5 percent of 10th- and 12th-graders say they've used nicotine pouches
More U.S. high-schoolers used nicotine pouches — smokeless nicotine powder products — last year than the year before, according to new research published in JAMA Network Open.
The researchers, who used data from a nationally representative survey of 10,146 youths in 2023 and 2024, said 5.4 percent of 10th- and 12th-graders reported having used nicotine pouches, up from 3 percent the year before. The 10th- and 12th-graders' use of pouches in the 12 months and 30 days before the surveys also increased year to year. Males were also more likely to use pouches than females.
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Medscape
12 minutes ago
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Peptide Predicts Cardiac Risk in Women With Unblocked Arteries
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Fast Company
26 minutes ago
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Is ‘de-extinction' here? How gene editing can help endangered species
IMPACT Gene editing's real value is not in re-creating copies of long-extinct species like dire wolves, but instead using it to recover ones in trouble now. Red Wolves are seen at the North Carolina Museum of Life + Science on Thursday, November 8, 2017, in Durham, NC. [Photo: Salwan Georges/The] BY Listen to this Article More info 0:00 / 8:48 Have you been hearing about the dire wolf lately? Maybe you saw a massive white wolf on the cover of Time magazine or a photo of Game of Thrones author George R.R. Martin holding a puppy named after a character from his books. The dire wolf, a large, wolflike species that went extinct about 12,000 years ago, has been in the news after biotech company Colossal claimed to have resurrected it using cloning and gene-editing technologies. Colossal calls itself a ' de-extinction ' company. The very concept of de-extinction is a lightning rod for criticism. There are broad accusations of playing God or messing with nature, as well as more focused objections that contemporary de-extinction tools create poor imitations rather than truly resurrected species. While the biological and philosophical debates are interesting, the legal ramifications for endangered species conservation are of paramount importance. As a legal scholar with a PhD in wildlife genetics, my work focuses on how we legally define the term 'endangered species.' The use of biotechnology for conservation, whether for de-extinction or genetic augmentation of existing species, promises solutions to otherwise intractable problems. But it needs to work in harmony with both the letter and purpose of the laws governing biodiversity conservation. Of dire wolves and de-extinction What did Colossal actually do? Scientists extracted and sequenced DNA from Ice Age-era bones to understand the genetic makeup of the dire wolf. They were able to piece together around 90% of a complete dire wolf genome. While the gray wolf and the dire wolf are separated by a few million years of evolution, they share over 99.5% of their genomes. Subscribe to the Daily Company's trending stories delivered to you every day SIGN UP The scientists scanned the recovered dire wolf sequences for specific genes that they believed were responsible for the physical and ecological differences between dire wolves and other species of canids, including genes related to body size and coat color. CRISPR gene-editing technology allows scientists to make specific changes in the DNA of an organism. The Colossal team used CRISPR to make 20 changes in 14 different genes in a modern gray wolf cell before implanting the embryo into a surrogate mother. While the technology on display is marvelous, what should we call the resulting animals? Some commentators argue that the animals are just modified gray wolves. 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Biologists are notorious for failing to adopt a single clear definition of 'species,' and there are dozens of competing definitions in the biological literature. Biologists can afford to be flexible and imprecise when the stakes are merely a conversational misunderstanding. Lawyers and policymakers, on the other hand, do not have that luxury. Deciding what counts as an endangered 'species' In the United States, the Endangered Species Act is the main tool for protecting biodiversity. To be protected by the act, an organism must be a member of an endangered or threatened species. Some of the most contentious ESA issues are definitional, such as whether the listed species is a valid 'species' and whether individual organisms, especially hybrids, are members of the listed species. Colossal's functional species concept is anathema to the Endangered Species Act. It shrinks the value of a species down to the way it looks or the way it functions. When passing the act, however, Congress made clear that species were to be valued for their 'aesthetic, ecological, educational, historical, recreational, and scientific value to the Nation and its people.' In my view, the myopic focus on function seems to miss the point. Despite its insistence otherwise, Colossal's definitional sleight of hand has opened the door to arguments that people should reduce conservation funding or protections for currently imperiled species. Why spend the money to protect a critter and its habitat when, according to Interior Secretary Doug Burgum, you can just ' pick your favorite species and call up Colossal '? Putting biotechnology to work for conservation Biotechnology can provide real conservation benefits for today's endangered species. I suggest gene editing's real value is not in recreating facsimiles of long-extinct species like dire wolves, but instead using it to recover ones in trouble now. Projects, by both Colossal and other groups, are underway around the world to help endangered species develop disease resistance or evolve to tolerate a warmer world. Other projects use gene editing to reintroduce genetic variation into populations where genetic diversity has been lost. For example, Colossal has also announced that it has cloned a red wolf. Unlike the dire wolf, the red wolf is not extinct, though it came extremely close. After decades of conservation efforts, there are about a dozen red wolves in the wild in the reintroduced population in eastern North Carolina, as well as a few hundred red wolves in captivity. The entire population of red wolves, both wild and captive, descends from merely 14 founders of the captive breeding program. This limited heritage means the species has lost a significant amount of the genetic diversity that would help it continue to evolve and adapt. 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Due to its hybrid nature, the animal Colossal cloned is likely not legally considered a red wolf at all. Under the Endangered Species Act, hybrid organisms are typically not protected. So by cloning one of these animals, Colossal likely sidestepped the need for ESA permits. It will almost certainly run into resistance if it attempts to breed these 'ghost wolves' into the current red wolf captive breeding program that has spent decades trying to minimize hybridization. How much to value genetic 'purity' versus genetic diversity in managed species still proves an extraordinarily difficult question, even without the legal uncertainty. Biotechnology could never solve every conservation problem—especially habitat destruction. The ability to make 'functional' copies of a species certainly does not lessen the urgency to respond to biodiversity loss, nor does it reduce human beings' moral culpability. 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Medscape
