Rest may not be best after concussion

After a concussion, most pediatricians recommend that teens and children rest until all their symptoms disappear. A new study questions this advice.

Compared with those who rested, children who began physical activity within seven days of an injury reduced their risk of persistent postconcussive symptoms, according to research published Tuesday in the Journal of the American Medical Association.

“We know that there are hundreds of thousands of pediatric emergency visits across North America for acute concussions,” said Dr. Roger Zemek, lead author and director of the research unit at Children’s Hospital of Eastern Ontario. “Approximately one-third of those children will continue to experience ongoing or worsening symptoms for one month following their original injury.”

Zemek added that the actual rates are difficult to calculate, given that many children do not report injuries or do not get treated.

Postconcussive syndrome
Concussion is a form of mild traumatic brain injury. If the effects last for weeks or even months, doctors refer to this as “postconcussive syndrome.” Each child is different, so each may experience a unique set of symptoms, explained Zemek.

“Typically, children can have ongoing symptoms that are physical in nature. Examples of that would be ongoing headaches, dizziness, maybe even some nausea or vision changes,” Zemek said. Other children may have symptoms that are more cognitive in nature, so they might have problems concentrating or feel like they’re “in a fog. They can have symptoms that are more emotional or behavioral in nature, feeling sad or feeling low energy.” Sometimes, patients can’t sleep.

Although postconcussion symptoms usually go away within three months, some can last a year or more.

Typically, pediatricians recommend that patients get rest until their symptoms disappear. “Unfortunately, most of those recommendations were not based on evidence; they were based on expert opinion only,” Zemek said.

Other experts agree that more work is needed in the area of concussions, generally.

“The big question following a concussion is: How long should kids and adults stay away from physical activity?” said Dr. Richard Temes, director of the Center for Neurocritical Care at North Shore University Hospital in Manhasset, New York. He did not participate in the research. “This paper is kind of the first step to addressing the timing of physical activity.”

Noting that early physical rehabilitation is encouraged after a stroke — severe brain trauma — Zemek and his colleagues set to work to find out whether it might also help prevent lingering concussion symptoms.

Is exercise the greatest medicine?
To investigate the possible effects of physical activity, Zemek and his colleagues assessed more than 2,400 children and teens diagnosed with concussion. After rating each child’s physical activity participation and postconcussive symptom severity using standardized questionnaires at day seven, the researchers assessed persistent postconcussive symptoms at day 28.

Of all the participants, about 70% became active again within seven days. Activity primarily consisted of light aerobic or sport-specific exercise, noncontact drills and even, in a small percentage of cases, full-contact practice.

Of the patients who began physical activity early, 31% were symptom-free and 48% had at least three persistent or worsening postconcussive symptoms at day seven. By comparison, 80% of those who rested for the first week after a concussion had at least three postconcussive symptoms at day seven. At 28 days, the proportion with postconcussive symptoms was nearly 40% among those who rested versus about 29% among those who resumed early activity — a significant difference.

“I think there are many different ways in which exercise may be beneficial,” Zemek said, explaining that activity can improve cerebral blood flow, promote neuroplasticity and release endorphins, which may heal the brain.

Getting out of the “home jail” can be a psychologically important factor for kids as well, he said, reinforcing the message that they are going to get better. However, he still urges caution: Patients should not go skiing, participate in collision sports or risk another head injury while symptomatic.

Temes wholeheartedly agrees. “This is not a stamp of approval to get back in the football game,” he said, adding that the study tells families only that “some level of physical activity may be helpful in improving symptoms of concussion.”

This was not a randomized control trial but a simple observational study based on self-reports from families, noted Dr. Lynn Babcock, associate professor in the division of emergency medicine at Cincinnati Children’s Hospital Medical Center. Some attempt was made to guess at the quantity, intensity and timing of exercise after an injury, but objective data are still needed, she said.

“Still, we’re pretty excited to see more evidence saying we need to better study this question,” said Babcock, who was not involved in the research.

Zemek and his colleagues have begun a randomized clinical trial to learn more about preventing postconcussive syndrome. “One-third of all kids is too many,” he said. “Exercise itself can be a great medicine.”

Bullying is Bad—Unless You’re Bullying Hunters and Other Gun Owners, and Then It’s OK

A 12-year-old big-game hunter who regularly snags huge wild beats alongside her father is learning that, while the Internet generally frowns on cyber-bullying, it has no trouble berating children who legally use guns for recreation.

