Scientists create a labor-saving automated method for studying electronic health records

Mount Sinai study suggests new method is as effective as manually-based “gold-standard” at classifying a diagnosis

Peer-Reviewed Publication

THE MOUNT SINAI HOSPITAL / MOUNT SINAI SCHOOL OF MEDICINE

 

IMAGE: MOUNT SINAI SCIENTISTS CREATED AN AI-BASED, AUTOMATED SYSTEM THAT LEARNS TO READ PATIENT DATA FROM ELECTRONIC HEALTH RECORDS. HERE THE SYSTEM IDENTIFIED DEMENTIA CASES (PURPLE DOTS) FROM A DATABASE OF NEARLY 2 MILLION PATIENTS (BLUE DOTS). view more 

CREDIT: COURTESY OF THE GLICKSBERG LAB, MOUNT SINAI, N.Y., N.Y.

In an article published in the journal Patterns, scientists at the Icahn School of Medicine at Mount Sinai described the creation of a new, automated, artificial intelligence-based algorithm that can learn to read patient data from electronic health records. In a side-by-side comparison, they showed that their method, called Phe2vec (FEE-to-vek), accurately identified patients with certain diseases as well as the traditional, “gold-standard” method, which requires much more manual labor to develop and perform.

“There continues to be an explosion in the amount and types of data electronically stored in a patient’s medical record. Disentangling this complex web of data can be highly burdensome, thus slowing advancements in clinical research,” said Benjamin S. Glicksberg, PhD, Assistant Professor of Genetics and Genomic Sciences, a member of the Hasso Plattner Institute for Digital Health at Mount Sinai (HPIMS), and a senior author of the study. “In this study, we created a new method for mining data from electronic health records with machine learning that is faster and less labor intensive than the industry standard. We hope that this will be a valuable tool that will facilitate further, and less biased, research in clinical informatics.”

The study was led by Jessica K. De Freitas, a graduate student in Dr. Glicksberg lab.

Currently, scientists rely on a set of established computer programs, or algorithms, to mine medical records for new information. The development and storage of these algorithms is managed by a system called the Phenotype Knowledgebase (PheKB). Although the system is highly effective at correctly identifying a patient diagnosis, the process of developing an algorithm can be very time-consuming and inflexible. To study a disease, researchers first have to comb through reams of medical records looking for pieces of data, such as certain lab tests or prescriptions, which are uniquely associated with the disease. They then program the algorithm that guides the computer to search for patients who have those disease-specific pieces of data, which constitute a “phenotype”. In turn, the list of patients identified by the computer needs to be manually double-checked by researchers. Each time researchers want to study a new disease, they have to restart the process from scratch.

In this study, the researchers tried a different approach—one in which the computer learns, on its own, how to spot disease phenotypes and thus save researchers time and effort. This new, Phe2vec method was based on studies the team had already conducted.

“Previously, we showed that unsupervised machine learning could be a highly efficient and effective strategy for mining electronic health records,” said Riccardo Miotto, PhD, a former Assistant Professor at the HPIMS and a senior author of the study. “The potential advantage of our approach is that it learns representations of diseases from the data itself. Therefore, the machine does much of the work experts would normally do to define the combination of data elements from health records that best describes a particular disease.”

Essentially, a computer was programmed to scour through millions of electronic health records and learn how to find connections between data and diseases. This programming relied on “embedding” algorithms that had been previously developed by other researchers, such as linguists, to study word networks in various languages. One of the algorithms, called word2vec, was particularly effective. Then, the computer was programmed to use what it learned to identify the diagnoses of nearly 2 million patients whose data was stored in the Mount Sinai Health System.

Finally, the researchers compared the effectiveness between the new and the old systems. For nine out of ten diseases tested, they found that the new Phe2vec system was as effective as, or performed slightly better than, the gold standard phenotyping process at correctly identifying a diagnoses from electronic health records. A few examples of the diseases included dementia, multiple sclerosis, and sickle cell anemia.

“Overall our results are encouraging and suggest that Phe2vec is a promising technique for large-scale phenotyping of diseases in electronic health record data,” Dr. Glicksberg said. “With further testing and refinement, we hope that it could be used to automate many of the initial steps of clinical informatics research, thus allowing scientists to focus their efforts on downstream analyses like predictive modeling.”

This study was supported by the Hasso Plattner Foundation, the Alzheimer’s Drug

Discovery Foundation, and a courtesy graphics processing unit donation from the NVIDIA Corporation.

Article

De Freitas, J.K., et al., Phe2vec: Automated Disease Phenotyping based on Unsupervised Embeddings from Electronic Health Records, Patterns, September 2, 2021, DOI: 10.1016/j.patter.2021.100337.

About the Mount Sinai Health System

The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai advances medicine and health through unrivaled education and translational research and discovery to deliver care that is the safest, highest-quality, most accessible and equitable, and the best value of any health system in the nation. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture ambulatory surgery centers; more than 415 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. The Mount Sinai Hospital is ranked on U.S. News & World Report's "Honor Roll" of the top 20 U.S. hospitals and is top in the nation by specialty: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. Mount Sinai Kravis Children's Hospital is ranked in U.S. News & World Report’s “Best Children’s Hospitals” among the country’s best in four out of 10 pediatric specialties. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and No. 14 in the nation for National Institutes of Health funding. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.

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JOURNAL

Patterns

DOI

10.1016/j.patter.2021.100337 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Phe2vec: Automated Disease Phenotyping based on Unsupervised Embeddings from Electronic Health Records

ARTICLE PUBLICATION DATE

2-Sep-2021

 

Nano ‘camera’ made using molecular glue allows real-time monitoring of chemical reactions

Peer-Reviewed Publication

UNIVERSITY OF CAMBRIDGE

 

IMAGE: THE DEVICE, MADE BY A TEAM FROM THE UNIVERSITY OF CAMBRIDGE, COMBINES TINY SEMICONDUCTOR NANOCRYSTALS CALLED QUANTUM DOTS AND GOLD NANOPARTICLES USING MOLECULAR GLUE CALLED CUCURBITURIL (CB). WHEN ADDED TO WATER WITH THE MOLECULE TO BE STUDIED, THE COMPONENTS SELF-ASSEMBLE IN SECONDS INTO A STABLE, POWERFUL TOOL THAT ALLOWS THE REAL-TIME MONITORING OF CHEMICAL REACTIONS. view more 

CREDIT: UNIVERSITY OF CAMBRIDGE

Researchers have made a tiny camera, held together with ‘molecular glue’ that allows them to observe chemical reactions in real time.

