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HRT ‘potentially important’ in reducing women’s dementia risk | Health

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Hormone replacement therapy may help prevent Alzheimer’s disease in millions of women at risk of developing the condition, research suggests.

Dementia is one of the world’s biggest health threats. The number of people living with the condition worldwide is set to nearly triple to 153 million by 2050, and experts have warned it presents a major and rapidly growing threat to future health and social care systems in every community, country and continent.

Almost two in three people with Alzheimer’s are female, and about a quarter of women in the UK alone carry a gene called APOE4, which is the strongest risk factor gene for the disease.

A team of researchers from the University of East Anglia (UEA) and the University of Edinburgh have found evidence of the “potential importance” of hormone replacement therapy (HRT) in reducing the risk of Alzheimer’s disease in women carrying the APOE4 gene. The study was published in the Alzheimer’s Research & Therapy journal.

Although they stressed they could not say for sure that HRT cut the risk in women, the findings were “really important” amid limited drug options for dementia and an urgent need for novel treatments.

HRT, which helps control symptoms of the menopause, is associated with better memory, cognitive function and larger brain volumes in later life in women with the APOE4 gene, the researchers found.

Prof Michael Hornberger, of UEA’s Norwich Medical School, said: “It’s too early to say for sure that HRT reduces dementia risk in women, but our results highlight the potential importance of HRT and personalised medicine in reducing Alzheimer’s risk.

“The next stage of this research will be to carry out an intervention trial to confirm the impact of starting HRT early on cognition and brain health. It will also be important to analyse which types of HRT are most beneficial.”

In the study, researchers found that HRT was most effective when given during perimenopause – where symptoms build up months or years before periods stop – and could lead to brains that appear several years younger.

Prof Anne-Marie Minihane, also of Norwich Medical School, and the co-leader of the study, said: “We know that 25% of women in the UK are carriers of the APOE4 gene and that almost two-thirds of Alzheimer’s patients are women.

“In addition to living longer, the reason behind the higher female prevalence is thought to be related to the effects of menopause and the impact of the APOE4 genetic risk factor being greater in women.

“We wanted to find out whether HRT could prevent cognitive decline in at-risk APOE4 carriers.”

The team analysed data from 1,178 women taking part in the European Prevention of Alzheimer’s Dementia initiative, which was set up to study participants’ brain health over time.

The project, which involves 10 countries, tracked the brains of 1,906 people over 50 who did not have dementia at the start of the study. For the new research, experts looked at the results of cognitive tests and brain volumes as recorded by MRI scans.

The results showed that APOE4 carriers who also used HRT had better cognition and higher brain volumes than people not on HRT and non-APOE4 carriers.

Dr Rasha Saleh, of Norwich Medical School, said: “We found that HRT use is associated with better memory and larger brain volumes among at-risk APOE4 gene carriers. The associations were particularly evident when HRT was introduced early – during the transition to menopause, known as perimenopause.

“This is really important because there have been very limited drug options for Alzheimer’s disease for 20 years and there is an urgent need for new treatments. The effects of HRT in this observation study, if confirmed in an intervention trial, would equate to a brain age that is several years younger.”

Minihane said the team did not look at dementia cases, but that cognitive performance and lower brain volumes are predictive of future dementia risk.

The risk of Alzheimer’s and other types of dementia increases with age, affecting an estimated one in 14 people over the age of 65 and one in every six over the age of 80. Inheriting APOE4 does not mean someone will definitely develop the condition.

Prof Craig Ritchie, a co-leader of the study from the University of Edinburgh, said it “highlights the need to challenge many assumptions about early Alzheimer’s disease and its treatment, especially when considering women’s brain health”.

He added: “An effect on both cognition and brain changes on MRI supports the notion that HRT has tangible benefit. These initial findings need replication, however, in other populations.”

Dr Sara Imarisio, head of strategic initiatives at Alzheimer’s Research UK, said the findings were “encouraging” but need to be confirmed in further studies.
“They provide evidence that HRT could have some cognitive benefits, particularly in women who carry the APOE4 Alzheimer’s risk gene,” she said. “The next step is to investigate this in more detail.”

Imarisio said if the new findings were subsequently confirmed, it could pave the way for clinical trials to see if HRT can eventually prevent dementia.

Dr Richard Oakley, associate director of research at the Alzheimer’s Society, said: “Studies of this kind are important as they hint at a link between HRT and the changes to the brain. We need more studies, on a larger scale, to better understand this link.”

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Effectively Reducing Stress and Treating Anxiety Disorders Without Antidepressant Drugs

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According to a randomized clinical trial out of Georgetown University Medical Center, mindfulness-based stress reduction is as effective at treating anxiety disorders as a common antidepressant drug.

Mindfulness-based stress reduction is as effective as an antidepressant drug for treating anxiety disorders.

A guided mindfulness-based stress reduction program was as effective as the use of the gold-standard drug – the common antidepressant drug escitalopram – for patients with anxiety disorders. This is according to the results of a first-of-its-kind, randomized clinical trial led by researchers at Georgetown University Medical Center.

The findings were published on November 9, 2022m, in the journal JAMA Psychiatry. This follows the announcement on October 11, 2022, by the United States Preventive Services Task Force that, for the first time, recommended screening for anxiety disorders due to the high prevalence of these conditions.

According to the CDC, 11.7% of adults in the U.S. have regular feelings of worry, nervousness, or anxiety.

