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Genetic risk scores alone aren’t that good at predicting health

The UK’s health secretary said last week that he had booked a blood test because genetic testing revealed he had a high risk of getting prostate cancer. But a new study suggests that this type of genetic technique may not yet be accurate enough to inform healthcare decisions.

Genetic tests for conditions caused by a single gene, such as cystic fibrosis, are already used in healthcare. But many health problems involve multiple genes that each have a small effect, making it more difficult to screen for a person’s genetic risk for heart disease or diabetes, for example.

A new type of genetic screening, however, can estimate a person’s risk of developing common conditions like these. “Polygenic risk scores” are calculated by looking at genetic variants in a person’s genome and comparing these with analyses of large data sets of genetic data to produce an illustrative picture of how likely an individual is to develop a particular condition.

One US study last year said that such polygenic risk scores could help identify people with four times the usual risk of heart disease. The scores could be used to help prevent high-risk individuals from developing the disease by treating them or supporting lifestyle changes, the team behind the work said.

But new work by David Curtis of University College London disputes the accuracy of this study, suggesting that polygenic risk scores may in fact be of little use in healthcare.

Quadruple risk

When Curtis ran computational models on the US team’s data, he found that the polygenic risk score they tested was only about 65 per cent accurate at predicting a person’s risk of suffering heart disease. This is far lower than the 81 per cent calculated by the US team.

When a person’s age and sex are also factored in, the accuracy jumped back up to 81 per cent, which Curtis argues suggests that gene-based scores alone are a poor predictor of risk. “I don’t see that these tests are ready for clinical use yet,” he says.

Sekar Kathiresan at Massachusetts General Hospital, who worked on the earlier study, says his team did make it clear they looked at age and sex, as well as the risk implied by the analysis of genetic data.

Kathiresan’s colleague Amit Khera says any debate over the accuracy measure doesn’t affect the original paper’s key finding. “The whole point of the paper is we made a score that can find people at quadruple the usual risk of a heart attack,” he says.

Future research may find that combining age, sex and genetic data in this way is medically useful. But Anneke Lucassen, at the University of Southampton, UK, told New Scientist last week that it remains unclear what people can do with the information provided by polygenic risk scores.

“We tend to assume that picking up something early makes it more treatable, but sometimes there is little evidence for that assumption and the downside of over-diagnosis is oft ignored,” she said.

Journal reference: Annals of Human Genetics, DOI: 10.1111/ahg.12302

Thought crime science: Case studies in becoming an enemy of liberal orthodoxy

The resulting uproar caused the professor endless grief – even after an exhaustive post-publication review of the paper confirmed her key conclusions. She lost her consulting job and some local clinicians even called for her immediate firing from Brown. Ironically, Littman is not a conservative – showing that a liberal worldview won’t save you from the outrage mob. In an interview with Quillette, she claimed that she received pushback because her paper “did not support the gender-affirming perspective.”

James Watson alleges link between race and IQ

The scientist who discovered the structure of the DNA molecule, and received a Nobel Prize for his findings in 1962, found himself on the receiving end of social justice wrath in 2007, after suggesting a genetic link between race and IQ.

According to Watson, his unpopular position on the subject quickly transformed him into an “unperson.” The ire of the scientific community eventually led to his expulsion from most of his positions, and left him bereft of public speaking opportunities for years to come. Stripped of most sources of income, Watson was forced to sell his Nobel Prize medal.

Undeterred, he recently said that he stands by his controversial idea that there’s a genetically-backed “difference on the average between blacks and whites on IQ tests.”

It was not Watson’s only eccentric idea. He believes, for example, in a link between sunlight and libido – and that doesn’t devalue his genuine input in genetic research. Nonetheless, his thought crime essentially led to his banishment from the public stage and the scientific community.

Larry Summers and female aptitude

Former Treasury Secretary Larry Summers, who served two Democratic presidents, found himself ostracized by the left after he gave a short address exploring the reasons why women are underrepresented in tenured positions in science and engineering at elite universities and research institutions.

Summers ultimately concluded that the phenomenon may be due to a difference in aptitude at the highest levels of scientific work – but admitted his hypothesis was provocative and encouraged the audience to prove him wrong.

