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E-cigarettes may be independently linked to erectile dysfunction, new research finds

Men between 20 and 65 years of age with no prior history of CVD but who use ENDS daily are more than twice (2.4 times) as likely as men who have never used ENDS to report erectile dysfunction.

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Smoking has long been associated with Erectile Dysfunction (ED) and Cardiovascular Disease (CVD). However, little research has explored if there is a similar association among men who use Electronic Nicotine Delivery Systems (ENDS), commonly referred to as e-cigarettes. In the first population-based study of its kind, researchers from NYU Grossman School of Medicine and Johns Hopkins University School of Medicine published a study online today in the American Journal of Preventive Medicine that suggests men between 20 and 65 years of age with no prior history of CVD but who use ENDS daily are more than twice (2.4 times) as likely as men who have never used ENDS to report erectile dysfunction.   

According to the researchers, since ENDS use seems to be associated with ED independent of age, CVD and other common ED risk factors, ENDS users should be informed about the possible link between ENDS use and experiencing ED—which impacts one in five men over the age of 20 in the United States.

“Given that many people use e-cigarettes as a form of smoking harm reduction or to help them with smoking cessation, we need to fully investigate the relationship between vaping products and erectile dysfunction, and potential implications for men’s sexual health. Our findings underscore the need to conduct further studies to contextualize the e-cigarette use pattern that is relatively safer than smoking,” said Omar El Shahawy, MD, PhD, MPH, assistant professor in the Department of Population Health at NYU Langone and lead author of the study. “Our analyses accounted for the cigarette smoking history of participants, including those who were never cigarette smokers to begin with, so it is possible that daily e-cigarette vaping may be associated with higher odds of erectile dysfunction regardless of one’s smoking history.”

The research team used data from the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative study of 45,971 U.S. adults aged 18 years and older that examines various tobacco use behaviors and health outcomes.

This study was restricted to 13,711 males, 20 years and older, who responded to a question regarding ED. Dr. Tanmik Shah, NYU Langone, the lead statistician and study co-author, examined the association between ENDS and ED in the full sample, as well as in a restricted sample of 11,207 adult males aged 20 to 65 years with no prior CVD diagnosis, while adjusting for multiple risk factors. Respondents were classified as never, former and current (occasional or daily) users. Almost half of the participants were former cigarette smokers, 21 percent were current cigarette smokers, and 14 percent used other tobacco products.

Compared to those who never used ENDS, daily users were more than two times more likely to report having ED (2.2 times in the full sample and 2.4 times in the restricted sample). There was a significant association between ENDS use and ED among respondents aged 20 to 65 with normal Body Mass Index and without CVD, suggesting an association of ED with ENDS use among a relatively healthy population.

Within the restricted sample, 10.2 percent of respondents reported ED. Five and a half percent reported occasional ENDS use while 2.5 percent reported daily ENDS use. Compared to those who reported never using ENDS, current daily ENDS users were more likely to report ED in both the full and restricted samples. Physical activity was associated with lower odds of ED in both population samples.

In addition to El Shahawy, other NYU Langone researchers include Scott Sherman, MD; Tanmik Shah, MPH; Meghan Durr, MPH; Ria Pinjani, MPH. Researchers from the Johns Hopkins School of Medicine include Michael J. Blaha, MD, who is the senior author of this work; Olufunmilayo H. Obisesan, MD, MPH; Albert D. Osei, MD, MPH; Iftekhar Uddin, MD, MSPH and Mohammadhassan Mirbolouk, MD. Additional investigators include Emilia J. Benjamin, MD, Boston University School of Medicine; Andrew Stokes, PhD, Boston University School of Medicine, Tom Loney, PhD, Mohammed Bin Rashid University of Medicine and Health Sciences, UAE.

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Combination of drugs for obesity and Type 2 diabetes may be more effective than a single therapy

The researchers conclude that combining the drugs has several advantages, including higher effectiveness in at least some patients and fewer side-effects.

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Canadian and German researchers are teaming up to identify new drug combinations to treat people with obesity and Type 2 diabetes. 

The goal is to develop personalized prescriptions that are more effective than single drugs and that can potentially replace more invasive treatments such as bariatric surgery, especially for children. 

