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Are three-dimensional mammograms better than two-dimensional imaging at detecting complex cancers?
A clinical trial is recruiting thousands of volunteers, adding up to a huge number of Black women facing disparities in breast cancer death rates, to get it checked out.
People like Carole Stovall, a psychologist in Washington, D. C. , signed up for the study to answer that question.
“We all want a mammogram anyway, so why not do it with a study that allows scientists to better understand and get closer to finding better treatments and even tactics to save it?” said Stovall.
The underrepresentation of women and minorities in studies is a long-standing factor affecting fitness issues, such as Alzheimer’s disease, stroke, and COVID-19. Trials without diversity create gaps in how new remedies work for everyone.
“Until we have more Black women participating in clinical trials, we probably won’t be able to replace science. And we want more science for the black body,” said Ricki Fairley, a breast cancer survivor and activist working on the issue.
Black women are 40% more likely to die from breast cancer than white women and tend to be diagnosed younger. But it’s not clear whether 3D mammography is better for them, Dr. Schulz said. Worta McCaskill-Stevens of the National Cancer Institute.
“Are there populations for which early diagnosis might be vital?” asked McCaskill-Stevens. Or is it harmful” and causes too many false alarms or follow-up tests and treatments?
McCaskill-Stevens, who is Black, leads NCI’s efforts to access cancer studies in rural and minority communities. She joined the firm herself.
The new three-dimensional strategy has been around for a decade, but there has never been conclusive evidence that it is better than 2D at detecting complex cancers. The screening strategy combines photographs of the breast taken from other angles to create a three-dimensional image. as an image. 3D and 2D mammograms compress the breast and use low doses of radiation.
Previous studies recommend that 3-D detects more cancers than 2D, but detecting more cancers doesn’t necessarily mean more lives are saved. Some cancers that are ignored by popular screening tests may not progress or may require treatment. Previous studies did not randomly assign patients to a screening method, the popular gold in research.
The concept that “if it’s new, it’s brilliant, then it’s better” isn’t necessarily true, McCaskill-Stevens said. “Until we have the evidence to back it up, we want well-designed, randomized trials. “
So far, the trial has enrolled approximately 93,000 women with a target of 128,000. The NCI-funded study is currently underway in Canada, South Korea, Peru, Argentina, Italy, and 32 U. S. states. U. S. It will soon begin recruiting patients in Thailand.
“We’ve added more foreign sites to increase the diversity of the trial, especially for Hispanic and Asian women,” said Dr. Schulz. Etta Pisano, who runs the studio.
Overall, 42% of participants are Hispanic. As recruitment continues, enrolling Black and other people of color will “absolutely” remain a priority, Pisano said.
Participants are randomly assigned to 2D or 3D mammograms and are followed for several years. The number of complex cancers detected by the two strategies will be compared.
At U. S. study sites, 21 percent of study participants are black women, which is higher than a typical cancer treatment study, in which nine percent of participants are black, McCaskill-Stevens said.
The University of North Carolina enrolled more black women than any other site. Nearly a quarter of the roughly 3,000 women registered at the two UNC sites are black.
“Women in North Carolina need to be a component of something bigger than themselves,” said Dr. Harris. Cherie Kuzmiak, who directs the UNC study arm. “They need to play an active role in helping women’s physical care in the long term. “
In Washington, D. C. , word of mouth led to successful recruitment.
A possible encounter at his barbershop convinced Stovall to sign up for the search. While waiting for a hairdresser appointment, she met Lucile Adams-Campbell, an oncology researcher at Georgetown University. The two men, both black, began to talk.
“She talked about how vital it is to include women of color in the program,” said Stovall, who jumped at the chance to catch up on her mammograms after the COVID-19 pandemic delayed screening for herself and thousands of others.
For Stovall, there was a private explanation for why he should participate in the research. Her sister recently finished treatment for triple-negative breast cancer, a competitive type that affects black women more than white women.
Women between the ages of 45 and 74 with no personal history of breast cancer are eligible for the study, which was launched in 2017. Many women also provide blood and cheek samples for a database that will be leveraged for information.
“It’s a dream that other people have been dreaming since the beginning of screening — that we don’t put everyone in the same box,” Pisano said. The study’s findings could simply “reduce disparities if we’re successful, assuming other people have to care. “
Powdered drink mixes widely touted as “toddler milks” for older children and children up to age 3 are unregulated and “nutritionally incomplete,” the American Academy of Pediatrics warned Friday.
The drinks, promoted to parents on TikTok, in TV commercials and elsewhere, contain added sugar and salt. Manufacturers make unproven claims that the beverages spice up children’s brains or immune systems, said Dr. George Fuchs, a member of the AAP. Committee on Nutrition, which released the new report.
Infant formula industry officials have said the beverages can be helpful in filling “nutritional gaps” in children’s nutrition. But Fuchs said older children and young children should receive balanced nutrition from artificial foods, in addition to drinking breast milk, fortified whole cow’s milk. milk and water after one year of age.
Powdered milk mixes are sold in cans and are designed to be combined with water. They are produced through infant formula manufacturers with the main logo, packaged with similar labels, and sold in the same store aisles.
The products are advertised for toddlers between 6 and 12 months of age and for preschoolers up to 3 years old as nutritious beverages for the next level of development.
However, they differ from standard infant formulas, which are regulated by the U. S. Food and Drug Administration. Breastfed infants in the U. S. and must meet certain nutritional requirements as a replacement for breast milk for toddlers up to 12 months of age. The facilities where infant formulas are manufactured are inspected.
