Nepal has eliminated rubella as a public health problem, the World Health Organization has said, citing the success of its immunisation campaigns and disease-surveillance programme.
Rubella is a highly contagious viral infection transmitted through coughs and sneezes.
It occurs most often in children and young adults, most of whom will develop a mild fever and rash. But it is particularly serious for pregnant women as infection can lead to miscarriage, stillbirth, or a range of lifelong and debilitating birth defects.
A vaccination exists against rubella, which Nepal started using in its immunisation programme in 2012. By 2024, Nepal had achieved over 95 per cent coverage for at least one dose of rubella vaccine.
A child is dressed as Lord Krishna during the Krishna Janmashtami festival in Lalitpur, Nepal, on Saturday. The WHO has hailed Nepal’s “unwavering commitment” in tackling rubella. Photo: Xinhua
Catharina Boehme, head of the WHO’s 10-country Southeast Asia regional division, on Monday hailed the “unwavering commitment” of Nepal’s leadership, and the work of its healthcare professionals, in tackling rubella.
The sky at night. It inspires awe. It inspires thoughts of an existential nature: Who are we? Why are we here? And, perhaps most importantly of all, in which direction should I roll this big ball of shit? That is, if you’re a dung beetle.
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Yes, in 2013, the global community was stunned by the first report of an insect using a galaxy for orientation. Reaching this groundbreaking discovery required wit, it required cunning, and best of all, it required putting little hats on dung beetles.
“African ball-rolling dung beetles exploit the [Sun], the [Moon], and the celestial polarization pattern to move along straight paths, away from the intense competition at the dung pile,” wrote the study authors. “Even on clear moonless nights, many beetles still manage to orientate along straight paths. This led us to hypothesize that dung beetles exploit the starry sky for orientation, a feat that has, to our knowledge, never been demonstrated in an insect.”
The Handmaid’s Tale, or scientific study? You decide.
Image credit: Marcus Byrne
To find out, they set up some dung beetles in little arenas in the Wits Planetarium and popped cardboard caps on their heads. These caps obscured different visual fields for the Scarabaeus satyrus contestants, enabling them to study how blocking out certain celestial stimuli altered their performance in rolling big balls of poop under various night sky conditions.
What they saw revealed that the beetles roll their dung balls along straight paths under a starlit sky but lose this ability under overcast conditions. In the planetarium experiment, they were able to orient equally well when rolling under a full starlit sky as they were when only the Milky Way was present.
The team also discovered that, if a little lost, the beetles will climb on top of their dung balls and perform a little orientation “dance”. This makes it easier for them to locate some light sources that can put them back on course, and they may even have a hierarchy of preference when it comes to choosing between the stars, the Moon, and the galaxy.
“The use of this bidirectional celestial cue for orientation has been proposed for vertebrates, spiders, and insects, but never proven,” concluded the authors. “This finding represents the first convincing demonstration for the use of the starry sky for orientation in insects and provides the first documented use of the Milky Way for orientation in the animal kingdom.”
Side profile of an adult Bogong moth.
Another star-savvy invertebrate recently hit the news as it was discovered that Bogong moths (Agrotis infusa) fly up to 1,000 kilometers (621 miles) navigating by the night sky. In another experiment that set a bunch of insects loose in a planetarium, it was found that when the stars were projected on the roof to match their true positions, the moths flew in the correct direction for their seasonal migration and didn’t waver when the positions were rotated between the start and end of the night.
When the locations of the stars were flipped north to south, the moths turned and flew in the opposite direction from the one that would take them to shelter. Somehow, these creatures can navigate by the stars, like an ancient mariner.
Something to ponder the next time you can’t remember where you parked your car.
Newcastle striker Alexander Isak is not expected to attend Tuesday night’s Professional Footballers’ Association’s awards gala.
The Sweden international has been nominated for the main award but could miss the ceremony amid ongoing uncertainty over his future at St James’ Park.
Isak is currently in the middle of a stand-off with Newcastle over his ambition to join Liverpool before the transfer deadline.
Just over 24 hours before the awards, BBC Sport has learned Isak is yet to confirm his attendance at the function, which will be held at the Manchester Opera House, casting doubt over whether he plans to appear.
