Connect with us

Science

Human milk is essential, yet scientists know little about it. UCSD plans to change that

Published

on

Human milk is essential, yet scientists know little about it. UCSD plans to change that

It is without doubt one of the few meals that almost everybody on the planet has consumed sooner or later. It’s linked to a number of well being advantages, from decreasing the danger of bronchial asthma and Sort 1 diabetes to preventing off infections.

But regardless of the outsized function it performs in sustaining our species, this important substance — human milk — has been the topic of curiously little analysis, particularly in comparison with different facets of eating regimen and replica.

At the moment, UC San Diego formally inaugurates the Human Milk Institute, the primary tutorial establishment within the U.S. dedicated to an important factor of human diet that science is, in some ways, solely starting to know.

“I discover it fascinating that we all know so little about it,” mentioned institute director Lars Bode, a sugar biologist at UCSD. “How is it doable that there’s a whole biosynthetic pathway within the human physique the place should you needed to put this in a biochemistry textbook, you’d have an empty web page?”

The UC Well being Milk Financial institution has been processing a mean 45,000 milliliters of breast milk every day.

Advertisement

(Nelvin C. Cepeda / The San Diego Union-Tribune)

Roughly 95% of infants devour human milk sooner or later of their younger lives, in keeping with a 2018 UNICEF report. The American Academy of Pediatrics, the World Well being Group and UNICEF all say it needs to be the one meals given to infants of their first six months of life.

Plentiful analysis has discovered correlations between an toddler eating regimen of human milk and higher well being outcomes in infancy and later life, together with diminished dangers of long-term points like weight problems, heart problems, childhood leukemia and even sudden toddler dying syndrome. Whereas many infants get their milk by way of breastfeeding, the advantages nonetheless apply if it comes from a bottle or hospital feeding tube. The milk doesn’t should be from a organic father or mother: in contrast to blood or bone marrow, there aren’t any organic markers in donated breast milk that restrict who can obtain it.

At the UC Health Milk Bank, bottles are filled with breast milk to be pasteurized.

On the UC Well being Milk Financial institution, bottles are stuffed with breast milk to be pasteurized.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

Advertisement

Human milk’s worth to our species is not any secret, however many questions on it stay unanswered. Amongst them: Why does milk produced from a human physique have advantages that aren’t in components designed to imitate it as intently as doable? Why does milk provide differ so extensively amongst ladies, and between particular person pregnancies?

And the way is it that we’ve been lactating for so long as we’ve been on the planet and we nonetheless don’t know these items?

Some half-dozen U.S. universities have institutes dedicated to wine, a few of them going again many years. Vanderbilt College has an institute for the examine of espresso since 1999.

In a 2018 TED discuss, Katie Hinde, director of the Comparative Lactation Lab at Arizona State College, mentioned the Nationwide Library of Medication has extra research dedicated to tomatoes than to human milk.

Advertisement

“That we all know a lot much less about breast milk, the primary fluid a younger mammal is customized to devour, ought to make us offended,” she mentioned in her discuss.

The UC Health Milk Bank, which is operated by UC San Diego Health.

“There’s a lot milk coming by way of right here, we will actually drive analysis,” mentioned Dr. Lisa Stellwagen, who runs the UC Well being Milk Financial institution.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

At UCSD, the brand new institute’s three predominant parts are Bode’s lab, the Mom-Milk-Toddler Heart of Analysis Excellence; the UC Well being Milk Financial institution, which distributed 200,000 ounces of donated breast milk final 12 months; and the Human Milk Analysis Biorepository, which holds greater than 50,000 samples of donated human milk to be used in scientific analysis.

“There’s a lot milk coming by way of right here, we will actually drive analysis,” mentioned Dr. Lisa Stellwagen, a pediatrician and co-director of the institute who runs the milk financial institution. Having the ability to perceive instantly how a pathogen impacts the meals provide for infants is crucial, she mentioned, including that, in a disaster, “you may’t shut down breastfeeding.”

Advertisement
Dr. Lisa Stillwagen, a co-director of the Human Milk Institute, walks through the milk bank.