Instead of sparking a rigorous academic debate on the subject, Summers was dragged through the mud and labeled an unrepentant sexist. He later stepped down as president of Harvard University – a decision which many attribute to his “sexist” comments.

Although Summers provided economic guidance for the Obama White House, his remarks reportedly cost him the top job at the Treasury Department.

The toll of excessive text communications on your psyche

I am not known for being especially easy to get hold of via text. I tend to keep my phone on silent as the high-pitched ping of an incoming message makes my cheeks flush with dread. I wish I could mute all my contacts’ notifications – sorry, mom, dad, and everyone I care about, but communicating with you makes me incredibly anxious. But, obviously, that’s not feasible. I do, however, mute text threads with more than three people, and I opt out of family threads entirely. It is a small gesture, but bowing out of these communal conversations eases my mind, even if I sometimes feel left out and lonely – not to mention guilty that I’ve made my family feel like an annoyance.

Yet I’ve found that ignoring my family for the sake of my sanity can be therapeutic. Smartphones seem to cause more trouble than they’re worth: these devices have opened up a universe of new ways for people (not just family) to bother us. One study from the American Psychological Association in 2017 found that constantly checking emails and texts contributes significantly to our overall stress. Nancy Cheever, professor of communications at California State University, Dominguez Hills, research show cellphone use affects our moods, and says that being ‘constantly connected’ through email, text and social media guarantees that you’ll experience anxiety. The distraction seeps into your work life, too: as Scott Bea, a psychologist at the Cleveland Clinic in Ohio, told the Daily Mail last year, constantly checking your notifications can drop productivity by about 40 per cent.

Sometimes, it’s impossible to avoid texts from work, but you can give yourself permission to take a break from texting with family. Writing for Psychology Today in 2014, Theresa DiDonato, a social psychologist at Loyola University Maryland, said that constant texting can lead to ‘a cycle of mobile relationship maintenance’, in which ‘individuals begin to feel an over dependence’, potentially violating your sense of privacy and autonomy. The otherwise innocuous act of texting can then strain close bonds between loved ones, and even create feelings of resentment toward people who are probably well-intentioned, but unaware of the toll of their excessive communications on your psyche.

If texting ‘is starting to feel frustrating, stressful, or if you’re overwhelmed or trapped by it, that’s a good indication that you need to set a boundary’, I was told by Dana Gionta, a clinical psychologist in Connecticut and the co-author, with Dan Guerra, of From Stressed to Centered (2015). For most people, she notes, a barrage of text messages leads to an unwelcome – even distressing – distraction. That would hold true for text messages from anyone, but what makes it extra-frustrating from family is that the distraction is now coupled with a feeling of obligation. There’s pressure to get back to a family member and this can weigh on you while you’re trying to accomplish other tasks.

If you’re receiving a stream of (non-emergency) texts from loved ones (on subjects ranging from, let’s say, family gossip to plans for a visit or critiques of films), you’ll probably feel required to read each one to keep up with the conversation. The result is what Mark Dombeck, a psychologist in California who has written extensively about boundary-setting and assertive (as opposed to aggressive) behaviour, calls a ‘cognitive load’ that you might find difficult to take on in the midst of other responsibilities. Yet your responsibility to family will inevitably seem more urgent, and weigh heavier on you, than all the others. ‘Family relationships are important to most people and there will be a motivation to follow social protocols and respond when queried, creating a feeling of pressure which might not be present in relationship with a stranger,’ he notes.

There are gentle ways to broach the topic of texting without offending your family. You might be right to feel irritated if they act as though texting is an open invitation to relentless communication, but it’s crucial that you don’t lash out, or respond when you’re feeling angry or annoyed. ‘When people come into your territory, and they are being disrespectful, you have the right to defend yourself,’ explains Dombeck. ‘Not to attack them but to defend yourself.’

What you must do, he tells me, is make an assertive statement. Assertion is the ‘fulcrum, the balance point’ between aggression and passivity. But unlike aggression, assertion shouldn’t come from a place of hostility. When it comes to gently asking family to stop texting you, that means being straightforward and firm. ‘Please text me only for true emergencies’ is the kind of language he suggests.

