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<title>25 August, 2023</title>
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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>Is the future of work experience online? An examination of stakeholder attitudes towards online internships.</strong> -
<div>
Purpose The world of work is becoming digital, a process accelerated by the recent COVID-19 pandemic and resultant remote working guidelines. Online internships have become more popular in this context, and yet there remains a lack of research investigating how these internships are perceived across stakeholders. The purpose of this paper was to begin to address this research gap by exploring academic, student and employer perceptions of online internships with a focus on employability. Design The research explored 156 stakeholders (53 students, 50 academics, 53 employer / professionals) perceptions via a mixed-methods online study encompassing quantitative responses to internship vignettes, alongside open-ended questions designed to explore stakeholder attitudes in more depth. Findings Stakeholder groups reported similar attitudes towards online internships. Overall, online internships were viewed as valid, flexible, work experience, linked to skill development and likely to enhance student employability. However, concerns were raised regarding communication protocols and development, intern isolation and a lack of organisational immersion. Implications Based on our research we make three recommendations to continue to enhance and develop the online internship experience; ensure multiple methods of regular communication between student and organisation, attempt virtual immersion in the organisation, and assign each intern additional support beyond their immediate supervisor. Originality Based on a holistic and novel analysis of key stakeholders’ viewpoints, this paper provides much needed insights and evidence on how to design and quality assure effective online internship practice.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/uawbs/" target="_blank">Is the future of work experience online? An examination of stakeholder attitudes towards online internships.</a>
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<li><strong>Is Social tourism a vector for destination resilience to external shocks? Evidence from Spain.</strong> -
<div>
Unpredictable external shocks exacerbate the negative effects usually attributed to cyclical seasonality. Two such recent shocks, the Global Financial Crisis and the COVID-19 pandemic, shifted debates from crisis management towards concerns for greater resilience in visitor economies. Social tourism is an effective stimulus to destination economies and ameliorates some negative effects of seasonality, but there is little evidence on its contributions to greater destination resilience. Furthermore, resilience, a relatively new concept, is poorly defined. We establish a conceptual link between seasonality and resilience through a holistic multivariate analysis of supply, demand and employment patterns. An empirical study examines resilience longitudinally using municipal-level data, applying multivariate analysis and innovative visualization techniques, and assesses how, where and to what degree the Imserso social tourism program has contributed to the greater resilience of Spanish destinations, demonstrating its effectiveness in contributing to resilience in those which are more vulnerable due to high seasonal imbalances.
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🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/trcqv/" target="_blank">Is Social tourism a vector for destination resilience to external shocks? Evidence from Spain.</a>
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<li><strong>Reimagining Public Health Literacy in Outbreak Settings</strong> -
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Throughout the COVID-19 pandemic, the proliferation and uptake of misinformation and disinformation revealed widespread misunderstanding of health and infectious diseases that hampered effective response to a global pandemic. Viewing this as a challenge of public health literacy—oriented to the interconnectedness of self and community health—we sought guidance from the literature to better define public health literacy in outbreak settings. We attempted to conduct a scoping literature review to identify relevant concepts and gaps in the literature on public health literacy in the context of infectious disease outbreaks. Although literature with this emphasis was sparse, we identified four papers with unique definitions of health and public health literacy that incorporated community themes. We then used these definitions to develop a new framework and definition of public health literacy in outbreaks. Public health literacy in outbreaks (PHLiO) encompasses an individual’s and a community’s ability to obtain, understand, evaluate, and respond to the complexity of rapidly changing public health and scientific information, with the goal of empowering individual and collective agency to make public health decisions that benefit the community and promote comprehensive societal responses. Elements of PHLiO appear to have been useful in successful responses to a range of public health challenges. The proposed PHLiO framework provides a foundation for developing educational materials, measurement tools, and research. The framework also outlines minimum competencies required to effectively avoid mis/disinformation, move from a self/individual-care model of disease prevention to a model of community care, and improve effectiveness at preventing disease during outbreaks.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/y5n7j/" target="_blank">Reimagining Public Health Literacy in Outbreak Settings</a>
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<li><strong>Pediatric and Adult Patients with ME/CFS following COVID-19: A Structured Approach to Diagnosis Using the Munich Berlin Symptom Questionnaire (MBSQ)</strong> -
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Purpose: A subset of patients with post-COVID-19 condition (PCC) fulfill the clinical criteria of myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). To establish the diagnosis of ME/CFS for clinical and research purposes, comprehensive scores have to be evaluated. Methods: We developed the Munich Berlin Symptom Questionnaires (MBSQs) and supplementary scoring sheets (SSSs) to allow for a rapid evaluation of common ME/CFS case definitions. The MBSQs were applied to young patients with chronic fatigue and post-exertional malaise (PEM) who presented to the MRI Chronic Fatigue Center for Young People (MCFC). Trials were retrospectively registered (NCT05778006, NCT05638724). Results: Using the MBSQs and SSSs, we report on ten patients aged 11 to 25 years diagnosed with ME/CFS after asymptomatic SARS-CoV-2 infection or mild to moderate COVID-19. Results from their MBSQs and from well-established patient-reported outcome measures indicated severe impairments of daily activities and health-related quality of life. Conclusions: ME/CFS can follow SARS-CoV-2 infection in patients younger than 18 years, rendering structured diagnostic approaches most relevant for pediatric PCC clinics. The MBSQs and SSSs represent novel diagnostic tools that can facilitate the diagnosis of ME/CFS in children, adolescents, and adults with PCC and other post-viral syndromes.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.23.23293081v1" target="_blank">Pediatric and Adult Patients with ME/CFS following COVID-19: A Structured Approach to Diagnosis Using the Munich Berlin Symptom Questionnaire (MBSQ)</a>
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<li><strong>Safety and Immunogenicity of XBB.1.5-Containing mRNA Vaccines</strong> -
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<b>Background:</b> Subvariants of the severe acute respiratory syndrome coronavirus (SARS-CoV-2) omicron XBB-lineage have the potential to escape immunity provided by prior infection or vaccination. For Covid-19 immunizations beginning in the Fall 2023, the U.S. FDA has recommended updating to a monovalent omicron XBB.1.5-containing vaccine. <b>Methods:</b> In this ongoing, phase 2/3 study participants were randomized 1:1 to receive 50-µg doses of mRNA-1273.815 monovalent (50-µg omicron XBB.1.5 spike mRNA) or mRNA-1273.231 bivalent (25-µg omicron XBB.1.5 and 25-µg omicron BA.4/BA.5 spike mRNAs)vaccines, administered as 5th doses, to adults who previously received a primary series and 3rd dose of an original mRNA coronavirus disease 2019 (Covid-19) vaccine, and a 4th dose of a bivalent (omicron BA.4/BA.5 and original SARS-CoV-2) vaccine. Interim safety and immunogenicity data 15 days post-vaccination are presented. <b>Results:</b> In April 2023, participants received mRNA-1273.815 (n=50) and mRNA-1273.231 (n=51). The median intervals from the prior dose of BA.4/BA.5-containing bivalent vaccine were 8.2 and 8.3 months for the mRNA-1273.815 and mRNA-1273.231 groups, respectively. Both vaccines increased neutralizing antibody (nAb) geometric mean titers against all variants tested at day 15 post-booster nAb compared to pre-booster levels. Geometric mean fold-rises from pre-booster titers after the monovalent booster were higher against XBB.1.5, XBB.1.16 and SARS-CoV-2 (D614G) than those of the bivalent booster and were comparable against BA.4/BA.5 and BQ1.1 variants for both vaccines. The monovalent vaccine also elicited nAb responses against omicron XBB.2.3.2, EG.5.1, and FL.1.5.1 that were similar to those seen for XBB.1.5 in a subset (n=20) of participants. The occurrence of solicited adverse reactions and unsolicited adverse events were overall similar to those previously reported for the original mRNA-1273 50-µg and omicron BA.4/BA.5-containing bivalent mRNA-1273 vaccines. <b>Conclusion:</b> In this interim analysis, XBB.1.5-containing monovalent and bivalent vaccines elicited potent neutralizing responses against variants of the omicron XBB-lineage (XBB.1.5, XBB.1.6, XBB.2.3.2) as well as more recent (EG.5.1, FL.1.5.1) variants. The safety profile of the XBB.1.5-containing vaccine was consistent with those of prior vaccines. These results support the Covid-19 vaccine update in 2023-2024 to a monovalent XBB.1.5-containing vaccine.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v1" target="_blank">Safety and Immunogenicity of XBB.1.5-Containing mRNA Vaccines</a>
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<li><strong>COVID-19 Testing and Vaccination among US Older Adults with Vision Impairment: The National Health and Aging Trends Study 2021</strong> -
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Purpose: To examine the associations between vision impairment (VI) and COVID19 testing and vaccination services in older US adults. Methods: This cross-sectional study assessed data from adults aged 65 years or older who participated in the National Health and Aging Trends Study (year 2021), a nationally representative sample of Medicare beneficiaries. Exposure: Distance VI (&lt;20/40), near VI (&lt;20/40), contrast sensitivity impairment (CSI) (&lt;1.55 logCS), and any VI (distance, near, or CSI). Outcomes: Self-reported COVID-19 testing and vaccination. Results: Of 2,822 older adults, the majority were female (weighted; 55%) and White (82%), and 32% had any VI. In fully-adjusted regression analyses, older adults with any VI had similar COVID19 vaccination rates to adults without any VI (OR:0.77, 95% CI:0.54, 1.09), but had lower odds of COVID19 testing (OR:0.82, 95% CI:0.68, 0.97). Older adults with distance (OR:0.47, 95% CI:0.22, 0.99) and near (OR:0.68, 95% CI:0.47, 0.99) VI were less likely to be vaccinated for COVID19, while those with CSI were less likely to test for COVID19 (OR:0.76, 95% CI:0.61, 0.95), as compared to peers without respective impairments. The remaining associations were not significant (p&gt;.05). Conclusions and Relevance: These findings highlight inequities in the COVID19 pandemic response for people with vision disability and emphasize the need for equitable prioritization of accessibility of healthcare services for all Americans.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.23.23294511v1" target="_blank">COVID-19 Testing and Vaccination among US Older Adults with Vision Impairment: The National Health and Aging Trends Study 2021</a>
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<li><strong>Risk of long COVID and associated symptoms after acute SARS-COV-2 infection in ethnic minorities: a Danish nationwide cohort study</strong> -
