation of industry payments to emergency physicians in the United States between 2013 and 2021</strong> -
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Objectives To examine the characteristics and trends in the industry payments to emergency physicians since the inception of the Open Payments Database in 2013 and the COVID-19 pandemic in 2020. Methods Using the Open Payments Database between August 2013 and December 2021, this population based cohort study examined all research and general payments made by the healthcare industry to emergency physicians registered in the National Plan and Provider Enumeration System in the United States. We performed descriptive analyses on payment data and generalized estimating equations for payment trends. Results Among 50,483 active emergency physicians, 28,678 (56.8%) accepted a total of $457,640,796.73 payments from the healthcare industry between 2013 and 2021. 56.6% and 1.3% of all emergency physicians received general and research payments, respectively. 20.8% ($94.98 million) of overall industry payments were general payments. Median general and research payments per-physician (interquartile range) were $133.21 ($44.78-$355.77) and $62,842.97 ($10,320.00-$273,285.28), respectively. The top 1% of emergency physicians received 86.2% of overall general payments, respectively. The number of physicians receiving general payments decreased by 2.9% (95% CI: -3.2 to -2.5, p&lt;0.001) annually between 2014 and 2019 and 47.8% (95% CI: -49.8 to -45.6, p&lt;0.001) in 2020. Although there were no significant changes in research payments before the COVID-19 pandemic, the research payments significantly increased by 69.4% (95% CI: 28.9 to 122.7, p&lt;0.001) in 2021 compared to those in 2020. Conclusions The majority of emergency physicians accepted general payments from the healthcare industry, but the number of emergency physicians accepting general payments significantly decreased since the inception of the Open Payments Database.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.24.23293098v1" target="_blank">A nine-year investigation of industry payments to emergency physicians in the United States between 2013 and 2021</a>
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<li><strong>Industry payments to anesthesiologists in the United States between 2014 and 2022</strong> -
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Background: Financial relationships between physicians and the healthcare industry could be beneficial to improve patient care, but could lead to conflicts of interest. However, there was no study specifically evaluating the extent of financial relationships between anesthesiologists and the healthcare industry in the United States. Methods Using the Open Payments Database between 2014 and 2022, this longitudinal cross-sectional study examined the size, prevalence and trends of general (non-research) payments made by the healthcare industry to all anesthesiologists in the United States. Results: Over the nine-year period, 67.0% of all anesthesiologists received general payments totaling $272.0 million over nine years, while 21.0% to 35.3% of anesthesiologists received one or more general payments each year. Median annual general payments to anesthesiologists ranged from $57 to $115. The top 1%, 5%, and 10% of anesthesiologists received 73.4%, 90.3%, and 94.8% of all general payments, respectively. There were no constant yearly trends in the total amounts and per-anesthesiologist general payments between 2014 and 2019, but significant declines occurred in 2020, likely due to the COVID-19 pandemic. Pain medicine physicians received the highest median general payments of $4,426 in nine-year combined total amounts, followed by addiction medicine ($431), critical care medicine ($277), and general anesthesiology ($256). Conclusion: This study reveals significant financial relationships between the healthcare industry and anesthesiologists, with a disproportionate concentration of payments among a minority of anesthesiologists. While no clear trends in payments were evident before the pandemic, there was a substantial reduction during the COVID-19 outbreak.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.24.23293096v1" target="_blank">Industry payments to anesthesiologists in the United States between 2014 and 2022</a>
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<li><strong>Age- and sex-specific differences in immune responses to BNT162b2 COVID-19 and live-attenuated influenza vaccines in UK adolescents</strong> -
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Key to understanding COVID-19 correlates of protection is assessing vaccine-induced immunity in different demographic groups. Sex- and age-specific immune differences have a wide impact on outcomes from infections and immunisations. Typically, adult females make stronger immune responses and have better disease outcomes but suffer more adverse events following vaccination and are more prone to autoimmune disease. To understand better the mechanisms underlying these differences in vaccine responses, we studied immune responses to two doses of BNT162b2 Pfizer COVID-19 vaccine in an adolescent cohort (n=34, ages 12-16), an age group previously shown to make significantly greater immune responses to the same vaccine compared to young adults. At the same time, we were able to evaluate immune responses to the co-administered live attenuated influenza vaccine, which has been shown to induce stronger immune responses in adult females. Blood samples from 34 adolescents taken pre- and post-vaccination with COVID-19 and influenza vaccines were assayed for SARS-CoV-2-specific IgG and neutralising antibodies, and cellular immunity specific for SARS-CoV-2 and endemic betacoronaviruses. IgG targeting influenza lineages contained in the influenza vaccine was also assessed. As previously demonstrated, total IgG responses to SARS-CoV-2 Spike antigens were significantly higher among vaccinated adolescents compared to adults (aged 32-52) who received the BNT162b2 vaccine (comparing infection-naive, 49,696 vs 33,339; p=0.03; comparing SARS-CoV-2 previously-infected, 743,691 vs 269,985; p&lt;0.0001) by MSD v-plex assay. However, unexpectedly, antibody responses to BNT162b2 and the live-attenuated influenza vaccine were not higher among female adolescents compared to males; among infection-naive adolescents, antibody responses to BNT162b2 were higher in males than females (62,270 vs 36,951 p=0.008). No sex difference was identified in vaccinated adults. These unexpected findings may result from the introduction of novel mRNA vaccination platforms, generating patterns of immunity divergent from established trends, and providing new insights into what might be protective following COVID-19 vaccination.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.24.23293091v1" target="_blank">Age- and sex-specific differences in immune responses to BNT162b2 COVID-19 and live-attenuated influenza vaccines in UK adolescents</a>
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<li><strong>WEIRD or not: A Cross-Cultural Behavioral Economic Assessment of Demand for HIV and COVID-19 Vaccines</strong> -
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Background: Despite empirical evidence supporting vaccine effectiveness, vaccine hesitancy continues to thrive. Demand as a behavioral economic process provides useful indices for evaluating vaccine acceptance likelihood in individuals and groups. Using this framework, our study investigates the dynamics governing vaccine acceptance in two culturally dissimilar countries. Methods: Hypothetical purchase tasks (HPTs) assessed how Nigerian and US participants varied vaccine acceptance as a function of hospitalization risks due to vaccination (N = 109). Aggregate and individual demand indices (Q0 and Pmax) were computed with nonlinear regressions. Secondary analyses were conducted using repeated measures ANOVAs with vaccine type (COVID-19 and HIV) as the within-subject factor; country, age, and socioeconomic status as between-subjects factors; demand indices served as dependent variables. Results: Demand indices varied significantly as a function of vaccine type (F(1, 57) = 17.609, p &lt; .001, ηp2 = .236). Demand for HIV vaccines was higher relative to COVID-19 vaccines. Interactions between vaccine type and country of origin (F(1, 56) = 4.001, p = .05, ηp2 = .067) were also significant with demand for HIV vaccines among Nigerian respondents higher than that of COVID-19 vaccines. This was reversed for US participants. Interactions between vaccine type, country of origin and age were also significant (F(2, 51) = 3.506, p &lt; .05, ηp2 = .121). Conclusions: These findings provide evidence that vaccine type can influence demand. The relationship between demand and vaccine type also varies as a function of country of origin and age. Significance, limitations, and future directions are also discussed.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.24.23293101v1" target="_blank">WEIRD or not: A Cross-Cultural Behavioral Economic Assessment of Demand for HIV and COVID-19 Vaccines</a>
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<li><strong>Fight or Flight: Emergency Healthcare Workers Willingness to Work during Crises and Disasters: A cross-sectional multicentre study in the Netherlands</strong> -
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Objective: Expanding staff levels is a strategy for hospitals to increase surge capacity. This study aimed to evaluate whether emergency healthcare workers (HCWs) are willing to work (WTW) during a crises or disaster and which working conditions would influence their decision. Methods: HCWs of emergency departments (ED) and intensive care units (ICU) of five Dutch hospitals were surveyed about elevens disaster scenarios. For each scenario, HCWs were asked about their WTW and which conditions would influence their decision. Knowledge and perceived risk and danger was assessed per scenario. Results: 306/630 HCWs completed the survey. An influenza epidemic, SARS-CoV-2 pandemic and natural disaster were associated with highest WTW rates (69.0%, 63.7% and 53.3% respectively). WTW was lowest in nuclear incident (4.6%) and dirty bomb (3.3%) scenarios. WTW was higher in physicians than in nurses. Male ED HCWS, single HCWs and childless HCWs were more often WTW. Personal protective equipment (PPE) and safety of HCWs family were the most important working conditions. Perceived knowledge scored lowest in dirty bomb, biological and nuclear incident scenarios. These scenarios rated highest with regards to perceived danger. Conclusions: WTW depended on disaster type, profession and working department. Provision of PPE and safety of HCWs family were found to be predominant working conditions.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.25.23293139v1" target="_blank">Fight or Flight: Emergency Healthcare Workers Willingness to Work during Crises and Disasters: A cross-sectional multicentre study in the Netherlands</a>
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<li><strong>The Cost of Keeping Patients Waiting: Retrospective Treatment-Control Study of Additional Healthcare Utilisation for UK Patients Awaiting Elective Treatment Following COVID-19</strong> -
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Objective The COVID-19 pandemic has led to increased waiting times for elective treatments in many countries. This study seeks to address a deficit in the literature concerning the effect of long waits on the wider consumption of healthcare resources. Methods We carried out a retrospective treatment-control study in a healthcare system in South West England from 15 June 2021 to 15 December 2021. We compared weekly contacts with health services of patients waiting over 18 weeks for treatment (Treatments) and people not on a waiting list (Controls). Controls were matched to Treatments based on age, sex, deprivation and multimorbidity. Treatments were stratified by the clinical specialty of the awaited treatment, with healthcare usage assessed over various healthcare settings. T-tests assessed whether there was an increase in healthcare utilisation and bootstrap resampling was used to estimate the magnitude of any differences. Results A total of 44,616 patients were waiting over 18 weeks (the constitutional target in England) for treatment during the study period. Evidence suggests increases (p &lt; 0.05) in healthcare utilisation for all specialties. Patients in the Cardiothoracic Surgery specialty had the largest increase, requiring 17.9 [4.3, 33.8] additional contacts with secondary care and 17.3 [-1.1, 34.1] additional prescriptions per year. Conclusion People waiting for treatment consume higher levels of healthcare than comparable individuals not on a waiting list. These findings are relevant for clinicians and managers in better understanding patient need and reducing harm. Results also highlight the possible false economy in failing to promptly resolve long elective waits.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.25.23293143v1" target="_blank">The Cost of Keeping Patients Waiting: Retrospective Treatment-Control Study of Additional Healthcare Utilisation for UK Patients Awaiting Elective Treatment Following COVID-19</a>
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<li><strong>Inflammation-related pathology in the olfactory epithelium: its impact on the olfactory system in psychotic disorders</strong> -
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Smell deficits and neurobiological changes in the olfactory bulb (OB) and olfactory epithelium (OE) have been observed in patients with psychosis. The OE is the most peripheral olfactory system located outside the cranium, and is connected with the brain via direct neuronal projections to the OB. Nevertheless, it is unknown whether and how a disturbance of the OE affects the OB in psychosis. Addressing this gap would be the first step in studying the impact of OE pathology in the disease pathophysiology in the brain. In this cross-species study, we observed that chronic OE inflammation with a set of upregulated genes (IOI genes) led to a volume reduction, layer structure changes, and alterations of neuron functionality in the OB in an inducible olfactory inflammation (IOI) mouse model. In first episode psychosis (FEP) patients, we observed a significant alteration in immune/inflammation-related molecular signatures in olfactory neuronal cells (ONCs) enriched from biopsied OE and a significant reduction in the OB volume, compared with those of healthy controls (HC). The increased expression of immune/inflammation-related molecules in ONCs was significantly correlated to the OB volume reduction in FEP patients, but no correlation was found in HCs. Moreover, the increased expression of human orthologues of the IOI genes in ONCs was significantly correlated with the OB volume reduction in FEP, but not in HCs. Together, our study implies a potential mechanism of the OE-OB pathology in psychosis. We hope that this mechanism may have a cross-disease implication, including COVID-19-elicited mental conditions that include smell deficits.