Gionta, meanwhile, recommends a gentler approach. You don’t have to share that you’re feeling overwhelmed or frustrated by the text messages, she emphasizes, and you should make it clear that cutting down on texting doesn’t have anything to do with how much you love the person in question. Provide a vague reason – ‘I’m finding it hard to keep up with all the text messages and emails that I’m receiving’ – and then negotiate a timeframe to respond that works for both sides. Try a line such as: ‘I would love for us to stay close, however daily texting isn’t working for me. Could we try twice a week?’

Confronting the issue is probably the simplest part of this scenario. It’s the reaction, and the ensuing guilt, that turns out to be the most emotionally straining. In fact, the thought of dealing with blowback from your family can be enough to stop you addressing a frustrating issue altogether.

‘The reality is most people only know aggression and passivity, and they think of anything that isn’t passive as being aggressive,’ Dombeck says. ‘In doing this, you are making a decision: are you going to do what you need to do to maintain your peace of mind, which might alienate other people in the family system? All you’re doing is saying that you refuse to be abused. Other people won’t see it that way. You have to become willing to stand your ground.’

While we can’t control or predict how other people will react to our actions, Gionta adds, we can control ‘how we express ourselves and the level of consideration and respect that we use’. As long as you state your case calmly and with kindness, you shouldn’t feel beholden to someone who guilt-trips you, or makes you feel obliged to participate in a text thread that stresses you out.

You should also feel empowered to completely ignore people with toxic responses. Dombeck says that, in families where one person feels entitled to power over others, ‘any encroachment on that power is going to feel aggressive’. Those people might demand that you justify your actions or subject you to so-called flying monkeys: other family members who have been dispatched to check on you.

So why invite the drama? Wouldn’t you be better off simply ignoring the messages, never speaking up about how each new one brings you one step closer to panic? Dombeck thinks it is an issue worth addressing because an overabundance of texting likely points to a pattern between you and your family members. ‘If this is happening in text message, it’s been happening in all mediums of communication. This is not some unique isolated behaviour. When you ask: “Is this the hill I’m going to die on?” you have to understand that the hill is not limited to text messages but the whole history of communication.’

Kids are missing out on climbing trees

As long as I can remember, my girls have climbed trees. Skinny trees, big trees, crooked trees, straight trees, old trees, young trees, pine trees, deciduous trees… They’ve climbed trees in snow suits in the winter and barefoot in the summer. On more than one occasion, they’ve climbed trees wearing princess dresses. And you know what? Sometimes I join them on their tree climbing missions. (Minus the Disney dresses, that is…)

For my generation, tree climbing was a quintessential childhood experience, on a par with running under the sprinkler on a hot summer day and skinning your knees when riding your bike just a tad too fast on a gravel road. But today, it isn’t a given activity for many kids, and for a number of reasons. For one, we all know that they spend more time indoors on electronic devices, which leaves less time to romp around in the woods in the first place. Parents and caregivers also worry more about the safety of tree climbing and many simply don’t allow it. (A study by Play England showed that as many as half of all British children have been stopped from climbing trees.) In some cases, home owners associations or neighbors complain about kids climbing trees because they think it’s a nuisance, and in more than a few places, tree climbing is banned altogether.

And the kids are missing out.

I’m not saying that out of nostalgia. Tree climbing has real benefits for kids – physically, mentally, cognitively and socially. Just think about it. As your child scales the tree he’s building muscle strength, practicing gross motor skills such as balance and improving spatial awareness and proprioception (the awareness of your body’s position and movement, sometimes called the sixth sense). When he decides which branches are safe to stand on and how high to go, he’s learning how to judge risk and developing critical thinking skills. As he plans his path up through the limbs, he’s gaining decision-making and problem-solving skills, and if things don’t go according to plan, he gains emotional strength and resilience by trying again. When he successfully negotiates the branches, he feels a sense of accomplishment, which in turn boosts his self-confidence. Once in the tree, he lets his mind wander and engages in imaginative and creative play – maybe pretending to be a pirate on a ship or a monkey in the jungle. If he’s got friends with him, chances are they’ll join him, nurturing his social skills. As he feels the rugged bark against the palms of his hands and listens to the leaves ruffle in the wind, he connects with nature on a deeper, subconscious level. Most importantly – he’s having fun!