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Background Ethnic minorities living in high-income countries have been disproportionately affected by COVID-19 in terms of infection rates and hospitalisations; however, less is known about long COVID in this population. Our aim was to examine the risk of long COVID and associated symptoms among ethnic minorities. Methods and Findings A Danish nationwide register-based cohort study of individuals diagnosed with COVID-19 aged ≥18 years (n=2 334 271) between January 2020 and August 2022. We calculated the risk of long COVID diagnosis and long COVID symptoms among ethnic minorities compared with native Danes using multivariable Cox proportional hazard regression and logistic regression, respectively. Ethnic minorities from North Africa (adjusted hazard ratio [aHR] 1.41; 95% CI 1.12–1.79), Middle East (aHR 1.38; 95% CI 1.24–1.55), Eastern Europe (aHR 1.35; 95% CI 1.22–1.49), and Asia (aHR 1.23; 95% CI 1.09–1.40) had significantly greater risk of long COVID diagnosis than native Danes in both unadjusted and adjusted models. In the analysis by largest countries of origin, the greater risks of long COVID diagnosis were found in Iraqis (aHR 1.56; 95% CI 1.30– 1.88), Turks (aHR 1.42; 95% CI 1.24–1.63), and Somalis (aHR 1.42; 95% CI 1.07–1.91) after adjustment for confounders. Significant factor associated with an increased risk of long COVID diagnosis was COVID-19 hospitalisation. Furthermore, the odds of reporting cardiopulmonary symptoms (including dyspnoea, cough, and chest pain) and any long COVID symptoms were higher among North African, Middle Eastern, Eastern European, and Asian than among native Danes in both unadjusted and adjusted models. Conclusions Belonging to an ethnic minority group was significantly associated with an increased risk of long COVID indicating the need to better understand long COVID drivers and address care and treatment strategies in this population.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23294402v1" target="_blank">Risk of long COVID and associated symptoms after acute SARS-COV-2 infection in ethnic minorities: a Danish nationwide cohort study</a>
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<li><strong>A Causal Inference of the Effect of Vaccination on COVID-19 Disease Severity and Need for Intensive Care Unit Admission Among Hospitalized Patients in an African Setting</strong> -
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Background: The COVID-19 pandemic is a respiratory illness that has spread to over 210 countries and killed over 6 million people. There is no specific treatment for COVID-19, but vaccines have been developed that can help prevent severe illness and death. A number of studies have investigated the effect of vaccination on disease severity and outcome, and the findings indicate that vaccination is linked to a significant reduction in the risk of hospitalization, intensive care unit admission, and death from the disease. However, there is a scarcity of evidence in Africa in general, and no similar study has been conducted in Ethiopia yet. Therefore, the study aimed to assess the effect of vaccination on COVID-19 disease severity and need for Intensive Care Unit (ICU) admission among hospitalized patients at a private specialty clinic in Ethiopia. Methods: A retrospective cohort study was conducted among 126 patients with COVID-19, 41 vaccinated and 85 unvaccinated, who were hospitalized between September 2021 and May 2022. Data was summarized using frequency (percentage) and median (interquartile range). To compare the characteristics of the two groups, Chi-square/ Fisher9s Exact and Mann Whitney U tests at p-value of ≤ 0.05 were used. To identify the effect of vaccination on COVID-19 disease severity, Marginal Structural Model (MSM) with inverse probability weighting (IPW) approach using robust poisson regression model was fitted and adjusted relative risk (ARR) and 95% CI for ARR were used for interpreting the result. Results: The cohort included groups that were fairly comparable in terms of their sociodemographic and clinical characteristics. More than half of the participants were older than 60 years (52.4%), were males (56.3%) and had one or more comorbid illness (52.4%). At admission 85 (67.5%) had severe disease and 11 (8.7%) progressed after hospitalization and required ICU admission, of which three unvaccinated cases died. From the final model, vaccination was found to be associated with a 62% decreased risk of developing severe COVID-19 disease if infected, compared to not getting vaccinated (ARR=0.38, 95% CI=0.23-0.65, p&lt;0.0001). Conclusions: The study9s findings support previous reports that vaccinated people are less likely to develop severe COVID-19 disease if infected with the virus, emphasizing the importance of continuing efforts to promote COVID-19 vaccination not only to safeguard individuals but also to confer community-level immunity.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23294414v1" target="_blank">A Causal Inference of the Effect of Vaccination on COVID-19 Disease Severity and Need for Intensive Care Unit Admission Among Hospitalized Patients in an African Setting</a>
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<li><strong>Incidence and Severity of COVID-19 with the use of the MMR Vaccine before or after the COVID-19 Vaccine</strong> -
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Introduction: The MMR vaccine has been shown by several studies over the years to have a potent effect on heterologous immunity. The reduction in mortality and respiratory and gastrointestinal diseases in childhood has been consolidated with recent studies demonstrating a better evolution of COVID-19 with the use of this vaccine. Stimulation of innate immunity by the MMR vaccine can be very useful, both used alone or in association with other vaccines, especially those for COVID-19. Objectives: To evaluate the decrease in the incidence of infection or severity of COVID-19 with the use of the MMR vaccine before and after the use of specific vaccines against COVID-19. Methods: This extension analysis followed 120 volunteers healthcare professionals aged 18 to 60 who received the MMR vaccine before the specific COVID-19 vaccine and 73 volunteers who used the MMR vaccine after the COVID-19 vaccine. Visits to the Research Center were carried out at an average interval of 4 weeks for 12 weeks. The diagnosis of COVID-19 was performed using the RT-PCR technique for the SARS-CoV-2 virus. Results: The most used vaccine against COVID-19 was Coronavac in 59.1%. A total of 44 cases of COVID-19 were diagnosed (20% of the sample), the vast majority of which were mild cases (70.5%). There was no difference in the incidence and severity of COVID-19 in health professionals who used the MMR vaccine before or after the specific vaccine against the SARS-CoV-2 virus (Coronavirus or AstraZeneca). Conclusion: The incidence and severity of COVID-19 does not differ with the use of the MMR vaccine before or after the specific vaccine against COVID-19.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23294439v1" target="_blank">Incidence and Severity of COVID-19 with the use of the MMR Vaccine before or after the COVID-19 Vaccine</a>
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<li><strong>COVID-19 Symptoms and Immunotherapy in People with Multiple Sclerosis: An Analysis of the COVID-19 in MS Global Data Sharing Initiative Dataset</strong> -
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OBJECTIVES: To analyze the symptoms and severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (pwMS) on immunotherapy using data from the COVID-19 in multiple sclerosis (MS) Global Data Sharing Initiative dataset provided by PhysioNet. METHODS: The open-access COVID-19 in MS Global Data Sharing Initiative dataset was obtained through credentialed access using PhysioNet. The variables analyzed included body mass index (BMI), symptoms of COVID-19, age, current use of disease-modifying therapy (DMT), efficacy of DMT, comorbidities, hospitalization status, and type of MS. A linear regression analysis was completed. Data analysis and visualization were completed using STATA v1.5, R-Studio v1.1.447, Python v3.8, and its associated libraries, including NumPy, Pandas, and Matplotlib. RESULTS: A total of 1141 participants were included in the analysis. 904 women and 237 men were diagnosed with MS. Among the pwMS included in the study; 208 (19.54%) had a suspected infection with COVID-19 and only 49 (5.25%) were confirmed. Any COVID-19 symptom was present in 360 individuals. The commonly reported DMT agents included dimethyl fumarate (12.71%) and fingolimod (10.17%). 101 in total (8.85%) reported not using any DMT. Factors associated with hospitalization and/or admission to the ICU included having any comorbidity (p = 0.01), neuromuscular disorder (p = 0.046), hypertension (p = 0.005), chronic kidney disease (p &lt; 0.001), and immunodeficiency (p = 0.003). The type of MS, the duration of the disease, and high-efficacy DMT therapy did not have a statistically significant influence on hospitalization. CONCLUSION: This study underscores the importance of comorbidities, especially neuromuscular disorders, hypertension, chronic kidney disease (CKD), and immunodeficiencies, as possible prognostic indicators for worse outcomes of COVID-19 in pwMS. On the contrary, the type of MS, the duration of the disease, and the efficacy of disease-modifying therapy did not significantly affect the severity of the symptoms of COVID-19 in this cohort.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.23.23294509v1" target="_blank">COVID-19 Symptoms and Immunotherapy in People with Multiple Sclerosis: An Analysis of the COVID-19 in MS Global Data Sharing Initiative Dataset</a>
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<li><strong>Circulating ADAM17 is associated with COVID-19 severity</strong> -
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Abstract Background ADAM17 are emerging as an important role in the severe outcomes of COVID-19. This study aims to characterize causal relationship between ADAM17 and COVID-19. Methods Using mendelian randomization analyses, we examined the causal effects for circulating ADAM17 on COVID-19 outcomes using summary statistics from large genome wide association studies of ADAM17 (up to 35 559 individuals) from the Icelandic Cancer Project and deCODE genetics, critical COVID-19 (cases:13 769; controls:1 072 442), hospitalized COVID-19 (cases:32 519; controls: 2 062 805) and SARS-CoV-2 infection (cases:122 616; controls:2 475 240) from the COVID-19 Host Genetics Initiative. Results Mendelian randomization analyses demonstrated that 1 standard deviation increase of genetically determined circulating ADAM17 at extracellular domain were associated with increasing risk of developing critical COVID-19 (odds ratio [OR]=1.26, 95% CI 1.03-1.55). Multivariable MR analysis suggested a direct causal role of circulating ADAM17 at extracellular domain on the risk of critical COVID-19 (OR=1.09; 95% CI 1.01-1.17), accounting for body mass index. Casual effects for the cytoplasmic domain of ADAM17 on COVID-19 were not observed. Conclusion Our results suggest that the increased circulating ADAM17 at extracellular domain are associated with a high risk of critical COVID-19 strengthening that of ADAM17 may contribute to the risk stratification and a therapeutic option for severe COVID-19.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.23.23294465v1" target="_blank">Circulating ADAM17 is associated with COVID-19 severity</a>
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<li><strong>Engineered Wnt7a ligands rescue blood brain barrier and neurobehavioral deficits in a mouse model of COVID-19</strong> -
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Persistent cognitive impairment and neuropsychiatric disorders are prevalent sequelae of SARS-CoV-2-induced COVID-19 in middle-aged adults. To model age-related neurological vulnerability to COVID-19, we induced respiratory SARS-CoV-2 MA10 infections by nasal inoculation in young (2 months) and middle-aged (12 months) mice. We hypothesized that aging and SARS-CoV-2 synergistically damage the blood-brain barrier (BBB) to worsen disease. Indeed, the combined action of aging and SARS-CoV-2 infection caused more fibrinogen leakage, T cell infiltration, and neuroinflammation in middle-aged SARS-CoV-2-infected mice than in similarly inoculated young adults. Mechanistically, SARS-CoV-2 exacerbated age-related increases in Caveolin-1 BBB transcellular permeability and loss of Wnt/{beta}-catenin ligands, with no apparent changes in tight junction proteins. Finally, SARS-CoV-2 infection induced age-dependent neuropsychiatric abnormalities including bradykinesia and repetitive behavior. These observations indicate that cerebrovascular aging, including loss of Wnt suppression of Caveolin-1, heightens vulnerability to SARS-CoV-2-induced neuroinflammation and neuropsychiatric sequalae. Our work suggests that modulation of Wnt signaling or its downstream effectors at the BBB could be potential interventional strategies for Long COVID.
