YCLOAK

U.S. Defense Secretary Lloyd Austin ordered a number of improvements in access to mental health care on Thursday to reduce suicides in the military but held off on endorsing more controversial recommendations to restrict gun and ammunition purchases by young troops, sending them to another panel for study.

An independent committee in late February recommended that the Defense Department implement a series of gun safety measures, including waiting periods for the purchase of firearms and ammunition by service members on military property and raising the minimum age for service members to buy guns and ammunition to 25.

In a memo released Thursday, Austin called for the establishment of a suicide prevention working group to “assess the advisability and feasibility” of recommendations made by the initial study committee — which would include the gun measures. He also asked for cost estimates and a description of any “barriers” to implementing other changes and set a deadline of June 2 for that report. At no point did he specifically refer to the gun proposals or mention gun safety.

Growing concern 

Austin’s orders reflect increasing concerns about suicides in the military despite more than a decade of programs and other efforts to prevent them and spur greater intervention by commanders, friends and family members. But his omission of any gun safety and control measures underscores the likelihood that they would face staunch resistance, particularly in Congress, where such legislation has struggled in recent years.

The more immediate changes address broader access to care.

To more quickly provide help for troops who might be struggling, Austin directed the Pentagon to hire more behavioral health specialists and implement a scheduling system for appointments where patients receive multiple health care visits weekly when they first seek care.

Austin also ordered military primary care health clinics to screen for unhealthy levels of alcohol use, make unhealthy alcohol use treatment easier to receive, and make sure mental health care is available through service members’ primary care as well.

“The mental health support available for our teammates must be comprehensive and easy to access,” Austin said in the memo.

Brigadier General Pat Ryder, the Pentagon press secretary, told reporters in a briefing Thursday that Austin’s orders involved areas where the department already has the authority to take immediate steps.

“While we recognize that suicide has no single cause, and that no single preventative action, treatment or cure will eliminate suicide altogether, we will exhaust every effort to promote the wellness, health and morale of our total force,” Ryder said.

Committee recommends rules about firearms

The initial study committee recommended that the department require anyone living in military housing to register all privately owned firearms. In addition, the panel said the department should restrict the possession and storage of privately owned firearms in military barracks and dorms.

Confirming findings in annual suicide reports, the panel noted that about 66% of all active-duty military suicides — and more than 70% of those by National Guard and Reserve members — are done with firearms. It said reducing access to guns could prevent some deaths.

Craig Bryan, a clinical psychologist and member of the Suicide Prevention and Response Independent Review Committee, said the department should slow down troops’ access to guns — specifically those bought in stores on bases — so people under stress can survive periods of high risk.

He likened the expanded gun safety measures to requirements that the department puts on motorcycle usage — such as mandated helmets — that are often more strict than some state laws. Asked how likely such changes would be, Bryan said he believes troops are more receptive to such limits than civilians might be.
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Deaths of pregnant women in the United States fell in 2022, dropping significantly from a six-decade high during the pandemic, new data suggests.

More than 1,200 U.S. women died in 2021 during pregnancy or shortly after childbirth, according to a final tally released Thursday by the Centers for Disease Control and Prevention. In 2022, there were 733 maternal deaths, according to preliminary agency data, though the final number is likely to be higher.

Officials say the 2022 maternal death rate is on track to get close to pre-pandemic levels. But that’s not great: The rate before COVID-19 was the highest it had been in decades.

“From the worst to the near worst? I wouldn’t exactly call that an accomplishment,” said Omari Maynard, a New Yorker whose partner died after childbirth in 2019.

Experts blame COVID-19 

The CDC counts women who die while pregnant, during childbirth, and up to 42 days after birth. Excessive bleeding, blood vessel blockages, and infections are leading causes.

COVID-19 can be particularly dangerous to pregnant women, and experts believe it was the main reason for the 2021 spike. Burned-out physicians could have added to the risk by ignoring pregnant women’s worries, some advocates said.

In 2021, there were about 33 maternal deaths for every 100,000 live births. The last time the government recorded a rate that high was 1964.

What happened “isn’t that hard to explain,” said Eugene Declercq, a longtime maternal mortality researcher at Boston University. “The surge was COVID-related.”

