Sleep-deprived people that try to rebound by snoozing longer on weekends don’t see improvements to the harmful effects that too little rest has on the heart, new research shows. Adults who get less than seven hours of sleep each night are more likely to have high blood pressure and an increased heart rate, the U.S. Centers for Disease Control and Prevention says. Over time, a poor sleep regimen increases the risk for cardiovascular disease, heart attack and stroke. Lack of sleep also is tied to higher rates of type 2 diabetes and unhealthy weight gain. To make up for lost sleep during the week, many people choose to stay in bed longer on weekends in hopes of restoring their energy. But behavioral health researchers at Penn State University say the heart doesn’t easily recover from a poor sleep schedule. When people develop these habits at a young age, they could potentially be setting themselves up for heart problems. Only about 65% of adults maintain a sleep schedule that gets them seven hours per night. “Our research reveals a potential mechanism for this longitudinal relationship, where enough successive hits to your cardiovascular health while you’re young could make your heart more prone to cardiovascular disease in the future,” said researcher Anne-Marie Chang, an associate professor of biobehavioral health. The Penn State study examined 15 healthy men, ages 20-35, as they wen through an 11-day, inpatient sleep experiment. On the first three nights, the men were allowed to sleep up to 10 hours to establish baselines for their heart functions. Over the next five nights, they were restricted to five hours of sleep, followed by two nights when they again were allowed to sleep up to 10 hours. Each day, the researchers measured the participants’ resting heart rates and blood pressure every two hours. This enabled the study to account for heart activity during different periods of the day, since heart rates lower when people wake up. During each day of the study, the mens’ heart rates increased by an average of nearly a beat per minute. The average baseline heart rate was 69 beats per minute. By the end of the study, even after two consecutive nights of unrestricted sleep, the average heart rate was 78 beats per minute. Systolic blood pressure, which measures pressure in the arteries when the heart beats, also increased over the course of the study. Chang said the results of the study don’t necessarily mean that people shouldn’t try to catch up on sleep after long weeks. But the findings suggest people should work toward establishing healthier sleep schedules on a consistent basis. “Sleep is a biological process, but it’s also a behavioral one and one that we often have a lot of control over,” Chang said. “Not only does sleep affect our cardiovascular health, but it also affects our weight, our mental health, our ability to focus and our ability to maintain healthy relationships with others, among many other things.” Another factor to consider with sleep health is not just how many hours people get, but the time of day they get it. Social jet lag is a common effect people experience when their sleep schedules vary during the week compared to the weekend. The concept is similar to jet lag from traveling, except that different sleep patterns can have chronic impacts on circadian rhythms and work performance. This is true even when people are getting at least seven hours of sleep, researchers have found. The Penn State study follows recent research that examined why night owls tend to live shorter lives than early risers. That study of 23,000 people concluded that behaviors like smoking and drinking alcohol were significant factors. “As we learn more and more about the importance of sleep, and how it impacts everything in our lives, my hope is that it will become more of a focus for improving one’s health,” Chang said.
Day: July 1, 2024
Companies Regeneron Pharmaceuticals Inc Follow U.S. Food and Drug Administration Follow Aug 18 (Reuters) – Regeneron Pharmaceuticals (REGN.O) said on Friday the U.S. health regulator approved its drug to treat a rare blood disease. The company said its drug, Veopoz, was approved in adult and pediatric patients 1 year of age and older with the life-threatening CHAPLE disease. People with CHAPLE disease have mutated CD55 gene, which regulates the body’s mechanism for destroying microbes. Without proper gene regulation, the mechanism may start attacking normal cells of the body. In most patients, this results in a range of potentially life-threatening symptoms beginning in early childhood. The company did not immediately respond to a Reuters request for comment on the drug’s price. Reporting by Vaibhav Sadhamta, Khushi Mandowara and Pratik Jain in Bengaluru; Editing by Shilpi Majumdar Our Standards: The Thomson Reuters Trust Principles. Acquire Licensing Rights, opens new tab
