Artificial intelligence, or AI, could potentially transform arts and entertainment, from music to movies, but it is also raising concerns. Is AI a creative tool or a threat to creators and artists? VOA’s Mike O’Sullivan examines the question.
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The European Union’s environment agency on Wednesday urged member states to reduce pesticide use over concern that sales of harmful chemicals remain strong despite its effects on human health and biodiversity.

The warning comes amid findings that one or more pesticides were detected above thresholds of concern at 22% of all monitoring sites in rivers and lakes across Europe in 2020, the European Environment Agency said.

“From 2011 to 2020, pesticide sales in the EU-27 remained relatively stable at around 350,000 tonnes (tons) per year,” the EEA said in a new report, citing data from Eurostat.

Pesticides are widely used in the agriculture sector but also in forestry, along roads and railways, and in urban areas such as public parks, playgrounds or gardens.

The insecticide imidacloprid and the herbicide metolachlor showed the highest absolute number of above-threshold levels across Europe, primarily in northern Italy and northeastern Spain.

In groundwater, the herbicide atrazine caused the most above-threshold levels, even though it has been banned since 2007.

Dangers of pesticides

Human exposure to chemical pesticides, primarily through food but also through the air in agriculture-intense regions, is linked to the development of cardiac, respiratory and neurological disease, as well as cancer, the report said.

“Worryingly, all of the pesticides monitored … were detected in higher concentrations in children than in adults,” the EEA said.

In a study conducted in Spain, Latvia, Hungary, Czech Republic and the Netherlands between 2014 and 2021, at least two pesticides were detected in the bodies of 84% of survey participants.

Pesticide pollution is also driving biodiversity loss across the continent, causing significant declines in insect populations and threatening the critical role they play in food production.

A German study cited in the report found a 76% decline in flying insects in protected zones over a period of 27 years.

It identified pesticides as one of the reasons for the decline.

Sales drop in some countries

In 11 EU member states, pesticide sales decreased between 2011 and 2020, with the biggest drops in the Czech Republic, Portugal and Denmark.

Latvia and Austria saw the strongest rates of increase in terms of sales, while the sharpest rises in volumes were registered in Germany and France.

These two latter countries, along with Spain and Italy, the EU’s four biggest agricultural producers, account for the highest volumes sold for most groups of active substances.

Modern food production systems rely on high volumes of chemical pesticides to ensure crop yield stability and quantity, and to maintain food security.

According to the EEA, 83% of agricultural soils tested in a 2019 study contained pesticide residues.

“We could reduce our dependency on chemical pesticides to maintain crop yields and our overall pesticide use volumes by shifting to alternative models of agriculture, such as agroecology,” it said.

A separate report published Wednesday by the European Food Safety Authority showed that in 2021, 96% percent of food samples analyzed were within legal limits for pesticide residue.

Grapefruit imported from outside the EU had the highest level of pesticide residues in 2021 and new controls were therefore introduced, the EFSA said.
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Mars is Earth’s next-door neighbor in the solar system — two rocky worlds with differences down to their very core, literally.

A new study based on seismic data obtained by NASA’s robotic InSight lander is offering a fuller understanding of the Martian deep interior and fresh details about dissimilarities between Earth, the third planet from the sun, and Mars, the fourth.

The research, informed by the first detection of seismic waves traveling through the core of a planet other than Earth, showed that the innermost layer of Mars is slightly smaller and denser than previously known. It also provided the best assessment to date of the composition of the Martian core.

Both planets possess cores comprised primarily of liquid iron. But about 20% of the Martian core is made up of elements lighter than iron — mostly sulfur, but also oxygen, carbon and a dash of hydrogen, the study found. That is about double the percentage of such elements in Earth’s core, meaning the Martian core is considerably less dense than our planet’s core — though more dense than a 2021 estimate based on a different type of data from the now-retired InSight.

“The deepest regions of Earth and Mars have different compositions —  likely a product both of the conditions and processes at work when the planets formed and of the material they are made from,” said seismologist Jessica Irving of the University of Bristol in England, lead author of the study published this week in the journal Proceedings of the National Academy of Sciences.

The study also refined the size of the Martian core, finding it has a diameter of about 2,212-2,249 miles (3,560-3,620 km), approximately 12-31 miles (20-50 km) smaller than previously estimated. The Martian core makes up a slightly smaller percentage of the planet’s diameter than does Earth’s core.