Aryanna Gourdin and her dad recently returned from a sojourn to South Africa where the pair legally bagged some major hunting prizes: a zebra and giraffe. Aryanna posed with her gun and her dead giraffe and put the picture up on Facebook—where she attracted 78,000 comments, most of them unhappy with her choice of extracurricular activity.

Gourdin and her dad say they aren’t ashamed of their prize. Speaking to Good Morning America, her dad defended their father-daughter bonding—”We’re proud to be hunters and we’ll never apologize for being a hunter”—and said they were doing the game preserve a favor, humanely killing an older animal that was terrorizing the rest of the herd.

But while the concept of big-game hunting—a sport of the rich and famous, who can afford to pay huge fees to hunt trophy game in controlled areas—is itself controversial, the response to Gourdin’s post hasn’t been just about the dead giraffe.

Commenters have made the  attacks personal, calling Gourdin a “killer,” “sick” and an “animal hater.” Some have even left death threats, telling the pair they should meet the same fate as the animals.

But while Twitter and Facebook have been quick to set up “trust and safety councils” and “advisory boards” designed to curb bullying on their platforms, the abuse on Gourdin’s page seems to continue unabated.

Are hunters and shooters the only group of people online that it’s still acceptable to bully? Dana Loesch, a gun rights advocate and bestselling author, receives hundreds of hateful messages for her stance on the Second Amendment per day. And Ginny Thrasher, the 19-year-old who won a gold medal in an Olympic shooting event, was roundly lambasted online for the crime of being an American who knows her way around an air rifle.

In the latter case, celebrities and social justice warriors who would normally be incredibly vocal on the subject of social media bullying went straight for Thrasher’s gut in an Olympics of their own: winning gold in virtue signaling over America’s “obsession” with weapons.

Big Game Hunter Luciano Ponzetto Dead at 55

Game Hunter Loathed By Animal Activists Fall to His Death While Shooting Birds.

Ponzetto, a veterinarian who received media attention after posing with a photograph of a lion he had killed, fell to his death during a hunting trip in Italy.

On 13 December 2016, the tabloid The Sun published an article reporting the death of Luciano Ponzetto, a 55-year-old veterinarian who drew the ire of the Internet in November 2015 after posing for a photograph with a lion he had killed:

A big game hunter who sparked worldwide fury when he posed next to a lion he had killed has died after falling 100ft down a ravine while shooting birds.

Vet Luciano Ponzetto, 55, received death threats and hate mail after he posted the snaps of him with the lion on social media last year.

He insisted he had done nothing wrong but the controversy forced him to step down as the medical director of a kennel business after being slammed for shooting Cecil the lion despite working with animals.

Officials say he was out hunting with pals when he slipped on ice and fell down the ravine at Colle delle Oche in hills above the Italian city of Turin.

While several media outlets reported on Ponzetto's death, the circumstances of his demise (a veterinarian infamous for big game hunting photographs, who died during a hunting trip) were too surreal for some to immediately believe. 

However, the report is genuine. News about Ponzetto's death was first reported by Italian outlets such as Corriere Della Sera and Torina Today on 10 December 2016. According to those reports, Ponzetto was "chasing prey" when he slipped on ice and fell more than a dozen meters into a deep ravine:

As he often did, Ponzetto left early in the morning for a hunting trip with a friend in the valley of the Rio Giassetto. The accident occurred at an altitude of 2,200 meters in the valley of the Colle delle Oche, above Pianprato. The vet, who was well equipped, being a decent climber, lost his balance and fell tumbling into a deep ravine a few dozen meters. 

Police and mountaineers found his body after about an hour and a half of searching, and say that he appeared to have died instantly.

Social media sites immediately picked up on his death and described it as “karma”.

One wrote: “I don’t quite see how this man could have worked as a vet and then 

happily gone out and killed animals.

“He should have had more respect.”

An Italian police spokesman said: “We were called by the mountain rescue services 

who had been alerted to the incident by someone who was out with him.

“His body was recovered by helicopter and taken to a local hospital.

“It looks like he slipped and fell when he was out hunting.

“He died instantly and there was nothing that could be done.”

The case drew comparisons with that of legendary Cecil the Lion who was shot dead by an American game hunter in Zimbabwe last year.

