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<title>13 April, 2023</title>
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<title>Covid-19 Sentry</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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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>Should Health Communication During the SARS-CoV-2 Pandemic Emphasize Self- or Other-Focused Impacts of Mitigation Behaviors? Insights from Two Message Matching Studies</strong> -
<div>
Mask-wearing, social distancing, and vaccination remain effective ways to mitigate the spread of COVID-19. Yet, many hesitate to enact some or all these preventive behaviors. We created three persuasive messages—framed to promote benefits to either 1) oneself, 2) close-others, or 3) distant-others—to determine whether the effectiveness of these messages varied based on personality differences (specifically independent/interdependent self-construal and chronic construal level). In two online experiments (N = 862), we measured individual differences and showed participants one of the three messages. Consistent interactions between interdependent self-construal and message conditions showed that those high in interdependent self-construal responded most positively to the self-focused messages promoting mask-wearing, social distancing, and COVID-19 vaccination. Those low in interdependent self-construal responded most negatively to the self-focused messages. Although no interaction effect was observed for independent self-construal, and inconsistent evidence emerged for construal level, other-focused messages performed either better or equally well to the self-focused messages for most participants and may thus be promising for future public health communication efforts.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/2ysn5/" target="_blank">Should Health Communication During the SARS-CoV-2 Pandemic Emphasize Self- or Other-Focused Impacts of Mitigation Behaviors? Insights from Two Message Matching Studies</a>
</div></li>
<li><strong>Combination treatment of persistent COVID-19 in immunocompromised patients with remdesivir, nirmaltrevir/ritonavir and tixegavimab/cilgavimab</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Little data exists to guide the treatment of persistent COVID-19 in immunocompromised patients. We have employed a unique protocol combining tixegavimab/cilgavimab, and short-term combination antivirals including remdesivir. Methods: A retrospective single-center analysis of persistent COVID-19 in immunocompromised patients. Response was assessed by symptom resolution, declining C-reactive protein (CRP) levels and increasing SARS-CoV-2-PCR cycle-threshold (Ct) values. Results: Fourteen patients were included, including 2 kidney transplant recipients, 11 with B-cell lymphoproliferative disease, treated with anti-CD20 or ibrutinib, and 1 with rheumatoid arthritis, treated with anti-CD20. Median Ct-value was 27 (interquartile range (IQR):24-32). All patients received tixegavimab/cilgavimab and a 5-day course of remdesivir. Eleven also received nirmaltrevir/ritonavir and one received molnupiravir. Median follow-up was 45 days (IQR:12-89). Eleven patients had complete responses including symptom resolution, decrease in CRP, and increase in Ct values (all with either a negative PCR or Ct value&gt;30 on day 4-16). Three patients had a partial response with relapses requiring re-admission. One had died, and two responded to prolonged antiviral treatments. Conclusions: A combination of monoclonal antibodies with antivirals has led to complete resolution of persistent COVID-19 in most severely-immunocompromised patients. Controlled studies will further direct the treatment of these patients, while more effective antivirals are urgently needed.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.07.23288144v1" target="_blank">Combination treatment of persistent COVID-19 in immunocompromised patients with remdesivir, nirmaltrevir/ritonavir and tixegavimab/cilgavimab</a>
</div></li>
<li><strong>The COVID-19 vaccination campaign in Switzerland and its impact on disease spread</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
We analyse infectious disease case surveillance data stratified by region and age group to estimate COVID-19 spread and gain an understanding of the impact of introducing vaccines to counter the disease in Switzerland. The data used in this work is extensive and detailed and includes information on weekly number of cases and vaccination rates by age and region. Our approach takes into account waning immunity. The statistical analysis allows us to determine the effects of choosing alternative vaccination strategies. Our results indicate greater uptake of vaccine would have led to fewer cases with a particularly large effect on undervaccinated regions while an alternative distribution scheme ignoring age would affect the vulnerable population at the time (the elderly) and is less ideal.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.06.23288251v1" target="_blank">The COVID-19 vaccination campaign in Switzerland and its impact on disease spread</a>
</div></li>
<li><strong>A methodological framework for assessing the benefit of SARS-CoV-2 vaccination following previous infection: case study of five to eleven year olds in the UK</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Vaccination rates against SARS-CoV-2 in children aged five to 11 years remain low in many countries. The current benefit of vaccination in this age group has been questioned given that the large majority of children have now experienced at least one SARS-CoV-2 infection. However, protection from infection, vaccination or both wanes over time. National decisions on offering vaccines to this age group have tended to be made without considering time since infection. There is an urgent need to evaluate the additional benefits of vaccination in previously infected children and under what circumstances those benefits accrue. We present a novel methodological framework for estimating the potential benefits of COVID-19 vaccination in previously infected children aged five to 11, accounting for waning. We apply this framework to the UK context and for two adverse outcomes: hospitalisation related to SARS-CoV-2 infection and Long Covid. We show that the most important drivers of benefit are: the degree of protection provided by previous infection; the protection provided by vaccination; the time since previous infection; and future attack rates. Vaccination can be very beneficial for previously infected children if future attack rates are high and several months have elapsed since the previous major wave in this group. Benefits are generally larger for Long Covid than hospitalisation, because Long Covid is both more common than hospitalisation and previous infection offers less protection against it. Our framework provides a structure for policy makers to explore the additional benefit of vaccination across a range of adverse outcomes and different parameter assumptions. It can be easily updated as new evidence emerges.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.11.23288409v3" target="_blank">A methodological framework for assessing the benefit of SARS-CoV-2 vaccination following previous infection: case study of five to eleven year olds in the UK</a>
</div></li>
<li><strong>A gene-expression module in circulating immune cells is associated with cell migration during immune diseases.</strong> -
<div>
Circulating immune cells are critical mediators of the response to inflammation upon recruitment to the tissue but how gene expression state influences recruitment is not well known. Here we report the longitudinal single-cell transcriptome profiling of blood mononuclear cells in patients undergoing kidney transplantation rejection. We identify a gene expression module which is associated to transcriptional regulation, homing and early activation in multiple cell types. The circulating cells expressing this module are reduced in patients undergoing graft rejection. This reduction was confirmed in a pig model of acute kidney transplantation rejection. In connection with this, the module expression drastically increased in the kidney grafts undergoing rejection indicating a preferential recruitment of cells highly expressing this module. We identify the receptor CXCR4 within the module and its ligand CXCL12 expressed in the graft as a likely recruitment mechanism between circulating cells and the tissue. We then explore publicly available transcriptomics data in circulating cells and show that this module is generally expressed in healthy individuals and more importantly is associated with the response to infection, including SARS Covid-19. Moreover, we find that module expression is predictive of immune mediated diseases. In summary, we find a gene expression module in circulating immune cells which enables preferential recruitment to inflamed tissues to mediate effector function.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.11.536347v1" target="_blank">A gene-expression module in circulating immune cells is associated with cell migration during immune diseases.</a>
</div></li>
<li><strong>A simulation-based method to inform serosurvey designs for estimating dengue force of infection using existing blood samples</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The extent to which dengue virus has been circulating in Africa is largely unknown. Testing available blood samples from previous cross-sectional serological surveys offers a convenient strategy to investigate past dengue infections, as such serosurveys provide the ideal data to reconstruct the age-dependent immunity profile of the population and to estimate the average per-capita annual risk of infection; the force of infection (FOI), which is a fundamental measure of transmission intensity. In this study, we present a novel methodological approach to inform the size and age distribution of blood samples to test when samples are acquired from previous surveys. The method was used to inform a dengue seroprevalence survey which is currently being conducted in Ghana by the Drug for Neglected disease initiative, utilizing samples previously collected fora SARS-CoV-2 serosurvey. The method described in this paper can be employed to determine sample sizes and testing strategies for different diseases and transmission settings.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.07.23288282v1" target="_blank">A simulation-based method to inform serosurvey designs for estimating dengue force of infection using existing blood samples</a>
</div></li>
<li><strong>Development of Accurate Long-lead COVID-19 Forecast</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Coronavirus disease 2019 (COVID-19) will likely remain a major public health burden; accurate forecast of COVID-19 epidemic outcomes several months into the future is needed to support more proactive planning. Here, we propose strategies to address three major forecast challenges, i.e., error growth, the emergence of new variants, and infection seasonality. Using these strategies in combination we generate retrospective predictions of COVID-19 cases and deaths 6 months in the future for 10 representative US states. Tallied over &gt;25,000 retrospective predictions through September 2022, the forecast approach using all three strategies consistently outperformed a baseline forecast approach without these strategies across different variant waves and locations, for all forecast targets. Overall, probabilistic forecast accuracy improved by 64% and 38% and point prediction accuracy by 133% and 87% for cases and deaths, respectively. Real-time 6-month lead predictions made in early October 2022 suggested large attack rates in most states but a lower burden of deaths than previous waves during October 2022 - March 2023; these predictions are in general accurate compared to reported data. The superior skill of the forecast methods developed here demonstrate means for generating more accurate long-lead forecast of COVID-19 and possibly other infectious diseases.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.11.14.22282323v2" target="_blank">Development of Accurate Long-lead COVID-19 Forecast</a>