The device, made by a team from the University of Cambridge, combines tiny semiconductor nanocrystals called quantum dots and gold nanoparticles using molecular glue called cucurbituril (CB). When added to water with the molecule to be studied, the components self-assemble in seconds into a stable, powerful tool that allows the real-time monitoring of chemical reactions.

The camera harvests light within the semiconductors, inducing electron transfer processes like those that occur in photosynthesis, which can be monitored using incorporated gold nanoparticle sensors and spectroscopic techniques. They were able to use the camera to observe chemical species which had been previously theorised but not directly observed.

The platform could be used to study a wide range of molecules for a variety of potential applications, such as the improvement of photocatalysis and photovoltaics for renewable energy. The results are reported in the journal Nature Nanotechnology.

Nature controls the assemblies of complex structures at the molecular scale through self-limiting processes. However, mimicking these processes in the lab is usually time-consuming, expensive and reliant on complex procedures.

“In order to develop new materials with superior properties, we often combine different chemical species together to come up with a hybrid material that has the properties we want,” said Professor Oren Scherman from Cambridge’s Yusuf Hamied Department of Chemistry, who led the research. “But making these hybrid nanostructures is difficult, and you often end up with uncontrolled growth or materials that are unstable.”

The new method that Scherman and his colleagues from Cambridge’s Cavendish Laboratory and University College London developed uses cucurbituril – a molecular glue which interacts strongly with both semiconductor quantum dots and gold nanoparticles. The researchers used small semiconductor nanocrystals to control the assembly of larger nanoparticles through a process they coined interfacial self-limiting aggregation. The process leads to permeable and stable hybrid materials that interact with light. The camera was used to observe photocatalysis and track light-induced electron transfer.

“We were surprised how powerful this new tool is, considering how straightforward it is to assemble,” said first author Dr Kamil Sokołowski, also from the Department of Chemistry.

To make their nano camera, the team added the individual components, along with the molecule they wanted to observe, to water at room temperature. Previously, when gold nanoparticles were mixed with the molecular glue in the absence of quantum dots, the components underwent unlimited aggregation and fell out of solution. However, with the strategy developed by the researchers, quantum dots mediate the assembly of these nanostructures so that the semiconductor-metal hybrids control and limit their own size and shape. In addition, these structures stay stable for weeks.

“This self-limiting property was surprising, it wasn’t anything we expected to see,” said co-author Dr Jade McCune, also from the Department of Chemistry. “We found that the aggregation of one nanoparticulate component could be controlled through the addition of another nanoparticle component.”

When the researchers mixed the components together, the team used spectroscopy to observe chemical reactions in real time. Using the camera, they were able to observe the formation of radical species – a molecule with an unpaired electron – and products of their assembly such as sigma dimeric viologen species, where two radicals form a reversible carbon-carbon bond. The latter species had been theorised but never observed.

“People have spent their whole careers getting pieces of matter to come together in a controlled way,” said Scherman, who is also Director of the Melville Laboratory. “This platform will unlock a wide range of processes, including many materials and chemistries that are important for sustainable technologies. The full potential of semiconductor and plasmonic nanocrystals can now be explored, providing an opportunity to simultaneously induce and observe photochemical reactions.”

“This platform is a really big toolbox considering the number of metal and semiconductor building blocks that can be now coupled together using this chemistry– it opens up lots of new possibilities for imaging chemical reactions and sensing through taking snapshots of monitored chemical systems,” said Sokołowski. “The simplicity of the setup means that researchers no longer need complex, expensive methods to get the same results.”

Researchers from the Scherman lab are currently working to further develop these hybrids towards artificial photosynthetic systems and (photo)catalysis where electron-transfer processes can be observed directly in real time. The team is also looking at mechanisms of carbon-carbon bond formation as well as electrode interfaces for battery applications.

The research was carried out in collaboration with Professor Jeremy Baumberg at Cambridge’s Cavendish Laboratory and Dr Edina Rosta at University College London. It was funded in part by the Engineering and Physical Sciences Research Council (EPSRC).

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JOURNAL

Nature Nanotechnology

DOI

10.1038/s41565-021-00949-6 

METHOD OF RESEARCH

Experimental study

ARTICLE TITLE

Nanoparticle surfactants for kinetically arrested photoactive assemblies to track light-induced electron transfer

ARTICLE PUBLICATION DATE

1-Sep-2021

 

Researchers sequence genome of drug-resistant Salmonella enteritidis strain that can sicken poultry

Peer-Reviewed Publication

NORTH CAROLINA STATE UNIVERSITY

Researchers from North Carolina State University sequenced the genome of a virulent Salmonella Enteritidis strain that sickened two poultry flocks in consecutive years and found that it was both antibiotic resistant and could potentially infect humans. Characterizing the strain, designated SE_TAU19, will aid public health agencies in tracing outbreaks and preventing exposures.

There are two species of Salmonella, and one of these, Salmonella enterica, is implicated in human disease. S. enterica contains over 2,500 serovars, or groups of bacteria, many of which can cause disease in humans. Salmonella serovar Enteritidis (SE) is most frequently associated with poultry and is the leading cause of human illness globally.

Most human Salmonella infections are foodborne in origin, and many animals – such as chickens – can harbor the pathogen without becoming sick themselves. The ability of SE_TAU19 to cause clinical disease in poultry interested Grayson Walker, a combined DVM and Ph.D. student in Luke Borst’s laboratory at NC State’s College of Veterinary Medicine and first author of a paper describing the research.