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🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.06.02.494552v2" target="_blank">Engineered Wnt7a ligands rescue blood brain barrier and neurobehavioral deficits in a mouse model of COVID-19</a>
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<li><strong>COVID-19 self-testing: Countries accelerating policies ahead of WHO guidelines during pandemics: A Global Survey.</strong> -
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Introduction The widespread use of antigen-detection rapid diagnostic tests (Ag-RDTs) has revolutionized SARS-CoV-2 (COVID-19) testing, particularly through the option of self-testing. The full extent of Ag-RDT utilization for self-testing, however, remains largely unexplored. To inform the development of WHO guidance on COVID-19 self-testing, we conducted a cross-sectional survey to gather the views and experiences of policy makers, researchers, and implementers worldwide. Methods The survey was shared through professional networks via email and social media, encouraging onward sharing. We used closed and open-ended questions related to policy and program information concerning the regulation, availability, target population, indications, implementation, benefits, and challenges of COVID-19 self-testing (C19ST). We defined self-testing as tests performed and interpreted by an untrained individual, often at home. Descriptive summaries, cross-tabulations, and proportions were used to calculate outcomes at the global level and by WHO region and World Bank income classifications. Results Between 01 and 11 February 2022, 844 individuals from 139 countries responded to the survey, with 45% reporting affiliation with governments and 47% operating at the national level. 504 respondents from 101 countries reported policies supporting C19ST for a range of use cases, including symptomatic and asymptomatic populations.  More respondents from low-and-middle-income countries (LMICs) than high-income countries (HICs) reported a lack of an C19ST policy (61 vs 11 countries) and low population-level reach of C19ST. Respondents with C19ST experience perceived that the tests were mostly acceptable to target populations, provided significant benefits, and highlighted several key challenges to be addressed for increased success. Reported costs varied widely, ranging from specific programmes enabling free access to certain users and others with high costs via the private sector. Conclusion Based on the survey responses, systems for the regulatory review, policy development and implementation of C19STappeared to be much more common in HIC when compared to LIC in early 2022, though most respondents indicated self-testing was available to some extent (101 out of 139 countries) in their country. Addressing such global inequities is critical for ensuring access to innovative and impactful interventions in the context of a public health emergency of international concern. The challenges and opportunities highlighted by survey respondents could be valuable to consider as future testing strategies are being set for outbreak-prone diseases.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.23.23294474v1" target="_blank">COVID-19 self-testing: Countries accelerating policies ahead of WHO guidelines during pandemics: A Global Survey.</a>
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<li><strong>The role of social network structure and function in moderate and severe social and emotional loneliness: the Dutch SaNAE study in older adults</strong> -
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Background. Loneliness is a serious public health problem and became even more visible during the COVID-19 pandemic. Yet it is unknown which aspects of social networks are most important. Here, we evaluated social network structure and function and associations with moderate and severe social and emotional loneliness in older adults. Methods. This cross-sectional study includes online questionnaire data (SaNAE cohort, August-November 2020), in independently living Dutch adults aged 40 years and older. For the separate outcomes social and emotional loneliness, associations with structural network aspects (e.g., network diversity - having various types of relationships, and density - having network members who know each other), and functional network aspects (informational, emotional, and practical social support) were assessed and risk estimates were adjusted for the number of contacts, age, educational level, level of urbanization and chronic conditions. Multivariable logistic regression analyses were stratified by sex. Results. Of 3,396 participants (55% men; mean age 65 years), 18% were socially lonely which was associated with a less diverse and less dense network, living alone, feeling less connected to friends, not having a club membership, and fewer emotional supporters (men only) or informational supporters (women only). 28% were emotionally lonely, which was associated with being socially lonely, and more exclusively online (versus in-person) contacts (men only), and fewer emotional supporters (women only). Conclusion. Network structure and function beyond the mere number of contacts is key in loneliness, and in particular, the types of relationships are important. Public health strategies should be sex-tailored and promote network diversity and density, club membership, informational and emotional support, and in-person contact.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.23.23294457v1" target="_blank">The role of social network structure and function in moderate and severe social and emotional loneliness: the Dutch SaNAE study in older adults</a>
</div></li>
<li><strong>Prediction of COVID-19 infection risk using personal mobile location data only</strong> -
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Predicting an individual9s risk of infectious disease is a critical technology in infectious disease response. During the COVID-19 pandemic, identifying and isolating individuals at high risk of infection was an essential task for epidemic control. We introduce a new machine learning model that predicts the risk of COVID-19 infection using only individuals9 mobile cell tower location information. This model distinguishes the cell tower location information of an individual into residential and non-residential areas and calculates whether the cell tower locations overlapped with other individuals. It then generates various variables from the information of overlapping and predicts the possibility of COVID-19 infection using a machine learning algorithm. The predictive model we developed showed performance comparable to models using individual9s clinical information. This predictive model, which can be used to predict infections of diseases with asymptomatic infections such as COVID-19, has the advantage of supplementing the limitations of existing infectious disease prediction models that use symptoms and other information.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23294419v1" target="_blank">Prediction of COVID-19 infection risk using personal mobile location data only</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>THE EFFECT OF ARGININE AND GLUTAMINE ON COVID-19 PATIENTS OUTCOME: A RANDOMIZED CLINICAL TRIAL</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Dietary Supplement: Neomune<br/><b>Sponsors</b>:   Universitas Sriwijaya;   M. Djamil General Hospital<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study of Obeldesivir in Children and Adolescents With COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: Obeldesivir<br/><b>Sponsor</b>:   Gilead Sciences<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 Pilot Clinical Evaluation of Astepro® Nasal Spray for Management of Early SARS-CoV-2 Infection</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Experimental: Primary Cohort;   Other: Placebo Comparator: Primary Cohort - Placebo<br/><b>Sponsor</b>:   University of Chicago<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>Immunogenicity and Safety of AdCLD-CoV19-1 OMI as a Booster: A COVID-19 Preventive Vaccine in Healthy Volunteers</strong> - <b>Conditions</b>:   COVID-19;   Vaccines<br/><b>Interventions</b>:   Biological: AdCLD-CoV19-1 OMI;   Biological: Comirnaty Bivalent 0.1mg/mL (tozinameran and riltozinameran)<br/><b>Sponsor</b>:   Cellid Co., Ltd.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Using Text Messages to Boost COVID-19 Vaccine Booking Rate</strong> - <b>Conditions</b>:   Vaccination Hesitancy;   COVID-19<br/><b>Interventions</b>:   Behavioral: Behavioural science-informed text messages;   Behavioral: Control<br/><b>Sponsors</b>:   The Behavioural Insights Team;   Public Health England;   Department of Health and Social Care;   NHS England and NHS Improvement<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>Ivermectin to Prevent SARS-CoV-2 (COVID-19) Hospitalisation in Subjects Over 50</strong> - <b>Conditions</b>:   COVID-19;   SARS-CoV-2<br/><b>Interventions</b>:   Drug: Ivermectin;   Drug: Placebo<br/><b>Sponsor</b>:   Insud Pharma<br/><b>Terminated</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>Digital Health Literacy on COVID-19 for All: Co-creation and Evaluation of Interventions for Ethnic Minorities and Chinese People With Chronic Illnesses in Hong Kong</strong> - <b>Conditions</b>:   Digital Health Literacy;   COVID-19<br/><b>Intervention</b>:   Behavioral: Digital health literacy intervention<br/><b>Sponsor</b>:   The Hong Kong Polytechnic 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>Methylprednisolone in Patients With Cognitive Deficits in Post-COVID-19 Syndrome (PCS)</strong> - <b>Condition</b>:   Post-COVID-19 Syndrome<br/><b>Intervention</b>:   Drug: Methylprednisolone<br/><b>Sponsor</b>:   Charite University, Berlin, Germany<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>COVID-19 Vaccination Hesitancy in Adults With Sickle Cell Disease</strong> - <b>Conditions</b>:   Sickle Cell Disease;   COVID-19 Vaccine;   Vaccine Hesitancy<br/><b>Intervention</b>:   Behavioral: SCD-specific COVID-19 vaccination information (SCVI) video<br/><b>Sponsors</b>:   Duke University;   American Society of Hematology<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 Learn About New COVD-19 RNA Vaccine Candidates for New Varients in Healthy Individuals</strong> - <b>Conditions</b>:   SARS-CoV-2 Infection;   COVID-19<br/><b>Intervention</b>:   Biological: BNT162b2 (Omi XBB.1.5)<br/><b>Sponsors</b>:   BioNTech SE;   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>Leveraging Community Health Workers to Combat COVID-19 and Mental Health Misinformation in Haiti, Malawi, and Rwanda</strong> - <b>Conditions</b>:   Mental Health;   COVID-19;   Misinformation<br/><b>Interventions</b>:   Behavioral: Card-Sorting Activity (Pre-intervention design);   Behavioral: SMS Crafting (Pre-intervention design);   Behavioral: SMS Messaging<br/><b>Sponsors</b>:   Harvard Medical School (HMS and HSDM);   Partners in Health<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>Effect of Pulmonary Rehabilitation Among Post-COVID-19 Patients in a Tertiary Care Hospital in Bangladesh</strong> - <b>Condition</b>:   Pulmonary Pathology<br/><b>Intervention</b>:   Behavioral: Pulmonary Rehabilitation<br/><b>Sponsor</b>:   Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh<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>Pulmonary Artery Pressure in COVID-19 Survivors</strong> - <b>Condition</b>:   Pulmonary Hypertension Secondary<br/><b>Intervention</b>:   Diagnostic Test: right heart catheterization (RHC).<br/><b>Sponsor</b>:   Mansoura University Hospital<br/><b>Enrolling by invitation</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>Preliminary Efficacy of a Technology-based Physical Activity Intervention for Older Korean Adults During the COVID-19 Pandemic</strong> - <b>Conditions</b>:   Cardiovascular Health;   Physical Function<br/><b>Intervention</b>:   Behavioral: Golden Circle<br/><b>Sponsor</b>:   University of Illinois at Urbana-Champaign<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>Study of LAU-7b for the Treatment of Long COVID in Adults</strong> - <b>Condition</b>:   Long COVID<br/><b>Interventions</b>:   Drug: LAU-7b for 3 cycles;   Drug: LAU-7b for 1 cycle, then placebo;   Other: Placebo for 3 cycles<br/><b>Sponsor</b>:   Laurent Pharmaceuticals Inc.<br/><b>Not yet recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The contribution of Australian fathers in getting food on the table among families with young children</strong> - CONCLUSIONS: The findings suggest the need to consider father-specific strategies to overcome time barriers and opportunities to enhance their capabilities for healthy home food provisioning.</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>Design, synthesis, and greener pasture biological assessment of a novel nucleoside: 1-(α-D-ribofuranosyl)-6,7-difluoro-2-methyl-4-quinazolinone as an inhibitor of COVID-19 and Alzheimer’s disease</strong> - Synthesis of a new fluorinated nucleoside of 6,7-difluoro-2-methyl-4-quinazolinone was described. 2-Amino-4,5-difluorobenzoic acid 1 reacts with (CH(3)CO)(2)O followed by ammonia to form (1H)-6,7-difluoro-2-methyl-4-quinazolinone 3a. Ribosylation of a silylated 4 with l-O-acety1-2,3-5-tri-O-benzoyl-α-D-ribofuranose 5 forms a protected nucleoside 6 then unprotected from 6 to give a free nucleoside 7. Greener pasture biological docking of the cystine protease of COVID-19 [M^(pro), code 7BQY, PDB]…</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>Reducing airborne transmission of SARS-CoV-2 by an upper-room ultraviolet germicidal irradiation system in a hospital isolation environment</strong> - Upper-room ultraviolet germicidal irradiation (UVGI) technology can potentially inhibit the transmission of airborne disease pathogens. There is a lack of quantitative evaluation of the performance of the upper-room UVGI for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) airborne transmission under the combined effects of ventilation and UV irradiation. Therefore, this study aimed to explore the performance of the upper-room UVGI system for reducing SARS-CoV-2 virus transmission in…</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>Dexamethasone attenuates interferon-related cytokine hyperresponsiveness in COVID-19 patients</strong> - CONCLUSION: We describe the anti-inflammatory impact of dexamethasone on the pathways contributing to cytokine hyperresponsiveness observed in severe manifestations of COVID-19, including type I/II IFN signaling. Dexamethasone could have adverse effects in COVID-19 patients with mild symptoms by inhibiting IFN responses in early stages of the disease, whereas it exhibits beneficial effects in patients with severe clinical phenotypes by efficiently diminishing cytokine hyperresponsiveness.</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>Investigation of Iminosugars as Antiviral Agents against SARS-CoV-2 Main Protease: Inhibitor Design and Optimization, Molecular Docking, and Molecular Dynamics Studies to Explore Potential Inhibitory Effect of 1-Deoxynojirmycin Series</strong> - CONCLUSION: The present findings confer opportunities for compounds 17a, 7, and 8 that could be developed as new therapeutic agents against COVID-19. These compounds are suggested on the basis of pharmacokinetic parameters as well as therapeutic importance and hence could be tested in-vitro.</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 complement atlas identifies interleukin-6-dependent alternative pathway dysregulation as a key druggable feature of COVID-19</strong> - Improvements in COVID-19 treatments, especially for the critically ill, require deeper understanding of the mechanisms driving disease pathology. The complement system is not only a crucial component of innate host defense but can also contribute to tissue injury. Although all complement pathways have been implicated in COVID-19 pathogenesis, the upstream drivers and downstream effects on tissue injury remain poorly defined. We demonstrate that complement activation is primarily mediated by 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>The S1’-S3’ Pocket of the SARS-CoV-2 Main Protease Is Critical for Substrate Selectivity and Can Be Targeted with Covalent Inhibitors</strong> - The main protease (Mpro) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a well-characterized target for antiviral drug discovery. To date, most antiviral drug discovery efforts have focused on the S4-S1’ pocket of Mpro; however, it is still unclear whether the S1’-S3’ pocket per se can serve as a new site for drug discovery. In this study, the S1’-S3’ pocket of Mpro was found to differentially recognize viral peptidyl substrates; for instance, S3’ in Mpro strongly favors Phe…</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>Cyclotheonellazoles D-I, Potent Elastase Inhibitory Thiazole-Containing Cyclic Peptides from <em>Theonella</em> sp. (2131)</strong> - Six new thiazole-containing cyclic peptides, the cyclotheonellazoles D-I (1-6), were isolated from the Australian marine sponge Theonella sp. (2131) with their structures assigned by comprehensive 1D and 2D NMR spectroscopic and MS spectrometric analyses, Marfey’s derivatization studies, and comparison with time-dependent density functional theory (TDDFT) calculated ECD data. The Type 2 azole-homologated peptides herein comprise up to five nonproteinogenic amino acids, including the protease…</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 efficacy and safety of endoscopic lung volume reduction with one-way valves in patients with a very low FEV<sub>1</sub></strong> - CONCLUSION: Our study highlights the potential efficacy of one-way valves, even in patients with very low FEV(1), as these patients experienced significant improvements in FEV(1), 6MWD and quality of life. No death was reported, suggesting a good safety profile, even in these high-risk patients.