Scientists Take 'Huge' Step Toward Reversing Aging

'Our study shows that aging may not have to proceed in one single direction'

In the future, we may be able to treat aging itself, rather than just the diseases that come with it, the Guardian reports. “Our study shows that aging may not have to proceed in one single direction," researcher Juan Carlos Izpisua Belmonte says. "With careful modulation, aging might be reversed.” According to the New York Times , the study—published Thursday in Cell—is science's first attempt at combating aging by rejiggering the genome. In the study, researchers genetically engineered mice to produce four proteins that revert cells back to their embryonic state, the San Diego Union Tribune reports. They then created an on/off switch for the proteins to keep cells from permanently reverting to their embryonic state and becoming useless.

After six weeks of treatment, mice genetically engineered to have the rapid-aging disease progeria lived 30% longer. Mice without progeria had better functioning hearts, pancreases, and muscles, as well as improved healing of wounds, following treatment. Basically, they seemed younger. The study's results were described by outside experts as "exciting" and "huge." While similar treatments for humans are likely at least a decade away, researchers believe they could be used to slow down the body's internal clock and control at least some aspects of aging. They won't, however, "lead to immortality," says Izpisua Belmonte (Meanwhile, optimistic women may live longer.)

Daily low-dose aspirin may cut pancreatic cancer risk

There's evidence that daily low-dose aspirin may decrease the risk of pancreatic cancer, according to a new study.

The Chinese-based study couldn't prove cause-and-effect. However, "the balance of evidence shows that people who use aspirin to reduce risk for cardiovascular disease or colorectal cancer can feel positive that their use likely also lowers their risk for pancreatic cancer," said study lead author Dr. Harvey Risch.

He's professor of epidemiology at the Yale School of Public Health and Yale Cancer Center in New Haven, Conn.

According to the American Cancer Society, about 53,000 Americans will be diagnosed with pancreatic cancer this year, and almost 42,000 will die from the disease. Pancreatic cancer is often a "silent killer" because symptoms do not emerge until the tumor is advanced.

The new study tracked 761 people diagnosed with pancreatic cancer in Shanghai from 2006 to 2011, and compared them to 794 people who didn't have the cancer.

All the participants were asked about whether they took low-dose aspirin on a regular basis. Almost all who said they took it did so on a daily basis.

Eighteen percent of the non-cancer patients reported regular use of low-dose aspirin compared to 11 percent of the pancreatic cancer patients.

After adjusting their statistics so they wouldn't be thrown off by various factors, the researchers estimate that aspirin may reduce the already small risk of pancreatic cancer by 46 percent.

However, Risch's team stressed that the study doesn't prove that aspirin directly produces a lower risk, and the participants may not have precisely remembered their aspirin intake.

An analysis of other studies found similar results. The researchers examined 18 other studies that had investigated aspirin use and pancreatic cancer risk over the past two decades and found that as aspirin use increased, the risk of pancreatic cancer significantly decreased.

"Pancreatic cancer is relatively rare -- just 1.5 percent of U.S. adults will be diagnosed with it at some point during life -- and regular aspirin use can cause appreciable complications for some," Risch said in a news release from the American Association for Cancer Research. "Therefore, a person should consult his or her doctor about aspirin use."

One oncologist who reviewed the data said Americans should be cautious in interpreting the results.

"This is an interesting study that suggests that regular aspirin use may reduce the incidence of pancreas cancer -- in people living in China," said Dr. Tony Philip, an oncologist at Northwell Health Cancer Institute in Lake Success, N.Y.

"Anything more than that cannot be extrapolated from this study," he said. "We know the genetics of people in one part of the world is very different from other parts. In addition, we don't know what else these patients were doing, for example, taking herbal medicine, their family history, or access to medical care."

Philip said that he wouldn't suggest daily low-dose aspirin to his patients based on this data alone. But the findings "can be the basis for further work" researching this issue, he added.

The study was published Dec. 20 in Cancer Epidemiology, Biomarkers & Prevention.

More information

For more about pancreatic cancer, try the  American Cancer Society

Copyright © 2016 HealthDay. All rights reserved.

Physical activity soon after children's concussion better than complete rest

Complete rest is a cornerstone of concussion treatment, but a new study indicates that physical activity within a week of a youth's head injury may hasten recovery.

Concussed children and teens were less likely to have persistent symptoms four weeks later if they engaged in light aerobic exercise within the first seven days, according to the new research from Canada.

Under current guidelines for concussion management, pediatricians recommend a period of physical and mental rest until symptoms such as headache resolve.