</div></li>
<li><strong>A methodological framework for assessing the benefit of SARS-CoV-2 vaccination following previous infection: case study of five to eleven year olds in the UK</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Vaccination rates against SARS-CoV-2 in children aged five to 11 years remain low in many countries. The current benefit of vaccination in this age group has been questioned given that the large majority of children have now experienced at least one SARS-CoV-2 infection. However, protection from infection, vaccination or both wanes over time. National decisions on offering vaccines to this age group have tended to be made without considering time since infection. There is an urgent need to evaluate the additional benefits of vaccination in previously infected children and under what circumstances those benefits accrue. We present a novel methodological framework for estimating the potential benefits of COVID-19 vaccination in previously infected children aged five to 11, accounting for waning. We apply this framework to the UK context and for two adverse outcomes: hospitalisation related to SARS-CoV-2 infection and Long Covid. We show that the most important drivers of benefit are: the degree of protection provided by previous infection; the protection provided by vaccination; the time since previous infection; and future attack rates. Vaccination can be very beneficial for previously infected children if future attack rates are high and several months have elapsed since the previous major wave in this group. Benefits are generally larger for Long Covid than hospitalisation, because Long Covid is both more common than hospitalisation and previous infection offers less protection against it. Our framework provides a structure for policy makers to explore the additional benefit of vaccination across a range of adverse outcomes and different parameter assumptions. It can be easily updated as new evidence emerges.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.11.23288409v2" target="_blank">A methodological framework for assessing the benefit of SARS-CoV-2 vaccination following previous infection: case study of five to eleven year olds in the UK</a>
</div></li>
<li><strong>Evaluation of association of anti-PEG antibodies with anaphylaxis after mRNA COVID-19 vaccination</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: The mechanism for anaphylaxis following mRNA COVID-19 vaccination has been widely debated; understanding this serious adverse event is important for future vaccines of similar design. A mechanism proposed is type I hypersensitivity (i.e., IgE-mediated mast cell degranulation) to excipient polyethylene glycol (PEG). Using an assay that, uniquely, had been previously assessed in patients with anaphylaxis to PEG, our objective was to compare anti-PEG IgE in serum from mRNA COVID-19 vaccine anaphylaxis case-patients and persons vaccinated without allergic reactions. Secondarily, we compared anti-PEG IgG and IgM to assess alternative mechanisms. Methods: Selected anaphylaxis case-patients reported to U.S. Vaccine Adverse Event Reporting System December 14, 2020 - March 25, 2021 were invited to provide a serum sample. mRNA COVID-19 vaccine study participants with residual serum and no allergic reaction post-vaccination (“controls”) were frequency matched to cases 3:1 on vaccine and dose number, sex and 10-year age category. Anti-PEG IgE was measured using a dual cytometric bead assay. Anti-PEG IgG and IgM were measured using two different assays. Laboratorians were blinded to case/control status. Results: All 20 case-patients were women; 17 had anaphylaxis after dose 1, 3 after dose 2. Thirteen (65%) were hospitalized and 7 (35%) were intubated. Time from vaccination to serum collection was longer for case-patients vs controls (post-dose 1: median 105 vs 21 days). Among Moderna recipients, anti-PEG IgE was detected in 1 of 10 (10%) case-patients vs 8 of 30 (27%) controls (p=0.40); among Pfizer-BioNTech recipients, it was detected in 0 of 10 case-patients (0%) vs 1 of 30 (3%) controls (p&gt;0.99). Anti-PEG IgE quantitative signals followed this same pattern. Neither anti-PEG IgG nor IgM was associated with case status with both assay formats. Conclusion: Our results support that anti-PEG IgE is not a predominant mechanism for anaphylaxis post-mRNA COVID-19 vaccination.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.11.23288372v1" target="_blank">Evaluation of association of anti-PEG antibodies with anaphylaxis after mRNA COVID-19 vaccination</a>
</div></li>
<li><strong>Autoantibody production is enhanced after mild SARS-CoV-2 infection despite vaccination in patients with and without long COVID</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Long COVID patients who experienced severe acute SARS-CoV-2 infection can present with humoral autoimmunity. However, whether mild SARS-CoV-2 infection provokes autoantibody responses and whether vaccination can decrease these responses in long COVID patients is unknown. Here, we demonstrate that mild SARS-CoV-2 infection increases autoantibodies associated with systemic lupus erythematosus (SLE) and inflammatory myopathies in long COVID patients with persistent neurologic symptoms to a greater extent than convalescent controls at more than 8 months post-infection. Furthermore, high titers of SLE-associated autoantibodies in long COVID patients are associated with impaired cognitive performance and greater symptom severity, and subsequent vaccination does not decrease autoantibody titers. In summary, we found that mild SARS-CoV-2 infection can induce long-term humoral autoimmunity in both long COVID patients and healthy COVID convalescents, suggesting that a reappraisal of vaccination and mitigation strategies is warranted.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.07.23288243v1" target="_blank">Autoantibody production is enhanced after mild SARS-CoV-2 infection despite vaccination in patients with and without long COVID</a>
</div></li>
<li><strong>An Azapeptide Platform in Conjunction with Covalent Warheads to Uncover High-Potency Inhibitors for SARS-CoV-2 Main Protease</strong> -
<div>
Main protease (MPro) of SARS-CoV-2, the viral pathogen of COVID-19, is a crucial nonstructural protein that plays a vital role in the replication and pathogenesis of the virus. Its protease function relies on three active site pockets to recognize P1, P2, and P4 amino acid residues in a substrate and a catalytic cysteine residue for catalysis. By converting the P1 C(alpha) atom in an MPro substrate to nitrogen, we showed that a large variety of azapeptide inhibitors with covalent warheads targeting the MPro catalytic cysteine could be easily synthesized. Through the characterization of these inhibitors, we identified several highly potent MPro inhibitors. Specifically, one inhibitor, MPI89 that contained an aza-2,2-dichloroacetyl warhead, displayed a 10 nM EC50 value in inhibiting SARS-CoV-2 from infecting ACE2+ A549 cells and a selectivity index of 875. The crystallography analyses of MPro bound with 6 inhibitors, including MPI89, revealed that inhibitors used their covalent warheads to covalently engage the catalytic cysteine and the aza-amide carbonyl oxygen to bind to the oxyanion hole. MPI89 represents one of the most potent MPro inhibitors developed so far, suggesting that further exploration of the azapeptide platform and the aza-2,2-dichloroacetyl warhead is needed for the development of potent inhibitors for the SARS-CoV-2 MPro as therapeutics for COVID-19.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.11.536467v1" target="_blank">An Azapeptide Platform in Conjunction with Covalent Warheads to Uncover High-Potency Inhibitors for SARS-CoV-2 Main Protease</a>
</div></li>
<li><strong>Analysis of SARS-CoV-2 Recombinant Lineages XBC and XBC.1 in the Philippines and Evidence for Delta-Omicron Co-infection as a Potential Origin</strong> -
<div>
We report the sequencing and analysis of 60 XBC and 114 XBC.1 SARS-CoV-2 lineages detected in the Philippines from August to September 2022, which are regarded as recombinant lineages of the BA.2 Omicron and B.1.617.2 Delta (21I Clade) variants. The sequences described here place the Philippines as the country with the earliest and highest number of XBC and XBC.1 cases within the included period. Majority of the detected cases were sampled from the adjacent Davao and Soccskargen regions in southern Philippines, but have also been observed at lower proportions in other regions of the country. Time-scaled phylogenetic analysis with global samples from GISAID reaffirms the supposed root of XBC-like cases from the Philippines. Furthermore, the apparent clustering of some foreign cases separate from those collected in the country suggests several occurrences of cross-border transmissions resulting in the spread of XBC-like lineages within and among those countries. The consensus mutation profile shows regions harboring mutations specific to either the Omicron BA.2 or Delta B.1.617.2 lineages, supporting the recombinant nature of XBC. Finally, alternative allele fraction pattern and intrahost mutation analysis revealed that a relatively early case of XBC collected in March 2022 is likely to be an active co-infection event. This suggests that co-infection of Omicron and Delta was already occurring in the Philippines early in 2022, facilitating the generation of recombinants that may have further evolved and gained additional mutations enabling its spread across certain local populations at a later time.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.12.534029v1" target="_blank">Analysis of SARS-CoV-2 Recombinant Lineages XBC and XBC.1 in the Philippines and Evidence for Delta-Omicron Co-infection as a Potential Origin</a>
</div></li>
<li><strong>Learning from pre-pandemic data to forecast viral escape</strong> -
<div>
Effective pandemic preparedness relies on anticipating viral mutations that are able to evade host immune responses in order to facilitate vaccine and therapeutic design. However, current strategies for viral evolution prediction are not available early in a pandemic - experimental approaches require host polyclonal antibodies to test against and existing computational methods draw heavily from current strain prevalence to make reliable predictions of variants of concern. To address this, we developed EVEscape, a generalizable, modular framework that combines fitness predictions from a deep learning model of historical sequences with biophysical structural information. EVEscape quantifies the viral escape potential of mutations at scale and has the advantage of being applicable before surveillance sequencing, experimental scans, or 3D structures of antibody complexes are available. We demonstrate that EVEscape, trained on sequences available prior to 2020, is as accurate as high-throughput experimental scans at anticipating pandemic variation for SARS-CoV-2 and is generalizable to other viruses including Influenza, HIV, and understudied viruses with pandemic potential such as Lassa and Nipah. We provide continually updated escape scores for all current strains of SARS-CoV-2 and predict likely additional mutations to forecast emerging strains as a tool for ongoing vaccine development (evescape.org).