“Our study provides evidence for clinicians, insurers, and healthcare systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers,” says Elizabeth Hoge, MD, director of the Anxiety Disorders Research Program and associate professor of psychiatry at Georgetown and first author. “A big advantage of mindfulness meditation is that it doesn’t require a clinical degree to train someone to become a mindfulness facilitator. Additionally, sessions can be done outside of a medical setting, such as at a school or community center.”

Anxiety disorders can be highly distressing; they include generalized anxiety, social anxiety, panic disorder, and fear of certain places or situations, including crowds and public transportation. All of these can lead to an increased risk for suicide, disability, and distress and therefore are commonly treated in psychiatric clinics.

Drugs that are currently prescribed for the disorders can be very effective, but many patients either have difficulty getting them, do not respond to them, or find the side effects (e.g., nausea, sexual dysfunction, and drowsiness) as a barrier to consistent treatment.

Developed at the University of Massachusetts Medical Center in the 1970s, mindfulness-based stress reduction (MBSR) is an eight-week evidence-based program that offers secular, intensive mindfulness training to assist people with stress, anxiety, depression and pain.

Standardized mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), can reduce anxiety. However, prior to this study, the interventions had not been studied in comparison to effective anti-anxiety drugs. Of note, approximately 15% of the U.S. population tried some form of meditation in 2017.

The clinicians recruited 276 patients between June 2018 and February 2020 from three hospitals in Boston, New York City, and Washington, D.C., and randomly assigned people to either mindfulness-based stress reduction or the antidepressant drug escitalopram. MBSR was offered weekly for eight weeks via two-and-a-half-hour in-person classes, a day-long retreat weekend class during the 5th or 6th week, and 45-minute daily home practice exercises. Patients’ anxiety symptoms were assessed upon enrollment and again at the completion of the intervention at 8 weeks, along with post-treatment assessments at 12 and 24 weeks after enrollment. The assessments were conducted in a blinded manner – the trained clinical evaluators did not know whether the patients they were assessing received the drug or MBSR.

At the end of the trial, 102 patients had completed MBSR and 106 had completed their medication course. The patients were relatively young, with a mean age of 33, and included 156 women, which comprised 75% of the enrollees, mirroring the disease prevalence in the U.S.

The researchers used a validated assessment measure to rate the severity of symptoms of anxiety across all of the disorders using a scale of 1 to 7 (with 7 being severe anxiety). Both groups saw a reduction in their anxiety symptoms (a 1.35 point mean reduction for MBSR and 1.43 point mean reduction for the drug, which was a statistically equivalent outcome), dropping from a mean of about 4.5 for both, which translates to a significant 30% or so drop in the severity of peoples’ anxiety.

Olga Cannistraro, 52, says she utilizes her MBSR techniques as needed, but more than a decade ago, the practice transformed her life. She was selected for an MBSR study after responding to an advertisement asking, “Do you worry?”

“I didn’t think of myself as anxious – I just thought my life was stressful because I had taken on too much,” she recalls. “But I thought ‘yeah, I do worry.’ There was something excessive about the way I responded to my environment.”

After participating in an earlier study led by Hoge, she learned two key MBSR techniques. “It gave me the tools to spy on myself. Once you have awareness of an anxious reaction, then you can make a choice for how to deal with it. It’s not like a magic cure, but it was a life-long kind of training. Instead of my anxiety progressing, it went in the other direction and I’m very grateful for that.”

“It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect,” Hoge said. “Also, virtual delivery via videoconference is likely to be effective, so long as the ‘live’ components are retained, such as question-and-answer periods and group discussion.”

Hoge points out that there are many phone apps that offer guided meditation, however, researchers don’t know how apps compare with the full in-person, weekly group class experience.

Trial enrollment was wrapping up as the COVID pandemic started in early 2020 but most enrollees completed their eight-week course of treatment before the pandemic started. Additionally, the researchers conducted a second phase of the study during the pandemic that involved moving the treatments to an online, videoconference, and that will be the focus of future analyses. The researchers also hope to explore the effects of MBSR on sleep and depression.

Reference: “Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial” by Elizabeth A. Hoge, MD; Eric Bui, MD, PhD; Mihriye Mete, PhD; Mary Ann Dutton, PhD; Amanda W. Baker, PhD and Naomi M. Simon, MD, MSc, 9 November 2022, JAMA Psychiatry.
DOI: 10.1001/jamapsychiatry.2022.3679

In addition to Hoge, the other author from Georgetown is Mary Ann Dutton. Eric Bui is from the University of Caen Normandy and Caen University Hospital, Caen, France. Mihriye Mete is from Medstar Health Research Institute, Hyattsville, MD. Amanda W. Baker is from Massachusetts General Hospital / Harvard Medical School, Boston. Naomi M. Simon is from the University Grossman School of Medicine, New York NY.

This research was supported by the Patient-Centered Outcomes Research Institute (PCORI; CER-2017C1–6522). PCORI had no role in study design, data collection, data analysis, data interpretation, or writing of the report.



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Common Medication Found Effective at Reducing Odds of Serious Outcomes for COVID-19 Patients

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Researchers have found that metformin, a commonly prescribed diabetes medication, lowers the odds of emergency department visits, hospitalizations, or death due to COVID-19 by over 40 percent; and over 50 percent if prescribed early in onset of symptoms.