The nature of the core can play a role in governing whether a rocky planet or moon could harbor life. The core, for instance, is instrumental in generating Earth’s magnetic field that shields the planet from harmful solar and cosmic particle radiation.

“On planets and moons like Earth, there are silicate — rocky — outer layers and an iron-dominated metallic core. One of the most important ways a core can impact habitability is to generate a planetary dynamo,” Irving said.

“Earth’s core does this but Mars’ core does not — though it used to, billions of years ago. Mars’ core likely no longer has the energetic, turbulent motion which is needed to generate such a field,” Irving added.

Mars has a diameter of about 4,212 miles (6,779 km), compared to Earth’s diameter of about 7,918 miles (12,742 km), and Earth is almost seven times larger in total volume.

The behavior of seismic waves traveling through a planet can reveal details about its interior structure. The new findings stem from two seismic events that occurred on the opposite side of Mars from where the InSight lander — and specifically its seismometer device — sat on the planet’s surface.

The first was an August 2021 marsquake centered close to Valles Marineris, the solar system’s largest canyon. The second was a September 2021 meteorite impact that left a crater of about 425 feet (130 meters).

The U.S. space agency formally retired InSight in December after four years of operations, with an accumulation of dust preventing its solar-powered batteries from recharging.

“The InSight mission has been fantastically successful in helping us decipher the structure and conditions of the planet’s interior,” University of Maryland geophysicist and study co-author Vedran Lekic said. “Deploying a network of seismometers on Mars would lead to even more discoveries and help us understand the planet as a system, which we cannot do by just looking at its surface from orbit.”
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Food and Drug Administration regulators on Tuesday approved a first-of-a-kind drug for a rare form of Lou Gehrig’s disease, though they are requiring further research to confirm it truly helps patients.

The FDA approved Biogen’s injectable drug for patients with a rare genetic mutation that’s estimated to affect less than 500 people in the U.S. It’s the first drug for an inherited form of ALS, or amyotrophic lateral sclerosis, a deadly disease that destroys nerve cells needed for basic functions like walking, talking and swallowing.

Approval came via FDA’s accelerated pathway, which allows drugs to launch based on promising early results, before they’re confirmed to benefit patients. That shortcut has come under increasing scrutiny from government watchdogs and congressional investigators.

The FDA is requiring Biogen to continue studying the drug in a trial of people who carry the genetic mutation but do not yet have ALS symptoms.

ALS patients hope the decision could lay the groundwork for more expedited approvals to fight the disease, which affects 16,000 to 32,000 people in the U.S. The FDA has long used accelerated approval to speed the availability of drugs for cancer and other deadly conditions.

The drug, tofersen, is designed to block the genetic messengers that produce a toxic form of protein that is thought to drive the disease in about 2% of ALS patients. Cambridge, Massachusetts-based Biogen will sell it under the brand name Qalsody. Patients receive three initial spinal injections of the drug over a two-week period, followed by a monthly dose. The most common side effects linked to the drug were pain, fatigue and increased spinal fluid.

Biogen’s 100-person study failed to show that the drug significantly slowed the disease compared with a dummy treatment. Patients were tracked for more than six months using a scale that measures the decline of basic movements, including writing, walking and climbing stairs.

But those who received tofersen showed significant changes in levels of the toxic protein and a second neurological chemical that is considered a key indicator of the disease’s progression.

“The findings are reasonably likely to predict a clinical benefit in patients,” the FDA said in a statement announcing the approval.

Last month an outside panel of FDA advisers voted unanimously that those changes warranted granting conditional approval while more data is gathered to confirm the drug’s benefit. The same panel said Biogen’s current data, including the failed patient study, wasn’t strong enough to warrant full approval.

FDA regulators have the authority to pull accelerated approval from drugs that fail to live up to their expected promise, though until recently, they rarely used that power. In recent years, the FDA has stepped up efforts to force unproven drugs off the market, amid criticism that too many expensive, ineffective medications remain available for years.

At the same time, the FDA has shown increased “regulatory flexibility” in approving drugs for rare and debilitating neurological diseases, including Alzheimer’s and ALS.

In September, the FDA granted full approval to another ALS drug based on one small, mid-stage study in which patients appeared to progress more slowly and survive several months longer. Normally, the FDA requires two large studies or one study suggesting a “very persuasive” improvement in survival.

Some insurers have limited access to the new drug, Relyvrio, citing its uncertain benefit and $158,000-per-year cost.