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.07.21.501023v2" target="_blank">Learning from pre-pandemic data to forecast viral escape</a>
</div></li>
<li><strong>Effectiveness of mRNA COVID-19 monovalent and bivalent vaccine booster doses against Omicron severe outcomes among adults aged ≥50 years in Ontario, Canada</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objective: We estimated the effectiveness of booster doses of monovalent and bivalent mRNA COVID-19 vaccines against Omicron-associated severe outcomes among adults aged ≥50 years in Ontario, Canada. Methods: We used a test-negative design to estimate vaccine effectiveness (VE), with unvaccinated adults as the comparator, against hospitalization or death among SARS-CoV-2-tested adults aged ≥50 years between June 19, 2022 and January 28, 2023 stratified by time since vaccination. We explored VE by vaccine product (Moderna Spikevax ® monovalent; Pfizer-BioNTech Comirnaty® monovalent; Moderna Spikevax® BA.1 bivalent; Pfizer-BioNTech Comirnaty® BA.4/BA.5 bivalent). Results: We included 3,755 Omicron cases and 14,338 test-negative controls. For the Moderna and Pfizer-BioNTech monovalent vaccines, VE 7-29 days after vaccination was 85% (95% confidence interval [CI], 72-92%) and 88% (95%CI, 82-92%), respectively, and was 82% (95%CI, 76-87%) and 82% (95%CI, 77-86%) 90-119 days after vaccination. For the Moderna BA.1 bivalent vaccine, VE was 86% (95%CI, 82-90%) 7-29 days after vaccination and was 76% (95%CI, 66-83%) 90-119 days after vaccination. For the Pfizer-BioNTech BA.4/BA.5 bivalent vaccine, VE 7-29 days after vaccination was 83% (95%CI, 77-88%) and was 81% (95%CI 72-87%) 60-89 days after vaccination. Conclusions: Booster doses of monovalent and bivalent mRNA COVID-19 vaccines provided similar, strong initial protection against severe outcomes in community-dwelling adults aged ≥50 years in Ontario. Nonetheless, uncertainty remains around waning protection of these vaccines.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.04.11.23288403v1" target="_blank">Effectiveness of mRNA COVID-19 monovalent and bivalent vaccine booster doses against Omicron severe outcomes among adults aged ≥50 years in Ontario, Canada</a>
</div></li>
<li><strong>The landscape of biomedical research</strong> -
<div>
The number of publications in biomedicine and life sciences has rapidly grown over the last decades, with over 1.5 million papers now published every year. This makes it difficult to keep track of new scientific works and to have an overview of the evolution of the field as a whole. Here we present a 2D atlas of the entire corpus of biomedical literature, and argue that it provides a unique and useful overview of the life sciences research. We base our atlas on the abstract texts of 21 million English articles from the PubMed database. To embed the abstracts into 2D, we use a large language model PubMedBERT, combined with t-SNE tailored to handle samples of our size. We use our atlas to study the emergence of the Covid-19 literature, the evolution of the neuroscience discipline, the uptake of machine learning, and the distribution of gender imbalance in academic authorship. Furthermore, we present an interactive web version of our atlas that allows easy exploration and will enable further insights and facilitate future research.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.04.10.536208v1" target="_blank">The landscape of biomedical research</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>Effectiveness and Safety of Quinine Sulfate as add-on Therapy for COVID-19 in Hospitalized Adults in Indonesia ( DEAL-COVID19 )</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Standard of Care + Quinine Sulfate;   Drug: Standard of Care<br/><b>Sponsors</b>:   Universitas Padjadjaran;   National Research and Innovation Agency of Indonesia;   Prodia Diacro Laboratories P.T.<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>Safety and Efficacy of Umbilical Cord Mesenchymal Stem Cell Exosomes in Treating Chronic Cough After COVID-19</strong> - <b>Condition</b>:   Long COVID-19 Syndrome<br/><b>Intervention</b>:   Biological: MSC-derived exosomes<br/><b>Sponsor</b>:   Huazhong University of Science and Technology<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>A Nasal Treatment for COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Optate;   Drug: Placebo<br/><b>Sponsor</b>:   Indiana University<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Clinical Study for the Efficacy and Safety of Ropeginterferon Alfa-2b in Adult COVID-19 Patients With Comorbidities</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Ropeginterferon alfa-2b;   Procedure: SOC<br/><b>Sponsor</b>:   National Taiwan University Hospital<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>Assessment of Immunogenicity, Safety and Reactogenicity of a Booster Dose of Various COVID-19 Vaccine Platforms in Individuals Primed With Several Regimes.</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: SCB-2019/Clover;   Biological: AstraZeneca/Fiocruz;   Biological: Pfizer/Wyeth<br/><b>Sponsors</b>:   D’Or Institute for Research and Education;   Bill and Melinda Gates Foundation<br/><b>Active, not recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Tailored COVID-19 Testing Support Plan for Francophone African Born Immigrants</strong> - <b>Condition</b>:   COVID19 Testing<br/><b>Interventions</b>:   Behavioral: FABI tailored COVID-19 testing pamphlet;   Behavioral: Standard COVID-19 home-based test kit<br/><b>Sponsors</b>:   Texas Woman’s University;   National Institutes of Health (NIH)<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>Complementary Self-help Strategies for Patients With Post-COVID-19 Syndrome</strong> - <b>Condition</b>:   Post-COVID-19 Syndrome<br/><b>Interventions</b>:   Behavioral: Complementary self-help strategies in addition to treatment as usual;   Other: Treatment as usual<br/><b>Sponsor</b>:   Universität Duisburg-Essen<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 to Understand the Effect and Safety of the Study Medicine PF-07817883 in Adults Who Have Symptoms of COVID-19 But Are Not Hospitalized.</strong> - <b>Condition</b>:   SARS-CoV-2 Infection<br/><b>Interventions</b>:   Drug: PF-07817883;   Drug: Placebo<br/><b>Sponsor</b>:   Pfizer<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>Traditional Chinese Medicine or Low-dose Dexamethasone in COVID-19 Pneumonia</strong> - <b>Condition</b>:   COVID-19 Pneumonia<br/><b>Interventions</b>:   Other: conventional western medicine treatment;   Drug: Dexamethasone oral tablet;   Other: Traditional Chinese medicine decoction<br/><b>Sponsor</b>:   China-Japan Friendship 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>Inpatient COVID-19 Lollipop Study</strong> - <b>Conditions</b>:   COVID-19;   Diagnostic Test<br/><b>Intervention</b>:   Device: Lollipop<br/><b>Sponsor</b>:   University of Wisconsin, Madison<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>Exploring the Effect of Video Interventions on Intentions for Continued COVID-19 Vaccination</strong> - <b>Conditions</b>:   Vaccine Refusal;   COVID-19<br/><b>Interventions</b>:   Behavioral: Informational Video;   Behavioral: Altruistic Video;   Behavioral: Individualistic Video<br/><b>Sponsor</b>:   Sir Mortimer B. Davis - Jewish General Hospital<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>Effectiveness of Testofen Compared to Placebo on Long COVID Symptoms</strong> - <b>Condition</b>:   Long Covid19<br/><b>Interventions</b>:   Drug: Testofen;   Drug: Microcrystalline cellulose<br/><b>Sponsor</b>:   RDC Clinical 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>Building Resilience During the COVID-19 Pandemic: a Randomized Controlled Trial</strong> - <b>Conditions</b>:   Healthy;   COVID-19;   Distress, Emotional<br/><b>Interventions</b>:   Behavioral: RASMUS Resilience Training;   Behavioral: Progressive Muscle Relaxation<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>Rehabilitation Treatment of Patients With COVID-19</strong> - <b>Conditions</b>:   Rehabilitation;   Pneumonia, Viral;   COVID-19;   Quality of Life<br/><b>Interventions</b>:   Other: exercises;   Other: massage<br/><b>Sponsors</b>:   I.M. Sechenov First Moscow State Medical University;   MEDSI Clinical Hospital 1, ICU<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>Addressing Vaccine Acceptance in Carceral Settings Through Community Engagement</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Behavioral: ADVANCE Steering Committee interventions<br/><b>Sponsors</b>:   Yale University;   National Institute on Minority Health and Health Disparities (NIMHD)<br/><b>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>Low Peripheral B-Cell Counts in Patients With Systemic Rheumatic Diseases Due to Treatment With Belimumab and/or Rituximab Are Associated With Low Antibody Responses to Primary COVID-19 Vaccination</strong> - Background: Immunosuppressive agents inhibit COVID-19 vaccine antibody (Ab) responses in patients with systemic rheumatic diseases. Rituximab may fully block Ab responses when B cells become undetected. The effect of detected but low number of B cells due to treatment with a B-cell agent (belimumab and/or rituximab) has not been established. Purpose: We sought to examine whether there is an association between a low number of B cells due to treatment with belimumab and/or rituximab and impaired…</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>Impulsive Neural Control to Schedule Antivirals and Immunomodulators for COVID-19</strong> - New SARS-CoV-2 variants escaping the effect of vaccines are an eminent threat. The use of antivirals to inhibit the viral replication cycle or immunomodulators to regulate host immune responses can help to tackle the viral infection at the host level. To evaluate the potential use of these therapies, we propose the application of an inverse optimal neural controller to a mathematical model that represents SARS-CoV-2 dynamics in the host. Antiviral effects and immune responses are considered as…</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>Anti-SARS-CoV-2 Activity of <em>Ampelozizyphus amazonicus</em> (Saracura-Mirá): Focus on the Modulation of the Spike-ACE2 Interaction by Chemically Characterized Bark Extracts by LC-DAD-APCI-MS/MS</strong> - Traditional medicine shows several treatment protocols for COVID-19 based on natural products, revealing its potential as a possible source of anti-SARS-CoV-2 agents. Ampelozizyphus amazonicus is popularly used in the Brazilian Amazon as a fortifier and tonic, and recently, it has been reported to relieve COVID-19 symptoms. This work aimed to investigate the antiviral potential of A. amazonicus, focusing on the inhibition of spike and ACE2 receptor interaction, a key step in successful…</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>Papaverine: A Miraculous Alkaloid from Opium and Its Multimedicinal Application</strong> - The pharmacological actions of benzylisoquinoline alkaloids are quite substantial, and have recently attracted much attention. One of the principle benzylisoquinoline alkaloids has been found in the unripe seed capsules of Papaver somniferum L. Although it lacks analgesic effects and is unrelated to the compounds in the morphine class, it is a peripheral vasodilator and has a direct effect on vessels. It is reported to inhibit the cyclic adenosine monophosphate (cAMP) and cyclic guanosine…</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>Repurposing FIASMAs against Acid Sphingomyelinase for COVID-19: A Computational Molecular Docking and Dynamic Simulation Approach</strong> - Over the past few years, COVID-19 has caused widespread suffering worldwide. There is great research potential in this domain and it is also necessary. The main objective of this study was to identify potential inhibitors against acid sphingomyelinase (ASM) in order to prevent coronavirus infection. Experimental studies revealed that SARS-CoV-2 causes activation of the acid sphingomyelinase/ceramide pathway, which in turn facilitates the viral entry into the cells. The objective was to inhibit…</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>Exploring the Potential Medicinal Benefits of <em>Ganoderma lucidum</em>: From Metabolic Disorders to Coronavirus Infections</strong> - Ganoderma lucidum is a medicinal mushroom that has been traditionally used in Chinese medicine for centuries. It has been found to have a wide range of medicinal properties, including antioxidant, anti-inflammatory, and immune-boosting effects. Recent research has focused on the potential benefits of G. lucidum in treating metabolic disorders such as diabetes and obesity, as well as its possible role in preventing and treating infections caused by the coronavirus. Triterpenoids are a major group…</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 Signaling Pathway of the ADP Receptor P2Y<sub>12</sub> in the Immune System: Recent Discoveries and New Challenges</strong> - P2Y(12) is a G-protein-coupled receptor that is activated upon ADP binding. Considering its well-established role in platelet activation, blocking P2Y(12) has been used as a therapeutic strategy for antiplatelet aggregation in cardiovascular disease patients. However, receptor studies have shown that P2Y(12) is functionally expressed not only in platelets and the microglia but also in other cells of the immune system, such as in monocytes, dendritic cells, and T lymphocytes. As a result, 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>COVID-19 and Diarylamidines: The Parasitic Connection</strong> - As emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants (Omicron) continue to outpace and negate combinatorial vaccines and monoclonal antibody therapies targeting the spike protein (S) receptor binding domain (RBD), the appetite for developing similar COVID-19 treatments has significantly diminished, with the attention of the scientific community switching to long COVID treatments. However, treatments that reduce the risk of “post-COVID-19 syndrome” and associated…</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>Roles of p53-Mediated Host-Virus Interaction in Coronavirus Infection</strong> - The emergence of the SARS-CoV-2 coronavirus has garnered global attention due to its highly pathogenic nature and the resulting health crisis and economic burden. Although drugs such as Remdesivir have been considered a potential cure by targeting the virus on its RNA polymerase, the high mutation rate and unique 3’ to 5’ exonuclease with proofreading function make it challenging to develop effective anti-coronavirus drugs. As a result, there is an increasing focus on host-virus interactions…</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>Identification of Potential Lead Compounds Targeting Novel Druggable Cavity of SARS-CoV-2 Spike Trimer by Molecular Dynamics Simulations</strong> - The global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become an urgent public health problem. Spike (S) protein mediates the fusion between the virus and the host cell membranes, consequently emerging as an important target of drug design. The lack of comparisons of in situ full-length S homotrimer structures in different states hinders understanding the structures and revealing the function, thereby limiting the discovery and development of therapeutic agents….