Dr. Lisa Stillwagen, a co-director of the Human Milk Institute, walks by way of the milk financial institution.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

This turned obvious when COVID-19 hit. Although the U.S. Facilities for Illness Management and Prevention and the World Well being Group inspired mother and father to proceed breastfeeding, there was no dependable information on whether or not the coronavirus might go to kids by way of contaminated milk.

Epidemiologist Christina Chambers, who runs the biorepository, put out a name for milk donations from nursing moms who suspected or knew that they had caught the coronavirus. Working with Bode’s lab and infectious illness pediatricians at UCLA, they had been in a position to decide that the SARS-CoV-2 virus was not current in portions that would infect a child, and that pasteurization eradicated any traces of it in donated milk.

Bottles of breast milk are prepared for pasteurization at the UC Health Milk Bank.

Bottles of breast milk are ready for pasteurization on the UC Well being Milk Financial institution.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

Advertisement

Even earlier than their examine was revealed within the Journal of the American Medical Assn. in August 2020, the WHO posted a pre-print model to its web site, providing assurance to docs and households world wide that it was secure to proceed breastfeeding.

Having the ability to analyze the results of latest drugs, ailments and vaccines on human milk is crucial, mentioned Chambers, who can be a co-director of the milk institute. “Ladies who’re lactating should take drugs and get vaccines identical to everyone else,” she mentioned. “Within the absence of data, ladies will select to not breastfeed or to not take a wanted remedy, neither of which is perfect for them or the child.”

The institute goals to collaborate with researchers who might not even notice their work has any bearing on human lactation.

Bode’s lab has funded early-stage analysis initiatives that used milk to check remedies for heart problems, perceive the intestinal microbiome and develop a biosensor that may detect sure compounds in milk in minutes.

Advertisement

The institute’s long-term targets embrace establishing a medical board certification in breastfeeding. The closest factor at present accessible to physicians is a certification from the Worldwide Board of Lactation Marketing consultant Examiners, although that coursework was designed for nurses and breastfeeding help consultants.

The absence of a board specialty in lactation “is mostly a hole,” Stellwagen mentioned.

Donated human milk that can’t be fed to infants is used for research.

Donated human milk that may’t be fed to infants is used for analysis.

(Nelvin C. Cepeda / The San Diego Union-Tribune)

Bode, too, marveled {that a} occupation with greater than 160 specialties and subspecialties doesn’t have one known as lactology. “To me, that’s mind-boggling,” he mentioned.

Advertisement

Translating the analysis on the Human Milk Institute into real-life enhancements within the well being of infants and moms would require change far past its partitions. Feeding a child nothing however breast milk requires {that a} mom have each the time to supply it and entry to assist if any well being points have an effect on her provide. Within the U.S., households with decrease socioeconomic standing are likely to have decrease breastfeeding charges.

“Scientifically decoding the complexities of human milk is an important element for bettering human well being,” Hinde mentioned, “however provided that we as a society do extra to help infants and households, from laws that ensures paid parental go away to common entry to lactation help and baby-friendly hospitals.”

Bode agrees.

“This isn’t simply an educational train. We need to have an effect on the native and the worldwide neighborhood in relation to public well being,” he mentioned. “We have to be working with the communities, working with different stakeholders, working with policymakers. That’s completely the purpose.”

Advertisement
Continue Reading
Advertisement
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Science

How a water scientist hopes to save California habitats that could be pumped dry

Published

on

How a water scientist hopes to save California habitats that could be pumped dry

California is recognized as one of the world’s hotspots of biodiversity, with more species of plants and animals than any other state. And a significant number of the state’s species, from frogs to birds, live in habitats that depend on groundwater.

These rich ecosystems — including spring-fed streams, wetlands, riparian forests and oak woodlands — are vulnerable to declines in groundwater levels. In areas where unchecked pumping from wells severely depletes aquifers, once-thriving wetlands and forests can dry up and die.

Spotting threats to vulnerable natural areas has become a mission for Melissa Rohde, a hydrologist who has spent years analyzing satellite data and water levels in wells to come up with strategies for preventing ecosystems from being left high and dry.

“Nature has been getting the short end of the stick. It basically gets whatever is left behind, which oftentimes is not enough,” Rohde said. “How do we ensure that these ecosystems are protected?”

Advertisement

More than 300 species of birds have been seen at Kern River Preserve.

