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November 16, 2021

Long COVID may affect how women recover from exercise

woman exercising in the sunset — New research explores the link between long COVID and women’s ability to exercise. Artur Widak/NurPhoto via Getty Images

Long COVID or post-acute COVID syndrome is characterized by a multitude of symptoms that persist beyond the acute phase of 3–4 weeks after getting the SARS-CoV-2 virus.
Women hospitalized with COVID-19 are more likely to experience persistent deficits in cardiovascular and lung function than men in the months following discharge.
A new study found that even women with mild-to-moderate COVID-19 may experience slower declines in their resting heart rate after physical activity in the post-acute phase of the SARS-CoV-2 infection.
Such deficits in cardiovascular function during exercise are associated with reduced capacity for physical exercise and, potentially, activities of daily life.
Women presenting with specific long COVID symptoms, namely shortness of breath or joint or muscle aches, were also more limited in their ability to do a walking test than people who had had a SARS-CoV-2 infection but experienced no lingering symptoms.

Although the majority of individuals recover within the first 3–4 weeks after contracting COVID-19, a considerable number continue to experience lingering symptoms for weeks or months after this initial or acute phase of the disease.

These symptoms, which people refer to collectively as long COVID or post-acute COVID-19, include shortness of breath, loss of smell and taste, brain fog, headaches, and fatigue.

Studies have shown that more than half of the individuals hospitalized with COVID-19 during the initial phase of the SARS-CoV-2 infection show persistent impairments in cardiovascular and lung function several months after discharge. Furthermore, women hospitalized with severe COVID-19 are more likely than men to present with such persistent deficits in cardiovascular and lung function after discharge.

Individuals may present with persistent symptoms during the post-acute phase of COVID-19, regardless of the severity of symptoms during the acute phase of the illness. The effects of mild-to-moderate COVID-19 on lung and cardiovascular function and, subsequently, on daily physical functioning during the post-acute phase is not well-understood.

Researchers at Indiana University, Bloomington, recently examined how mild-to-moderate COVID-19 affected exercise capacity or tolerance during the post-acute phase in women. Exercise tolerance or capacity refers to the ability of an individual’s cardiovascular system to sustain physical activity.

The researchers used an exercise test called the 6-minute walk test to assess the persistent effects of SARS-CoV-2 infection on cardiovascular function in women during the post-acute phase of the infection.

They found that women with COVID-19 who had mild-to-moderate illness during the acute phase showed a slower decline in their heart rate after the 6-minute walk test than the participants in the control group. This difference was more pronounced in women actively experiencing long COVID symptoms.

However, encouragingly, they found no statistically significant differences in a range of other measures, including pre- and post-test oxygen saturations, pre- and post-test heart rate, ratings of perceived exertion, and ratings of perceived breathlessness.

The study’s lead author, Dr. Stephen Carter, a professor at Indiana University, told Medical News Today: “A puzzling feature of post-acute COVID-19 syndrome is the variable presentation of symptoms that appear to be independent of initial illness severity. The present work shows even those with mild-to-moderate initial symptoms can be affected with underlying cardiac-related irregularities with the potential to affect exercise tolerance and/or activities of daily living.”

“It’s also plausible that lingering symptoms, particularly muscle/joint pain and/or shortness of breath, may trigger a maladaptive pattern that accelerates systemic deconditioning. However, further research is needed.”

Dr. Ziyad Al-Aly, chief of research and education service at Veterans Affairs St. Louis Health Care System, also spoke with MNT. Dr. Al-Aly, who was not involved with the study, said, “Studies like this are important to help us understand why some people with long COVID experience profound exertional fatigue that may limit their ability to exercise and their ability to carry out activities of daily living.”

The study appears in the journal Experimental Physiology.

The study included 29 women who had experienced mild or moderate illness due to COVID-19. These women had received a positive SARS-CoV-2 diagnosis at least 4 weeks prior to the study, with the average time of diagnosis being 94 days before the study. The control group consisted of 16 women who had never tested positive for a SARS-CoV-2 infection.

Out of the 29 participants in the test group, 17 women reported experiencing at least one long COVID symptom at the time of the study. These long COVID symptoms included shortness of breath, fatigue, cough, muscle or joint pain, loss of smell or taste, and skin irritation.

The researchers administered pulmonary function tests to assess various aspects of lung function. They found that the women who had tested positive for SARS-CoV-2 exhibited reduced total lung capacity compared with those in the control group.