The new findings "call into question the standard operating procedure where athletes have to be symptom-free before they are allowed to start exertion," said Dr. John Kuluz.

Kuluz is director of traumatic brain injury and neurorehabilitation at Nicklaus Children's Hospital in Miami. He wasn't involved in the study.

Although the researchers found a link between early physical activity and fewer long-term symptoms, Kuluz said the study can't prove cause-and-effect.

"I'm not really going to change my practice based on this," he said. In reality, he said, a lot of doctors are already following this approach instead of advising total rest until symptoms disappear.

And no one is advising vigorous exercise, Kuluz said.

After a concussion, "I think getting up off the couch and moving, at low intensity, for short duration, one or two times a day, is important," he explained. "It helps to reduce the deconditioning."

He also added, "It has to be done on an individualized basis."

Based on the finding, study author Dr. Roger Zemek said light jogging, walking or light activity on a stationary bike probably would be OK after a concussion.

Zemek is a senior scientist and director of the clinical research unit at Children's Hospital of Eastern Ontario in Ottawa.

Beyond expert input, he said, "there is very little evidence'' to support the advice to avoid physical activity after a concussion.

To see what effect activity might have on recovery, Zemek's team analyzed data on more than 2,400 Canadian kids, ages 5 to 17, who suffered a concussion.

The researchers reviewed persistent post-concussive symptoms and levels of physical activity in the month after the head injury. Persistent post-concussive symptoms (PPCS) were defined as three or more symptoms, such as headache or problems thinking or learning.

After 28 days, 25 percent of those who engaged in early physical activity still had persistent or worsening symptoms, Zemek said. In the no-activity group, 44 percent still had symptoms. That difference was significant statistically, he said.

The study was published Dec. 20 in the Journal of the American Medical Association.

Zemek isn't suggesting kids who suffer a concussion return to athletic play quickly.

"What I don't want is someone to read this and say, 'Oh, I will let Johnny play football tomorrow [right after a concussion] because there is no harm,'" he said.

Light physical activity early on may help reduce persistence of symptoms, Zemek noted.

While the study didn't assess the best intensity or duration of exercise, Zemek thinks that engaging in light activity earlier than is currently recommended by many experts could have physical and psychological benefits.

The kids feel less like they are in jail at home, for one thing, he said.

This approach is used successfully in post-stroke patients, Zemek added, explaining doctors want them out of bed and moving as soon as possible.

Why does this seem to help? Zemek couldn't say for sure, but said he suspects activity may increase blood flow to the brain, which can help healing.

More information To learn more about concussions, head to the  American Academy of Pediatrics.

Copyright © 2016 HealthDay. All rights reserved.

Berlin crash suspect released; Islamic State claims credit

BERLIN, (UPI) -- German authorities said Tuesday they've released a man initially suspected in the truck crash that killed 12 people at a holiday market in Berlin -- an event officials are investigating as an act of terrorism.

Berlin police said their investigation has determined a 23-year-old Pakistani asylum-seeker they arrested appears to be above suspicion -- based partly on the fact that he had no blood on his clothing at the time of his arrest, shortly after the crash. He was detained leaving the scene.

Police said the driver of the delivery truck almost certainly would have had blood on his clothing, because it was everywhere inside the truck's cab.

"The investigations so far did not result in an urgent grounds for suspicion," prosecutors said in a statement. "The criminal investigations carried out so far have not been able to prove a presence of the accused during the incident in the truck."

Officials said the driver is likely still at large, and they continue to acknowledge the possibility that the event was carried out by a migrant.

The stolen truck, loaded with steel beams and belonging to a Polish company, drove through a festive holiday market in Berlin's west flank on Monday. At least 48 people were injured, 18 seriously.

The company that owned the truck said it lost contact with its driver prior to the attack, leading police to suspect it had been hijacked somewhere along its route.

German Chancellor Angela Merkel on Tuesday said the incident is being treated by police as a terrorist attack.

"I know it would be especially hard to bear for all of us if it should be confirmed that the person who committed this act sought protection and asylum in Germany," she said. "This would be especially despicable toward the many, many Germans who are daily engaged in helping refugees, and toward the many, many people who truly need this protection and strive to integrate themselves into our country."

Tuesday Dec 23, through its Amaq news agency, the Islamic State claimed credit for the Berlin truck crash,  saying, one of its “soldiers” as responsible.