36 minutes ago
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PHOENIX — Historically, optic nerve involvement has been excluded from multiple sclerosis (MS) diagnostic criteria, but its inclusion in the upcoming 2024 McDonald Diagnostic Criteria is expected to significantly accelerate the time to definitive diagnosis in patients with clinically isolated syndrome (CIS). Driven by advances in imaging protocols and the evidence that it improves diagnostic specificity, 'the optic nerve will now be included as a fifth topography,' said Peter Calabresi, MD, director of the Multiple Sclerosis Center, Johns Hopkins Medicine, Baltimore. Although this is just one change from the 2017 McDonald Diagnostic Criteria aimed at facilitating diagnosis, those involved in the 2024 revisions consider the addition of this fifth topographical sign among the most significant, said writing committee members Calabresi and Jiwon Oh, MD, PhD, medical director of the Barlo Multiple Sclerosis Program at St. Michael's Hospital, University of Toronto, Toronto. Specifically, optic nerve lesions will make it easier to fulfill the dissemination in space (DIS) principle, a pivotal concept for delivering a diagnosis of MS in patients with CIS, said Calabresi at a May 29 symposium here at the Consortium of Multiple Sclerosis Centers (CMSC) 2025 Annual Meeting. Context Still Key Citing several studies published since 2017, Calabresi noted that incorporating optic nerve lesions into the DIS criteria increases diagnostic sensitivity to over 90% compared to the four existing DIS signs — periventricular, spinal cord, infratentorial, and cortical/juxtacortical. In one study, sensitivity increased from 85% to 95%. Under the revised criteria, optic nerve lesions may be documented using MRI, optical coherence tomography (OCT), or visual evoked potentials (VEP). Calabresi noted that patients meeting all four of the existing 2017 DIS criteria already demonstrate near 100% specificity for MS. While adding a fifth topographical site cannot improve specificity, it will make it easier to detect evidence of DIS across at least four regions and make a diagnosis when combined with other criteria. Several challenging case studies were employed to illustrate his point. This included a 47-year-old woman presenting with isolated optic neuritis and a 31-year-old woman presenting with ataxia. Neither would have been diagnosed with MS on the basis of the 2017 criteria, but both would meet the 2024 criteria due to the involvement of the optic nerve. Like other MS diagnostic criteria, the fifth topographical sign is relevant only in context, not in isolation, Calabresi said. For MRI, the definition is expected to require one or more topical short-segment intrinsic optic nerve lesions when there is no better explanation. For example, prominent chiasmal involvement or perineuritis would not allow for inclusion of definite optic nerve involvement. For OCT, the signs of MS-related optic nerve involvement include significant asymmetry in the peripapillary retinal nerve fiber layer or ganglion cell and inner plexiform layer (GCIPL). GCIPL thickness below the lower limits of normal is also an acceptable sign. However, a better explanation for these changes must be explicitly ruled out. An abnormal VEP suggesting optic nerve involvement depends on significant intraocular asymmetry or a peak time exceeding 100 microseconds — above the upper limit of normal — in the absence of a better explanation. Better Outcomes? Whether or not optic nerve DIS involvement is demonstrated, the new criteria 'do not mandate anything about treatment,' Calabresi said. This is a separate issue even if it is reasonable to anticipate a better outcome from a faster diagnosis when an earlier start of disease-modifying therapy reduces tissue damage and future disability. The transition to evaluating the optic nerve as a means of establishing an MS diagnosis may not be entirely smooth, said Calabresi. 'The challenges will involve the added demand on radiology,' Calabresi said. He also expressed concern about a learning curve for documenting optic nerve involvement either by MRI, OCT, or VEP, each of which involves precise interpretation. 'Everything is dependent on quality control,' he said. With OCT, for example, Calabresi noted that the ability to confirm optic nerve involvement depends on knowing and employing the established cutoffs for what qualifies as a likely MS-related lesion, a step that is at least somewhat technique-dependent. As examples, Calabresi mentioned the critical performance of using adequate light and ruling out artefacts. However, he noted that even though the new McDonald Diagnostic Criteria are expected to improve sensitivity and specificity, it 'will not take away from the importance of thorough clinical evaluation.' New Evidence When the 2010 McDonald Diagnostic Criteria were issued, the concept of DIS was already established. It was not until 2017 that cortical lesions were added as a fourth topography. In 2017, there was also extensive discussion about the value of optic nerve involvement as a fifth topography based, at least in part, on 2016 consensus guidelines from MRI in MS (MAGNIMS), a European network dedicated to the study of MS through MRI. Ultimately, optic nerve involvement was not included due to uncertainty about how much involvement would improve sensitivity and because of unresolved questions about the optimal use of MRI, OCT, and VEP. The optic nerve was included in the current iteration of the criteria because the evidence has evolved, said Calabresi. The bottom line is the addition of optical nerve topography to DIS means patients with CIS will be far more likely to be diagnosed immediately,' agreed Oh, who joined Calabresi during the CMSC symposium. Her own focus is on other new markers of MS that will be included in the new criteria, including documentation of the central vein sign and paramagnetic rim lesions on MRI, as well as the addition of the optic nerve in DIS. 'For clinicians, the new criteria will be a lot to take in, but I think they will allow more patients with signs and symptoms to receive a diagnosis of MS,' said Oh, in particular patients who receive a diagnosis of CIS or radiologically isolated syndrome without knowing if they have progressive disease.