The Centers for Disease Control and Prevention said it is tracking a new lineage of the virus that causes COVID-19 after it was detected in the United States. Named BA.2.86, the strain was first detected in Denmark on July 24 of this year, then Israel, followed by Michigan in August for a total of four cases, according to the open global genome sequencing database GISAID. “Today we are more prepared than ever to detect and respond to changes in the COVID-19 virus,” a CDC spokesperson told ABC News. “Scientists are working now to understand more about the newly identified lineage in these for cases and we will share more information as it becomes available.” According to lab data, BA.2.86 has more than 30 mutations in total, much more than other variants currently circulating. “Based on the available evidence, we do not yet know what risks, if any, this may pose to the public’s health beyond what has been seen with other currently circulating lineages,” the spokesperson said. A man receives a nasal swab COVID-19 test at Tom Bradley International Terminal at Los Angeles International Airport (LAX), Dec. 22, 2020, in Los Angeles. Mario Tama/Getty Images On Thursday, the World Health Organization listed BA.2.86 as a “variant under monitoring” also due to its large number of mutations. Experts told ABC News that even though the number of cases spotted in laboratories is low, the fact that the variant has been detected on three continents suggests a high level of transmissibility and that there could be more cases out there. “The reason that scientists are concerned, I think it’s the numbers of mutations plus the fact that the four sequences were found on three continents,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital. “So that does tell you that it has some level of fitness, to be able to spread and potentially escape the immune system to create infection, but we don’t know the extent.” Brownstein, an ABC news contributor, said the number of mutations, particularly on the spike protein, which the virus uses to enter and infect cells indicates “features of a variant that could take off.” However, he explained that because there’s been no real-world data observation done yet, there’s no cause for alarm, just for continued public surveillance. Recently, CDC data has shown COVID hospitalizations are increasing. For the week ending Aug. 5, hospitalizations rose 14.3% from 9,026 to 10,320 weekly hospitalizations. Although a double-digit percentage increase seems scary, experts said it’s important to remember hospitalizations are much lower than during other surges such as the omicron surge of winter 2021-22. Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, said there is a combination of immunity from vaccines, boosters, previous infection and multiple infections that would stem any potential surge from BA.2.86 or at least lessen the severity. “Many people won’t get ill because the population has been so exposed with lots of different kinds of COVID and variants and vaccines and previous infections,” he told ABC News. “So, the body’s immune system has already seen a lot of the repertoire of COVID in all different angles. So, it’s unlikely even if it takes off that it will result in a huge wave of illness.” A 3D model shows the structure of the Covid-19 virus. STOCK IMAGE/Longhua Liao/Getty Images He added, “For example, if BA.2.86 came in March of 2020, it probably would be a different story, given the lack of population immunity, the repertoire of the immune response in people, then compared to now.” Until more information is learned about BA.2.864, the CDC said its “advice on protecting yourself from COVID-19 remains the same.” ABC News’ Sony Salzman contributed to this report.
The Connecticut Department of Public Health today announced that a resident has tested positive for West Nile virus infection. This is the first human case of WNV-associated illness identified in Connecticut this season. The female is a resident of New Haven County and is between 50-59 years of age. She became ill during the third week of July with West Nile fever and has since recovered. Laboratory tests confirmed the presence of antibodies to WNV. “As we approach the end of summer and continue to enjoy time outdoors with family, friends, and neighbors, it is important to prevent mosquito bites to reduce your risk of exposure to West Nile virus infection,” said DPH Commissioner Manisha Juthani. “Using insect repellent, covering bare skin, and avoiding being outdoors during the hours of dusk and dawn are effective ways to help keep you from being bitten by mosquitoes.” “The mosquitoes that carry West Nile virus are most abundant in urban and suburban areas and are most active between dusk and dawn. We anticipate continued risk for human infection until mosquito activity subsides in October,” added Philip Armstrong, medical entomologist at the Connecticut Agricultural Experiment Station. West Nile virus has been detected in Connecticut every year since 1999 and is the most prevalent mosquito-borne disease in the US. Most people infected with WNV do not develop symptoms. About one in five people who are infected develop West Nile fever, an illness which includes a fever and other symptoms such as body aches, joint pain, headache, or a rash. About one out of 150 infected people develop a severe illness affecting the central nervous system. About one out of 10 cases of severe illness are fatal. People over the age of 60 are at highest risk of serious illness. Tips for reducing mosquitoes around homes Mosquitoes require water for reproduction. The following are measures that can help reduce mosquitoes: Eliminate standing water suitable for mosquitoes. Dispose