"The executor of the operation in Berlin is a soldier of the Islamic State and he executed the operation in response to calls to target nationals of the coalition countries," the statement said.

Authorities will likely be at least somewhat skeptical of the claim, however, as the terror group has previously demonstrated its willingness to take responsibility for acts of violence in which it is not directly involved.

The group claimed credit for a knife attack in October that killed a teenage boy. Investigators doubted the claim, though, saying it didn't align with evidence in the case.

German authorities still aren't sure yet whether Monday's crash was a deliberate act.

While the number of refugees entering Germany dropped in 2016, Merkel's  open-door-policy has polarized voters. 

The Berlin incident threatens to undermine her domestic policy as Germany heads to an election year, and could lead to more support for the anti-immigrant Alternative for Germany Party, known as AfD.

"Germany is no longer safe," AfD co-chairwoman Frauke Petry said. "We must be under no illusions. The breeding ground in which such acts can flourish has been negligently and systematically imported over the past year and a half."

First trailer for 'The Emoji Movie' released, features meh, ice cream cone and poo emojis

 The Emoji Movie will be released on Aug. 4, 2017

Click  here to watcth the trailer

LOS ANGELES, Dec. 21 (UPI) -- The first trailer for The Emoji Movie has been released and features meh, ice cream cone and poo emojis. The story follows T.J. Miller's (Silicon Valley, Deadpool) character Gene, who can't seem to fit in because he has way too many emotions. His father (voiced by Steven Wright) is a Meh emoji and Gene is supposed to follow in his footsteps.

Gene begins to malfunction and sets off on an adventure with pals Hi-5 (James Corden) and Jailbreak (Ilana Glazer of Broad City).

"Gene is perfect for T.J. Miller, who's an unstoppable personality brimming with exuberance and passion," Emoji Movie director Tony Leondis told EW. "As for Jailbreak, there's really no hacker/codebreaker emoji, so who is she? That's the mystery. Where did she come from? Which also has a lot to do with how women are portrayed in emoji sets. And she's played by the great Ilana Glazer, who is bold and uncompromising. 

James Corden is the lovable Hi-5. He is so funny and he's a little bit of a ham character. He's like an aging rock star who wants to get back on top and still thinks he should be treated like royalty everywhere he goes. He's amazing."

How did the Sahara Desert get so dry?

"It has been something of a mystery to understand how the tropical rain belt moved so far north of the equator," researcher Robert Korty said.

Some 6,000 years ago, the Sahara Desert was regularly drowned by tropical rains. It wasn't a desert at all, but vast grasslands. Today, the Sahara features some of driest acreage on Earth.

Recently, a pair of researchers from Texas A&M University and Yale University set out to explain how such a vast climatic transformation can happen in such a short amount of time. In order to do so, the researchers built a model to contrast rain patterns of the Holocene era with those of today.

Their analysis offers new insights into the nature of the Hadley circulation, the cycle of warm air rising near the equator and descending in the subtropics. The Hadley circulation influences everything from the trade winds and tropical rain belts to jet streams and hurricanes.

"The framework we developed helps us understand why the heaviest tropical rain belts set up where they do," Robert Korty, associate professor of atmospheric sciences at Texas A&M, said in a news release. "Tropical rain belts are tied to what happens elsewhere in the world through the Hadley circulation, but it won't predict changes elsewhere directly, as the chain of events is very complex. But it is a step toward that goal."

Over time, the rain belt that once provided the Sahara with moderate rainfall has slowly moved northward toward the Mediterranean.

"It has been something of a mystery to understand how the tropical rain belt moved so far north of the equator," Korty said. "Our findings show that that large migrations in rainfall can occur in one part of the globe even while the belt doesn't move much elsewhere."

Korty and colleague William Boos of Yale argue the shifting rain belt alone fails to explain the transformation of the Sahara. Instead, falling precipitation totals likely created a sort of climatological feedback loop that triggered more drastic change in the soil and atmosphere.

"We were able to conclude that the variations in Earth's orbit that shifted rainfall north in Africa 6,000 years ago were by themselves insufficient to sustain the amount of rain that geologic evidence shows fell over what is now the Sahara Desert," Korty explained. "Feedbacks between the shifts in rain and the vegetation that could exist with it are needed to get heavy rains into the Sahara."

The pair of scientists hope their findings -- published  in the journal Nature Geoscience -- will improve models designed to predict the impacts of climate change on regional weather patterns.