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🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.09.23.509224v2" target="_blank">Inflammation-related pathology in the olfactory epithelium: its impact on the olfactory system in psychotic disorders</a>
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<li><strong>Competitive fitness and homologous recombination of SARS-CoV-2 variants of concern</strong> -
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SARS-CoV-2 variants continue to emerge and cocirculate in humans and wild animals. The factors driving the emergence and replacement of novel variants and recombinants remain incompletely understood. Herein, we comprehensively characterized the competitive fitness of SARS-CoV-2 wild type (WT) and three variants of concern (VOCs), Alpha, Beta and Delta, by coinfection and serial passaging assays in different susceptible cells. Deep sequencing analyses revealed cell-specific competitive fitness: the Beta variant showed enhanced replication fitness during serial passage in Caco-2 cells, whereas the WT and Alpha variant showed elevated fitness in Vero E6 cells. Interestingly, a high level of neutralizing antibody sped up competition and completely reshaped the fitness advantages of different variants. More importantly, single clone purification identified a significant proportion of homologous recombinants that emerged during the passage history, and immune pressure reduced the frequency of recombination. Interestingly, a recombination hot region located between nucleotide sites 22995 and 28866 of the viral genomes could be identified in most of the detected recombinants. Our study not only profiled the variable competitive fitness of SARS-CoV-2 under different conditions, but also provided direct experimental evidence of homologous recombination between SARS-CoV-2 viruses, as well as a model for investigating SARS-CoV-2 recombination.
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🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.07.26.550688v1" target="_blank">Competitive fitness and homologous recombination of SARS-CoV-2 variants of concern</a>
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<li><strong>Got used to make less: the lasting earnings losses of COVID-19 short-time work</strong> -
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This study is the first to investigate the impact of short-time work (STW) schemes on earnings during the COVID-19 pandemic. STW schemes have been implemented to preserve employee-employer matches, support workers’ incomes and uphold consumption. By construction, affected workers suffer temporary earnings losses, yet an important question is whether negative earnings effects of STW persist beyond the STW period or are limited to the STW spell. Using a dynamic difference-in-difference (DiD) identification strategy on administrative data, this study aims to identify any lasting causal STW effects on earnings, accounting for the factors that influence the selection of workers into STW and testing for heterogeneous effects across subgroups of workers. We find lasting earnings losses that persist beyond the actual STW participation. First and foremost, these earnings losses depend on the duration of STW exposure, with greater negative effects especially in the case of long-term or recurring STW spells. In general, lasting earnings losses post STW tend to be more pronounced in white-collar jobs, where women incur larger losses than men. The largest losses, however, are observed among men in blue-collar jobs with long STW spells of more than one year.
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🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/p2qvh/" target="_blank">Got used to make less: the lasting earnings losses of COVID-19 short-time work</a>
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<li><strong>Parental intention, attitudes, beliefs, trust and deliberation towards childhood vaccination in the Netherlands in 2022: Indications of change compared to 2013</strong> -
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<b>Background and aim</b> Vaccine uptake within the Dutch National Immunisation Programme (NIP) has slightly declined since the COVID-19 pandemic. We studied psychosocial factors of vaccine uptake, namely parental intention, attitudes, beliefs, trust and deliberation (i.e. self-evidence), before (2013) and two years into the pandemic (2022). <b>Methods</b> In 2022 and 2013, parents with a young child (aged &lt;3.5 years) participated in online surveys on vaccination (n=1,000 and 800, (estimated) response=12.2% and 37.2%, respectively). Psychosocial factors were measured on 7-point Likert scales. Multivariate logistic regression analysis was used to study differences between parents in 2022 and 2013 in 9negative9 scores (≤2) of psychosocial factors. <b>Results</b> In both 2022 and 2013, most parents with a young child expressed positive intention (2022=83.1%, 2013=87.0%), attitudes (3 items: 2022=66.7%-70.9%, 2013=62.1%-69.8%) and trust (2022=51.8%, 2013=52.0%) towards the NIP and felt that vaccinating their child was self-evident (2022=57.2%, 2013=67.3%). Compared to parents with a young child in 2013, parents with a young child in 2022 had significantly higher odds of reporting negative attitudes towards vaccination (3 items combined: OR=2.84), believing that vaccinations offer insufficient protection (OR=4.89), that the NIP is not beneficial for the protection of their child9s health (OR=2.23), that vaccinating their child does not necessarily protect the health of other children (OR=2.24) or adults (OR=2.22) and that vaccinations could cause severe side effects (OR=2.20), preferring natural infection over vaccination (OR=3.18) and reporting low trust towards the NIP (OR=1.73). <b>Conclusions</b> Although most parents had positive intention, attitudes and trust towards vaccination and perceived vaccinating their child as self-evident, proportions of parents with negative scores were slightly larger in 2022 compared to 2013. Monitoring these determinants of vaccine uptake and developing appropriate interventions could contribute to sustaining high vaccine uptake.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.24.23291934v1" target="_blank">Parental intention, attitudes, beliefs, trust and deliberation towards childhood vaccination in the Netherlands in 2022: Indications of change compared to 2013</a>
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<li><strong>Comparative effectiveness of sotrovimab versus no treatment in non-hospitalised high-risk patients with COVID-19 in North West London: a retrospective cohort study using the Discover dataset</strong> -
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<b>Introduction:</b> There is uncertainty regarding how <i>in vitro</i> antibody neutralisation activity translates to the clinical efficacy of sotrovimab against severe acute respiratory syndrome coronavirus 2, although real-world evidence has demonstrated continued effectiveness during both BA.2 and BA.5 predominance. We previously reported descriptive results from the Discover dataset for patients treated with sotrovimab, nirmatrelvir/ritonavir or molnupiravir, or patients at highest risk per National Health Service (NHS) criteria but who were untreated. This study sought to assess the effectiveness of sotrovimab compared with no early coronavirus disease 2019 (COVID-19) treatment in highest-risk patients with COVID-19. <b>Methods:</b> Retrospective cohort study using the Discover dataset in North West London. Patients had to be non-hospitalised at index, aged ≥12 years old and meet ≥1 of the NHS highest-risk criteria for receiving early COVID-19 treatment with sotrovimab. The primary objective was to assess the risk of COVID-19-related hospitalisation and/or COVID-19-related death within 28 days of the observed/imputed treatment date between patients treated with sotrovimab and highest-risk patients who received no early COVID-19 treatment. We also performed subgroup analyses for patients aged &lt;65 and ≥65 years, patients with renal dysfunction, and by Omicron subvariant prevalence period (BA.1/2 emergence: 1 December 2021–12 February 2022 [period 1]; BA.2 reaching and at its peak: 13 February–31 May 2022 [period 2]; BA.2 falling and BA.4/5 emergence: 1 June–31 July 2022 [period 3]). Inverse probability of treatment weighting based on propensity scores was used to adjust for measured known and likely confounders between the cohorts. Cox proportional hazards models with stabilised weights were performed to assess hazard ratios (HRs). <b>Results:</b> A total of 599 highest-risk patients treated with sotrovimab and 5,191 untreated highest-risk patients were included. Compared with untreated patients, sotrovimab treatment reduced the risk of COVID-19 hospitalisation or death by 50% (HR=0.50; 95% confidence interval [CI] 0.24, 1.06); however, statistical significance was not reached (p=0.07). In addition, sotrovimab reduced the risk of COVID-19 hospitalisation by 57% (HR=0.43; 95% CI 0.18, 1.00) compared with the untreated group, although also not statistically significant (p=0.051). Among patients aged ≥65 years and patients with renal disease, sotrovimab treatment was associated with a significantly reduced risk of COVID-19 hospitalisation, by 89% (HR=0.11; 95% CI 0.02, 0.82; p=0.03) and 82% (HR=0.18; 95% CI 0.05, 0.62; p=0.007), respectively. In period 1, sotrovimab treatment was associated with a 75% lower risk of COVID-19 hospitalisation or death compared with the untreated group (HR=0.25; 95% CI 0.07, 0.89; p=0.032). In periods 2 and 3, HRs of COVID-19 hospitalisation or death were 0.53 (95% CI 0.14, 2.00; p=0.35) and 0.78 (95% CI 0.23, 2.69; p=0.69), respectively, for the sotrovimab versus untreated groups, but differences were not statistically significant. <b>Conclusions:</b> Sotrovimab treatment was associated with a significant reduction in risk of COVID-19 hospitalisation in patients aged ≥65 years and those with renal disease compared with the untreated cohort. For the overall cohort, the risk of hospitalisation following sotrovimab treatment was also lower compared with the untreated group; however, this did not achieve statistical significance (p=0.051). The risk of hospitalisation and/or death was lower for the sotrovimab-treated cohort across all time periods but did not reach significance for periods 2 and 3.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.26.23293188v1" target="_blank">Comparative effectiveness of sotrovimab versus no treatment in non-hospitalised high-risk patients with COVID-19 in North West London: a retrospective cohort study using the Discover dataset</a>