But what if he falls?

Surprisingly little data is available on accidents related to kids climbing trees, but statistics from the U.K. showed that in 2007, children were nearly three times as likely to be admitted to the hospital after falling out of bed than after falling from a tree. In 2016, researchers from University of Phoenix surveyed 1,600 parents who let their children climb trees and found that the most common injury by far was scraped skin. Only 2% of the parents responded that their child had broken a bone and even fewer had suffered from a concussion. Meanwhile, more than 3.5 million American children under the age of 14 receive medical treatment for injuries from organized sports every year.

Besides, what is often forgotten in today’s fear-driven culture is that risky play like tree climbing isn’t just completely normal for kids, it’s absolutely necessary for normal development. Psychologist Peter Gray, who is a thought leader on risky play, goes as far as saying that the decline in children’s play has contributed to a massive increase in mental disorders among young people the past decades.

“The story is both ironic and tragic,” Gray writes.

“We deprive children of free, risky play, ostensibly to protect them from danger, but in the process we set them up for mental breakdowns. Children are designed by nature to teach themselves emotional resilience by playing in risky, emotion-inducing ways. In the long run, we endanger them far more by preventing such play than by allowing it.”

I know from experience that allowing risky play can be hard, because we’re wired to protect our progeny. That parental instinct is a good thing, until it turns into irrational fear of things that are actually healthy for our kids. Just like researchers believe being overly clean can cause the immune system to turn on itself and increase the risk of asthma and allergies, keeping kids overly safe can make them less able to manage risk and regulate their emotions.

But let’s face it: even for parents who know the benefits of risky play and embrace it, it can be hard to stay totally cool when your child disappears 15 feet up into a tree. That’s why, as we head out into the woods, we need to remember that it’s our kids’ job to push their boundaries. Sometimes, them climbing a tree can make us feel nervous and uncomfortable, but that doesn’t mean they aren’t safe!

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CVS Pharmacy to sell CBD products in 800 stores in 8 states

CBD-infused sprays, roll-ons, creams and salves will be offered as an ‘alternative source of relief’.

CVS Pharmacy announced Wednesday that it will begin selling hemp-derived CBD products in eight states. The national drug store chain will be marketing the topical cannabidiol products, such as creams, sprays and roll-ons, as “an alternative source of relief,” CVS said in a statement to NBC News. CVS will also be partnering with a company to test and verify the quality of the CBD topicals sold in its drug stores.

“We are carrying hemp-derived CBD products in select states to help meet consumer demand for alternative care options,” said CVS Health Spokesperson, Mike DeAngelis.

The items will be sold in Alabama, California, Colorado, Illinois, Indiana, Kentucky, Maryland and Tennessee.

CBD, or cannabidiol, comes from the hemp plant, a close relative to another member of the cannabis family, marijuana. Both plants contain abundant types of cannabinoids, but marijuana is high in the psychoactive chemical THC, while hemp is rich in CBD, the non-psychoactive component of cannabis that has generated quite a buzz for its potential medicinal benefits.

CBD has been touted as a treatment for a wide range of conditions – including anxiety, pain, inflammation and even cancer – but little reliable research has been done on CBD’s effects on humans, experts say. The only FDA-approved CBD oil is Epidiolex, an oral solution prescribed for the treatment of seizures associated with two rare, severe forms of epilepsy.

“Societies have jumped far far ahead of science,” said Dr. Margaret Haney, a professor of neurobiology at Columbia University Medical Center and director of Columbia’s Marijuana Research Laboratory. “So it’s showing up in lotions and pretty much any form of product one can use. There’s a lot of different ways one could use CBD, but the ways we have studied CBD is much more limited.”

CVS has at least 9,800 stores nationwide and will soon roll out the CBD products in over 800 stores in the eight states. The health care chain says that effectiveness claims will vary from product-to-product, but that the company does not plan to market any of the items as a ‘cure-all’ product.

“We’re going to walk slowly, but this is something we think our customers will be looking for,” CVS Health CEO Larry Merlo said in an interview Wednesday with CNBC’s Jim Cramer.

