It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Tuesday, July 15, 2025
US consumer inflation accelerates as tariff scrutiny grows
The US consumer price index was up 2.7 percent from a year ago in June, accelerating from the figure in May, government data showed - Copyright AFP/File Patrick T. Fallon Beiyi SEOW
US consumer inflation picked up in line with analyst expectations last month, government data showed Tuesday, as policymakers try to gauge how President Donald Trump’s ever-growing list of tariffs is affecting the economy.
Observers are expecting to learn more about the effects of Trump’s duties over the summer months, meaning June’s data marks the start in a series of closely-watched figures — particularly as officials mull changes to interest rates as well.
The consumer price index (CPI) was up 2.7 percent from a year ago in June, rising from the 2.4 percent figure in May as energy costs rose, said the Department of Labor.
Other areas that saw cost increases included household furnishings and apparel, both segments that experts are eyeing for signs of cost hikes after Trump’s sweeping tariffs this year.
While Trump imposed a 10 percent tariff on almost all trading partners in April and separately slapped steeper duties on imports of steel, aluminum and autos, US officials have pushed back against warnings that these could spark price increases.
Economists caution that tariff hikes could fuel inflation and weigh on economic growth, but US Treasury Secretary Scott Bessent has labeled such expectations “tariff derangement syndrome.”
CPI rose 0.3 percent in June from the previous month, an uptick from the 0.1 percent increase in May as well.
Excluding the volatile food and energy segments, CPI climbed 0.2 percent on-month, picking up from May too.
Compared with a year ago, “core” CPI was up 2.9 percent in June.
Even if headline inflation figures show no “meaningful” surge because of tariffs alone, Nationwide economist Oren Klachkin warned it may be too soon to see their full impact just yet.
Businesses have been trying to hold off consumer price hikes through a range of actions, from eating into their own margins to trying to share costs with their suppliers, he said.
But it remains to be seen how long they can do this.
There could be a bigger impact over the summer, Klachkin added.
For now, he is looking “under the surface” at components most exposed to Trump’s tariffs, such as furnishings, recreational goods and cellphones, to discern their effects.
Besides steep tariffs that have already taken effect, Trump has also threatened even higher levels on dozens of key trading partners including the European Union, India, Japan and South Korea if they do not strike deals to avert these elevated levels.
He has also opened doors to further levies on sector-specific imports ranging from semiconductors to pharmaceuticals, injecting more uncertainty in the global economy and worries of supply chain snags.
Trump and Netanyahu are dishonest, duplicitous and worse
Donald Trump speaks as Benjamin Netanyahu waves at the White House. REUTERS/Kevin Mohatt
Meetings between US President Donald Trump and Israeli Prime Minister Benjamin Netanyahu are more akin to a master class in posturing and duplicity than in diplomacy. This month’s meetings were no exception.
Both men are master manipulators, products of our media age. They create illusions that they insist are real. They repeat a lie over and over, and with such force, that it becomes real for those who trust them. Those who do not believe in the illusion are threatened, belittled, or shunned.
Both leaders have utilized their craftiness to achieve personal success in domestic politics. They have developed strong constituent bases, followers who believe that their leadership must be supported and protected. At the same time, they are polarizing figures who have contributed to creating deep fissures within their countries.
Because the illusions they project are based on lies, there are limits to their successes. In the first place, reality invariably presents a strong check to illusions. And ignoring reality can result in social unrest and political chaos.
For example, President Trump promoted his signature budget plan — which he called the “Big Beautiful Bill” — promising that it would be fiscally sound and bring greater prosperity to more Americans. Instead, it appears that it will dramatically increase the nation’s deficit while potentially causing 17 million Americans to lose their healthcare.
For his part, Netanyahu has prolonged his war on Gaza (and Lebanon, Syria, and Iran) promising that it would lead to “total victory,” making Israel more respected and secure. Instead, it has led to his being indicted for war crimes and Israel seeing its international standing diminished because of its genocidal policy.
