A bird stars in rare feel-good tale about Afghan evacuations

By ISABEL DEBRE

French Ambassador to the United Arab Emirates, Xavier Chatel, speaks to The Associated Press as Juji, a rescued yellow-beaked mynah carried into the United Arab Emirates by a fleeing Afghan refugee, sits in a cage, in Abu Dhabi, United Arab Emirates, Sunday, Oct. 10, 2021. The small bird rescued from Kabul by Chatel during France’s frantic evacuations has touched a global nerve, providing an uplifting counterpoint to the crises afflicting Afghanistan amid the Taliban takeover (AP Photo/Jon Gambrell)


ABU DHABI, United Arab Emirates (AP) — The mynah bird squawks from a new cage in the French ambassador’s sunlit living room in Abu Dhabi, a far cry from its life as the pet of a young Afghan woman who has since found refuge in France.

Talkative, yellow-beaked “Juji” had a brief star turn on social media, its story of survival amid the frenzied evacuations from Taliban-run Afghanistan striking a nerve with a global audience.

While searing scenes from the American-led airlift from Kabul after 20 years of war — such as those of Afghans falling to their deaths after trying to cling to the wheels of a military transport jet — gripped the world, France also was intensely involved in evacuating those who had risked their lives to cooperate with its government over the years.

Juji, a rescued yellow-beaked mynah carried into the United Arab Emirates by a fleeing Afghan refugee, sits in a cage at the French ambassador's home in Abu Dhabi, United Arab Emirates, Sunday, Oct. 10, 2021 The small bird rescued from Kabul by French Ambassador to the UAE, Xavier Chatel, during France’s frantic evacuations has touched a global nerve, providing an uplifting counterpoint to the crises afflicting Afghanistan amid the Taliban takeover (AP Photo/Jon Gambrell)

French Ambassador Xavier Chatel was scrambling to support the efforts at Al-Dhafra air base in the United Arab Emirates. Thousands of Afghan evacuees flooded the base near the UAE capital, along with military bases across the region, to be screened by American, French and other authorities over 12 sweltering days in August.

“There were many exhilarating stories because there were artists, there were musicians, there were people who were so relieved that they could be evacuated,” Chatel told The Associated Press Sunday from his residence overlooking the turquoise waters of the Persian Gulf. “But at the same time there was also an outpouring of distress.”

Some 2,600 Afghan interpreters, artists, journalists, activists and military contractors squeezed onto flights out of Kabul to Abu Dhabi on their way to Paris with barely enough time to consider all they’d left behind. French authorities had started evacuations around a year ago, with 2,400 people airlifted from Kabul in the months before the fall, Chatel said.

In the midst of the chaos at Al-Dhafra, Chatel received a security alert. Officers, on the lookout for al-Qaida and Islamic State extremist threats, had discovered illegal cargo on board.

A woman no older than 20 appeared, clutching a mystery cardboard box. Packed inside was her beloved pet with clipped wings — the famously chatty mynah, common in its range across Southeast Asia.

But because of sanitary concerns, there was no way she could take the small bird with her to Paris.

She was in tears, Chatel said, her body shaking. He declined to disclose details about the young woman and her circumstances for privacy reasons, except to say that “she had lost everything. She had lost her country. She had lost her house, she had lost her life.”

Chatel’s story of what happened next took hold on Twitter last week and turned Juji into a minor sensation, providing an uplifting counterpoint to the economic and humanitarian crises afflicting Afghanistan amid the Taliban takeover.

After receiving detailed instructions about Juji’s dietary preferences — cucumbers, grapes, bread slices and the occasional potato — Chatel decided to adopt the bird, promising he’d take good care of it.

The young woman found the ambassador on Twitter soon after landing in France. Top of her mind upon starting a new life as a refugee was her pet stranded on the Arabian Peninsula.

Chatel replied with videos of Juji snacking on fruit, flitting around its white cage and even learning French from his marble-floored living room. After chirping in Pashto for its first few days in Abu Dhabi, Juji had managed to utter something akin to “Bonjour.”

“(The woman) told me something which still remains with me,” Chatel said. “The fact that the bird was still alive and that he was well looked after gave her faith and and hope to start again.”

Exactly why the story was so avidly embraced on social media remains a mystery, Chatel said. But there were no good news days out of Afghanistan during the anguished withdrawal of U.S. and NATO forces.

A suicide bomber blew himself up at Kabul airport in late August, killing scores of Afghans and 13 U.S. service members, and those who managed to escape their homes for new lives abroad were grappling with feelings of bewilderment and guilt. With the country’s economy in free fall, ordinary people have struggled to survive.

At Al-Dhafra air base in August, you could see the fear in people’s faces, Chatel said. Children cried at the sound of popping balloons. One woman said she had “forgotten” her parents in a traumatic haze at Kabul airport. Parents arrived with stories of children they’d abandoned.

Until Chatel can devise a way to reunite Juji with its former owner, he said the black-winged bird remains a reminder to France of those frantic days — the courage of those embarking on new lives and the emotional toll of so many left behind.

“In the middle of this,” Chatel said, “in the middle of these hundreds of people arriving here, there was this girl and there was this bird.”

French actor breaks silence on child sex abuse within church
By SYLVIE CORBETan hour ago

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Author and actor Laurent Martinez gestures as he speaks during an interview with The Associated-Press at "Theo Theater" in Paris, Thursday, Oct. 7, 2021. French author and actor Laurent Martinez has been sexually abused by a priest. Over forty years later, he has chosen to make his story a theater play to show the devastating consequences and how speaking out can help overcoming the trauma. The play called "Pardon?" is deeply inspired from the Martinez's own life, describing how he felt devoured from the inside and the difficulties of daily life after being abused. (AP Photo/Michel Euler)

PARIS (AP) — At the age of eight, Laurent Martinez was sexually abused by a priest. Forty years later, he has chosen to make his story into a play, to show the devastating consequences and how speaking out can help victims heal and rebuild.

The play called “Pardon?” is drawn from the French author and actor’s own life, describing how he felt devoured from the inside by the abuse and struggled with daily life after it.

Martinez’s play was shown to bishops earlier this year, ahead of the presentation of a groundbreaking report last week that estimated that about 330,000 children in France were sexually abused over the past 70 years within France’s Catholic Church.

Despite the shocking revelations, Martinez deplored that “there is no — absolutely no — sense of urgency” within the church

“They are clearly slammed by the numbers” but “they are just talking, talking, talking,” he said in an interview with The Associated Press.

For Martinez, now 52, memories of the abuse remain vivid.

The priest who was teaching his catechism classes found pretexts to see the 8-year-old Martinez alone, kissing and touching his genitals, he said. One day, Martinez recalls, the abuser invited him to his apartment and forced the boy to engage in oral sex. Under French law, that would be classified as rape.

Martinez later told his parents, who alerted the diocese, and the priest was moved away. He believes the priest is now dead. Like most victims of sex abuse in the church, particularly before the church abuse scandals of the 2000s, Martinez didn’t seek legal recourse. Now it would be too late because of statutes of limitations.

For decades, Martinez buried the abuse inside him, only speaking about it to his two wives.

“For me, sexual relationships were marked in me as something forbidden. So it’s been very difficult for me to go through it, and I had to find very patient partners,” he said.

The play shows how the abuse affected his emotional and sexual life as an adult, making him sometimes grow aggressive or overreact to everyday worries — but also how it led him to be very protective towards children.