</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>Prevalence of oral complications in the course of severe SARS-CoV-2 infection under mechanical non-invasive ventilation</strong> - CONCLUSIONS: COVID-19 hospitalised patients with severe symptoms crossing with poor oral health-related conditions. This may exacerbate a response for COVID infection, and play a role in cytokine storm. For Covid-19 management, to inhibit extraoral/intraoral complications, it is recommended to adjust oral hygiene procedures, including antibacterial, protective, moisturising agents after individual oral health assessment.</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 Possible Mechanisms of Cu and Zn in the Treatment and Prevention of HIV and COVID-19 Viral Infection</strong> - Due to their unique properties and their potential therapeutic and prophylactic applications, heavy metals have attracted the interest of many researchers, especially during the outbreak of COVID-19. Indeed, zinc (Zn) and copper (Cu) have been widely used during viral infections. Zn has been reported to prevent excessive inflammatory response and cytokine storm, improve the response of the virus to Type I interferon (IFN-1), and enhance the production of IFN-a to counteract the antagonistic…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SARS-CoV-2 nucleocapsid protein inhibits the PKR-mediated integrated stress response through RNA-binding domain N2b</strong> - The nucleocapsid protein N of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enwraps and condenses the viral genome for packaging but is also an antagonist of the innate antiviral defense. It suppresses the integrated stress response (ISR), purportedly by interacting with stress granule (SG) assembly factors G3BP1 and 2, and inhibits type I interferon responses. To elucidate its mode of action, we systematically deleted and over-expressed distinct regions and domains. We show that…</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 Mixture of Essential Oils from Three Cretan Aromatic Plants Inhibits SARS-CoV-2 Proliferation: A Proof-of-Concept Intervention Study in Ambulatory Patients</strong> - INTRODUCTION: The need for effective therapeutic regimens for non-critically ill patients during the COVID-19 pandemic remained largely unmet. Previous work has shown that a combination of three aromatic plants’ essential oils (CAPeo) (Thymbra capitata (L.) Cav., Origanum dictamnus L., Salvia fruticose Mill.) has remarkable in vitro antiviral activity. Given its properties, it was urgent to explore its potential in treating mild COVID-19 patients in primary care settings.</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>Peptide foldamer-based inhibitors of the SARS-CoV-2 S protein-human ACE2 interaction</strong> - The entry of the SARS-CoV-2 virus into a human host cell begins with the interaction between the viral spike protein (S protein) and human angiotensin-converting enzyme 2 (hACE2). Therefore, a possible strategy for the treatment of this infection is based on inhibiting the interaction of the two abovementioned proteins. Compounds that bind to the SARS-CoV-2 S protein at the interface with the alpha-1/alpha-2 helices of ACE2 PD Subdomain I are of particular interest. We present a stepwise…</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>CD36 mediates SARS-CoV-2-envelope-protein-induced platelet activation and thrombosis</strong> - Aberrant coagulation and thrombosis are associated with severe COVID-19 post-SARS-CoV-2 infection, yet the underlying mechanism remains obscure. Here we show that serum levels of SARS-CoV-2 envelope (E) protein are associated with coagulation disorders of COVID-19 patients, and intravenous administration of the E protein is able to potentiate thrombosis in mice. Through protein pull-down and mass spectrometry, we find that CD36, a transmembrane glycoprotein, directly binds with E protein and…</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>A Chaotic Display of Conservatism at the First Republican Debate</strong> - Donald Trump was absent, but the fissures he has opened in the G.O.P. took center stage. - <a href="https://www.newyorker.com/news/daily-comment/a-chaotic-display-of-conservatism-at-the-first-republican-debate">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>David Zaslav, Hollywood Antihero</strong> - The C.E.O. of a conglomerate that includes Warner Bros. studios, CNN, and HBO takes on an entertainment business in turmoil. - <a href="https://www.newyorker.com/news/annals-of-communications/can-david-zaslav-make-it-in-hollywood">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Abortion Opponents Are Targeting a Signature G.O.P. Public-Health Initiative</strong> - A program that funds H.I.V./AIDS treatment in more than fifty countries has been ensnared in the post-Roe abortion wars. - <a href="https://www.newyorker.com/news/daily-comment/abortion-opponents-are-targeting-a-signature-gop-public-health-initiative">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What a Heat Wave Does to Your Body</strong> - The human body is a remarkably effective cooling machine—but it has a limit. - <a href="https://www.newyorker.com/news/annals-of-a-warming-planet/what-a-heat-wave-does-to-your-body">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Harsh Glare of Justice for Donald Trump</strong> - On the ex-President’s snarly mug shot from the Fulton County Jail and a 2024 reality of Trump, Trump, and more Trump. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/the-harsh-glare-of-justice-for-donald-trump">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>What the GOP debate revealed about Republican health care hypocrisy</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/WoyURbQ1nez-XISsmx_fUd9ZEsI=/284x0:5507x3917/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72577305/GettyImages_1619654606.0.jpg"/>
<figcaption>
The 2024 Republican presidential candidates do want the government to interfere with people’s medical decisions — but don’t want it to help people get health care. | Bloomberg via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The GOP loves Big Government in health care — if it’s blocking abortion or trans care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="G5MkUn">
As the Republican Party begins to define itself for the <a href="https://www.vox.com/2024-elections/">2024 presidential campaign,</a> its philosophy on <a href="https://www.vox.com/health-care">health care</a> is coming into focus: The government is not here to help you. But it should be allowed to get in your way.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XpOQES">
<a href="https://www.vox.com/2024-elections/2023/8/24/23843989/republican-debate-who-won-milwaukee-2024-election">Wednesday night’s debate</a>, which featured eight of the leading not-Donald-Trump candidates for the Republican nomination, spent little time on health care except for an extended exchange on <a href="https://www.vox.com/abortion">abortion</a>, <a href="https://www.vox.com/2023/8/24/23840850/gop-debate-abortion-2024-dobbs-roe">covered in depth by Vox’s Rachel Cohen</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nzmeRD">
But if you piece together the abortion debate with other moments in which health care briefly took the spotlight, the party’s position on federal power in the medical sphere begins to take shape. On abortion, on health care for <a href="https://www.vox.com/lgbtq">transgender</a> people, even on <a href="https://www.vox.com/mental-health">mental health</a> care, the candidates were comfortable flexing governmental authority to dictate the terms of medical treatment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XyEv7j">
But when it comes to using that same authority to protect people during a global pandemic or providing health coverage to people with low incomes, they don’t want the government getting involved.
</p>
<h3 id="FhE59N">
How the GOP candidates want to use state power to restrict health care
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ymmNNw">
Abortion — which Fox moderator Martha MacCallum cast as a “losing” political issue for Republicans ever since the <a href="https://www.vox.com/scotus">Supreme Court</a> <a href="https://www.vox.com/2022/5/3/23055125/roe-v-wade-abortion-rights-supreme-court-dobbs-v-jackson">overturned <em>Roe v. Wade</em></a> — led to a contentious exchange in which former South Carolina Gov. <a href="https://www.vox.com/policy-and-politics/2023/2/14/23599194/nikki-haley-donald-trump-2024-presidential-campaign">Nikki Haley</a> urged her fellow candidates to be square with GOP voters: It will be difficult to pass a national abortion ban given the political realities of the US Senate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VZcvDl">
Haley was largely an outlier, though North Dakota Gov. Doug Burgum also argued the issue would be rightfully left to the states under the 10th Amendment. Former Vice President <a href="https://www.vox.com/mike-pence">Mike Pence</a> and US Sen. <a href="https://www.vox.com/2023/5/22/23731910/tim-scott-2024-presidential-candidate">Tim Scott</a> of South Carolina made impassioned pleas for a 15-week national abortion ban. Scott argued that the decision on abortion policy should be taken away from the states — the elected representatives who are closest to the pregnant people affected and who conservatives have traditionally argued should make these decisions — because they cannot be trusted to set these standards on their own.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0RqB9W">
“We cannot let states like California, New York, and Illinois have abortions on-demand up until the day of birth. That is immoral. It is unethical. It is wrong,” Scott said to applause from the audience of Republican primary voters. (For the record, fact-checkers <a href="https://www.factcheck.org/2023/05/the-political-disagreement-over-a-health-exception-for-later-abortions/">have</a> <a href="https://www.statesman.com/story/news/politics/politifact/2022/08/08/fact-check-would-democratic-bill-allow-abortion-up-until-delivery/65393371007/">repeatedly</a> <a href="https://www.washingtonpost.com/politics/2022/09/22/gop-claim-that-democrats-support-abortion-up-moment-birth/">corrected</a> Republicans for making similar claims in the past and only 1 percent of abortions occur after 21 weeks of gestation.)
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“We must have a president of the United States who will advocate and fight for at the minimum a 15-week limit,” Scott continued.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="q74nkj">
The entire premise of the anti-abortion movement is to involve the state in a life-altering medical decision otherwise handled privately between a doctor and a patient. In spite of the evidence of the <a href="https://www.vox.com/policy-and-politics/23057032/supreme-court-abortion-rights-roe-v-wade-state-aid">economic</a> and <a href="https://www.vox.com/policy-and-politics/23055300/supreme-court-overturn-roe-wade-abortion-bans-health-care">health</a> consequences of restricting abortion and in spite of <a href="https://www.vox.com/policy-and-politics/23444732/2022-midterm-elections-results-abortion-rights-nebraska-north-carolina">the political losses</a> the GOP has incurred since the Supreme Court negated the right to privacy enshrined in <em>Roe</em>, Scott and others reaffirmed a commitment to keeping the state in that position. The crowd roared.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uiQ8sQ">
Transgender rights and <a href="https://www.vox.com/politics/23631262/trans-bills-republican-state-legislatures">the myriad conservative laws</a> passed in the past few years to restrict access to gender-affirming care were referenced only obliquely in the debate but carried the same message. <a href="https://www.vox.com/ron-desantis">Florida Gov. Ron DeSantis</a> touted his record of “eliminat[ing] gender ideology from our K-12 schools.” North Dakota Gov. Doug Burgum defended his signing of a bill that banned certain students from participating in school sports. In his closing remarks, Scott pledged that “if God made you a man, you play sports against men.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="56fLcG">
As Katelyn Burns <a href="https://www.vox.com/22360030/trans-kids-health-care-arkansas-explained">wrote for Vox in 2021,</a> medicine itself has undergone a transformation on the subject of gender diversity and gender-affirming care. Historically, people who identified as a different gender than they were assigned at birth were viewed as having a disorder that needed to be fixed. More recently, most doctors have come to believe that such patients should be handled more humanely and affirmatively; permitting them to make a social gender transition (changing their name and pronouns, using a different bathroom, etc.) is treated as a given. Medical interventions for young people are to be taken on a case-by-case basis.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rlysEq">
But as the GOP candidates’ comments at the debate made clear, they have little interest in permitting even a social transition for transgender youth. And in statehouses across the US, the party has sought to restrict this kind of medical care as much as possible.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OdWfg3">
“Trans advocates have pointed out that these bills fit comfortably within the larger GOP plan to seize minority power in an effort to force their preferred gender dynamics,” Burns wrote. The state, not the individual nor their doctor, is dictating the terms of health care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WMY5JF">
In one of the most striking tangents of the night, businessman <a href="https://www.vox.com/2024-elections/23720391/vivek-ramaswamy-affirmative-action-woke-capitalism-ideas">Vivek Ramaswamy</a> even advocated for reopening “mental health institutions” that have closed over the decades as the country sought to cut costs (starting in the Reagan administration) and tried — but has largely failed — to invest in more humane home- and community-based services. He framed putting more people with mental health problems into those institutions as one of the most important ways to address crime.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CnMA9m">
“Just over the same period that we have closed mental health institutions, we have seen a spike in violent crime. Do we have the spine to bring them back?” he said. “I think we should. As president, I will.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YW3lWB">
I have <a href="https://dylanlscott.files.wordpress.com/2011/02/fighting-for-a-healthy-future.pdf">interviewed</a> people who were subjected to the cruel treatment that was often commonplace in the mental health asylums of old. The new mental health paradigm is focused much more on treating people where they are. While the US has <a href="https://www.vox.com/2023/8/4/23815827/mental-health-therapy-services-health-insurance">struggled</a> to erect a sufficient mental health system given the scale of the country’s needs, few people who work in the field would argue that a return to the institutions of that era is the recipe for fixing our mental health crisis.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ermwvu">
But Ramaswamy, the biggest non-Trump sensation of the <a href="https://www.vox.com/politics/2023/2/23/23611828/2024-republican-presidential-candidates-trump-hurd">GOP primary</a> so far, does. He even implicitly allowed that “drugging up people in those psychiatric institutions with Zoloft and Seroquel” would be part of the program (but not the only part; he also wants a return to the patriotism, faith, and family that he believes constitutes the American character).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4Ijyhf">
It demonstrated an astonishing willingness to use the power of the state to interfere with the ability of certain people, particularly the historically marginalized, to achieve health and well-being — a consistent theme of the night.