The company noted that they would not be selling any CBD-based supplements or food additives. Under the Federal Food, Drug, and Cosmetic Act, it is illegal to introduce drug ingredients like CBD into the food supply or to market them as dietary supplements.

“Selling unapproved products with unsubstantiated therapeutic claims is not only a violation of the law, but also can put patients at risk, as these products have not been proven to be safe or effective,” FDA Commissioner Scott Gottlieb said in a statement in December.

For this reason, CVS will market the creams and salves as over-the-counter medicinal products, merchandised in a dedicated display.

There have been more dangerous situations where people turn down effective medications to use unproven products, like CBD.

To assure accurate labeling and safety for customers, CVS has partnered with Eurofins, a third party laboratory, to test all CBD topicals for THC, CBD content, and other contaminants, DeAngelis said in the statement to NBC News.

“We are working only with CBD product manufacturers that are complying with applicable laws and that meet CVS’s high standards for quality. Only products passing these independent tests are offered for sale in our stores,” the statement said.

Some experts believe the move by CVS to sell CBD over-the-counter may provide more questions than answers, at least initially.

“It’s a way to reduce the stigma for a product that really doesn’t deserve to be stigmatized,” said nutritionist and cannabis practitioner Brooke Alpert. “On the other hand, because of the lack of regulation it raises questions like: do people really know what they’re getting; can other brands get away with selling inferior products; and where can people find more information about these products?”

Another big concern for experts is that patients will avoid proven medications in favor of CBD.

“There have been more dangerous situations where people turn down effective medications to use unproven products, like CBD,” said Haney.

Social media is making Americans unhappy, but can they ditch it?

The digital age has coincided with decreasing happiness and well-being. Study after study shows this to be true, but the latest sign that we might all benefit from a digital detox comes from the World Happiness Report.

It’s bad news for the United States, which dropped in the ranking to 19th position, the unhappiest the US has been since the study began. This could be due to what the researchers called an “epidemic of addictions” – everything from drug and alcohol abuse, to gambling – and yes, obsession with digital media, which is hardly an American phenomenon alone. Hands up if you’re a recovering Twitter addict, like me?

These days, most of the criticism I fire off at sites like Facebook and Twitter has to do with their many privacy-related failings or their political biases and fondness for censorship – but what if it was something else that really started pushing us away? Something that the social media gods of Silicon Valley have less control over: How spending time on these platforms actually makes us feel.

It seems like every other day I’m hearing about a new study linking social media and unhappiness – and when you look into it, the statistics are fairly shocking. Happiness and life satisfaction in US adolescents increased between 1991 and 2011 – but suddenly declined after 2012. Similar trends were seen across the same period in the United Kingdom.

One researcher, Jean M. Twenge, posits that this is partly due to shifts in how people are spending their leisure time. By 2017, the average 12th grader was spending over 6 hours a day online, texting or on social media. By 2018, 45 percent of US adolescents said they were online “almost constantly.” I’d venture to guess the same could be said of some adults, too.

To fit in all that mindless screen time, people need to be spending less time face-to-face; less time reading, less time sleeping, less time in nature – all which no doubt serve us better than staring at a screen for hours. In fact, the only activity teens spent significantly more time on over the last decade is digital media.

So, we know social media is making us more unhappy, but why exactly is that? One likely reason is the plague of social comparison. People, particularly young people, see what Twenge calls the “highlight reels” of everyone else’s lives and decide that their own lives pale in comparison. Then of course there are the more serious reasons like cyberbullying or the fact that social media validation – likes, retweets etc. – can literally become an addiction for some people. Whatever it is, we could do without it.

The other day, a family member sent me a picture of a group of kids – about 12 or 13 years old – sitting on a pavement painting pictures (with actual paper and paints – it wasn’t an app!) There was not a phone to be seen. “I had to take a photo,” she said “Because I couldn’t believe it!” Indeed, it was a genuinely shocking sight in 2019.

Speaking of being outside, a 2017 US study found a widening disconnect between people and nature, with parents of 8 to 12 year-olds saying their kids spent three times as many hours with screens each week as they did being outside. More than half of adults themselves said they spent less than 5 hours outside each week.

Why does that matter? Nature makes us happy. There’s a huge body of research detailing the positive impacts of spending time in nature. Even looking at pictures or videos of nature can make us feel better (although I’d recommend the real thing, if possible).