There are no federal regulations governing formulas for older children and toddlers. Toddler beverages are also distinct from prescription medical formulas for specific conditions, such as core diseases or digestion disorders of certain foods.
Fuchs and other experts point to the lack of standard criteria for infant milk, which means ingredients vary widely between brands.
Most involve added sugar and are aimed at young people who are at an age where they can develop a long-lasting taste for sweets, which can lead to obesity and other diseases.
“You can just call it the sweet drink of the main course,” said Frances Fleming-Milici, director of marketing projects and professor of studies at the Rudd Center for Food Policy.
According to experts, infant formulas are also more than cow’s milk.
“Not only are they not as smart as cow’s milk and a balanced diet, but they’re also worse,” said Fuchs, a professor of pediatrics at the University of Kentucky.
Toddler milks have been widely advertised and sales have skyrocketed in years — from $39 million in 2006 to $92 million in 2015, according to a 2020 study.
The products are explicitly rated for children 12 months and older and “may contribute to nutritional intake and potentially fill nutritional gaps,” according to the Infant Nutrition Council of America. Members of the professional organization are leading brands of infant formulas and infant products. beverages, adding Abbott Nutrition, Perrigo Nutrition and Reckitt.
Fleming-Milici said corporations are selling those products in a way that can lead parents to figure out which beverages are nutritionally necessary. “They look a lot like infant formula,” she said. Parents actually accept as truth the formula they use for their children. “”.
In one study, 60% of caregivers said they thought drinks provided nutrients that children would get from other foods.
NEW YORK – As more and more young people emerge from the pandemic and struggle with intellectual fitness issues, their parents are looking for tactics for them to build emotional resilience.
And toy brands are paying attention to this.
While still in its infancy, an increasing number of toy marketers are adopting MESH (or mental, emotional, and social fitness) as a designation for toys that teach young people skills such as how to adapt to new challenges, conflicts, protect themselves, or solve problems. problems. problem.
The acronym was first used in child development circles and through the American Camp Association 10 years ago and has gained new resonance after the pandemic. Rachele Harmuth, director of ThinkFun, a division of toy company Ravensburger, and Deborah Gilboa, a resilience expert and circle expert at A Family Doctor, formed a MESH organization earlier this year with the goal of getting brands to design toys with emotional resilience in the brain and bringing stores to market.
“We just want to teach parents and educators a little bit to know that we can be their playtime a little bit intentionally,” Gilboa said.
The plan is to certify MESH toys by mid-2024, similar to what the Toy Association did with STEAM toys, which emphasize science, technology, engineering, arts and math. Adrienne Appell, a spokeswoman for the Toy Association, notes that MESH is a domain it will continue to monitor as it evolves.
Many toys that could simply be MESH are already found in children’s toy boxes, such as memory sets, puppets, certain types of Legos, Pokemon swap sets, and dungeons.
James Zahn, editor-in-chief of the industry publication Toy Book, noted that most of the new toys developed with MESH in the brain will be available starting next year.
But some worry that the MESH technique will end up promising parents everything it can’t offer. There is also the threat that corporations will exploit parents’ considerations of their children’s intellectual health.
“I’m concerned that MESH will be used as the next marketing gimmick,” said Chris Byrne, an independent analyst for the toy industry. “This will create a culture of concern that your children won’t expand socially and emotionally. And that’s not the job of the toy industry. “
Experts say depression and anxiety in the formative years have been on the rise for years, but the unrelenting strain and pain of the pandemic has magnified the problems, especially for those who were already suffering from intellectual fitness issues and were excluded from counselors and other schools. Remote learning resources. In response, many educators have begun emphasizing social and emotional learning, which teaches young people comfortable skills, such as helping them manage their feelings and create positive relationships with others.
Dave Anderson, vice president of school systems and networks and senior psychologist at the Child Mind Institute’s Center for ADHD and Behavioral Disorders, praised the toy industry’s efforts to also address emotional resilience, but added that parents They want to be careful with corporate claims. could do. Although there is some evidence that the skills developed through the MESH work group can build resilience, there is no evidence that the toys themselves do so, he said.
“They’re evidence-based; the toys themselves don’t,” he said.
Byrne points out that the skills highlighted through the MESH race organization are the foundation of the game, whether it’s skateboarding that develops perseverance or learning to share toys with conflict resolution.
“In my opinion, if you’re in a healthy household, you’re playing healthily and your parents are engaged, MESH happens automatically,” he said.
The U. S. toy industry itself The U. S. needed a boost after a weak year, especially a lackluster 2022 holiday season, in which stores found themselves stuck with a toy surplus after taking advantage of a pandemic-induced toy wave. U. S. toy sales fell 8% between January and August, according to Circana’s retail sales tracking service.
For its part, the MESH working group works first and foremost with specialty retail outlets like Learning Express and smaller toy corporations like Crazy Aaron’s, which has expanded beyond its Thinking Putty to upload activity kits that teach young children how to solve problems, such as how magnets work. Pictures with putty. ThinkFun markets a game: Rush Hour, a logic game with sliding blocks that allows youngsters to fight traffic jams.
But primary stores like Amazon are also waking up to the MESH approach.
“The growing popularity of MESH toys is a testament to the power of play and the role toys play in our lives,” said Anne Carrihill, Amazon’s head of toys and games.
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