“We usually think of Salmonella as harbored by chickens without harming them; however, this strain was virulent and actually made them sick,” Walker says. “We also know that Salmonella likes to stick around. This strain killed broiler chickens throughout the growing period and recurred one year later in a different flock. So, we decided to sequence the genome and see which resistance and virulence features made the strain unique.”

The team sequenced the genome of the strain and found that it included seven antimicrobial resistance genes, 120 virulence genes, and a large virulence plasmid. Plasmids are “swappable” genetic elements that can be exchanged between strains to make them more antibiotic resistant or infectious.

“While we cannot say that it is a ‘new’ strain of Salmonella, we can say that not only is this strain deadly to poultry, antibiotic resistant and infectious, but also that it could infect humans,” Walker says. “The good news is that by sequencing the genome we now have data that could help pinpoint the origin of and contain any future outbreaks.”

The research appears in Frontiers in Veterinary Science and is supported by the United States Department of Agriculture Animal Plant Health Inspection Service’s National Bio and Agro-defense Facility Scientist Training Program. Whole-genome sequencing was completed by the FDA GenomeTrakr program funded under grant 1U18FD00678801 in the lab of co-author Sid Thakur, professor of population health and pathobiology and the director of NC State’s and the College of Veterinary Medicine’s Global Health programs. Borst, associate professor of veterinary anatomic pathology at NC State, is corresponding author.

-peake-

Note to editors: An abstract follows.

“Genomic characterization of a nalidixic acid-resistant Salmonella Enteritidis strain causing persistent infections in broiler chickens”

DOI: 10.3389/fvets.2021.725737

Authors: Grayson K. Walker, M. Mitsu Suyemoto, Dawn M. Hull, Sesny Gall, Fernando Jimenez, Laura R. Chen, Siddhartha Thakur, Rocio Crespo, and Luke B. Borst, North Carolina State University

Published: Sept. 1, 2021 in Frontiers in Veterinary Science

Abstract:
Virulent strains of Salmonella enterica subsp. enterica serovar Enteritidis (SE) harbored by poultry can cause disease in poultry flocks and potentially result in human foodborne illness. Two broiler flocks grown a year apart on the same premises experienced mortality throughout the growing period due to septicemic disease caused by SE. Gross lesions predominantly consisted of polyserositis followed by yolk sacculitis, arthritis, osteomyelitis, and spondylitis. Tissues with lesions were cultured yielding 59 SE isolates. These were genotyped by Rep-PCR followed by whole-genome sequencing of 15 isolates which were clonal. The strain, SE_TAU19, was further characterized for antimicrobial susceptibility and virulence in a broiler embryo lethality assay. SE_TAU19 was resistant to nalidixic acid and sulfadimethoxine and was virulent to embryos with 100% mortality of all challenged broiler embryos within 3.5 d. Screening the SE_TAU19 whole-genome sequence revealed 7 antimicrobial resistance genes, 120 virulence genes, and 2 IncF plasmid replicons corresponding to a single, serovar-specific pSEV virulence plasmid. The pef, spv, and rck virulence genes localized to the plasmid sequence assembly. We report phenotypic and genomic features of a virulent SE strain from persistently infected broiler flocks and present a workflow for SE characterization from isolate collection to genome assembly and sequence analysis. Further SE surveillance and investigation of SE virulence in broiler chickens is warranted.

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JOURNAL

Frontiers in Veterinary Science

DOI

10.3389/fvets.2021.725737 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Genomic characterization of a nalidixic acid-resistant Salmonella Enteritidis strain causing persistent infections in broiler chickens

ARTICLE PUBLICATION DATE

1-Sep-2021

 

Study: Normal concussion recovery could take up to a month

Peer-Reviewed Publication

UNIVERSITY OF MICHIGAN

Video

The largest study of concussion ever conducted in college athletes is redefining the timeline for recovery as a process taking up to 28 days, up from the suggested normal recovery time of up to 14 days. 

The findings are detailed in the journal Sports Medicine, in one of the marquee papers to emerge from the NCAA-DoD Concussion Assessment, Research and Education Consortium. The study's lead researcher, Steve Broglio, director of the University of Michigan Concussion Center, is on the CARE Consortium leadership team and leads the CARE clinical study core. 

"Normal return-to-play time was previously set at 14 days––meaning 50% of people recovered in that time. Our paper suggests that 28 days more fully encapsulates the recovery process. At that point, 85% of people have returned to play," Broglio said.

The study found that though median recovery times were consistent with the previously suggested 14 days, it was not until one month post-injury that most athletes were cleared for unrestricted sport participation. 

This doesn't mean that universities must revise their return to play protocols.  

"The RTP protocols are driven by clinical presentation (symptoms), not time, so they don't need to be revised," Broglio said.  

Rather, coaches, parents and athletes should reframe their expectations for return to

play, in part to avoid stigmatizing concussed athletes who take longer than 14 days to recover, he said. Reframing the normal recovery time to 28 days helps eliminate unintentional social pressure from teammates, coaches or parents who hope to see their player back on the field. If a concussed athlete takes longer than 14 days or up to a month, that's completely normal, he said.

There wasn't much variation in recovery times among study subgroups, with various factors altering recovery by only up to two days. The total return-to-play duration was shorter with ADHD medication usage, males and greater assessment frequency. Those with greater initial post-injury symptom severity, practice/training-related injuries and three or more prior concussions had longer recoveries. 

Concussion management recommendations are outlined every four years by the Concussion in Sport Group, an international body that reviews the medical literature and develops guidelines on clinical care. This paper and others resulting from the CARE Consortium will likely be taken into consideration when the group meets next year, said Broglio, who is also a member of CISG.

Despite increased research in concussion over the previous decade, the trajectory of concussion recovery times across diverse populations of athletes has remained poorly defined, because most sport concussion research centered on male athletes in collision sports, or on female soccer players, Broglio said. 