Is it mere coincidence that the people who spend most time online are also less happy? Nope. A 2015 study found that higher amounts of screen time were associated with lower odds of happiness. Another study found girls who spend 5 or more hours on social media are three times more likely to be depressed.

I know what you’re thinking: Maybe it’s not social media making them depressed, maybe it’s just that depressed people flock to social media, while happy people are frolicking around outside. Twenge examines that possibility of “reverse causation” in the report, too. It turns out, however, that several studies following the same people over time found digital media use predicts lower well-being later on – and random experiments have found that adults who suddenly limit their social media use in turn improve their overall well-being.

Now, I wasn’t part of any studies (and nor am I American), but my own experience would also bear this out. A while back, I did a no-Twitter experiment. At first, it was impossible. The app insisted on sending notifications about tweets which I (God forbid) might be missing. But as soon as I deleted the app, I managed two weeks of Twitter-free bliss. I returned because it’s essential to me for work, but I discovered that the apps themselves were never necessary – and I ultimately deleted the Facebook one, too.

On another occasion, more recently, it dawned on me that I even hated using Facebook on the actual website, nevermind the app. In an effort to cleanse my Facebook environment, I went on an ‘unliking’ spree and unfollowed about 200 pages. It was like the Marie Kondo method, but for clearing out the unnecessary crap that clogs your Facebook feed. “Does this bring me joy?” I would ask, before quickly hitting the ‘unlike’ button. I also disappeared people whose posts usually left me feeling annoyed and after an hour or so of purging, I was left with mostly dog videos and pictures of birds – highly recommendable.

A few weeks before, I inquired as to why my teen cousin seemed to have ditched social media, including Instagram. “Too much drama” and “I just feel better without it” was essentially the answer. I can’t exactly say my very limited experience in this regard amounts to any kind of ‘trend’ but it does increasingly seem like social media holds less allure for people.

Teens are dropping from Facebook, at least, like flies. A 2018 study found a dramatic plunge in the numbers of teens using the social networking site. Another study found that more than half of people born after 1995 (Gen Z) had quit or were considering quitting at least one social media platform.

Los Angeles County Board bans use of Roundup for all county departments

The Los Angeles County Board of Supervisors Tuesday directed all departments to stop using a popular weed killer until more is known about its potential health and environmental effects.

Supervisor Kathryn Barger recommended the moratorium on glyphosate — a main ingredient in the herbicide brand Roundup.

“I am asking county departments to stop the use of this herbicide until public health and environmental professionals can determine if it’s safe for further use in L.A. County and explore alternative methods for vegetation management,” Barger said.

Roundup was developed decades ago by Monsanto Co., now owned by Bayer, and is believed to be the most widely used herbicide worldwide.

The motion, co-authored by Supervisor Sheila Kuehl, cites “a growing body of scientific study” of herbicide safety and the potential for negative impacts.

“In a 2015 study led by 17 experts from 11 countries, the World Health Organization’s International Agency for Research on Cancer concluded that glyphosate should be classified as ‘probably carcinogenic to humans,'” Kuehl said. “That conclusion makes it imperative that we question any long-term use of this controversial herbicide, and that’s exactly what this motion calls for.”

The WHO finding has been disputed by Monsanto, and other governmental agencies have stopped short of reaching the same conclusion.

The federal Environmental Protection Agency says the weed killer has low toxicity for humans and concluded in 2017 that it is not likely to cause cancer in humans. California disagreed and tried unsuccessfully to force the company to label the weed killer with a warning.

The European Food Safety Agency does not agree with the WHO. However, a recent court ruling requires EFSA to disclose the details of its own studies.

A jury in a federal lawsuit brought against Bayer by a Sonoma man concluded that his non-Hodgkins lymphoma was caused by exposure to Roundup, the Wall Street Journal reported Tuesday. That panel will now hear evidence related to whether the company should be held liable.

The Board of Supervisors directed the Department of Public Works to coordinate with public health and other personnel to survey current use of the chemical and explore alternatives, including identifying best practices followed by other jurisdictions.

A report is expected back in 30 days.