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<li><strong>Chronic Shedding of a SARS-CoV-2 Alpha Variant Lineage Q.3/Q.4 in Wastewater</strong> -
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Central Michigan University (CMU) participated in a state-wide SARS-CoV-2 wastewater monitoring program since 2021. Wastewater samples were collected from on-campus sites and nine off-campus wastewater treatment plants servicing small metropolitan and rural communities. SARS-CoV-2 genome copies were quantified using droplet digital PCR and results were reported to the health department. One rural, off-campus site consistently produced higher concentrations of SARS-CoV-2 genome copies. Samples from this site were sequenced and initially contained predominately Alpha variant lineage Q.3, which transitioned to lineage Q.4. Alpha variant lineage Q.3/Q.4 was detected at this site beginning in fall 2021 and continued until summer 2023. Mutational analysis of reconstructed genes revealed divergence from the Alpha variant lineage Q.3 clinical sequence over time, including numerous mutations in the surface glycoprotein RBD and NTD. We discuss the possibility that a chronic SARS-CoV-2 infection accumulated adaptive mutations that promoted long-term infection. This study reveals that small wastewater treatment plants can enhance resolution of rare events and facilitate reconstruction of viral genomes due to the relative lack of contaminating sequences.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.26.23293191v1" target="_blank">Chronic Shedding of a SARS-CoV-2 Alpha Variant Lineage Q.3/Q.4 in Wastewater</a>
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<li><strong>KCL TEST: an open-source inspired asymptomatic SARS-CoV-2 surveillance programme in an academic institution</strong> -
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Testing was paramount in the management of the COVID-19 pandemic. Rapid deployment of new laboratories became widespread worldwide. Our university established KCL TEST: a SARS-CoV-2 asymptomatic testing programme that enabled sensitive and accessible PCR testing of SARS-CoV-2 RNA in saliva at 20 to 50% the price of commercial kits. We performed 158,277 PCRs in saliva for staff, students and their household contacts of Kings College London, free of charge and with an average turnaround time of 8 hours. Our pipeline is mainly made of open-source automation and non-commercial reagents and has been recently recommended for ISO15189 accreditation. Here we provide our blueprint and results to enable the rapid launch of diagnostic laboratories where and when needed. Our data span over 18 months and parallels that of the UK Office for National Statistics, with a lower positive rate and virtually no delta wave. Our observations strongly support regular asymptomatic community testing to decrease outbreaks and provide safe working spaces. KCL TEST demonstrates that universities can provide agile, resilient and accurate testing that reflects the infection rate and trend of the general population. We call for the integration of academic institutions in pandemic preparedness, with capabilities to rapidly deploy highly skilled staff, as well as develop, test and accommodate efficient low-cost pipelines.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.25.23293154v1" target="_blank">KCL TEST: an open-source inspired asymptomatic SARS-CoV-2 surveillance programme in an academic institution</a>
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<li><strong>Asymmetry in the peak in Covid-19 daily cases and the pandemic R-parameter</strong> -
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Within the context of the standard SIR model of pandemics, we show that the asymmetry in the peak in recorded daily cases during a pandemic can be used to infer the pandemic R-parameter. Using only daily data for symptomatic, confirmed cases, we derive a universal scaling curve that yields: (i) reff , the pandemic R-parameter; (ii) Leff, the effective latency, the average number of days an infected individual is able to infect others and (iii) α, the probability of infection per contact between infected and susceptible individuals. We validate our method using an example and then apply it to estimate these parameters for the first phase of the SARS-Cov-2/Covid-19 pandemic for several countries where there was a well separated peak in identified infected daily cases. The extension of the SIR model developed in this paper differentiates itself from earlier studies in that it provides a simple method to make an a-posteriori estimate of several useful epidemiological parameters, using only data on confirmed, identified cases. Our results are general and can be applied to any pandemic.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.23.23292960v1" target="_blank">Asymmetry in the peak in Covid-19 daily cases and the pandemic R-parameter</a>
</div></li>
<li><strong>The role of (trust in) the source of prebunks and debunks of misinformation. Evidence from online experiments in four EU countries</strong> -
<div>
Misinformation surrounding crises poses a significant challenge for public institutions. Understanding the relative effectiveness of different types of interventions to counter misinformation and understanding which segments of the population are most or least receptive to them, is crucial. We conduct a preregistered online experiment involving 5,228 participants from Germany, Greece, Ireland, and Poland. Participants were exposed to misinformation on climate change or Covid-19. In addition, they were pre-emptively exposed to a prebunk, warning them of commonly used misleading strategies, before encountering the misinformation, or a debunking intervention afterward. The source of the intervention (i.e. the European Commission) was either revealed or not. Findings show that both interventions effectively change the four outcome variables in the desired direction in almost all cases, with debunks sometimes being more effective than prebunks. Moreover, revealing the source of the interventions does not significantly impact their overall effectiveness. Although one case of undesirable effect heterogeneity – debunks with revealed source were less effective in decreasing credibility of misinformation for people with low trust in the European Union – was observed, the results mostly suggest that the European Commission, and possibly other institutions, can confidently debunk and prebunk misinformation regardless of the trust level of its recipients.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/vd5qt/" target="_blank">The role of (trust in) the source of prebunks and debunks of misinformation. Evidence from online experiments in four EU countries</a>
</div></li>
</ul>
<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>Effects of Exercise Training on Patients With Long COVID-19</strong> - <b>Condition</b>:   Long COVID-19<br/><b>Intervention</b>:   Behavioral: Exercise training<br/><b>Sponsor</b>:   Guangdong Provincial People’s Hospital<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>Smell in COVID-19 and Efficacy of Nasal Theophylline (SCENT 3)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: theophylline;   Drug: Placebo<br/><b>Sponsor</b>:   Washington University School of Medicine<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>Lymph Node Aspiration to Decipher the Immune Response of Beta-variant Recombinant Protein Booster Vaccine (VidPrevtyn Beta, Sanofi) Compared to a Bivalent mRNA Vaccine (Comirnaty Original/Omicron BA.4-5, BioNTech-Pfizer) in Adults Previously Vaccinated With at Least 3 Doses of COVID-19 mRNA Vaccine.</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Procedure: Lymph node aspiration / Blood sampling<br/><b>Sponsor</b>:   Assistance Publique - Hôpitaux de Paris<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>COVID-19 Trial of the Candidate Vaccine MVA-SARS-2-S in Adults</strong> - <b>Condition</b>:   Covid19<br/><b>Interventions</b>:   Biological: MVA-SARS-2-S;   Other: Placebo<br/><b>Sponsors</b>:   Universitätsklinikum Hamburg-Eppendorf;   German Center for Infection Research;   Philipps University Marburg Medical Center;   Ludwig-Maximilians - University of Munich;   University Hospital Tuebingen;   CTC-NORTH<br/><b>Withdrawn</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>Treatment of Long COVID (TLC) Feasibility Trial</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Low-dose Naltrexone (LDN);   Drug: Cetirizine;   Drug: Famotidine;   Drug: LDN Placebo;   Drug: Cetirizine Placebo;   Drug: Famotidine Placebo<br/><b>Sponsors</b>:   Emory University;   CURE Drug Repurposing Collaboratory (CDRC)<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>Immunoadsorption vs. Sham Treatment in Post COVID-19 Patients With Chronic Fatigue Syndrome</strong> - <b>Conditions</b>:   Fatigue;   Post-Acute COVID-19 Syndrome<br/><b>Intervention</b>:   Procedure: Immunoadsorption vs. sham immunoadsorption<br/><b>Sponsor</b>:   Hannover Medical School<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>Non-ventilated Prone Positioning in the COVID-19 Population</strong> - <b>Conditions</b>:   COVID-19;   Proning;   Oxygenation;   Length of Stay<br/><b>Interventions</b>:   Other: Proning group;   Other: Control group<br/><b>Sponsor</b>:   Baylor St. Luke’s Medical Center<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>HD-Tdcs and Pharmacological Intervention For Delirium In Critical Patients With COVID-19</strong> - <b>Conditions</b>:   COVID-19;   Delirium;   Critical Illness<br/><b>Interventions</b>:   Combination Product: Active HD-tDCS;   Combination Product: Sham HD-tDCS<br/><b>Sponsors</b>:   Suellen Andrade;   City University of New York<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>Safety, Efficacy, and Dosing of VIX001 in Patients With Neurological Symptoms of Post Acute COVID-19 Syndrome (PACS).