The current study included 34,709 male and female athletes from 30 colleges and universities—more than 1,700 of whom were concussed while participating in 22 sports.

Concussed male athletes most commonly played football (54.7%), soccer (10.7%), basketball (6.8%) and wrestling (6.4%), while concussed female athletes most commonly played soccer (23.4%), volleyball (14%), basketball (12.9%) and lacrosse (8.4%). Broglio said male and female athletes took about the same amount of time to recover from concussion, give or take a day.

Concussion education and treatment has improved dramatically in the last two decades, he said.

"Back when I started in concussion research 20 years ago, we'd manage these

injuries with a light switch. We'd ask, 'Do you have symptoms?' and if the answer was no, the athlete was put back on the field. Gone are the days when concussed athletes are put back in the same day," Broglio said. "Now, we can think of it as a dial, where we

slowly progress people back into the sport. Once a player is asymptomatic, it can still take some time. We have to respect the injury and respect the recovery process."

Co-authors include: Thomas McAllister, Barry Katz, Michelle LaPradd and Wenxian Zhou of Indiana University; Michael McCrea of the Medical College of Wisconsin; and CARE Consortium investigators. 

Study: The Natural History of Sport-Related Concussion in Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium

JOURNAL

Sports Medicine

Green Party leader accidentally endorses Liberal environment plan

Richard Raycraft 

It was an endorsement Justin Trudeau and the Liberals probably weren't expecting.

At a press conference this afternoon in Toronto, Green Party Leader Annamie Paul appeared to give a thumbs-up to the Liberals' plan on climate change.

"I'll tell the people of Canada that if you want a real plan, one that is going to grow our economy, that is going to put us at the front of the competitive green economy of the future ... the only option in this election for you is the Liberals," Paul said.

In a media statement subsequently sent to CBC News, Paul's press secretary Rosie Emery said the Green leader misspoke.

"Ms. Paul does not support the Liberal climate plan. What she meant to say was that the Green Party cannot support it, and that we must work collaboratively to confront climate change and that the Green Party platform remains the only platform with clear climate action," the statement reads.

In a video posted to Twitter, Paul acknowledged both the mistake and its potential as a meme.

"It was bound to happen. You do one press conference too many without having had your lunch, and there you go — saying things that are definitely, definitely good for a meme." Paul said in a video posted to Twitter.

"What I meant to say is that if you want real action on the climate, if you want the real possibility of the strong, green economy of the future, if you want Canada to join the green rush that's going on globally, then there's one option and one option only, and that is ... the Greens."

WHILE IN MANITOBA NDP LEADER JAGMEET SINGH WAS ACCOMPANIED BY FIRST NATIONS LEADERS AT ONE RIDING WHERE THEY ANNOUNCED THEIR  SUPPORT FOR THE LIBERAL OPPOSING THE NDP INCUMBENT MP

Alberta NDP calls for mandatory COVID-19 vaccine rules on non-essential businesses

EDMONTON — Alberta’s Opposition New Democrats are urging Premier Jason Kenney to bring in new rules to make COVID-19 vaccines mandatory for anyone attending non-essential businesses and mass gatherings.

© Provided by The Canadian Press

RACHEL AND DOUGH BOY 

NDP Leader Rachel Notley says the province should also return to mandatory masking for anyone unvaccinated entering essential places, including grocery stores.

Notley says it’s critical Kenney act now to arrest rapidly rising infection rates and to protect hospitals from being overwhelmed.

Ontario, Manitoba, British Columbia and Quebec are phasing in or already have requirements for people to show a vaccine card, online image or smartphone verification for many activities deemed non-essential, including visiting bars, restaurants, casinos and sports events.

“This is coming and if we don’t act now, I fear we will reach a place where Albertans will be scrambling to catch up with the rest of the world, and our health care and our economy will have been needlessly injured in the process,” Notley said Thursday in Calgary.

“No one wants to go back to restrictions. That’s why we’re proposing a better way.”

Notley suggested Alberta could develop a QR digital code that would be available on smartphones or for downloading online to prove vaccination status.

Kenney’s United Conservative government, citing health privacy as one reason, has repeatedly said it will not mandate proof of vaccination.

Many municipalities, schools, universities, sports teams and businesses developed their own rules on masking, testing and vaccinations.

On Friday, Edmonton officially reinstates a requirement to wear face coverings in indoor public areas, including stores and restaurants.

Kenney’s government lifted almost all health restrictions July 1. It said it was time to stop treating COVID-19 as a crisis and instead manage it long term, which would free up health workers and resources for other health issues.

In recent weeks, case counts have been rising sharply, averaging more than 1,000 new infections a day for the past week. On Thursday, there were 1,339 new cases and 487 people in hospital, 114 of whom were in intensive care.

The caseload is putting renewed pressure on health care. Surgeries have been delayed, patients have been transferred and some emergency room beds have been temporarily closed.

Kenney, Health Minister Tyler Shandro and Dr. Deena Hinshaw, the province's chief medical officer of health, haven't met with the media in weeks to say what — if anything — they will do.

Kenney took self-selected questions from Albertans for about 70 minutes Wednesday night on Facebook. In the online chat, he said his government would be using more incentives to get people vaccinated, but didn’t give details.

He also said his government is considering renewed public health measures.

“We have always looked at restrictions as a last and limited resort,” said Kenney. “If indeed we do see this wave jeopardizing the health-care system, we may have to take some very targeted actions.”

Kenney read aloud multiple comments from Facebook viewers lauding his leadership, but another accused him of hiding by not holding a news conference.

Kenney rejected that.

“I’m hiding in plain view,” he said.

“This (online chat) goes straight to ordinary Albertans, gives you a chance and others a chance to ask a question. I think that’s public accountability right there.”

When Kenney announced in mid-June that all health restrictions would be lifted, he said the plan was predicated on more people getting vaccinated.

Kenney said he hoped 75 per cent of eligible Albertans — those 12 and older — would be fully immunized by fall. The government organized three $1-million prize draws along with other gifts to spur Albertans to get their shots.