</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>Stabilization of the Dimeric State of SARS-CoV-2 Main Protease by GC376 and Nirmatrelvir</strong> - The main protease (Mpro or 3CLpro) is an enzyme that is evolutionarily conserved among different genera of coronaviruses. As it is essential for processing and maturing viral polyproteins, Mpro has been identified as a promising target for the development of broad-spectrum drugs against coronaviruses. Like SARS-CoV and MERS-CoV, the mature and active form of SARS-CoV-2 Mpro is a dimer composed of identical subunits, each with a single active site. Individual monomers, however, have very low or…</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>Aged brain and neuroimmune responses to COVID-19: post-acute sequelae and modulatory effects of behavioral and nutritional interventions</strong> - Advanced age is one of the significant risk determinants for coronavirus disease 2019 (COVID-19)-related mortality and for long COVID complications. The contributing factors may include the age-related dynamical remodeling of the immune system, known as immunosenescence and chronic low-grade systemic inflammation. Both of these factors may induce an inflammatory milieu in the aged brain and drive the changes in the microenvironment of neurons and microglia, which are characterized by a general…</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>Broad-spectrum coronavirus 3C-like protease peptidomimetic inhibitors effectively block SARS-CoV-2 replication in cells: Design, synthesis, biological evaluation, and X-ray structure determination</strong> - Despite the approval of vaccines, monoclonal antibodies and restrictions during the pandemic, the demand for new efficacious and safe antivirals is compelling to boost the therapeutic arsenal against the COVID-19. The viral 3-chymotrypsin-like protease (3CL^(pro)) is an essential enzyme for replication with high homology in the active site across CoVs and variants showing an almost unique specificity for Leu-Gln as P2-P1 residues, allowing the development of broad-spectrum inhibitors. The…</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>Modulation of <em>in Vitro</em> SARS-CoV-2 Infection by <em>Stephania tetrandra</em> and Its Alkaloid Constituents</strong> - Botanical natural products have been widely consumed for their purported usefulness against COVID-19. Here, six botanical species from multiple sources and 173 isolated natural product compounds were screened for blockade of wild-type (WT) SARS-CoV-2 infection in human 293T epithelial cells overexpressing ACE-2 and TMPRSS2 protease (293TAT). Antiviral activity was demonstrated by an extract from Stephania tetrandra. Extract fractionation, liquid chromatography-mass spectrometry (LC-MS),…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of drug-drug interactions of ensitrelvir, a SARS-CoV-2 3CL protease inhibitor, with transporter substrates based on in vitro and a clinical study</strong> - Drug-drug interaction (DDI) potentials of ensitrelvir, a novel oral inhibitor of 3C-like protease of SARS-CoV-2, for drug transporters were evaluated by in vitro and clinical studies. The target drug transporters assessed were P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), organic anion transporting polypeptide (OATP) 1B1, OATP1B3, organic anion transporter (OAT) 1, OAT3, organic cation transporter (OCT) 1, OCT2, multidrug and toxin extrusion (MATE) 1 and MATE-2K. In vitro study…</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>Behind the Expulsions of Two State Representatives in Tennessee</strong> - How Republican super-majorities in state legislatures are undermining the democratic process. - <a href="https://www.newyorker.com/news/daily-comment/behind-the-expulsions-of-two-state-representatives-in-tennessee">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ro Khanna’s Progressive Case for Saving Silicon Valley Bank</strong> - The ambitious California congressman has made a career of navigating the demands of Big Tech and the Bernie Sanders wing of the Democratic Party. - <a href="https://www.newyorker.com/news/the-political-scene/ro-khannas-progressive-case-for-saving-silicon-valley-bank">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What’s Behind the Fight Between Pope Francis and the Latin Mass Movement?</strong> - The discord has become a stand-in for conflicts over the decline in Catholics’ participation in Mass, over the progressive orientation of Francis’s pontificate, and over Vatican II itself. - <a href="https://www.newyorker.com/news/daily-comment/whats-behind-the-fight-between-pope-francis-and-the-latin-mass-movement">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What Really Happened at Waco</strong> - Thirty years later, an avoidable tragedy has spawned a politically ascendant mythology. - <a href="https://www.newyorker.com/news/letter-from-the-southwest/what-really-happened-at-waco">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A New Phase in the Rollback of Abortion Access</strong> - A Texas judge’s injunction on the use of mifepristone has further eroded the country’s standing as a leader in reproductive rights. - <a href="https://www.newyorker.com/news/daily-comment/a-new-phase-in-the-rollback-of-abortion-access">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>What we know about the Louisville shooting</strong> -
<figure>
<img alt="A row of white crosses with blue hearts stand in front of the bank’s steps, which are covered in colorful flowers. The sun shines on them, golden with late afternoon light." src="https://cdn.vox-cdn.com/thumbor/r7qaAuQ3KbADEHUQ85tnHcywXFc=/0x0:4809x3607/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72165587/GettyImages_1251752467.7.jpg"/>
<figcaption>
A memorial to those killed in the Louisville Old Dominion Bank shooting on April 10, 2023. | Michael Swensen/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
There were multiple casualties in a shooting at a downtown bank.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rwepLu">
On Monday, at least five people were killed and eight were injured<strong> </strong>in a shooting in Louisville, Kentucky, according to police. The shooter is also<strong> </strong>dead, officers said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8xEjHj">
The shooting took place around 8:38 am ET in the first-floor conference room of Old National Bank in downtown Louisville. The shooter, a 25-year old white male who was an employee at the bank, <a href="https://www.cnn.com/us/live-news/louisville-kentucky-shooting-04-11-23/index.html">reportedly opened fire during a morning meeting</a> and livestreamed the attack on Instagram. Bank employees who had joined the meeting via video call also witnessed the violence and were among those who called police.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tjX00k">
Louisville Interim Police Chief <a href="https://www.youtube.com/watch?v=EkBWgYOq4B4">Jacquelyn Gwinn-Villaroel</a> said the shooter was an active employee and there was “no discussion about this individual being terminated,” <a href="https://www.cnn.com/2023/04/10/us/louisville-ketucky-incident/index.html">after CNN had previously reported</a> that he had been told he was going to be fired from his job.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S24zaL">
Police described the shooting as a “targeted” attack since he knew the victims.<strong> </strong>On Tuesday and Wednesday, they also released <a href="https://www.cnn.com/2023/04/12/us/louisville-kentucky-bank-shooting-wednesday/index.html">audio of 911 calls</a> and body cam footage that captured a shootout with the shooter, and a distressed call from a woman inside the bank.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="i4B8PF">
The five reported dead are Joshua Barrick, Thomas Elliott, Juliana Farmer, James Tutt, and Deana Eckert, all of whom were employees at the bank. Of the people who were initially injured, three — including a police officer who was shot in the head — were still hospitalized, as of Wednesday; one, Eckert, died due to their wounds. The city of Louisville plans to hold a vigil for the victims at 5 pm ET at the <a href="https://twitter.com/AliCenter/status/1645914288819961856">Muhammad Ali Center</a> on Wednesday evening.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4vtXAI">
Officers said the shooter used an AR-15 rifle that was legally obtained during the attack and had no “prior engagement” with police.<strong> </strong>Police have yet to disclose a specific motive, <a href="https://www.cnn.com/us/live-news/louisville-kentucky-shooting-04-11-23/index.html">with a law enforcement source telling CNN</a> that the shooter left a note for his parents and a friend.<strong> </strong>The shooting in Louisville follows other recent workplace shootings, including at a mushroom farm in Half Moon Bay, California, in January, and at a Walmart in Chesapeake, Virginia, in November 2022.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YZlY3f">
Some regional Democratic lawmakers have called for gun reforms in the wake of the shootings. “This isn’t about partisan politics. This is about life and death. This is about preventing tragedies,” said Louisville Mayor Craig Greenberg, who has been the victim of gun violence himself.<strong> </strong>At the national level, <a href="https://twitter.com/POTUS/status/1645469188813619209">President Joe Biden</a> shared his condolences and similarly asked, “When will Republicans in Congress act to protect our communities?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OtIlAc">
Kentucky Gov. Andy Beshear did not make similar calls in his initial appearances; at one press briefing, he<strong> </strong>spoke emotionally about one of his “closest friends” who was killed in the shooting and said there would be time to discuss “issues” in the days to come.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7T3hI4">
“Acts of violence like this hurt,” Beshear said. “They tear at the fabric of who we are, at our society, at our state, at our country, and this city. Today, I’m hurt and I’m hurting, and I know so many people out there are, as well.” <a href="https://www.kentucky.com/news/politics-government/article274175600.html">According to the Lexington Herald-Leader</a>, the legislature’s Republican supermajority has recently focused on bills loosening gun laws, including recently approving a policy that <a href="https://www.wtvq.com/bill-to-make-ky-a-second-amendment-sanctuary-becomes-law/">bars local and state police from enforcing federal regulations</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QXG4hq">
The Louisville bank shooting follows <a href="https://www.vox.com/23142734/covenant-school-nashville-mass-shootings">more than 100 mass shootings</a> that have taken place this year, including a school shooting at <a href="https://www.vox.com/politics/2023/3/27/23658533/nashville-school-shooting-covenant-school">Covenant School in Nashville in late March</a> that left six people dead.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RecYO8">
The country’s large number of shootings <a href="https://www.vox.com/23142734/covenant-school-nashville-mass-shootings">points to the unique problem</a> that the US, which has a significantly high rate of civilian gun ownership relative to other countries, has with firearms.<strong> </strong>A second shooting in the Louisville area on Tuesday at Jefferson Community and Technical College only served to underscore the pervasiveness of gun violence. At least <a href="https://www.wlky.com/article/lmpd-suspect-run-shooting-jctc-louisville-jefferson/43553620">one person was killed and another injured</a> in that shooting, which is not believed to be connected to the Old National Bank mass shooting.
