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Building a new vaccine arsenal to eradicate polio

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Despite some of the most successful international vaccination campaigns in history, the poliovirus continues to circulate around the world, posing a threat of neurological damage and even paralysis to anyone who is not vaccinated.

While the original polio strains, called wildtype, have largely been eliminated, new strains can develop from the oral polio vaccine (OPV), which is the one most used in the developing world. Oral vaccines use live, weakened virus that occasionally mutates to an active form, leading to outbreaks even in countries believed to have eliminated polio.

Scientists at UCSF and the UK’s National Institute of Biological Standards and Control (NIBSC) have developed two novel oral polio vaccines (nOPVs) to bolster the World Health Organization’s most recent push to finally eradicate polio, which began two years ago using the first nOPV developed by the same team. These are the first new polio vaccines in 50 years.

Like the first nOPV, the two newest nOPVs, which were described in Nature on June 14, are made from weakened poliovirus that has been genetically engineered to reduce reversion to dangerous forms of the virus. The development of these new vaccines was led jointly by Raul Andino, PhD, UCSF professor of microbiology and immunology, and Andrew Macadam, PhD, a virologist at NIBSC.

“With such variation in vaccination within and between countries, poliovirus has persisted into the 21st century, with sometimes tragic consequences,” said Andino, co-senior author of the paper along with Macadam. “We’ve designed these new vaccines using lessons learned from many years of fighting polio and believe they will help eliminate the disease once and for all.”

The evolving battle against polio

Polio is insidious: it is usually asymptomatic, but can cause severe disability, paralysis or death in about one in every hundred children. It spreads via fecal or oral particles, so it is particularly problematic in regions with poor sanitation. In the first half of the 20th century, polio outbreaks routinely rolled through the US, leading to a race to develop vaccines.

The first effective polio vaccines emerged in the 1950s, kicking off massive campaigns to immunize every person, with an emphasis on children. The inactivated polio vaccine (IPV), made of dead poliovirus, was given via injection, while the oral polio vaccine (OPV), made of weakened poliovirus, was given on a sugar cube or in a candy. Today, IPV is the vaccine of choice in countries with robust healthcare, and OPV — the cheaper, easier-to-administer option — is used otherwise.

In populations where everyone is immunized early in life, it doesn’t matter whether they receive IPV or OPV, although these vaccines act in different ways in the environment. People vaccinated with IPV can still get infected with any polio that happens to be circulating. They will not get sick, but they can silently transmit the virus to the unvaccinated. People vaccinated with OPV can’t silently transmit circulating polio in this way, but they can shed the weakened virus they were inoculated with and spread it to the unvaccinated. If the weakened virus mutates, it can become pathogenic polio once more.

In populations with unvaccinated children — whether due to refusal to vaccinate, natural disaster, or war — such vaccine-derived polio can spread widely, causing severe disease in the unlucky few.

While the original, or “wildtype,” poliovirus has only been recently detected in Afghanistan and Pakistan, vaccine-derived polio has been detected in countries as far flung as Syria, the Democratic Republic of Congo, and the U.S. In fact, there have been more cases of vaccine-derived polio than wildtype in recent years, creating an urgency to counter this new source of polio.

In 2017, Andino and his colleagues discovered how OPV reverts to its harmful form: a single mutation restores the virus’s capacity to migrate from the human gut and into the nervous system. Within a few years, the group had devised a trio of mutations that make such genetic reversion much less likely and packaged it into a new vaccine.

That vaccine, nOPV2, earned the WHO’s first-ever emergency use listing for a vaccine in 2020 and was quickly manufactured and distributed.

“Over 600 million doses were delivered to more than 28 countries, and in ten instances it stopped ongoing outbreaks of vaccine-derived polio,” said Andino. “It gave us a lot more confidence that this actually was working as anticipated.”

Covering all the bases with polio eradication

Despite its effectiveness, nOPV2 only protects against one of three strains of polio, and cases of polio have recently emerged in Israel, which is heavily vaccinated, as well as in pockets of the US where people refuse to vaccinate their kids.

Even where there are no polio cases in hospitals, polio continues to be detected in wastewater in major cities. There may be 99% fewer polio cases today than there were 30 years ago, but the last 1% has proven hard to snuff out.

“If there’s polio anywhere, it will come back where there are gaps in vaccination,” Andino said.

The latest work from Andino’s group takes the solution they crafted for nOPV2 — the three mutations that usually prevent the vaccine from becoming dangerous over time — and engineers it into the other two types of OPV. The resulting vaccines, nOPV1 and nOPV3, effectively prevented polio in animal models. All three are much safer than the original OPVs, which can occasionally cause paralysis in those who get the vaccine, although this is rare (on the order of one case per two million children vaccinated).

The two new vaccines are currently being tested in clinical trials to ensure that they are both effective and do not revert to dangerous forms in humans. Andino is hopeful they will be incorporated into bivalent or trivalent combinations with nOPV2. Children of the future will be equally protected from polio for life, and perhaps the world will someday experience decades in which zero polio is detected.

“The perception that polio is gone is a dangerous one,” said Andino. “For instance, just in India, 500,000 children are born each week, an enormous number of susceptible people. We now have what we need to protect them.”

 

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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