A global diabetes epidemic is fueling record demand for insulin but tens of millions will not get the injections they need unless there is a dramatic improvement in access and affordability, a new study concluded on Wednesday.

Diabetes — which can lead to blindness, kidney failure, heart problems, neuropathic pain and amputations — now affects 9 percent of all adults worldwide, up from 5 percent in 1980. The vast majority have type 2 diabetes, the kind linked to obesity and lack of exercise, and cases are spreading particularly rapidly in the developing world as people adopt more Western, urban lifestyles.

Researchers said the amount of insulin needed to effectively treat type 2 diabetes would rise by more than 20 percent over the next 12 years, but insulin would be beyond the reach of half the 79 million type 2 diabetics predicted to need it in 2030. The shortfall is most acute in Africa, where the team led by Dr Sanjay Basu from Stanford University estimated supply would have to rise sevenfold to treat at-risk patients who had reached the stage of requiring insulin to control their blood sugar.

“These estimates suggest that current levels of insulin access are highly inadequate compared to projected need, particularly in Africa and Asia,” Basu said.

​”Despite the U.N.’s commitment to treat non-communicable diseases and ensure universal access to drugs for diabetes, across much of the world insulin is scarce and unnecessarily difficult for patients to access.”

Global insulin supply is dominated by three companies — Novo Nordisk, Sanofi and Eli Lilly– which have various programs to try to improve access to their products.

Insulin, however, remains costly and prices can be especially out of reach in poorer countries where tortuous supply chains and high mark-ups by middlemen often make it unaffordable for many patients.

Overall, Basu and colleagues calculated that global insulin use was set to rise to 634 million 1,000-unit vials by 2030 from 526 million in 2018.

Their study, published in the Lancet Diabetes; Endocrinology journal and funded by the Helmsley Charitable Trust, was based on projections of diabetes prevalence from the International Diabetes Federation.

Dr Hertzel Gerstein from Canada’s McMaster University wrote in an accompanying commentary that it was important to estimate and ensure insulin supplies, but added the forecasts should be treated cautiously as they were based on mathematical models.
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Public health officials in the United States and Canada on Tuesday warned against eating romaine lettuce while they investigate an outbreak of E. coli that has sickened 50 people in the two countries, including 13 who were hospitalized. 

The alerts, issued as millions of Americans plan their Thanksgiving Day menus, covered all forms of romaine, including whole heads, hearts, bags, mixes and Caesar salad. 

Officials were uncertain of the source of the tainted lettuce. 

“Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick,” the U.S. Centers for Disease Control said in its food safety alert. 

Refrigerator drawers and shelves where romaine lettuce had been stored should be sanitized, the CDC said. 

The Public Health Agency of Canada, which is investigating 18 of the E. coli cases, directed its romaine lettuce alert at consumers in Ontario and Quebec. 

In the United States, the CDC said the outbreak affected 32 people in 11 states between Oct. 8 and Oct. 31. No deaths have been reported, it said. 

Symptoms of the infection often include a moderate fever, severe stomach cramps, vomiting and diarrhea, which is often bloody, the CDC said. Most people get better in five to seven days, but it can be life-threatening, it said. 

The agency said the current outbreak is unrelated to another multistate rash of E. coli infections related to romaine lettuce earlier this year that left five people dead and sickened nearly 200. 

The U.S. Food and Drug Administration and the CDC traced the origin of that contamination to irrigation water in the Yuma, Ariz., growing region. 
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Biologists are trying to save the last of the endangered Puerto Rican parrots after more than half the population of the bright green birds with turquoise-tipped wings disappeared when Hurricane Maria hit Puerto Rico and destroyed their habitat and food sources.

In the tropical forest of El Yunque, only two of the 56 wild birds that once lived there survived the Category 4 storm that pummeled the U.S. territory in September 2017. Meanwhile, only 4 of 31 wild birds in a forest in the western town of Maricao survived, along with 75 out of 134 wild parrots living in the Rio Abajo forest in the central mountains of Puerto Rico, scientists said.

And while several dozen new parrots have been born in captivity and in the wild since Maria, the species is still in danger, according to scientists.

“We have a lot of work to do,” said Gustavo Olivieri, parrot recovery program coordinator for Puerto Rico’s Department of Natural Resources.