</p>
<h3 id="rtNpY7">
The US has a unique problem with guns
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rgcFgN">
<a href="https://www.gunviolencearchive.org/reports/mass-shooting?page=1">According to the Gun Violence Archive</a>, which defines mass shootings as an incident in which four or more people are shot, the Louisville incident <a href="https://www.bbc.com/news/world-us-canada-41488081">marks the 146th mass shooting</a> in the US in 2023.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z6uF3E">
That’s far more than other places: <a href="https://www.cnn.com/2015/08/27/health/u-s-most-mass-shootings/index.html">While it accounts for 5 percent of the world’s population</a>, the US made up 31 percent of the public mass shootings that occurred globally between 1966 and 2012, according to a 2016 study from <a href="https://pubmed.ncbi.nlm.nih.gov/26822013/">University of Alabama criminal justice professor Adam Lankford</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5ufPSG">
The US also has more civilian-owned guns than any other country in the world, <a href="https://www.vox.com/23142734/covenant-school-nashville-mass-shootings">with one 2018 estimate</a> putting the number at <a href="https://www.smallarmssurvey.org/sites/default/files/resources/SAS-BP-Civilian-Firearms-Numbers.pdf">120.5 firearms per 100 residents</a>. For comparison, the countries with the next highest civilian gun ownership levels are Yemen, at 52.8 firearms per 100 residents, and Montenegro, at 39.1 firearms per 100 residents.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hb8ANW">
<a href="https://www.vox.com/23142734/covenant-school-nashville-mass-shootings">As Vox’s Nicole Narea has explained</a>, researchers have identified clear links between gun ownership and gun violence. Notably, <a href="https://everytownresearch.org/rankings/">a study from the gun control advocacy group Everytown for Gun Safety</a> has also found that states with weaker gun laws have higher rates of gun violence.<strong> </strong>According to Everytown, Kentucky is among the states with weaker laws, with legislators rolling back a permit requirement for <a href="https://www.usnews.com/news/national-news/articles/2019-03-01/kentucky-lawmakers-pass-nra-backed-concealed-carry-law">carrying concealed handguns in 2019</a>. The Kentucky legislature also recently passed <a href="https://thehill.com/homenews/state-watch/3903941-kentucky-lawmakers-pass-bill-to-make-state-a-second-amendment-sanctuary/">“Second Amendment sanctuary” legislation</a> that directs local law enforcement to ignore federal firearms bans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="giKxcE">
More aggressive gun reforms, like an assault weapons ban, have been stymied at the federal level due to Republican opposition. Last year, Congress <a href="https://www.vox.com/policy-and-politics/2022/6/23/23180893/senate-gun-control-bipartisan-bill-2022-pass">passed a bipartisan gun control package</a> that included a narrow set of reforms including funding for states to implement “red flag” laws, more screening for gun buyers under 21, and a crackdown on illegal guns.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dfECGc">
Republicans, who have close ties to the National Rifle Association and who fear backlash from their base voters, have broadly signaled, however, that they aren’t interested in doing more on the issue at this time.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="r4C0zA">
<em><strong>Update, April 12, 5:15 pm ET:</strong></em><em> This piece was originally published on April 10 and has been updated with new developments, most recently to reflect the shooter’s employment status and the release of additional law enforcement documents. </em>
</p></li>
<li><strong>Why the workplace is a common site of mass shootings</strong> -
<figure>
<img alt="Wide concrete stairs behind a yellow caution tape hold bouquets of flowers tossed onto them." src="https://cdn.vox-cdn.com/thumbor/xQVXvCF769MjUfiA9YGMGXOPByU=/0x0:4800x3600/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72171498/1251604100.0.jpg"/>
<figcaption>
Bouquets of flowers lie at the entrance of the Old National Bank for the victims of the mass shooting on April 11, 2023, in Louisville, Kentucky.  | Michael Swensen/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The Louisville shooting is the latest such incident, though they remain rare.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vxnKmp">
<a href="https://www.vox.com/politics/2023/4/10/23677156/louisville-shooting-kentucky-active-shooter-police">Monday’s mass shooting</a> at Old National Bank in Louisville, Kentucky, is the latest instance of horrific gun violence in a workplace. According to Louisville police, the shooter was an “active employee” at the bank, and there had been no “discussion about this individual being terminated.” <a href="https://www.cnn.com/2023/04/10/us/louisville-ketucky-incident/index.html">CNN had previously reported</a> the shooter had been told he was being fired from his job.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="f2v2r9">
The Louisville attack follows other recent workplace shootings including on a mushroom farm in <a href="https://www.vox.com/policy-and-politics/2023/1/26/23571698/asian-americans-california-mass-shootings-monterey-park-half-moon-bay">Half Moon Bay, California</a>, in January and <a href="https://nymag.com/intelligencer/article/shooting-virginia-walmart.html">at a Walmart in Chesapeake, Virginia</a>, in November 2022. Both were perpetrated by someone who was employed or formerly employed by these establishments.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DcQVij">
Mass shootings at work, like mass shootings generally, <a href="https://apnews.com/article/shootings-us-news-wisconsin-united-states-brewery-shooting-950c07fc95752095d7336b0a053ffd9b">are rare occurrences</a>. Though more common in the US than elsewhere in the world, mass shootings make up less than <a href="https://www.npr.org/sections/health-shots/2022/05/26/1101423558/how-can-mas-shootings-be-prevented-definitive-answers-are-hard-to-come-by">1 percent of gun violence deaths in the US</a>, and workplace shootings comprise a smaller subset of those fatalities. The workplace is the most common location for a mass shooting, however, according to <a href="https://abcnews.go.com/US/workplaces-common-mass-shooting-site-data-shows/story?id=98502802">the Violence Project</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ab7fsj">
And mass shootings in the workplace have seen a slight uptick in recent years. Since 2020, there have been eight such mass shootings, per data that James Densley, a sociologist at Metropolitan State University, shared with Vox. That’s a higher rate than in preceding years, when there were nine workplace mass shootings documented between 2010-2019. In the decades before, such shootings were more prevalent, however, with 14 taking place between 2000-2009 and 17 occurring between 1990-1999.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L0fHb5">
According to gun violence experts, workplace mass shootings typically involve current or former employees who have a problem with the workplace, who have easy access to guns, and who may be experiencing their own mental health challenges. “They are underlined by some grievance with the workplace and the people in it. But mass shootings generally, including workplace shootings, are more deeply driven by despair,” says Densley.
</p>
<h3 id="H1TVs0">
What drives workplace mass shootings
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EBSgSB">
There could be several factors behind the increased frequency of workplace mass shootings in recent years compared to the previous decade. The data suggests they’ve gone up slightly as more people <a href="https://www.nbcnews.com/news/us-news/fedex-killings-mark-return-mass-workplace-shootings-paused-pandemic-n1264355">physically returned to work</a> when different places reopened. Around that same time, overall workplace gun violence also spiked. In 2021, for example, there were 387 fatal shooting injuries in workplaces, compared to 304 in 2020 and 351 in 2017, <a href="https://www.bls.gov/news.release/cfoi.t02.htm">per data from the Bureau of Labor Statistics</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6MoJnh">
“It’s quite possible there will be an increase in these kinds of killings when people who have been working remotely start to return,” James Alan Fox, a criminology professor at Northeastern University in Boston, told NBC News <a href="https://www.nbcnews.com/news/us-news/fedex-killings-mark-return-mass-workplace-shootings-paused-pandemic-n1264355">in April 2021.</a> <a href="https://www.news4jax.com/news/local/2023/04/11/i-team-workplaces-top-target-for-mass-shooters-attackers-usually-have-connection/">According to the Violence Project</a>, most of these mass shootings — 70 percent — involved an employment issue like a firing, 23 percent involved interpersonal conflict, 13 percent involved an economic issue, and 13 percent involved a legal issue.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6Oi8H4">
<a href="https://www.bbc.com/news/world-us-canada-64377360">Mass shootings have also increased overall</a>, and workplace mass shootings appear to be following the same trends as gun violence in general, says Jaclyn Schildkraut, the executive director of the Regional Gun Violence Research Consortium at the Rockefeller Institute. Workplace shooters tend to pick these locations because of “ease of access and familiarity of the location,” she adds.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XNp2dG">
There were <a href="https://www.bbc.com/news/world-us-canada-64377360">33,599 gun-related deaths in the US in 2019,</a> and that number jumped to 44,290 in 2022. That broader increase has taken place as more people have purchased guns during the pandemic, and as people continue to navigate emotional and financial stressors related to it. According to one <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697522/">paper</a> published in the <em>Annals of Internal Medicine</em>, roughly 7.5 million people, or nearly 3 percent of US adults, became new gun owners between 2019 and 2021. A study from the University of California Davis and the University of California Firearm Violence Research Center noted that <a href="https://www.opb.org/news/article/gun-violence-statistics-covid-19-pandemic/">increased gun ownership</a> as well as factors like “financial stress, tension [and] trauma,” exacerbated by the pandemic have played a role in rising violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0mOuVh">
Policies may be a factor, too. During that same time, more states abolished permitting requirements for carrying a concealed handgun in public, which research has <a href="https://www.americanprogress.org/article/fact-sheet-weakening-requirements-to-carry-a-concealed-firearm-increases-violent-crime/#:~:text=Scientific%20research%20consistently%20shows%20that,gun%20homicides%20and%20violent%20crime.">linked to a rise in shootings</a> as well. “​​The relaxation of laws about carrying guns in public has clearly led to a rise in gun violence generally, and I assume this impacts workplace violence along with schools, malls, grocery stores, and so on,” says Drury Stevenson, a University of Houston law professor who has studied workplace violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rYyTgK">
Moving forward, experts note that there are proposals that have the potential to reduce mass shootings. Specific gun control policies — such as permitting requirements — have been tied to lower incidences of mass shootings overall. And specific workplace responses, such as early reporting of threats, could help curb such incidents.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6n5NYi">
“People coming forward and reporting threats and then threat assessment are the main ways that these events are often prevented, both in and out of workplaces,” says Schildkraut.