Previous government analyses concluded that one quarter of maternal deaths in 2020 and 2021 were COVID-related — meaning that the entire increase in maternal deaths was due to coronavirus infections or the pandemic’s wider impact on health care. Pregnant women infected with the coronavirus were nearly eight times as likely to die as their uninfected peers, according to a recent study published by BMJ Global Health.

The bodies of pregnant women are already under strain, their heart forced to pump harder. Other health problems can make their condition more fragile. And then on top of that, “COVID is going to make all that much worse,” said Dr. Elizabeth Cherot, chief medical and health officer for the March of Dimes.

It didn’t help that vaccination rates among pregnant women were low in 2021 — particularly among Black women. Part of that was related to limited vaccine availability, and that the CDC did not fully recommend shots for pregnant women until August 2021.

“Initially, there was a lot of mistrust of the vaccine in Black communities,” said Samantha Griffin, who owns a doula service that mainly serves families of color in the Washington area.

But there’s more to it than that, she and others added. The 2021 maternal mortality rate for Black women was nearly three times higher than it was for white women. And the maternal death rate for Hispanic American women that year rose 54% compared with 2020, also surpassing the death rate for white moms.

More than a year into the pandemic, a lot of doctors and nurses were feeling burned out and they were getting less in-person time with patients.

Providers at the time “were needing to make snap decisions and maybe not listening to their patients as much,” Griffin said. “Women were saying that they thought something was wrong and they weren’t being heard.”

‘She wasn’t being heard’

Maynard, who is 41 and lives in Brooklyn, said he and his partner experienced that in 2019.

Shamony Gibson, a healthy 30-year-old, was set to have their second child. The pregnancy was smooth until her contractions stopped progressing and she underwent a cesarean section.

The operation was more involved than expected but their son Khari was born in September. A few days later, Shamony began complaining of chest pains and shortness of breath, Maynard said. Doctors told her she just needed to relax and let her body rest from the pregnancy, he said.

More than a week after giving birth, her health worsened and she begged to go to the hospital. Then her heart stopped, and loved ones called for help. The initial focus for paramedics and firefighters was whether Gibson was taking illicit drugs, Maynard said, adding that she didn’t.

She was hospitalized and died the next day of a blood clot in the lungs. Her son was 13 days old.

“She wasn’t being heard at all,” said Maynard, an artist who now does speaking engagements as a maternal health advocate.
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For the first time, scientists have created baby mice from two males. 

This raises the distant possibility of using the same technique for people — although experts caution that very few mouse embryos developed into live mouse pups, and no one knows whether it would work for humans. 

Still, “It’s a very clever strategy,” said Diana Laird, a stem cell and reproductive expert at the University of California, San Francisco, who was not involved in the research. “It’s an important step in both stem cell and reproductive biology.” 

Scientists described their work in a study published Wednesday in the journal Nature. 

First, they took skin cells from the tails of male mice and transformed them into “induced pluripotent stem cells,” which can develop into many different types of cells or tissues. Then, through a process that involved growing them and treating them with a drug, they converted male mouse stem cells into female cells and produced functional egg cells. Finally, they fertilized those eggs and implanted the embryos into female mice. About 1% of the embryos — 7 out of 630 — grew into live mouse pups. 

The pups appeared to grow normally and were able to become parents themselves in the usual way, research leader Katsuhiko Hayashi of Kyushu University and Osaka University in Japan told fellow scientists at the Third International Summit on Human Genome Editing last week. 

In a commentary published alongside the Nature study, Laird and her colleague, Jonathan Bayerl, said the work “opens up new avenues in reproductive biology and fertility research” for animals and people. Down the road, for example, it might be possible to reproduce endangered mammals from a single male. 

“And it might even provide a template for enabling more people,” such as male same-sex couples, “to have biological children, while circumventing the ethical and legal issues of donor eggs,” they wrote. 

But they raised several cautions. The most notable one: The technique is extremely inefficient. They said it’s unclear why only a tiny fraction of the embryos placed into surrogate mice survived; the reasons could be technical or biological. They also stressed that it’s still too early to know if the protocol would work in human stem cells at all. 

Laird also said scientists need to be mindful of the mutations and errors that may be introduced in a culture dish before using stem cells to make eggs. 

