Janine Benyus on Biomimicry and the Art of Generous Design
From the Spring 2025 Bioneers Conference – In this insight keynote presentation, biomimicry icon Janine Benyus helps us imagine a city that functions like a forest – storing the same amount of water, cleaning and cooling as well as the same amount of air, cycling of nutrients and the nurturing of biodiversity. She also shares inspiring news about Biomimicry 3.8's Project Positive initiatives that reveal that this regenerative vision is indeed achievable and within our reach, if we are able to quiet our human cleverness sufficiently to be able to ask: What would Nature do here?
We encourage you to learn more about her work at Biomimicry 3.8 - it begins by watching her video here - https://greenmoney.com/janine-benyus-on-becoming-a-welcome-species-biomimicry-and-the-art-of-generous-design
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Medscape
an hour ago
- Medscape
Daytime Sleepiness Tied to Risk for Early Death in Women
SEATTLE — Excessive daytime sleepiness (EDS) was associated with a significantly increased risk for all-cause mortality in women, results of a large observational study showed. After adjusting for health and demographic factors, women aged 50 and 65 years with high scores on the Epworth Sleepiness Scale (ESS) were 16% more likely to die from any cause than their counterparts who had normal levels of sleepiness on this tool. This association was not found in younger women or in those over age 65 years. 'Identifying middle age as a critical period suggests clinicians should prioritize an Epworth Sleepiness Scale assessment and excessive daytime sleepiness management in women approaching their 50s and early 60s,' lead author Arash Maghsoudi, PhD, with Baylor College of Medicine in Houston, said in a news release. The findings were presented on June 9 at SLEEP 2025. Data Gap in Women EDS has been associated with all-cause mortality in previous studies, which primarily focused on men. Maghsoudi and colleagues analyzed the medical records of 40,250 female veterans (mean age, 48 years) from 1999 to 2022, focusing on individuals with sleep-related International Classification of Diseases, 9th/10th Revision codes, or those who had received clinical sleep services. They used a validated natural language processing tool to extract ESS scores from clinical notes, with scores categorized as normal (0-10) or high (11-24). Participants were further stratified into three age groups: Young (< 50 years), middle-aged (≥ 50 to < 65 years), and older adults (≥ 65 years). The results were adjusted for age, race, ethnicity, BMI, and Charlson Comorbidity Index. In the overall cohort, the adjusted odds ratio for all-cause mortality in those with high ESS scores compared to those with normal ESS scores was not statistically significant. However, when stratified by age, middle-aged women with high ESS scores had a significantly higher likelihood of all-cause mortality (adjusted odds ratio, 1.16), with no significant associations seen in the younger or older age groups. The researchers said further studies are needed to explore potential mechanisms, including sex-specific responses to sleepiness and the role of age in this association. 'Intriguing' Data Commenting on this research for Medscape Medical News , Indira Gurubhagavatula, MD, MPH, director of the Sleep Medicine Fellowship and professor of medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia, said the finding that subjectively reported EDS in middle-aged women is associated with mortality strengthens the American Academy of Sleep Medicine (AASM) position that 'sleepiness matters.' The AASM recently published a position statement highlighting how sleepiness can interfere with daily functioning and serve as a marker for other conditions such as mental health problems, sleep disorders, or side effects of medications, as previously reported by Medscape Medical News . 'For these reasons, it is important for clinicians to ask their patients about sleepiness,' said Gurubhagavatula, a spokesperson for AASM. 'The Epworth Sleepiness Scale is a method to get quick, subjective responses and can help guide next steps in clinical evaluation. Improving sleepiness by treating the underlying cause can help restore daytime functioning at home and work, reduce risks of chronic health conditions, and improve people's quality of life,' Gurubhagavatula said. She noted that mechanistic reasons for the relationship between sleepiness and mortality in middle-aged women remain unknown. 'We need more studies to investigate the causal factors that would explain why this association exists,' she added. That said, 'the adjusted odds ratio is just above 1 (average 1.16) in the middle age group. If this is confirmed to be true, even though the risk seems small at an individual level, when you consider it across an entire population, the risk burden to society may be significant,' Gurubhagavatula told Medscape Medical News . She also cautioned that the study involved women veterans, whose risks for sleepiness and mortality may be different than those in other populations. Moreover, the results may not necessarily generalize to other groups. 'The bottom line is that the report is intriguing and calls for more studies to confirm this finding and help explain the mechanism,' Gurubhagavatula concluded.