On Thursday, the province announced 70 per cent of those eligible were fully vaccinated.

Kenney renewed his call for Albertans to get vaccinated and noted that the majority in hospital with COVID-19 were not. He cautioned his Facebook watchers to be aware of false information.

“Please don’t believe every crazy Facebook page you might stumble upon.”

LIKE HIS

This report by The Canadian Press was first published Sept. 2, 2021.

Dean Bennett, The Canadian Press

Afghanistan resistance fighters clash with Taliban in Panjshir valley

Both sides claim they inflicted casualties in skirmishes in the last province to resist Taliban takeover

An Afghan resistance movement has clashed with Taliban

 fighters in Panjshir province. 

Photograph: Ahmad Sahel Arman/AFP/Getty Images

Staff and agencies
Fri 3 Sep 2021

Taliban forces and fighters loyal to local leader Ahmad Massoud battled in Afghanistan’s Panjshir Valley on Thursday, more than two weeks after the Islamist militia seized power, as Taliban leaders in the capital, Kabul, worked to form a government.

Panjshir is the last province resisting rule by the Taliban, who retook control of the country as US and foreign troops withdrew after 20 years of conflict following the September 11 attacks on the United States.

Each side made competing claims about territorial gains and inflicting heavy casualties.

Taliban spokesman Zabihullah Mujahid said: “We started operations after negotiation with the local armed group failed.” Taliban fighters had entered Panjshir and taken control of some territory, he said. “They [the enemy] suffered heavy losses.”


‘Panjshir stands strong’: Afghanistan’s last holdout against the Taliban

A spokesman for the National Resistance Front of Afghanistan (NRFA) rebel grouping said it had full control of all passes and entrances and had driven back efforts to take Shotul district.

“The enemy made multiple attempts to enter Shotul from Jabul-Saraj and failed each time,” he said, referring to a town in neighbouring Parwan province.

The Afghan resistance movement takes part in military training in the Dara district of Panjshir province on Thursday. Photograph: AFP/Getty Images

Panjshir valley, north of Kabul in the Hindu Kush, was a resistance stronghold for decades, first against the Soviets in the 1980s, then against the Taliban in the 1990s. It is still dotted with rusting tanks from the fights of those decades.

The vice-president, Amrullah Saleh, who was born and trained to fight there, vowed it would reprise the role of stronghold, after he declared himself “caretaker” head of state after the Taliban takeover.

Afghanistan’s ambassador to Tajikistan, Lt Gen Zahir Aghbar, a former senior security official before becoming an envoy, earlier promised Panjshir would form a base for those who wanted to fight on. “Panjshir stands strong against anyone who wants to enslave people,” he said.

Since the Taliban swept into Kabul on 15 August, several thousand fighters from local militias and remnants of the government’s armed forces have massed in Panjshir under the leadership of Massoud, the son of a former Mujahideen commander.

They have been holding out in the steep valley where attacks from outside are difficult.

Efforts to negotiate a settlement appear to have broken down, with each side blaming the other for the failure.

Mujahid said the announcement of a new government was a few days away, while Taliban official Ahmadullah Muttaqi said a ceremony was being organised at the presidential palace.

The legitimacy of the government in the eyes of international donors and investors will be crucial for the economy as the country battles drought and the ravages of a conflict that killed an estimated 240,000 Afghans.

With Reuters

Taliban says it captured key entrance to Panjshir valley, local resistance denies it – as both claim heavy losses on other side

2 Sep, 2021 

Afghan resistance forces patrol Darband area in Anaba district, Panjshir province, September 1, 2021 © AFP / Ahmad Sahel Arman

The Taliban has claimed its fighters seized a key position at the entrance to the Panjshir valley – the only Afghan province still out of the group’s control. Local resistance has denied the Taliban made any advances.

The Taliban launched a major operation to take the Panjshir valley on Thursday, after the negotiations with the local resistance movement failed, according to spokesman Zabihullah Mujahid. He said the Taliban fighters entered the province and captured eleven “important” positions along the main road leading to the eastern province of Badakhshan. Among them was the town of Shattal in the Parwan province, at the southwestern entrance to the valley.

Representatives of the National Resistance Front (NRF) denied the Taliban made any advances into the valley, however, and claimed they were still in full control of all the passes leading into Panjshir. The Taliban’s “multiple” attempts to enter the area were thwarted, the militia claimed.

ALSO ON RT.COM Mujahideen v Taliban: Battle for strategic valley looms as anti-Taliban warlord & remnants of Afghan military refuse to surrender

“They did not succeed in their offensive and they did not advance even a kilometer,” said Fahim Dashti, a NRF spokesman.

Both sides claimed to have inflicted heavy losses on their enemies, but the claims were impossible to verify independently.

The Taliban’s Mujahid said the fighting started after the talks with the Panjshir militia failed. According to some reports, the Taliban was ready to accept any governor the local militias would appoint but demanded that the flag of the “Islamic Emirate of Afghanistan” be raised over the valley – something the NRF refused to do.

ALSO ON RT.COM  7 Taliban fighters killed in clashes with Panjshir valley resistance, as challenges remain for new rulers after US exit

According to Amrullah Saleh, who now styles himself the “acting president” of Afghanistan, the flags of the Islamic Republic – the former, US-backed government – are still flying in Panjshir.

Saleh was the deputy to Ashraf Ghani, the NATO-backed president who fled the country on August 14, as the Taliban approached Kabul, triggering the mad scramble of the US-organized airlift.

The standoff between the Taliban and the Panjshir resistance has been shaping up since then. On August 31, Reuters reported that at least eight Taliban fighters were killed as they tried to move on the NRF positions. The Taliban did not comment on the losses at that time, as the group apparently was still seeking a negotiated solution to the conflict with the militias.

Last week it was reported that local militias in the northern Baghlan province had evicted Taliban members from three districts, only for one to be recaptured soon after. The Taliban now claims to have recaptured all three.