Truth wins out. And so, we can expect the day to come when Trump voters lose their health care plans and see their rural hospitals forced to close and realize that the illusion of the “Big Beautiful Bill” didn’t include them. Much the same will occur in Israel when Israelis realize that “total victory” is a farce — the conflict with Palestinians will continue as long as they are denied rights — and as tens of thousands of young Israeli soldiers return from having served multiple tours of duty in Gaza with PTSD, wreaking havoc at home and in their communities.
With this as a backdrop, it was both fascinating and deeply disturbing to see the two master manipulators at work with and on each other last week: a bizarre exercise in log-rolling flattery. As we say in colloquial English: “They laid it on thick.”
Netanyahu, the indicted war criminal, gave Trump the letter he sent to the Nobel Prize Committee nominating him for the peace prize. And Trump returned the faux compliment calling Netanyahu “the greatest man alive.”
All of this can be dismissed as buffoonery or maybe even harmless puffery — just two manipulators playing each other. But where the efforts of these two become truly dangerous is when they and their acolytes come to believe the deceit and attempt to extend their efforts to supplant reality with illusion through policies that impact others.
From what little we know of what transpired in the meetings between Trump and Netanyahu, what’s clear is that the ideas driving both are not reality based. Trump’s plan was to evacuate Palestinians from Gaza to a location outside of Palestine where housing will be provided so they can live productive lives, making way for Gaza to become a Riviera-style resort. This was trashed early on as being based on illegal ethnic-cleansing and blatant colonialism.
Netanyahu appears to have nothing better to offer than a slight modification of Trump’s idea. He wouldn’t expel all of Gaza’s Palestinians. But he would force as many to leave as possible to other countries that would take them. Those who remain would be “relocated” to what the Israelis are calling “a humanitarian relocation site” where Palestinians can be provided for and “deradicalized.”
Both plans share three elements. First, to sell their ideas, both Trump and Netanyahu clothe them in humanitarian language. Second, no matter how they try to dress them up, both plans are designed and offered without consideration for what Palestinians really want. And finally, therefore, both are delusional and destined not only to fail, but to exacerbate an already volatile situation.
Maybe the biggest illusion projected by both men is the notion that their “plans” will create the conditions for regional peace. Ignoring the reality that a root cause of tension in the Middle East is the Israeli dispossession of Palestinians, their proposals only add to that dispossession and the resistance it spawns in Gaza (all the while compounding the same dispossession in the West Bank and East Jerusalem).
As history has shown, it is perilous to ignore the humanity of Palestinians. It is also foolish for Trump and Netanyahu to assume that their projected illusions will be believed in the Arab world, making possible an “era of peace.” This fantasy only exists in their minds and in the minds of the sycophants who surround them.
As a great Republican president (may have) said 160 years ago, “You can fool some of the people all of the time, and all of the people some of the time, but you cannot fool all of the people all of the time.”
Dr. James J. Zogby is the author of Arab Voices (2010) and the founder and president of the Arab American Institute (AAI), a Washington, D.C.-based organization which serves as the political and policy research arm of the Arab American community.
Scientists find the first ice core from the European Alps that dates back to the last Ice Age
The ice core holds clues to 12,000 years of human and environmental history.
Glaciers hold layers of history preserved in ice, offering unique insights into Earth's past that can also help us interpret the future. Trapped amidst the frozen water are microscopic deposits of dust, pollen, and even pollutants that scientists can use to examine environmental changes through time. DRI’s Ice Core Lab has used this technique to highlight atmospheric lead pollution and economic turbulence in Ancient Rome. Now, their latest study found that a glacier in the French Alps dates back to the last Ice Age – the oldest known glacier ice in the region. Serving as a record that spans through the development of agriculture in Western Europe and the advent of industrialization, the glacier holds insights into an era of rapid change.