</p>
<h3 id="2wGsqH">
Republicans still don’t want the government to help people get health care
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="phQITC">
What affirmative actions the candidates might take to improve people’s health was generally neglected in the first debate of the 2024 campaign. No candidate laid out a health care reform agenda, as Republicans are still in the health policy wilderness after their failure to repeal and replace the <a href="https://www.vox.com/obamacare">Affordable Care Act</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qad54K">
But a few select moments revealed that GOP candidates, while perfectly comfortable interfering with certain medical decisions, remain opposed to using that same government authority to provide assistance to people who need access to health care or to protect people whose health may be at risk in a <a href="https://www.vox.com/public-health">public health</a> emergency. They will still cling to the veneer of small government and individual liberty in certain contexts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5igcEN">
The most obvious such moment is when DeSantis took a line of questioning about the <a href="https://www.vox.com/economy">economy</a> and touted his willingness to shirk the public health consensus on Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xlXwZU">
“Why are we in this mess? A major reason is because how this federal government handled Covid-19 by locking down this economy. It was a mistake. It should have never happened,” he said. “In Florida, we led the country out of lockdown. We kept our state free and open. And I can tell you this: As your president, I will never let the deep state bureaucrats lock you down.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JVF9AK">
DeSantis’s pandemic record is complicated and <a href="https://www.vox.com/policy/23682263/ron-desantis-covid-19-vaccines-joseph-ladapo">I covered it in depth earlier this year</a>. In brief, yes, the state enjoyed an earlier economic recovery as pandemic restrictions were sunset, but it also had a middling performance in terms of health outcomes. DeSantis also pushed beyond ending lockdowns to embrace vaccine skepticism, including empowering a vaccine skeptic as his state surgeon general. Experts who saw the administration’s response up close believe DeSantis’s about-face was detrimental to the health of his state’s citizens — and believe it was more politically calculated than anything else.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gDIoPx">
But a governor who signed <a href="https://apnews.com/article/florida-abortion-ban-approved-c9c53311a0b2426adc4b8d0b463edad1">a six-week abortion ban</a> and <a href="https://apnews.com/article/florida-transgender-health-care-adults-e7ae55eec634923e6593a4c0685969b2">a ban on gender-affirming care for minors</a> while placing new requirements on such care for adults, putting the state firmly in the middle of individual medical decisions, was proudly unwilling to use the same power to try to tame the spread of a virus that ultimately <a href="https://www.nytimes.com/interactive/2023/us/covid-cases.html">killed</a> more than 1 million Americans including 80,000 Floridians.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2rDpBI">
One other brief moment, on another subject, reinforced the same ideas. As Haley tried to take Republicans to task for their role in increasing government spending in recent years, she mentioned the increase in Medicaid enrollment that followed the institution of an emergency policy that allowed people to stay on the program’s rolls.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kBxVB3">
“Our Republicans did this to us too. When they passed that $2.2 trillion Covid stimulus bill, they left us with 90 million people on Medicaid, 42 million people on <a href="https://www.vox.com/social-programs">food stamps</a>” she said. “No one has told you how to fix it. I’ll tell you how to fix it. They need to stop the spending.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vsULAq">
Her meaning was clear: It was a problem that so many people enjoyed government benefits and didn’t need to worry about their health coverage, even during the pandemic. As it happens, the government is <a href="https://www.vox.com/science-and-health/2023/2/13/23582863/medicaid-health-insurance-covid-19-coverage-florida-texas">unwinding</a> that emergency policy — and <a href="https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/">millions of Americans</a> are losing their health insurance as a result.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6OAZHL">
Nobody asked the Republican candidates about what they might do to address the dramatic increase in the uninsured rate that will result. As Wednesday night’s debate made clear, they don’t think of that as the government’s job.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8LuanN">
But if you are a certain kind of person who needs a certain kind of treatment, they are ready and willing to put the state between you and your health care.
</p></li>
<li><strong>Extreme heat is transforming work</strong> -
<figure>
<img alt="Three construction workers in traffic safety vests sit in the shade against a building and take off their hardhats." src="https://cdn.vox-cdn.com/thumbor/EjJo0IURDxIZIGeOmI6qe6jMcdM=/322x0:2989x2000/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72577188/GettyImages_1557929497.0.jpg"/>
<figcaption>
LA street services workers in July take a break in the shade of a nearby storefront as crews lay down new pavement. A heat wave brought triple-digit temperatures to the city; spiking temperatures across the country are continuing to affect workers, from farm laborers to teachers. | Brian van der Brug/Los Angeles Times via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Why breaks, water, and shade for a sea of US workers could trigger the next big labor battle.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1MTB0i">
It’s been a summer of record-breaking heat waves. In July, a <a href="https://www.washingtonpost.com/weather/2023/07/21/us-heat-wave-heat-dome-climate/">heat dome smothered much of the South</a>, while Phoenix sweltered under a 31-day streak of temperatures <a href="https://www.nytimes.com/2023/07/31/us/phoenix-heat-july.html">above 110 degrees</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VYvsia">
Another wave of searing temperatures is currently sweeping <a href="https://www.washingtonpost.com/weather/2023/08/21/record-heat-wave-midwest-south/">the central US</a>, with the <a href="https://www.weather.gov/ama/heatindex">heat index</a> — a metric that combines relative humidity with air temperature to gauge what the temperature actually feels like — creeping above 120 degrees in many cities.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="R4fws0">
The Midwest may be used to acute winters, but not such searing summers: Some buildings have <a href="https://www.nytimes.com/2023/08/22/us/heat-wave-midwest-central-weather.html">no air conditioning</a>, and <a href="https://midwestepi.files.wordpress.com/2017/10/mepi-infrastructure-and-climate-change-final.pdf">infrastructure such as asphalt roads</a> may not have been built with extreme heat in mind.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0Dd69n">
As the mercury rises, many US jobs become magnitudes more difficult and dangerous — and not just on construction sites and farm fields, where the <a href="https://www.washingtonpost.com/climate-environment/2022/08/09/climate-change-heat-workers/">majority of heat-related deaths happen</a>. Many workers toiling in places without sufficient cooling or ventilation face high risk, too, including those in factories and warehouses, <a href="https://www.washingtonpost.com/food/2022/08/01/heat-restaurant-workers-osha/">restaurant employees</a>, and delivery drivers and gig workers exposed to dangerous temperatures as they lug packages out in the sun. Even people who work in indoor environments <em>with</em> cooling mechanisms are at risk, given that faulty or weak HVAC systems are common — as <a href="https://www.nbcnews.com/news/us-news/hot-classrooms-are-impairing-student-learning-health-record-hot-year-t-rcna100298">teachers across the country</a> are experiencing. The list of jobs where heat can be a health hazard is endless.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S6rEqA">
From 2017 to 2022, <a href="https://www.washingtonpost.com/business/2023/07/14/heat-workers-osha-protections/">121 workers died from heat</a>, according to the federal Occupational Safety and Health Administration (OSHA), though the agency acknowledges that this is likely an undercount. The Bureau of Labor Statistics has recorded another almost <a href="https://www.osha.gov/heat/sbrefa">34,000 work-related heat injuries and illnesses</a> that required time away from the job between 2011 and 2020. This summer, Eugene Gates, a 66-year-old letter carrier in Dallas, <a href="https://www.cnn.com/2023/07/21/business/worker-safety-heat-protections-osha/index.html">died on the job</a> on a June day when the temperature reached 97 degrees, and a month later, Dario Mendoza, a 26-year-old farm worker, <a href="https://www.azcentral.com/story/news/local/arizona/2023/07/24/yuma-farmworker-dies-arizona-heat-wave/70457694007/">died after working in the fields</a> amid the Phoenix area’s historic heat wave.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nojnyn">
“Many people are saying that this summer feels worse than the summer before,” says Mayra Reiter, project director of occupational safety and health for Farmworker Justice, a worker protection nonprofit. “And it’s making people work in the fields that much harder — people are feeling unsafe.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RWyEyG">
The recent spate of heat injuries and deaths among workers is just a preview of what’s to come as climate change continues to send summer temperatures soaring in many US cities. By 2050, some will see <a href="https://www.vox.com/a/weather-climate-change-us-cities-global-warming">their average summer highs</a> rise by as much as 6 degrees. According to a <a href="https://www.epa.gov/climateimpacts/climate-change-and-health-workers#insect">report from the Environmental Protection Agency</a>, wildfire smoke — and even <a href="https://www.epa.gov/climateimpacts/climate-change-and-health-workers#insect">increased risk</a> of diseases from insects such as ticks and mosquitoes, as the warmer weather expands their habitats — will add extra strain to outdoor workers. Indoor workers won’t be exempt from peril either, as buildings with poor insulation and ventilation become ovens during heat waves.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1yDIMh">
The far-reaching ripple effects of climate change will impact where we can work, when we can work, and how long we can work. Yet there’s <a href="https://www.osha.gov/top10citedstandards">no federal regulation</a> setting a threshold for when heat becomes too dangerous for employees to work, or even what employers are required to provide their workers in those conditions — such as water, more frequent breaks, shade, or air conditioning.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ThshO5">
For many workers, there’s simply no relief in sight.
</p>
<h3 id="8Ji67M">
How heat harms your health — and how it can make work deadly
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nhkWls">
There’s no single temperature at which physical exertion becomes risky for everyone. But researchers have found that at a <a href="https://www.weather.gov/ict/wbgt">wet bulb globe temperature</a> — a reading that includes humidity, wind speed, whether there’s direct sun exposure, and more — of about 95 degrees Fahrenheit, even the most <a href="https://www.pnas.org/doi/10.1073/pnas.0913352107">fit people will overheat</a>. Exposure to that level of heat for as little as six hours could result in death.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cwmplo">
Heat begins impacting how efficiently we can work, however, long before the temperature reaches 95 degrees. It varies by region, but in the US the <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00170-4/fulltext">optimal temperature for physical outdoor work is 57.7 degrees</a>. Above that point, productivity starts to decline. It goes to show how quickly heat impacts our bodies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sImgFA">
As a worker overheats, they start feeling weak and dizzy. Their speech may slur. These first signs can lead to heat stroke, as well as rhabdomyolysis — in which muscle tissue breaks down — or even a heart attack. There are more long-term effects, too. A person’s <a href="https://www.outsideonline.com/health/training-performance/am-i-more-likely-get-heatstroke-if-ive-already-had-it">heat tolerance can shrink</a> after they suffer a heat stroke, and scientists are also looking into a possible link between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984407">working in heat and kidney disease</a> that’s been observed among agricultural workers.