The research is the latest to test new ways to create mouse embryos in the lab. Last summer, scientists in California and Israel created “synthetic” mouse embryos from stem cells without a dad’s sperm or a mom’s egg or womb. Those embryos mirrored natural mouse embryos up to 8 ½ days after fertilization, containing the same structures, including one like a beating heart. Scientists said the feat could eventually lay the foundation for creating synthetic human embryos for research in the future.
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Moonwalking astronauts will have sleeker, more flexible spacesuits that come in different sizes when they step onto the lunar surface later this decade. 

Exactly what that looks like remained under wraps. The company designing the next-generation spacesuits, Axiom Space, said Wednesday that it plans to have new versions for training purposes for NASA later this summer. 

The moonsuits will be white like they were during NASA’s Apollo program more than a half-century ago, according to the company. That’s so they can reflect heat and keep future moonwalkers cool. 

The suits will provide greater flexibility and more protection from the moon’s harsh environment, and will come in a wider range of sizes, according to the Houston-based company. 

NASA awarded Axiom Space a $228.5 million contract to provide the outfits for the first moon landing in more than 50 years. The space agency is targeting late 2025 at the earliest to land two astronauts on the moon’s south pole. 

At Wednesday’s event in Houston, an Axiom employee modeled a dark spacesuit, doing squats and twisting at the waist to demonstrate its flexibility. The company said the final version will be different, including the color. 

“I didn’t want anybody to get that mixed up,” said Axiom’s Russell Ralston. 
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In the early days of the COVID-19 pandemic, nurses, truck drivers, grocery clerks and other essential workers were hailed as heroes.

“Now we are vilifying them … and this has long-term ramifications for our well-being,” said Manuela Tomei, International Labor Organization assistant director-general for governance, rights, and dialogue.

“The work that these persons perform is absolutely essential for families and societies to function,” she said, speaking Wednesday in Geneva. “So, the non-availability of their services would really result into a loss of well-being and the impossibility of ensuring safe lives to society at large.”

And yet a new study by the International Labor Organization (ILO) finds essential workers are undervalued, underpaid and laboring under poor working conditions, exposed to treatment that “exacerbates employee turnover and labor shortages, jeopardizing the provision of basic services.”

The U.N. agency’s report classifies key workers into eight main occupation groups covering health, food systems, retail, security, cleaning and sanitation, transport, manual, and technical and clerical occupations.

Data from 90 countries show that during the COVID-19 crisis key workers suffered higher mortality rates than non-key workers overall, with transport workers being at highest risk.

The report found 29% of key workers globally are low paid, earning on average 26% less than other employees. It reports they tend to work long, unpredictable hours under poor conditions.

Tomei said inaction in improving sub-standard conditions of work is having consequences today.

“In a number of countries, these sectors are facing some labor shortages because people are increasingly reluctant to engage in work which is not fairly valued by society and rewarded in terms of better pay and also improved working conditions.

“So, we are facing a crisis right now,” she added.

Richard Samans, director of the ILO research department, noted that a critical shortage of nurses in many countries is of particular concern.

“This affects the very life of people,” he said Wednesday. “Many people in countries are facing long delays in treatment. In the event of a shock — some sort of a major health disruption or natural disaster or otherwise — if the system is already strained, it cannot handle the major influx of demand for those nursing services.”

A new report by the World Health Organization warns the “widespread disruptions to health services” due to the COVID-19 pandemic “has resulted in a rapid acceleration in the international recruitment of health professionals,” mainly from poor to rich countries, exacerbating shortages of this vital workforce in developing countries.

The ILO reports that countries are still experiencing supply shortages three years after WHO declared COVID-19 a pandemic. ILO research director Richard Samans attributes this to a scarcity of truck drivers due to lack of training and bad working conditions.

“In the event of a shock that increases the demand for certain types of products and services, if the underlying logistical infrastructure is not fit for purpose, then that affects the daily livelihood of people and, in some cases, their health and well-being,” he said.

The ILO report also says key workers fare worse than non-key workers in both wealthy and poor countries, but ILO senior economist Janine Berg said the problems are worse in low-income countries.

“There are particularly severe problems, for example, in agricultural work in low-income countries, and the entire agricultural food chain is part of the key worker definition,” she said. “There are also very severe problems in lower-income countries with respect to very low coverage in social protection.”