Federal and local scientists will meet next month to debate how best to revive a species that numbered more than 1 million in the 1800s but dwindled to 13 birds during the 1970s after decades of forest clearing.

The U.S. and Puerto Rican governments launched a program in 1972 that eventually led to the creation of three breeding centers. Just weeks before Maria hit, scientists reported 56 wild birds at El Yunque, the highest since the program was launched.

But the population decline is now especially worrisome because the parrots that vanished from El Yunque were some of the last remaining wild ones, said Marisel Lopez, who oversees the parrot recovery program at El Yunque for the U.S. Fish & Wildlife Service.

“It was devastating. After so many years of having worked on this project…,” she stopped talking and sighed.

The Puerto Rican Amazon is Puerto Rico’s only remaining native parrot and is one of roughly 30 species of Amazon parrots found in the Americas. The red-foreheaded birds grow to nearly a foot in length, are known for their secrecy and usually mate for life, reproducing once a year.

More than 460 birds remain captive at the breeding centers in El Yunque and Rio Abajo forests, but scientists have not released any of them since Hurricane Maria. A third breeding center in a forest in the western rural town of Maricao has not operated since the storm. Scientists are now trying to determine the best way to prepare the parrots for release since there are such few birds in the wild they can interact with, and whether Puerto Rico’s damaged forests can sustain them.

One proposal scientists will consider is whether to capture some of the remaining wild parrots in the Rio Abajo forest and place them in the same cage as birds that will be released to the wild, so they can learn to emulate their social behavior to ensure their survival, said Jafet Velez, a wildlife biologist with U.S. Fish & Wildlife Service.

Scientists are tentatively planning to release 20 birds next year in Rio Abajo.

Another proposal is to release more parrots in Maricao, which was not as heavily damaged by Maria.

“Our priority now is not reproduction. … it’s to start releasing them,” Lopez said, adding that breeding centers can hold only so many parrots.

But first, scientists need to make sure the forests can offer food and safe shelter.

Jessica Ilse, a forest biologist at el Yunque for the U.S. Forest Service, said scientists are collecting data about the amount of fruit falling from trees and the number of leaves shed. She said the canopy still has not grown back since Maria and warned that invasive species have taken root since more sunlight now shines through. Ilse said that many of the large trees where parrots used to nest are now gone and noted that it took 14 months for El Yunque’s canopy to close after Hurricane Hugo hit Puerto Rico in 1989 as a Category 3 storm.

Scientists also are now collecting new data on the number of predators at El Yunque, including el guaraguao, a red-tailed hawk that hunts Puerto Rico parrots. Without a canopy and proper camouflage, wild parrots have become an easy target.

Ilse said local and federal scientists plan to help the forest recover through planting. By the end of November, they expect to have a map detailing the most damaged areas in El Yunque and a list of tree species they can plant that are more resistant to hurricanes.

“People keep asking us, ‘How long is it going to take?'” Ilse said.

But scientists don’t know, she added.

“The damage is more extensive than [hurricanes] Hugo and Georges. … It’s been a complete change to the ecosystem.”
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Mars is about to get its first U.S. visitor in years: a three-legged, one-armed geologist to dig deep and listen for quakes.

NASA’s InSight makes its grand entrance through the rose-tinted Martian skies on Monday, after a six-month, 300 million-mile (480 million-kilometer) journey. It will be the first American spacecraft to land since the Curiosity rover in 2012 and the first dedicated to exploring underground.

NASA is going with a tried-and-true method to get this mechanical miner to the surface of the red planet. Engine firings will slow its final descent and the spacecraft will plop down on its rigid legs, mimicking the landings of earlier successful missions.

That’s where old school ends on this $1 billion U.S.-European effort.

Once flight controllers in California determine the coast is clear at the landing site — fairly flat and rock free — InSight’s 6-foot (1.8-meter) arm will remove the two main science experiments from the lander’s deck and place them directly on the Martian surface.

No spacecraft has attempted anything like that before.

The firsts don’t stop there.

One experiment will attempt to penetrate 16 feet (5 meters) into Mars, using a self-hammering nail with heat sensors to gauge the planet’s internal temperature. That would shatter the out-of-this-world depth record of 8 feet (2 { meters) drilled by the Apollo moonwalkers nearly a half-century ago for lunar heat measurements.