The new study, published in the June issue of PNAS Nexus, examines a 40-meter long ice core from Mont Blanc’s Dôme du Goûter. Using radiocarbon dating techniques, the research team found that the glacier provides an intact record of aerosols and climate dating back at least 12,000 years. Aerosols are small droplets and particles in the air such as desert dust, sea salts, sulfur from volcanic eruptions, soot from forest fires, as well as pollutants and other emissions from human activities. Glacier ice offers the most detailed record of past atmospheric aerosols, and this is the first ice core record from the European region that extends back to the last climatic transition. Aerosols play an important role in regional climate through their interactions with clouds and solar radiation, and the insights offered by the ice record can help inform accurate climate modeling for both the past and future.
“For the first time, we have a fairly complete Alpine record of atmospheric and precipitation chemistry going all the way back to the Mesolithic Period,” said Joe McConnell, Director of DRI’s Ice Core lab who co-authored the study. “And that’s a big deal, because you have two major climate states – glacial and interglacial – and to get a record of atmospheric precipitation chemistry across that huge climate change tells you the most extreme natural aerosol concentrations that you’d expect. On top of that, you have humans going from hunter-gatherers with a very low population through the development of agriculture, domestication of animals, mining, etc, and then a vast population increase and the clearing of land. All of that is happening around this ice core site. It spans the full range of natural and anthropogenic change, and it’s right in the center of Europe – where much of Western civilization evolved.”
The glacier’s location in the Alps is important because it serves as a more intact record of Europe’s local climate than those found in distant Arctic ice. Many aerosols play important roles in driving Earth’s climate, so scientists would like to know how sources and concentrations in the air have varied in the past.
“Ice cores collected from glaciers and ice sheets can provide such information, but since these droplets and particles stay in the air only for a few days to maybe a week, records developed from glaciers close to the sources often are the most informative,” said lead author, Michel Legrand.
The ice core analyzed in this study was first collected in 1999 by some of the study’s French authors. It was stored in a freezer in France for more than 20 years before McConnell and his team brought it to DRI’s Ice Core Lab in Reno, Nevada, where specialized equipment and methods known as continuous flow analysis allowed it to be melted down and the chemistry measured, layer by icy layer.
“Determining what year or period of time a layer in the ice represents can be challenging, so here we used a unique combination of radiometric methods to establish the chronology in the ice,” said coauthor Werner Aeschbach.
“We were relieved to find that even under the unusually warm climate of the 20th century, the cold temperatures at over 14,000 feet near Mont Blanc’s peak had preserved the glacier so that the ice record hadn’t yet been impacted by melting,” said co-author Nathan Chellman.
The historic age of the ice at the base of the core, around 40 meters deep into the glacier, surprised the researchers. Another core collected from a glacier located less than 100 meters away at Col du Dome was found to contain ice only about a century old, despite being much deeper. The scientists attribute this to the strong wind patterns found on Mont Blanc.
“It's exciting to find the first ice core from the European Alps containing an intact record of climate that extends back through the current ten-thousand-year warm period and into the very different climate of the last ice age,” said coauthor Susanne Preunkert, who was a member of the field team that collected the ice core in 1999.
Insights into Europe’s Past Climate
The uniquely detailed ice record revealed a temperature difference of about 3 degrees Celsius between the last Ice Age and the current Holocene Epoch. Using pollen records embedded in the ice, reconstructions of summer temperatures during the last Ice Age were about 2 degrees Celsius cooler throughout western Europe, and about 3.5 degrees Celsius cooler in the Alps.
The phosphorous record also told researchers the story of vegetation changes in the region over the last 12,000 years. Phosphorous concentrations in the ice were low during the last Ice Age, increased dramatically during the early to mid-Holocene, and then decreased steadily into the late Holocene. This is consistent with the spread of forests under the warmer climate, and their decline following the proliferation of modern society and the land-clearing that resulted from agriculture and the spread of industry.
Records of sea salt also helped the researchers examine changes in historical wind patterns. The ice core revealed higher rates of sea salt deposition during the last Ice Age that may have resulted from stronger westerly winds offshore of western Europe. Sea salt aerosols can scatter solar radiation back to space and affect climate via their impacts on cloud droplet, size, and albedo, making them important drivers of the regional climate.