The report urges nations to identify gaps in decent work and develop national strategies to address the problems facing key workers through strengthened policies and investment.

Among its recommendations, the report calls on governments to reinforce occupational health and safety systems, improve pay for essential workers, guarantee safe and predictable working hours through regulation, and increase access to training so that key workers can carry out their work effectively and safely.
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Every month, young girls in Ghana are forced to miss school days due to menstruation. But a schoolteacher is working to find a solution by providing reusable sanitary pads. Hamza Adams visited a school in Afari, Ghana, and has this story narrated by Salem Solomon.
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The Webb Space Telescope has captured the rare and fleeting phase of a star on the cusp of death.

NASA released the picture Tuesday at the South by Southwest conference in Austin, Texas.

The observation was among the first made by Webb following its launch in late 2021. Its infrared eyes observed all the gas and dust flung into space by a huge, hot star 15,000 light years away. A light year is about 5.8 trillion miles.

Shimmering in purple like a cherry blossom, the cast-off material once comprised the star’s outer layer. The Hubble Space Telescope snapped a shot of the same transitioning star a few decades ago, but it appeared more like a fireball without the delicate details.

Such a transformation occurs only with some stars and normally is the last step before they explode, going supernova, according to scientists.

“We’ve never seen it like that before. It’s really exciting,” said Macarena Garcia Marin, a European Space Agency scientist who is part of the project.

This star in the constellation Sagittarius, officially known as WR 124, is 30 times as massive as our sun and already has shed enough material to account for 10 suns, according to NASA.
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Illegal fishing, a multibillion-dollar industry closely linked to organized crime, is set to pose a greater threat to global security as climate change warms the world’s oceans, according to a report by the Royal United Services Institute, a research organization based in London, in partnership with The Pew Charitable Trust.

Illegal, unreported and unregulated, or IUU, fishing is worth up to $36.4 billion annually, according to the report, representing up to a third of the total global catch.

Fish stocks

As climate change warms the world’s oceans, fish stocks are moving to cooler, deeper waters, and criminal operations are expected to follow.

“IUU actors and fishers in general will be chasing those fish stocks as they move. And there’s predictions, or obviously concern, that they will move in across existing maritime boundaries and IUU actors will pursue them across those boundaries,” report co-author Lauren Young told VOA.

RUSI said that global consumption of seafood has risen at more than twice the rate of population growth since the 1960s. At the same time, an increasing proportion of global fish stocks have been fished beyond biologically sustainable limits.

The report also highlights that fish play a key role in capturing carbon through feeding, so a decline in fish stocks itself could accelerate warming temperatures.

Crime nexus

“Climate change will impact in other ways, with impacts on coastal erosion as well, and that will have impacts on local small-scale fisheries. As their livelihoods become more vulnerable, they may begin engaging more in IUU practices like disruptive fishing practices or engaging in other type of criminal activity as well.”

“There is a nexus with other crime types as well, like narcotics, human trafficking and labor abuses,” Young added.

Many poorer countries do not have the capacity to police their waters. In parts of Africa and South America, foreign trawlers — including many vessels from China — have devastated fish stocks. Beijing denies its fleets conduct illegal fishing.

The United States Coast Guard said in 2021 that IUU fishing had replaced piracy as the leading global maritime security threat. “If IUU fishing continues unchecked, we can expect deterioration of fragile coastal states and increased tension among foreign-fishing nations, threatening geo-political stability around the world,” the document warned.

US response

The United States launched a sustainable fishing initiative in Peru and Ecuador in October. Project “Por la Pesca” is aimed at helping artisanal fishing in the face of depleted stocks caused by IUU fishing.

“It’s having a profound impact on stocks of fish, on the livelihoods of fisherpeople, on sustainability,” U.S. Secretary of State Antony Blinken said on a visit to Peru in October. “We have many countries around the world where fishing is at the heart of their economy and the heart of their culture as well, where illegal, unreported, unregulated fishing is a real and growing challenge.”

South China Sea

RUSI highlights the warming South China Sea as a flashpoint. Already, fishing grounds and maritime boundaries are hotly contested, with frequent armed confrontations.