Martinez said he spent 40 years “wearing the mask of someone else” and “seeking to hide something that was like a cancer inside me.”

A few years ago, he felt he needed to speak out because he was fed up with keeping the trauma inside him.

“I thought: I need to do something. It’s not possible to continue like that,” he said.

The play was shown for the first time at the Avignon arts festival in 2019. That is also when he first told his two sons, now 21 and 11, about the abuse. Since then, Martinez’s play has been playing in theaters in Paris and across France and a performance of it was shown on France’s Catholic television network KTO.




Flyers of the play "Pardon?" written by actor and author Laurent Martinez are seen on the table at "Theo Theater" in Paris, Thursday, Oct. 7, 2021. French author and actor Laurent Martinez has been sexually abused by a priest. Over forty years later, he has chosen to make his story a theater play to show the devastating consequences and how speaking out can help overcoming the trauma. The play called "Pardon?" is deeply inspired from the Martinez's own life, describing how he felt devoured from the inside and the difficulties of daily life after being abused. (AP Photo/Michel Euler)

“I’ve been in pain for so long, and now I’m an actor so ... I’m acting my pain. I’m not in it anymore,” he said.

In recent weeks, Martinez, who lost his faith following the abuse, made a new, decisive step. After much hesitation, he asked the head of the Conference of Bishops of France, Eric de Moulins-Beaufort, whether he could seek Martinez’ forgiveness in the name of his abuser.

“He accepted and it was tremendous emotionally for everybody that night,” Martinez remembers. “I gave my forgiveness to the priest that raped me.”

After that, “I felt really completely free of the whole burden of anger, of the desire of revenge. All the bad feelings I had just had vanished, just because I had forgiven,” he said.

“Little by little the trauma is disappearing,” Martinez added. “What helped more was to be able to forgive the priest.”

The actor had been previously in touch with Moulins-Beaufort, who supported the play and offered to show it to French bishops as part of the church’s efforts to face up to shameful secrets that were long covered up.

The offer is evidence of the Catholic hierarchy’s belated realization that listening to survivors is a fundamental part of the church’s own process of coming to terms with the problem and helping them heal.

Pope Francis came to that realization at a 2019 summit he convened with the heads of all the world’s bishops conferences, which featured wrenching testimonies from victims about abuse and the lifelong trauma it caused. For many bishops, it was the first time they had ever actually listened to a survivor, since so often the church ignored victims or treated them as an enemy out to harm the institution.

Among many recommendations in last week’s report about church abuse in France are measures that would institutionalize ways for church hierarchy to better help and hear victims. The report estimates that at least 2,900-3,200 male clergy members were responsible for sexual abuse of children in France since the 1950s, and accuses the church of a systemic coverup.

Martinez knows that his play is helping other people who suffered similar ordeals, and hopes it encourages them to speak out and seek help.

Some “come to see me and say: ‘Thank you so much, because, you know, this is also my story. And you are the first person I’m telling that to.’”

“The most difficult thing is to say it once,” Martinez stressed. “Then you get the strength to say it again and again and again. And then you’re free, or at least you are on the good path to freedom.”

___

Jeffrey Schaeffer in Paris and Nicole Winfield in Rome contributed.

Fiona Hill, a nobody to Trump and Putin, saw into them both

By LYNN BERRY and CALVIN WOODWARD

In this Nov. 21, 2019, file photo, fFormer White House national security aide Fiona Hill, testifies before the House Intelligence Committee on Capitol Hill in Washington. (AP Photo/Jose Luis Magana, File)


WASHINGTON (AP) — Vladimir Putin paid scant attention to Fiona Hill, a preeminent U.S. expert on Russia, when she was seated next to him at dinners. Putin’s people placed her there by design, choosing a “nondescript woman,” as she put it, so the Russian president would have no competition for attention.

Fluent in Russian, she often carefully took in the conversations of men who seemed to forget she was there and wrote it all down later, she recalled in an Associated Press interview. “Hey, if I was a guy, you wouldn’t be talking like this in front of me,” she remembered thinking. “But go ahead. I’m listening.”

Hill expected not to be similarly invisible when she later went to work for another world leader, Donald Trump, as his Russia adviser in the White House. She could see inside Putin’s head, had co-written an acclaimed book about him, but Trump did not want her counsel, either. He ignored her in meeting after meeting, once mistaking her for a secretary and calling her “darlin.”

Again, though, she was listening. She was reading Trump like she had read Putin.

The result is “There Is Nothing for You Here,” her book out last week. Unlike other tell-all authors from the Trump administration, she isn’t obsessed with the scandalous. Much like her measured but riveting testimony in Trump’s first impeachment, the book offers a more sober, and thus perhaps more alarming, portrait of the 45th president.

If Hill’s tone is restrained, it is damning by a thousand cuts. It lays out how a career devoted to understanding and managing the Russian threat crashed into her revelation that the greatest threat to America comes from within.

In fly-on-the-wall detail, she describes a president with a voracious appetite for praise and little to no taste for governing — a man so consumed with what others said about him that U.S. relations with other countries rose or fell according to how flattering foreign leaders were in their remarks.

“From his staff and everyone who came into his orbit, Trump demanded constant attention and adulation,” she writes. Particularly in international affairs, ”The president’s vanity and fragile self-esteem were a point of acute vulnerability.”

Hill describes Putin manipulating Trump by offering or withholding compliments, a maneuver she said was more effective with this president than getting dirt and blackmailing him would have been. At their joint news conference in Finland, when Trump appeared to side with Putin over his own intelligence agencies on Russian interference in the 2016 U.S. election, Hill almost lost it.

“I wanted to end the whole thing,” she writes. “I contemplated throwing a fit or faking a seizure and hurling myself backward into the row of journalists behind me. But it would only have added to the humiliating spectacle.”

Yet in Trump she saw a rare if ultimately wasted talent. He spoke the language of many average people, disdained the same things, operated without a filter, liked the same food and gleefully shredded the tiresome norms of the elite. While Hillary Clinton sipped champagne with donors, Trump was out there pitching coal and steel jobs — at least that was the impression.

“He clearly had a feel for what people wanted,” she told AP. “He could talk the talk even if he couldn’t walk the walk in having their experiences. But he understood it.”

Yet that skill was squandered, in her view. Where it could have been used to mobilize people for good, it was instead used only in service of himself — “Me the People” as a chapter title puts it.

Trump’s vanity also doomed his Helsinki meeting with Putin and any chances for a coveted arms control deal with Russia. The questions at the news conference “got right to the heart of his insecurities,” Hill writes. If Trump had agreed that Russia had interfered in the election on his behalf, in his mind he might as well have said “I am illegitimate.”

It was clear to Putin that the resulting backlash would undermine even the vague commitments he and Trump had made. “On his way out the door from the conference,” Hill writes, “he told his press secretary, within earshot of our interpreter, that the press conference was ‘bullshit.’”

Trump admired Putin for his wealth, power and fame, seeing him, in Hill’s words, as the “ultimate badass.” During the course of his presidency, Trump would come to resemble the autocratic and populist Russian leader more than he resembled any recent American presidents, she writes, and “Sometimes even I was startled by how glaringly obvious the similarities were.”

Putin’s ability to manipulate the Russian political system to potentially stay in power indefinitely also made an impression. “Trump sees that and says what’s there not to like about that kind of situation?” Hill told AP.