The astronauts also left behind instruments to measure moonquakes. InSight carries the first seismometers to monitor for marsquakes — if they exist. Yet another experiment will calculate Mars’ wobble, providing clues about the planet’s core.

It won’t be looking for signs of life, past or present. No life detectors are on board.

The spacecraft is like a self-sufficient robot, said lead scientist Bruce Banerdt of NASA’s Jet Propulsion Laboratory.

“It’s got its own brain. It’s got an arm that can manipulate things around. It can listen with its seismometer. It can feel things with the pressure sensors and the temperature sensors. It pulls its own power out of the sun,” he said.

By scoping out the insides of Mars, scientists could learn how our neighbor — and other rocky worlds, including the Earth and moon — formed and transformed over billions of years. Mars is much less geologically active than Earth, and so its interior is closer to being in its original state — a tantalizing time capsule.

InSight stands to “revolutionize the way we think about the inside of the planet,” said NASA’s science mission chief, Thomas Zurbuchen.

But first, the 800-pound (360-kilogram) vehicle needs to get safely to the Martian surface. This time, there won’t be a ball bouncing down with the spacecraft tucked inside, like there were for the Spirit and Opportunity rovers in 2004. And there won’t be a sky crane to lower the lander like there was for the six-wheeled Curiosity during its dramatic “seven minutes of terror.”

“That was crazy,” acknowledged InSight’s project manager, Tom Hoffman. But he noted, “Any time you’re trying to land on Mars, it’s crazy, frankly. I don’t think there’s a sane way to do it.”

No matter how it’s done, getting to Mars and landing there is hard — and unforgiving.

Earth’s success rate at Mars is a mere 40 percent. That includes planetary flybys dating back to the early 1960s, as well as orbiters and landers.

While it’s had its share of flops, the U.S. has by far the best track record. No one else has managed to land and operate a spacecraft on Mars. Two years ago, a European lander came in so fast, its descent system askew, that it carved out a crater on impact.

This time, NASA is borrowing a page from the 1976 twin Vikings and the 2008 Phoenix, which also were stationary and three-legged.

“But you never know what Mars is going to do,” Hoffman said. “Just because we’ve done it before doesn’t mean we’re not nervous and excited about doing it again.”

Wind gusts could send the spacecraft into a dangerous tumble during descent, or the parachute could get tangled. A dust storm like the one that enveloped Mars this past summer could hamper InSight’s ability to generate solar power. A leg could buckle. The arm could jam.

The tensest time for flight controllers in Pasadena, California: the six minutes from the time the spacecraft hits Mars’ atmosphere and touchdown. They’ll have jars of peanuts on hand — a good-luck tradition dating back to 1964’s successful Ranger 7 moon mission.

InSight will enter Mars’ atmosphere at a supersonic 12,300 mph (19,800 kph), relying on its white nylon parachute and a series of engine firings to slow down enough for a soft upright landing on Mars’ Elysium Planitia, a sizable equatorial plain.

Hoffman hopes it’s “like a Walmart parking lot in Kansas.”

The flatter the better so the lander doesn’t tip over, ending the mission, and so the robotic arm can set the science instruments down.

InSight — short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport — will rest close to the ground, its top deck barely a yard, or meter, above the surface. Once its twin circular solar panels open, the lander will occupy the space of a large car.

If NASA gets lucky, a pair of briefcase-size satellites trailing InSight since their joint May liftoff could provide near-live updates during the lander’s descent. There’s an eight-minute lag in communications between Earth and Mars.

The experimental CubeSats, dubbed WALL-E and EVE from the 2008 animated movie, will zoom past Mars and remain in perpetual orbit around the sun, their technology demonstration complete.

If WALL-E and EVE are mute, landing news will come from NASA orbiters at Mars, just not as quickly.

The first pictures of the landing site should start flowing shortly after touchdown. It will be at least 10 weeks before the science instruments are deployed. Add another several weeks for the heat probe to bury into Mars.

The mission is designed to last one full Martian year, the equivalent of two Earth years.

With landing day so close to Thanksgiving, many of the flight controllers will be eating turkey at their desks on the holiday.

Hoffman expects his team will wait until Monday to give full and proper thanks.
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A new report has taken the results of thousands of papers on the impacts of climate change and put them together into a giant assessment detailing the multiple ways that climate change will impact humanity in the coming century.