“Many relate to China’s commitment to the nine-dash line, which is the country’s self-declared sort of maritime boundary,” said RUSI’s Young. “And they enforce that through armed fishing militia. So that obviously plays into it a lot as well. But those existing tensions there are likely to be exacerbated by climate change. And that is in line with predictions of climate change being this kind of threat multiplier.”

Enforcement

Earlier this month, United Nations member states agreed to the High Seas Treaty, aimed at protecting biodiversity by establishing vast marine protected areas.

“Whilst it’s a positive move with climate change that we’re looking to protect more of the world’s oceans, we need to improve our ability to actually monitor and enforce [the agreements] as well,” Young said.

The report authors call on governments and multinational bodies to tackle illegal fishing based on climate change predictions; enhanced vessel monitoring capabilities and tougher enforcement, with greater recognition on the role the industry plays in wider criminal networks.
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Poorer countries are increasingly losing health care workers to wealthier ones as the latter seek to shore up their own staff losses from the COVID-19 pandemic, sometimes through active recruitment, the World Health Organization said on Tuesday. 

The trend for nurses and other staff to leave parts of Africa or Southeast Asia for better opportunities in wealthier countries in the Middle East or Europe was already under way before the pandemic but has accelerated since, the U.N. health agency said, as global competition heats up.

“Health workers are the backbone of every health system, and yet 55 countries with some of the world’s most fragile health systems do not have enough and many are losing their health workers to international migration,” said Tedros Adhanom Ghebreyesus, the WHO director-general.

He was referring to a new WHO list of vulnerable countries which has added eight extra states since it was last published in 2020. They are: Comoros, Rwanda, Zambia, Zimbabwe, East Timor, Laos, Tuvalu and Vanuatu.

Jim Campbell, director of the WHO’s health workforce department, told journalists safeguards for countries on the WHO list were important so they “can continue to rebuild and recover from the pandemic without an additional loss of workers to migration”.

Some 115,000 health care workers died from COVID around the world during the pandemic but many more left their professions due to burnout and depression, he said. As a sign of the strain, protests and strikes have been organised in more than 100 countries since the pandemic began, he added, including in Britain and the United States.

“We need to protect the workforce if we wish to ensure the population has access to care,” said Campbell.

Asked which countries were attracting more workers, he said wealthy OECD countries and Gulf states but added that competition between African countries had also intensified.

The WHO says it is not against migration of workers if it was managed appropriately. In 2010, it released a voluntary global code of practice on the international recruitment of health personnel and urges its members to follow it.
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Jiang Yanyong, a Chinese military doctor who revealed the full extent of the 2003 SARS outbreak and was later placed under house arrest for his political outspokenness, has died, a long-time acquaintance and a Hong Kong newspaper said Tuesday.  

Jiang was 91 and died of pneumonia Saturday in Beijing, according to human rights activist Hu Jia and the South China Morning Post.

News of Jiang’s death and even his name were censored within China, underscoring how he remained a politically sensitive figure even late in life.

Jiang had been chief surgeon at the People’s Liberation Army’s main 301 hospital in Beijing when the army fought its way through the city to end weeks of student-led pro-democracy protests centered on Tiananmen Square, causing the deaths of hundreds — possibly thousands — of civilians.

In April 2003, as the ruling Communist Party was suppressing news about the outbreak of the highly contagious Severe Acute Respiratory Syndrome, Jiang wrote an 800-word letter stating there were many more SARS cases than were being officially reported by the country’s health minister.

Jiang emailed the letter to state broadcaster CCTV and Hong Kong’s Beijing-friendly Phoenix Channel, both of which ignored it. The letter was then leaked to Western media outlets that published it in its entirety, along with reports on the true extent of the outbreak and official Chinese efforts to hide it.

The letter, along with the death of a Finnish United Nations employee and statements by renowned physician Zhong Nanshan, forced the lifting of government suppression, leading to the resignations of both the health minister and Beijing’s mayor. Strict containment measures were imposed virtually overnight, helping to restrain the spread of the virus that had already begun appearing overseas.

In all, more than 8,000 people from 29 countries and territories were infected with SARS, resulting in at least 774 deaths.