Trump was impeached by the House in late 2019 for trying to use his leverage over Ukraine to undermine Joe Biden, his eventual Democratic rival, among the first of his efforts to stay in office by unconventional means, stretching to the Jan. 6 insurrection at the Capitol by a mob he had told to “fight like hell.”

Hill had served as the national intelligence officer for Russia from early 2006 until late 2009 and was highly respected in Washington circles, but it was only during the impeachment hearings that she was introduced to the nation. She became one of the most damaging witnesses against the president she had served, undercutting his defense by testifying that he had sent his envoys to Ukraine on a “domestic political errand” that had nothing to do with national security policy.

She began her testimony by describing her improbable journey as the daughter of a coal miner from an impoverished town in northeast England to the White House. She also explained her desire to serve a country that “has offered me opportunities I never would have had in England.”

Much of her new book expands on that personal journey, a story told with self-deprecating humor and kindness. Along the way, Hill the Brookings Institution scholar weaves in a study of the changing societies she witnessed over the decades as a child in Britain, a student and researcher in Russia and finally as a citizen of the United States.

The changes in all three countries are strikingly similar, due in part to the destruction of heavy industry. The result is what she calls a “crisis of opportunity” and the rise of populist leaders like Putin, Trump and British Prime Minister Boris Johnson able to tap into the fears and grievances of those feeling left behind.

She said she went into the White House worried about what Russia was doing and “came out, having realized fully watching all of this, that actually the problem was the United States ... and the Russians were just exploiting everything.”

Hill calls Russia a cautionary tale, “America’s Ghost of Christmas Future,” if the U.S. is unable to heal its political divisions.

Hailing from a more civil form of politics, President Joe Biden is trying to bring the country together and advance its reputation abroad, she said, but “he’s, in a way, a kind of man standing alone and people are not pulling behind him.”

AP video journalist Nathan Ellgren contributed to this report.

Doctors claim Brazil hospitals gave dodgy COVID-19 care

By DÉBORA ÁLVARES

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A demonstrator in a Brazilian President Jair Bolsonaro mask protests against the Prevent Senior health care company outside its headquarters in Sao Paulo, Brazil, Sept. 30, 2021. Whistleblowing doctors, through their lawyer, testified at the Senate last week that Prevent Senior enlisted participants to test unproven drugs without proper consent and forced doctors to toe the line on prescribing unproven drugs touted by President Jair Bolsonaro as part of a “COVID kit,” in the treatment of the new coronavirus. (AP Photo/Marcelo Chello)


BRASILIA, Brazil (AP) — Irene Castilho didn’t even have a day to grieve after her husband died of COVID-19. She was sick, too, coughing and struggling to breathe; he was barely gone when she started using his oxygen mask. The same day, on March 22, she was admitted to a hospital in Sao Paulo.

The 71-year-old had followed doctors’ instructions to the letter – dutifully taking her doses of hydroxychloroquine. She also took ivermectin and a battery of anti-inflammatories and vitamins in the so-called “COVID kit” that her health care company, Prevent Senior, mailed to her home.

Still, her condition had deteriorated.

At the hospital, Castilho received dialysis and was intubated. When physicians consulted Castilho’s daughters about giving her flutamide — a drug typically used for prostate cancer – they declined, worried about possible side effects for their mother who recently had liver cancer.



Luiz Cezar Pereira gets emotional when talking about his late mother during an interview at his family's home in Guarulhos, Brazil, Friday, Oct. 1, 2021. Pereira's mother died of COVID-19 and was treated by health care company Prevent Senior, which is under investigation for allegedly forcing doctors to test unproven drugs on coronavirus patients. Pereira's mother was treated with flutamide, a drug typically used for prostate cancer, for which he eventually consented after resisting when his online research found it wasn’t scientifically proven. (AP Photo/Marcelo Chello)


They later saw a nurse administering flutamide; she told them it had been prescribed despite their objection.

Castilho died in late April, 33 days after her husband, and her daughters scattered her ashes upon his grave.

“You know that passionate couple? That was them,” her daughter Kátia Castilho told the Associated Press in a video call from northeastern city Joao Pessoa. “That’s what keeps me from staying silent. That’s what makes me unafraid. It’s a truth that I wish were a lie. It’s a wound that will never scar.”

Castilho’s case is one of a series of examples that have led to explosive accusations against Prevent Senior, which operates 10 hospitals in Sao Paulo, that have scandalized Brazil since mid-September.

Whistleblowing doctors, through their lawyer, testified at the Senate last week that Prevent Senior enlisted participants to test unproven drugs without proper consent and forced doctors to toe the line on prescribing unproven drugs touted by President Jair Bolsonaro as part of a “COVID kit.”

Some senators have said it appears Prevent Senior falsified death certificates to omit COVID-19 as cause of death. Authorities are also investigating the complaints the company conducted research without proper permission.

The case underscores the resilient rift in polarized Brazil over proper treatment of COVID-19 patients, with many in the nation — including the unvaccinated president — bucking global scientific recommendations. And there’s concern that other providers likewise implemented dodgy policies.

Two weeks ago, Pedro Batista Júnior, Prevent Senior’s executive director, testified to senators that doctors were free to make their own prescriptions for treatment of COVID-19 and said patients had freely agreed to take their COVID kits.

In response to more than a dozen questions from the AP, Prevent Senior denied all wrongdoing, irregularities at its facilities or having conducted unapproved trials. It said all patients or family members consented before receiving treatment.

It didn’t respond to questions about how many patients received the COVID kits.

Brazil has a public health care system, though service is often subpar. Many middle-class Brazilians have private plans, but costs for the elderly are high.

Prevent Senior seemed to help fill that gap. It was founded in 1997 and grew among those who couldn’t afford premium care; its monthly cost is about $300, half that of some competitors. The company has more than 500,000 clients, with an average age of 68.

Three doctors formerly employed by Prevent Senior — George Joppert, Alessandra Joppert and Walter Correa de Souza Neto — told television program “Fantastico” on Oct. 3 that doctors received instructions from company officials to prescribe hydroxychloroquine. Until that interview, all had remained anonymous.

Souza Neto repeated that assertion in Senate testimony on Thursday: “Between the end of March and April (2020), (Prevent Senior) instituted a protocol to prescribe hydroxychloroquine for patients. There was no autonomy for the doctor; it was mandatory.”

The antimalarial has been given glowing endorsements by Bolsonaro and his allies, who are among few remaining global champions for the drug. While a few studies at the pandemic’s onset suggested it might be promising, they were largely conducted in lab dishes, not people. Extensive worldwide research has long since found it to be ineffective and potentially dangerous for COVID-19.

The doctors also said they were told to prescribe ivermectin, an anti-parasite drug whose effectiveness for COVID-19 remains unproven. The American Medical Association recommends against prescribing it outside of formal trials.

Both drugs are part of what President Jair Bolsonaro and his allies refer to as “early treatment” for COVID-19. The president defended “early treatment” as recently as Sept. 20 at the U.N. General Assembly. He and his lawmaker son have also cited the healing potential of proxalutamide, an anti-androgen similar to flutamide that is still undergoing trials as a potential COVID-19 medication.

Pressure to prescribe hydroxychloroquine and ivermectin is corroborated by internal Prevent Senior chat groups on WhatsApp obtained by The Associated Press, and which were previously shared with the Senate committee investigating the nation’s COVID-19 response.

They include messages sent by Benedito Júnior and another executive, two current clinic directors, one former clinic director, and an unnamed physician.

Both drugs are also relatively inexpensive. One of the directors sent messages demanding their prescription while highlighting Prevent Senior’s slipping finances.

