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Rising Threat: Candida Auris Spreads In 2023 With Climate Change Suspected As Culprit

(CTN NEWS) – In 2016, hospitals in New York made a startling discovery – a rare and serious fungal illness, Candida auris, which had never been reported in the United States before.

Further investigations by research laboratories revealed that the fungus had been present in the country since at least 2013, prompting concerns about its prevalence.

Since its initial detection, New York City has become the epicenter of Candida auris infections.

While the virus has spread to other locations, New York state consistently recorded the highest number of confirmed cases in the nation every year until 2021, as per data from the Centres for Disease Control and Prevention (CDC), analyzed by The Associated Press.

Candida auris poses an increasingly serious public health risk, as it can lead to severe illnesses like bloodstream, wound, and respiratory infections.

Its estimated death rate of 30% to 60% makes it a significant concern, especially for patients with major medical conditions in healthcare facilities.

Last year, patients in 29 states had the fungus clinically recognized, with Nevada and California reporting the highest number of instances. However, New York remains a key hotspot for the infection.

Traditionally, most fungal pathogens struggled to survive in mammal bodies, including humans, due to body temperatures. This provided some protection against infections.

However, as temperatures rise, fungi may adapt to warmer settings, potentially reducing human resistance. Studies suggest that Candida auris is already undergoing such adaptation.

Interestingly, Candida auris appeared on three continents simultaneously 14 years ago, in Venezuela, India, and South Africa, surprising experts due to the diverse climates in these regions.

Arturo Casadevall, a microbiologist, immunologist, and professor at Johns Hopkins University specializing in fungus diseases, pointed out the significance of this occurrence.

As Candida auris continues to pose challenges to public health, researchers and healthcare authorities are closely monitoring its spread and working towards effective prevention and treatment strategies.

The Warming Planet: Candida Auris’ Challenge to Mammals’ Warmth Defense

With warmth providing mammals an excellent defense against environmental fungi, there is concern that certain fungi will breach the temperature barrier if the planet continues to warm.

According to Casadevall, some fungi now possess higher temperature tolerances, a departure from history when warm body temperatures safeguarded mammals.

Initially linked to patients who had traveled to the United States from other countries, instances of Candida auris are now predominantly acquired locally, spreading among patients in medical settings, as stated by Meghan Marie Lyman, a CDC medical epidemiologist for the mycotic diseases branch.

The United States witnessed a dramatic surge in confirmed clinical cases, with 2,377 detected last year, marking an increase of over 1,200% from 2017. Notably, Candida auris is spreading globally, with case counts in Europe nearly doubling between 2020 and 2021, according to a survey.

Despite improved screens and surveillance, the geographic spread of the infection has expanded along with the rising number of cases, as observed by Lyman.

The CDC highlighted the pathogen’s resistance to conventional antifungal treatments and its alarming rate of spread in a news release in March, emphasizing the urgency of transmission mitigation techniques in healthcare settings.

Dr. Luis Ostrosky, an infectious diseases professor at McGovern Medical School at UTHealth Houston, described Candida auris as a “nightmare scenario.”

It possesses the potential for multi-drug resistance and rapid dissemination in medical facilities, distinguishing it as a unique challenge in the realm of fungal infections.

Challenging Candida Auris: A Resistant and Elusive Fungal Threat

Candida auris, a formidable fungal infection, often exhibits resistance to the most widely used class of antifungal drugs, and occasionally even to another drug prescribed for serious catheter fungal infections in hospitals.

Dr. Ostrosky, who has treated about ten patients with this fungus and advised many others, shared his disheartening experiences of having to inform families that no effective treatment is available for their loved ones suffering from the infection.

He witnessed its rapid spread throughout an entire Intensive Care Unit in just two weeks.

Researchers, academics, and public health organizations are actively exploring theories to explain the emergence of Candida auris. Among the most widely recognized theories is climate change, according to Dr. Ostrosky.

It is believed that the fungus might have always existed among the bacteria inhabiting the human body, but its potential health risks were overlooked until it began causing infections.