Indeed, other sources have indicated that Isak – as things stand – is not planning on attending the event.
Previous PFA award nominees and players selected in their respective division’s teams of the year have confirmed their attendance inside the final 24 hours before the ceremony, so it remains to be seen whether Isak makes a late decision.
Even this close to the gala, it is likely the PFA would welcome Isak’s presence.
The 25-year-old is currently not training with Eddie Howe’s first team and there has been no indication of a reintegration any time soon.
Attending the PFA ceremony could leave Isak in an awkward spot given the controversy over his future.
There were 19 872 twin births to 9936 women between January 1, 2010, and November 30, 2018, in Tianjin. After excluding outlier records, 9375 women and 18 750 infants were included (Table 1). To obtain a healthy population, we excluded 8029 women due to the presence of disease or unhealthy infants (Fig. 1).
This study analyzed maternal groups by prepregnancy BMI: 900 underweight (< 18.5), 5517 normal (18.5–23.9), 2068 overweight (24.0–27.9), and 890 obese (> 28). Mean age and parity rose slightly with BMI, from 27.5 ± 4.2 years and 1.2 ± 0.5 in the underweight group to around 29–29.7 years and 1.4 ± 0.6 in the obese group. Birthweight (2426–2514 g) and body length (46.9–47.2 cm) were similar across groups. Higher education proportions decreased from 56.9% (normal) to 38.4% (obese). Over 95% of each group were Han Chinese, and urban registration increased from 80% (underweight) to 89% (obese). Employment rates were 60–65%, with smoking rates < 1%. Anemia incidence dropped with higher BMI from 64.1 to 40.3%, while diabetes and hypertension rates rose, from 16.3 to 33.9% for diabetes, and 3.2–23.1% for hypertension (Table 1).
Table 1 Demographic information and maternal characteristics for each prepregnancy BMI group
Fig. 1
Flow diagram of the study population
The evidence strongly suggests that many diseases during pregnancy may influence GWG. Therefore, only records from a healthy population were used to construct the guideline. Considering the determinant role of BMI in determining GWG, the guideline was established according to the BMI category. After excluding unhealthy women, the study included 1346 pregnant women and 7813 records of their entire pregnancy (Fig. 1). Among these patients, 117 were in the underweight (UW) group, 783 were in the normal weight (NW) group, 320 were in the overweight (OW) group, and 126 were in the obese (OB) group based on the Chinese BMI classification. According to the WHO classification, 117 patients were UW, 897 were NW, 268 were OW, and 64 were OB.
The smoothed percentile curve in Fig. 2 indicates that the underweight group and normal weight group had greater body weight gain during pregnancy than the overweight and obese groups. Underweight, normal weight, overweight, and obese women had median [interquartile range] weight gains at delivery of 20.3 [17.0-24.2], 20.8 [16.6–25.3], 16.7[12.7–20.8], and 16.6[11.5–21.7] kg, respectively. As gestational age increased, the difference in weight gain became more apparent, which is consistent with the IOM 2009 guidelines. What’s more, obese and overweight pregnant women experienced slow weight gain or mild weight loss in the first trimester, which may be attributed to morning sickness or weight control during pregnancy.
Fig. 2
GWG percentile curve for the WHO BMI recommendation. A: underweight group, B: normal weight group, C: overweight group, D: obesity group
As the BMI classification of the Chinese population differs from the WHO classification, we compared the percentile curve of weight gain during pregnancy based on the Chinese BMI classification (Fig. 3). According to the Chinese BMI, the appropriate range of weight gain during pregnancy was underweight group 20.27 [17.00-24.24] kg, normal group 20.95 [16.64–25.66] kg, overweight group 16.94 [13.39–20.62] kg, and obese group 16.44 [11.29–21.79] kg respectively [17]. The GWGs were similar between the Chinese and WHO normal weight groups. For the obese population, the percentile line calculated based on the Chinese BMI classification was slightly greater than the percentile line from the BMI recommended by the WHO throughout pregnancy. The differences in GWG between the Chinese and WHO BMI charts tended to decrease with increasing gestational age and with increasing GWG in the overweight and obese groups.