of water-holding containers, such as ceramic pots, used tires, and tire swings. Drill holes in the bottom of containers such as those used for recycling Clean clogged roof gutters. Turn over objects that may trap water when not in use, such as wading pools and wheelbarrows. Change water in bird baths on a weekly basis. Clean and chlorinate swimming pools. When pools are not in use, use pool covers and drain when necessary. Tips for avoiding mosquito bites when outdoors Mosquitoes require a blood meal for reproduction. The following are measures that can help reduce bites from mosquitoes that feed on people: Minimize outdoor activities at dusk and dawn when mosquitoes are most active. Wear shoes, socks, long pants, and long-sleeved shirts. Clothing material should be tightly woven and loose fitting. Use mosquito netting when sleeping outdoors. Consider the use of CDC-recommended mosquito repellents, containing DEET, picaridin, oil of lemon eucalyptus, IR3535, or 2-undecanone, and apply according to directions, when it is necessary to be outdoors. When using DEET, use the lowest concentration effective for the time spent outdoors (for example, 6 percent lasts approximately two hours and 20% for four hours) and wash treated skin when returning indoors. Do not apply under clothing, to wounds or irritated skin, the hands of children, or to infants less than two months old. Be sure door and window screens are tight fitting and in good repair to avoid mosquito bites when indoors. For information on West Nile virus and how to prevent mosquito bites, visit the Connecticut Mosquito Management Program Web site at www.ct.gov/mosquito.
A heart drug that combines three medications in one pill — otherwise known as a polypill — has been included in the List of Essential Medicines from the World Health Organization (WHO). The unique polypill is designed for those who have had a prior heart attack or other heart-related event, with the goal of preventing a repeat occurrence. It took 15 years of intense study and several versions to create it. The List of Essential Medications are those that meet the population’s “priority health care needs” and can save lives, improve health and decrease suffering, according to the WHO’s website. “This cardiovascular polypill could become an integral part of global strategies to prevent cardiovascular events in patients who have suffered a heart attack and who are currently already being treated with separate mono-components,” said Valentin Fuster, M.D., Ph.D., president of Mount Sinai Heart and physician-in-chief of The Mount Sinai Hospital in New York City, in a news release. “This approach has the potential to reduce the risk of recurrent disease and cardiovascular death,” he added. A heart drug that combines three medications in one pill is otherwise known as a polypill.Getty Images WHO selects the essential drugs based on their relevance to public health, the prevalence of disease, evidence of clinical efficacy and safety, and comparative costs and cost-effectiveness, according to the global health organization’s website. “This really, I think, is a change in medicine,” Fuster, who is also general director of the Spanish National Center for Cardiovascular Research (CNIC), which spearheaded the research, told Fox News Digital in an interview. “The inclusion of this therapeutic solution in the WHO’s List of Essential Medicines confirms our aim to make a positive impact in society and is an important step in our mission to bring significant and differential value to people with cardiovascular disease,” Oscar Pérez, chief marketing, and business development officer at Ferrer, a Spain-based pharmaceutical company involved in the polypill research, said in a news release. The new pill has been included in the List of Essential Medicines from the World Health Organization (WHO). Getty Images The polypill contains three medications that are typically used to treat patients after they suffer their first heart attack, as Fox News Digital previously reported. Researchers found it to be effective in preventing secondary adverse cardiovascular events in those who have previously had a cardiac event, according to the SECURE trial led by Fuster that was published in The New England Journal of Medicine in August 2022. The polypill also reduced cardiovascular mortality by 33% among patients who had previous heart attacks, the study found. The polypill contains three medications that are typically used to treat patients after they suffer their first heart attack, according to reports.Getty Images “The SECURE results showed for the first time that the cardiovascular polypill that we helped develop led to clinically relevant reductions in recurrent cardiovascular events in patients who had suffered a myocardial infarction,” Fuster said in the release. The three drugs contained in the polypill include acetylsalicylic acid, which helps thin the blood to prevent blood clots; ramipril, an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure; and a cholesterol-lowering drug called atorvastatin, according to Fuster. Keep up with today’s most important news Stay up on the very latest with Evening Update. A patient is less likely to take the three separate pills on a daily basis, Fuster said, which increases the