Biogen did not announce a price for its drug Tuesday but said it will be “comparable to other recently launched ALS treatments.”

The ALS Association and other patient groups hailed the approval.

“This is the second time in less than a year our community gets to celebrate the approval of a new drug to treat ALS and we have great hope for the future,” said Calaneet Balas, the group’s president and CEO.

The FDA has now approved four medications for ALS, only one of which has been shown to extend life. The disease gradually destroys nerve connections needed for basic movements and—eventually—breathing. There is no cure and most people die within three to five years of diagnosis.
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A Japanese company tried to land its own spacecraft on the moon early Wednesday, but its fate was unknown as flight controllers lost contact with it moments before the planned touchdown. 

Flight controllers peered at their screens in Tokyo, expressionless, as the minutes went by with still no word from the lander. 

A webcast commentator urged everyone to be patient, as the controllers investigated what might have happened. 

“Everyone, please give us a few minutes to confirm,” he urged. 

If successful, the company ispace would be the first private business to pull off a lunar landing. 

Only three governments have successfully landed on the moon: Russia, the United States and China. The spacecraft carried a mini lunar rover for the United Arab Emirates and a toylike robot from Japan designed to roll around in the moon dust. There were also items from private customers on board. 
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A Japanese space start-up will attempt Tuesday to become the first private company to put a lander on the Moon.   

If all goes to plan, ispace’s Hakuto-R Mission 1 lander will start its descent towards the lunar surface at around 15:40 GMT.   

It will slow its orbit some 100 kilometers above the Moon, then adjust its speed and altitude to make a “soft landing” around an hour later.   

Success is far from guaranteed. In April 2019, Israeli organization SpaceIL watched their lander crash into the Moon’s surface.   

ispace has announced three alternative landing sites and could shift the lunar descent date to April 26, May 1 or May 3, depending on conditions.   

“What we have accomplished so far is already a great achievement, and we are already applying lessons learned from this flight to our future missions,” ispace founder and CEO Takeshi Hakamada said earlier this month.   

“The stage is set. I am looking forward to witnessing this historic day, marking the beginning of a new era of commercial lunar missions.”   

The lander, standing just over two meters tall and weighing 340 kilograms, has been in lunar orbit since last month.   

It was launched from Earth in December on one of SpaceX’s Falcon 9 rockets after several delays.   

So far only the United States, Russia and China have managed to put a robot on the lunar surface, all through government-sponsored programs.   

However, Japan and the United States announced last year that they would cooperate on a plan to put a Japanese astronaut on the Moon by the end of the decade.   

SEE ALSO: A related video by VOA’s Alexander Kruglyakov

The lander is carrying several lunar rovers, including a miniature Japanese model of just eight centimeters that was jointly developed by Japan’s space agency with toy manufacturer Takara Tomy.   

The mission is also being closely watched by the United Arab Emirates, whose Rashid rover is aboard the lander as part of the nation’s expanding space program.   

The Gulf country is a newcomer to the space race but sent a probe into Mars’ orbit in 2021. If its rover successfully lands, it will be the Arab world’s first Moon mission.   

Hakuto means “white rabbit” in Japanese and references Japanese folklore that a white rabbit lives on the Moon.   

The project was one of five finalists in Google’s Lunar X Prize competition to land a rover on the Moon before a 2018 deadline, which passed without a winner.   

With just 200 employees, ispace has said it “aims to extend the sphere of human life into space and create a sustainable world by providing high-frequency, low-cost transportation services to the Moon.”   

Hakamada has touted the mission as laying “the groundwork for unleashing the Moon’s potential and transforming it into a robust and vibrant economic system.”   

The firm believes the Moon will support a population of 1,000 people by 2040, with 10,000 more visiting each year.   

It plans a second mission, tentatively scheduled for next year, involving both a lunar landing and the deployment of its own rover. 
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The U.S. Space Force said on Monday that Elon Musk’s SpaceX was granted approval to lease a second rocket launch complex at a military base in California, setting the space company up for its fifth launch site in the United States. 

Under the lease, SpaceX will launch its workhorse Falcon rockets from Space Launch Complex-6 at Vandenberg Space Force Base, a military launch site north of Los Angeles where the space company operates another launchpad. It has two others in Florida and its private Starbase site in south Texas. 

A Monday night Space Force statement said a letter of support for the decision was signed on Friday by Space Launch Delta 30 commander Col. Rob Long. The statement did not mention a duration for SpaceX’s lease. 