Trial compared the effect of ivermectin, fluvoxamine, and metformin in randomized double-blinded placebo- controlled trial.

Scientists have found that metformin, a commonly prescribed diabetes medication, lowers the odds of emergency department visits, hospitalizations, or death due to

“We are pleased to contribute to the body of knowledge around COVID-19 therapies in general, with treatments that are widely available,” said Carolyn Bramante, MD, principal investigator of the study. Bramante is an assistant professor of internal medicine and pediatrics at the U of M Medical School. “Our trial suggests that metformin may reduce the likelihood of needing to go to the emergency room or be hospitalized for COVID-19.”

Bramante noted that this was a secondary outcome of the trial. The primary outcome included whether someone had low oxygen on a home oxygen monitor. None of the medications in the trial prevented the primary outcome.

The COVID-OUT trial was the nation’s first to study whether metformin, a medication for type 2 diabetes; low-dose fluvoxamine, an antidepressant; and ivermectin, an antiparasitic, or their combinations could serve as possible treatments to prevent emergency department visits or hospitalization, as well as Long-COVID.


Dr. Carolyn Bramante from the University of Minnesota answers questions about COVID OUT. Credit: University of Minnesota Medical School

The study design was simple and straightforward. Patients were randomly assigned to receive one of the three drugs individually, placebo, or a combination of metformin and fluvoxamine or metformin and ivermectin. Even though the study was placebo-controlled with exact-matching placebo pills, Dr. Bramante says 83% of volunteers received medications supported by existing data because of the six-arm design. Each volunteer received 2 types of pills to keep their treatment assignment hidden, for 3 to 14 days of treatment. Each participant tracked their symptoms, and after 14 days, they completed a survey.

The 1,323 participants in the trial were limited to adults with a body mass index (BMI) greater than or equal to 25 kg/m2, which qualifies as overweight – for instance, someone who was at least five feet and six inches tall and weighed more than 155 pounds. To qualify for the study, participants voluntarily enrolled within three days after receiving a positive COVID-19 test. It was among the first randomized clinical trials for COVID-19 to include pregnant women.

The study included both those who were vaccinated against COVID-19 and those who were not. This is the first published trial where the majority of participants were vaccinated.

The clinical trial launched in January 2021 after U of M Medical School scientists identified, through computer modeling and observational studies, that outpatient metformin use appeared to decrease the likelihood of mortality from, or being hospitalized for, COVID-19. Their research, in partnership with UnitedHealth Group, was published in the Journal of Medical Virology and in The Lancet Healthy Longevity. Test-tube studies also found that metformin inhibited the Covid-19 virus in lab settings. These findings, along with additional prospective studies supporting the use of higher-dose fluvoxamine and ivermectin, provided the evidence to include all three medications as well as combination arms.

“Observational studies and in vitro experiments cannot be conclusive but do contribute to bodies of evidence,” said Bramante, who is also an internist and pediatrician with M Health Fairview. “To complete this study, we enrolled volunteers nationwide through six institutions in the U.S., including in Minneapolis.”

Reference: “Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19” by Carolyn T. Bramante, M.D., M.P.H., Jared D. Huling, Ph.D., Christopher J. Tignanelli, M.D., John B. Buse, M.D., Ph.D., David M. Liebovitz, M.D., Jacinda M. Nicklas, M.D., M.P.H., Kenneth Cohen, M.D., Michael A. Puskarich, M.D., Hrishikesh K. Belani, M.D., M.P.H., Jennifer L. Proper, B.S., Lianne K. Siegel, Ph.D., Nichole R. Klatt, Ph.D., David J. Odde, Ph.D., Darlette G. Luke, Pharm.D., Blake Anderson, M.D., Amy B. Karger, M.D., Ph.D., Nicholas E. Ingraham, M.D., Katrina M. Hartman, B.A., Via Rao, M.S., Aubrey A. Hagen, B.A., Barkha Patel, M.S., Sarah L. Fenno, M.P.H., Nandini Avula, B.S., Neha V. Reddy, B.S., Spencer M. Erickson, B.A., Sarah Lindberg, M.P.H., Regina Fricton, B.A., Samuel Lee, B.S., Adnin Zaman, M.D., Hanna G. Saveraid, Walker J. Tordsen, B.A., Matthew F. Pullen, M.D., Michelle Biros, M.D., Nancy E. Sherwood, Ph.D., Jennifer L. Thompson, M.D., David R. Boulware, M.D., M.P.H., and Thomas A. Murray, Ph.D. for the COVID-OUT Trial Team, 18 August 2022, New England Journal of Medicine.
DOI: 10.1056/NEJMoa2201662

Participating clinical trial sites included M Health Fairview and Hennepin Healthcare in Minneapolis,

The trial received monetary support from the Parsemus Foundation, Rainwater Charitable Foundation, Fast Grants, and UnitedHealth Group.

In addition, this research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, grants UL1TR002494 and KL2TR002492, and the National Institute of Digestive, Diabetes, and Kidney diseases K23 DK124654. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences.



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‘Masked’ cancer drug stealthily trains immune system to kill tumors while sparing healthy tissues, reducing treatment side effects

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Many cancer treatments are notoriously savage on the body. Drugs often attack both healthy cells and tumor cells, causing a plethora of side effects. Immunotherapies that help the immune system recognize and attack cancer cells are no different. Though they have prolonged the lives of countless patients, they work in only a subset of patients. One study found that fewer than 30% of breast cancer patients respond to one of the most common forms of immunotherapy.