Medscape
an hour ago
- Medscape
Cardiac Risk Warning for Lamotrigine Challenged
Real-world data from two new studies showed no increased risk for cardiac issues in older adults with epilepsy taking the antiseizure medication (ASM) lamotrigine (Lamictal) vs levetiracetam. The findings add to growing evidence that may eventually lead the FDA to reconsider its current cardiac safety warning, researchers said. The FDA added the cardiac warning label in 2020 based on in vitro studies and case reports of arrhythmias in some patients with underlying heart disease who were taking the drug. However, as reported by Medscape Medical News at that time, several groups challenged the severity of the warning — particularly given that clinicians had been prescribing lamotrigine for three decades without the widespread evidence of such risks. The first new cohort study used data from US Medicare claims and UK claims for more than 53,00 total patients. Its findings showed no difference in new diagnoses of ventricular tachycardia/ventricular fibrillation (VT/VF) between patients initiating the use of lamotrigine and those initiating the use of levetiracetam. Results from the second cohort study, which used Medicare data of nearly 12,000 new lamotrigine users and nearly 150,000 new levetiracetam users, showed no significant between-group differences in incidence of ventricular arrhythmia and sudden cardiac arrest (VA/SCA). The study was prompted by the FDA's safety warning, which was based on limited evidence, lead author Gloria Y.F. Ho, PhD, told Medscape Medical News . 'Our study was done in people, had a comparator, and also looked at several subgroups. And we did not find an increased risk' for cardiac outcomes, said Ho, visiting scholar at the Center for Pharmacoepidemiology and Treatment Science at Rutgers University, New Brunswick, New Jersey. The findings for both studies were published online on June 11 in Neurology . Closing the Evidence Gap Lamictal accounts for 'about 10% of all antiseizure medication use,' the investigators noted in a press release. It remains first-line therapy for certain forms of epilepsy, according to the American Epilepsy Society (AES) and the American Academy of Neurology. The drug inhibits voltage-gated sodium channels, which is a mechanism also implicated in regulating cardiomyocyte excitability. In October 2020, the FDA updated the lamotrigine label to warn about its potential to prolong QT interval, induce new arrhythmias, and slow ventricular conduction in patients with structural or functional heart disease on the basis of an in vitro electrophysiologic study and some case reports. In addition, rodent studies have shown prolonged QT interval time with high-dose lamotrigine vs placebo or a low dose of the drug. 'However, it is uncertain whether these findings are applicable to human physiology,' Ho and colleagues wrote. They added that other studies have often been underpowered to detect rare outcome risks. 'In such instances, real-world data sources can help provide valuable insights to fill this gap,' they noted. Class III Evidence In the first study, led by Samuel W. Terman, MD, from the Department of Clinical Neurosciences at the University of Calgary, Calgary, Alberta, Canada, participants were included if they had filled their first ASM prescription following a first seizure or epilepsy diagnosis, with no prescriptions for this drug class in the previous year. The full patient population included 40,554 patients from Medicare (3038 lamotrigine users and 37,516 levetiracetam users) and 13,098 patients from the UK Clinical Practice Research Datalink (CPRD; 8694 lamotrigine users and 4404 levetiracetam users). In the Medicare group, the median age of those receiving lamotrigine vs levetiracetam was 61 vs 74 years. In the CPRD group, the median age was 34 vs 48 years. The adjusted hazard ratio (HR) for VT/VF was 0.73 for lamotrigine vs levetiracetam in the Medicare dataset and 0.75 for lamotrigine vs levetiracetam in the CPRD dataset. The cumulative incidences were 1.7% vs 2.3% and 0.2% vs 0.3%, respectively. In addition, lamotrigine showed a 'slightly, but nonsignificantly, lower 2-year absolute difference' in cumulative VT/VF incidence in both datasets, the researchers wrote. Sensitivity analyses assessing such things as atrial or any arrhythmias and existing cardiovascular diagnoses showed similar results. 'This study provides class III evidence that lamotrigine did not significantly increase the 2-year cumulative incidence of VT/VF in adult patients with epilepsy,' the investigators wrote. They added that the findings 'do not support concerns regarding lamotrigine increasing arrhythmias.' No Risk in Patients With Heart Disease Using 2007-2019 data of Medicare-insured patients with epilepsy and aged at least 65 years, Ho and her team assessed 11,786 new users of lamotrigine (mean age, 74 years; 64% women) and 147,130 new users of levetiracetam (mean age, 77 years; 60% women). Results showed similar incidence of VA/SCA between the two treatment groups (7 vs 8.2 per 1000 person-years; P =.15) and a nonsignificantly higher adjusted HR of 0.84 for the lamotrigine vs levetiracetam groups ( P =.13). The HRs for VA and SCA individually were similar at 0.86 and 0.83, respectively. Secondary analyses showed no increased risk for VA/SCA in lamotrigine vs levetiracetam users with a baseline history of cardiac conditions, such as heart disease or heart failure. However, lamotrigine users with a baseline history of arrhythmias had a significantly reduced risk for VA/SCA (HR, 0.51) and for the use of any antiarrhythmic drugs (HR, 0.67). The investigators noted that although 'it has been postulated that lamotrigine increases the risk for VA/SCA because of its pharmacodynamic properties,' this assertion was based on studies that did not include older at-risk adults, including those with a history of heart disease. The new findings 'do not support' the current FDA warning label, they added. 