</p>
<div>
<div class="c-image-grid">
<div class="c-image-grid__item">
<figure class="e-image">
<img alt="A farm worker bends to gather produce on the ground. He’s wearing a hat, long black shirt, jeans, and sneakers." src="https://cdn.vox-cdn.com/thumbor/nk8ekhiVg2yHywl2f3_Fuobibx0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24871110/GettyImages_1588298884.jpg"/> <cite>Mario Tama/Getty Images</cite>
<figcaption>
A farmworker wears protective layers while gathering produce in the heat this month near Hemet, California.
</figcaption>
</figure>
</div>
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/KryCaEntDOwoqLX4an8hLgETmZQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24871126/GettyImages_1553720321.jpg"/> <cite>Eddie Seal/Bloomberg via Getty Images</cite>
<figcaption>
Workers install new sidewalks during a heat wave in Corpus Christi, Texas, in July as heat advisories blanketed much of the nation.
</figcaption>
</figure>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2nYTQR">
Temperatures also don’t have to be very high for strenuous work to become deadly. The lack of heat acclimatization all too frequently kills workers; the majority of workers who die from heat do so <a href="https://www.osha.gov/heat-exposure">in the first few days at work</a>. “A lot of workers will actually end up in heatstroke during the first week on the job,” says Brenda Jacklitsch, a health scientist at the National Institute for Occupational Safety and Health (NIOSH).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lMzsAZ">
Extreme heat is also affecting productivity. According to a <a href="https://www.lancetcountdown.org/data-platform/health-hazards-exposures-and-impacts/1-1-health-and-heat/1-1-4-change-in-labour-capacity">2022 study by The Lancet</a>, which is tracking the relationship between climate change and public health, about 470 billion hours of labor were lost in 2021 due to extreme heat. The US alone lost 2.5 billion hours, mostly in the construction, manufacturing, service, and agriculture sectors. “Workers slow down,” says Shouro Dasgupta, an environmental economist and a co-author of The Lancet report. “They either have to work fewer hours or they put less effort during the hours they can work.” Limited work hours will likely ripple down to all parts of the economy; it could affect the pace and availability of consumer goods and services, slow down delivery orders, and delay air travel.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="va9A6S">
Across the country, airport ground services workers, whether it’s <a href="https://www.nytimes.com/2023/07/20/climate/how-extreme-heat-affects-workers-and-the-economy.html">cabin cleaners</a>, <a href="https://www.atlantanewsfirst.com/2023/07/27/workers-hartsfield-jackson-international-airport-battle-blistering-heat/">baggage handlers</a>, or others who have to be out on the tarmac, have reported facing vicious heat on the job. Rashele Bates, a 26-year-old who cleans plane cabins at the Charlotte, North Carolina airport and who is an active member of the Service Employees International Union (SEIU), told Vox she felt sick and nauseous on the job one day in late July after she and a coworker had been cleaning for about three hours without a proper break. Bates vomited, and her coworker passed out and went to the hospital.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9oRsP5">
“I’m sitting there drowning in sweat,” Bates recalls. The air conditioning isn’t always turned on in the plane while they work, Bates says, nor is there any air conditioning on the jet bridge connecting the plane to the terminal, where she and her coworker fell ill. Bates and a coalition of other airport workers sent a petition to the airline contractor she works for, Jetstream Ground Services, demanding water bottles and functioning air conditioning in each break room. The SEIU is also supporting legislation to improve labor conditions at airports. Jetstream Ground Services did not respond to a request for comment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7ZtyIn">
There’s no great mystery on how to address heat illness in the workplace. NIOSH, which operates under the Centers for Disease Control, published its first recommended standards on workplace heat safety back in 1972,<strong> </strong>and the recommendations haven’t changed much since.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="W9G5QS">
“A lot of the work that’s done is not necessarily rocket science,” said Andrew Levinson, director of standards and guidance at OSHA. “It’s making sure people have water, rest, shade, and that they can ease into work that first week to make sure that they’re adequately acclimatized.”
</p>
<h3 id="Wgsz45">
Why don’t we have workplace heat protection laws?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="s8Wi6y">
About half of states could make their own <a href="https://www.osha.gov/top10citedstandards">heat standards</a> for the workplace, but only California, Oregon, Washington, Colorado, and Minnesota have done so. In California, an 80-degree heat index triggers employer requirements for regular rest, shade, and water for outdoor workers. Oregon’s heat safety rules, which Reiter of Farmworker Justice said are the country’s strongest, also kick in at 80 degrees, and apply to indoor workers, too.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="V5tmyl">
Texas, meanwhile, is going in the other direction. Governor Greg Abbott <a href="https://www.texastribune.org/2023/06/16/texas-heat-wave-water-break-construction-workers/">signed a bill in June</a> that bans local ordinances going beyond state-level workplace safety rules, after Austin and Dallas had passed ordinances in 2010 and 2015, respectively, mandating more frequent water breaks for construction workers. On a state level, employers are <a href="https://www.osha.com/blog/lunch-break-laws">not required to give any breaks</a> to employees. Texas is the most lethal state for heat-related deaths at work — according to the Bureau of Labor Statistics, which also keeps track of heat deaths on the job, 42 people have died there since 2011.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VqCGbU">
A federal OSHA heat standard is still years away, and not because the agency isn’t aware of the problem. It began working on a proposed rule in 2021, but creating a new standard is notoriously hard because Congress requires the agency to follow a long, labyrinthine process. For example, it must do a cost-benefit analysis, calculating the cost not just to the agency but for all affected industries as well, and go through multiple rounds of public comment.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jCd9Kx">
“That doesn’t mean that the agency is not out there, shouting from the rooftops on the importance of this,” says Levinson, who added that a lot of workers are calling on OSHA to develop heat standards quickly.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Yzpi55">
The agency also has to contend with political headwinds. The conservative stance on <a href="https://www.washingtonpost.com/national/republicans-poised-to-roll-back-worker-safety-regulations/2017/03/06/87a6c266-fd27-11e6-8f41-ea6ed597e4ca_story.html">workplace safety rules</a> is broadly <a href="https://weartv.com/news/local/floridas-top-gop-lawmakers-want-out-of-osha">that they</a> <a href="https://www.nytimes.com/2001/03/08/us/house-joins-senate-in-repealing-rules-on-workplace-injuries.html">shouldn’t exist</a>. “Republican administrations don’t do OSHA rules,” says Jordan Barab, a former deputy assistant secretary of labor at the agency under the Obama administration who now publishes a <a href="https://jordanbarab.com/confinedspace/">workplace safety newsletter</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="asIpbu">
In the absence of a heat standard, OSHA has been deploying the <a href="https://www.osha.gov/laws-regs/oshact/section5-duties">“General Duty” clause</a> — an all-purpose rule that employers must provide a workplace free from “recognized hazards.” There are four steps to the clause, though, and OSHA has to build its case for proving each one. “These cases are very legally vulnerable,” says Barab.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="csop24">
Reiter of Farmworker Justice says that OSHA could issue an emergency heat standard while it works on issuing a more permanent standard, but rules like these have been <a href="https://www.cnn.com/2022/01/25/politics/vaccine-mandate-osha-withdrawn/index.html">successfully challenged</a> in court. Instead, Reiter’s group, along with a number of <a href="https://adams.house.gov/media-center/press-releases/adams-labor-leaders-introduce-heat-stress-legislation-protect-workers#:~:text=%E2%80%9CThe%20Asunci%C3%B3n%20Valdivia%20Heat%20Illness,heat%20stress%20and%20extreme%20temperatures.">unions</a>, are backing a <a href="https://www.brown.senate.gov/newsroom/press/release/sherrod-brown-legislation-protect-workers-extreme-heat#:~:text=%E2%80%9CThe%20Asunci%C3%B3n%20Valdivia%20Heat%20Illness,heat%20stress%20and%20extreme%20temperatures">federal bill</a>, recently introduced in the Senate, that would give OSHA a year to issue an interim standard and make it harder to challenge. The bill has won support from a number of Democratic lawmakers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OqDkWB">
The Coalition of Immokalee Workers (CIW), which advocates for farm workers in Florida and beyond, isn’t waiting on the federal government. In 2011, the group launched the <a href="https://www.fastcompany.com/90865096/one-one-florida-program-is-helping-eradicate-modern-day-slavery-on-farms">Fair Food Program</a>, which sets stronger labor standards, including <a href="https://indd.adobe.com/view/2e8c5302-3772-4122-a6a7-f345d4801a16">heat standards</a>, on farms. So far more than 20 crop growers, along with Burger King, McDonald’s, Whole Foods, Trader Joe’s, and other large food companies, have <a href="https://fairfoodprogram.org/partners/">signed on</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xrygNW">
Gerardo Reyes Chavez, an organizer with CIW and a former farmworker himself, says the difference between conditions on farms signed up with the program and those that aren’t are like night and day. “Before, you didn’t have any way to protect yourself, you were basically down to your luck. But the way I see it, human rights shouldn’t depend on luck.”
</p>
<figure class="e-image">
<img alt="A woman speaks in front of microphones." src="https://cdn.vox-cdn.com/thumbor/qM0JzQh3z_KdWdTpsScid1NCJzU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24871151/GettyImages_1542215814.jpg"/> <cite>Giorgio Viera/AFP via Getty Images</cite>
<figcaption>
Antonia Catalan, a member of the Farmworker Association of Florida Homestead Office, speaks during a press conference and vigil in Homestead, Florida, days after the death of farmworker Efrain Lopez Garcia, 30, from heat complications.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VyleVB">
Other unions — including the United Steelworkers, the Teamsters, the SEIU, the ROC United (which advocates for restaurant workers), National Nurses United, and more — are taking up regulations directly with major employers: Recently, UPS drivers unionized with the Teamsters won a contract that, among other changes, requires new company vehicles to have air conditioning. Many existing delivery cars will also be retrofitted with AC, fans, and vents.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VkdLmu">
Some employers and industry representatives are less than thrilled about a looming OSHA heat standard. The <a href="https://www.regulations.gov/comment/OSHA-2021-0009-0770">American Farm Bureau Federation</a>, a trade association representing farm producers — an industry with some of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657558">highest numbers</a> of heat-related worker injuries and deaths — has argued that the General Duty clause already protected workers and questioned whether new regulations could be implemented “without imposing new, onerous burdens on farmers and ranchers that will lead to economic losses.” It then implored the agency to focus on “the responsibility on the individual employee and the personal health choices that are made outside of the workplace,” a sentiment that has been echoed by other <a href="https://www.regulations.gov/comment/OSHA-2021-0009-0776">pro-business groups</a>. The organization declined an interview request for this story.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kQZB53">
It goes to show how heat isn’t necessarily what’s making workers sick, Barab says. “It’s really more employers’ refusal to implement measures to protect workers. That’s killing workers.”