But what if drugs could be engineered to attack only tumor cells and spare the rest of the body? To that end, my colleagues and I at the University of Chicago’s Pritzker School of Molecular Engineering have designed a method to keep one promising cancer drug from wreaking havoc by “masking” it until it reaches a tumor.

The promise of IL-12

Cytokines are proteins that can modulate how the immune system responds to threats. One way they do this is by activating killer T cells, a type of white blood cells that can attack cancer cells. Because cytokines can train the immune system to kill tumors, this makes them very promising as cancer treatments.

One such cytokine is interleukin-12, or IL-12. Though it was discovered more than 30 years ago, IL-12 still isn’t an FDA-approved therapy for cancer patients because of its severe side effects, such as liver damage. This is in part because IL-12 instructs immune cells to produce a large amount of inflammatory molecules that can damage the body.

Scientists have since been working to reengineer IL-12 to be more tolerable while retaining its powerful cancer-killing effects.

Masking the killer

To create a safer version of IL-12, my colleagues and I took advantage of one of the main differences between healthy and cancerous tissue: an excess of growth-promoting enzymes in cancers. Because cancer cells proliferate very rapidly, they overproduce certain enzymes that help them invade the nearby healthy tissue and metastasize to other parts of the body. Healthy cells grow at a much slower pace and produce fewer of these enzymes.

With this in mind, we “masked” IL-12 with a cap that covers the part of the molecule that normally binds to immune cells to activate them. The cap is removed only when it comes into contact with enzymes found in the vicinity of tumors. When these enzymes chop off the cap, IL-12 is reactivated and spurs nearby killer T cells to attack the tumor.

When we applied these masked IL-12 molecules to both healthy and tumor tissue donated by melanoma and breast cancer patients, our results confirmed that only the tumor samples were able to remove the cap. This indicated that masked IL-12 could potentially drive a strong immune response against tumors without causing damage to healthy organs.

We then examined how safe masked IL-12 is by measuring liver damage biomarkers in mice. We found that immune-related side effects typically associated with IL-12 were notably absent in mice treated with masked IL-12 over a period of several weeks, indicating improved safety.

In breast cancer models, our masked IL-12 resulted in a 90% cure rate, while treatment with a commonly used immunotherapy called a checkpoint inhibitor resulted in only a 10% cure rate. In a model of colon cancer, masked IL-12 showed a 100% cure rate.

Our next step is to test the modified IL-12 in cancer patients. While it will take time to bring this encouraging development directly to patients, we believe a promising new treatment is on the horizon.

This article is republished from The Conversation, a nonprofit news site dedicated to sharing ideas from academic experts. It was written by: Aslan Mansurov, University of Chicago Pritzker School of Molecular Engineering.

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Aslan Mansurov consults to and owns shares in Arrow Immune Inc, which is developing the technology presented in the article.

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Asthma Drug Montelukast (Singulair) Can Block Crucial COVID Protein, Reducing Viral Replication

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Targeting Nsp1 with montelukast (Singulair) helps prevent shutdown of host protein synthesis. Credit: Mohammad Afsar

An oral medication used to treat asthma and allergies can bind to and block a crucial protein produced by the

Montelukast is a drug used in the maintenance treatment of asthma that is marketed under the trade name Singulair and others. In general, it is less favored for this application than inhaled corticosteroids. It is ineffective in treating acute asthma attacks. Other applications include allergic rhinitis and long-lasting hives. It is a second-line therapy for allergic rhinitis.

“The mutation rate in this protein, especially the C-terminal region, is very low compared to the rest of the viral proteins,” explains Tanweer Hussain, Assistant Professor in the Department of Molecular Reproduction, Development and Genetics (MRDG), IISc, and senior author of the study. Since Nsp1 is likely to remain largely unchanged in any variants of the virus that emerge, drugs targeting this region are expected to work against all such variants, he adds.

Hussain and his team first used computational modeling to screen more than 1,600 FDA-approved drugs in order to find the ones that bound strongly to Nsp1. From these, they were able to shortlist a dozen drugs including montelukast and saquinavir, an anti-HIV drug. “The molecular dynamic simulations generate a lot of data, in the range of terabytes, and help to figure out the stability of the drug-bound protein molecule. To analyze these and identify which drugs may work inside the cell was a challenge,” says Mohammad Afsar, former Project Scientist at MRDG, currently a postdoc at the University of Texas at Austin, and first author of the study.

Working with the group of Sandeep Eswarappa, Associate Professor in the Department of Biochemistry, Hussain’s team then cultured human cells in the lab that specifically produced Nsp1, treated them with montelukast and saquinavir separately, and found that only montelukast was able to rescue the inhibition of protein synthesis by Nsp1.

“There are two aspects [to consider]: one is affinity and the other is stability,” explains Afsar. This means that the drug needs to not only bind to the viral protein strongly, but also stay bound for a sufficiently long time to prevent the protein from affecting the host cell, he adds. “The anti-HIV drug (saquinavir) showed good affinity, but not good stability.” Montelukast, on the other hand, was found to bind strongly and stably to Nsp1, allowing the host cells to resume normal protein synthesis.