“Jiang had the conscience of a doctor to people the patients first. He saved so many lives with that letter, without thought for the consequences,” Hu told The Associated Press.  

Chinese authorities later sought to block media access to Jiang, who retired with the rank of major general. He turned down an interview with The Associated Press, saying he had been unable to obtain the necessary permission from the Ministry of Defense.

From 2004, Jiang and his wife were periodically placed under house arrest for appealing to Communist leaders for a re-evaluation of the 1989 protests that remains a taboo topic. That recalled Jiang’s earlier experiences when he was persecuted as a rightist under Mao Zedong during the 1950s, ’60s and ’70s.

In 2004, Jiang was awarded the Ramon Magsaysay Award for Public Service from the Philippines, considered by some an Asian version of the Nobel Peace Prize. In the citation, he was praised for having broken “China’s habit of silence and forced the truth of SARS into the open.”

Jiang was prevented from leaving the country and the award was collected by his daughter on his behalf.

Three years later, he won the Heinz R. Pagels Human Rights of Scientists Award given by the New York Academy of Sciences, but was again blocked from traveling.

Echoes of Jiang’s experience were heard in China’s approach to the initial outbreak of COVID-19, first detected in the central Chinese city of Wuhan in late 2019.

A Wuhan eye doctor, Li Wenliang, was detained and threatened by police for allegedly spreading rumors on social media following an attempt to alert others about a “SARS-like” virus. Li’s death on Feb. 7, 2020, sparked widespread outrage against the Chinese censorship system. Users posted criticism for hours before censors moved to delete posts. 

Sympathy and the outpouring of anger of the treatment of Li and other whistleblowers prompted the government to change course and declare him and 13 others martyrs.

COVID-19 has killed almost 7 million people worldwide, including an estimated 1.5 million in China, whose government has been accused of massively undercounting the true number of deaths.

Jiang is survived by his wife, Hua Zhongwei, a son and a daughter, according to the South China Morning Post.   
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Pfizer Inc PFE.N struck a $43 billion deal for Seagen Inc SGEN.O to add innovative targeted therapies to its portfolio of cancer treatments as it braces for a steep fall in COVID-19 product sales and stiff competition for some top sellers.

Monday’s deal, Pfizer’s biggest in a string of acquisitions following a once-in-a-lifetime cash windfall from its COVID-19 vaccine and pill, will add four approved cancer therapies with combined sales of nearly $2 billion in 2022.

Washington-based Seagen is a pioneer of antibody-drug conjugates, which work like “guided missiles” designed for a targeted destructive effect and spare healthy cells.

The deal helps Pfizer move into an area “that it is more protected from regulators, patent perspectives and market dynamics,” Chief Executive Officer Albert Bourla said in a conference call. 

Seagen, Bourla said, is set to benefit from out-of-pocket health care spending caps for older Americans under President Joe Biden’s Inflation Reduction Act (IRA), meaning more patients could have access to the company’s expensive treatments.

A focus on complex biotech medicines also provides a longer exclusivity on the market versus pills before becoming subject to government price limits under the IRA, he said.

Pfizer will pay $229 in cash per Seagen share, a 32.7% premium to Friday’s closing price. Seagen’s shares rose to $200 in early trading.

The latest deal comes as Pfizer seeks to mitigate an anticipated $17 billion hit to revenue by 2030 from patent expirations for top drugs and decline in demand for its COVID products.

The drugmaker expects more than $10 billion in sales from Seagen products in 2030, and another $15 billion from its other recent acquisitions.

Pfizer’s recent deals include its purchase of Global Blood Therapeutics for $5.4 billion, migraine drug maker Biohaven Pharmaceutical Holding for $11.6 billion, and a $6.7 billion buyout of drug developer Arena Pharmaceuticals.

Pfizer’s portfolio of oncology therapies includes 24 approved drugs, while Seagen’s includes Adcetris for lymphoma, Padcev for bladder cancers, Tivdak for cervical cancer and breast cancer treatment Tukysa.

The companies expect to complete the deal in late 2023 or early 2024. Pfizer said antitrust regulators could closely review the deal due to its size but eventually approve it.

Pfizer rival Merck & Co Inc MRK.N and Seagen were in advanced deal talks last year but those reportedly collapsed over antitrust concerns. 
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