“As a pediatric endocrinologist, I can tell you we’re seeing more and more Type 2 diabetes in kids and adolescents, and it seems to be a more aggressive form than adult onset diabetes, so we do need better therapies to achieve even greater efficacy and degree of weight loss,” said Andrea Haqq, a professor in the University of Alberta’s Faculty of Medicine & Dentistry.

The researchers recently published a paper that examines the potential of several drugs that control incretins. These metabolic hormones stimulate the body to produce insulin and use it effectively. They also suppress appetite in order to control blood sugars and reduce weight. 

The researchers conclude that combining the drugs has several advantages, including higher effectiveness in at least some patients and fewer side-effects. 

Even a five per cent weight loss is considered clinically meaningful, and patients in some of the combination drug trials are achieving 10 or 15 per cent, said Haqq, who is a member of the Alberta Diabetes Institute and the Women and Children’s Health Research Institute. 

Haqq’s laboratory is collaborating with that of Timo Müller, director of the Institute for Diabetes and Obesity at the Helmholtz Diabetes Center and a researcher with the German Center for Diabetes Research in Münich, Germany.

As part of the collaboration with the Müller team, first author Qiming Tan, a PhD candidate in the U of A Faculty of Medicine & Dentistry, will study for a term in Germany and a German student will join Haqq’s lab here.

Haqq and Tan recommend further research to identify why some individuals respond differently to the drugs. Some racial and ethnic groups bear a disproportionate burden of obesity and Type 2 diabetes, they said, so more participants from these groups are needed in trials. Further studies should also focus on how differences in biological sex affect drug efficacy and safety. 

In addition to drug combinations, the researchers are looking for non-pharmacological solutions, such as how adding fibre to a person’s diet can slow weight gain and improve the effectiveness of existing diabetes medications.

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How sleep helps to process emotions

According to the researchers, the coexistence of both mechanisms is beneficial to the stability and survival of the organisms: “This bi-directional mechanism is essential to optimize the discrimination between dangerous and safe signals,” says Mattia Aime from the DBMR, first author of the study.

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Researchers at the Department of Neurology of the University of Bern and University Hospital Bern identified how the brain triages emotions during dream sleep to consolidate the storage of positive emotions while dampening the consolidation of negative ones. The work expands the importance of sleep in mental health and opens new ways of therapeutic strategies.

Rapid eye movement (REM or paradoxical) sleep is a unique and mysterious sleep state during which most of the dreams occur together with intense emotional contents. How and why these emotions are reactivated is unclear. The prefrontal cortex integrates many of these emotions during wakefulness but appears paradoxically quiescent during REM sleep.

“Our goal was to understand the underlying mechanism and the functions of such a surprising phenomenon,” says Prof. Antoine Adamantidis from the Department of Biomedical Research (DBMR) at the University of Bern and the Department of Neurology at the Inselspital, University Hospital of Bern.

Processing emotions, particularly distinguishing between danger and safety, is critical for the survival of animals. In humans, excessively negative emotions, such as fear reactions and states of anxiety, lead to pathological states like Post-Traumatic Stress Disorders (PTSD). In Europe, roughly 15% of the population is affected by persistent anxiety and severe mental illness. The research group headed by Antoine Adamantidis is now providing insights into how the brain helps to reinforce positive emotions and weaken strongly negative or traumatic emotions during REM sleep. This study was published in the journal Science.

A dual mechanism

The researchers first conditioned mice to recognize auditory stimuli associated with safety and others associated with danger (aversive stimuli). The activity of neurons in the brain of mice was then recorded during sleep-wake cycles. In this way, the researchers were able to map different areas of a cell and determine how emotional memories are transformed during REM sleep.  

Neurons are composed of a cell body (soma) that integrates information coming from the dendrites (inputs) and send signals to other neurons via their axons (outputs). The results obtained showed that cell somas are kept silent while their dendrites are activated. “This means a decoupling of the two cellular compartments, in other words soma wide asleep and dendrites wide awake,” explains Adamantidis.