The researchers then evaluated changes in cardiovascular function during and after the 6-minute walk test. The test measures the distance that participants walk in 6 minutes at their normal pace, and researchers use it to assess exercise tolerance. The team adjusted the results for age, sex, and body mass index (BMI) to prevent these variables from influencing the test results.

There was no significant difference between the distances that the two groups covered during the test.

However, women with SARS-CoV-2 who experienced shortness of breath or joint or muscle pain had a lower adjusted distance value than those with SARS-CoV-2 who did not experience these long COVID symptoms.

The researchers assessed the blood pressure, heart rate, and blood oxygen or oxygen saturation levels before and immediately after the 6-minute walk test. They calculated the heart rate response during exercise by subtracting the heart rate at rest from the heart rate after the completion of the test.

The heart rate response during exercise is a measure of cardiovascular function, with a lower heart rate response being a predictor of reduced exercise capacity and cardiovascular disease-associated mortality.

The women in the SARS-CoV-2 group showed a lower heart rate response than those in the control group.

Moreover, the participants in the SARS-CoV-2 group who reported shortness of breath as a long COVID symptom at the time of the study had a lower heart rate response during the test than those in the SARS-CoV-2 group who did not have this symptom.

The researchers also measured heart rate recovery, which is another indicator of cardiovascular health and all-cause mortality.

Heart rate tends to drop immediately after strenuous exercise. Heart rate recovery measures the decrease in heart rate after the cessation of exercise. Specifically, heart rate recovery quantifies the decrease in heart rate at a predefined time interval — generally 1 minute — from the end of the physical activity.

In the current study, the researchers measured the participants’ heart rate at the end of each minute during the 5-minute recovery period after the 6-minute walk test.

The SARS-CoV-2 group participants showed a less significant decrease in heart rate at 1 minute after the completion of the test than those in the control group. This suggests that the decline in heart rate occurred more gradually in the women in the SARS-CoV-2 group. Such a delay in heart rate recovery is associated with reduced exercise capacity.

Furthermore, women in the SARS-CoV-2 group who exhibited specific long COVID symptoms at the time of the study had decreased heart rate recovery compared with the SARS-CoV-2 group participants without these symptoms.

Specifically, women in the SARS-CoV-2 group with symptoms such as fatigue, loss of taste or smell, joint and muscle aches, or shortness of breath had decreased heart rate recovery compared with women who had not had SARS-CoV-2.

“A lot of long COVID-19 patients are placed into rehabilitation programs that are designed for non-COVID-19 patients. These programs may not be suitable for long COVID patients. It is important to understand that people with long COVID need programs designed for them (pacing, etc.). Findings from this study and others should be taken into account when designing rehabilitation programs for people with long COVID,” said Dr. Al-Aly.

Dr. Carter noted: “SARS-CoV-2 participants and [people without the infection] were matched for age, BMI, smoking status, and history of cardiopulmonary disease. As such, we have better assurance that reported differences were attributed to SARS-CoV-2, as opposed to another comorbidity.”

“A strength of the work is that comparisons were performed among women — who appear to be susceptible to persistent SARS-CoV-2-related symptoms — during and following a 6-minute walk test.”

Dr. Carter acknowledged that the study had a few limitations. He said: “Indeed, the 6-minute walk test is a widely used clinical tool that offers insight into exercise capacity and walking autonomy. However, it should be noted we cannot disregard the possibility of undiagnosed pulmonary abnormalities and/or autonomic dysfunction that existed prior to a SARS-CoV-2 infection. Additionally, it is conceivable some controls may have had an asymptomatic SARS-CoV-2 infection and/or a previous false-negative diagnostic test for SARS-CoV-2.”

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

November 16, 2021

Princess Diana’s ‘royal rebel’ wardrobe inspires designers today, model claims

Princess Diana’s ‘rebellious’ sense of trend continue to conjures up large-finish fashion designers today, a product and activist has claimed.

Talking in Channel 4’s Diana: Queen of Design, which airs tonight at 10pm, British model Leomie Anderson says the late royal, who died in 1997, conveyed a ‘chic’ sense of insurrection in her outfits that designers even now check out to emulate.

‘I assume Diana evokes a ton of large manner designers, due to the fact she was observed as the royal rebel,’ Leomie suggests. ‘And I really feel which is an electricity that a lot of designers consider and capture in their personal collection.’

‘I come to feel that when folks are referencing Diana, they are trying to seize that stylish, couture ingredient, but with a rebellious touch.’