</strong> - <b>Conditions</b>:   Post-Acute COVID-19 Syndrome;   Cognitive Impairment;   Neurological Complication<br/><b>Intervention</b>:   Drug: VIX001<br/><b>Sponsor</b>:   Neobiosis, LLC<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>A Study on the Safety and Immune Response of a Booster Dose of Investigational COVID-19 mRNA Vaccines in Healthy Adults</strong> - <b>Condition</b>:   SARS-CoV-2<br/><b>Interventions</b>:   Biological: CV0701 Bivalent High dose;   Biological: CV0701 Bivalent Medium dose;   Biological: CV0701 Bivalent Low dose;   Biological: CV0601 Monovalent High dose;   Biological: Control vaccine<br/><b>Sponsors</b>:   GlaxoSmithKline;   CureVac<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>PROTECT-APT 1: Early Treatment and Post-Exposure Prophylaxis of COVID-19</strong> - <b>Condition</b>:   SARS-CoV-2<br/><b>Interventions</b>:   Drug: Upamostat;   Drug: Placebo (PO)<br/><b>Sponsors</b>:   Henry M. Jackson Foundation for the Advancement of Military Medicine;   Joint Program Executive Office Chemical, Biological, Radiological, and Nuclear Defense Enabling Biotechnologies;   FHI Clinical, Inc.;   RedHill Biopharma Limited<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>A Clinical Evaluation of the Safety and Efficacy of Randomized Placebo Versus the 8-aminoquinoline Tafenoquine for Early Symptom Resolution in Patients With Mild to Moderate COVID 19 Disease and Low Risk of Disease Progression</strong> - <b>Conditions</b>:   COVID 19 Disease;   Mild to Moderate COVID 19 Disease;   SARS-CoV-2;   Infectious Disease;   Severe Acute Respiratory Syndrome Coronavirus 2<br/><b>Interventions</b>:   Drug: Tafenoquine Oral Tablet;   Drug: Placebo<br/><b>Sponsor</b>:   60P Australia Pty 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>Impact of COVID-19 on Sinus Augmentation Surgery</strong> - <b>Condition</b>:   Bone Loss<br/><b>Interventions</b>:   Procedure: Sinus lift in patients with positive COVID-19 history;   Procedure: Sinus lift with negative COVID-19 history<br/><b>Sponsor</b>:   Cairo 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>MR-spectroscopy in Post-covid Condition Prior to and Following a Yoga Breathing Intervention</strong> - <b>Conditions</b>:   Post COVID-19 Condition;   Somatic Symptom Disorder<br/><b>Interventions</b>:   Behavioral: yoga;   Behavioral: social contact<br/><b>Sponsor</b>:   Medical University Innsbruck<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>Clinical Evaluation of SARS-COV-2 (COVID-19), Influenza and RSV 8-Well MT-PCR Panel for In Vitro Diagnostics</strong> - <b>Condition</b>:   Respiratory Viral Infection<br/><b>Interventions</b>:   Diagnostic Test: SARS-COV-2, Influenza and RSV 8-Well MT-PCR Panel;   Diagnostic Test: BioFire Respiratory Panel 2.1<br/><b>Sponsor</b>:   AusDiagnostics Pty Ltd.<br/><b>Not yet 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>Complete Protection from SARS-CoV-2 Lung Infection in Mice Through Combined Intranasal Delivery of PIKfyve Kinase and TMPRSS2 Protease Inhibitors</strong> - Emerging variants of concern of SARS-CoV-2 can significantly reduce the prophylactic and therapeutic efficacy of vaccines and neutralizing antibodies due to mutations in the viral genome. Targeting cell host factors required for infection provides a complementary strategy to overcome this problem since the host genome is less susceptible to variation during the life span of infection. The enzymatic activities of the endosomal PIKfyve phosphoinositide kinase and the serine protease TMPRSS2 are…</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>Proteolytic cleavage and inactivation of the TRMT1 tRNA modification enzyme by SARS-CoV-2 main protease</strong> - Nonstructural protein 5 (Nsp5) is the main protease of SARS-CoV-2 that cleaves viral polyproteins into individual polypeptides necessary for viral replication. Here, we show that Nsp5 binds and cleaves human tRNA methyltransferase 1 (TRMT1), a host enzyme required for a prevalent post-transcriptional modification in tRNAs. Human cells infected with SARS-CoV-2 exhibit a decrease in TRMT1 protein levels and TRMT1-catalyzed tRNA modifications, consistent with TRMT1 cleavage and inactivation by…</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 Cyproheptadine on Ventilatory Support-free Days in Critically Ill Patients with COVID-19: An Open-label, Randomized Clinical Trial</strong> - CONCLUSION: In patients with COVID-19 and in need of ventilatory support, the use of cyproheptadine plus usual care, compared with usual care alone, did not increase the number of ventilatory support-free days in 28 days.</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>Potential pharmacokinetic interactions with concurrent use of herbal medicines and a ritonavir-boosted COVID-19 protease inhibitor in low and middle-income countries</strong> - The COVID-19 pandemic sparked the development of novel anti-viral drugs that have shown to be effective in reducing both fatality and hospitalization rates in patients with elevated risk for COVID-19 related morbidity or mortality. Currently, nirmatrelvir/ritonavir (Paxlovid™) fixed-dose combination is recommended by the World Health Organization for treatment of COVID-19. The ritonavir component is an inhibitor of cytochrome P450 (CYP) 3A, which is used in this combination to achieve needed…</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>Alpha-ketoglutarate supplementation reduces inflammation and thrombosis in type 2 diabetes by suppressing leukocyte and platelet activation</strong> - The interplay between platelets and leukocytes contributes to the pathogenesis of inflammation, thrombosis and cardiovascular diseases (CVDs) in type 2 diabetes (T2D). Our recent studies described alpha-ketoglutarate (αKG), a Krebs cycle intermediate metabolite as an inhibitor to platelets and leukocytes activation by suppressing phosphorylated-Akt (pAkt) through augmentation of prolyl hydroxylase-2 (PHD2). Dietary supplementation with a pharmacological concentration of αKG significantly…</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>Computational analysis of spike protein of SARS-CoV-2 (Omicron variant) for development of peptide-based therapeutics and diagnostics</strong> - In the last few years, the worldwide population has suffered from the SARS-CoV-2 pandemic. The WHO dashboard indicated that around 504,079,039 people were infected and 6,204,155 died from COVID-19 caused by different variants of SARS-CoV-2. Recently, a new variant of SARS-CoV-2 (B.1.1.529) was reported by South Africa known as Omicron. The high transmissibility rate and resistance towards available anti-SARS-CoV-2 drugs/vaccines/monoclonal antibodies, make Omicron a variant of concern. Because…</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 case of T-cell-Epstein-Barr virus-haemophagocytic lymphohistiocytosis and sustained remission following ruxolitinib therapy</strong> - CONCLUSION: EBV viraemia requires adequate treatment to control EBV-associated HLH as rituximab may be insufficient, and corticosteroid resistance can result in continued EBV infection in CD8^(+) T cells. This entity is known as T-cell-EBV-HLH. Ruxolitinib is a novel treatment strategy in this specific context and has several advantages, including inhibition of corticosteroid resistance to promote apoptosis of EBV-infected T cells.</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>Neuroimaging findings in adolescent gaming disorder: a systematic review</strong> - CONCLUSIONS: A number of key brain regions are affected in adolescent gaming disorder. These findings can help clinicians understand adolescent presentations with gaming disorder from a neurobiological perspective. Future studies should focus on forming a robust neurobiological and clinical framework for adolescent gaming disorder.</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 high-throughput screening system for SARS-CoV-2 entry inhibition, syncytia formation and cell toxicity</strong> - CONCLUSION: A BSL-2 compatible assay system that is equivalent to the infectious SARS-CoV-2 is a promising tool for high-throughput screening of large compound libraries for viral entry inhibitors against SARS-CoV-2 along with toxicity and effects on syncytia. Studies using clinical isolates of SARS-CoV-2 are warranted to confirm the antiviral potency of the leads and the utility of the screening system.</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>Rapid genetic screening with high quality factor metasurfaces</strong> - Genetic analysis methods are foundational to advancing personalized medicine, accelerating disease diagnostics, and monitoring the health of organisms and ecosystems. Current nucleic acid technologies such as polymerase chain reaction (PCR) and next-generation sequencing (NGS) rely on sample amplification and can suffer from inhibition. Here, we introduce a label-free genetic screening platform based on high quality (high-Q) factor silicon nanoantennas functionalized with nucleic acid fragments….</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>Corrigendum: Inhibition of phosphodiesterase 12 results in antiviral activity against several RNA viruses including SARS-CoV-2</strong> - No abstract</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>Chemoinformatics approach to design and develop vanillin analogs as COX-1 inhibitor</strong> - CONCLUSION: In comparison to other vanillin derivative compounds, 4-formyl-2-methoxyphenyl benzoate has the lowest binding energy value; hence, this analog can continue to be synthesized and its potential as an antithrombotic agent might be confirmed by in vivo studies.</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>Korean Red Ginseng Relieves Inflammation and Modulates Immune Response Induced by Pseudo-Type SARS-CoV-2</strong> - Few studies have reported the therapeutic effects of Korean red ginseng (KRG) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the positive effects of KRG on other viruses have been reported and the effects of KRG on pulmonary inflammatory diseases have also been studied. Therefore, this study investigated the therapeutic effects of KRG-water extract (KRG-WE) in a pseudo-type SARS-CoV-2 (PSV)-induced lung injury model. Constructing the pseudovirus, human…</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>Vector-delivered artificial miRNA effectively inhibits Porcine epidemic diarrhea virus replication</strong> - CONCLUSIONS: In summary, these results suggest that an RNAi based on amiRNA targeting the conserved region of the virus is an effective method to improve PEDV nucleic acid inhibitors and provide a novel treatment strategy for PEDV infection.</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>Deciphering the role of fucoidan from brown macroalgae in inhibiting SARS-CoV-2 by targeting its main protease and receptor binding domain: Invitro and insilico approach</strong> - The current study investigated the role of fucoidan from Padina tetrastromatica and Turbinaria conoides against 3-chymotrypsin like protease (3CL^(pro)) and receptor binding domain (RBD) spike protein of SARS-CoV-2 using an invitro and computational approach. The 3CL^(pro) and RBD genes were successfully cloned in pET28a vector, expressed in BL-21DE3 E. coli rosetta cells and purified by ion exchange affinity and size exclusion chromatography. Fucoidan extracted from both biomass using green…</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>Heat Waves and the Sweep of History</strong> - This burning summer is taking us out of human time. - <a href="https://www.newyorker.com/news/daily-comment/heat-waves-and-the-sweep-of-history">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Should Hotel Chains Be Held Liable for Human Trafficking?