Afghanistan's last holdout against Taliban suffers heavy casualties

Following the fall of Kabul on Aug. 15, several thousand fighters from local militias and the remnants of army and special forces units have massed in Panjshir.

By REUTERS
SEPTEMBER 3, 2021 

Taliban fighters march in uniforms on the street in Qalat, Zabul Province, Afghanistan, in this still image taken from social media video uploaded August 19, 2021
(photo credit: REUTERS)
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Taliban forces and fighters loyal to local leader Ahmad Massoud battled in Afghanistan's Panjshir Valley on Thursday, more than two weeks after the Islamist militia seized power, as Taliban leaders in the capital, Kabul, worked to form a government.

Panjshir is the last province resisting rule by the Taliban, who retook control of the country as US and foreign troops withdrew after 20 years of conflict following the Sept. 11, 2001, attacks on the United States.

Each side said it had inflicted heavy casualties.

"We started operations after negotiation with the local armed group failed," Taliban spokesman Zabihullah Mujahid said.

Taliban fighters had entered Panjshir and taken control of some territory, he said. "They (the enemy) suffered heavy losses."

MEMBERS OF TALIBAN forces sit at a checkpoint in Kabul earlier this month. (credit: REUTERS)

A spokesman for the National Resistance Front of Afghanistan (NRFA) rebel grouping said it had full control of all passes and entrances and had driven back efforts to take Shotul district.

"The enemy made multiple attempts to enter Shotul from Jabul-Saraj, and failed each time," he said, referring to a town in neighboring Parwan province.

Since the Taliban swept into Kabul on Aug. 15, several thousand fighters from local militias and remnants of the government's armed forces have massed in Panjshir under the leadership of Massoud, son of a former Mujahideen commander.

They have been holding out in the steep valley where attacks from outside are difficult.

Efforts to negotiate a settlement appear to have broken down, with each side blaming the other for the failure.

Mujahid said the announcement of a new government was a few days away, while Taliban official Ahmadullah Muttaqi said a ceremony was being organized at the presidential palace.

HUMANITARIAN CATASTROPHE

The legitimacy of the government in the eyes of international donors and investors will be crucial for the economy as the country battles drought and the ravages of a conflict that killed an estimated 240,000 Afghans.

Humanitarian organizations have warned of impending catastrophe and the economy - reliant for years on many millions of dollars of foreign aid - is close to collapse.

Many Afghans were struggling to feed their families amid severe drought well before the Taliban militants seized power and millions may now face starvation with the country isolated and the economy unraveling, aid agencies say.

"Since the 15th of August, we have seen the crisis accelerate and magnify with the imminent economic collapse that is coming this country's way," Mary-Ellen McGroarty, World Food Programme country director in Afghanistan, told Reuters from Kabul.

In a positive development, a senior executive of Western Union Co said it was resuming money-transfer services to Afghanistan - a decision he said was in line with a US push to allow humanitarian activity to continue there.

"Much of our business involving Afghanistan is low-value family and support remittances that support basic needs of the people there, so that's the grounding that we have and why we want to reopen our business," said Jean Claude Farah, Western Union's president in Asia, Europe, the Middle East and Africa.

Western Union and MoneyGram International Inc had suspended services in Afghanistan after the Taliban captured Kabul.

RECOGNITION

The Taliban enforced a radical form of sharia, or Islamic law, when it ruled from 1996-2001 but have tried to present a more moderate face to the world this time, promising to protect human rights and refrain from reprisals against old enemies.

The United States, the European Union and others have cast doubt on such assurances, saying formal recognition of the new government - and the economic aid that would flow from that - is contingent on action.

German Foreign Minister Heiko Maas said on Thursday that Germany was ready to resume a diplomatic presence in Kabul if the Taliban met certain conditions.

"We want to see an inclusive government (in Kabul), the respect for fundamental human and women's rights - and Afghanistan must not again become a breeding ground for international terrorism," Maas told reporters in Slovenia, where he met his EU counterparts to discuss Afghanistan.

French Foreign Minister Jean-Yves Le Drian told Le Figaro newspaper that Paris had yet to see positive signals the group had changed.

A source with direct knowledge of the move said Afghan diplomats had been asked to stay in overseas posts for the time being. The Taliban wanted to maintain a sense of continuity, the source said.

The Taliban have promised safe passage out of the country for any foreigners or Afghans left behind by the huge airlift that ended when US troops withdrew on Monday. But with Kabul airport still closed, many were seeking to flee over land.

Thousands of Afghans - some with no documentation or pending US visa applications, others in families with mixed immigration statuses - are also waiting in "transit hubs" in third countries following the chaotic scramble to evacuate.

Afghan resistance fighters hold out against Taliban in Panjshir

Issued on: 03/09/2021 - 

An anti-Taliban resistance fighter in a military training exercise in the Malimah area of Dara district in Panjshir province on September 2, 2021. © Ahmad Sahel Arman, AFP

Text by: FRANCE 24
Video by: FRANCE 24

Anti-Taliban resistance fighters loyal to local leader Ahmad Massoud claimed they have full control of the passes into their stronghod Panjshir Valley following clashes against the Taliban on Thursday, more than two weeks after the Islamist militia swept into the captial, Kabul. But the Taliban claimed they inflicted heavy casualties in the battle.

A spokesman for the National Resistance Front (NRF) comprising anti-Taliban militia fighters and former Afghan security forces said the movement had full control of all the passes and entrances into the Panjshir Valley and had driven back Taliban efforts to take Shotul district.

"The enemy made multiple attempts to enter Shotul from Jabul-Saraj, and failed each time," he said, referring to a town in neighbouring Parwan province.

Surrounded by towering snow-capped mountains, the rugged Panjshir Valley, which begins around 80 kilometres (50 miles) north of the capital Kabul, is a stronghold of resistance after the Taliban swept into Kabul on August 15 and seized power.

But the Taliban also said it had inflicted heavy casualties on the NRF.