(Robert Gauthier / Los Angeles Times)

California is the only state with a groundwater law that includes provisions intended to protect groundwater-dependent ecosystems. But the law, adopted in 2014, gives considerable leeway to local agencies in developing water management plans that prevent “significant and unreasonable adverse impacts.”

When Rohde and other scientists examined the local plans for parts of the state that fall under regulation, they found only about 9% of groundwater-dependent ecosystems are adequately protected, while the remaining 91% are vulnerable.

Advertisement

When they looked at the entire state, they determined only 1% of the ecosystems are sufficiently protected under measures adopted to date.

Aggressive and impactful reporting on climate change, the environment, health and science.

Rohde has been focusing on finding ways to change that, in California and around the world.

Often working at home, she has pored over satellite data to spot decreases in vegetation greenness during drought, a telltale sign of die-off caused by declining aquifer levels. And she has analyzed how different types of trees, including willows, cottonwoods and oaks, fare when water levels fall depending on the depth of their roots.

Advertisement

Rohde and other researchers recently published a study outlining how California can set targets for maintaining groundwater levels — based on a formula including the type of vegetation, local water data and satellite imagery — to ensure the plants that anchor each ecosystem will be able to reach water and survive during dry times.

Cattle graze at the Kern River Preserve.

Cattle graze at the Kern River Preserve.

(Robert Gauthier / Los Angeles Times)

“If we don’t have groundwater levels that are able to support these diverse native vegetation ecosystems, then basically we run the risk of losing that important habitat for a lot of our threatened and endangered species,” Rohde said. “When you play around with keeping groundwater levels too deep to support the habitat, then you could lose species, and then that’s irreversible. The consequences can be severe.”

In California’s Mediterranean climate, trees, shrubs and the species they support are naturally adapted to drought. But excessive pumping from wells can push habitats beyond ecological limits by depleting the sources that sustain them.

Advertisement

With humanity’s heating of the planet intensifying droughts, the strains affecting these ecosystems continue to grow.

Already, California has lost the vast majority of its original wetlands to development, water diversions and agriculture. To avoid losing what remains, Rohde said, the state needs “a precautionary and preventative approach that can ensure that these ecosystems can withstand the intensification of droughts in climate change.”

During a recent visit to Kern County, Rohde and several conservation specialists walked in the shade through a lush forest of cottonwood trees near the south fork of the Kern River, visiting a nature preserve she had previously seen only in satellite images.

Scientist Melissa Rohde stands in a riparian forest.

Scientist Melissa Rohde visits a riparian forest at the Kern River Preserve.

(Robert Gauthier / Los Angeles Times)

Advertisement

At the edge of a clearing, she came upon the bare, sunbleached skeletons of dead trees.

She said satellite data had revealed that parts of the forest died along this part of the Kern River during the drought between 2012 and 2016.

“That’s because the groundwater levels rapidly declined,” Rohde said.

After that die-off, she said, groundwater levels rebounded in the area, and the native vegetation has been growing back.

A sign reads "Kern River Preserve" on a gate, with trees in the background.

The Kern River Preserve protects the riparian ecosystem along the south fork of the Kern River.

(Robert Gauthier / Los Angeles Times)

Advertisement

It helps that this forest is protected as part of the Kern River Preserve, which is managed by the National Audubon Society, and that some nearby farmlands have been retired and converted to conservation lands over the years.

The preserve’s managers, working with the organization Ducks Unlimited, have also restored an expanded wetland by diverting water from the river and flooding a section of pastureland where cattle used to graze.

The wetland attracts birds, such as coots and tricolored blackbirds, and also recharges the aquifer that the roots of cottonwoods and willows tap into.

Scientists and conservation specialists stand on a rock formation overlooking a wetland.

Scientist Melissa Rohde, left, and conservation specialists from Ducks Unlimited and the Audubon Society, including Reed Tollefson, right, stand on rocks overlooking a wetland at the Kern River Preserve.

(Robert Gauthier / Los Angeles Times)

Advertisement

The 3,300-acre preserve has expanded as adjacent alfalfa fields have been purchased and agricultural wells have been shut down, said Reed Tollefson, the preserve’s manager. These efforts have helped protect a refuge for birds including willow flycatchers and yellow-billed cuckoos.