“We can’t lose focus. We’ve started having bad revenues again,” a director named Rodrigo Esper wrote to doctors in May 2020 while urging use of the drugs. “We still haven’t hit the peak of the pandemic and we’re losing revenue.”

Lawyer Bruna Morato, who represents 12 doctors currently or previously employed by Prevent Senior, told senators on Sept. 28 that her clients were repeatedly told to choose between prescribing dubious drugs or losing their jobs.

In polarized Brazil, perspectives on COVID-19 have assumed ideological contours, particularly as Bolsonaro repeatedly downplayed the disease’s severity and undermined governors’ and mayors’ measures to control its spread.

Armchair epidemiologists have shown themselves willing to excoriate anyone who voices trust in the so-called global experts or expresses doubt about the effectiveness of the COVID kit prescribed by doctors at Prevent and elsewhere. Bolsonaro claims that the Senate committee is politically motivated and working unfairly to pin the pandemic’s deaths on him.

The press office of Brazil’s presidency didn’t respond to requests for comment for this story.

In response to questions from the AP, Prevent Senior insisted that doctors had been free to prescribe the COVID kit or not.

But that medical autonomy has been challenged by the three doctors interviewed by “Fantastico,” Senate testimony by the lawyer of 12 doctors and five of the messages reviewed by the AP.

On March 21 this year, a doctor sent a message saying an executive named Rafael had told her that prescription of the COVID kit was mandatory.

“Rafael told me prescription of the COVID kit is obligatory, but I don’t feel comfortable with that. I’d like to know how I should proceed,” the doctor wrote to a recipient who was not identified. The message was one of those shared with Senate investigators.

Some patients other than Castilho also were given flutamide — though with consent.

Luiz Cesar Pereira said he had initially resisted a doctor urging him to use the drug for his mother after he researched on the internet and found it wasn’t scientifically proven.

”‘Trust me, we’re going to recover your mom,’” Pereira recalled the doctor saying. He finally relented, and gave consent.

“In my blessed ignorance, I believed. ... Because I don’t know anything. I don’t have any friend who’s a doctor,” said Pereira, 45, who sells construction materials.

His mother eventually died.

Dr. José Davi Urbaez, president of the capital’s society of infectious disease specialists, said he believes Prevent Senior’s use of unproven treatments is just “the tip of the iceberg.”

“What was done with ‘early treatment’ is criminal, and not limited to Prevent,” he said. “There needs to be a very precise investigation of this, and punishment should be exemplary, because it underscores failure in the ethics of medical practice.”

Prevent Senior told the AP that it wasn’t formally testing flutamide, but said doctors were allowed to administer it. The company maintained that the drug can be helpful in treating COVID-19.

Jorge Venâncio, commissioner of Brazil’s National Research Ethics Commission, told the AP that the only application Prevent Senior made for COVID-19 research was related to the prescription of hydroxychloroquine and azithromycin, an anti-inflammatory that also hasn’t proven helpful.

He said the council approved that request to start trials in April 2020 and the hospital published its results just three days later, indicating the study had already been done.

Prevent Senior told the AP it was not a scientific study, but rather an “observational report” comparing patients who received hydroxychloroquine and azithromycin with others who didn’t take the drugs, and which started in March.

“They published a pre-print with the results of the research, with 636 patients, which is impossible; there’s no way to do that,” Venâncio said. “Even if it were observational research, as they’re saying now, it would have to be registered.”

Prevent Senior disputed the need for registration with the commission.

But the research council gave that information to prosecutors in Sao Paulo who are investigating the healthcare provider, and who have received complaints from doctors and patients. The Senate committee is also sharing information with prosecutors.

The lawmakers are also investigating possible fraud in death certificates. In May 2020, the Health Ministry issued guidelines stating that a death stemming from COVID-19 should still be classified as such on a death certificate, even if the patient had stopped testing positive for the virus itself.

“If the person was admitted for COVID, COVID has to be on the death certificate,” said Daniel Dourado, a doctor, lawyer and researcher at the University of Sao Paulo.

But that didn’t always happen. Luciano Hang, a department store magnate who is a fervent Bolsonaro supporter, told the Senate committee his mother was admitted to a Prevent Senior facility in Sao Paulo with COVID-19. Yet the disease doesn’t appear on her death certificate, a copy of which the AP reviewed.


Demonstrators protest against the Prevent Senior health care company outside its headquarters in Sao Paulo, Brazil, Sept. 30, 2021. Whistleblowing doctors, through their lawyer, testified at the Senate last week that Prevent Senior enlisted participants to test unproven drugs without proper consent and forced doctors to toe the line on prescribing unproven drugs touted by President Jair Bolsonaro as part of a “COVID kit,” in the treatment of the new coronavirus. (AP Photo/Marcelo Chello)


It remains unclear whether that means patients’ deaths were omitted from state and national tallies of COVID-19 deaths.

Prevent Senior’s press office told the AP that this didn’t interfere with compulsory notification to authorities.

Sen. Randolfe Rodrigues, who sits on the committee, told the AP he believes it did affect the tallies, but there will be no way to prove that for months. Others agree.

“Prevent hid COVID-19 deaths. And that was intentional. I have never seen anything of this scale,” said Dr. Gonzalo Vecina, one of the founders of Brazil’s health regulator. “They committed crimes and we need to identify who produced false information that fed into the public health care system.”

Neither Sao Paulo state’s health secretariat nor Brazil’s Health Ministry confirmed whether patients who died from COVID-19 at Prevent Senior facilities factored into the nation’s death toll, which is the world’s second highest at more than 600,000.

Like Urbaez, many say the revelations from Prevent Senior reflect what is going on elsewhere. Similar allegations have emerged regarding Hapvida, the nation’s third-largest healthcare provider, with almost 5 million clients.

The major newspaper O Globo published messages indicating Hapvida directors pressured doctors to prescribe hydroxychloroquine as recently as January. Several doctors confirmed this to the paper, without revealing their names.

Felipe Peixoto Nobre, a former Hapvida doctor in Ceara state, told television station Globo that he was red-flagged for not prescribing the COVID kit, and was told he ran the risk of being fired if his refusal continued.

Hapvida said in a statement to the AP that, at the start of the pandemic, hydroxychloroquine was understood to be beneficial and “there was significant adherence in our network,” but that it never amounted to the majority of prescriptions. It said it no longer recommends hydroxychloroquine “because there is no scientific proof of its effectiveness.”

The government regulator of private health care plans said in a statement to the AP it is investigating Hapvida, Prevent Senior and another provider, Unimed Fortaleza. Sao Paulo’s medical council also told the AP it is investigating Prevent Senior.

Meanwhile, the Senate committee aims to release its final report within two weeks and some lawmakers have already signaled they want to make an example of Prevent Senior.

Sen. Renan Calheiros, who is assigned to write the committee report, said in an interview, “Prevent Senior is the most shocking case investigated by this committee from a humanitarian and civilizational perspective,” and accused it of giving some patients medicine without their consent. “This isn’t a health care plan, but an operator of death stimulated by the president of the republic.” ___ AP journalists Tatiana Pollastri and Mauricio Savarese contributed from Sao Paulo

Study confirms rise in child abuse during COVID-19 pandemic

By Denise Mann, HealthDay News

Physical abuse of school-aged kids tripled during the early months of the pandemic when widespread stay-at-home orders were in effect, a new study finds.