Fig. 3
The difference between the GWG percentile curve for the Chinese BMI recommendation and the WHO BMI recommendation. A: Normal weight group, B: overweight group, C: obesity group
We classified pregnant women based on prepregnancy BMI according to WHO classification. While adjusting for other variables, odds of premature is 0.45 times lower among the excessive GWG group compared with the interquartile range of GWG group in the first trimester (95% CI: 0.23–0.97). In the excessive GWG group, a decreased risk for diabetes (1st trimester, aOR = 0.80, 95% CI: 0.69–0.94, 2nd trimester, aOR = 0.73, 95% CI: 0.64–0.83, 3rd trimester, aOR = 0.78, 95% CI: 0.67–0.89) and thyroid-related diseases (1st trimester, aOR = 0.71, 95% CI: 0.58–0.88, 2nd trimester, aOR = 0.81, 95% CI: 0.69–0.96, 3rd trimester, aOR = 0.82, 95% CI: 0.69–0.98) were observed throughout the entire pregnancy period. In the second trimester, adjusted odds of hypertension and adverse pregnancy outcome are 1.53 (95% CI: 1.24–1.91) and 0.68 (95% CI: 0.47–0.98) among women with excessive GWG. The rate of hypertension was increased in women with excessive GWG in the third trimester (aOR = 1.59, 95% CI: 1.28–1.98) (Fig. 4). While controlling for other variables, odds of abnormal birthweight is higher among insufficient GWG group compared with an interquartile range of GWG throughout the entire pregnancy period (1st trimester, aOR = 2.19, 95% CI: 1.03–4.56, 2nd trimester, aOR = 2.22, 95% CI: 1.40–3.57, 3rd trimester, aOR = 1.92, 95% CI: 1.23–3.04). Furthermore, adjusted odds ratios of hypertension and adverse pregnancy outcome are 1.68 times higher (95% CI: 1.16–2.45) and 2.35 times higher (95% CI: 1.18–4.59) among insufficient GWG in the first trimester. Patients in the insufficient GWG group in the second trimester were more likely to have thyroid-related diseases (aOR = 1.27, 95% CI: 1.06–1.51)) and premature(aOR = 2.37, 95% CI: 1.18–4.94). Adjusted odds of diabetes and thyroid_diseases are 1.17 (95% CI: 1.03–1.32) and 1.23 (95% CI: 1.05–1.45) times higher among insufficient GWG group compared with an interquartile range of GWG, while aOR of postpartum_hemorrhage is 0.34 (95% CI: 0.18–0.61) times lower in the third trimester (Fig. 4).
Fig. 4
Association between the perinatal outcomes and WHO BMI categorized GWG according to GWG targets by different trimesters. The clinical records of patients were grouped by pregnancy period: (1) first trimester, (2) second trimester, and (3) third trimester. Prepregnant BMI was determined according to the WHO standard. The small square represents the estimated value of the aOR, and the line segment represents the 95% confidence interval of the aOR. IQR: interquartile range
When a similar analysis was carried out based on the Chinese BMI classification, a decreased risk for diabetes (1st trimester, aOR = 0.81, 95% CI: 0.69–0.95, 2nd trimester, aOR = 0.73, 95% CI: 0.65–0.83, 3rd trimester, aOR = 0.78, 95% CI: 0.68–0.90) and thyroid-related diseases (1st trimester, aOR = 0.69, 95% CI: 0.57–0.85, 2nd trimester, aOR = 0.79, 95% CI: 0.67–0.93, 3rd trimester, aOR = 0.83, 95% CI: 0.70-1.00) were observed in the excessive GWG group throughout the entire pregnancy period as well. The women with excessive GWG compared to an interquartile range were at increased risk for hypertension in the second (aOR = 1.56, 95% CI: 1.26–1.93) and third (aOR = 1.62, 95% CI: 1.30–2.02) trimesters. Moreover, aOR of abnormal birthweight was 1.76 times higher among women with excessive GWG in the third trimester (95% CI: 1.09–2.86) (Fig. 5). The aOR among pregnant women with insufficient GWG showed a similar trend except for postpartum hemorrhage in the second trimester (aOR = 0.41, 95% CI: 0.21–0.77) (Fig. 5).