Lead researcher Camilo Mora says the report shows what he calls a “massive domino effect” of bad news as climate change intensifies in the coming century if the world doesn’t mitigate the amount of carbon we are pumping into the atmosphere.

In the report being published Monday in Nature Climate Change, Mora says there is literally no place on the planet that’s safe.

Putting all the data in one place

The study is unique in that it doesn’t produce any new information, but is basically a mother of all spreadsheets that takes all of the predicted effects of climate change and puts them into one place.

Mora told VOA he and his team of dozens of researchers spent six months gathering and inputting data on climate change into their system and watching how all of these impacts would affect individual sites around the world.

What they came up with was exactly 467 ways that climate change is going to negatively impact the weather, from localized changes like more droughts, heatwaves, wildfires, and storms, to the global changes like sea level rise, and changes in ocean chemistry.

Mora also looked at how climate change is expected to impact everything from food supplies, to increased susceptibility to disease, as well as more difficult to gauge effects like climate insecurity’s impact on mental health.

What he found was surprising, “I couldn’t stop being mind blown every single day,” he told VOA, mainly by the fact that the dangerous and damaging effects of climate change are already impacting humans all over the globe.  “We think this is going to happen later,” he says, “but we found that this is already happening.”

“Last year, for instance, Florida recorded extreme drought, record high temperatures, over 100 wildfires, and the strongest ever recorded hurricane in its Panhandle: the category 4 Hurricane Michael,” Mora says.  “Likewise, California is currently experiencing ferocious wild fires and one of the longest droughts, plus extreme heatwaves this past summer.”

And he says if carbon levels in the atmosphere continue to increase on pace there will no place on earth that isn’t affected.

Take New York, for instance. Mora lays out a future scenario in which in 2100 New York will be constantly dealing with the potentially devastating effects of four different climate hazards, including extreme weather and sea level rise.

All of these effects are measurable and in the future a city like Miami might be dealing with drought, extreme heat, sea level rise and more numerous and more powerful hurricanes.  “Any coastal area in the tropics is going to be on fire” Mora says.  Sydney, Los Angeles, Brazil and Mexico City are all at risk as the effects of climate change stack up.”

Mora’s study is impressive in its detail, noting, “Planes can’t fly during heat waves … wires short circuit during heat waves,” Mora says.  And for people who work outdoors it can literally get too hot and “their livelihoods depend on their job ability to work out doors.”  

All of these impacts add up and have a profound economic effect.  Mora says they create stressed communities that have less economic ability to deal with change, plus higher financial costs thanks to the infrastructure damage and repair associated with predicted extreme weather events.

Is it too late?

But despite all of the bad news in this assessment, Mora is bullish on our ability to head off the effects of climate change.

“This is not game over,” he says. “We are not too late to turn this around and we have pathways to reduce emissions what we need to do is implement them.”

Mora says the solution to the world’s carbon problem will not come from the world’s leaders, despite agreements like the Paris Accord for which hundreds of the world’s leaders came together to commit to cutting their greenhouse gas emissions.

He says the real change to mitigate climate change through gradual cutting of emissions will come from the public, and he points to efforts like Hawaii’s decision to become a carbon neutral state by 2045 and to shift to 100 percent renewable energy.

Mora is also involved with tree planting efforts in Hawaii that he says if done worldwide could help the planet actually remove carbon from the atmosphere, not just stop putting it in.  He calls it one of “many simple steps to clean our footprint all together.”

 
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People in Finland are using social media to mock U.S. President Donald Trump’s suggestion that they “spend a lot of time raking” in forests in order to prevent wildfires.

Trump said Saturday while visiting the area of the deadliest wildfire in California history that Finnish President Sauli Niinisto told him of that method when the two met last week.

In an interview published Sunday in the Ilta-Sanomat newspaper, Niinisto said he only told Trump about the country’s warning system and had no recollection of discussing raking.

The reaction from Finland included many people posting on Twitter with the hashtag “haravointi,” Finnish for raking.

There were lots of posts rebranding Trump’s “Make America Great Again” campaign slogan as “Rake America Great Again.”

Some took a more creative approach to the task, employing more efficiency to cleaning the forest floor.

And from Canada, a suggestion that the whole process could be even easier.

 
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