</p>
<h3 id="X4ptoD">
Stronger gun control and better workplace reporting could help prevent shootings
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9vrYzE">
There are policies, such as requirements for gun permits and licenses, that researchers have found to be related to lower mass shooting rates overall, while other policies, like stronger concealed carry laws, have been found to lower workplace violence in general.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TI93hI">
According to a <a href="https://rockinst.org/wp-content/uploads/2021/08/policy-solutions-public-mass-shootings.pdf">report from the Rockefeller Institute</a> compiled by multiple gun violence researchers, there are state laws that effectively lead to fewer mass public shooting incidents. <a href="https://www.vox.com/2018/11/13/17658028/massachusetts-gun-control-laws-licenses">Massachusetts</a>, which has the lowest rate of gun deaths in the country, for example, requires that people obtain a background check, complete paperwork, and sit for an interview in order to get a license to purchase a gun. Making it harder to get a gun reduces the number of guns in circulation, which appears to reduce rates of gun violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ybtm6K">
Additionally, laws that banned large-capacity magazines, or the ability for a gun to fire off many rounds of ammunition in a short period of time, were tied to fewer victims in shootings. According to <a href="https://www.everytown.org/solutions/prohibit-high-capacity-magazines/">data from Everytown for Gun Safety</a>, a gun control advocacy group, mass shootings that included shooters using high-capacity magazines had nearly 10 times as many casualties.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sr1PAK">
“Several studies have demonstrated that permit laws reduce overall rates of firearm homicide,” <a href="https://rockinst.org/wp-content/uploads/2021/08/policy-solutions-public-mass-shootings.pdf">the researchers write</a>. “Thus, an increased difficulty in obtaining a gun appears to translate into a decreased use of guns in the commission of crime. This same conceptual framework may explain our finding that states with permit laws experience a lower rate of mass public shootings.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="p7JzW4">
A study published in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6951380/"><em>American Journal of Public Health</em> in 2020</a> focused on lowering not just mass shootings, but all workplace violence. It found that “as states strengthened regulations related to firearms, workplace homicide rates decreased.” In particular, more stringent concealed carry permitting, domestic-violence-related restrictions, and stronger background checks, coupled with other gun control polices, could reduce <a href="https://www.bc.edu/bc-web/bcnews/nation-world-society/social-work/researchers-probe-gun-policies.html">workplace homicides by 3.7 percent</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZQHgRc">
Extreme risk protection orders (ERPO), also known as “red flag” laws, have also been found to be effective. These laws allow family members and law enforcement to report individuals exhibiting concerning behavior, enabling police to confiscate their firearms.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="W3qWf0">
These laws can ensure that those who’ve made violent threats don’t have access to guns, Stevenson notes. In San Diego, there have been more than 1,000 restraining orders put <a href="https://www.kqed.org/news/11939499/red-flag-laws-in-california-san-francisco-san-diego">forth under the state’s ERPO law</a>, including in cases of workplace and school threats<strong>. </strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="27rmO3">
While gun reform is seen as the most effective way to lower gun deaths, it’s off the table nationally and in many states. And that can place the onus of gun safety on individual workplaces and companies, experts say.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5SBygt">
“HR processes are key to workplace violence prevention,” says Densley, including “training all employees to look for warning signs of despair and establishing reporting mechanisms so people can get connected to help they need.” Educating people about how to identify and report threats, and then developing a plan that manages the concern, is important, experts say.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hl7XeM">
The thinking behind an approach like this — much like in the case of extreme risk protection orders — is that there are observable behaviors that some perpetrators of violence have exhibited in the past, and that identifying these behaviors could help prevent or restrict them from going down a dangerous path.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="psyoza">
Studying the effectiveness of threat assessments can be difficult, as <a href="https://www.newyorker.com/news/annals-of-inquiry/can-researchers-show-that-threat-assessment-stops-mass-shootings">the New Yorker’s Matthew Hutson writes</a>, since they are designed to prevent violence before it happens. But putting together a process to identify and address such threats is one thing companies of all sizes can do in the face of government inaction.<strong> </strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rTaBqk">
<em><strong>Update, April 12, 5 pm ET:</strong></em><em> This story was originally published on April 11 and has been updated to reflect police statements about the shooter’s employment status. </em>
</p></li>
<li><strong>7 questions about mifepristone and abortion access, answered</strong> -
<figure>
<img alt="Smartphone with picture of mifepristone pills on it." src="https://cdn.vox-cdn.com/thumbor/GRIqDC8qxoprhFUPoLSe3pDWW58=/174x0:3826x2739/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72174201/1212435851.0.jpg"/>
<figcaption>
In this photo illustration, a person looks at an mifepristone pill on a smartphone. | Olivier Douliery/AFP via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Is mifepristone legal? Is it safe? What’s going on in the courts?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="U7kJPN">
It’s been a confusing, consequential few days for the future of abortion access in America.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IodfKG">
<a href="https://www.vox.com/policy-and-politics/2022/12/17/23512766/supreme-court-matthew-kacsmaryk-judge-trump-abortion-immigration-birth-control">Matthew Kacsmaryk</a>, a federal judge in Texas, issued an April 7 decision <a href="https://www.vox.com/policy/2023/4/7/23593396/medication-abortion-pills-mifepristone-misoprostol-pregnancy-texas">suspending the Food and Drug Administration’s approval</a> of mifepristone, one of two drugs used to conduct medication abortion — a procedure that makes up the majority of abortions in the US.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bcO80K">
Although mifepristone has been used for more than 20 years in the US with few severe side effects, the judge agreed with the argument put forth by the plaintiff, the anti-abortion group Alliance for Hippocratic Medicine, which claimed that the FDA had <a href="https://www.vox.com/policy/2023/4/7/23593396/medication-abortion-pills-mifepristone-misoprostol-pregnancy-texas">bowed to political pressure</a> from the Clinton administration in approving the medication and did not adequately evaluate safety concerns. Former FDA Commissioner Jane Henney <a href="https://www.npr.org/2023/04/11/1169318342/former-fda-commissioner-defends-original-approval-of-mifepristone">defended her agency’s approval to NPR</a> this week, saying, “Mifepristone was handled in a very proper way. It was given a very thorough review. It was not rushed.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bQL0HQ">
Also on Friday, a judge in Washington state issued a contradictory order, saying that the FDA could not impose any more restrictions on access to the drug.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LU7TYG">
Kacsmaryk’s ruling provided a seven-day waiting period for the case to be appealed. But the situation has raised big questions about mifepristone and medication abortion. Here are some of those questions and their answers.
</p>
<h3 id="u5fEq9">
<ol type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">What is mifepristone?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WNshx4">
Mifepristone is one of two drugs used to perform an abortion. It blocks the hormone progesterone, which maintains the interior of the uterus. If progesterone is blocked, the uterus can’t support a pregnancy and the embryo is detached. The FDA recommends the drug be taken within the first 10 weeks of a pregnancy, though the World Health Organization recommends it up to 12 weeks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xdk69d">
Medication abortion — the combination of mifepristone and<strong> </strong>a second drug, misoprostol — has <a href="https://www.guttmacher.org/article/2022/02/medication-abortion-now-accounts-more-half-all-us-abortions">become the most common method</a> for ending pregnancies in the United States, partly due to its <a href="https://www.guttmacher.org/evidence-you-can-use/medication-abortion">safety record</a>, its <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01528">lower cost</a>, diminished access to in-person care, and greater opportunities for privacy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mCkuWv">
Mifepristone has been used by over 5 million women in the United States since it was first authorized by the FDA 23 years ago. In 2016, the FDA <a href="https://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/020687Orig1s020MedR.pdf">reported</a> that mifepristone’s “efficacy and safety have become well-established by both research and experience, and serious complications have proven to be extremely rare.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RGp1bb">
Mifepristone is also used for other situations like miscarriage management, and <a href="https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/side-effects/drg-20067123?p=1">helping patients</a> with Cushing’s syndrome who also have Type 2 diabetes. <em>—Rachel Cohen</em>
</p>
<h3 id="EuEovg">
<ol start="2" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">Is mifepristone still legal?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1681322094.706909">
Kacsmaryk’s decision has not gone into effect yet, meaning nothing has changed since before the decision was issued. Doctors in <a href="https://www.guttmacher.org/state-policy/explore/state-policies-later-abortions">states without total abortion bans</a> can still prescribe mifepristone for abortions, and patients can still get it at clinics, by mail, or at a <a href="https://www.plannedparenthood.org/blog/i-heard-that-you-can-get-the-abortion-pill-at-pharmacies-now-instead-of-directly-from-a-nurse-or-doctor-is-this-true-and-what-if-abortion-is-illegal-in-my-state">pharmacy</a> (if their pharmacy has been certified to dispense it).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h1SjEd">
If the FDA is ultimately forced to rescind its approval of mifepristone, it will have to decide how to enforce that decision, which will determine how health care providers respond and where and how patients can get the medication.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nrNmuJ">
But, regardless of what happens, the medication will not become a controlled substance like heroin or other illegal drugs. Instead, for people who are still able to get mifepristone (more on that below), possessing it will be legally the same as having most other drugs<strong> </strong>without a prescription — a misdemeanor, not a felony, in most states. Having mifepristone would be akin to having Viagra or a statin drug without a prescription, said Farah Diaz-Tello, senior counsel and policy director at the reproductive justice legal group If/When/How.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ARzbnU">
Reproductive justice advocates aren’t especially worried about people being prosecuted for possessing mifepristone without a prescription, but are concerned about people being criminalized for taking mifepristone to end a pregnancy if Kacsmaryk’s ruling goes into effect.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9pr6RG">
Currently, taking the drug is not explicitly illegal in most states — <a href="https://www.reprolegalhelpline.org/sma-faq/">only two</a>, South Carolina and Nevada, actually have laws against self-managed abortion, procedures patients complete<strong> </strong>outside the medical system using pills obtained online or through friends or acquaintances.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YVU75K">
In other states, prosecutors have attempted to charge people for ending their own pregnancies under homicide or assault laws or other statutes, often after they sought medical treatment. Prosecutors may become more zealous in prosecuting people for taking abortion medication in the wake of Kacsmaryk’s ruling, Diaz-Tello said, but only because it will increase attention to and scrutiny of medication abortions — the actual laws around self-managed abortion have not changed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="w9mV18">