The ice record tells a more dramatic story for the changes in dust aerosols during the climatic shift. Dust serves as an important driver of climate by both absorbing and scattering incoming solar radiation and outgoing planetary radiation, and impacts cloud formation and precipitation by acting as cloud condensation nuclei. During the last Ice Age, dust was found to be about 8-fold higher compared to the Holocene. This contradicts the mere doubling of dust aerosols between warm and cold climate stages in Europe simulated by prior climate models. The difference may be explained by increased plumes of Saharan dust depositing in Europe, which remains the main source of dust in the region. The ice core record is consistent with other paleoclimate records that suggest more arid conditions over the Mediterranean during colder climates.
The 1999 expedition team collecting the ice core from Dome du Goûter on the shoulder of Mont Blanc. Credit: LGGE/OSUG, Bruno Jourdain
Uncovering More Stories Entombed in the Ice
This study is only the beginning of the Mont Blanc ice record’s story, as the researchers plan to continue analyzing it for indicators of human history. The first step in uncovering every ice core’s record is to use isotopes and radiocarbon dating to establish how old each layer of ice is. Now, with that information, the scientists can take an even deeper look at what it can tell us about past human civilizations and their impact on the environment.
“Now we can start to interpret all these other records that we have of lead and arsenic and other things like that, in terms of human history,” said McConnell.
The information can also be used to help interpret how changes in aerosols impact the climate and improve modeling to help us understand current and future climatic shifts.
“If you’re really going to go back and examine all possible climate states, past and future, you need a model that captures true climate variability,” McConnell said. “It’s a laudable goal, but to evaluate how good the models are, you’ve got to be able to compare them to observations, right? And that’s where the ice cores come in.”
Study coauthor Nathan Chellman carefully preparing longitudinal ice core samples for high-resolution measurements in DRI’s Ice Core Lab
Credit
DRI/Jessi LeMay
An ice sample on the melter during continuous ice core chemical analyses in the lab (credit: Sylvain Masclin).
Credit
Sylvain Masclin
More information: The full study, Alpine ice core record of large changes in dust, sea-salt, and biogenic aerosol over Europe during deglaciation, is available from PNAS Nexus at https://doi.org/10.1093/pnasnexus/pgaf186
Study authors include: Michel Legrand, Joe McConnell, Susanne Preunkert, David Wachs, Nathan Chellman, Kira Rehfeld, Gilles Bergametti, Sophia Wensman, Werner Aeschbach, Markus Oberthaler, and Ronny Friedrich
About DRI
We are Nevada’s non-profit research institute, founded in 1959 to empower experts to focus on science that matters. We work with communities across the state — and the world — to address their most pressing scientific questions. We’re proud that our scientists continuously produce solutions that better human and environmental health.
Scientists at DRI are encouraged to follow their research interests across the traditional boundaries of scientific fields, collaborating across DRI and with scientists worldwide. All faculty support their own research through grants, bringing in nearly $5 to the Nevada economy for every $1 of state funds received. With more than 600 scientists, engineers, students, and staff across our Reno and Las Vegas campuses, we conducted more than $52 million in sponsored research focused on improving peoples’ lives in 2024 alone.
At DRI, science isn’t merely academic — it’s the key to future-proofing our communities and building a better world. For more information, please visit www.dri.edu.
Spanning from the heart-stage embryo to seed germination, the study charts dynamic gene expression patterns in the embryo axis and cotyledon, revealing key regulatory networks. This work uncovers how transcription factors, hormone signals, and metabolic genes cooperate throughout development—and even shows that dehydration-resistance genes were positively selected during domestication.
Soybean is a globally important legume crop, supplying over 45% of plant-derived oil and 67% of animal feed in China alone. Its seeds develop from embryos, meaning that embryo growth directly determines seed size, weight, and quality. While transcriptome atlases have been constructed for crops like maize, wheat, and Arabidopsis, a high-resolution map covering the full embryo development process in soybeans—and other legumes—has been lacking. Soybean also differs from these models in cotyledon development, metabolite accumulation, and environmental sensitivity. A complete transcriptome atlas would thus not only clarify key developmental processes but also support advanced crop breeding strategies in soybean and related species.