As he pointed to several dead trees poking from the living cottonwoods, he said protecting the forest from groundwater pumping and climate change will require additional effort.

“I think it’s tenuous,” he said. “We’ve got more work to do to try and really sustain this.”

The dead trees that have appeared here and elsewhere in California over the past decade represent the sort of die-off that water managers need to focus on preventing, Rohde said.

Advertisement

“It has to be an intentional practice of setting thresholds, monitoring, using satellite data or other scalable means to measure the impacts, in order to make sure that we are not allowing this to happen on a wider scale,” she said. “From a biodiversity perspective, it’s absolutely critical.”

Rohde said she felt hopeful seeing the forest rebounding and much greener than it was several years ago, with many young trees coming up.

Some other parts of California haven’t fared nearly as well.

One rainy day last month, Rohde visited an area along the Santa Clara River in Ventura County where several hundred acres of willows and cottonwoods dried up and died during the drought in the mid-2010s.

When groundwater pumping by farms and communities caused aquifer levels to fall, many trees died along the river near the city of Fillmore.

Advertisement

“We saw this catastrophic drop in groundwater at this site,” Rohde said.

She visited the area with a research colleague and two managers from The Nature Conservancy. They stood on a gravel road next to a lemon grove, checking on what remained of the forest.

Scientist Melissa Rohde stands beside tall reeds.

Scientist Melissa Rohde stands in a thicket of arundo, an invasive reed that has proliferated along parts of the Santa Clara River in Ventura County. There are ongoing efforts to remove the nonnative reeds in the area.

(Brian van der Brug / Los Angeles Times)

Where native trees died, an explosion of invasive reeds has taken over. The nonnative reeds, called arundo, have grown into thickets more than 20 feet tall. And unlike willows, Rohde said, arundo offers little value as habitat for birds.

Advertisement

“When we had that massive die-off, and the groundwater levels remained deep, there was no way for the native vegetation to regenerate,” she said. “But arundo is extremely efficient at extracting soil moisture. And so it was able to outcompete the native vegetation.”

She said efforts to prevent this sort of habitat degradation should be prioritized.

When managers of local agencies set goals for maintaining groundwater levels, she said, they can tailor targets to the type of vegetation — whether there are cottonwood trees, with roots averaging about 9 feet long, or oaks, with roots that average nearly 30 feet but can grow much deeper.

Her colleague Michael Bliss Singer said when native trees are ravaged by multiple years of low water levels, they will start losing leaves and then dropping branches.

In one study, Singer and others documented a “brown wave” of trees drying along the Santa Clara River between 2012 and 2016 — a loss they saw in satellite images.

Advertisement
A man looks out on a muddy river.

Scientist Michael Bliss Singer looks out over the Santa Clara River in Ventura County.

(Brian van der Brug / Los Angeles Times)

“It’s completely transformed the ecosystem here,” said Singer, a professor at Cardiff University in Wales who is also a researcher at UC Santa Barbara.

When plants die off like this and don’t recover, it’s a symptom of an ecosystem in decline. To prevent more of these losses in an era when climate change is driving more severe droughts, Singer said, it’s crucial to “come up with creative solutions for the worst-case scenario.”

Rohde has found in her research, however, that most local groundwater plans in California haven’t adequately accounted for climate projections.

Advertisement

Previously, Rohde did other types of climate research, including a stint in Antarctica in 2010, where she was part of a drilling team collecting ice cores. From that experience, Rohde said she realized that “I didn’t want to spend my career convincing people that climate change was an issue; I wanted to do something about it.”

She wore a faded cap with an Antarctica map, a memento of that trip. Rohde said her recent work is motivated by concerns about the climate crisis and biodiversity, as well as a conviction that proactive steps to protect ecosystems can make a difference.

“I have two young kids. I really want to make sure that I’m doing the best thing that I can to ensure a sustainable future for them, where they can access nature,” Rohde said.

A man holds binoculars as he observes a wetland.

E.J. Remson, a senior project director for The Nature Conservancy, surveys a wetland along the Santa Clara River in Ventura County.

(Brian van der Brug / Los Angeles Times)

Advertisement

“Often groundwater is out of sight, out of mind,” she said. “We don’t measure it, we don’t understand it and we misuse it. And we need to make sure that we are managing groundwater so that it is supporting us, and making sure that we have a sustainable future.”