These legal nuances are likely to be confusing to the average American who is, as Diaz-Tello put it, “just living their life and trying to figure out a way to exercise some control over their reproductive future.” If/When/How <a href="https://www.ifwhenhow.org/repro-legal-helpline/">maintains a legal helpline</a> where people can get free, confidential advice about self-managed abortion. “I really want people to know that they’re not alone in trying to have to parse this,” Diaz-Tello said. <em>—Anna North</em>
</p>
<h3 id="oDURr1">
<ol start="3" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">Is mifepristone safe?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pNItF0">
Many FDA-approved drugs come with some safety risks. But the high level of scrutiny means that over the last 23 years, we’ve learned a lot about mifepristone — and it’s shown that medication abortion is very, very safe. Rates of patient deaths due to mifepristone are lower for mifepristone than they are for <a href="https://www.ansirh.org/sites/default/files/publications/files/mifepristone_safety_4-23-2019.pdf">Tylenol, penicillin, or Viagra</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Onwheg">
A 2013 <a href="https://www.contraceptionjournal.org/article/S0010-7824(12)00643-9/fulltext">report</a> reviewed results from 87 studies, which included data from more than 45,000 people who’d had medication abortions worldwide. It found the drug combination effectively ended pregnancy in 95 percent of patients. It also showed that serious side effects — symptoms so severe they required hospitalization — were very rare. The most common ones were vaginal bleeding, pelvic pain, and infection. Symptoms this serious occurred in only 3 out of every 1,000 patients, and only 1 out of 1,000 needed a blood transfusion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ghQAiQ">
For Americans, taking mifepristone is far safer than pregnancy: A 2012 study found the death rate associated with childbirth was <a href="https://journals.lww.com/greenjournal/Abstract/2012/02000/The_Comparative_Safety_of_Legal_Induced_Abortion.3.aspx">14 times</a> that associated with abortion.<em> </em>—<em>Keren Landman</em>
</p>
<h3 id="K8FxQW">
<ol start="4" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">What’s going on in the courts?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JYndly">
The short answer is that it is really messy. Currently, there are two conflicting orders, handed down by two different federal courts, which require the FDA to behave in mutually contradictory ways.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Kiflil">
The first of the two is Judge Matthew Kacsmaryk’s decision in <a href="https://www.dropbox.com/s/jnm4r233xat6tv4/ND%20Tex%20FDA%20decision.pdf?dl=0"><em>Alliance for Hippocratic Medicine v. FDA</em></a><em>, </em>which halts the FDA’s 23-year-old decision to allow mifepristone to be marketed in the United States. Kacsmaryk’s order is not currently in effect, but it will take effect on April 14 unless a higher court intervenes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lmf9sG">
The second order is from Judge Thomas Rice in a case called <a href="https://www.washingtonpost.com/documents/832ff674-557b-4ee0-b8e8-34663b927302.pdf?itid=lk_inline_manual_5"><em>Washington v. FDA</em></a>, and prohibits the FDA from “altering the status quo and rights as it relates to the availability of Mifepristone,” at least in the 17 states plus the District of Columbia which filed this lawsuit. It is not possible for the FDA to simultaneously maintain the status quo, as Rice’s order requires, and to effectively bar mifepristone from the marketplace, as Kacsmaryk’s order will require if it takes effect.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0qJTs8">
Neither of these orders are paragons of legal reasoning. Kacsmaryk’s order is a <a href="https://www.vox.com/politics/23678636/supreme-court-anthony-comstock-abortion-mifepristone-matthew-kacsmaryk">train wreck</a> riddled with <a href="https://adamunikowsky.substack.com/p/mifepristone-and-the-rule-of-law-9c4">so many legal errors</a> that it raises serious questions about whether Kacsmaryk, a <a href="https://www.vox.com/policy-and-politics/2022/12/17/23512766/supreme-court-matthew-kacsmaryk-judge-trump-abortion-immigration-birth-control">longtime Christian right operative</a>, even attempted to comply with the law when he wrote his opinion. Rice’s decision, meanwhile, is less of a disaster than Kacsmaryk’s. But it is unclear why he had the authority to issue an injunction requiring the FDA to keep doing what it is already doing.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b7jty2">
In any event, there is a <a href="https://www.vox.com/politics/2023/3/16/23642927/supreme-court-abortion-matthew-kacsmaryk-mifepristone-texas-trump">decent chance that a higher court will intervene</a> before Friday — thus rescuing the FDA from the impossible task of trying to comply with these two mutually contradictory orders.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hECZRg">
The Justice Department has asked the Washington judge to clarify his order. But more importantly, the US Court of Appeals for the Fifth Circuit is right now considering the Justice Department’s <a href="https://affordablecareactlitigation.files.wordpress.com/2023/04/5c-us-stay-ms.pdf">request to temporarily block Kacsmaryk’s order</a> while this case is fully litigated on appeal. The DOJ asked the Fifth Circuit to rule on this request by noon on Thursday. And the court, which required both parties to brief this case on a highly expedited schedule, appears likely to honor that request.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aZQUIG">
That said, the Fifth Circuit is probably the <a href="https://www.vox.com/policy-and-politics/2022/12/27/23496264/supreme-court-fifth-circuit-trump-court-immigration-housing-sexual-harrassment">most right-wing appeals court in the entire federal system</a>. So it is more likely than not that the Fifth Circuit will deny the DOJ’s request; if that happens, the agency will almost certainly seek an emergency order from the Supreme Court halting Kacsmaryk’s order before it goes into effect.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wx9MKH">
Though the Supreme Court is very conservative, it claimed in <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf"><em>Dobbs v. Jackson Women’s Health Organization</em></a> (2022), the decision overruling <em>Roe v. Wade</em>, that “it is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.” Similarly, Justice Brett Kavanaugh wrote in a separate concurring opinion that his Court “must scrupulously adhere to the Constitution’s neutral position on the issue of abortion.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="r6GxKB">
So the Supreme Court has at least claimed that it will not allow federal judges like Kacsmaryk to impose their anti-abortion views on the nation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DuANjM">
The current fight in the Fifth Circuit (and the possible coming fight in the Supreme Court) concerns only whether Kacsmaryk’s order will be temporarily blocked while this case is being appealed. There will be <a href="https://www.vox.com/politics/2023/3/16/23642927/supreme-court-abortion-matthew-kacsmaryk-mifepristone-texas-trump">another round of appeals</a> to determine whether Kacsmaryk’s decision should be permanently reversed. Those appeals will also be heard first by the Fifth Circuit, and then potentially by the Supreme Court.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MiGB0r">
So, while there’s a real chance that a higher court will temporarily halt Kacsmaryk’s attempt to ban mifepristone as soon as Wednesday afternoon, the case may not be permanently resolved for months or more. <em>—Ian Millhiser</em>
</p>
<h3 id="xz9zrQ">
<ol start="5" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">How do people get mifepristone now?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NqbD52">
Until and unless Kacsmaryk’s ruling actually goes into effect, access to mifepristone is unchanged — people can still get mifepristone in <a href="https://www.guttmacher.org/state-policy/explore/medication-abortion?gclid=CjwKCAjwitShBhA6EiwAq3RqAwEQp_3MkBVU--r8P9hZXRPbGfCusirs_kScLNghPFyHYr7BLSx8jRoCgPUQAvD_BwE">states that allow medication abortion</a>. If the ruling does go into effect, patients may not be able to get the medication at a clinic or pharmacy, or from <a href="https://www.vox.com/the-highlight/22968993/abortion-pills-mail-medication-fda-texas">telehealth providers</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="K7JX5D">
However, they will still have options for obtaining the drug. They can order pills either from the European-based nonprofit <a href="https://www.vox.com/23056530/aid-access-abortion-roe-wade-pills-mifepristone">Aid Access</a>, which bypasses US restrictions by prescribing the drugs to patients from overseas, or through <a href="https://www.plancpills.org/find-pills">alternative methods</a> vetted by the reproductive justice group <a href="https://www.plancpills.org/">Plan C</a>, such as mail forwarding, as <a href="https://www.vox.com/policy/2023/4/7/23593396/medication-abortion-pills-mifepristone-misoprostol-pregnancy-texas">Vox’s Rachel Cohen reported</a>. In addition, at least two states, <a href="https://www.npr.org/2023/04/10/1162182382/california-strikes-deal-to-stock-up-on-abortion-pills#:~:text=Last%20week%2C%20Washington%20Gov.%20Jay,and%20Drug%20Administration%20in%202000.">Massachusetts and Washington</a>, have stockpiled doses of the medication in case it becomes unavailable nationwide. These states are also <a href="https://www.nytimes.com/2023/04/12/us/democratic-states-abortion-pills.html?partner=slack&amp;smid=sl-share">developing legal workarounds</a> to allow health care providers to stock and dispense the drug if Kacsmaryk’s ruling goes into effect.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bZqUQf">
Though nothing is certain in the current legal climate, providers in states that are stockpiling mifepristone would probably be at low legal risk if they continue to prescribe it, said Rosann Mariappuram, senior policy counsel for reproductive rights at State Innovation Exchange, a group that works with state lawmakers on progressive policies. Authorities in those states, she said, are signaling that they are friendly to mifepristone and unlikely to cooperate with efforts to remove it from the market. <em>—Anna North </em>
</p>
<h3 id="Ws5Fnl">
<ol start="6" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">What does it mean to revoke FDA approval?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ntrKKi">
Getting Food and Drug Administration approval for a drug is an arduous process, and if it’s ever revoked, it’s usually because an investigation has revealed safety concerns, said Mariappuram.<strong> </strong>But that’s not what happened in this case; instead, if the drug’s approval is revoked, it would be because of a court ruling.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iRdfjU">
Kacsmaryk’s ruling has not gone into effect yet. If it does, the FDA has several options for how to respond.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cDbK7V">
The agency could simply send warning letters to providers who are prescribing mifepristone stating that the medication is no longer approved. “They don’t have to go further than that,” Mariappuram said. The FDA could also be more aggressive, by working with local law enforcement to seize the medication, or by filing suit to keep an individual or group from prescribing it. However, several progressive-leaning states, including New York and Washington, have already signaled that they want to safeguard medication abortion access, and may be unlikely to work with federal regulators to seize mifepristone or otherwise penalize providers who offer it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TxhBqq">
Some lawmakers, including Reps. Alexandria Ocasio-Cortez (D-NY) and Nancy Mace (R-SC) and Sen. Ron Wyden (D-OR), <a href="https://www.axios.com/2023/04/10/abortion-pills-ruling-mace-aoc">have said</a> that the FDA should simply ignore Kacsmaryk’s ruling. That will likely be difficult, Mariappuram said, since the conflicting ruling by Rice in Washington state requires the FDA to maintain approval of mifepristone. Moreover, <a href="https://www.politico.com/news/2023/04/08/biden-appeals-abortion-pill-ruling-texas-mifepristone-00091105">legal experts</a> have cautioned that just ignoring Kacsmaryk’s ruling wouldn’t really protect access to the drug, since doctors might be afraid to prescribe it in such an uncertain legal landscape, and a future Republican administration could always decide to abide by Kacsmaryk’s ruling and act aggressively to get mifepristone off the market.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2NoFsc">
With two competing rulings, too, Mariappuram said, the FDA will probably have to do something — and what it does will probably depend on how or if the rulings hold up in court. Even if Kacsmaryk’s ruling prevails, one legal scholar <a href="https://www.politico.com/news/2023/04/08/biden-appeals-abortion-pill-ruling-texas-mifepristone-00091105">told Politico</a> that the FDA could “re-initiate the approval process of mifepristone all over again to get it back on the market.” However, it’s unclear if that option is on the table at this point. <em>—AN </em>
</p>
<h3 id="XDYxSE">
<ol start="7" type="1">
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">If mifepristone is taken off the market, what happens to people seeking abortions?