The new launch site, vacated last year by the Boeing-Lockheed joint venture United Launch Alliance, gives SpaceX more room to handle an increasingly busy launch schedule for commercial, government and internal satellite launches. 

Vandenberg Space Force Base allows for launches in a southern trajectory over the Pacific Ocean, which is often used for weather-monitoring, military or spy satellites that commonly rely on polar Earth orbits. 

SpaceX’s grant of Space Launch Complex-6 comes as rocket companies prepare to compete for the Pentagon’s Phase 3 National Security Space Launch program, a watershed military launch procurement effort expected to begin in the next year or so. 
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An intense solar storm has the northern lights gracing the skies farther south than usual. 

A blast of superhot material from the sun late last week hurled scorching gases known as plasma toward Earth at about 3 million kph, the National Oceanic and Atmospheric Administration said Monday. 

Earth felt the brunt of the storm Sunday, according to NOAA, with forecasters warning operators of power plants and spacecraft of the potential for disruption. 

“I don’t want any expectations of these green curtains moving back and forth” so far south, said Bill Murtagh, program coordinator at the NOAA Space Weather Prediction Center in Boulder, Colorado.  

Auroras were reported across parts of Europe and Asia. In the U.S., skygazers took in the sights from northern states such as Wisconsin and Washington, but also states farther south, including Colorado, California, New Mexico and even Arizona — mostly a reddish glow instead of the typical green shimmer. 

Although conditions have eased, auroras might still be visible as far south as South Dakota and Iowa late Monday and early Tuesday if skies are dark. 

The farther north, the better the chance of a show as the energized particles interact with the atmosphere closer to Earth, according to Murtagh. The farther south, the curvature of the Earth cuts off the possibility for the most dazzling scenes as the particles interact higher in the atmosphere. 

Murtagh said light pollution in Boulder prevented him from seeing the auroras Sunday night. But there could be more opportunities as the solar cycle ramps up. 

“Stay tuned, more to come,” he said. 

This was the third severe geomagnetic storm since the current 11-year solar cycle began in 2019, according to NOAA. The agency expects the cycle to peak in 2024. 

For those Down Under, the southern lights should provide equally good shows, Murtagh said. 
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Scientists said Monday they have developed the first mobile printer that can produce thumbnail-sized patches able to deliver mRNA COVID-19 vaccines, hoping the tabletop device will help immunize people in remote regions.

While many hurdles remain and the 3D printer is likely years away from becoming available, experts hailed the “exciting” finding.

The device prints 2-centimeter-wide patches that each contain hundreds of tiny needles that administer a vaccine when pressed against the skin.

These “microneedle patches” offer a range of advantages over traditional jabs in the arm, including that they can be self-administered, are relatively painless, could be more palatable to the vaccine-hesitant and can be stored at room temperature for long periods of time.

The popular mRNA COVID-19 vaccines from Pfizer and Moderna need to be refrigerated, which has caused distribution complications — particularly in developing countries that have condemned the unequal distribution of doses during the pandemic.

The new printer was tested with the Pfizer and Moderna jabs, according to a study in the journal Nature Biotechnology, but the goal of the international team of researchers behind it is for it to be adapted to whatever vaccines are needed.

Robert Langer, co-founder of Moderna and one of the study’s authors, told AFP that he hoped the printer could be used for “the next COVID, or whatever crisis occurs.” 

Ana Jaklenec, a study author also from the Massachusetts Institute of Technology, said the printer could be sent to areas such as refugee camps or remote villages to “quickly immunize the local population,” in the event of a fresh outbreak of a disease like Ebola.

Vacuum-sealed

Microneedle patch vaccines are already under development for COVID-19 and a range of other diseases, including polio, measles and rubella.

But the patches have long struggled to take off because producing them is an expensive, laborious process often involving large machines for centrifugation. 

To shrink that process down, the researchers used a vacuum chamber to suck the printer “ink” into the bottom of their patch molds, so it reaches the points of the tiny needles.

The vaccine ink is made up of lipid nanoparticles containing mRNA vaccine molecules, as well as a polymer similar to sugar water.

Once allowed to dry, the patches can be stored at room temperature for at least six months, the study found. The patches even survived a month at a balmy 37 degrees Celsius (99 Fahrenheit).

Mice that were given a vaccine patch produced a similar level of antibody response to others immunized via a traditional injection, the study said.