Exactly what triggered the surge is not fully understood, but other studies have also reported similar upticks in child abuse. A pediatrician who was not involved in the new research suspects COVID-19 and pandemic-related stresses created a "perfect storm" for abuse.

"Stressful situations can be a trigger for poor judgment and impulsive reactions," said Dr. Allison Jackson, division chief of the Child and Adolescent Protection Center at Children's National Hospital in Washington, D.C.

"There was a great deal of economic stress, job insecurity, and loss of housing potential during this time frame along with the closing of schools, which can be a reprieve for parents and kids," Jackson said.

For the study, researchers analyzed data on more than 39,000 children treated at nine pediatric trauma centers between March and September of last year. Of these, 2,064 were victims of suspected child abuse.

Among children aged 5 and older, the number of child abuse victims tripled to 103, up from an average of 36 during a similar period before the pandemic, the study found.

Researchers said a greater proportion of older children reported abuse after stay-at-home orders went into effect last year.

"The most common injury identified was head injury, followed by a mix of chest, abdomen, extremity and burn injuries," said senior study author Dr. Katherine Flynn-O'Brien, associate trauma medical director at Children's Wisconsin in Milwaukee.

The overarching public health message is clear, she said.

"Systemic safeguards such as social services that help families, particularly those least resourced and most vulnerable, should be considered essential during a national crisis," Flynn-O'Brien said.

The findings are to be presented Saturday at an online meeting of the American Academy of Pediatrics. Findings presented at meetings are typically considered preliminary until published in a peer-reviewed journal.

Dr. Andrea Asnes is a leader of the AAP Council on Child Abuse and Neglect and director of Yale Programs for Safety, Advocacy and Healing in New Haven, Conn.

Despite the rise in abuse of school-aged children, she pointed out that other studies have found no increase in abuse of younger children during this same time frame.

"Daycare centers for little kids were considered essential and remained open, which allowed some families to function, but older kids were stuck at home," she explained.

Unfortunately, the new study may just be the tip of the iceberg when it comes to child abuse in older kids during the pandemic, she added.

"The vast majority of child physical abuse is not managed in the hospital," said Asnes, who was not involved in the study. "Older kids who get punched or beaten with a belt don't always require medical care, so it's certainly possible that more abuse could have gone undetected."

Jackson also noted that these older children weren't going to school or seeing other adults who might have noticed and reported the abuse.

"The onus is usually on the bystander to report child abuse," she added.

The hope is that with the world is opening up and schools again in session, rates of child abuse will decrease, Jackson said.

"We are seeing a decrease back to baseline levels in my practice," she added.More information

Learn how you can help if you suspect a child is being abused at ChildCare.gov.

Copyright © 2021 HealthDay. All rights reserved.

More than 140K U.S. children have lost a caregiver to COVID-19

By HealthDay News


In the United States, roughly 1 in 4 COVID-19 deaths has left a child without a caregiver -- either primary or secondary -- according to a new study. File Photo by Sarah Silbiger/UPI | License Photo

It is an excruciating statistic: One in every four COVID-19 deaths in the United States leaves a child without a parent or other caregiver, researchers report.

The analysis of data shows that from April 2020 to July 2021, more than 120,000 children under the age of 18 lost a primary caregiver -- a parent or grandparent who provided housing, basic needs and care -- and about 22,000 lost a secondary caregiver, often grandparents who provided housing, but not most basic needs.

"Children facing orphanhood as a result of COVID-19 is a hidden, global pandemic that has sadly not spared the United States," study author Susan Hillis, a U.S. Centers for Disease Control and Prevention researcher, said in a U.S. National Institutes of Health news release.

Overall, about 1 in 500 children in the United States have become orphans or lost a grandparent caregiver to COVID-19, according to the study published Thursday in the journal Pediatrics.

Children of racial and ethnic minorities accounted for 65% of youngsters who lost a primary caregiver to COVID-19, compared with 35% of white children, even though whites account for 61% of the U.S. population, and people of racial and ethnic minorities represent 39% of the population.

Orphanhood or the death of a primary caregiver due to COVID-19 was experienced by: 1 of every 168 American Indian/Alaska Native children, 1 of every 310 Black children, 1 of every 412 Hispanic children, 1 of every 612 Asian children, and 1 of every 753 White children.

Compared to White children, American Indian/Alaska Native children were 4.5 times more likely to lose a parent or grandparent caregiver, Black children were 2.4 times more likely, and Hispanic children were 1.8 times more likely.

States with large populations -- California, Texas and New York -- had the highest overall numbers of children who lost primary caregivers to COVID-19.

The researchers also found significant racial/ethnic differences between states.

In New Mexico, Texas, and California, 49% to 67% of children who lost a primary caregiver were Hispanic.

In Alabama, Louisiana and Mississippi, 45% to 57% of children who lost a primary caregiver were Black.

American Indian/Alaska Native children who lost a primary caregiver were more common in South Dakota (55%), New Mexico (39%), Montana (38%), Oklahoma (23%), and Arizona (18%).

The fallout from losing a parent is significant for children: It is associated with mental health problems fewer years of school lower self-esteem high-risk sexual behaviors and increased risk of substance abuse, suicide, violence, sexual abuse and exploitation, the researchers noted.

"All of us -- especially our children -- will feel the serious immediate and long-term impact of this problem for generations to come. Addressing the loss that these children have experienced -- and continue to experience -- must be one of our top priorities, and it must be woven into all aspects of our emergency response, both now and in the post-pandemic future," Hillis said.

"The magnitude of young people affected is a sobering reminder of the devastating impact of the past 18 months," said study co-lead researcher Alexandra Blenkinsop, from Imperial College London.

"These findings really highlight those children who have been left most vulnerable by the pandemic, and where additional resources should be directed," Blenkinsop said.More information

The American Academy of Pediatrics has more on childhood grief

Copyright © 2021 HealthDay. All rights reserved. 

Ecuador's legislature to investigate president over Pandora Papers


Issued on: 11/10/2021 - 

Guillermo Lasso is among scores of politicians, businessmen and celebrities who appear in the Pandora Papers 

RODRIGO BUENDIA AFP/File

Quito (AFP)

Ecuador's legislature on Sunday voted to open an investigation into whether President Guillermo Lasso broke the law by keeping assets in tax havens, after the Pandora Papers leaks.

Lasso, Ecuador's first right-wing president in 14 years, is among scores of politicians, businessmen and celebrities who appear in the Pandora Papers, an investigation by an international consortium of journalists that exposed secret offshore accounts.

The probe of Lasso's activity will be conducted by the country's Constitutional Commission within 30 days, the legislature said in a statement.

The investigation is meant to determine whether the 65-year-old president "may have breached" the norm that "prohibits candidates and public officials from having their resources or assets in tax havens," the legislature said.

According to the Pandora Papers, Lasso controlled 14 offshore companies, most of them based in Panama, and closed them after the passage of a law in 2017 that prohibited presidential candidates from having companies in tax havens.

Lasso, who took office in May, has said that years ago he had "legitimate investments in other countries" and that he got rid of them to compete in the presidential election.

© 2021 AFP

Turkey court keeps civil rights activist in jail despite EU pressure

Osman Kavala told an Istanbul court the charges against him "are not based on any evidence." He's spent years in pretrial detention, and was arrested again on separate charges hours after a Turkish court acquitted him.