"We started operations after negotiation with the local armed group failed," Taliban spokesman Zabihullah Mujahid said Thursday.

Since August 15, several thousand fighters from local militias and remnants of the government's armed forces have massed in Panjshir under the leadership of Massoud, son of the Afghan resistance hero, Ahmad Shah Massoud.

Efforts to negotiate a settlement appear to have broken down, with each side blaming the other for the failure.

Anti-Taliban leader Massoud wants to talk but ready to fight

01:40

(FRANCE 24 with AFP and REUTERS)

Taliban claim capture of district in Panjshir, resistance forces deny

By Sadaf Shinwari / in Afghanistan / on Friday, 03 Sep 2021 1



Islamic Emirate of Afghanistan claims to have captured the Shutul district of Panjshir province but resistance forces have denied the claim.

Acting minister of culture and information and spokesperson of the Taliban, Zabiullah Mujahid said that eleven outposts have also been taken and over 30 resistance forces have been killed.

Meanwhile, unconfirmed reports by the Taliban read that the districts of Paryan and Onaba districts of the province have also been taken.

It has been the fourth day since the heavy conflicts erupted in Panjshir province between the resistance forces of the province and the Taliban.

A spokesperson of resistance forces Fahim Dashti in a voice clip denied the capture of Shutul district and claimed to have driven back the Taliban fighters in the district.

Dashti claimed that tens of dead bodies of the Taliban fighters are left on the ground and the latter asked tribal elders of Parwan province to mediate and let them take their dead bodies.

Pictures leaked from the Panjshir province show that the fighters in Panjshir province are using rocket launchers, missiles, and other weapons from the era of the Soviet Union.

The resistance forces also claim to have killed 350 Taliban fighters and wounded 290 more.

The heavy and deadly fight between the warring sides erupted after peace negotiations between the two sides failed.

Afghanistan’s anti-Taliban resistance is growing. Is it enough to retake the country?


The anti-Taliban resistance movement is growing in Afghanistan, but experts aren't convinced they can retake the country

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© Provided by Global News Afghan resistance movement and anti-Taliban uprising forces take rest as they patrol on a hilltop in Darband area in Anaba district, Panjshir province on September 1,2021. - Panjshir -- famous for its natural defences never penetrated by Soviet forces or the Taliban in earlier conflicts -- remains the last major holdout of anti-Taliban forces led by Ahmad Massoud, son of the famed Mujahideen leader Ahmed Shah Massoud. (Photo by Ahmad SAHEL ARMAN / AFP) (Photo by AHMAD SAHEL ARMAN/AFP via Getty Images)

The National Resistance Front of Afghanistan, also known as the Panjshir resistance, has been making waves after seven Taliban fighters were killed attempting to enter the Panjshir valley earlier this week.

The military group, comprised of former Northern Alliance and anti-Taliban fighters, was formed in August after the Taliban overtook Afghanistan in a stunning week-long rout that saw seven people die rushing to the tarmac of Kabul's international airport in a desperate bid to escape.

The NRF is run by Ahmad Massoud, son of a former Mujahideen commander and former Afghanistan vice-president Amrullah Saleh.

Read more: ‘We need your solidarity’: What the Taliban takeover means for Afghanistan’s women and girls

On Wednesday, the Taliban said it had the group surrounded and called on them to negotiate a settlement. According to experts, no resistance movement inside the country stands much of a chance.

"I don't think there will be successful anti-Taliban resistance movement at all," said, Erika Simpson, president of the Canadian Peace Research Association.

U.S. President Joe Biden announced he would begin withdrawing American troops from Afghanistan in April. The U.S. flew its last soldier out on Aug. 30, ending the country's longest war that spanned two decades.

When the U.S. began withdrawing its troops, Simpson said the U.S. withdrew equipment that helped support the Afghan National Defence Forces, which helped prevent the resistance from fighting a high technology war.

But Simpson, who is also an associate professor of international relations with Western University, said this could have actually given the Taliban, which are typically a low-technology group, an edge.

If an anti-Taliban resistance movement is to pick up speed, Simpson debated whether they would have enough arms to topple the Taliban.

"Who would arm them?" she said. "Who would risk it?"

Video: Learn how UNICEF is helping women and children in Afghanistan

She added that any real resistance would likely come from the hundreds of thousands of refugees who will eventually fight to return to their homes and dismantle the organization that displaced them.

Simpson said it would be smarter to "forget" about trying to arm resistance movements in Afghanistan, and focus on the "resistance movement" happening outside.

Adding to that, Aurel Braun, an international relations and political science professor at the University of Toronto, said even if the NRF have some equipment, they would be desperately short of food, medicine and weapons — "and I don't see how that would be provided to them."

Afghanistan is a landlocked country, meaning it is surrounded by land but no oceans, making it difficult to trade. The country also shares borders with Iran, Pakistan, Tajikistan, Turkmenistan, and Uzbekistan, which Braun said would make airlifting supplies "a very difficult task" for Afghanistan.

Even resistance in the form of ongoing protest in Afghanistan may be futile, Nader Hashemi, director of the Center for Middle East Studies at the University of Denver.

Read more: Hunger crisis looms in Afghanistan under new Taliban regime

"The Taliban is not known for its toleration and moderation," Hashemi said.

He added Afghan women, who have been at the centre of protests demanding gender equality rights throughout the country, will likely be "repressed very severely, in the way that the Taliban have done in the past."
The Taliban are in power. What's next?

What comes next for Afghanistan appears to be a series of hardships, in-fighting and financial woes.

Politically, the Taliban may have to deal with challengers such as ISIS-K, who claimed responsibility for a suicide bombing last week that killed 182 people including 13 U.S. service members at Kabul's international airport.

ISIS-K is an extremist organization at war with the Taliban, comprised mainly of disgruntled Taliban members, radical extremists from neighbouring countries and leftover remnants of ISIS in Iraq and Syria.

It's much more extreme, much more radical," Hashemi said.