</strong> - For decades, franchised hotels have been a common scene of sex-trafficking crimes in the U.S. A new legal strategy is targeting the corporations that collect royalties from them. - <a href="https://www.newyorker.com/news/a-reporter-at-large/should-hotel-chains-be-held-liable-for-human-trafficking">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>In Israel, a Glimpse of a Trumpian Future</strong> - Netanyahu is willing to undermine the rule of law in order to insure his own political survival. Sound familiar? - <a href="https://www.newyorker.com/news/daily-comment/in-israel-a-glimpse-of-a-trumpian-future">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How UPS and the Teamsters Staved Off a Strike—for Now</strong> - With work stoppages under way or looming in a variety of industries, is the U.S. in the midst of a “hot labor summer”? - <a href="https://www.newyorker.com/news/daily-comment/how-ups-and-the-teamsters-staved-off-a-strike-for-now">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Prosecutors Might Charge Trump for January 6th</strong> - The Justice Department is reportedly using a civil-rights law that “puts front and center the injury to the American people,” rather than to the government. - <a href="https://www.newyorker.com/culture/q-and-a/how-prosecutors-might-charge-trump-for-january-6th">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>This beetle’s sex is on fire. Literally.</strong> -
<figure>
<img alt="An image of a beetle superimposed on a picture of conflagration." src="https://cdn.vox-cdn.com/thumbor/nC8Xhes7NMZ9P_XAeWm1iROgrZQ=/47x0:2047x1500/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72492214/Untitled_6.0.png"/>
<figcaption>
Vox/Udo Schmidt/Wikipedia/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Tinder for these insects is actual tinder.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HaYsIT">
For Melanophila beetles, forest fires aren’t just hot. They’re <em>hot. </em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EWmg22">
As flames start ripping through forests, as they often do in the late summer, most animals flee or take refuge for obvious reasons: They don’t want to die. But Melanophila beetles flock to the flames and start looking for sex. While the wood is still smoldering, they find a mate and copulate in the heat of the moment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XFGvQ4">
Black and roughly thumbnail-sized, Melanophila are among a small number of species around the world known as fire, or pyrophilous, beetles. They are attracted to flames and depend on fire for their reproduction. After breeding among the embers, the insects lay their eggs in freshly scorched bark. Those eggs then hatch into wormlike larvae that feast on the recently burned wood.
</p>
<div class="c-float-left">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/r80JwOsTYOoZBpZd2M6ge7R-4i0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24813891/Melanophila_acuminata.jpeg"/> <cite>Helmut Schmitz/Wikipedia</cite>
<figcaption>
A fire beetle, Melanophila acuminata.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UUcwMm">
Deliberately putting oneself in a forest fire to reproduce may seem like an awful idea, but it comes with a number of advantages. There are few competitors and plenty of food for their bark-biting offspring, for example. That’s likely why this behavior evolved.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bXgEXa">
Adaptations like this will come in handy as the world continues to warm, making wildfires <a href="https://www.vox.com/climate/2023/6/8/23753980/canada-fires-smoke-climate-change-air-quality">more widespread and severe</a>. These beetles remind us that <a href="https://www.vox.com/climate">climate change</a> won’t just be a dead end for animals; some species may thrive in a world ravaged by fire.
</p>
<h3 id="0DneuO">
How fire beetles find flames
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rJu2QD">
What’s most remarkable about these beetles is how they find wildfires in the first place. Like home security systems and night-vision goggles, the small body of a fire beetle has built-in infrared sensors. These sensors — known as sensory pit organs — detect infrared radiation, which is a proxy for heat. Located on the insects’ underside, those pits point them in the direction of a fire.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LgIkCa">
Research also <a href="https://link.springer.com/referenceworkentry/10.1007/978-94-017-9780-1_263">suggests</a> that fire beetles may be able to detect smoke using sensors found in their antennae. One particularly entertaining anecdote supports this idea: During football games at the University of California Berkeley, back in the 1940s, some 20,000 cigarettes would be lit at one time, according to the book <a href="https://islandpress.org/books/fire-ecology-pacific-northwest-forests"><em>Fire Ecology of Pacific Northwest Forests</em></a>. “A haze of tobacco smoke would hang over Memorial Stadium,” author James Agee wrote<em>. </em>Attracted to the smoke (or perhaps the warmth of the burning tobacco) a swarm of Melanophila beetles would swarm the stands, angering fans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nfhnhI">
These sensory systems help beetles detect wildfires from truly impressive distances. <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0037627">One study</a> in 2012, based on modeling, suggests that they can become “aware” of large fires from roughly 80 miles away, or about the distance between New York City and Philadelphia, as the crow flies. And so often where there is fire, there are fire beetles — a fact firefighters know all too well.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pLFUIE">
“Wildland firefighters hate these beetles,” said Lynn Kimsey, an entomologist at the University of California Davis and director of the Bohart Museum of Entomology. “When you’re in working on a fire line, especially around trees that are burning, the beetles will come in, in big numbers, and they’ll get into your turnouts and bite.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="N0J8Pz">
The bites can feel a bit like a bee sting, and sometimes firefighters <a href="https://baynature.org/article/fire-chasing-beetles-make-appearance/">will wear bee veils</a> to protect themselves.
</p>
<div id="yv7Kf4">
<blockquote class="twitter-tweet">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" dir="ltr" lang="en">
For the past few days covering the River Fire, these bugs have been plaguing <a href="https://twitter.com/anthonyjguevara?ref_src=twsrc%5Etfw"><span class="citation" data-cites="anthonyjguevara">@anthonyjguevara</span></a>, <a href="https://twitter.com/DwelleKMPH?ref_src=twsrc%5Etfw"><span class="citation" data-cites="DwelleKMPH">@DwelleKMPH</span></a> and me. They have a vicious bite and they gather near the fire in swarms - as though flames, ash, and smoke weren’t enough to deal with. We asked firefighters about them… <a href="https://t.co/IjDX5MUIbW">pic.twitter.com/IjDX5MUIbW</a>
</p>
— Marie Edinger FOX 35 (<span class="citation" data-cites="MarieEdinger">@MarieEdinger</span>) <a href="https://twitter.com/MarieEdinger/status/1415840201595703299?ref_src=twsrc%5Etfw">July 16, 2021</a>
</blockquote></div></li>
</ul>
<h3 id="YOcUt8">
Why these beetles seek out scorched Earth
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zPpQ0Q">
When male beetles arrive at a forest fire, they have one thing on their mind: sex. They often perch on a tree “close to burning or glowing wood or hot ashes,” <a href="https://link.springer.com/referenceworkentry/10.1007/978-94-017-9780-1_263">researchers explain</a>, and when they find a female, “they try to copulate vigorously.” Then the females lay eggs under the bark of burnt trees.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3pxjAB">
The simplest reason why they do this is that their offspring, the beetle larvae, can <a href="https://link.springer.com/referenceworkentry/10.1007/978-94-017-9780-1_263">only persist</a> on the wood of burned trees. This makes some sense: When a tree has been scorched by flame, it has a weak or nonexistent defense system, allowing the beetles to easily bore through the wood under the bark. “The beetles can get in there and feed freely,” Kimsey said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KpOmPb">
Fire beetles likely lay their eggs in forest fires for a few other reasons as well. Most insects tend to avoid recently burned areas, so the beetle larvae have fewer competitors — they have a wood buffet all to themselves. These regions also typically have fewer predators, such as birds. (Although, in a remarkable example of evolution, some species, <a href="https://www.vox.com/down-to-earth/23806750/wildfire-climate-change-animal-evolution">like the black-backed woodpecker</a>, have evolved to eat fire-associated insect larvae.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7iWCOp">
There’s also <a href="https://academic.oup.com/aesa/article/103/6/823/116622">some evidence</a> that beetle larvae develop faster in these environments because heat speeds up growth. That means beetles produce more babies in less time.
</p>
<h3 id="Qcpmpi">
A rare climate change winner?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Jslc3m">
Rising temperatures linked to climate change are <a href="https://www.vox.com/down-to-earth/2022/3/1/22954531/climate-change-ipcc-wildlife-extinction">already a problem</a> for many ecosystems and species. They’re fueling <a href="https://edition.cnn.com/2023/07/25/us/florida-ocean-heat-coral-bleaching-climate/index.html">coral-killing heat waves</a>, causing <a href="https://www.vox.com/22558979/animals-birds-shrinking-size-heat-climate-change">birds to shrink</a>, and generally making much of the planet less suitable for life.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rsBa5m">
At least in the short term, fire beetles may defy these negative trends. Climate change is likely to make wildfires more widespread and extreme, and scientists suspect these beetles can only breed with fire.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nmGJ56">
For now, this is just speculation, Kimsey said. “We have no idea what they’re doing when there isn’t a fire,” she said. But it’s clear that climate change will produce not only losers but some winners — and these beetles may be one of them. Indeed, a world on fire may be a world full of horny beetles.