Hussain’s lab then tested the effect of the drug on live viruses, in the Bio-Safety Level 3 (BSL-3) facility at the Centre for Infectious Disease Research (CIDR), IISc, in collaboration with Shashank Tripathi, Assistant Professor at CIDR, and his team. They found that the drug was able to reduce viral numbers in infected cells in the culture.

“Clinicians have tried using the drug … and there are reports that said that montelukast reduced hospitalization in

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Business

changing how cattle graze, reducing emissions

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Understanding Ag teaching farmers about regenerative grazing.

Photo courtesy Understanding Ag.

When Gabe Brown first got into regenerative agriculture more than 25 years ago, he wasn’t trying to solve climate change.

“I was just trying to keep the banker at bay and feed my family,” Brown told CNBC.

Brown grew up in Bismarck, N.D., and went to college to be an agriculture professor. Then he married his high school sweetheart, whose family had a farm. The young couple moved home to help on the farm, which used conventional farming practices for the time. After eight years, Brown bought a section of the farm from his in-laws.

From 1995 through 1998, Brown’s farm in North Dakota faced recurrent natural disasters: Three years of hail and a year of drought. Brown needed to figure out how to make his land profitable. Also, he didn’t have money to spend on fertilizer and chemicals.

“It took me on a learning path. And I really became a student of nature and of ecosystems and how to natural ecosystems function,” Brown told CNBC.

Today, Brown runs his 6,000-acre ranch near Bismarck with regenerative practices and helps run a consulting company, Understanding Ag, which consults with farmers managing 32 million acres across North America.

Gabe Brown came to regenerative agriculture as a way to save his farm two and a half decades ago.

Photo courtesy Gabe Brown

While Brown didn’t set out to combat climate change, regenerative cattle grazing is a way of sequestering carbon dioxide, a critical component of limiting global warming. Cattle who graze on the land eat plants that have absorbed carbon dioxide from the air. After grazing, the cows don’t graze the land for a long time, giving the roots a chance to grow another layer of leaves, capturing more carbon.

Dan Probert, a rancher in Oregon and the marketing director for ranching collective Country Natural Beef, explains that regenerative cattle ranching involves herding cattle from one paddock to another on a regular, almost daily basis. The cattle eat the grass in the pasture where they are grazing, cutting it down low, then move on. Each paddock they cut down has a significant portion of time to rest and restore so it can grow back.

“Those cattle are bunched, they’re kept pretty densely herded, and then they’re moved sometimes twice in one day. And then that land is left to rest and recover for a full year before the animals are back,” Probert told CNBC.

This process sequesters more carbon than feeding cows from typical monocultural crops like corn because those crops are annual and grow fairly slowly, and don’t perform photosynthesis when they’re lying fallow.

Dan Probert monitoring the soil on his farm in Oregon.

Photo courtesy Dan Probert

The amount of carbon sequestered with regenerative grazing practices varies significantly, depending on how well a farmer is grazing the cattle and how diverse the plant species are in the land being grazed. But the range is from between 2.5 and 7.5 metric tons of carbon per acre per year, according to Understanding Ag founding partner Allen Williams.

By comparison, southern pine forests, which have gotten some attention as a carbon sink, will sequester 1.4 to two tons of carbon per acre per year.

The collective Probert works for, Country Natural Beef, is working with non-profit Sustainable Northwest and a grant from the M.J. Murdock Charitable Trust to quantify the carbon impact of regenerative ranching more precisely by taking soil samples now and comparing the carbon content with samples that will be taken in three to five years.

A philosophy of land management, not a prescription

Regenerative agriculture is a philosophy about farming and raising cattle more than a specific prescription, explains Bobby Gill from the Savory Institute, a non-profit in the space. The practice is based on the work of Allan Savory, a leader in the field who started his work in the 1960’s in Zimbabwe.

“He’s been banging on this drum, developing these methods for decades now. And often times, he was the lone individual out there banging on this drum,” Gill told CNBC.

Savory’s revolutionary message was that farmers needed to prioritize soil health and graze livestock in ways that mimic natural patterns.

The group does not emphasize the environmental aspects raising of cattle, which activists have frequently criticized.

“Someone who’s a fifth-generation farmer…it sucks to be called a flyover state or to have people pointing the finger at them saying, ‘Climate change is because of you: it’s your fault’,” Gill said. “It’s important to engage in these conversations with empathy and understanding.”

Instead, Savory Institute talks to farmers about regenerative agriculture as a way to run a profitable farm, provide for their family, and be proud of their land.

Savory is no longer seen as a kook. The Savory Institute launched in 2009 and currently has 54 centers around the world which have trained 14,000 people and influenced the management of over 42 million acres of land.

When Will Harris got into regenerative farming in Georgia, he was not trying to solve climate change either. He didn’t even know the climate was changing.

Harris is in the fourth generation of his family to manage his 2,300-acre Georgia farm, White Oak Pastures, and has some perspective on the recent history of agriculture.

The White Oak Pastures Board of Directors: Front Row, Left to Right: Jean Turn, Jodi Benoit, Will Harris, Jenni Harris, Amber Harris. Back Row, Left to Right: John Benoit, Brian Sapp.

White Oak Pastures

In the years after World War II, farming became highly industrialized, Harris told CNBC.

“Europe was starving. There was a tremendous demand for cheap, abundant, safe food,” Harris said. “The industrialization, commoditization, centralization, really did that … it made food obscenely cheap and wastefully abundant, and very boring, very, very consistent.”

