Emojis are proposed as a powerful way for patients and doctors to communicate

Emoji are proposed as a powerful way for patients and doctors to communicate
Emoji are proposed as a powerful way for patients and doctors to communicate


Emoji, that universal lexicon of colorful and clever symbols meant to replace the written and spoken word, could be a valuable tool in the field of medicine, allowing patients to better communicate symptoms, concerns, and other clinically relevant information, argue a Massachusetts General Hospital (MGH) physician and others. In a commentary in the Journal of the American Medical Association, senior author Shuhan He, MD, an emergency department attending, suggests that each medical discipline begin discussions around the creation of its own unique set of iconography for official adoption and incorporation into everyday practice.

“The need to listen to patients is at the core of our mission as physicians, and the use of emoji is a great opportunity to take communication to another level,” says He, who is director of growth for the MGH Center for Innovation in Digital HealthCare and a member of MGH’s Lab of Computer Science. “Emoji could be particularly important in treating children with still-developing language skills, people with disabilities that impair their ability to communicate, and the many patients who speak a different language.”

Emoji (which means “picture character”) originated in Japan over a decade ago and today an estimated five billion are used daily on Facebook and Facebook Messenger alone. While around 3,500 emoji are currently within the domain of the Unicode Consortium — the nonprofit organization that maintains text standards across computers and which must approve every emoji before it can be digitally used – only about 45 emoji can be considered relevant to medicine. The first, introduced in 2015, were the syringe and the pill. In 2017, Apple added emoji to represent people with disabilities, followed by symbols of the stethoscope, bone, tooth and microbe in 2019. He was co-creator of the anatomical heart and the lung emoji introduced globally in 2020 and is now working with co-authors Debbie Lai and Jennifer 8. Lee, who are active in the field, as well as with a wide range of medical societies and organizations to advocate for an additional 15 medically related emoji.

“It’s tempting to dismiss emoji as a millennial fad, but they possess the power of standardization, universality and familiarity, and in the hands of physicians and other health care providers could represent a new and highly effective way to communicate pictorially with patients,” says He. In emergency medical settings where time is critical, emoji could lead to a point-and-tap form of communication that could facilitate important clinical decisions, he adds. The tiny graphic symbols which now span all digital platforms – from mobile to tablet to desktop – could also have utility as annotations to hospital discharge instructions, which are often confusing if not incomprehensible to some patients.

In addition, the recent growth of telemedicine could be a rich opportunity for emoji to make medical inroads. The interactive platform is seen as particularly well suited for patients to transmit to health care providers visual information that charts the intensity of pain they have experienced over a period of days, weeks or months, and for those providers to make it part of the patient’s digital health record for ongoing treatment.

He is continuing his research to better understand how emoji could help patients and doctors communicate common symptoms – such as mobility, mood, and duration and quality of pain – that are associated with various diseases and conditions. “It’s clear that emoji have become part of the global, mainstream conversation, and that medical societies and physician committees and organizations need to take them seriously,” says He. “Which means they should be determining now which emoji would best serve the interests of their patients, building consensus around the medical accuracy of these emoji, then working to get them approved through the global standard-setting body and working through the long adaptation and implementation process.”

Co-author Jennifer 8. Lee is founder of Emojination, a grassroots group that has led successful campaigns for over 100 new emoji over the past five years. Co-author Debbie Lai is chief operating officer of the Act Now Coalition, a nonprofit that provides visualizations of data on COVID-19 and climate change.

Sober Curious: What It Is and How to Do it

Sober curious
Sober curious

According to research, the UK is the only European country that saw alcohol consumption rise at the start of the pandemic. It is thought that this occurred as the UK was more stressed than other countries as the nation experienced higher death tolls and financial instability. This is in line with previous reports of Britain getting drunk more often than 35 other nations and having higher levels of binge drinking than a lot of other countries.

However, that being said, there are those who have actually reduced their alcohol intake in the pandemic and are looking for ways to live a healthier lifestyle. Where one in three people increased their alcohol consumption during lockdown, many opted for sobriety and jumped on board the “sober curious” trend.

What is sober curious?

Often, the hangovers, fuzzy head, and nausea after a night out can make us feel like drinking just isn’t worth it. Not only can drinking affect our bodies but it can even leave us feeling anxious, which has been dubbed “hangxiety”. More people are deciding to stay sober without meeting the criteria for alcohol dependency or disorders – they just prefer to live a sober life out of personal choice or for wellness reasons.

If you’re starting to wonder whether becoming teetotal might have a positive impact on your life, you’re not alone. There is a growing number of “sober curious” people cutting alcohol out of their lives.

Sober curious
Sober curious

What is encouraging sobriety?

It seems that there are more younger people abstaining from alcohol than there are older people. There are several reasons why fewer people are drinking. A prime one may be economic factors, with young people having less time and money to spend on alcohol.

Furthermore, we are becoming more aware of the health risks of alcohol and the benefits of looking after ourselves. Particularly after living through a pandemic, many of us are taking our wellbeing more seriously and eliminating things from our lives that may compromise our immune systems and general health.