</p>
<ul>
<li><strong>Is it time to be worried about Covid-19 again?</strong> -
<figure>
<img alt="Four roughly circular blobs, each with a halo of spike proteins." src="https://cdn.vox-cdn.com/thumbor/0BrqU1XYnNeVIdYMWtjq8i-nmvI=/202x0:3429x2420/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72492099/GettyImages_179795265.0.jpg"/>
<figcaption>
BSIP/Universal Images Group via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
What to make of the uptick of Covid-19 this summer — and what to expect this winter.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gpWn0n">
Don’t call it a comeback — because it’s not, really — but <a href="https://www.vox.com/coronavirus-covid19">Covid-19</a> appears to be in the midst of another summer uptick, a reminder that the virus that caused so much economic and social turmoil in the past few years has not been completely eliminated as a public health threat.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="F9Fu3P">
It’s not a surge. The waves the US experienced with <a href="https://www.vox.com/22547537/delta-coronavirus-variant-covid-19-vaccines-masks-lockdown">the delta variant</a> and <a href="https://www.vox.com/23100593/covid-subvariant-omicron-ba-2-4-5-vaccine-paxlovid">omicron</a> are unlikely to be repeated again, now that so many people have either been vaccinated or infected or both. But wastewater surveillance — which some experts regard as the best measure of Covid activity now that testing is so scattershot — indicates an increase in the virus’s prevalence. The concentration of Covid-19 in US wastewater has roughly doubled in the past month, according to <a href="https://biobot.io/data/">Biobot Analytics</a>. It has been the first notable upswing since last winter.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/kqRNwAQShJzz7l18EqZMM0ChMrY=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24814195/Screenshot_2023_07_27_at_2.12.53_PM.png"/> <cite>Biobot Analytics</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cSd1QC">
Likewise, emergency department diagnoses have ticked up, according to <a href="https://covid.cdc.gov/covid-data-tracker/#ed-visits_all_ages_combined">CDC data</a>, another indication of more Covid activity in the community. Thus far, hospitalizations and deaths <a href="https://www.nytimes.com/interactive/2023/us/covid-cases.html">are still flat</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aQnUjh">
Because of preexisting immunity and evolutions of the virus itself, most cases should be mild. Some people may not even realize it’s Covid. Even if immunity from antibodies is waning, which may lead to people feeling sick, <a href="https://www.vox.com/22878133/omicron-coronavirus-covid-19-immunity-antibodies-vaccine">immunity in their T cells</a> should help most people avoid getting seriously ill.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uA9di4">
But some rise in severe disease is expected when the virus is spreading more; it is a statistical inevitability. In Nashville and surrounding middle Tennessee, Dr. William Schaffner, formerly the medical director of the National Foundation for Infectious Diseases, said his surveillance network’s number of hospitalized Covid patients had grown slightly, from the mid-teens to the low 20s, in the past few weeks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xrufFz">
It’s the summer travel season, so people are out and about, mingling with others and sharing germs. Most people have also not received a Covid-19 vaccine shot in a while, given the low uptake of the boosters, and so their vaccine-conferred immunity is starting to wane.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jdLH33">
“The way I like to characterize it is it’s smoldering along,” Schaffner told me of Covid-19 these days. “There are many opportunities now for spread to take place. Here and there, there will be little upticks.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZsDt2f">
This summer bump is not a crisis. But it is a reminder that, so soon after the US finally reached the point that <a href="https://www.nytimes.com/2023/07/17/briefing/covid.html">there were no longer any “excess deaths”</a> that defined the pandemic, Covid-19 is still with us. CDC Director Mandy Cohen <a href="https://www.nbcnews.com/health/health-news/tripledemic-covid-rsv-flu-winter-cdc-rcna95448">told NBC News this week</a> the agency is preparing for <a href="https://www.vox.com/policy-and-politics/2022/10/27/23421344/covid-19-flu-rsv-symptoms-vaccines-2022">another “tri-demic”</a> this winter — with Covid, influenza, and another respiratory virus, RSV, circulating widely — that could challenge the US health care system.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jO7XLM">
“We need to make sure the American people understand all three and what they can do to protect themselves,” Cohen said.
</p>
<h3 id="LebFYu">
How the US can best minimize Covid’s damage going forward
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7LXmJ0">
We do have the tools to minimize the damage these viruses can do. The challenge has been getting people to take advantage of them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8gLRQi">
Last year, the number of people who said they planned to get a flu shot <a href="https://www.cnbc.com/2022/10/04/fewer-americans-plan-to-get-a-flu-shot-this-season-2022.html">was actually down</a>. Only one-third of Americans received a booster dose of the Covid-19 vaccine, despite the CDC’s recommendation that most people should, and less than one in five received the omicron-specific booster. Experts have <a href="https://www.nature.com/articles/s41591-023-02282-y">attributed</a> those trends to “vaccine fatigue” and a general skepticism about public health among some patients after a contentious discourse about interventions during the pandemic.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kPAqYj">
This winter, an RSV vaccine will be available for the first time for people over 60. A new variation of the Covid-19 vaccine is expected to be ready as well. And then there will be an updated version of the flu shot. The vaccine campaign will be another test for a health care system that is still in the middle of a transition from the pandemic to a new normal.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wpkIOB">
Last year, that transition was felt primarily by the early and wide spread of RSV and influenza. After two years of being suppressed by Covid and mitigation measures, those viruses returned with vigor. Biology was dictating the terms of the public health response.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="acmbEk">
This year, Schaffner said he doesn’t expect such an early, steep spike in infections. The transition is centered more on the health system itself and its ability to take advantage of these new tools to slow the viruses.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BBHbkH">
“Our challenge will be to organize ourselves to actually receive these vaccines,” he said, calling it “a learning and transitional year.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="B2GQFW">
The playbook for patients to help the health care system work through that transition is the same as it’s always been. Even though most people are no longer wearing masks, people who may be at higher risk because of their age or health may still want to consider doing so if they are indoors around large groups of people.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ivHuNa">
And then, if people do feel sick, it’s still important to take tests. A positive result allows doctors to prescribe the antiviral Paxlovid for patients who would benefit from it. The drug has been shown to significantly reduce the risk of hospitalization and death and yet, <a href="https://www.nytimes.com/2023/01/31/briefing/paxlovid-prescription.html?smid=nytcore-ios-share&amp;referringSource=articleShare">as of the beginning of this year</a>, it was being prescribed in less than half of confirmed Covid-19 cases.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HhPTur">
People are going to get sick with Covid-19. It’s too widespread and too transmissible to stamp out entirely. But catching it early helps prevent the worst outcomes: hospitalization and death.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="p03s6R">
“It’s severe disease that should be the focus, because it is essentially preventable by Paxlovid, which is underutilized in high-risk individuals,” Amesh Adalja, a senior scholar at Johns Hopkins University, told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="le5S7D">
At-home testing is the first step toward taking better advantage of Paxlovid, Schaffner said. If you’re feeling sick, take a rapid test. If it’s positive, call your doctor. If it’s negative, take another in the next 24 to 48 hours. Even if they remain negative, if symptoms worsen, you should still keep your doctor in the loop.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1FSKIG">
According to Schaffner, public health officials also have more work to do in educating doctors on <a href="https://www.fda.gov/media/155050/download">the best practices for prescribing Paxlovid</a>. “We are not optimally using Paxlovid,” he told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GzbVbT">
But patients can help themselves by paying close attention to their symptoms. Masking may be worthwhile if you’re older or immunocompromised.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8m0gtW">
As we prepare for another year of a “tri-demic,” adjusting to this world where even in the hot summer months Covid is still with us, we all have a part to play to protect ourselves and others.
</p></li>
<li><strong>Republicans are threatening to sabotage George W. Bush’s greatest accomplishment</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/rHv8y0TQbUy9VBPa5aQFre5DN5k=/63x0:3000x2203/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72492048/GettyImages_74358271.0.jpg"/>
<figcaption>
Then-President George W. Bush holds Baron Mosima Loyiso Tantoh, son of South African HIV-AIDS activist Kunene Tantoh, during a White House visit on PEPFAR in 2007. | Mandel Ngan/AFP/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A program that’s saved 25 million lives is at risk of losing its congressional authorization for the first time.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lM4n8X">
You may not have heard of the President’s Emergency Plan for AIDS Relief (PEPFAR). But you should: It has saved more lives than any other US government policy in the 21st century. And now, for the first time in the program’s history, it is at risk of losing a critical vote in Congress — for reasons that say a lot about today’s Republican Party.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XoVoA6">
First passed in 2003 under President George W. Bush, PEPFAR is a vehicle for distributing HIV/AIDS drugs to people in poor countries who wouldn’t otherwise have access to them. It has been astonishingly effective: The most recent US government estimates suggest it has <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2023/01/28/statement-from-president-joe-biden-on-the-20th-anniversary-of-the-u-s-presidents-emergency-plan-for-aids-relief-pepfar/">saved as many as 2<em>5 million</em> lives</a> since its enactment. It is currently supporting treatment for over 20 million people who depend on the program for continued access to medication.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rGGDpI">
Given its success, PEPFAR has historically enjoyed bipartisan support. In 2018, Congress reauthorized PEPFAR for another five years <a href="https://www.vox.com/future-perfect/2018/12/12/18136716/pepfar-hiv-aids-trump-congress">without a fuss</a>. But this time around, <a href="https://www.christianitytoday.com/news/2023/july/pepfar-hiv-aids-congress-pro-life.html">things look different</a>. Some House Republicans, prodded by an array of influential groups, are threatening to block another five-year reauthorization. Their argument is pure culture war: that PEPFAR has become a vehicle for promoting abortion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eGwJPr">
In reality, PEPFAR is legally prohibited from funding abortion services, and the argument against the program on anti-abortion grounds is very thin. But in today’s political climate, where the culture war reigns supreme on the right, this is enough to jeopardize the continued good functioning of a program that the Republican Party used to champion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gz79o1">
“This is not a fact-based argument. It’s an attempt to destroy a program,” Asia Russell, the executive director of the global health advocacy group Health GAP, tells me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cf7zus">
The clock is ticking: PEPFAR’s current congressional authorization runs through September 30, and failure to extend it could be quite damaging. The fact that this traditionally uncontroversial program is now under threat says a lot about our current political dysfunction — and the ideological currents reshaping the Republican Party.