While reports of the fungus in natural environments like soil and wetlands exist, environmental sampling has been limited, and its origins and potential human involvement remain uncertain.

The complex interplay of human interaction with nature, environmental changes, and the use of fungi in agriculture might have allowed Candida auris to adapt and spread into new environments, leaving many unanswered questions.

Regardless of its origins, the fungus poses a significant threat to human health.

Immunocompromised individuals in hospitals are particularly vulnerable, but long-term care facilities and nursing homes also face risks due to limited access to diagnostics and infection control specialists.

Diagnosing Candida auris is challenging, as it mimics common signs of infection like sepsis, fever, and low blood pressure, which can have various causes. The rarity of the infection means that many doctors might not even be aware of its existence.

Treatment is equally problematic, with limited options available. The difficulty in diagnosis and treatment underscores the urgency of understanding and combating this elusive and dangerous fungal pathogen.

Blood tests are used to identify the fungus, but even detecting its presence can be a complex process, involving specialized nutrient-rich mediums to encourage growth and facilitate detection of infectious organisms.

Detection Challenges and Humorous “Gold Standard” for Candida Auris Cases

Ostrosky points out, however, that relying solely on current detection methods misses approximately 50% of the Candida auris cases. While more recent equipment is available to enhance bloodstream detection, its high cost and limited usage in hospitals remain barriers.

He humorously remarks that their current “gold standard” for detection is only slightly better than flipping a coin.

In addition to the rise in incidence, popular culture has played a role in increasing public awareness of fungal infections.

The HBO drama “The Last of Us” revolves around surviving a fungus outbreak, blurring the line between science fiction and the real challenge of combating climate change, which is reshaping the landscape of diseases posing major threats to human health.

Johns Hopkins researcher Casadevall explains that global warming exerts selection pressure on microbes through the increasing frequency of extremely hot days.

Each day with temperatures above 100 degrees Fahrenheit (37.7 degrees Celsius) becomes a selection event for microbes, and the more such days occur, the higher the probability that some will adapt and survive.

Ostrosky reflects on how mycology has been relatively overlooked for decades, as fungal infections were not as commonly seen before.

However, with the emergence of challenging pathogens like Candida auris, the spotlight is now on fungal diseases and the urgent need to understand, detect, and treat them effectively.

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Google’s Search Dominance Is Unwinding, But Still Accounting 48% Search Revenue

Google

Google is so closely associated with its key product that its name is a verb that signifies “search.” However, Google’s dominance in that sector is dwindling.

According to eMarketer, Google will lose control of the US search industry for the first time in decades next year.

Google will remain the dominant search player, accounting for 48% of American search advertising revenue. And, remarkably, Google is still increasing its sales in the field, despite being the dominating player in search since the early days of the George W. Bush administration. However, Amazon is growing at a quicker rate.

google

Google’s Search Dominance Is Unwinding

Amazon will hold over a quarter of US search ad dollars next year, rising to 27% by 2026, while Google will fall even more, according to eMarketer.

The Wall Street Journal was first to report on the forecast.

Lest you think you’ll have to switch to Bing or Yahoo, this isn’t the end of Google or anything really near.

Google is the fourth-most valued public firm in the world. Its market worth is $2.1 trillion, trailing just Apple, Microsoft, and the AI chip darling Nvidia. It also maintains its dominance in other industries, such as display advertisements, where it dominates alongside Facebook’s parent firm Meta, and video ads on YouTube.

To put those “other” firms in context, each is worth more than Delta Air Lines’ total market value. So, yeah, Google is not going anywhere.

Nonetheless, Google faces numerous dangers to its operations, particularly from antitrust regulators.

On Monday, a federal judge in San Francisco ruled that Google must open up its Google Play Store to competitors, dealing a significant blow to the firm in its long-running battle with Fortnite creator Epic Games. Google announced that it would appeal the verdict.

In August, a federal judge ruled that Google has an illegal monopoly on search. That verdict could lead to the dissolution of the company’s search operation. Another antitrust lawsuit filed last month accuses Google of abusing its dominance in the online advertising business.