Rohde now works as an independent scientist. Previously, as a researcher for The Nature Conservancy, she helped write an atlas of threatened and endangered species that rely on groundwater.

California’s groundwater-dependent ecosystems lie not only along streams, but also in habitats such as mountain meadows, coastal redwood forests and mesquite bushes among desert sand dunes. The species they support range from tiger salamanders to desert pupfish, and from songbirds to mammals such as ground squirrels and bighorn sheep.

“The risks are high when species are on the verge of extinction,” Rohde said.

Rohde and other scientists have found that ecosystems sustained by groundwater are under threat worldwide. Some of the few regions that have measures intended to protect them, she said, include Australia, the European Union and California.

Advertisement

Still, even with California’s groundwater regulations and endangered species laws, Rohde said, “we continue to miss the mark in actually protecting them.”

Rohde said state officials should give local water agencies clear direction to ensure they’re using science-based methods to safeguard ecosystems in their state-mandated plans. She said agencies can now use the approaches scientists have outlined to map strongholds of biodiversity and set targets for maintaining aquifer levels.

“It’s very attainable,” she said. “Now, it’s just basically up to political will, or enforcement by the Department of Water Resources, to ensure that that happens.”

Walking in the rain at the Santa Clara River Preserve, Rohde followed her former Nature Conservancy colleagues Peter Dixon and E.J. Remson on a trail through a stand of healthy trees.

A man in a hooded rain jacket hikes along a soaked trail.

Peter Dixon, a project manager with The Nature Conservancy, walks on a trail through the riparian forest at the Santa Clara River Preserve.

(Brian van der Brug / Los Angeles Times)

Advertisement

They stood on the banks of the fast-flowing river, watching the muddy water churn past.

In the summer and fall, this part of the river usually dwindles to a trickle.

And during the next drought, when the river dries up, the forest will depend on the same groundwater that nearby communities and farms also use.

If the water needs of this and other ecosystems aren’t prioritized, Rohde said, vital habitats will suffer.

Advertisement

“We need to be deliberate about the planning, and ensuring that they get their fair share,” she said. “Their existence is potentially imperiled if we don’t act.”

Continue Reading

Science

Opinion: Most older Americans who need hearing aids don't use them. Here's how to change that

Published

on

Opinion: Most older Americans who need hearing aids don't use them. Here's how to change that

Having depended on hearing aids for nearly three decades, I’m astounded by the lack of Medicare coverage for devices that can solve a problem afflicting tens of millions of older Americans.

Nearly two-thirds of Americans over age 70 have some degree of hearing loss, and over half of those 75 and older experience impairment serious enough to be considered disabling. But most don’t wear hearing aids.

Because the legislation that created Medicare nearly 60 years ago specifically excluded hearing aids, those who rely on the program’s traditional coverage must pay for them out of pocket. That expense is among the chief barriers to wider use of the devices.

Age-related hearing loss impedes basic communication and the relationships that depend on it. Expanded access to hearing aids could therefore do no less than enable more older Americans to establish and maintain the social connections that are essential to a meaningful life.

Hearing loss is like an invisible, muffling curtain that falls in front of anyone speaking. Asking people to repeat themselves can yield irritated and hurtful responses. And it’s hopeless to ask a soft-spoken person to speak up. Sometimes it’s easier just to nod and smile.

Advertisement

Many older people I know choose to avoid social gatherings altogether because they can’t hear well. Without hearing aids, I’d stay home too.

Hearing loss can harm one’s health in other ways. For example, I’ve written about the need for a comprehensive approach to reducing cancer risk at older ages, including preventive services such as colorectal cancer screening. But these services rely on conversations between patients and their healthcare providers. An older patient’s ability to hear and understand such conversations shouldn’t be taken for granted or ignored.

The Food and Drug Administration did improve access to hearing aids by making some of them available without a prescription in 2022, but the over-the-counter devices are inadequate for serious hearing loss like mine. My private health insurance, meanwhile, started covering hearing aids a few years ago, providing up to $2,500 for them every five years. One hearing aid alone can cost that much or more, however.

Despite its limitations, my private coverage for hearing aids is better than nothing, which is what traditional Medicare provides.