</p>
<h3 id="ZoQn4e">
How PEPFAR became partisan
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CIpKZ8">
The idea of funding antiretroviral treatment in poor countries was developed in the early 2000s by public health specialists like <a href="https://globalhealth.weill.cornell.edu/gheskio-and-beginning-pepfar-programs">Anthony Fauci and Paul Farmer</a>. Politically, it was championed by some of the country’s most prominent Christian conservatives — like <a href="https://www.devex.com/news/he-came-up-with-the-name-michael-gerson-s-pepfar-legacy-104487">Bush speechwriter Michael Gerson</a> and <a href="https://www.nytimes.com/2023/06/07/world/africa/interpreter-hiv-aids-drugs-bush.html">mega-evangelist Franklin Graham</a>. The evangelicals provided the political muscle on the right, as well as a kind of unvarnished Christian moral argument for healing the sick, that ultimately got Bush and Congress on board — leading to PEPFAR’s creation in 2003.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Xt7iT8">
PEPFAR thus should not be seen only as a great American accomplishment, but also a great <em>evangelical </em>accomplishment — a program that not only saved millions of lives but did so <a href="https://www.cgdev.org/blog/how-economists-got-africas-aids-epidemic-wrong">more cost-effectively than most economists expected</a>. On both political and substantive grounds, the case for PEPFAR was airtight: No one in either major party had any interest in undermining the program.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EGS3qb">
Until recently.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qfZBsj">
According <a href="https://www.devex.com/news/abortion-politics-cast-shadow-over-pepfar-reauthorization-105627">to Devex</a>, the leading development news outlet, the push against PEPFAR began on May 1, when the Heritage Foundation, a leading conservative think tank, published <a href="https://www.heritage.org/sites/default/files/2023-05/BG3765.pdf">a white paper</a> attacking the program. On the same day, the leaders of 31 conservative groups released an <a href="http://c-fam.org/wp-content/uploads/PEPFAR-Coalition-Letter_Final-1.pdf">open letter</a> making similar arguments, with Heritage President Kevin Roberts as the first signatory.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NDf7tg">
The white paper’s author, Heritage fellow Tim Meisburger, is not a public health expert. His career has focused on <a href="https://www.linkedin.com/in/tim-meisburger-b2020913/">democracy promotion abroad</a> but has recently taken a turn toward conspiracy theorizing at home.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OBMA3K">
In 2017, he was appointed by Trump to a mid-level USAID position focusing on democracy — a job he lost in 2021 (per <a href="https://www.washingtonpost.com/national-security/2021/01/13/usaid-trump-capitol/">the Washington Post</a>) after saying on a conference call that the January 6 riot was merely the work of “a few violent people.” During the 2022 election cycle, he led a multi-million dollar “election integrity” campaign <a href="https://www.theguardian.com/us-news/2022/jul/07/sham-fears-over-trump-loyalists-election-integrity-drive">backed by Michael Flynn and Roger Stone</a>. In January, he wrote an essay for the <a href="https://amgreatness.com/2023/01/20/the-shameful-silence-of-the-democracy-promoters/">pro-Trump website American Greatness</a> arguing that there were “many egregious examples of election malpractice and fraud in 2020 and 2022,” including “statistically impossible results” — a seeming reference to <a href="https://www.washingtonpost.com/politics/2020/12/07/no-bidens-win-wasnt-statistically-impossible/">long-debunked arguments</a> that Biden could not possibly have won the 2020 election by the margin he did. (Meisburger did not respond to my request for comment.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="c7P8Un">
Many of the arguments in his anti-PEPFAR paper are of similar quality. He argues that “HIV/AIDS in the U.S. and in developing countries is primarily a lifestyle disease (like those caused by tobacco) and as such should be suppressed though [sic] education, moral suasion, and legal sanctions.” Moreover, Meisburger writes, PEPFAR has become a means for Democrats to promote “their own social priorities like abortion.” The Biden administration, in his view, has used PEPFAR to fund pro-abortion groups internationally.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IWJXr4">
The evidence offered for this is flimsy. PEPFAR operates primarily through partner groups, funding their efforts to directly distribute antiretroviral drugs and other HIV-AIDS treatments to supported populations. Meisburger notes that some of these partner groups have issued statements supporting legal abortion, and that campaign donations from their staff have leaned left (“PEPFAR is in fact an entirely Democrat-run program,” he writes).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LKRXbX">
PEPFAR, however, has always been prohibited from funding abortion. The program steers clear of many controversial social issues related to HIV/AIDS by design, a legacy of its bipartisan creation back in 2003. PEPFAR-supported groups that also support abortion services do not use any federal dollars for this purpose.
</p>
<figure class="e-image">
<img alt="A women hides her eyes while receiving an injection in the arm." src="https://cdn.vox-cdn.com/thumbor/z9WitDd_pPG2ySvFK65gxeMQKBY=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24814303/53062939.jpg"/> <cite>Per-Anders Pettersson/Getty Images</cite>
<figcaption>
A young woman being tested for HIV in 2005 at the Naguru Teenage Health Centre in Kampala, Uganda.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8t6RYl">
Shepherd Smith, an evangelical global health advocate, investigated Heritage’s allegations that PEPFAR supported abortion and found zero evidence of their veracity.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VohL3A">
“We have never, in all our years of intimate involvement with PEPFAR, heard of such a thing happening in the program,” he wrote in a memo obtained by Vox. “Without equivocation, all of PEPFAR’s leaders have been focused on the job ahead of them of ending the scourge of AIDS. All have overseen the spending of money, and none have found any dollars spent on abortions or the promotion of abortion.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Pnm7KT">
Nonetheless, Meisburger’s report has helped fuel the anti-PEPFAR campaign. Heritage Action, the group’s advocacy arm, said it will “score” the upcoming vote to reauthorize it for another five years — meaning that supporting the program will harm Republicans on Heritage’s influential ratings of representatives’ ideology. According to <a href="https://www.christianitytoday.com/news/2023/july/pepfar-hiv-aids-congress-pro-life.html">Christianity Today</a>, two other leading conservative groups — the anti-abortion Susan B. Anthony Pro-Life America and the social conservative Family Research Council — have said they will also score the vote.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NeAbht">
All of a sudden, a vote to reauthorize PEPFAR looks like a potential problem for Republicans worried about a primary challenge — helping create the conditions for actual legislative movement. Rep. Chris Smith (R-NJ), a member of the House Foreign Affairs Africa Subcommittee and longtime PEPFAR supporter who sponsored the 2018 reauthorization, has turned on the program — writing a letter in June criticizing a five-year reauthorization on grounds that the program supports groups who support abortion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9tkeTK">
“President Biden has hijacked PEPFAR, the $6 billion a year foreign aid program designed to mitigate HIV/AIDs in many targeted — mostly African — countries in order to promote abortion on demand,” Rep. Smith argues.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CbTSUG">
Like Meisburger, he did not reply to my request to discuss this claim further.