Plus, there are more non-alcoholic drink options available than there once was, helping encourage sobriety without making it difficult or unenjoyable. We’ve all experienced the disappointing and flat soda gun at pubs and bars. Flat cola and limited options make the thought of not drinking alcohol undesirable, but now there are more and more drinks out there to try. Instead of a boring drink, you can choose from exciting flavours like rose lemonade or elderflower.

How you can go sober

Choosing to go teetotal doesn’t mean you have to give up your social life – far from it. Here is an easy guide to balancing it with your newfound wellness.

Firstly, if you want to join your friends at the pub, suggest going somewhere you know has great non-alcoholic or mocktail options. You can buy craft-style sodas with natural ingredients and unique flavours, or botanical mixers that can be enjoyed on their own. Check out menus online to see what you can sip on while staying social with your friends.

Take up a new hobby in something that interests you, like sports or crafts. Here, you might find like-minded individuals who will be up for hanging out without the addition of alcohol. If you’re not drinking for health reasons, you could take up some cooking lessons to make the most of your meals and get all the nutrients and nourishment you need.

You’ll find that your weekends will seem longer and that you have more free time, so focusing on yourself and your personal development are great ways to make the most of these newfound sober perks.

For some individuals, going sober can be the best option. The sober curious movement could be just the thing you needed for your social life, development, and wellbeing!  

Sources

https://inews.co.uk/news/science/uk-is-the-only-country-in-europe-where-alcohol-consumption-increased-in-the-pandemic-1043572

https://www.theguardian.com/society/2019/may/15/britons-get-drunk-more-often-than-35-other-nations-survey-finds

https://www.cambridgeindependent.co.uk/news/one-in-three-increased-alcohol-consumption-during-lockdown-cambridge-study-finds-9146617/

https://www.healthline.com/health/hangover-anxiety

Avocados change belly fat distribution in women, controlled study finds

Avocados change belly fat distribution in women, controlled study finds

A diet that included an avocado a day reduced visceral belly fat in women in a randomized controlled study of adults with overweight and obesity. CREDIT Graphic by Michael Vincent

An avocado a day could help redistribute belly fat in women toward a healthier profile, according to a new study from the University of Illinois Urbana-Champaign and collaborators.

One hundred and five adults with overweight and obesity participated in a randomized controlled trial that provided one meal a day for 12 weeks. Women who consumed avocado as part of their daily meal had a reduction in deeper visceral abdominal fat.

Led by Naiman Khan, an Illinois professor of kinesiology and community health, the researchers published their study, funded by the Hass Avocado Board, in the Journal of Nutrition.

“The goal wasn’t weight loss; we were interested in understanding what eating an avocado does to the way individuals store their body fat. The location of fat in the body plays an important role in health,” Khan said.

“In the abdomen, there are two kinds of fat: fat that accumulates right underneath the skin, called subcutaneous fat, and fat that accumulates deeper in the abdomen, known as visceral fat, that surrounds the internal organs. Individuals with a higher proportion of that deeper visceral fat tend to be at a higher risk of developing diabetes. So we were interested in determining whether the ratio of subcutaneous to visceral fat changed with avocado consumption,” he said.

The participants were divided into two groups. One group received meals that incorporated a fresh avocado, while the other group received a meal that had nearly identical ingredients and similar calories but did not contain avocado.

At the beginning and end of the 12 weeks, the researchers measured participants’ abdominal fat and their glucose tolerance, a measure of metabolism and a marker of diabetes.

Female participants who consumed an avocado a day as part of their meal had a reduction in visceral abdominal fat – the hard-to-target fat associated with higher risk – and experienced a reduction in the ratio of visceral fat to subcutaneous fat, indicating a redistribution of fat away from the organs. However, fat distribution in males did not change, and neither males nor females had improvements in glucose tolerance.

“While daily consumption of avocados did not change glucose tolerance, what we learned is that a dietary pattern that includes an avocado every day impacted the way individuals store body fat in a beneficial manner for their health, but the benefits were primarily in females,” Khan said. “It’s important to demonstrate that dietary interventions can modulate fat distribution. Learning that the benefits were only evident in females tells us a little bit about the potential for sex playing a role in dietary intervention responses.”

The researchers said they hope to conduct a follow-up study that would provide participants with all their daily meals and look at additional markers of gut health and physical health to get a more complete picture of the metabolic effects of avocado consumption and determine whether the difference remains between the two sexes.

“Our research not only sheds a valuable light on benefits of daily avocado consumption on the different types of fat distribution across genders, it provides us with a foundation to conduct further work to understand the full impact avocados have on body fat and health,” said study coauthor Richard Mackenzie, a professor of human metabolism at the University of Roehampton in London.

“By taking our research further, we will be able to gain a clearer picture into which types of people would benefit most from incorporating avocados into their diets and deliver valuable data for health care advisers to provide patients with guidance on how to reduce fat storage and the potential dangers of diabetes,” Mackenzie said.

10 Ways to Live Better with Chronic Pain

Sarah Chicharro - YouTube


Chronic pain is physically and psychologically stressful and its constant discomfort can lead to anger and frustration with yourself and your loved ones. By definition, chronic pain is pain that lasts longer than six months and affects how a person lives their daily life. This video will help you to realize how to live better with chronic pain.