The ECHR has demanded Turkey free Osman Kavala, after several years in prison without a conviction

A Turkish court on Friday ordered civil society leader Osman Kavala be kept behind bars on charges he said were based on "conspiracy theories," four years after he was imprisoned without conviction.

The Parisian-born businessman and philanthropist faces charges linked to 2013 anti-government protests and a failed military coup in 2016.

The European Court of Human Rights (ECHR) ordered his release in December 2019.
What happened at the hearing?

US and European diplomats attended the trial which included a group of football supporters alleged to have been part of the 2013 protests.

About 35 defendants out of 52 charged in two separate cases combined into one were present in the courtroom.

Kavala was charged with allegedly trying to overthrow the Turkish government and espionage.

He faces a 20-year prison sentence without parole if convicted.

The 64-year-old Kavala himself denied the charges calling them "slanderous" and "an assassination attempt against my dignity."

"It is totally devoid of evidence, just like the accusation of espionage that was fabricated later,'' he told the court.

"What is striking about the charges brought against me is not merely the fact that they are not based on any evidence," he said. "They are allegations of a fantastic nature based on conspiracy theories overstepping the bounds of reason.''

Acquitted over protest, then charged with 'coup' participation instead

At the end of the session, the Istanbul court set a new hearing for November 26, with Kavala ordered to remain behind bars until that date.

European Parliament Turkey rapporteur Nacho Sanchez said Friday's session was "a missed opportunity for authorities to respect their international commitments."

Turkey risks sanctions, potentially even exclusion, from the 47-member Council of Europe when it next meets on November 30 unless Kavala has been released.

Human rights groups and some Western governments see his detention as part of President Recep Tayyip Erdogan's crackdown on dissent.

Kavala was originally cleared in February 2020 of being part of nationwide demonstrations that started at Istanbul's Gezi Park in 2013.

But he was immediately re-arrested for supposedly supporting the 2016 coup attempt which Turkey blames on US-based Muslim cleric Fethullah Gulen.An appeals court later overturned the Gezi Park acquittals, setting the stage for Friday's trial.

Mass arrests were common in the aftermath of the Gezi protests, and even more so in the months and years following the supposed coup attempt, when Turkey jailed almost 80,000 alleged Gulen supporters and suspended or sacked around 150,000 public sector workers accused of ties to the group.

A recent US State Department report singled out suspicious deaths of persons in custody, forced disappearances, torture and arbitrary arrests as NATO member Turkey's most pressing human rights issues.

Turkish authorities have hit hard on dissidents after the failed coup of July 2016

jc/msh (Reuters, AP, AFP)

The unknown consequences of plastic’s legacy, found in seabirds around the world

Peer-Reviewed Publication

TOKYO UNIVERSITY OF AGRICULTURE AND TECHNOLOGY

 

IMAGE: PHOTO : GREAT SHEARWATER AND INGESTED PLASTICS TAKEN BY PETER RYAN view more 

CREDIT: HIDESHIGE TAKADA/ TUAT

Seabirds from Gough Island in the south Atlantic, Marion Island near Antarctica and the coasts of both Hawaii and Western Australia have a dangerous habit: eating plastic. Across 32 species of seabirds sampled from around the globe, an international team from 18 institutions in seven countries found that up to 52 % of the birds not only ate plastic, but also accumulated the plastic’s chemical components in their bodies.

The researchers published their results on October 11th, 2021 in Environmental Monitoring and Contaminants Research.

“Globally, approximately 400 million metric tons of plastics are produced each year, and a portion of these escape into the environment, eventually find their way into the oceans,” said corresponding author Hideshige Takada, professor in the Laboratory of Organic Geochemistry (LOG), Tokyo University of Agriculture and Technology. “When floating on the sea surface or stranded on beaches, plastics are exposed to UV radiation from the sun and break down into smaller fragments.”

These fragments, as well as resin pellets used as plastic feedstock that also make their way into the waterways, are not biodegradable nor do they sink. They are similar in size to seabirds’ natural prey of small fish and insects, and they are light enough to float or move with the currents.

“Consequently, huge amounts of plastics are available to a suite of consumers in the world’s oceans,” Takada said. “As of 2020, 180 species of seabirds, corresponding to half of the total species of seabirds around the globe, have been reported to have ingested plastics. It has also been predicted that by 2050, 99% of seabird species will have ingested plastics.”

While eating plastic can cause physical damage and be a direct cause for seabird death, according to Takada, little is known about the biological consequences of consuming the chemicals added to bind, stabilize or otherwise improve plastic used in food packing, fishing gear and more.

“It was believed that additives are not easily available for leaching or accumulation in biological tissues as they are kneaded into the polymer matrix during plastic production,” Takada said. “However, it has been demonstrated that oily components in digestive fluids can act as organic solvents to facilitate additive leaching.”

As a result, Takada said, plastic additives can be accumulated in seabirds’ tissue.  

“In this study, we aimed to understand the spread threat of plastic-mediated accumulation of chemical additives to seabirds on a global basis,” Takada said.

CAPTION

World seabirds accumulation plastic additives

CREDIT

Hideshige Takada/ TUAT

The researchers analyzed oil from the preen gland, located just above the tail, from 145 seabirds in 16 different locations around the world. By examining the chemical concentrations in this oil, the researchers can determine the contaminant burden of the bird’s internal fat stores. They procured the oil by wiping the gland, which can be done without harm to the bird. They also examined the preen gland oil and stomach contents of 54 bird carcasses found on the beaches.

The researchers found one additive accumulated in 16 of the birds, and other additives in 67 of the birds. 

“High concentrations of additives were detected in seabirds that also contained large, ingested plastic loads,” Takada said, noting that the birds could also receive additives initially ingested by their natural prey, these occurrence patterns suggest that additives are derived mainly from directly ingested plastics. “The detection additives demonstrated that significant portions of the world’s seabirds — 10 to 30% — are likely the accumulate chemicals directly from ingesting plastics, but the health consequences of this are not fully understood.”

The researchers plan to further explore the biological effects of the accumulated additives in seabirds.

Other contributors include first author Rei Yamashita, Nagako Hiki, Fumika Kashiwada and Kaoruko Mizukawa, LOG, Tokyo University of Agriculture and Technology, Japan; Britta Denise Hardesty and Lauren Roman, CSIRO Oceans and Atmosphere, Australia; David Hyrenbach, Marine Science Programs at Oceanic Institute, Hawaii Pacific University, United States; Peter G. Ryan and Ben Dilley, FitzPatrick Institute of African Ornithology, DST-NRF Centre of Excellence, University of Cape Town, South Africa; Juan Pablo Muñoz-Pérez and Carlos A. Valle, Colegio de Ciencias Biológicas y Ambientales COCIBA and Galápagos Science Center GSC, Universidad San Francisco de Quito USFQ, Ecuador; Christopher K. Pham, OKEANOS R&D Centre, University of the Azores, Portugal; João Frias, Marine and Freshwater Research Centre (MFRC), Galway-Mayo Institute of Technology, Ireland; Bungo Nishizawa, Akinori Takahashi, Jean-Baptiste Thiebot, Nobuo Kokubun, Yuuki Y. Watanabe and Kozue Shiomi, National Institute of Polar Research, Japan; Alexis Will, Institute of Arctic Biology, University of Alaska Fairbanks, United States;  Takashi Yamamoto, Graduate School of Environmental Studies, Nagoya University, Japan; Ui Shimabukuro, Department of Polar Science, The Graduate University for Advanced Studies (SOKENDAI), Japan; and Yutaka Watanuki, Faculty of Fisheries Sciences, Hokkaido University, Japan. The following researchers have secondary affiliations: Yamashita, Atmosphere and Ocean Research Institute, The University of Tokyo, Japan; Hardesty, Centre for Marine Sociology, University of Tasmania, Australia; Roman, Institute for Marine and Antarctic Studies, University of Tasmania, Australia; Muñoz-Pérez, Faculty of Science and Engineering, University of the Sunshine Coast, Australia; Shiomi, Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Japan; and Yamamoto, Meiji Institute for Advanced Study of Mathematical Sciences, Organization for the Strategic Coordination of Research and Intellectual Properties, Meiji University, Japan.