Hearing loss is more common among lower-income people and those without advanced education. The toll from noisy workplaces compounds age-related hearing loss for some. One analysis found that most Americans with a serious hearing disability can’t afford the typical price of hearing aids.

Advertisement

Many of the older adults who can’t come up with these significant out-of-pocket expenses spent their working years in low-wage jobs that our country depends on. Denying them treatment for their hearing loss is a lousy way to treat people who gave years of service to our society.

Although some older adults with hearing loss won’t benefit from hearing aids, Medicare coverage for the devices might encourage more beneficiaries to get their hearing tested so they can get the treatment that’s right for them. And while Medicare coverage alone won’t address the stigma some people associate with hearing aids, the availability of newer, more comfortable and less obvious technology might win over some refuseniks.

Legislation reintroduced with bipartisan support last year would finally correct this glaring gap in Medicare coverage by removing the hearing aid exclusion from the law. There’s no reason to delay action on this any longer. Are our representatives listening?

Mary C. White is an adjunct professor of environmental health at Emory University’s Rollins School of Public Health, a Public Voices fellow at AcademyHealth in partnership with the OpEd Project and a former federal epidemiologist.

Advertisement
Continue Reading

Science

Second human case of bird flu detected in Michigan dairy worker

Published

on

Second human case of bird flu detected in Michigan dairy worker

A second human case of bird flu in a diary worker has been confirmed in Michigan, state and federal health officials announced Wednesday.

The symptoms were mild, consisting of conjunctivitis. The Texas dairy worker who contracted the virus in March also came down with pink eye.

At a press call on Wednesday, Nirav Shah, principal deputy director of the U.S. Centers for Disease Control and Prevention, said the finding was “not unexpected” and that it was a scenario “that we had been preparing for.”

He said that since the discovery of H5N1 in dairy cattle, state and federal health officials have been closely monitoring farmworkers and slaughterhouse workers and urging farmers and farmworker organizations to “be alert, not alarmed.”

Federal officials say they still believe the human health risk of bird flu is low; however, it underscores the need for people who are interacting with infected or potentially infected farm animals or birds to take precautions, including avoiding dead animals and wearing personal protective equipment (PPE) if there’s a need to be in close contact.

Advertisement

Though a nasal swab from the person in Michigan tested negative for influenza, an eye swab from the patient was shipped to the CDC and tested positive for influenza A(H5N1) virus.

This is the third case of H5N1 reported in the United States. A poultry worker in Colorado was identified in 2022.

Although the symptoms in the three farmworkers in the U.S. have been mild, people elsewhere in the world have suffered more severe illness, including death. According to the World Health Organization, between Jan. 1, 2003, and March 28, 2024, there have been 888 cases of human infection from 23 countries; 463 were fatal.

In preparation for a more widespread outbreak, the CDC updated its guidance for PPE in dairies and issued a nationwide order for healthcare providers to be on the lookout for novel influenza.

On Tuesday, the CDC asked clinical laboratories and health departments to increase the number of influenza samples being analyzed “to maximize the likelihood of catching a case of H5N1 in the community,” Shah said.

Advertisement

The US Department of Agriculture is also expanding its surveillance and support by providing $1500 to non-infected farms to beef up biosecurity, and $100 to producers who want to buy inline samplers to test their milk. The agency will also provide $2000 per farm to cover veterinary fees for testing, as well as shipping costs to send those tests to laboratories for analysis.

There have been no cases of H5N1 detected in California’s dairy herds.

Officials said ongoing analysis of the nation’s dairy supply suggests it is safe to consume, Despite the risk to human health being low, an official with the Administration for Strategic Preparedness and Response said it will make Tamiflu available upon request “to jurisdictions that do not have their own stockpile and are responding to pre-symptomatic persons with exposure to confirmed or suspected infected birds, cattle or other animal exposures.”

Dawn O’Connell, assistant secretary of the preparedness agency, said it started the “fill and finish” process for approximately 4.8 million doses of vaccine “that is well matched to the currently circulating strain of H5N1 through the national pre-pandemic influenza vaccine stockpile program.”

She said the decision to get started on H5N1 vaccines was not a response to any heightened concern, but since it takes several months to fill and finish vaccine doses, the agency “thought it made sense given what we were seeing.”

Advertisement
Continue Reading

Trending