</li></ol></h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Wb4IVv">
In states where in-person abortion clinics exist, people can still access surgical abortions. But those procedures typically <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01528">cost more</a> and wait times for an appointment will likely be longer, given the already existing staffing challenges clinics have been managing since <em>Roe’s </em>overturn.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7D0tWV">
Another option would be ordering pills either from the European-based nonprofit <a href="https://www.vox.com/23056530/aid-access-abortion-roe-wade-pills-mifepristone">Aid Access</a>, which bypasses US restrictions by prescribing the drugs to patients from overseas, or through <a href="https://www.plancpills.org/find-pills">alternative methods</a> vetted by the reproductive justice group <a href="https://www.plancpills.org/">Plan C</a> such as mail forwarding. “We will not let this unjust ruling stop people from accessing abortion pills, which are readily available through alternate supply routes in the US,” Plan C co-director Elisa Wells said after the Texas court ruling came down.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="X8Ohbg">
It’s also possible to pursue medication abortion using only <a href="https://www.vox.com/23672829/what-is-misoprostol-abortion-medication-mifepristone-kacsmaryk">misoprostol</a>. While not FDA-approved, this method is backed by the World Health Organization, and is a common way of ending pregnancies <a href="https://www.theatlantic.com/health/archive/2022/09/abortion-pill-misoprostol-effectiveness/671465/">around the world</a>. In February, researchers found <a href="https://onlinelibrary.wiley.com/doi/10.1363/psrh.12219">misoprostol-only abortions in the US</a> to be 88 percent effective, with few incidents of serious adverse events or signs of a potential abortion complication.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2WgJdD">
Some abortion providers have been preparing to offer misoprostol-only abortions if mifepristone is taken off market, though many say it will take them time to transition. The National Abortion Federation, <a href="https://prochoice.org/wp-content/uploads/2022-CPGs.pdf">in its clinical guidelines</a>, says that “where mifepristone is either not legally available or inaccessible, misoprostol-alone regimens may be offered.” Because misoprostol has been FDA-approved to treat stomach ulcers and can be prescribed off-label for solo use, there is less concern that access to that drug will disappear. <em>—RC</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>Silambam’s growing presence in Tamil Nadu: How the ancient Tamil martial art is breaking barriers</strong> - As Silambam marks an all-pervading presence in Chennai’s public spaces, we trace the ancient Tamil martial artform’s history, and its ability to cut across social strata</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>SC slams ex-IPL commissioner Lalit Modi, directs him to tender unconditional apology</strong> - The top court directed Lalit Modi to tender an apology on social media and also in leading national newspapers.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IPL 2023: KKR vs SRH | High-flying Kolkata faces Hyderabad, eyes hat-trick of wins</strong> - Early in the tournament, Kolkata Knight Riders is placed at fourth position while Sunrisers Hyderabad at ninth.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IPL 2023 | Dhoni nursing knee injury, Magala out for 2 weeks: CSK coach Fleming</strong> - Dhoni had scored 32 as the Chennai Super Kings lost to Rajasthan Royals in a last-ball thriller, but a knee injury hindered his movement</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>Champions League | Benzema strikes again as Real Madrid beat 10-man Chelsea 2-0; Milan beats Napoli</strong> - It was Karim Benzema’s 90th Champions League goal with the last 11 all coming against English clubs</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>Child rescued from well</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>Explained | India’s global initiative to save the big cats</strong> - What will be the role of the International Big Cats Alliance, or IBCA? Who can be a member of the global bloc?</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>Talks are on for merger with NPP in Meghalaya: PDF leader</strong> - Currently, the PDF has two MLAs — Banteidor Lyngdoh and Gavin M Mylliem — in the Assembly</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>IIT Madras restrains professor from visiting his lab pending inquiry after students protest on campus</strong> - Brother of a research scholar who had ended his life complained about the professor’s behaviour; students’ hold a meeting with the Director, who has assured them that reports about two suicides would be made public on April 18</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>Krishnaiah meets President, seeks caste census and political reservation</strong> -</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>Ukraine war: Pentagon leaks reveal Russian infighting over death toll</strong> - US documents suggest Russian officials disagreed over how casualties were being counted.</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>Norway expels 15 Russian diplomats accused of spying</strong> - The country’s foreign minister claims the intelligence officers were operating under diplomatic cover.</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>Macron on Taiwan: ‘An ally not a vassal’, says France leader</strong> - The French leader says his country should not get caught up in escalation between the US and China.</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>Joe Biden in Ireland: US president meets Michael D Higgins in Dublin</strong> - “Your feet will bring you where your heart is,” says Joe Biden as he meets the Irish president.</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>US thinks UN chief too accommodating to Moscow, leaked files suggest</strong> - Classified files indicate that Washington believed Antonio Guterres was soft on Russia over Ukraine.</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>Iconic image of M87 black hole just got a machine-learning makeover</strong> - “PRIMO is a new approach to the difficult task of constructing images from EHT observations.” - <a href="https://arstechnica.com/?p=1931284">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Europe is about to launch one of its most ambitious missions ever</strong> - “We wanted to see if these were possible habitats for life.” - <a href="https://arstechnica.com/?p=1931278">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Chemical reactions on the early Earth may have formed its ocean</strong> - Conditions that favor water may be common in the formation of rocky planets. - <a href="https://arstechnica.com/?p=1931349">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>House Republican tries to protect Musk and Twitter from FTC investigation</strong> - Rep. Jim Jordan (R-Ohio) subpoenas FTC, claims it “harassed” Twitter and Musk. - <a href="https://arstechnica.com/?p=1931342">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>DIY IBM Selectric type balls give ’60s typewriters new life (and Comic Sans)</strong> - A Selectric is nothing without its golf ball, but finding one is a costly pain. - <a href="https://arstechnica.com/?p=1931173">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>Why is gravity so cheap?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It’s mass-produced
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Different-Tie-1085"> /u/Different-Tie-1085 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/12kiazj/why_is_gravity_so_cheap/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/12kiazj/why_is_gravity_so_cheap/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A boy</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
asks his Dad, “Daddy, what is politics?” Dad says, “Well son, let me try to explain it this way: I’m the breadwinner of the family, so let’s call me Capitalism. Your mom, she’s the administrator of the money, so we’ll call her the Government. We’re here to take care of your needs, so we’ll call you the People. The nanny, we’ll consider her the Working Class. And your baby brother, we’ll call him the Future. Now, think about that and see if that makes sense.” So the little boy goes off to bed thinking about what Dad has said. Later that night, he hears his baby brother crying, so he gets up to check on him. He finds that the baby has severely soiled his diaper. The little boy goes to his parents’ room and finds his mother sound asleep. Not wanting to wake her, he goes to the nanny’s room. Finding the door locked, he peeks in the keyhole and sees his father having sex with the nanny. He gives up and goes back to bed. The next morning, the little boy says to his father, “Dad, I think I understand the concept of politics now.” The father says, “Good, son, tell me in your own words what you think politics is all about.” The little boy replies, “Well, while Capitalism is screwing the Working Class, the Government is sound asleep, the People are being ignored and the Future is in Deep Shit.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/thatguy2226xbox"> /u/thatguy2226xbox </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/12kb8rh/a_boy/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/12kb8rh/a_boy/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Two prawns….</strong> - <!-- SC_OFF --></p>
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Two prawns were swimming around in the sea one day. The first one was called Justin and the second one was called Kristian. They were continually being chased and threatened by the sharks that inhabited the area.
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Eventually Justin had had enough. He said to Kristian, “I’m fed up with being a prawn. I wish I was a shark, and then I wouldn’t have to worry about being eaten all the time.”
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As he said this, a large mysterious cod appeared and said, “Your wish is granted!”
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And believe it or not, with that Justin turned into a fearsome shark.
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Kristian was horrified and so immediately swam away as he was scared of being eaten by his old friend.
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As time went by, Justin found his new life as a shark to be boring and lonely. None of his old friends would let him get near them as they thought he would eat them and so they just swam away whenever he approached.
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It took a while, but eventually Justin realized that his new menacing appearance was the cause of his sad plight.
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Then one day he was swimming all alone as usual when he saw the mysterious cod again. He thought it’d be better if he could go back to his old life so he swam to the cod and begged to be changed back. The cod worked his magic and suddenly Justin was a prawn once more.
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With tears of joy streaming down his cheeks Justin swam straight to Kristian’s home.
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As he opened the coral gate, the happy memories came flooding back. He banged on the door and shouted, “Kristian, it’s me, Justin, your old friend. Come out and see me again.”
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Kristian replied, “No way! You’re a shark now and you’ll just eat me. I’m not being tricked into being your dinner.”
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Justin shouted back "No, I’m not a shark any more. That was the old me. I’ve changed…
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I’ve found Cod. I’m a prawn again Kristian."
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/al3x696"> /u/al3x696 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/12jvgx2/two_prawns/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/12jvgx2/two_prawns/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What is the difference between Americans and IT support?</strong> - <!-- SC_OFF --></p>
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Americans don’t have troubleshooting.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/xXSkerpXx"> /u/xXSkerpXx </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/12ki62o/what_is_the_difference_between_americans_and_it/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/12ki62o/what_is_the_difference_between_americans_and_it/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Looking for good president jokes.</strong> - <!-- SC_OFF --></p>
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Please post jokes that can’t be just copy-pasted from one administration to another.
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Here, I’ll start.
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George Bush and Dick Cheney stopped in to a small diner for breakfast while touring through the country.
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The waitress comes to take their orders. Cheney orders an omelette. She turns to the President and asks for his order. President Bush turns to the waitress, smiles, and says sweetly, “honey, could I have a quickie?”
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“Mr President!” shouts the waitress. “I thought you were bringing a new era of decency and morality to the White House, but now I see that was all a LIE!!” She storms off.
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After a few seconds, Dick Cheney says quietly, “George, it’s pronounced <em>quiche</em>.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/jsharpminor"> /u/jsharpminor </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/12jyy6l/looking_for_good_president_jokes/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/12jyy6l/looking_for_good_president_jokes/">[comments]</a></span></p></li>
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