This decoupling is important because the strong activity of the dendrites allows the encoding of both danger and safety emotions, while the inhibitions of the soma completely block the output of the circuit during REM sleep. In other words, the brain favors the discrimination of safety versus danger in the dendrites, but block the over-reaction to emotion, in particular danger.

A survival advantage

According to the researchers, the coexistence of both mechanisms is beneficial to the stability and survival of the organisms: “This bi-directional mechanism is essential to optimize the discrimination between dangerous and safe signals,” says Mattia Aime from the DBMR, first author of the study.

If this discrimination is missing in humans and excessive fear reactions are generated, this can lead to anxiety disorders. The findings are particularly relevant to pathological conditions such as post-traumatic stress disorders, in which trauma is over-consolidated in the prefrontal cortex, day after day during sleep.

Breakthrough for sleep medicine

These findings pave the way to a better understanding of the processing of emotions during sleep in humans and open new perspectives for therapeutic targets to treat maladaptive processing of traumatic memories, such as Post Traumatic Stress Disorders (PTSD) and their early sleep-dependent consolidation.

Additional acute or chronic mental health issues that may implicate this somatodendritic decoupling during sleep include acute and chronic stress, anxiety, depression, panic, or even anhedonia, the inability to feel pleasure. Sleep research and sleep medicine have long been a research focus of the University of Bern and the Inselspital, Bern University Hospital. “We hope that our findings will not only be of interest to the patients, but also to the broad public”, says Adamantidis.

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MetroMart to sell only cage-free eggs nationwide by 2025

MetroMart’s e-commerce platform connects consumers with local supermarkets and retailers including The Marketplace, Marks & Spencer, Landmark and All Day Supermarket. The company delivers throughout the Manila and Cebu regions, with plans to expand nationally.

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MetroMart, the country’s largest e-commerce grocery delivery platform, won praise today from U.S.-based global NGO Lever Foundation for its new commitment to source and sell only cage-free eggs nationwide by 2025.

“MetroMart is committed to social responsibility and benefiting the community, including through selling high quality, safe and humane food products,” said Evreem Fortich, Chief Operating Officer at MetroMart and ambassador of the company on the issue. “We’re pleased to share our new policy of selling only cage-free eggs to consumers on our platform by 2025, and we look forward to working closely with our partners to achieve that goal.”

MetroMart’s e-commerce platform connects consumers with local supermarkets and retailers including The Marketplace, Marks & Spencer, Landmark and All Day Supermarket. The company delivers throughout the Manila and Cebu regions, with plans to expand nationally. MetroMart has been actively promoting sustainability initiatives by using banners on its platform to raise public awareness of environmental issues, and offering promotional discounts for ethical and sustainable products.  

Numerous studies have found cage-free eggs are safer and have more vitamins and minerals and a better nutritional profile than caged eggs. Research by the European Food Safety Authority and others has found that cage-free egg farms are up to 25 times less likely to be contaminated with key strains of salmonella compared to hens raised in cages. Hens raised in cage-free systems enjoy better bone health, are free to move and express their natural behavior such as foraging, dust-bathing, flying and nesting.

“We applaud MetroMart for its commitment on this important issue, which will benefit the company’s customers by increasing food safety and quality while also improving the welfare of animals in its supply chain,” said Robyn del Rosario, Sustainability Program Manager at Lever Foundation, which worked with MetroMart on its pledge. “With e-commerce leaders like MetroMart rising in popularity and importance during the pandemic, the company’s commitment to socially responsible policies that benefit the community sets a stellar example for other retailers and food brands.”

Leading animal protection and food safety organizations around the world encourage a switch to cage-free eggs, which are less cruel to animals and safer for consumers. On caged egg farms, each egg-laying hen is confined for nearly her entire life in a cage so small she can barely turn around. Battery cage egg production has been banned throughout the European Union as well as in Australia, New Zealand, the UK, Canada, India, and parts of the United States.

In recent years a growing list of restaurant, hospitality, retail and packaged foods brands have pledged to use only cage-free eggs in the Philippines, including KFC, Pizza Hut, Burger King, Marriott, Nestle, Unilever, and many others. MetroMart is the first retailer in the Philippines and the first online grocery delivery platform in Asia to make the same pledge.

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