The Ministry of Education, Culture, Sports, Science and Technology of Japan supported this research.

##

For information about the Takada laboratory, please visit http://pelletwatch.org

Original publication

https://doi.org/10.5985/emcr.20210009

Environmental Monitoring and Contaminants Research Vol.1, pp. 97–112, 2021

 

About Tokyo University of Agriculture and Technology

TUAT is a distinguished university in Japan dedicated to science and technology. TUAT focuses on agriculture and engineering that form the foundation of industry, and promotes education and research fields that incorporate them. Boasting a history of over 140 years since our founding in 1874, TUAT continues to boldly take on new challenges and steadily promote fields. With high ethics, TUAT fulfills social responsibility in the capacity of transmitting science and technology information towards the construction of a sustainable society where both human beings and nature can thrive in a symbiotic relationship. For more information, please visit http://www.tuat.ac.jp/en/.

Contact

Hideshige Takada, Ph.D.
Professor,
Laboratory of Organic Geochemistry (LOG),
Tokyo University of Agriculture and Technology, Japan
e-mail: shige@cc.tuat.ac.jp

---

JOURNAL

Environmental Monitoring and Contaminants Research

DOI

10.5985/emcr.20210009 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Plastic additives and legacy persistent organic pollutants in the preen gland oil of seabirds sampled across the globe

Epigenetics, the misunderstood science that could shed new light on ageing

Illustration by Philip Lay.

The study of the epigenome came with claims that trauma could be inherited, but now researchers are more excited about its potential to measure the risk of disease


Laura Spinney
Sun 10 Oct 2021

Alittle over a decade ago, a clutch of scientific studies was published that seemed to show that survivors of atrocities or disasters such as the Holocaust and the Dutch famine of 1944-45 had passed on the biological scars of those traumatic experiences to their children.

The studies caused a sensation, earning their own BBC Horizon documentary and the cover of Time (I also wrote about them, for New Scientist) – and no wonder. The mind-blowing implications were that DNA wasn’t the only mode of biological inheritance, and that traits acquired by a person in their lifetime could be heritable. Since we receive our full complement of genes at conception and it remains essentially unchanged until our death, this information was thought to be transmitted via chemical tags on genes called “epigenetic marks” that dial those genes’ output up or down. The phenomenon, known as transgenerational epigenetic inheritance, caught the public imagination, in part because it seemed to release us from the tyranny of DNA. Genetic determinism was dead.


A decade on, the case for transgenerational epigenetic inheritance in humans has crumbled. Scientists know that it happens in plants, and – weakly – in some mammals. They can’t rule it out in people, because it’s difficult to rule anything out in science, but there is no convincing evidence for it to date and no known physiological mechanism by which it could work. One well documented finding alone seems to present a towering obstacle to it: except in very rare genetic disorders, all epigenetic marks are erased from the genetic material of a human egg and sperm soon after their nuclei fuse during fertilisation. “The [epigenetic] patterns are established anew in each generation,” says geneticist Bernhard Horsthemke of the University of Duisburg-Essen in Germany.
The study of epigenetics seems to reinforce the case that it’s not nature versus nurture, but nature plus nurture

Even at the time, sceptics pointed out that it was fiendishly difficult to disentangle the genetic, epigenetic and environmental contributions to inherited traits. For one thing, a person shares her mother’s environment from the womb on, so that person’s epigenome could come to resemble her mother’s without any information being transmitted via the germline, or reproductive cells. In the past decade, the threads have become even more tangled, because it turns out that epigenetic marks are themselves largely under genetic control. Some genes influence the degree to which other genes are annotated – and this shows up in twin studies, where certain epigenetic patterns have been found to be more similar in identical twins that in non-identical ones.

This has led researchers to think of the epigenome less as the language in which the environment commands the genes, and more as a way in which the genes adjust themselves to respond better to an unpredictable environment. “Epigenetics is often presented as being in opposition to genetics, but actually the two things are intertwined,” says Jonathan Mill, an epigeneticist at the University of Exeter. The relationship between them is still being worked out, but for geneticist Adrian Bird of the University of Edinburgh, the role of the environment in shaping the epigenome has been exaggerated. “In fact, cells go to quite a lot of trouble to insulate themselves from environmental insult,” he says.

Whatever that relationship turns out to be, the study of epigenetics seems to reinforce the case that it’s not nature versus nurture, but nature plus nurture (so genetic determinism is still dead). And whatever the contribution of the epigenome, it doesn’t seem to translate across generations.

All the aforementioned researchers rue the fact that transgenerational epigenetic inheritance is still what most people think of when they hear the word epigenetics, because the past decade has also seen exciting advances in the field, in terms of the light it has shed on human health and disease. The marks that accumulate on somatic cells – that is, all the body’s cells except the reproductive ones – turn out to be very informative about these, and new technologies have made it easier to read them.

A model of DNA methylation – the process that modulates genes. The influence of environment or lifestyle on this process is being studied. Photograph: Laguna Design/Science Photo Library

Different people define epigenetics differently, which is another reason why the field is misunderstood. Some define it as modifications to chromatin, the package that contains DNA inside the nuclei of human cells, while others include modifications to RNA. DNA is modified by the addition of chemical groups. Methylation, when a methyl group is added, is the form of DNA modification that has been studied most, but DNA can also be tagged with hydroxymethyl groups, and proteins in the chromatin complex can be modified too.

Researchers can generate genome-wide maps of DNA methylation and use these to track biological ageing, which as everyone knows is not the same as chronological ageing. The first such “epigenetic clocks” were established for blood, and showed strong associations with other measures of blood ageing such as blood pressure and lipid levels. But the epigenetic signature of ageing is different in different tissues, so these couldn’t tell you much about, say, brain or liver. The past five years have seen the description of many more tissue-specific epigenetic clocks.

Mill’s group is working on a brain clock, for example, that he hopes will correlate with other indicators of ageing in the cortex. He has already identified what he believes to be an epigenetic signature of neurodegenerative disease. “We’re able to show robust differences in DNA methylation between individuals with and without dementia, that are very strongly related to the amount of pathology they have in their brains,” Mill says. It’s not yet possible to say whether those differences are a cause or consequence of the pathology, but they provide information about the mechanisms and genes that are disrupted in the disease process, that could guide the development of novel diagnostic tests and treatments. If a signal could be found in the blood, say, that correlated with the brain signal they’ve detected, it could form the basis of a predictive blood test for dementia.

Details about smoking habits can be detected from the epigenome – researchers are working on a clinical application for these observations. 

Photograph: Chris Rout/Alamy

While Bird and others argue that the epigenome is predominantly under genetic control, some researchers are interested in the trace that certain environmental insults leave there. Smoking, for example, has a clear epigenetic signature. “I could tell you quite accurately, based on their DNA methylation profile, if someone was a smoker or not, and probably how much they smoked and how long they had smoked for,” says Mill.