The printed patches are currently being tested on primates, which if successful would lead to trials on humans. 

‘A real breakthrough’?

The printer can make 100 patches in 48 hours. But modelling suggested that — with improvements — it could potentially print thousands a day, the researchers said.

“And you can have more than one printer,” Langer added.

Joseph DeSimone, a chemist at Stanford University not involved in the research, said that “this work is particularly exciting as it realizes the ability to produce vaccines on demand.” 

“With the possibility of scaling up vaccine manufacturing and improved stability at higher temperatures, mobile vaccine printers can facilitate widespread access to RNA vaccines,” said DeSimone, who has invented his own microneedle patches.

Antoine Flahault, director of the Institute of Global Health at the University of Geneva, said that production and access to vaccines could be “transformed through such a printer.”

“It might become a real breakthrough,” he told AFP, while warning that this depended on approval and mass production, which could take years.

Darrick Carter, a biochemist and CEO of U.S. biotech firm PAI Life Sciences, was less optimistic. 

He said that the field of microneedle patches had “suffered for 30 years” because no one had yet been able to scale up manufacturing in a cost-effective way.

“Until someone figures out the manufacturing scale-up issues for microneedle patches they will remain niche products,” he told AFP. 
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Nine European countries held a summit on Monday aimed at scaling up wind power generation in the North Sea, spurred by the fallout from the war in Ukraine and the push for renewables. 

“We’ve seen over the past months what the impact is if you are too dependent on outsiders for the supply of energy,” said Belgian Prime Minister Alexander De Croo, who hosted the meeting in the coastal town of Ostend. 

The leaders of EU members France, Germany, Ireland, Denmark, the Netherlands and Luxembourg, along with European Commission chief Ursula von der Leyen, attended the summit. 

Norway and Britain also participated, with the latter represented by UK Energy Security Secretary Grant Shapps. 

In a joint op-ed published in Politico, the leaders of the nine nations emphasized the need to build more offshore wind turbines “to reach our climate goals, and to rid ourselves of Russian gas, ensuring a more secure and independent Europe.” 

Several leaders pointed to the need also to ensure security of offshore wind farms and their interconnectors, in the wake of recent reports of a Russian spy ship in the North Sea and last year’s sabotage of the Nord Stream gas pipelines in the Baltic Sea. 

De Croo said North Sea infrastructure, including turbines and undersea cables “are prone to sabotage or to espionage” and the topic was “an extremely important one” at the summit.

The summit’s collective goal, stated by all the leaders, is to boost offshore wind power generation to 120 gigawatts by 2030 — from just 30 GW today — and at least 300 GW by 2050.

They recognized the size of the task requires massive investment and that standardizing equipment is needed to bring down costs and timescales.

A key point, hammered by French President Emmanuel Macron, is to ensure the supply chain for the push for more North Sea wind power is anchored in Europe, rather than elsewhere, and that the jobs created are there.

“We want to secure our industrial chain, because it’s important to deploy this offshore wind power but we don’t want to repeat the errors we’ve sometimes committed in the past, of deploying equipment made on the other side of the world,” he said.

The comment appeared to be directed at China, which currently dominates the supply of critical elements, such as rare earth metals. The European Union is seeking to shift away from that reliance on China by bolstering its own industries.

German Chancellor Olaf Scholz said the “very important” summit underscored the potential to greatly expand renewable energy from the North Sea. 

Industry criticism 

WindEurope, an organization that promotes wind energy across Europe, believes the summit’s ambitions are achievable. But it highlighted a lack of “adequate funding mechanisms” and recruitment in the sector.

The organization says Europe needs to build the offshore infrastructure to add 20 GW in output per year, yet the sector currently has capacity for just seven GW annually, with supply chain bottlenecks for cables, substations and foundations, and in the availability of offshore support vessels.

Investment to get Europe where it wants to be is huge: The EU has calculated the cost of reaching 300 GW in offshore energy production by 2050 at $900 billion.

Britain has the biggest fleet of offshore wind farms, 45 of them, currently producing 14 GW, with plans to expand capacity to 50 GW by 2030.

Germany’s 30 wind farms produce 8 GW, followed by the Netherlands with 2.8 GW and Denmark and Belgium both with 2.3 GW.

The other participating countries produce less than a gigawatt from their existing installations but share ambitions to greatly ramp up wind energy capacity. 
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April 24 – April 30, is World Immunization Week.