</p></li>
<li><strong>AI-discovered drugs will be for sale sooner than you think</strong> -
<figure>
<img alt="A colorful pile of pills." src="https://cdn.vox-cdn.com/thumbor/mduHCNBYIrluD0uR8tKpEFThOLY=/0x116:1000x866/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72577106/shutterstock_192793853.0.0.jpg"/>
<figcaption>
SOMMAI/Shutterstock
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It takes forever to get drugs on the market. AI could help speed up the process.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ei3Wwt">
In the 1968 novel and film <a href="https://www.imdb.com/title/tt0062622/"><em>2001: A Space Odyssey</em></a>, the <a href="https://www.vox.com/2023/4/28/23702644/artificial-intelligence-machine-learning-technology">artificial intelligence</a> system Hal (short for <a href="https://www.nytimes.com/2018/03/30/movies/hal-2001-a-space-odyssey-voice-douglas-rain.html">HAL 9000</a>) kills its spaceship’s astronauts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BZC1wk">
In reality, the nickname Hal refers to a different kind of killer: not of humans, but of bacteria.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OWTY5P">
In February 2020 — more than <a href="https://news.mit.edu/2020/artificial-intelligence-identifies-new-antibiotic-0220">five decades</a> after the science fiction film introduced the world to perhaps the first great AI villain — a team of researchers at the Massachusetts Institute of Technology used artificial intelligence to <a href="https://www.nature.com/articles/s41589-023-01349-8">discover</a> an antibiotic capable of killing <a href="https://www.mayoclinic.org/diseases-conditions/e-coli/symptoms-causes/syc-20372058">E. coli</a>, which <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320345/#:~:text=An%20estimated%2073%2C480%20illnesses%20due,only%20a%20minority%20of%20E.">hospitalizes</a> thousands of people a year, as well as an antibiotic-resistant strain of another common bacterial infection, <a href="https://www.cdc.gov/hai/organisms/acinetobacter.html">Acinetobacter baumannii</a>. And taking a page from <em>2001</em>, they <a href="https://www.nature.com/articles/d41586-020-00018-3#:~:text=From%20the%20resulting%20hits%2C%20the,film%202001%3A%20A%20Space%20Odyssey.">named</a> it halicin, after HAL 9000.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Likebl">
The discovery of halicin paints a picture of just how rapid AI-assisted drug discovery can be. Scientists <a href="https://news.mit.edu/2020/artificial-intelligence-identifies-new-antibiotic-0220">trained</a> their AI model by introducing it to approximately 2,500 molecules (1,700 of which were FDA-approved drugs, and 800 of which were natural products). Once the researchers trained the model to understand which molecules could kill E. coli, the team ran 6,000 compounds through the system, including existing drugs, failed drugs, natural products, and a variety of other compounds.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jwzIQR">
The system found halicin in a fraction of the time that traditional methods would take, said Bowen Lou, an assistant professor at the <a href="https://www.business.uconn.edu/person/bowen-lou/">University of Connecticut’s School of Business</a> who studies how AI is changing the pharmaceutical industry. “Not only can halicin kill many species of antibiotic-resistant bacteria, it is also structurally distinct from prior antibiotics,” he said in an email. “This discovery is groundbreaking because antibiotic-resistant ‘<a href="https://www.vox.com/2019/4/8/18300388/candida-auris-superbug-drug-resistant">superbugs</a>’ are a major <a href="https://www.vox.com/public-health">public health</a> issue that traditional methods have largely failed to address.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FfBtbA">
“The idea that you can look at the structures of a small molecule and predict its properties is a very old idea. The way people thought of it is, if you can identify some structures within the molecule, some functional groups, and so on, you can sort of say, ‘What does it do?’” said Regina Barzilay, a <a href="https://www.regina.csail.mit.edu/">distinguished professor of AI and health</a> with MIT’s School of Engineering and <a href="https://www.nature.com/articles/s41589-023-01349-8">co-author</a> of a May 2023 study that identified another potential antibiotic candidate by building upon the methods used in the initial halicin study.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GVwhNV">
Prior to the use of AI, the challenge of discovering these structures and identifying a drug’s potential use was primarily one of speed, efficiency, and cost. Past analyses show that, between the early 1990s and the late 2000s, the typical drug discovery and development process took <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725284/">12 years or more</a>. In the case of halicin, the MIT team used AI that can <a href="https://news.mit.edu/2020/artificial-intelligence-identifies-new-antibiotic-0220">test more than 100 million chemical compounds</a> over the course of only a few days. “It became clear that molecular science is really a good place to apply machine learning and to use new technology,” Barzilay said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9rUHHH">
With <a href="https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis">at least 700,000 deaths</a> every year attributed to <a href="https://www.vox.com/future-perfect/22922018/antibiotic-resistance-epidemic-drug-resistant-infections">drug-resistant diseases</a> — a number projected to grow to <a href="https://news.un.org/en/story/2023/02/1133227#:~:text=Up%20to%2010%20million%20people,pharmaceuticals%2C%20agricultural%20and%20healthcare%20sectors.">10 million deaths</a> annually by 2050 — the need for speed is great, especially given that the rate of drug advancements has stalled in recent decades. Since 1987, the year scientists <a href="https://www.sciencedirect.com/science/article/pii/S1369527419300190">identified</a> the last successful antibiotic class used in treating patients, the world has entered what scientists call the “<a href="https://www.healthywomen.org/your-care/science-and-technology/antibiotic-resistance-crisis-point">discovery void</a>.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zM7635">
Crucially, AI can analyze vast amounts of medical data, and, as the discovery of halicin suggests, it can meaningfully accelerate the drug discovery process. This new technology continues to spur significant advancements in the medical field and holds the potential to improve patient outcomes and facilitate more precise treatment methods. It could also lower costs, which would be vital for antibiotic development, given that at least some of the industry’s stagnation is due not to the inability to identify new drugs, but to a <a href="https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html">lack of market interest and incentive</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SENnjl">
“The fact that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293739/#:~:text=1.,approved%20for%20clinical%20use1.">90 percent of drugs fail in the clinic</a> tells us that there’s room for improvement. It’s a really complex system. This is exactly what machine learning is made for: really complex systems,” Chris Gibson, the co-founder and CEO of biotech company <a href="https://www.recursion.com/">Recursion</a>, told Vox of recent breakthroughs in the drug discovery space. “It doesn’t mean getting rid of the role people play in many ways, but it augments and turns our scientists into super scientists to have these tools to go faster and to explore more broadly.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="py1bKP">
To be clear, the AI programs researchers use for drug discovery vary greatly from science fiction’s AI creations. These advances in pharmaceutical development do not mean <a href="https://www.vox.com/robots">robot</a> doctors will run the medical field any time in the near future. But halicin and other recent breakthroughs represent the ability of AI to transform the pharmaceutical industry and bridge more than three decades of the antibiotic discovery void.
</p>
<h3 id="N314q0">
The history of AI in medicine
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UMlbbm">
Language models and image generators like OpenAI’s <a href="https://chat.openai.com/">ChatGPT</a>, <a href="https://www.vox.com/google">Google</a>’s <a href="https://bard.google.com/">Bard</a>, and <a href="https://www.midjourney.com/home/?callbackUrl=%2Fapp%2F">Midjourney</a> introduced many to the concept of AI when they <a href="https://techcrunch.com/2023/07/24/chatgpt-everything-you-need-to-know-about-the-open-ai-powered-chatbot/">launched widely</a> in late 2022 and early 2023. But scientists have been using AI — of a sort — for decades.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ibq0gE">
In 1965, researchers at Stanford University attempted to use a computer program to identify chemical compounds. Considered the “<a href="http://web.mit.edu/6.034/www/6.s966/dendral-history.pdf">first application</a> of AI to a problem of scientific reasoning,” the <a href="https://exhibits.stanford.edu/ai/catalog/wr759qp9369">DENDRAL project</a> paved the way for future uses of the technology in the scientific community.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mJv3bo">
Almost a decade later, scientists at Stanford led further developments in medical AI when they <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616181/">created the computer system MYCIN</a>, which helped <a href="https://www.vox.com/health-care">health care</a> workers diagnose bloodborne bacterial infections in patients. This rules-based system posed a series of questions on symptoms, medical history, test results, and various other factors and would generate a response reporting the likelihood of a particular diagnosis.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y4RR4O">
However, the rigidity of rules-based systems means they lack the precision necessary to thrive in the ever-changing medical field. (Rules-based systems do not learn new information unless someone <a href="https://deepai.org/machine-learning-glossary-and-terms/rule-based-system">manually changes</a> the rules of the program.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mybCQR">
Still, in the late 1970s and the 1980s, several institutions and scientists developed knowledge-based AI systems to help diagnose illnesses, including <a href="https://www.nejm.org/doi/full/10.1056/NEJM198208193070803">INTERNIST-I</a>, <a href="https://groups.csail.mit.edu/medg/ftp/psz/AIM82/ch2.html">CASNET</a>, and <a href="https://pubmed.ncbi.nlm.nih.gov/8750392/">QMR</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WJahiH">
But, depending on your definition of AI, these early technologies don’t even qualify as such. “Many parties who you might talk to in our industry will say that AI existed for many decades or at least for over a decade,” said Alex Zhavoronkov, the CEO of Hong Kong-based AI drug discovery company Insilico Medicine. “They will be right if you define any form of machine learning to be AI.” (An MIT article <a href="https://mitsloan.mit.edu/ideas-made-to-matter/machine-learning-explained">defines</a> machine learning as a machine’s ability to “imitate intelligent human behavior.”)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3oxq67">
Zhavoronkov has a narrower definition of AI drug discovery, saying it refers specifically to the application of deep learning and generative learning in the drug discovery space. Deep learning is a type of machine learning where artificial neural networks (<a href="https://news.mit.edu/2022/neural-networks-brain-function-1102">similar but not exactly like</a> the neurons in our brain) allow a machine to <a href="https://www.ibm.com/topics/deep-learning">learn and advance</a> independent of human intervention.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="x11tuL">
The “deep learning revolution” — a time when development and use of the technology <a href="https://bdtechtalks.com/2023/04/10/deep-learning-revolution-terry-sejnowski/">exploded</a> — took off around 2014, Zhavoronkov said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xkCeYD">
Throughout the <a href="https://www.reuters.com/article/pharmaceuticals-ai-gsk/rpt-big-pharma-turns-to-ai-to-speed-drug-discovery-gsk-signs-deal-idINL8N1JR2HL">2000s</a>, pharmaceutical giants and plucky startups saw an opportunity to <a href="https://pubs.acs.org/doi/10.1021/acs.chemrev.8b00728">accelerate the drug development process</a>. Between 2008 and 2015, many companies focused on AI drug discovery launched, including Evaxion, Exscientia, Recursion, Benevolent AI, and Insilico Medicine. The industry grew even further in the late 2010s when Big Pharma started <a href="https://www.reuters.com/article/pharmaceuticals-ai-gsk/rpt-big-pharma-turns-to-ai-to-speed-drug-discovery-gsk-signs-deal-idINL8N1JR2HL">backing</a> some of these new startups.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SFMgAV">
“It is worth noting that earlier generations of IT only achieved limited success in drug discovery,” Lou said. “Recent advances in AI have brought about a significant shift in this landscape. AI, with its powerful algorithms and data-driven approaches, has the potential to revolutionize the process of discovering new drugs.”