Factory farming brought monoculture farming, where only one product is grown on a piece of land. It also brought the use of chemical fertilizers, tillage, pesticides, hormone implants in animals, sub-therapeutic antibiotics in animals, and large equipment.

Harris didn’t like any of that. Financially, he was doing just fine, he said, but he did not like the practices that had become standard in the industry.

White Oak Pastures, which is farmed with regenerative agriculture practices, is on the left. The land on the right is farmed with conventional, industrial practices.

“I had just become disenchanted with the excesses of that farming system. I just started moving away from it. I did this simply by ceasing to use the technological ‘products’ that I didn’t like, and doing the things that I didn’t like to do. I was not intentionally moving my farm towards anything. I was just moving away from whatever was displeasing to me.”

The change wasn’t free. It takes Harris two years to raise an 1,100-pound cow, where with industrial practices, a farmer can grow a 1,400-pound animal in 18 months, Harris said. But the quality of his meat is better, and he can charge more to discerning customers.

His margins have shrunk as international farmers get in on the “grass-fed” game and slide in to markets as “American” by doing even one small step of the production process in the U.S., Harris said, but the value of his land is not accounted for in the price of a steak.

“You don’t measure the degradation of that non-depreciating asset on your balance sheet,” Harris said.

“As a practitioner of 25 years of regenerative land management, I can tell you with authority that you can not regenerate degraded, desertified land without animal impact.”

In addition, his two daughters and their spouses have come back to the farm, a stark contrast with many other farming families whose children leave for other professions.

“I can pretty well assure you, if I had kept farming industrially, my daughters would not have chosen to come back.”

Good for business

Although it might take longer to bring cows to maturity using regenerative ranching, the practice can help ranchers use land more efficiently.

“My ranch maybe five years ago ran 1,000 head and now we’re running 1,200 head on the same land base,” Probert told CNBC.

There aren’t many up-front costs to shift a farm to a regenerative grazing paradigm, other than the education, which Williams notes, is tax-deductible for farmers.  

But farmers tend not to know that.

“They have a false perception that this is going to be costly and that they’re going to take a big financial hit in the first few years. But that is totally not true,” Williams said. Once farmers start to implement regenerative grazing, they don’t need to buy synthetic fertilizers, herbicides, fungicides and insecticides, so their input costs drop, Williams said.

Educating other farmers about the benefits of regenerative grazing and agriculture has become a business on its own.

Williams, a sixth-generation family farmer with farms in both Mississippi and Alabama, spent 15 years in academia teaching at both both Louisiana Tech University and Mississippi State University before he pivoted to teaching the practices of regenerative grazing and agriculture to farmers in the field — literally.

Allen Williams (left), a sixth generation family farmer and founding partner of Understanding Ag, teaching another farmer about regenerative grazing.

“You cannot implement what you do not know. So somebody has to be there to teach you and train you,” Williams told CNBC.

Spreading the world about regenerative grazing means putting a spotlight on yourself, a place that makes some farmers uncomfortable, Probert said.

Probert takes the lead for the farming collective he is part of because he knows it’s critical for the survival of his industry.

“We can’t live out here on an island. We are 100 ranches on six and a half million acres. And we depend heavily on Portland and San Francisco and Seattle and Los Angeles to market our products,” Probert said.

“So we we just continually work to bridge this urban-rural divide. And we know we can’t hide out here. We’ve got to find a way to tell our story and make people feel good about the food they eat.”

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Health

IBS: Choosing low FODMAP foods and reducing stress will deter weight gain

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Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhoea or constipation, or both. IBS is a chronic condition that you’ll need to manage long term but how does the condition affect weight?

Irritable bowel syndrome doesn’t cause a significant change in appetite.

However, the condition may make some people feel less hungry because of unpleasant gastrointestinal symptoms such as gas, bloating, and abdominal pain after eating.

For others, IBS can increase food cravings due to stress and anxiety that interfere with normal GI functioning and digestive health.

Weight gain doesn’t directly result from IBS, but it may be associated with stress related to the condition.

Stress triggers inflammatory responses throughout the body, including in the gut.

Inflammation can affect your body’s ability to digest food properly, which can lead to uncomfortable digestive symptoms like gas, bloating, cramping, abdominal pain, constipation or diarrhoea.

How to manage condition

Diets high in fruits and vegetables can support weight loss.

Choosing foods which are low in FODMAPs is key.

FODMAP is a type of carb that may trigger IBS symptoms with examples including carrots, broccoli, blueberries, and bananas.

Finding ways to help reduce your stress levels is also key for managing both IBS and weight gain.

This can include more exercise, reducing your caffeine intake and practicing calming practices such as meditation.



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Technology

Halo Infinite Developer 343 Industries Is ‘Focused on Reducing Pricing’ for In-Game Items

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343 Industries has confirmed that it is gearing up to make some changes to Halo Infinite’s in-game store, including reducing prices, improving bundles, putting individual items outside of certain bundles, and much more.

343’s Head of Design Jerry Hook shared the news on Twitter, saying that the team is going to begin implementing these changes on Tuesday, January 18, and they will continue to monitor and try new things throughout the remainder of Halo Infinite mutliplayer’s first season.

“We’ve been monitoring the discussions on the Shop, bundles, and pricing closely since launch,” Hook wrote. “Using data and community feedback, we’re going to begin rolling out changes to how we package and price items in @Halo Infinite – and it all starts next week.