Fig. 5
Association between the perinatal outcomes and Chinese BMI categorized GWG according to GWG targets by different trimesters. The clinical records of patients were grouped by pregnancy period: (1) first trimester, (2) second trimester, and (3) third trimester. Prepregnant BMI was determined according to Chinese standards. The small square represents the estimated value of the aOR, and the line segment represents the 95% confidence interval of the aOR. IQR: interquartile range
Starmer and Macron – pictured with Zelensky in May – are among the European leaders in Washington
European leaders may have rushed to Washington ostensibly to throw a protective arm around President Zelensky and head off any repeat of February’s Oval Office bust-up.
But their real aim is to stop US President Donald Trump threatening long-term European security after his abrupt change of course over how best to end the war in Ukraine.
Not only did Trump drop calls for a ceasefire as a prerequisite for talks about long-term peace, he also – diplomats say – made clear he had no intention of imposing further economic sanctions on Russia.
In short, the travelling European heads of government – plus EU and Nato leaders – want to avoid not just confrontation, but also capitulation.
President Macron of France was the latest to use the C word, saying on Sunday: “There is only one state proposing a peace that would be a capitulation: Russia.”
It takes a great deal for heads of government to upend their schedules at short notice – especially in August – when some are on holiday.
The French leader was enjoying water sports on the Riviera. The Italian leader, Giorgia Meloni, had been in Greece.
But such was the scale of President Trump’s change of strategy after meeting President Putin – and the consequent potential threat to Europe – that the European leaders changed their plans fast.
Officials say Meloni was first to invite herself along, followed closely by Macron, after which it became inevitable others would have to go too.
The leaders spent the weekend working the phones, holding no fewer than five separate group chats.
Their concern was Trump’s decision to change the diplomatic goal posts after meeting the Russian leader in Alaska.
Some officials think the huge impact of these two decisions – which overturned months of western strategy – has been under-priced. Both moves shifted the US position more closely in Russia’s favour.
“Things have moved very significantly and quite quickly to a timetable that no one was expecting,” one European official said.
“The US sees this as a moment to strike while the iron is hot. Our question is what are we trying to achieve here?”
They added: “The European position has long been that Putin needs to show a genuine desire to get around a table and stop the war, and that would involve a ceasefire. But since Friday we have moved on from that. The question now is how we can get out of today without a blow-up. This is a moment of extreme jeopardy.”
The aim for European leaders, diplomats say, is to shift White House thinking on two issues.
One, the idea that peace can be achieved simply by Ukraine ceding the Donbas to Russia. And two, that this is not just about the future of Ukraine.
“This is fundamentally about the security of our continent,” one British diplomat said.
In other words, any discussion about security guarantees – as part of a final deal – would be about ensuring the wider security of Europe and not just Ukraine.
That means convincing Trump of two things: one, that questions about territory and security guarantees cannot be separated, and two, that security guarantees must be about more than verbal or textual promises.
US negotiators have talked about giving Ukraine as yet ill-defined Nato-style assurances that the west would come to Kyiv’s aid against future Russian aggression.
“Nobody is clear what Trump means about a security guarantee,” one official said.
“He believes that him simply saying to Putin “don’t attack” is enough. That’s not good enough for Ukraine or us.”
Reuters
Trump dropped calls for a ceasefire as a condition for talks about long-term peace after meeting Putin in Alaska last week
The Europeans, instead, are expected to argue that Ukraine’s security will be guaranteed only by allowing its army to remain strong, with long-term and substantial allied military and financial support.
That would include American weapons bought by Europeans and gifted to Ukraine, plus continued Ukrainian access to US intelligence.
By definition, all that would exclude Russian demands for the demilitarisation of Ukraine.
The risk for the Europeans today is that they push Trump too hard, that he thinks he is being bullied, and that the meetings go badly.
The European delegation has been thrown together at the last minute.
It is – one official said – “quite unwieldy”, and some differ on how much Europe should commit to Ukraine’s future security.
What role a future European-based “reassurance” force might play in a post-conflict Ukraine remains unclear.
So the European aim today may be to slow things down and calm fevered talk about land-swap deals that should really be part of the endgame of a negotiation.
To some, that would be putting the cart before the horse.
Instead, the European leaders may look for progress on a possible trilateral summit with Trump, Zelensky and Putin; the carving out of some broad principles of any future deal; and how to have talks about talks deciding the location and framework of any negotiations.