risk for another cardiovascular event. The polypill helps patients remain compliant with taking the prescribed medications because it is only one pill. Fuster’s research team found that the polypill was also just as effective as the separate pill regimen commonly given to patients after a heart attack. “Adherence to treatment after an acute myocardial infarction is essential for effective secondary prevention,” he told Fox News Digital. “This cardiovascular polypill, as a strategy that combines three of the baseline treatments for these patients, has proven its value, because increased adherence means that patients are being treated for longer and, as a result, have a lower risk of cardiovascular events,” Fuster noted in the release. It took 15 years of intense study and several versions to develop this polypill, Fuster told Fox News Digital. WHO selects the essential drugs based on their relevance to public health, the prevalence of disease, evidence of clinical efficacy and safety, and comparative costs and cost-effectiveness. AP It is sold under the brand names Trinomia, Sincronium, and Iltria, depending on the country. “The 3% reduction in cardiovascular mortality demonstrates the efficacy of treatment with Trinomia compared to standard treatment,” Ferrer’s Perez said in the report. The polypill is commercially available right now in 25 countries, but the Food and Drug Administration (FDA) has not yet cleared it for use in the U.S. “This cardiovascular polypill could become an integral part of global strategies to prevent cardiovascular events,” said Dr. Valentin Fuster, president of Mount Sinai Heart. Getty Images/iStockphoto “Since our groundbreaking study was published, we have seen an increase in polypill usage across the world, and we are looking forward to having this medicine available in the United States and the rest of the countries where it is not available yet,” Fuster said. Each year in the United States, 805,000 people suffer a heart attack. Among those individuals, 200,000 previously had a cardiac event, according to the Centers for Disease Control and Prevention (CDC).
A new blood test that would enable the commonest childhood illnesses to be diagnosed in less than an hour could “transform” medical care, doctors say. Currently it can take doctors hours, days or even weeks to identify which of 18 infectious and inflammatory diseases a child with a worryingly high temperature is suffering from. The delay means clinical teams cannot be sure whether the infant has group B streptococcus, respiratory syncytial virus (RSV), tuberculosis or another ailment. Doctors therefore cannot immediately distinguish between a bacterial infection, which may be life-threatening, and other, less serious illnesses. The new findings suggest that the test, developed by an international team of doctors and scientists, could enable sick children around the world to be diagnosed more quickly and receive better treatment by cutting the time health professionals have to wait for a blood test to be analysed. Professor Michael Levin, an expert in child health at Imperial College London who has helped to develop the novel approach, said that it could prove “transformative for healthcare”. “Despite huge strides forward in medical technology, when a child is brought into hospital with a fever, our initial approach is to treat based on the doctors’ ‘impression’ of the likely causes of the child’s illness,” he said. “As clinicians, we need to make rapid decisions on treatment, often just based on the child’s symptoms, information from the parents, and our medical training and experience. “But we may not know whether a fever is bacterial, viral or something else until hours or days after a child has been admitted, when their test results come back. Such delays can stop patients getting the right treatment early on, so there is a clear and urgent need to improve diagnostics. “Using this new approach, once it’s translated to near point-of-care devices, could be transformative for healthcare.” The diagnostic test works by analysing a patient’s “gene expression”, according to new findings by the team involved, which has been published in the Cell Press journal Med. The experts behind it used data from several thousand patients, including more than 1,000 children who had had an infectious or inflammatory disease, to identify which key genes were turned “on” or “off” in their response to a range of ailments. That gave them a molecular signature of disease. They then used machine learning to work out which patterns of gene expression corresponded to which particular diseases and pathogens and focused on 161 genes for 18 conditions. Dr Myrsini Kaforou, a senior lecturer in Imperial’s department of infectious diseases and a co-author of the paper, said: “This body of work has enabled us to identify the molecular signature of a wide range of diseases based on 161 genes, out of thousands of genes in the human genome. “By distinguishing between many diseases at the same time within the same test, we have developed a more comprehensive and accurate model that aligns with the way clinicians think about diagnosis. “With this initial proof-of-concept study, we’ve been able to show that our multi-disease, machine-learning diagnostic approach works.”