A study (DOI: 10.48130/seedbio-0024-0021) published in Seed Biology on 13 December 2024 by Yingxiang Wang’s & Yalin Liu’s team, South China Agricultural University, serves as a powerful resource for functional genomics and opens doors for smarter breeding of high-yield, stress-resilient soybean varieties.
The study collected 18 tissue samples representing major stages of soybean embryo development, including the embryo axis and cotyledon, dry seeds, and germination phases. Each sample underwent RNA sequencing, generating high-coverage data with consistent replicates. Analysis revealed dynamic transcriptional activity: the number of expressed genes peaked during early maturation (over 25,000) and declined significantly in dry seeds, before rising again post-imbibition. EA typically exhibited more moderately expressed genes, while CT showed higher expression of select genes. Transcription patterns clustered according to developmental stages, with EA and CT from the same stage more similar than the same tissue across stages. Differential gene expression analysis revealed massive transcriptional reprogramming, especially during transitions into and out of maturation. For instance, nearly 5,000 genes were downregulated during late maturation, coinciding with seed desiccation. Gene ontology enrichment indicated key biological processes such as circadian rhythm regulation, hormone signaling, and flavonoid biosynthesis were stage-specific. Researchers also identified 1,922 active transcription factors (TFs), including well-known embryogenesis regulators such as BBM, STM, WOX11, and YABBY, which displayed tissue- and stage-specific expression. Moreover, genes involved in oil, protein, flavonoid, folate, and steroid biosynthesis revealed coordinated expression peaks, supporting the metabolic transitions during seed development. Notably, gibberellin-related genes peaked early, while abscisic acid-related genes dominated later stages. Surprisingly, dry seeds contained stored transcripts related to spliceosome and ribosome assembly, likely supporting rapid germination. Finally, genes associated with dehydration tolerance (LEA, HSP, oleosin, dehydrin) were found to be positively selected through domestication, showing increased expression from wild soybeans to modern cultivars. Altogether, this transcriptome landscape provides vital resources for crop improvement and evolutionary biology.
This transcriptome atlas offers a foundational resource for soybean functional genomics and seed trait improvement. The identified transcription factors and metabolic genes provide precise targets for breeding programs aimed at enhancing oil or protein content, improving stress resilience, or optimizing seed size. The discovery of stored transcripts in dry seeds may lead to strategies for boosting seed vigor and longevity. Moreover, the demonstrated selection of dehydration-related genes informs our understanding of how soybean adapted to changing climates over millennia. These insights can help accelerate the development of next-generation soybean varieties tailored for specific climates and agricultural needs.
This work was supported by the Guangdong Laboratory for Lingnan Modern Agriculture (NG2022002)，the Guangdong Ninth Pearl River Talent Program 'Team of plant meiosis recombination and germplasm innovation' (2021ZT09N333) and National Natural Science Foundation of China (32470344). We thank Chenjiang You and Yuan Fang (South China Agricultural University) for help with data analysis and Changkui Guo (South China Agricultural University) for help with soybean field organization.
About Seed Biology
Seed Biology (e-ISSN 2834-5495) is published by Maximum Academic Press in partnership with Yazhou Bay Seed Laboratory. Seed Biology is an open access, online-only journal focusing on research related to all aspects of the biology of seeds, including but not limited to: evolution of seeds; developmental processes including sporogenesis and gametogenesis, pollination and fertilization; apomixis and artificial seed technologies; regulation and manipulation of seed yield; nutrition and health-related quality of the endosperm, cotyledons, and the seed coat; seed dormancy and germination; seed interactions with the biotic and abiotic environment; and roles of seeds in fruit development. Seed Biology publishes a wide range of research approaches, such as omics, genetics, biotechnology, genome editing, cellular and molecular biology, physiology, and environmental biology. Seed Biology publishes high-quality original research, reviews, perspectives, and opinions in open access mode, promoting fast submission, review, and dissemination freely to the global research community.