"If (the Taliban) wants the type of diplomatic recognition and engagement with the international community that it's been talking about over the last couple of weeks, it will be dependent on them being able to control the territory of Afghanistan, including controlling and preventing ISIS-K from manifesting itself, from attacking other targets, whether they're in Afghanistan or a part of Afghanistan."

Shortly after the Taliban took control of Kabul on Aug. 15, Afghanistan's president Ashraf Ghani fled the country to the United Arab Emirates. Afghanistan’s ambassador to Tajikistan has since accused Ghani of stealing $169 million from state coffers, while the Russian Embassy claimed he'd escaped with four cars and a helicopter full of cash.

But Simpson said his return is unlikely.

"Ashraf Ghani has no legitimacy or credibility to organize a government in waiting outside Afghanistan. No legitimacy or credibility. People will spit on his grave," she said.

Simpson also noted that anyone hoping to see the formation of a coalition government may be waiting a long time.

The National Coalition of Afghanistan party is led by Abdullah Abdullah, Afghanistan's former foreign minister, while former Afghan president Hamid Karzai is also angling for a political role. Simpson said the pair could try to form a coalition with the Taliban but "they don't have any leverage. They don't have any bargaining power."

In the meantime, the Taliban are pushing for international recognition as the country's official government from the West. Braun said this is to secure aid from the U.S., which the Taliban will need if they hope to stabilize Afghanistan's economy without significantly increasing taxes.

Read more: With Kabul airport closed, Afghans fearful of Taliban reprisals rush for borders

According to the World Bank, Afghanistan is one of the world's top receivers per country of financial aid, rivalled only by Syria, Ethiopia, Bangladesh and Yemen. In 2019, the World Bank said Afghanistan received more than $4.2 billion in international aid, while the country's GDP remained just over $19.2 billion.

"Foreign aid was crucial in keeping the Afghan economy alive and so they would like to maintain that," he said.

But for residents who remain in Afghanistan -- particularly women and girls -- Braun predicted "desperation."

Braun pointed to emerging reports of residents taking dangerous routes to leave Afghanistan now that Kabul's airports have closed. There has also been an increase in food insecurity with more people being prohibited from going to work and school, particularly in households where women are the breadwinners.

"Women have been forced to stay at home (from work)," he said. "Once they run out of supplies -- ordinary things, household goods and so on, that's going to be a huge, huge problem."

The Taliban so far has publicly promised "amnesty" for anyone who fought against them and have said they would allow women to return to work.

But Hashemi said he is "deeply skeptical," given the Taliban's prior track record, which saw women barred from working or attending school, forced marriages and banned women from leaving their homes without a male escort.

In addition to this, Hashemi said the country is expected to suffer a massive "brain drain" as educated women, along with interpreters and Western administration staff and their families flee the country in droves.

As a result of U.S. military intervention, Hashemi said a "civil society" was formed. "Millions of Afghan girls and women were able to go to school."

"There was an intellectual class that emerged," he said. "Unfortunately, most of that international class has now fled."

— with files from the Associated Press

Taliban co-founder Baradar to lead new Afghanistan govt

Taliban co-founder Mullah Baradar currently heads the group's political office.

PHOTO: AFP


KABUL (REUTERS) - Taliban co-founder Mullah Baradar will lead a new Afghan government set to be announced shortly, sources in the Islamist group said on Friday (Sept 3), as it battled rebel fighters in the Panjshir Valley and strived to ward off economic collapse.

Mr Baradar, who heads the Taliban's political office, will be joined by Mullah Mohammad Yaqoob, the son of late Taliban co-founder Mullah Omar, and Sher Mohammad Abbas Stanekzai, in senior positions in the government, three sources said.

"All the top leaders have arrived in Kabul, where preparations are in final stages to announce the new government," one Taliban official said on condition of anonymity.

Haibatullah Akhunzada, the Taliban's surpreme religious leader, will focus on religious matters and governance within the framework of Islam, another Taliban source said.

The Taliban, which seized Kabul on Aug 15 after sweeping across most of the country, have faced resistance in the Panjshir Valley, north of the capital, with reports of heavy fighting and casualties.

Several thousand fighters of regional militias and remnants of the government's armed forces have massed in the rugged valley under the leadership of Ahmad Massoud, the son of former Mujahideen commander Ahmad Shah Massoud.

Efforts to negotiate a settlement appear to have broken down, with each side blaming the other for the failure.

Humanitarian catastrophe

The government's legitimacy in the eyes of international donors and investors will be crucial for an economy grappling with drought and the ravages of a conflict that killed an estimated 240,000 Afghans.

Humanitarian groups have warned of impending catastrophe and the economy, reliant for years on many millions of dollars of foreign aid, is close to collapse.

Many Afghans were struggling to feed their families amid severe drought well before the Taliban took power and millions may now face starvation, aid agencies say.

"Since August 15, we have seen the crisis accelerate and magnify, with the imminent economic collapse that is coming this country's way," Ms Mary-Ellen McGroarty, the director of the World Food Programme in Afghanistan, said from Kabul.

The administration of US President Joe Biden has no plans to release billions in Afghan gold, investments and foreign currency reserves parked in the United States that it froze after the Taliban's takeover.

In a positive development, a senior executive of Western Union Co said the firm was resuming money-transfer services to Afghanistan in line with a US push to keep up humanitarian work.

Recognition

The Taliban enforced a radical form of sharia, or Islamic law, when it ruled from 1996 to 2001.

But this time around, the movement has tried to present a more moderate face to the world, promising to protect human rights and refrain from reprisals against old enemies.

The United States, the European Union and others have cast doubt on such assurances, saying formal recognition of the new government, and the resultant flow of economic aid, was contingent on action.

The Taliban have promised safe passage out of the country for any foreigners or Afghans left behind by the huge airlift that ended when U.S. troops withdrew ahead of an Aug 31 deadline. But, with Kabul airport still closed, many were seeking to flee over land.

Thousands of Afghans, some without documents, others with pending US visa applications or whose families have mixed immigration status, also wait in "transit hubs" in third countries.