“Starting Tuesday, the Shop experience will vary week-to-week. We are focused on reducing pricing across the board, providing stronger values in our bundles, starting to put individual items outside of bundles, and more.

“We will be trying new things throughout the rest of the season so that we can continue to learn and improve for the future. Please keep the feedback coming during this process and I hope to see you all next week for the Cyber Showdown event!”

While Hook didn’t go into further detail as to how much these prices will be reduced and what other types of changes we can expect, we won’t have long to wait to see some of them put into action.

This is another example of 343 Industries communicating with the Halo Infinite community and committing to improvements, much like it did – and is still doing – for the Battle Pass, multiplayer progression, and lack of a dedicated Slayer playlist.

Halo Infinite’s shop isn’t the only focus of next week, as 343 has also promised that a fix for the Big Team Battle matchmaking bug is on the way that will hopefully solve the many issues players have been running into.

Have a tip for us? Want to discuss a possible story? Please send an email to newstips@ign.com.

Adam Bankhurst is a news writer for IGN. You can follow him on Twitter @AdamBankhurst and on Twitch.



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US

Fauci says reducing the recommended Covid isolation period for the fully vaccinated is being considered

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Fauci’s comments were the strongest yet from the nation’s top infectious disease expert in favor of revisiting the CDC’s isolation guidance, which recommends 10 full days for people who have the virus, even if asymptomatic.
Fauci told CNN that “no decisions” have been made yet, but that a discussion is underway about allowing infected health care workers who are asymptomatic to return to work sooner, as new Covid cases and hospitalizations rise and are expected to put a strain on the health care system.

“For example, if you get a health care worker who is infected and without any symptoms at all, you don’t want to keep that person out of work too very long because, particularly if we get a run on hospital beds and the need for health care personnel, that’s something that at least will be considered, at least considered,” Fauci told CNN’s John Berman on “New Day.”

Fauci said it may be possible for heath care workers who test positive to end their isolation period sooner and get back to work if they don’t have symptoms and wear N-95 masks and other personal protective equipment.

The Omicron Covid-19 variant is now the most dominant strain in the United States, accounting for over 73% of new coronavirus cases last week. While they believe the Omicron variant to be more contagious, scientists are still waiting on data on the severity of the variant in the US compared with others, but so far, most Omicron cases appear to be mild among those fully vaccinated.

Fauci also said Tuesday that Americans who are fully vaccinated and boosted against Covid-19 should feel comfortable traveling for the holidays and gathering with family who are also fully vaccinated and boosted — so long as they’re careful.

“You want to be prudent and always be extra special careful, because you’re dealing with an unprecedented situation of a virus that has an extraordinary capability of transmitting,” he told CNN, adding, “When you’re in the home with vaccinated and boosted people, you can feel comfortable enjoying the holiday celebration.”

He stressed that vaccination is the “main frontline of protection” against Covid-19.

“Testing is important, as is masking. But the real important thing that people need to do is get vaccinated. If you are vaccinated fully, to get boosted,” he told CNN.

The CDC’s interim clinical considerations define “fully vaccinated” as having completed two doses of either the Pfizer/BioNTech or Moderna coronavirus vaccines, or a single dose of the Johnson & Johnson vaccine. Fauci had previously said the CDC might consider redefining what it means to be “fully vaccinated” against Covid-19 to include a third dose of vaccine.

Asked Tuesday how often Americans should be tested now that cases are again on the rise, Fauci said it depends on the situation. He suggested that fully vaccinated Americans who received their booster may want to get tested if they wish to “go the extra mile.”

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Health

A Simple Guide To Reducing Your Holiday COVID Risk

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COVID-19 has a knack for rebounding just as life starts to reopen a bit more in New York City.

This fall, many businesses began hybrid operations — with a mix of office time and work-from-home schedules. International travelers are flooding back into the boroughs — a potential boon for the hard-hit hospitality industry. And holiday travel has almost rebounded to pre-pandemic levels.

But a coronavirus surge has also snuck up on New York City like a panther. The daily case rate is averaging around 1,300 infections and looks on course to end November twice as high as where it began. That would put infections near this summer’s high mark — when the delta variant took over.

Hospitalizations remain low in the city for now, but these severe cases are rising swiftly upstate. Those places are also less vaccinated than New York City, but one in four people still haven’t taken their shots in the five boroughs. That said, most holiday revelers are currently in a safer position now relative to a year ago when vaccines weren’t available.

But for any concerned parties, COVID-19 safety is all about layering on different types of protection. Vaccines drop risk the most. Testing can help screen out possible carriers. When that fails, mask-wearing indoors and good ventilation can reduce airborne spread.

To gauge how many precautions to take, the first step is thinking about how many people at your gathering would struggle the most if they caught the coronavirus. Next, a party host will want to consider how to limit those risks through a mixture of testing, mask use and ventilation.

No plan will be foolproof, and all gatherings will come with a certain amount of COVID risk whenever case rates rise. As of Tuesday, every county except one in New York, New Jersey and Connecticut is reporting a high level of community transmission. Keeping a few tips in mind can help minimize the danger.

The journey back to normal is naturally going to come with more risks than just staying home. From a public health perspective, people will hopefully try to do the right thing to limit coronavirus spread, while also striking a balance with the decisions that feel right for them.