Yoga, Tai Chi, walking and jogging may be the best forms of exercise to improve sleep quality and ease insomnia, suggest the findings of a comparative pooled data analysis published in the online journal BMJ Evidence Based Medicine.
The findings back the use of exercise as a primary treatment strategy for poor sleep patterns, say the researchers.
Characterised by difficulties falling and staying asleep, and early morning awakening, the prevalence of insomnia ranges from 4-22%, note the researchers. It is associated with heightened risks of various mental and physical health conditions, including dementia and cardiovascular disease.
Drug treatments for insomnia are not without their side effects, and cognitive behavioural therapy (CBT), while effective, isn’t always available due to the shortage of trained therapists, explain the researchers.
An emerging body of research suggests that exercise is helpful, but current guidelines don’t specify which types of exercise might be most beneficial. The researchers therefore set out to plug this knowledge gap, with a view to informing clinical practice and helping patients choose the most appropriate exercise for managing their insomnia.
They scoured research databases looking for relevant randomised clinical trials published up to April 2025 and included 22 in a network meta analysis—a statistical technique used to simultaneously compare multiple interventions.
The trials involved 1348 participants and 13 different treatment approaches to ease insomnia, seven of which were exercise based: yoga; Tai Chi; walking or jogging; aerobic plus strength exercise; strength training alone; aerobic exercise combined with therapy; and mixed aerobic exercises. These programmes ranged from 4 up to 26 weeks in length.
The other approaches included CBT; sleep hygiene; Ayurveda; acupuncture/massage; nothing; and existing treatment, such as usual care and/or lifestyle changes, the durations of which ranged from 6 to 26 weeks.
Validated scoring systems for sleep quality and insomnia severity —PSQI and the ISI45—as well as subjective and objective measures of total sleep time, sleep efficiency (percentage of time spent asleep while in bed), number of awakenings after going to sleep, and time taken to fall asleep (sleep latency) were used to assess sleep patterns.
Compared with existing treatment, CBT is likely to result in a large increase in total sleep time based on subjective sleep diary data. It may also improve sleep efficiency, and shorten the amount of time spent awake after falling asleep as well as sleep latency, with sustained improvements, the findings suggest.
But some of the exercise-based interventions also seemed to be effective, when compared with existing treatment.
Yoga likely results in a large increase in total sleep time of nearly 2 hours and may improve sleep efficiency by nearly 15%. It may also reduce the amount of time spent awake after falling asleep by nearly an hour, and shorten sleep latency by around half an hour.
Walking or jogging may result in a large reduction in insomnia severity of nearly 10 points, while Tai Chi may reduce poor sleep quality scores by more than 4 points, increase total sleep time by more than 50 minutes, and reduce time spent awake after falling asleep by over half an hour. It may also shorten sleep latency by around 25 minutes.
Further in-depth analyses revealed that Tai Chi performed significantly better on all subjectively and objectively assessed outcomes than existing treatments for up to 2 years.
There are potentially plausible biological explanations for the findings, say the researchers.
With its focus on body awareness, controlled breathing, and attentional training, yoga may alter brain activity, thereby alleviating anxiety and depressive symptoms which often interfere with a good night’s sleep, they suggest.
Tai Chi emphasises breath control and physical relaxation and has been shown to decrease sympathetic nervous system activity, dampening down hyperarousal, they add. And its combination of meditative movement and mindfulness may promote emotional regulation, deactivate ‘mental chatter’, and reduce anxiety. It may also help to curb the production of inflammatory chemicals over longer periods, they suggest.
Walking or jogging may improve sleep by increasing energy expenditure, curbing cortisol production, improving emotional regulation, boosting secretion of the sleep hormone melatonin, and enhancing the amount of deep sleep, they continue.