</p>
<h3 id="v49rvF">
Recent developments
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="raMeod">
According to a number of experts who spoke to Vox, the cataloging of biological and chemical information aided in recent drug breakthroughs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FjvjfN">
In 2018, <a href="https://www.deepmind.com/">DeepMind</a>, a Google-backed AI research laboratory, developed <a href="https://alphafold.ebi.ac.uk/">Alphafold</a>, a network that can determine a protein’s structure from its building blocks. “In my opinion, the most fundamental game-changer [in medical AI] is DeepMind’s Alphafold, which has now predicted the structure for essentially all proteins known to us and fundamentally advanced our understanding of biology,” Swarat Chaudhuri, a <a href="https://www.cs.utexas.edu/~swarat/">professor of computer science</a> at the University of Texas Austin, told Vox in an email. “The findings from Alphafold are already having a massive impact on drug and vaccine development.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yL5QyE">
Scientists have also been itemizing compounds, or molecules, into chemical libraries, such as the widely used <a href="https://enamine.net/compound-collections/real-compounds">Enamine REAL</a> Space, which contains 36 billion novel molecules. Drug development and pharmaceutical companies order molecules from Enamine Real and then evaluate whether that molecule has the desired effect on the protein being studied (the structure of which is known thanks to Alphafold and other similar software).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="W7k3U0">
Knowing the structure of these proteins and having access to a molecule library are instrumental in determining the potential usefulness of a drug candidate. In the case of halicin, the researchers found a successful antibiotic contender in a library of only 6,000 compounds.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VNRFgw">
With billions of data points, the potential for new drug discoveries is massive, and new advances could continue to accelerate the process. On August 8, <a href="https://ir.recursion.com/news-releases/news-release-details/recursion-bridges-protein-and-chemical-space-massive-protein">Recursion announced</a> that, in partnership with Nvidia, it predicted how the 36 billion target molecules in Enamine Real’s library interact with approximately 80,000 pockets, or protein binding sites, across over 15,000 proteins. Recursion evaluated around 2.8 quadrillion drug-target pairs, the first step to identifying new drugs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mBxsxQ">
“Think of this as locks and keys,” said Gibson. The target molecules are the keys, and the protein pockets are the locks. “The idea of a drug in many cases is like a key. You find a very specific key that fits a very specific lock.” Recursion’s work means all molecules in that library (not just those with a similar structure to known useful compounds) can be considered and tested.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SuMuN1">
Recursion’s development makes it easier to know which keys will fit which locks, but its predictions are not perfect. “It becomes a data layer upon which we can do fast searches,” Gibson said. “Just like a Google search result isn’t always exactly what you’re looking for, but they summarize the top searches … and usually what you want is in one of the top five. It’s the same kind of thing here. We can take 2.8 quadrillion parameters and basically say, ‘If you want an inhibitor of this particular protein, here’s the molecules you might start with.’”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WmTecK">
According to Gibson, Recursion’s lab currently conducts as many experiments every 15 minutes as he did in his entire five-year PhD program. “It’s taking almost like an artisanal and bespoke science of the old days and turning it into an industrialized science,” he said. “It’s almost like when making automobiles went from handmade automobiles — every one a little bit custom — to the assembly line.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1w1M8y">
Biological tools, robotic automation, and improved computation, among other technological advances, have all played a role in advancing the field of drug discovery and development, Gibson said. AI is simply a critical contributor to these improvements.
</p>
<h3 id="ey8bA4">
What can’t AI do?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5QpYwB">
AI systems cannot yet accomplish every part of the drug development process alone, particularly in the late stages. Returning to Gibson’s automobile-manufacturing analogy, he says the drug discovery space is currently at the point the Ford Motor Company was when founder Henry Ford <a href="https://corporate.ford.com/articles/history/the-model-t.html">quipped</a>, “Any customer can have a car painted any color that he wants so long as it’s black.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="D4spGj">
“We’re in the early days where there’s less flexibility in some of these datasets, but they’re built in a standardized way that allows machine learning to take off,” Gibson said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SoPwqq">
In June, Insilico Medicine <a href="https://www.cnbc.com/2023/06/29/ai-generated-drug-begins-clinical-trials-in-human-patients.html">began clinical trials</a> for what Zhavoronkov told CNBC was “the first fully generative AI drug to reach human clinical trials.” The drug, INS018_055, aims to treat idiopathic pulmonary fibrosis, a chronic lung disease, and reportedly relies on both an AI-discovered target and an AI-generated design. Insilico even uses <a href="https://www.youtube.com/watch?v=OPFx08L3lR0">robots in their target discovery lab</a> to develop their small-molecule drug candidates.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9vUk2u">
Drug candidates typically require at minimum six or seven years to pass through all the necessary human trials, said Zhavoronkov, and the first truly AI-generated drug candidates only started popping up about four years ago. “That is the reason why we haven’t seen AI-generated drugs on the market,” he said. “Many of those drugs that are true AI drugs, they were created just a couple years ago, so they didn’t have the time to get into the human clinical trials. We are I think the first one with a true generative AI drug.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wweEC8">
Still, according to Gibson, we are far from removing people entirely from the drug discovery process. “What’s important to know is that [machine learning and AI] is an incredible tool and, used well, it can help us with many steps in the process. The idea that somebody hits ‘enter’ on an AI algorithm and a drug just pops out, I believe that is a fallacy,” said Gibson. “I am confident no such technology exists today.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6QaKLU">
According to Chaudhuri, questions of reliability are a major limiting factor in expanding the role of AI in the medical field. “To deploy AI systems in safety-critical domains, for example, real-time decision-making in health care, you need to trust them,” he said. “But how do you trust a system like GPT-4, which gives you reasonable-sounding answers one minute and complete lies in the next?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eh5MAz">
And the truth is, it’s not clear yet when people should put their full trust in the machine’s decision-making processes, Barzilay said. No one needs a person to double-check that the products recommended to them by an <a href="https://www.mdm.com/article/tech-operations/technology/amazons-secret-to-ai-powered-product-recommendations/">Amazon algorithm</a> align with their shopping needs, but medical decisions carry far more weight.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Toc7bA">
Even with current limitations, however, experts see a great deal of promise in medical AI. “Today, we are paying several billion dollars for each molecule that goes into a drug. It’s unsustainable,” Barzilay said. “There are still a lot of diseases for which we don’t have good drugs, or even for diseases for which we do have approved drugs but we have a whole bunch of side effects.” For example, she said, the breast cancer treatment drug Tamoxifen, while often necessary, comes with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669724/#:~:text=Premenopausal%20individuals%20receiving%20chemotherapy%20plus,et%20al.%2C%202004).">host of harmful side effects</a>, including brain problems.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="U2cXqZ">
“What [Tamoxifen] shows to us is we’re nowhere close to where we want to be because of how we develop drugs,” Barzilay said. She believes AI, however, can change the process for the better: “I really think that machine learning should be part of each one of these processes. And I hope and believe that in five or 10 years, drug discovery will be different.”
</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>Successor, Dyf and Arc De Triomphe impress</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>Amateur Avani in Top-10 at pro event in Sweden</strong> - Avani, who shot 72, added 71 to get to 1-under after 36 holes and was tied 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>Neeraj Chopra qualifies for 2024 Olympics, enters World Championships final with 88.77m throw</strong> - The 25-year-old Chopra’s qualifying round lasted just a few minutes as he sent the spear to his season’s and fourth career-best distance.</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>U.S. Open to deploy Video Review system to help officials</strong> - The system will allow players to challenge a range of decisions, such as those relating to double bounces and foul shots, and will use various camera angles to get the best view of an incident, according to a document on the U.S. Open media site</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>FIFA opens case against Spanish soccer official who kissed a player on the lips at Women’s World Cup</strong> - The Spanish soccer federation would not comment on reports in Spanish media that Rubiales was set to resign on Friday after five years as head of the body.</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>City school students selected for camp in Russia</strong> - Of the 14 participants from India, three won the contest to attend the camp.</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>Airport underpass plan shelved; AAI-NHAI to fund diversion of Mysuru-Nanjangud highway</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>Governor and CM inaugurate temple, masjid and church constructed in the Secretariat complex</strong> - Governor visits the new secretariat for the first time</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>Andhra Pradesh: Explain Ambedkar’s ideology and greatness to children, parents and teachers told</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>Kaloji Narayana Rao University of Health Sciences extends last date to apply for MPH</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>Luis Rubiales refuses to step down as Spanish football federation president</strong> - Luis Rubiales refuses to step down as president of the Spanish football federation following his behaviour at the Women’s World Cup final.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Inside Mali: What now for the country that bet its security on Wagner?</strong> - Fears over Mali’s future are growing - it relies on Wagner for security but the group’s leader is now believed to be dead.</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>Putin breaks silence over Prigozhin’s reported death</strong> - The Russian president says the Wagner group boss was a “talented person” who made “serious mistakes”.</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>EU safety laws start to bite for TikTok, Instagram and others</strong> - Nineteen large platforms have to start complying with new rules as soon as Friday or risk big fines.</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>Heineken sells off Russian beer business for €1</strong> - The lager-maker will take a huge loss on the division which, it said, had taken longer to jettison.</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>Rocket Report: DOJ sues SpaceX; a look inside doomed Spaceport Camden</strong> - Elon Musk may again be in trouble for his social media posts. - <a href="https://arstechnica.com/?p=1962918">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The strange, secretive world of North Korean science fiction</strong> - Unusual and often breathtaking, the genre is relatively unknown in the West. - <a href="https://arstechnica.com/?p=1952074">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>FDA cracks down on bogus anti-viral products from Amazon, Walmart</strong> - The products contain dilutions of a toxic agent found in absinthe. - <a href="https://arstechnica.com/?p=1963140">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>California deploys AI-powered wildfire detection systems</strong> - New system scans over 1,000 cameras for signs of smoke—with 77 hits so far. - <a href="https://arstechnica.com/?p=1962998">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Barnacles could hold key to finding wreckage of Malaysia Airlines MH370</strong> - Scientists partially reconstruct debris drift path based on ocean temp data stored in shells. - <a href="https://arstechnica.com/?p=1962873">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>I told my wife I saw an alien on the way to work this morning</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She said “how do you know it’s on its way to work?”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Phippsy771"> /u/Phippsy771 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/160ry5h/i_told_my_wife_i_saw_an_alien_on_the_way_to_work/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/160ry5h/i_told_my_wife_i_saw_an_alien_on_the_way_to_work/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Two Trump supporters die and go to heaven.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
God meets them at the pearly gates and asks if they have any questions. One of them says, “Yes, what were the real results of the 2020 election and who was behind the fraud?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
God says, “My son, there was no fraud. Biden won the electoral college fair and square, 306 to 232.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
After a few seconds of stunned silence, the one guy turns to the other and whispers, “This goes higher up than we thought.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/OnlyMeFFS"> /u/OnlyMeFFS </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/160tjav/two_trump_supporters_die_and_go_to_heaven/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/160tjav/two_trump_supporters_die_and_go_to_heaven/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Wife: “I have a lot of my own clothes I’d like to donate.”</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Husband: “Why bother? It’s easier to throw the clothes in the garbage can.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Wife: “Don’t be selfish! There are so many poor people who have no clothes and are starving.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Husband: " Honey, anyone who fits into your clothing is not starving…"
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/MarcoDanielRebelo"> /u/MarcoDanielRebelo </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/160twb7/wife_i_have_a_lot_of_my_own_clothes_id_like_to/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/160twb7/wife_i_have_a_lot_of_my_own_clothes_id_like_to/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>My first time buying condoms as a teenager, I went to the pharmacy.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The hot cashier at the counter could see that I was new at it and gave me the pack asking if I knew how to use one. I said, “No, it’s my first time.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She took one out, put it on her thumb, and told me to make sure it was on tight.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I still looked confused.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She looked around the store to see if it was empty and it was.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Just a minute.” she said and locked the door.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She led me to the back room, took off her shirt and bra.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“You like these?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I could only nod my head.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She said to put the condom on.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
As I was putting it on, she dropped her skirt, removed her panties and laid down.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Come on.” she said. “We don’t have much time.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So I climbed on her.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It was so amazing that I couldn’t hold back and KAPOW! I was done in two minutes!
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She looked at me concerned and asked, “Did you put the condom on?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I said, “I sure did!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
…and held up my thumb to show her.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/OnlyMeFFS"> /u/OnlyMeFFS </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/160fek4/my_first_time_buying_condoms_as_a_teenager_i_went/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/160fek4/my_first_time_buying_condoms_as_a_teenager_i_went/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>First golf joke I’ve heard less than 1,000,000 times.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A Catholic, a Baptist and a Mormon are bragging about the size of their families.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“I have four boys, and my wife is expecting another,” says the Catholic. “One more son, and I’ll have a basketball team.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“That’s nothing,” says the Baptist. “I have 10 boys now, and my wife is pregnant with another child. One more son, and I’ll have a football team.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“That’s nothing,” says the Mormon. “I have 17 wives. One more wife, and I’ll have a golf course.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/FiddlebackGuy"> /u/FiddlebackGuy </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/1602848/first_golf_joke_ive_heard_less_than_1000000_times/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/1602848/first_golf_joke_ive_heard_less_than_1000000_times/">[comments]</a></span></p></li>
</ul>
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