The theme of this year’s observance is “The Big Catch-Up.”

The idea is for everyone, especially children, to catch up on the vaccinations they might have missed during the COVID outbreak.

The ultimate goal of World Immunization Week, according the World Health Organization, is for more children, adults and their communities to be protected from vaccine-preventable diseases, like polio and measles.

 
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Air pollution still causes more than 1,200 premature deaths a year in under 18’s across Europe and increases the risk of chronic disease later in life, the EU environmental agency said Monday.   

Despite recent improvements, “the level of key air pollutants in many European countries remain stubbornly above World Health Organization” (WHO) guidelines, particularly in central-eastern Europe and Italy, said the EEA after a study in over 30 countries, including the 27 members of the European Union.   

The report did not cover the major industrial nations of Russia, Ukraine and the United Kingdom, suggesting the overall death tolls for the continent could be higher.   

The EEA announced last November that 238,000 people died prematurely because of air pollution in 2020 in the EU, plus Iceland, Liechtenstein, Norway, Switzerland and Turkey.   

“Air pollution causes over 1,200 premature deaths per year in people under the age of 18 in Europe and significantly increases the risk of disease later in life,” the agency said.   

The study was the agency’s first to focus specifically on children.   

“Although the number of premature deaths in this age group is low relative to the total for the European population estimated by EEA each year, deaths early in life represent a loss of future potential and come with a significant burden of chronic illness, both in childhood and later in life,” the agency said.  

It urged authorities to focus on improving air quality around schools and nurseries as well as sports facilities and mass transport hubs.   

“After birth, ambient air pollution increases the risk of several health problems, including asthma, reduced lung function, respiratory infections and allergies,” the report noted.   

7 million dead annually 

Poor air quality can also “aggravate chronic conditions like asthma, which afflicts nine percent of children and adolescents in Europe, as well as increasing the risk of some chronic diseases later in adulthood.”   

Ninety-seven percent of the urban population were in 2021 exposed to air that did not meet WHO recommendations, according to figures released Monday.   

The EEA had last year underlined that the EU was on track to meet its target of reducing premature deaths by 50% by 2030 compared with 2005.   

In the early 1990s, fine particulates caused nearly a million premature deaths a year in the 27 EU nations. That fell to 431,000 in 2005.   

The situation in Europe looks better than for much of the planet, says the WHO, which blames air pollution for 7 million deaths globally each year, almost as many as for cigarette smoking or bad diets.   

It took until September 2021 to reach agreement to tighten limits set for major pollutants back in 2005.   

In Thailand alone, where toxic smog chokes parts of the country, health officials said last week that 2.4 million people had sought hospital treatment for medical problems linked to air pollution since the start of the year.   

Fine particulate matter, primarily from cars and trucks and which can penetrate deeply into the lungs, is considered the worst air pollutant, followed by nitrogen dioxide and ozone. 
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At age 93, struggling with the effects of a stroke, heart failure and recurrent cancer, Teri Sheridan was ready to end her life using New Jersey’s law that allows medically assisted suicide — but she was bedbound, too sick to travel.

So last Nov. 17, surrounded by three of her children, Sheridan drank a lethal dose of drugs prescribed by a doctor she had never met in person, only online. She died within minutes.

Soon, others who seek Sheridan’s final option may find it out of reach, the unintended result of a federal move to roll back online prescribing of potentially addictive drugs allowed during the COVID-19 pandemic.

“How much should one person suffer?” said Sheridan’s daughter, Georgene White, 68. “She wanted to just go to sleep and not wake up.”

Online prescribing rules for controlled drugs were relaxed three years ago under emergency waivers to ensure critical medications remained available during the COVID-19 pandemic. Now, the U.S. Drug Enforcement Administration has proposed a rule that would reinstate most previously longstanding requirements that doctors see patients in person before prescribing narcotic drugs such as Oxycontin, amphetamines such as Adderall, and a host of other potentially dangerous drugs.

The aim is to reduce improper prescribing of these drugs by telehealth companies that boomed during the pandemic. Given the ongoing opioid epidemic, allowing continued broad use of telemedicine prescribing “would pose too great a risk to the public health and safety,” the proposed rule said. It also cracks down on how doctors can prescribe other less-addictive drugs, like Xanax, used to treat anxiety, and buprenorphine, a narcotic used to treat opioid addiction.