And above all, whether this can happen only when a ceasefire of sorts has been agreed.
If you’re interested in a long-lasting smartwatch, and like to stay within Apple’s hardware ecosystem, the Apple Watch Ultra 2 is the best choice. It’s Apple’s most durable, longest-lasting smartwatch, and it’s currently on sale for $649.99 ($150 off), an all-time low price at Amazon and Best Buy. The Apple Watch Ultra 2 comes in a single case size (49mm), material (titanium), and configuration (GPS + Cellular), so the only choice you have to make is which band best fits your style.
The Apple Watch Ultra 2’s battery lasted roughly two and a half days in our tests, and Apple says you can get up to 72 hours with low power mode enabled. If you have the right accessories, you can charge the Apple Watch Ultra 2 from zero to 80 percent in under an hour. The smartwatch’s S9 SiP processor is powerful enough to handle on-device Siri queries, and enables the double tap gesture, which allows you to scroll or interact with buttons on its display by tapping your fingers instead of the screen. Apple introduced the S10 SiP with the Apple Watch Series 10 last year, but the Apple Watch Ultra 2’s processor is still plenty powerful.
The Apple Watch Ultra 2 supports several health and wellness features, including sleep apnea detection, fall detection, crash detection, sleep tracking, and heart tracking. The watch will send you a notification if it detects atrial fibrillation, and allows you to take an EKG (electrocardiogram) on device. Apple recently re-enabled the Apple Watch’s ability to monitor your blood oxygen level, though you’ll need to review the readings within your iPhone’s health app. When you exercise, you can select from a list of dozens of workout types to accurately log your fitness routine.
Apple has traditionally announced Apple Watch hardware updates at its iPhone event typically held in September, and rumors suggest the Apple Watch Ultra 3 will have a larger display, but the Ultra 2 is an excellent choice at its sale price.
New research published by Phadke et al in the Journal for ImmunoTherapy of Cancer found that adding a third immune-targeting drug to existing therapies may help to shrink tumors in laboratory models of treatment-resistant melanoma.
Although immunotherapeutics have improved survival for many patients with melanoma, a large percentage either do not respond or eventually relapse. Scientists are now searching for new drug combinations to overcome this resistance.
In this study, researchers tested combinations of drugs that block immune checkpoints—molecules such as PD-1, LAG-3, and TIM-3, which regulate immune responses. These checkpoints can be hijacked by cancer cells to avoid being destroyed.
Led by Keiran Smalley, PhD, Director of Moffitt Cancer Center’s Donald A. Adam Melanoma and Skin Cancer Center of Excellence, the research team found that a combination targeting all three checkpoints—PD-1, LAG-3, and TIM-3—was especially effective in models that had not responded to standard therapies. The triplet therapy helped restore immune function and led to complete tumor regression in some cases.
“TIM-3 is often found on immune cells that are too exhausted to fight cancer effectively,” said Dr. Smalley. “By blocking TIM-3 in addition to PD-1 and LAG-3, we saw a more powerful and targeted immune response, even in difficult-to-treat tumors.”
Researchers also analyzed tumor samples from patients with melanoma and found that TIM-3 was more common in those who had not responded to immunotherapy. This suggests that targeting TIM-3 may prove to be especially useful as a second-line treatment strategy.
Of note, the triplet drug combination did not appear to cause increased toxicity, supporting its potential for future clinical trials. “Our findings offer a new approach to treating melanoma in patients who currently have few options,” Dr. Smalley said. “We’re excited about the potential to bring this strategy to clinical trials and ultimately to patients.”
Disclosure: This study was supported by the Florida Bankhead-Coley Research Program, the National Institutes of Health, and the Huntsman Cancer Foundation. For full disclosures of the study authors, visit jitc.bmj.org.
When a wound on the skin creates a gap, the epithelial cells of the skin, surrounding the wound, move in a concerted fashion to close this gap. The boundaries of these gaps can have different curvatures; they could either be convex or concave. Interestingly, the cells situated at the convex-shaped surfaces form large membranous outgrowths and crawl towards the empty space; while at a concave surface, the layer of cells contracts together, tugging at the margins of the wound and gradually closing the gap.