</p>
<h3 id="bNqjrH">
What the PEPFAR fight says about the GOP — and America
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jQd3O4">
Conservatives differ on what should be done to fix this (fictitious) problem. Some, like Rep. Smith, want to impose the so-called <a href="https://www.vox.com/policy-and-politics/2017/1/26/14384260/global-gag-rule-trump-abortion-womens-health-global-health-world">“Mexico City” policy</a> on PEPFAR — which bans the federal government from funding any organization that supports abortion even with non-federal dollars. Others have suggested reducing PEPFAR’s operating window, forcing it to come up for reauthorization <a href="https://www.usglc.org/the-budget/house-appropriations-committee-approves-fy24-state-foreign-operations-bill/">every year rather than every five years</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BRYbo6">
Public health experts generally oppose both changes, arguing that they would cut off effective aid groups from federal dollars and make it impossible for the program to plan for the long term.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="X7joie">
Moreover, the mere act of picking a fight on either the Mexico City policy or reauthorization windows risks turning PEPFAR into more of a partisan football — and blowing past the September 30 deadline for reauthorization as a result. This would not lead to PEPFAR’s immediate demise, but it would do real damage to its continued good functioning.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Fe2EFo">
“Failure to reauthorize the program could have significant impacts,” warns Chris Collins, president and CEO of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria. Among several other problems, Collins warns, “the funds set aside to treat orphans and vulnerable children might be reduced” and “the Global Fund 2:1 match requirement that has for years successfully leveraged investment from other donors would no longer be required.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ADg7xg">
Hence why some conservative supporters of PEPFAR are warning against the current attempt to do anything but approve the program for another five years.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EwYvsz">
“Without a clean authorization, there will be no reauthorization,” <a href="https://www.newsmax.com/politics/african-bush-pharma/2023/07/20/id/1127878/">Rick Santorum</a>, the former Republican senator from Pennsylvania, <a href="https://www.newsmax.com/politics/african-bush-pharma/2023/07/20/id/1127878/">warned in a July Newsmax</a> op-ed supporting the reauthorization (co-authored with former Senate Republican Conference staff director Mark Rodgers).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZJvtEZ">
There’s something revealing about a figure like Santorum, a famously hardline culture warrior, acting as the moderate in this dispute — even calling out Heritage and Meisburger specifically for “revisiting the issue of abortion” and thereby putting the “consensus” in favor of PEPFAR support “at risk.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Curojx">
Santorum, who has not held public office since 2007, represents an older breed of social conservatives: the ones who influenced policy during the Bush administration and helped create PEPFAR in the first place. They were no less conservative on abortion, and arguably more aggressive than today’s right on other issues (just look up Santorum’s comments on <a href="https://www.hrc.org/resources/2016republicanfacts-rick-santorum">same-sex marriage</a> or <a href="https://www.facebook.com/watch/?v=10154296854371509">Islam</a>). But to their credit, they took seriously Christian ideas about the need for charity and helping the weak — leading to support for global health programs like PEPFAR or (in some cases) <a href="https://www.vox.com/first-person/2017/2/24/14720860/refugee-executive-order-evangelicals">taking in refugees fleeing conflict and persecution</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FGZHKk">
The Trump movement, with its “America First” slogan and attacks on “globalists,” undermined the ideological foundations of Republican support for global humanitarian efforts. In power, Trump put <a href="https://www.telegraph.co.uk/global-health/climate-and-people/trump-undermined-us-aid-still-spent-billions-transactional/">foreign aid on shaky political ground</a> and adopted a culture war approach to the field, <a href="https://www.hrw.org/news/2018/02/14/trumps-mexico-city-policy-or-global-gag-rule">dramatically expanding the Mexico City policy</a> from what had existed under Bush and other prior Republican presidents.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9Y9e2T">
The idea of a so-called “compassionate conservatism,” a favored slogan of the Bush years, has gone out the window — replaced instead by a conservative movement defined by its obsession with existential struggle against the perceived domestic left-wing enemy. On today’s right, the culture war is not merely a leading concern but <em>the</em> leading concern.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S2c9oU">
This is not “mere” partisan polarization at work, though that’s certainly an enabling factor. Rather, this is a story about the prevailing ideological mood on the right: <a href="https://www.vox.com/22600500/olympics-conservatives-simone-biles-anti-american">a paradoxical sense of both vulnerability and strength</a>. The vulnerability comes from the Biden presidency and the left’s alleged control over leading cultural institutions; the strength from some recent cultural victories, most notably, the <em>Dobbs</em> decision overturning <em>Roe v. Wade</em>. The contemporary right believes it is under siege, but also that the siege can be broken if it fights hard enough in enough places.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rQ0LU1">
The unremitting logic of total culture war means that every issue has the potential to become a flashpoint. PEPFAR shows how remarkably easy it can be in this environment to take what was once a settled bipartisan consensus and blow it up.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SgUJaO">
Despite these threats, PEPFAR could well make it through the current fight unscathed. The White House, for its part, believes that Congress is on the right track. “We are confident that the supporters of PEPFAR in both parties will find a path forward to get this critical and lifesaving program reauthorized,” an official said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NBenIP">
We can only hope they’re right. Because if PEPFAR becomes yet another casualty of America’s domestic culture wars, tens of millions of people will suffer and potentially die from a disease we already know how to fight.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h23y7v">
<em>Keren Landman contributed reporting to this piece.</em>
</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>Lakshya enters semifinals of Japan Open, Satwik-Chirag out</strong> - Sen, who had won the Canada Open Super 500 early this month, opened up a 5-3 lead early on before moving to 11-7 at the break</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>BCCI considers rescheduling a few World Cup games</strong> - Secretary Shah declines to comment on the reported move to reschedule the much-awaited India-Pakistan match to be played on Oct. 15</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>Three wushu players from Arunachal bound for World University Games in China handed ‘stapled visas’, team held back</strong> - Eight wushu players and four team officials were to travel to China from the IGI airport here in the wee hours of Thursday but all of them have now been told to stay put by the government</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 Ashes 2023, Test 5 day 1 | Australia bowl out England for 283</strong> - Australia inched to 61-1 after bowling England out for 283 with Mitchell Starc taking four wickets on the opening day of the final Ashes test</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>West Indies vs India, 1st ODI | Kuldeep, Jadeja set up easy victory as India check out batting options against weak Windies</strong> - The chase was never a problem but the wicket did offer a lot of turn apart from bounce which made life difficult for batters from both sides</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>Lessons in sustainability on college campus</strong> - With its volley of diverse agricultural projects, Sree Narayana Polytechnic College, Kottiyam, has been declared as a green campus and the first polytechnic college in the State to achieve the feat</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>BJP in Telangana demands all party meeting on rain damage</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>Missing man traced alive near Thodupuzha</strong> - He had been employed at a rubber plantation as a casual worker. He never used a mobile phone for the fear of being traced</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>Telangana CM convenes State Cabinet meeting on July 31</strong> - Over 40 items including the impact of recent floods listed in the agenda</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>Tamil Nadu announces panel to examine coir, pith industries’ demand</strong> - They want their industries to be re-classified from orange to white by TNPCB</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>Russia urged to renew Ukraine grain deal at Africa summit</strong> - Egypt’s leader says it is “essential” the deal allowing Kyiv to export produce be revived.</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>Greek fires at Nea Anchialos prompt blasts forcing F-16s to evacuate base</strong> - Residents escape by boat and the air force evacuates fighter planes as an ammunition depot explodes.</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>Are arsonists behind Italy’s devastating wildfires?</strong> - Residents suspect most of the blazes blighting their stunning region are intentionally lit.</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>Melting Swiss glacier uncovers climber missing since 1986</strong> - The body was discovered earlier this month by hikers who spotted a boot emerging from the ice.</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>Ancient 2,000-year-old Roman shipwreck found off coast of Italy</strong> - The cargo ship was found laden with hundreds of Roman pottery jars, most of which are intact.</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>Increasing levels of humidity are here to make heat waves even worse</strong> - This summer’s heat is only a preview of what’s in store for our future. - <a href="https://arstechnica.com/?p=1957233">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Getting TIE Fighter: Total Conversion working is worth the hassle and the $10</strong> - It has a 1999 engine, 2021 graphics, and that unmistakable ’90s LucasArts feel. - <a href="https://arstechnica.com/?p=1956747">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Formula E’s first visit to a proper American racetrack saw packed stands</strong> - We found a lot to be optimistic about for the all-electric racing series. - <a href="https://arstechnica.com/?p=1956870">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rocket Report: Starbase comes alive again; China launches four times</strong> - Maybe the next Starship launch isn’t all that far off. - <a href="https://arstechnica.com/?p=1957059">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>AMD Ryzen 7945HX3D could be a fast, super-efficient choice for your new gaming laptop</strong> - The chip is only launching in a single laptop from Asus, at least for now. - <a href="https://arstechnica.com/?p=1957094">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 woman entered a pub and saw a haggard looking soldier sitting at the bar.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She approached him and asked if everything was all right.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The soldier said, “I haven’t had sex since 2014.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The woman replied, “Wow that’s a long time. How about I get your tab and you come back to my hotel?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
They went to her hotel room and made passionate love for a solid two hours.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Wow!”, said the soldier. “That’s the best sex I’ve had all night!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The woman went, “Wait a minute. You told me you hadn’t had sex since 2014.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The soldier replied, “Yes, ma’am. That’s true. Now it’s 2355!”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/JoeFas"> /u/JoeFas </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15bhy8m/a_woman_entered_a_pub_and_saw_a_haggard_looking/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15bhy8m/a_woman_entered_a_pub_and_saw_a_haggard_looking/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Scientists have discovered a food that diminishes a woman’s sex drive by 95%.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It’s called a Wedding Cake.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Tightfit30"> /u/Tightfit30 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15bk5ps/scientists_have_discovered_a_food_that_diminishes/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15bk5ps/scientists_have_discovered_a_food_that_diminishes/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I asked my Chinese girlfriend for a 69.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She said she’s not getting the wok out at this time of night…
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/ntrott"> /u/ntrott </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15bs4vx/i_asked_my_chinese_girlfriend_for_a_69/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15bs4vx/i_asked_my_chinese_girlfriend_for_a_69/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A redneck went to the hospital as his wife was having their babies. Upon arriving, he sat down as the nurse said “congratulations, your wife has had quintuplets, 5 big baby boys.”</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The redneck said “I am not surprised. I have a penis the size of a chimney.” The nurse replied, “you might want to get it cleaned because they are all black.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/u24fun"> /u/u24fun </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15bcxmx/a_redneck_went_to_the_hospital_as_his_wife_was/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15bcxmx/a_redneck_went_to_the_hospital_as_his_wife_was/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>4 Friends meet 30 years after school</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
One goes to the toilet while the other 3 start to talk about how successful their sons became.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
No. 1 says his son studied economics, became a banker and is so rich he gave his best friend a ferrari.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
No. 2 said his son became a pilot, started his own airline, became so rich he gave his best friend a jet.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
No. 3 said his son became an engineer, started his own development company, became so rich he build his best friend a castle.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
No 4. came back from toilet and asks what the buzz is about.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
They told him they were talking about how successfull their sons became and ask him about his son.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He said his son is gay and is a Stripper at a Gay bar.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Other 3 said he must be very disappointed with his son for not becoming successful.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
" O no !! " said the father, he is doing good.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
" Last week was his birthday and he got a ferrari, a jet and a castle from 3 of his boyfriends…"
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
​
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Upper_Price2807"> /u/Upper_Price2807 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/15b33t7/4_friends_meet_30_years_after_school/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/15b33t7/4_friends_meet_30_years_after_school/">[comments]</a></span></p></li>
</ul>
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