'Lamotrigine is a very common and effective drug. Because of the FDA warning, it may limit its use in people who could benefit from it. Because they have a history of heart disease, they may not be able to get the prescription and this could affect the clinical management of epilepsy,' Ho said. Still, she recommended that clinicians evaluate patients on a case by case basis. 'At the end of the day, people in this age group may have other comorbidities and may be taking other medications. So I cannot just say, 'This is safe. Go ahead and use it,'' she said. Ho also noted that the findings may not be generalizable to younger patients because they used Medicare data of individuals older than 65 years or generalizable to those without epilepsy because the drug is also prescribed as a mood stabilizer for bipolar disorder. Two Studies, Same Conclusion In an accompanying editorial, Leah J. Blank, MD/MPH, assistant professor of neurology at the Icahn School of Medicine at Mount Sinai, New York City, noted that both groups of investigators used real-world data and advanced analysis techniques to answer safety questions surrounding the drug. Although Blank pointed out both studies were observational and retrospective in nature, she wrote that the researchers accounted for all of that in their measures. 'Together, these data suggest that lamotrigine likely is safe in clinical practice and can continue to be used as an effective and well tolerated antiseizure medication,' Blank wrote. She also told Medscape Medical News that she prescribes the medication in her own practice. 'The studies were important because lamotrigine is an excellent antiseizure medication and it appears to be very well tolerated. Patients tend to like it and do well on it,' said Blank. 'It's reassuring that two different groups, using slightly different methods, came to the same conclusion that there is not an increased risk for cardiac events in people taking lamotrigine,' she said. Blank said it is worth noting that the human data do not support the FDA warning label. Asked whether it would be taking the new findings into consideration regarding its safety warning, a spokesperson for the FDA told Medscape Medical News that, in general, it does not comment on specific studies. Rather, the organization 'evaluates them as part of the body of evidence to further our understanding about a particular issue and assist in our mission to protect public health.' In addition, a representative for the AES told Medscape Medical News that the organization is not currently working on a statement based on these studies at this time.
Geek Tyrant
an hour ago
- Geek Tyrant
SPACEBALLS 2: Lewis Pullman to Join Father Bill Pullman and Daphne Zuniga as Queen Vespa Returns — GeekTyrant
Get ready to jam it into ludicrous speed, Spaceballs 2 , the next generation of Lone Starrs is on deck. Lewis Pullman is in talks to join the cast of the long-awaited sequel to Mel Brooks' cult classic Spaceballs , reuniting with his real-life dad, Bill Pullman, who will once again don the vest of Lone Starr. And yes, Daphne Zuniga is also expected to return as the ever-iconic Queen Vespa. For fans of the original 1987 film, this sequel has been a decades-long joke made real, and now, it's happening with family ties front and center. Lewis Pullman, who's built a strong résumé with projects like Top Gun: Maverick , Marvel's Thunderbolts* , and his role in Lessons in Chemistry , is set to play 'Starburst,' the offspring of Lone Starr and Queen Vespa. It's a clever move that keeps the DNA of the original intact while launching a new generation of space parody. Pullman originally kept his career path independent of his father's legacy, but recently opened up about how that perspective has shifted: 'For a long time, I was like, 'I'm gonna do this on my own,' and was very stubborn. And I'm so glad that I got over whatever that was because now it's such a gift to be able to share different experiences with my dad and get advice from him.' Joining the cast is Keke Palmer in a key role named Destiny. Though details are still under wraps, she and Lewis Pullman will headline the film alongside Josh Gad, who co-wrote the script with Benji Samit and Dan Hernandez. Gad is also producing, and Mel Brooks returns as Yogurt, which is just the kind of beautiful continuity we needed in this galaxy of franchise chaos. On top pf that Rick Moranis will be back as Darth Helmet, which is the most exciting news! Amazon MGM Studios is producing the film and aiming for a 2027 theatrical release, and while the plot remains locked away, the studio's tongue-in-cheek description gives fans a good idea of what to expect: 'A Non-Prequel Non-Reboot Sequel Part Two' but with Reboot Elements Franchise Expansion Film.' Josh Greenbaum ( Barb and Star Go to Vista Del Mar ) will direct, with Imagine's Brian Grazer and Jeb Brody producing alongside Gad, Brooks, and Greenbaum. Executive producers include Kevin Slater, Adam Merims, and the screenwriting duo Samit and Hernandez. Spaceballs 2 is shaping up to be more than what I was hoping for! Source: THR