James Flanagan of Imperial College London is among those who are exploiting this aspect of the epigenome to try to understand how lifestyle factors such as smoking, alcohol and obesity shape cancer risk. Indeed, cancer is the area where there is most excitement in terms of the clinical application of epigenetics. One idea, Flanagan says, is that once informed of their risk a person could make lifestyle adjustments to reduce it.

Drugs that remodel the epigenome have been used therapeutically in those already diagnosed with cancer, though they tend to have bad side-effects because their epigenetic impact is so broad. Other widely prescribed drugs that have few side-effects might turn out to work at least partly via the epigenome too. Based on the striking observation that breast cancer risk is more than halved in diabetes patients who have taken the diabetes drug metformin for a long time, Flanagan’s group is investigating whether this protective effect is mediated by altered epigenetic patterns.

Meanwhile, the US-based company Grail – which has just been bought, controversially, by DNA sequencing giant Illumina – has come up with a test for more than 50 cancers that detects altered methylation patterns in DNA circulating freely in the blood.

Last month the NHS launched a trial of Grail’s Galleri blood test, designed to detect epigenetic modifications that identify more than 50 types of cancer. 

Photograph: Grail

Based on publicly available data on its false-positive and false-negative rates, the Grail test looks very promising, says Tomasz K Wojdacz, who studies clinical epigenetics at the Pomeranian Medical University in Szczecin, Poland. But more data is needed and is being collected now in a major clinical trial in the NHS. The idea is that the test would be used to screen populations, identifying individuals at risk who would then be guided towards more classical diagnostic procedures such as tissue-specific biopsies. It could be a gamechanger in cancer, Wojdacz thinks, but it also raises ethical dilemmas, that will have to be addressed before it is rolled out. “Imagine that someone got a positive result but further investigations revealed nothing,” he says. “You can’t put that kind of psychological burden on a patient.”

The jury is out on whether it’s possible to wind back the epigenetic clock. This question is the subject of serious inquiry, but many researchers worry that as a wave of epigenetic cosmetics hits the market, people are parting with their money on the basis of scientifically unsupported claims. Science has only scratched the surface of the epigenome, says Flanagan. “The speed at which these things happen and the speed at which they might change back is not known.” It might be the fate of every young science to be misunderstood. That’s still true of epidenetics, but it could about to change.

Sequencing the epigenome

Until recently, sequencing the epigenome was a relatively slow and expensive affair. To identify all the methyl tags on the genome, for example, would require two distinct sequencing efforts and a chemical manipulation in between. In the past few years, however, it has become possible to sequence the genome and its methylation pattern simultaneously, halving the cost and doubling the speed.

Oxford Nanopore Technologies, the British company responsible for much of the tracking of the global spread of Covid-19 variants, which floated on the London Stock Exchange last week, offers such a technology. It works by pushing DNA through a nanoscale hole while current passes either side. DNA consists of four bases or letters – A, C, G and T – and because each one has a unique shape in the nanopore it distorts the current in a unique and measurable way. A methylated base has its own distinctive shape, meaning it can be detected as a fifth letter.

The US firm Illumina, which leads the global DNA sequencing market, offers a different technique, and chemist Shankar Balasubramanian of the University of Cambridge has said that his company, Cambridge Epigenetix, will soon announce its own epigenetic sequencing technology – one that could add a sixth letter in the form of hydroxymethyl tags.

Protein modifications still have to be sequenced separately, but some people include RNA modifications in their definition of epigenetics and at least some of these technologies can detect those too – meaning they have the power to generate enormous amounts of new information about how our genetic material is modified in our lifetime. That’s why Ewan Birney who co-directs the European Bioinformatics Institute in Hinxton, Cambridgeshire, and who is a consultant to Oxford Nanopore, says that epigenetic sequencing stands poised to revolutionise science: “We’re opening up an entirely new world.”

Scientists are still puzzling over the mystery of what makes us conscious. 

Clues to consciousness: how dopamine fits into the mystery of what makes us conscious – podcast

October 7, 2021

What’s happening in our brains to create consciousness? In this episode of The Conversation Weekly podcast, we hear from two scientists uncovering clues to this mystery that could help people with severe brain injuries to recover. And the story of how artificial intelligence – and its human helpers – completed Beethoven’s unfinished 10th symphony.

Philosophers have pondered the meaning of consciousness for generations. But for a long time, scientists didn’t pay the question much attention. And as recently as the 1980s, the science of consciousness remained a controversial topic.

That all began to change in the 1990s, and since then neuroscientists and doctors around the world have discovered tantalising clues about what’s going on in our brains to make us conscious – or unconscious.

Emmanual Stamatakis, who leads the cognition and consciousness imaging group at the Division of Anaesthesia, University of Cambridge in the UK, explains how consciousness seems to work along a continuum. At one end are people in a coma, followed by those under anaesthesia and then an alert person with regular levels of consciousness. “In the last ten years or so, we started extending in a different direction,” he says, by exploring how stimulants such as LSD will “I hesitate saying this: increase your consciousness”.

Stamatakis and his colleagues are currently looking at how brain networks are connected to consciousness. He explains the results of their recent study which found the chemical dopamine may play a crucial role.

Read more: Consciousness: how the brain chemical 'dopamine' plays a key role – new research

Other researchers are already testing drugs that boost dopamine levels in patients with severe brain injuries. Leandro Sanz, a medical doctor and PhD candidate in medical sciences at the University of Liège in Belgium, talks to us about a randomised controlled trial he’s working on that is testing if molecules that mimic dopamine – called dopamine agonists – could help these patients recover better. “It’s a very active field because if we find the treatment that even has slight improvements in all the patients, that would be a huge step forward,” says Sanz.

In our second story (30m30), we shift from the power and mystery of the human brain to the power of artificial intelligence to mimic it. On October 10 in Bonn, the Beethoven Orchestra will give the world premiere of Ludwig van Beethoven’s Unfinished 10th symphony. The project came out of a collaboration between computer scientists and musicologists. Ahmed Elgammal, a professor of computer science and director of the Art and AI lab at Rutgers University in New Jersey, who led the artificial intelligence side of the project, tells us how they did it.

Read more: How a team of musicologists and computer scientists completed Beethoven's unfinished 10th Symphony

Plus, Holly Squire, arts and culture editor at The Conversation in the UK, gives us some of her recommended reads from the past week (44m45).

This episode of The Conversation Weekly was produced by Mend Mariwany and Gemma Ware, with sound design by Eloise Stevens. Our theme music is by Neeta Sarl. You can find us on Twitter @TC_Audio, on Instagram at theconversationdotcom or via email on podcast@theconversation.com. You can also sign up to The Conversation’s free daily email here.

Musical extracts from the Beethoven 10th symphony project in this episode from Deutsche Telekom and Beethoven’s 9th symphony via YouTube’s Audio Library.

Authors

Daniel Merino

Assistant Science Editor & Co-Host of The Conversation Weekly Podcast

Gemma Ware

Editor and Co-Host, The Conversation Weekly Podcast

Interviewed

Ahmed Elgammal

Professor, Director of the Art & AI Lab, Rutgers University

Emmanuel A Stamatakis

Lead, Cognition and Consciousness Imaging Group, Division of Anaesthesia, University of Cambridge

Leandro Sanz

PhD Candidate in Medical Sciences, Coma Science Group, University of Liège, Belgium, Université de Liège