FARGO — The smoldering coronavirus spread is creeping up in North Dakota but is unlikely to burst into another major conflagration of cases because many people have some level of immunity from vaccination or natural infection, experts say. Throughout the United States, COVID-19 infections have been increasing, with hospitalizations up 14.3% over the past week, according to the Centers for Disease Control and Prevention. But the trend so far is more subdued in North Dakota, which had three weekly reported COVID-19 hospital cases as of Friday, Aug. 18, and 197 weekly positive cases . The week earlier, one hospitalization and 115 positive cases were reported. Public health officials caution, however, that the spread of cases is largely invisible because few test results are reported, and cases in North Dakota have been gradually rising. “Testing is down, so reporting is down,” said Kirby Kruger, director of disease prevention at the North Dakota Department of Health and Human Services. ADVERTISEMENT “It really is trending upward,” he added. “We’ve been trending upward since the end of June. That indicates that viral activity is increasing.” Reported weekly COVID-19 infections, which do not include at-home test results, dropped to 44 on June 29, the lowest level since late March of 2020, when the pandemic started in North Dakota. Hospitalizations, a key indicator that is reliably reported, so far remain subdued. “Those hospitalizations are remaining low, and that’s encouraging,” Kruger said. North Dakota is unlikely to see another spike like the peak in late January of 2022 during the wave of cases from the Omicron variant, when reported cases reached an all-time high of 15,938 active infections, Kruger said. “We have a lot of protection in our population now that we didn’t have when this first emerged,” since many people have been vaccinated, infected or both, he said. Still, the virus continues to mutate into variants that spread more rapidly, and some people suffer severe illness, so people should not let down their guard, Kruger said. “This virus is still here and it’s still circulating now with severe illness for some,” he said. “So we don’t want to ignore this.” ADVERTISEMENT Infectious disease specialists at Essentia Health and Sanford Health in Fargo agreed the population has significant protection from prior vaccination or natural infection but caution that cases are likely to increase as people spend more time indoors in the fall and winter. “The peaks and troughs are significantly lower,” said Dr. Drubert Guerrero, an infectious disease specialist at Sanford. “At this time, there’s no reason to be alarmed.” In fall and winter, there likely will be a slight increase in COVID-19 infections, he said. Hospitalizations for COVID-19 have remained low at both Sanford and Essentia. Sanford no longer tracks COVID-19 hospital trends, and Dr. Bertha Ayi, an infectious disease specialist at Essentia, said COVID-19 hospitalizations are “remarkably down,” adding, “I haven’t seen a COVID case in months.” Generally, transmission levels are low in North Dakota, Ayi said. Looking ahead to fall and winter, “I’m optimistic that it won’t be a big issue,” she said. “But people should be sure to get vaccinated” and maintain good indoor ventilation whenever possible and take other precautions, such as wearing masks if risk levels are high. New vaccines formulated for the most prevalent strains now circulating are expected to be available in late September or early October, and people should get booster doses, Ayi, Guerrero and Kruger said. “It’s a good time to get updated this fall,” Guerrero said. “COVID is still here. It’s still causing a lot of illness, and there is some mortality associated with it.” ADVERTISEMENT Fortunately, vaccines and medicines, including antiviral medications, help reduce severe illness, he said, but people have to remain mindful that the coronavirus is circulating. “We now have to live in a post-pandemic environment,” and people must stay vigilant, Guerrero said. North Dakota health officials stopped monitoring coronavirus levels in municipal wastewater in December 2022, Kruger said. North Dakota’s health laboratory has the ability to do the analysis, and health officials are determining whether communities are interested in collecting samples. So far, no cities seem eager to participate. “There isn’t a lot of interest in COVID in general right now,” Kruger said.
The Michigan Department of Health and Human Services is appealing a federal court ruling over its infant blood sampling program. It’s been longstanding state practice to screen blood samples from newborn babies for various medical conditions. Last month, a federal district judge found the MDHHS may have violated the U.S. Constitution while storing and distributing some of those samples and related data without informed parental consent. The argument rested on Fourth and 14th Amendment claims dealing with illegal searches and seizures as well as and equal protection. The court ordered the department to give the plaintiffs the option of having the samples and data returned or destroyed or to provide informed consent. Now, the state health department and its sampling facilities are appealing that ruling—saying the state is committed to protecting “the health and well-being of all Michigan’s residents.”
Revised blood donation rules that do away with a rule that defers men who have sex with men (MSM) to abstain from sex for three months prior to donating blood are beginning to be implemented into blood banks throughout the country.
