What's next for medication abortion, learning from hibernating bears, & the burdens home health aides bear

Every winter bears curl up for months-long snoozes with no ill effects, whereas we immobilized humans risk a potentially fatal blood clot.

April 14, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. When you think of the organisms scientists study to better understand human health, you probably think of creatures like mice, fruit flies, frogs, and zebrafish. Jason Mast tells us why hibernating bears are in the mix, too.

reproductive Health Abortion pill case heads to U.S. Supreme Court as providers scramble The next legal battleground for the abortion pill mifepristone will be in the U.S. Supreme Court. The Justice Department moved yesterday to block Wednesday's ruling by a federal appeals panel that keeps the drug available but under restrictions. "We will be seeking emergency relief from the Supreme Court to defend the FDA's scientific judgment and protect Americans' access to safe and effective reproductive care," Attorney General Merrick Garland said in a statement.  Meanwhile, doctors, clinics, and telehealth providers are in limbo, not sure how they can keep offering what's become the most common form of abortion in the U.S. "This is going to have a severe, severe impact on access," Kirsten Moore, director of the Expanding Medication Abortion Access Project, told the Associated Press, adding that it will be "devastating" for underserved rural populations. Also yesterday, Florida's legislature passed a six-week abortion ban, a measure Gov. Ron DeSantis is expected to sign into law. in the lab A new study maps out how mutations accumulate in the body You might have learned that the 30 trillion cells inside your body all have the same DNA, but that's not exactly true. The reason? When cells divide, they sometimes make little errors in copying their genetic code. And in a recent study, scientists set out to map the mutations we accumulate throughout our lives to better understand where and when mutations show up, and how these changes are connected with disease, STAT's Jonathan Wosen reports. To do this, they used 54 tissue and cell types collected from nearly 950 individuals who'd died and donated their bodies to the NIH's Genotype-Tissue Expression Program. Their findings, published yesterday in Science, showed that the rate of so-called postzygotic mutations, DNA changes not inherited from either parent, varied from person to person and tissue to tissue. For instance, cells in the esophagus and liver had more mutations, which the authors speculated may have to do from these cells' exposure to toxins, while those in the brain cells had fewer mutations. mental health Home health aides need help, too Adobe Home health aides face a litany of hardships. Untenable hours, low pay, long commutes, and constant stress, all of which lead to poor mental health for 1 in 5 home care workers, a recent survey found. Compared with low-wage workers in other industries, home health aides had worse physical and mental health. As one worker told STAT contributor Gina Ryder, professional caregiving means prioritizing another person's needs and often burying your own — all while working 10- to 12-hour shifts for $10 per hour. Improving working conditions would help home health aides, but also the people they care for, especially as the need for them grows with the aging U.S. population. One effort, a peer coaching program, eased some of the mental health pressures home health aides felt, a 2020 study found, with more research planned. But that can go only so far. Read more.

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Closer Look Going on a bear hunt to solve blood clots deadly to us Courtesy Ole Frøbert What can hibernating bears teach us about human heart health? A lot, it turns out. Every winter brown bears curl up for months-long snoozes, with no blood-congealing consequences, whereas we humans, when immobilized by injury or infection, risk a potentially fatal blood clot called venous thromboembolism. To figure this out, an army of scientific investigators studied pigs, mice, spinal cord patients, and blood from 10 otherwise healthy people who volunteered to help the European Space Agency simulate a mission to Mars. And bears. Ultimately, researchers zoomed in on a single protein that all but vanishes from bears' blood when they lie down for winter. That protein, HSP47, is found on platelets, which patch wounds and stop bleeding. The finding, reported yesterday in Science, raises hope that one day researchers might develop drugs to block HSP47, and a new way to treat or prevent clots in immobile patients. STAT's Jason Mast has more. health EPA weighs adding more 'forever chemicals' to cleanup list If you want to be afraid of just about everything in your house, per- and polyfluoroalkyl substances are used in burger wrappers, paper straws, cosmetics, stain-proof carpeting, waterproof cycling gear, and to make nonstick pans, and have toxic effects at low levels. This led the EPA to propose highly restrictive standards for six PFAS in drinking water last month, my colleague Brittany Trang writes. But another major use of PFAS is in firefighting foams, which might cause trouble for the Department of Defense. Many of its military bases are polluted with PFAS from firefighting foam use, and the EPA yesterday announced it is looking into designating some of the PFAS in those foams and others as "hazardous substances" under the Superfund law, which mandates polluters clean up heavily polluted sites. Last year, the agency proposed this classification for two of the most popular PFAS compounds, PFOS and PFOA, but the new call for public input and data signals the potential for entire groups of the thousands of PFAS compounds to be designated as hazardous. health 1 in 5 American adults live with chronic pain It's a staggering number: Just over 50 million adults in the U.S. were living with chronic pain in 2016, a new CDC report says. The survey didn't include nursing home residents, but by 2021, it translated to 1 in 5 Americans enduring pain that lasted three months or more and 1 in 14 having what's called high-impact pain, substantially restricting their daily activities. Studies have linked such pain to depression, Alzheimer's disease and related dementias, higher suicide risk, and substance use and misuse.   Both kinds of chronic pain were more prevalent in older adults, females, those who were unemployed after previously working, veterans, people living in poverty, people not living in metropolitan areas, and people with public health insurance. There were other differences: Non-Hispanic American Indian or Alaska Native adults, adults who identify as bisexual, and adults who were divorced or separated were among the groups who experienced a higher prevalence of pain.

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What we're reading Promising new malaria vaccine for kids approved in Ghana, Associated Press Congress is launching a tobacco harm reduction caucus. Its biggest supporter so far? Philip Morris, STAT  Federal group studying surprise ambulance bills will finally meet — four months late, STAT Unpacking the flawed science cited in the Texas abortion pill ruling, Washington Post Flawed AI algorithms can cause harm in medicine. A research team has a plan to root out bias, STAT

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Thanks for reading! More Monday,

elizabeth.cooney@statnews.com

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