Meanwhile, European regulators have compelled Google to follow tough new standards, which have resulted in multiple $1 billion-plus fines.

google

Pixa Bay

Google’s Search Dominance Is Unwinding

On top of that, the marketplace is becoming more difficult on its own.

TikTok, the fastest-growing social network, is expanding into the search market. And Amazon has accomplished something few other digital titans have done to date: it has established a habit.

When you want to buy anything, you usually go to Amazon, not Google. Amazon then buys adverts to push companies’ products to the top of your search results, increasing sales and earning Amazon a greater portion of the revenue. According to eMarketer, it is expected to generate $27.8 billion in search revenue in the United States next year, trailing only Google’s $62.9 billion total.

And then there’s AI, the technology that (supposedly) will change everything.

Why search in stilted language for “kendall jenner why bad bunny breakup” or “police moving violation driver rights no stop sign” when you can just ask OpenAI’s ChatGPT, “What’s going on with Kendall Jenner and Bad Bunny?” in “I need help fighting a moving violation involving a stop sign that wasn’t visible.” Google is working on exactly this technology with its Gemini product, but its success is far from guaranteed, especially with Apple collaborating with OpenAI and other businesses rapidly joining the market.

A Google spokeswoman referred to a blog post from last week in which the company unveiled ads in its AI overviews (the AI-generated text that appears at the top of search results). It’s Google’s way of expressing its ability to profit on a changing marketplace while retaining its business, even as its consumers steadily transition to ask-and-answer AI and away from search.

google

Google has long used a single catchphrase to defend itself against opponents who claim it is a monopoly abusing its power: competition is only a click away. Until recently, that seemed comically obtuse. Really? We are going to switch to Bing? Or Duck Duck Go? Give me a break.

But today, it feels more like reality.

Google is in no danger of disappearing. However, every highly dominating company faces some type of reckoning over time. GE, a Dow mainstay for more than a century, was broken up last year and is now a shell of its previous dominance. Sears declared bankruptcy in 2022 and is virtually out of business. US Steel, long the foundation of American manufacturing, is attempting to sell itself to a Japanese corporation.

Could we remember Google in the same way that we remember Yahoo or Ask Jeeves in decades? These next few years could be significant.

SOURCE | CNN

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The Supreme Court Turns Down Biden’s Government Appeal in a Texas Emergency Abortion Matter.

Supreme Court

(VOR News) – A ruling that prohibits emergency abortions that contravene the Supreme Court law in the state of Texas, which has one of the most stringent abortion restrictions in the country, has been upheld by the Supreme Court of the United States. The United States Supreme Court upheld this decision.

The justices did not provide any specifics regarding the underlying reasons for their decision to uphold an order from a lower court that declared hospitals cannot be legally obligated to administer abortions if doing so would violate the law in the state of Texas.

Institutions are not required to perform abortions, as stipulated in the decree. The common populace did not investigate any opposing viewpoints. The decision was made just weeks before a presidential election that brought abortion to the forefront of the political agenda.

This decision follows the 2022 Supreme Court ruling that ended abortion nationwide.

In response to a request from the administration of Vice President Joe Biden to overturn the lower court’s decision, the justices expressed their disapproval.

The government contends that hospitals are obligated to perform abortions in compliance with federal legislation when the health or life of an expectant patient is in an exceedingly precarious condition.

This is the case in regions where the procedure is prohibited. The difficulty hospitals in Texas and other states are experiencing in determining whether or not routine care could be in violation of stringent state laws that prohibit abortion has resulted in an increase in the number of complaints concerning pregnant women who are experiencing medical distress being turned away from emergency rooms.

The administration cited the Supreme Court’s ruling in a case that bore a striking resemblance to the one that was presented to it in Idaho at the beginning of the year. The justices took a limited decision in that case to allow the continuation of emergency abortions without interruption while a lawsuit was still being heard.

In contrast, Texas has been a vocal proponent of the injunction’s continued enforcement. Texas has argued that its circumstances are distinct from those of Idaho, as the state does have an exemption for situations that pose a significant hazard to the health of an expectant patient.