Start by figuring out how many people are unvaccinated. Real-world estimates, collected this fall by the Centers for Disease Control and Prevention, showed unvaccinated persons to be nearly six times as likely to catch the virus and 14 times as likely to die from it. This trend held steady across all age groups eligible for the vaccines at the time, which means everyone older than 12. All of the country’s authorized and approved vaccines — Pfizer, Moderna and Johnson and Johnson — show this effect.

This year in New York City, the unvaccinated have experienced a rate of 266 cases per 100,000 people. Compare that against 40 cases per every 100,000 who are fully vaccinated. Look at hospitalizations, and it’s 21 for every 100,000 unvaccinated versus 2 among the same amount of inoculated people.

People who recovered naturally from an infection but haven’t been vaccinated should also think of themselves as carrying a greater risk for a bad outcome. Some debate exists over whether this so-called “natural immunity” offers the same protection against a future infection as vaccination, but differences start to emerge when you consider when a recovered person first caught the virus. If you became sick during the first or second waves in 2020, you’re now less protected against the delta variant that rose to prominence this year, according to multiple studies. And when it comes to hospitalization, Americans relying on natural immunity were five times as likely to experience a COVID hospitalization relative to vaccinated people.

The COVID-19 vaccines are also the easiest and most effective way to prevent transmission of the coronavirus. Before the delta variant arrived, inoculation reduced the chances of catching the virus by 90%. Even with the variant, the vaccines still reduce the chances of infection by 67%. Get a booster shot, and the odds return to the 90% range.

Fully vaccinated people are also less likely to spread the coronavirus in the rare cases where they experience a breakthrough infection. A recent U.S. study showed the noses of unvaccinated people excreted the virus for up to nine total days, while for fully vaccinated people, it was only four days. And infections are currently rising fastest among unvaccinated New Yorkers — with case rates about ten times higher among those without shots.

If your gathering intends to mix a lot of unvaccinated people with a bunch of high-risk folks, then you might want to reconsider.

Next, you will want to think about how many people would be considered high-risk for severe COVID-19, regardless of their vaccination status.

Even if you factor in the waning immunity, which slowly happens over months, the vaccines still reduce the chances of hospitalization by around 90% or more.

But look deeper, and one will find the waning effect is most prominent and most dangerous for vulnerable people. COVID hospitalization is most common among senior citizens, followed by those in their 50s, then those in their 40s and so on. Other at-risk groups include immunocompromised people and those with certain underlying conditions. (The city’s department of health has a nice review sheet at the bottom of this webpage.)

“These are the people who are most likely to have a severe complication from COVID, even if they’re vaccinated,” Dr. Céline Gounder, an infectious disease specialist and epidemiologist at New York University and Bellevue Hospital, told Science Friday last week. “They are at higher risk for a breakthrough infection that can progress on to severe COVID.”

It’s obviously too late to get your first course of vaccines or be boosted in time for Thanksgiving. At the quickest, it takes 21 days to receive two shots of Pfizer or Moderna vaccines, then your immune system needs to incubate for two weeks to be fully vaccinated. Children ages 5-11 will still be in this limbo when the turkey arrives, given eligibility for the Pfizer vaccine didn’t open for them until November 2nd. And booster shots, likewise, need 14 days to take full effect.

So if you’re worried about a contagious person showing up for dinner, then your guests will want to take a COVID-19 antigen test the day before and the day of your gathering.

“The day that a person is contagious, that day those antigen tests are positive,” Dr. Daniel Griffin, an infectious disease specialist at Columbia University, told The Brian Lehrer Show on Friday.

An antigen test detects protein pieces of the virus being pumped out by a well-embedded infection in your nose and throat. Griffin said these antigen tests are very accurate during the period of time when a person is able to spread the virus to others. So that’s either two days before symptoms like runny nose and sore throat appear or about seven to 10 days afterward, when you are still not fully recovered, he said.

“That’s when those antigen tests are 98% or, or better at picking it up,” Griffin added.

Or if you’re trying to exclude anyone carrying the coronavirus from entering your gathering, you can go with the more classic PCR test. Because it detects genetic material, a PCR test can detect lower traces of the virus and is 30 to 40% more sensitive than an antigen. This extra sensitivity means PCR tests are better at identifying people who are not yet contagious.

Both antigen and PCR tests can be done in 15 minutes, depending on which clinic you visit or which at-home test you take. In September, health reporter Caroline Lewis wrote a helpful guide for finding these tests in New York City and what you might pay. Note: Watch out for hidden fees at some for-profit clinics.

When discussing children, health experts, including New York City Health Commissioner Dr. Dave Chokshi, often say the best mask is the one they can wear consistently and comfortably.

In truth, this rule applies to all ages because masks stymie airborne transmission from anyone who might be positive. During the holidays, this exposure will be the riskiest among crowded places with strangers — such as airports — where you cannot adequately practice social distancing.

So, when picking a mask, focus on two things: the filtration and the fit.

Loosely-fitting cloth and surgical masks will only knock out about 50% of airborne particles, according to multiple studies. But tighten the ear loops on a surgical mask or layer one under a cloth mask, and the filtration jumps up to 70-90%

As their names suggest, N95 masks and their KN95 equivalents from China block 95% of the smallest airborne particles — but again, that only applies if they fit well. People should also watch out for fakes. The CDC says 60% of KN95 masks are counterfeit in the U.S., and it offers a guide for finding legit makers.

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