Teen’s bizarre sudden-onset schizophrenia & hallucinations caused by cat scratch disease

In 2015, a 14-year-old patient developed rapid-onset schizophrenia with hallucinations, thoughts of suicide and homicide. He also believed his cat was trying to kill him, which was closer to the truth than you might think.

His pet cat was not, in fact, a homicidal maniac but it did harbor the pathogen Bartonella henselae, which is associated with ‘cat scratch disease.’

This bacterium is typically found in cat blood, particularly that of kittens, and just one bite or scratch can be enough to transmit the pathogen to humans, causing localized swelling and lesions, in addition to issues in the heart and nervous system.

Now, according to new research by scientists at North Carolina State University, in extremely rare cases, ‘cat scratch disease’ may also induce extreme schizophrenia.

The unnamed patient developed psychiatric symptoms in 2015, claiming to be the “damned son of the devil” while experiencing violent outbursts and suspecting that the family cat was trying to kill him.

Initial treatment with medication reduced his suicidal tendencies and violent impulses but was ineffective at stopping his psychosis. Medical experts were at a loss as to why the boy’s symptoms were so extreme and hard to treat. But then came an unexpected breakthrough.

Some 10 months later, the boy’s parents noticed red stripes across his skin which they had initially dismissed as stretch marks from a growth spurt. Thankfully, when they brought the boy to a doctor for a check up and mentioned the marks, this led the doctors treating him to the real culprit behind the patient’s extreme psychotic break; a cat-borne bacteria.

Having finally honed in on the cause, the medical team used antimicrobial chemotherapy, which ultimately proved to be the cure for his feline-induced psychosis. The patient no longer has any symptoms and has fully recovered both physically and mentally

“Beyond this one case, there’s a lot of movement in trying to understand the potential role of viral and bacterial infections in these medically complex diseases. This case gives us proof that there can be a connection, and offers an opportunity for future investigations,” veterinary medical scientist Ed Breitschwerdt said of the case.

Keeping the candlelight illuminated: Thich Nhat Hanh’s final mindfulness lesson – how to die peacefully

Eliza Barclay: What have you learned about dying from your teacher?

Phap Dung: There is dying in the sense of letting this body go, letting go of feelings, emotions, these things we call our identity, and practicing to let those go.

The trouble is, we don’t let ourselves die day by day. Instead, we carry ideas about each other and ourselves. Sometimes it’s good, but sometimes it’s detrimental to our growth. We brand ourselves and imprison ourselves to an idea.

Letting go is a practice not only when you reach 90. It’s one of the highest practices. This can move you toward equanimity, a state of freedom, a form of peace. Waking up each day as a rebirth, now that is a practice.

In the historical dimension, we practice to accept that we will get to a point where the body will be limited and we will be sick. There is birth, old age, sickness, and death. How will we deal with it?

Eliza Barclay: What are some of the most important teachings from Buddhism about dying?

Phap Dung: We are aware that one day we are all going to deteriorate and die – our neurons, our arms, our flesh and bones. But if our practice and our awareness is strong enough, we can see beyond the dying body and pay attention also to the spiritual body. We continue through the spirit of our speech, our thinking, and our actions. These three aspects of body, speech, and mind continues.

In Buddhism, we call this the nature of no birth and no death. It is the other dimension of the ultimate. It’s not something idealized, or clean. The body has to do what it does, and the mind as well.

But in the ultimate dimension, there is continuation. We can cultivate this awareness of this nature of no birth and no death, this way of living in the ultimate dimension; then slowly our fear of death will lessen.

This awareness also helps us be more mindful in our daily life, to cherish every moment and everyone in our life.

One of the most powerful teachings that he shared with us before he got sick was about not building a stupa [shrine for his remains] for him and putting his ashes in an urn for us to pray to. He strongly commanded us not to do this. I will paraphrase his message:

“Please do not build a stupa for me. Please do not put my ashes in a vase, lock me inside, and limit who I am. I know this will be difficult for some of you. If you must build a stupa though, please make sure that you put a sign on it that says, ‘I am not in here.’ In addition, you can also put another sign that says, ‘I am not out there either,’ and a third sign that says, ‘If I am anywhere, it is in your mindful breathing and in your peaceful steps.'”