The researchers acknowledge that 15 (68%) of the included trials contained design and methodological flaws. And there were no standardised, quantifiable metrics for the frequency or intensity of exercise interventions, while the sample sizes of some of the studies were small.
Nevertheless, they conclude: “The findings of this study further underscore the therapeutic potential of exercise interventions in the treatment of insomnia, suggesting that their role may extend beyond adjunctive support to serve as viable primary treatment options.
“Although current clinical guidelines make only limited mention of exercise, this study provides relatively comprehensive comparative evidence that may inform the development of more specific and actionable clinical recommendations.
“Given the advantages of exercise modalities such as yoga, Tai Chi, and walking or jogging—including low cost, minimal side effects, and high accessibility—these interventions are well-suited for integration into primary care and community health programmes.”
And there may well be one type of exercise that is best suited to easing a particular symptom of insomnia, they suggest, which further research may clarify.
Medical tourism for bariatric and weight reduction surgery needs urgent regulation to protect recipients’ health, especially as the data show that tourist numbers are increasing despite the advent of weight loss drugs, say experts in a commentary published online in BMJ Global Health.
The high prevalence of obesity coupled with healthcare resource constraints and increased globalisation have resulted in more people accessing obesity treatment abroad, amid the rapid growth of services to meet this demand, note Dr Jessica McGirr of the Obesity Research and Care Group RCSI University of Medicine and Health Sciences, Dublin, Ireland and Imperial College London, and colleagues.
Despite its size, this industry is largely unregulated, point out the authors. Although reliable data are in short supply, the wider medical tourism industry is worth more than U$400 billion annually, with anticipated year on year growth of 25%, they highlight.
And while it’s anticipated that access to weight loss drugs may curb some of the demand for weight reduction surgery, the numbers of medical tourists in search of bariatric surgery continues to rise, particularly as this is often cheaper overseas, they add.
The out-of-pocket cost for this type of surgery done privately in the UK is around £10, 000–£15,000, but £2500–£4500 in countries, such as Turkey, they say.
The largest global survey to date of providers of bariatric and weight reduction surgery shows that most patients (71%) self-refer. They may therefore not have appropriate medical indication to undergo major surgery: ineligibility for this type of surgery in their home country is often cited by patients as a reason for accessing it overseas, say the authors.
And there are other risks in opting for this type of surgery overseas, they suggest. Providers may not always be clear about the potential complication rates; there’s no preoperative and long-term nutritional, psychological, or other medical follow-up; and there’s often no multidisciplinary care, which is integral to appropriate case selection, they argue.
“When considering adverse outcomes, including anastomotic [surgical tissue join in the gut] leakage, sepsis, and even death, equally concerning is the absence of regulation to ensure that only accredited procedures are performed by appropriately qualified providers,” they highlight.
“Further concern arises in the context of medical tourism ‘packages’ in which patients are offered multiple procedures within the same trip,” which are often accompanied by financial incentives, they add.
And there are also ethical issues to consider, they point out. They highlight the results of a provider survey, showing that nearly a third of respondents believed the consent process was “inappropriate” while 14% believed that patients were personally responsible for surgical complications.
“The need to regulate the [bariatric and metabolic tourism] industry to mitigate these safety, ethical, and legal risks for patients is essential,” urge the authors.
The financial and resource impacts of dealing with postoperative complications in returning medical tourists–and in those countries offering this type of surgery—of disinvesting in public health services to boost private sector trade, raise ethical questions, they add.
The current situation “highlights the need for transnational collaboration among all sectors to implement regulation,” explain the authors, suggesting that bodies, such as the World Trade Organisation, the World Health Organization, and the European Union, among others, should be involved in a global forum designated with this task.
They conclude: “This unregulated industry presents opportunity for quicker access to effective treatment for individuals with obesity but carries potential safety, ethical, and legal risks.
“The economy and healthcare resources of both home and destination countries may benefit financially from [bariatric and metabolic tourism], but the potential for unintended negative consequences and widening health inequity are significant.
“Establishing regulation through transnational collaboration is essential to protect health and health equity.”