Loss of placental hormone linked to autism

Loss of placental hormone linked to brain and social behavior changes
Loss of placental hormone linked to brain and social behavior changes

Preterm birth has been shown to increase the risk of autism s and other developmental problems, particularly in males. The more premature a baby is, the greater the risk of either motor or cognitive deficits. What does the preterm baby lose that is so critical to long-term outcomes?

A new study, in mice, suggests that one factor may be the loss of a placental hormone that the developing brain would normally see in the second half of pregnancy.

The study is the first to provide direct evidence that loss of a placental hormone alters long-term brain development.

In the study, researchers in the laboratory of Anna Penn, MD, PhD, now at Columbia University Vagelos College of Physicians and Surgeons and previously at Children’s National Hospital in Washington, D.C., found that reducing amounts of a single hormone, called allopregnanolone(ALLO), in the placenta caused brain and behavior changes in male offspring that resemble changes seen in some people with autism spectrum disorder.  

The study also found that both brain structure and behavioral changes in the mice could be prevented with a single injection of ALLO in late pregnancy.

“Our study provides new and intriguing insights into how the loss of placental hormones—which happens in preterm birth or if the placenta stops working well during pregnancy—can lead to long-term structural changes in the brain that increase the risk for autism or other neuropsychiatric disorders,” says lead author Claire-Marie Vacher, PhD, assistant professor of neonatal sciences in the Department of Pediatrics at Columbia University’s Vagelos College of Physicians and Surgeons. “What’s encouraging is that these disorders may be preventable if diagnosed and treated early.”

The study was published online August 16 in the journal Nature Neuroscience.

The placenta is an organ that provides the fetus with oxygen and nutrients and removes waste products. It also produces hormones, including high levels of ALLO in late pregnancy that may influence brain development. Penn, now the L. Stanley James Associate Professor of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons and chief of neonatology at Columbia and NewYork-Presbyterian Morgan Stanley Children’s Hospital, coined the term “neuroplacentology” to describe this new field of research connecting placental function to brain development.

About one in 10 infants is born prematurely (and is thus deprived of normal levels of ALLO and other hormones), and many more pregnancies have poor placental function.

For this study, the researchers created a mouse model in which they were able to selectively decrease the production of ALLO during pregnancy so that some developing pups were exposed to sufficient placental ALLO while others were not. Although male and female fetuses were both subjected to ALLO deficiency, only male mice showed autism-like behaviors after birth. Working with collaborators in Washington, D.C., France, and Canada, the Penn laboratory analyzed brain development and long-term behavioral outcomes in the offspring. 

ALLO reduction led to cerebellum changes, autism-like behaviors

The male mice that lacked placental ALLO had structural changes in the cerebellum, a brain region that coordinates movement and has been linked to autism, while their littermates did not. 

“In particular, we observed thickening of the myelin sheaths, the lipid coating that protects nerve fibers and speeds up neural signaling,” Vacher says. The same type of thickening is also known to occur transiently in the cerebellum of some boys with autism.

The degree of myelin thickening in juvenile male mice correlated with abnormal behavior, the researchers also found. The more the sheath was thickened (as measured by myelin protein levels), the more the male mice exhibited autism-like behaviors, such as decreased sociability and repetitive activities.

“Our experimental model demonstrates that losing placental ALLO alters cerebellar development, including white matter development. Cerebellar white matter development occurs primarily after birth, so connecting a change in placental function during pregnancy with lingering impacts on later brain development is a particularly striking result,” says Penn.  

“The findings provide a new way to understand poor placental function. Subtle but important changes during pregnancy or after delivery may set in motion neurodevelopmental disorders that children experience later in life.”

Similarities with human tissue

To determine if similar changes occur in infants, the researchers also examined post-mortem cerebellar tissues from preterm and full-term infants who had died soon after birth. Analysis of these human tissues showed similar changes in brain proteins when cerebellum from male babies born preterm were compared to male full-term babies.

“This study is an important first step in understanding how placental hormones may contribute to specific human neurobehavioral outcomes. We look forward to continuing our collaboration with Dr. Penn and her team to help define how cerebellar neurons and glia respond to environmental factors, including placental function, that can compromise the developing brain,” says study co-author Vittorio Gallo, PhD, interim chief academic officer at Children’s National Hospital and interim director of the Children’s National Research Institute. 

Hormone injection reduced autism symptoms 

ALLO’s therapeutic potential was then tested in the preclinical model. 

Male offspring of mice given a single injection of ALLO in late pregnancy had fewer autism-like behaviors, the researchers found. Similar results were seen after an injection of muscimol, a drug that enhances the function of GABA receptors—the same receptors that respond to ALLO. Myelin protein levels in the developing cerebellum also normalized with the treatment.

“Identifying when key hormone levels are abnormal, and figuring out how and when to adjust these levels, provides an opportunity to intervene,” Penn says. “Performing additional studies with our mouse model, and measuring hormone levels in moms and babies, may lead to earlier treatment to reduce or prevent long-term cognitive and behavioral impairments in high-risk fetuses and newborns.”