According to the state, the discrepancy is the result of this exemption. The state of Idaho had a provision that safeguarded a woman’s life when the issue was first broached; however, it did not include protection for her health.

Certified medical practitioners are not obligated to wait until a woman’s life is in imminent peril before they are legally permitted to perform an abortion, as determined by the state supreme court.

The state of Texas highlighted this to the Supreme Court.

Nevertheless, medical professionals have criticized the Texas statute as being perilously ambiguous, and a medical board has declined to provide a list of all the disorders that are eligible for an exception. Furthermore, the statute has been criticized for its hazardous ambiguity.

For an extended period, termination of pregnancies has been a standard procedure in medical treatment for individuals who have been experiencing significant issues. It is implemented in this manner to prevent catastrophic outcomes, such as sepsis, organ failure, and other severe scenarios.

Nevertheless, medical professionals and hospitals in Texas and other states with strict abortion laws have noted that it is uncertain whether or not these terminations could be in violation of abortion prohibitions that include the possibility of a prison sentence. This is the case in regions where abortion prohibitions are exceedingly restrictive.

Following the Supreme Court’s decision to overturn Roe v. Wade, which resulted in restrictions on the rights of women to have abortions in several Republican-ruled states, the Texas case was revisited in 2022.

As per the orders that were disclosed by the administration of Vice President Joe Biden, hospitals are still required to provide abortions in cases that are classified as dire emergency.

As stipulated in a piece of health care legislation, the majority of hospitals are obligated to provide medical assistance to patients who are experiencing medical distress. This is in accordance with the law.

The state of Texas maintained that hospitals should not be obligated to provide abortions throughout the litigation, as doing so would violate the state’s constitutional prohibition on abortions. In its January judgment, the 5th United States Circuit Court of Appeals concurred with the state and acknowledged that the administration had exceeded its authority.

SOURCE: AP

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Supreme Court Rejects Appeal From ‘Pharma Bro’ Martin Shkreli, To repay $6.4 Million

shkreli

Washington — The Supreme Court rejected Martin Shkreli’s appeal on Monday, after he was branded “Pharma Bro” for raising the price of a lifesaving prescription.

Martin appealed a decision to repay $64.6 million in profits he and his former company earned after monopolizing the pharmaceutical market and dramatically raising its price. His lawyers claimed the money went to his company rather than him personally.

The justices did not explain their reasoning, as is customary, and there were no notable dissents.

Prosecutors, conversely, claimed that the firm had promised to pay $40 million in a settlement and that because Martin orchestrated the plan, he should be held accountable for returning profits.

shkreli

Supreme Court Rejects Appeal From ‘Pharma Bro’ Martin Shkreli

Martin was also forced to forfeit the Wu-Tang Clan’s unreleased album “Once Upon a Time in Shaolin,” which has been dubbed the world’s rarest musical album. The multiplatinum hip-hop group auctioned off a single copy of the record in 2015, stipulating that it not be used commercially.

Shkreli was convicted of lying to investors and defrauding them of millions of dollars in two unsuccessful hedge funds he managed. Shkreli was the CEO of Turing Pharmaceuticals (later Vyera), which hiked the price of Daraprim from $13.50 to $750 per pill after acquiring exclusive rights to the decades-old medicine in 2015. It cures a rare parasite condition that affects pregnant women, cancer patients, and HIV patients.

shkreli

He defended the choice as an example of capitalism in action, claiming that insurance and other programs ensured that those in need of Daraprim would eventually receive it. However, the move prompted criticism, from the medical community to Congress.

shkreli

Supreme Court Rejects Appeal From ‘Pharma Bro’ Martin Shkreli

Attorney Thomas Huff said the Supreme Court’s Monday ruling was upsetting, but the high court could still overturn a lower court judgment that allowed the $64 million penalty order even though Shkreli had not personally received the money.

“If and when the Supreme Court does so, Mr. Shkreli will have a strong argument for modifying the order accordingly,” he told reporters.

Shkreli was freed from prison in 2022 after serving most of his seven-year sentence.

SOURCE | AP

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