The rule would allow some of these drugs to be prescribed with telemedicine for an initial 30-day dose, though patients would need to be seen in person to get a refill. And patients who have been referred to a new doctor by one they had previously met in person could continue to receive prescriptions for the drugs via telemedicine.

DEA Administrator Anne Milgram called the plan “telemedicine with guardrails.”

The agency, with input from the Department of Health and Human Services, is working to finalize the rule by May 11, when the COVID public health emergency officially ends, an HHS spokeswoman said. If approved by then, the new requirements would take effect in November.

The proposal has sparked a massive backlash, including more than 35,000 comments to a federal portal and calls from advocates, members of Congress and medical groups to reconsider certain patients or provisions.

“They completely forgot that there was a population of people who are dying,” said Dr. Lonny Shavelson, a California physician who chairs the American Clinicians Academy on Medical Aid in Dying, a coalition of doctors who help patients access care under so-called right-to-die laws.

Among the biggest complaints: The rule would delay or block access for patients who seek medically assisted suicide and hospice care, critics said. Many of the comments — including nearly 10,000 delivered in person to DEA offices — came from doctors and patients protesting the effect of the rule on seriously ill and dying patients.

“Please do not make the end of life harder for me,” wrote Lynda Bluestein, 75, of Bridgeport, Connecticut. In March, Bluestein, who has terminal fallopian tube cancer, reached a settlement with the state of Vermont that will allow her to be the first non-resident to use its medically assisted suicide law. By the time she’s ready to use the drugs, she expects to be too ill to travel to see a doctor in person for the prescription, she wrote.

The clash between desperate patients who need treatment and DEA’s efforts to bar telehealth companies from overprescribing dangerous medications was inevitable, said David Herzberg, a historian of drugs at the University of Buffalo.

“The balancing act is so tricky,” he said.

Laws in 10 states and Washington allow dying people with a prognosis of six months or less to end their lives with a lethal combination of medications covered by the DEA rule. But such patients are often too sick to visit a doctor in person or they live hundreds of kilometers from the nearest willing and qualified provider, Shavelson said.

There are similar issues for the 1.7 million Medicare recipients enrolled in hospice care in the United States, said Judi Lund Person, who oversees regulatory compliance for the National Hospice and Palliative Care Organization. Rolling back online prescribing flexibilities could mean a dying patient would wait for days for drugs to ease pain and other symptoms.

“They just don’t have time for that,” she said.

Shavelson and his colleagues called for an exception to the rule for the hundreds of patients a year who qualify for medically assisted suicide. Both the American Medical Association and the California Medical Association sent letters asking the DEA to carve out provisions for doctors prescribing the most dangerous category of drugs to patients receiving hospice or palliative care.

“These patients are extremely fragile and their medical conditions do not allow them to easily access a physician’s office,” wrote Dr. Donaldo D. Hernandez, president of the California group. Such people pose a “reduced risk for abuse” given their clear need for the medications.

Congress directed the DEA in 2008 to create exceptions for certain providers to permit remote prescribing, but the agency has not done so, Virginia Democrat Sen. Mark Warner said in a statement last month.

DEA officials did not respond to questions about whether COVID-19 telehealth waivers would remain in effect if the proposed rule isn’t finalized by May 11 or whether the agency will allow exceptions for remote prescribing.

During the pandemic, prescriptions for medically assisted suicide went up, in some cases significantly. In Oregon, for instance, they climbed nearly 49%, to 432 in 2022 from 290 in 2019. The number of deaths under the law in that state rose, too, to 246 from 170. Nationally, at least 1,300 people die each year using the process, according to available state figures.

Telemedicine was key to access during the COVID emergency, said Dr. Robin Plumer, the New Jersey doctor who prescribed the drugs Teri Sheridan took. Plumer has overseen 80 assisted suicide deaths since 2020. Without online prescribing, 35% to 40% of her patients wouldn’t have been able to use the law.

“I feel like we’ve taught people over the past couple of years that telemedicine does work in so many areas and it’s a great improvement for people,” especially for those who are homebound or dying, Plumer said.

“And what?” she said. “They’re suddenly going to yank that away?”
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An organ transplant surgeon from New York is planning a third trip to Ukraine, where he has been working with doctors to help patients caught up in Russia’s war on Ukraine. The surgeon, Dr. Robert Montgomery, is also working to raise money to buy medical equipment for a hospital in Lviv. Iryna Solomko has the story, narrated by Anna Rice. VOA footage by Pavlo Terekhov.
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