Mother Jones illustration; Getty Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters. Until last week, no study had ever been published that tested period products—tampons, pads, discs, cups, and underwear—using human blood. A team of four women just changed that. On August 7, Dr. Bethany Samuelson Bannow and a group at Oregon Health & Science University in Portland released a study to test saturation and capacity levels in menstrual products in hopes of better understanding how to diagnose heavy menstrual bleeding, or HMB, which impacts millions of Americans. Why had it taken so long to test a product made to contain human blood with human blood? “I think with women’s health, including menstrual health, we’ve been a little bit behind the eight ball,” Dr. Bannow told me. “They didn’t even require women to be included in NIH studies until 1993. I think that that’s telling of what we prioritize as a society.” Providers trying to diagnose HMB depend on self-reporting, which can be subjective with people falling prey to myths and miseducation. A patient experiencing pain, fatigue, or other related symptoms will come in and ask: Is this normal? To tell if the bleeding is excessive, doctors try to ascertain how many period products are used per hour. But measurement is imperfect. Menstruators change out products for tons of reasons; and products may claim they can sustain a certain amount of “flow,” but their actual capacity is different. That is what Dr. Bannow hoped to make clear in her testing. The team took 21 different products and saturated or filled them with expired human-packed red blood cells. This isn’t an exact match to menstrual blood—which has clots and secretions—but it’s a lot closer than salty water. In their research, they found that how the companies were labeling the boxes did not match up with their results. The majority of menstrual products reported that they had greater capacity than the testing found. “[There is a] disconnect between who’s making the products and what their goals are, and those of us who are using them as a diagnostic method,” said Dr. Bannow, a hematologist who works with HMB patients, “I think [that] plays a role” in this being the first study to use human blood. Dr. Bannow and I spoke about their research, its implications, and how the stigma about period blood continues to stifle care. Could you tell me a bit about how you learned or found out that no studies testing period products with human blood had been published? In anticipation of another study, we did a little bit of a deep dive into the literature trying to figure out how much different period products should absorb. And that’s when I learned about The Tampon Task Force from the 80s. [Editor’s note: At the request of the Food and Drug Administration, industry leaders and other stakeholders convened as part of The Tampon Task Force in 1982 to create standardization across their products.] The FDA and The Tampon Task Force really set the standard of saline being the liquid used to test menstrual products. We really couldn’t find anything in the literature about using blood. A researcher named Nancy Reame reportedly tried heparinized blood, but the data wasn’t ever published. That’s when we sort of realized that this is an important frame that’s missing! How has the diagnosis and treatment process been complicated in the past by different understandings of absorption and saturation of period products? So there are two main sets of objective criteria that we can consider using for diagnosing heavy menstrual bleeding. The first is a great tool called the pictorial blood loss assessment chart, or PBAC, which has folks document their pads and tampons used over a cycle and how saturated they are. And then the other is just taking an in-office history, which also relies on pads and tampons. Typically, anybody who changes a pad or tampon more often than every two hours probably has HMB. But it’s all dependent on pads and tampons. This testing is all multiple decades old. Modern technology is so much better. I think we’ve been grossly underestimating HMB based on these old data and methods. It’s remarkable that there’s no across-the-board standard for these products. At the same time, it seems like these companies were misrepresenting the absorption or saturation levels. Is that what you all found? I wouldn’t go so far as to say they’re misrepresenting. We found something different than they did when using a different substance than they did. If I was testing somebody for diabetes, I have instruments in a lab, or in my office, that are standardized. When it comes to periods, we’re dependent on using these products that weren’t created with the goal of diagnosing HMB in mind. They’re created to help somebody who’s menstruating manage their periods. I think the bottom line isn’t so much that companies need to standardize things as we need to be aware as physicians and other health care providers just how much these products can hold. My friends are talking about switching from tampons and pads to alternative products like cups and discs. You note in the study that you’ve seen this as well in practice. Yes! What do you think this shift will mean for the diagnosis and treatment of HMB and other conditions? Honestly, I think it’s gonna be better. The menstrual cups report the volume that it takes to fill them. The volume is the volume is the volume. I think it actually has the potential to make things a lot easier and more straightforward. A lot of the language that we use around menstrual bleeding is really vague. Even on these products’ websites, it’s talking about if your flow is light or medium. As a menstruator, I don’t really know what that means. Have you seen this vague language with your patients? It’s very vague, and it’s also very subjective. For example, I’ll have