While these specific modes of cell movement had been well-documented, it was unclear how the cells near the gaps mounted such distinctly different responses. How does something so seemingly inconsequential as a curvature of a gap, that too at the microscopic scale, end up dictating how cells move to heal a wound?
Four years ago, Simran Rawal, a graduate student in Tamal Das’s lab at the Tata Institute of Fundamental Research, Hyderabad, India , decided to take a closer look at what happens inside epithelial cells when they respond to differently shaped gaps created in the tissue. The findings from this study , now published in Nature Cell Biology, reveal that the largest intracellular organelle, the Endoplasmic Reticulum (ER), senses the curvature of the wound gap and in response, drastically changes its structure: becoming tubular in shape when the wound surface is convex, and flattened into sheet-like structures when the wound surface is concave. And turns out, this distinct difference in the ER morphology ends up playing a crucial role in deciding how the cell will move to seal a wound.
The morphology of ER influences how the cells move while sealing a gap
The epithelial barrier is not only adept at mending centimetre-scale large gaps in the tissue, but also shows equal discipline while sealing off small micron-scale gaps caused by a cell or two extruding out of a cell layer.
Tamal Das and Simran Rawal mapped out the structural changes in specific organelles—lysosomes, Golgi, endoplasmic reticulum (ER), and mitochondria—to gain a better understanding of what happens inside the cell when it mounts a response to gaps of different geometries. Rawal observed that among these organelles, the ER showed the most drastic change in morphology.
Since the ER structure of the cells situated at the concave edges is flattened and sheet-like, Rawal observed what happens when this morphological restructuring is disrupted and forcibly changed into tube-like structures. Cells which had previously been contracting resulting in purse-string-like closure of the gap had now switched their mode of migration and started to crawl towards the empty gap instead.
A closer look at other associated intra-cellular components during this remodelling reveal that the structural changes in the ER were dependent on the changing dynamics of both actin and microtubules, the two major cytoskeletal frameworks of the cell. However, at convex-shaped gap edges, the microtubules are more crucial for the ER to change into tube-like structures.
Meanwhile, it was becoming important to quantify these morphological changes and characterise the mechanical cues the cell may be experiencing. Pradeep Keshavanarayana from Fabian Spill’s lab at the University of Birmingham, UK , developed a mathematical model that helped quantify the strain on the cell when it begins to migrate towards a gap at different curvatures. Ideally, a cell tries to achieve a lower strain energy. This study revealed how the changed ER structures at both convex and concave surfaces helped lower the strain energy experienced by the cell during protrusion and contraction.
ER: A possible link between mechanical cues and cell signalling?
An intriguing bit about the ER is that it spans the entire cell dynamically, starting from the nuclear envelope to the cell periphery as a single entity. Thus, any drastic changes in its structure have the potential to exert mechanical forces or set off signalling cascades spanning the breadth of the entire cell.
This study reports that the ER is a potential mechanotransducer, acting as a link between a mechanical cue (in this case, it is the wound gap geometry) and the biochemical changes inside the cell, thus regulating the overall response of the cell to an external mechanical stimulus. Simran Rawal explains, “Cytoskeleton has long been recognised as a primary sensor of mechanical cues in the cells; it was fascinating to discover that multiple intracellular membrane-bound organelles, such as the ER, primarily known for their conventional roles in calcium signalling and protein synthesis, also respond to mechanical signals in their environment and reorganise themselves.”
While most studies on wound healing focus on biochemical signals and protein interactions, this study reveals a surprising new player—the shapes of the wounds themselves. The findings show that the physical geometry of a wound can influence: (a) how a cell rearranges its internal structures, and (b) its decision on how to move while sealing the gap.
The fundamental observations in this study open up multiple new avenues for investigation; as Tamal Das says, “This work is part of our larger effort to uncover unexpected roles for cell organelles in shaping how tissues behave. Simran’s discovery that the endoplasmic reticulum, a structure usually known for protein synthesis, can sense wound geometry and influence how cells move, opens up many exciting questions. Could the ER – or that matter, other cellular organelles – help guide how tissues form in a developing embryo? Might similar mechanisms be involved in repairing organs after injury? Could other organelles be doing similar jobs in ways we haven’t yet imagined? These are some of the big questions we are now eager to explore.”
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