In the meantime, sesigner Jacque Azagury, who dressed Diana on various situations, notes how the late royal wore short, revealing attire – this kind of as the 1 she famously donned through a check out to the Serpentine Gallery in June 1994 or the blue ensemble she wore at the Royal Albert Corridor in June 1997 – to exhibit she was a ‘free woman.’

Channel 4’s Diana: Queen of Design and style, which airs tonight at 10pm, explores how Princess Diana’s wardrobe even now influences fashion right now. Pictured: The royal in the Christina Stambolian black gown that is now referred to as the ‘revenge gown,’ in June 1994 at the Serpentine Gallery, London

The documentary explores how the late Princess of Wales’ wardrobe and feeling of style have stood the take a look at of time and are nevertheless well-known with the community 24 years soon after her demise.

Somewhere else, trend author Justine Picardie statements Princess Diana’s clothes helped her to join with the public – including that the personalized way in which she utilized her wardrobe to connect will appeal to potential generations to appear.

‘Every generation will return to Diana because every single generation understands the cloth of lifestyle, the material of appreciate and decline,’ she clarifies.

‘And it’s that we recognise in Diana’s wardrobe, what we are recognising is anything that demonstrates in ourselves: in our have pleasure, our own sorrows, our have grief, our possess joy, our personal losses, that is there, in the cloth of her clothes.’

But in accordance to Elizbeth Emanuel, who famously created Diana’s wedding ceremony costume, the royal was not often clued up on the power clothes could have.

Pictured: Princess Diana in a light blue costume intended by Jacques Azagury, which she wore to attend a performance of ‘Swan Lake’ by the English Countrywide Ballet at the Royal Albert Corridor in June 1997

The royal was not normally clued up on the electricity of clothes, but was stylish even as a shy newcomer. Pictured in her famous sheep sweater from 1980

‘In the commencing, when we very first met Diana, I do not assume she thought a lot about manner,’ she describes. ‘I imagine she appreciated sporting clothes but under no circumstances considered it by way of on the kind of stuff that would be suitable for her to put on. And we have been incredibly young of course and it was all new to us as nicely.’

She suggests this shifted when the Princess – who was just 19 at the time and had just received engaged to the heir-to-the-throne Prince Charles – wore a black taffetas gown with a revealing neckline for an night at the Royal Opera Household in 1981.

‘We occurred to have this black gown that was hanging on the rail which was a sample but she loved it, she tried it on and we all assumed “wow, she seems to be good in it”, Elizabeth recalls. ‘But we did not know at the time that black was not a great colour to wear because it is really ordinarily reserved for funerals.

‘But it was also quite low-slash, and when she wore that gown, most people just went ridiculous. It was a controversial outfit. It centered the eyes of all the fashion journalists at the time.’

The dress is nowadays found as the second Diana went from a shy newcomer to a manner powerhouse.

‘I consider that from that stage on, she realised the electrical power of the vocabulary of clothing and as several years went by she employed that. She understood it could seriously create an impact,’ Elizabeth notes.

Justine also explains how the late royal often employed her clothing to covey a message.

‘In the early 80s, we even now lived in a sexist society and women like Diana had been observed but not listened to,’ she states. ‘Clothes have been her way of speaking with the globe.’

She provides Princess Diana’s wardrobe was what manufactured her relatable, prior to the facts of her unhappy relationship to Prince Charles came to light-weight.

‘I feel that Diana is the People’s Princess, the female that folks sense they know her as if she is their good friend, their sister, their mother, really attained construction in that Australia tour,’ Justine claims. ‘That will have to come down in aspect to her outfits. Mainly because at that level, no person understood that her relationship was in hassle.’

British design Leomie Anderson, pictured in 2020, says Diana’s rebellious flair conjures up style designers to this day

‘So it wasn’t as if you could relate to Diana as someone that was struggling heartbreak.’

Author Banseka Kayembe agrees: ‘I assume basically, her garments is a way to have a voice in a media landscape that doesn’t like to give women of all ages voices and won’t like to give women any type of autonomy about their own narrative and their tale.’

Right after her separation from Prince Charles in 1992, Princess Diana arrived out with an emboldened wardrobe.

Her pay a visit to to the Serpentine Gallery in June 1994 on the night exactly where Prince Charles and Camilla Parker-Bowles’ affair came to gentle – now the Duchess of Cornwall – is even now talked about.

For the celebration she donned a revealing dress by Christina Stambolian which is even now spilling ink nowadays.

The style, which was a black fitted off-the-shoulder gown with a short hemline, was dubbed the ‘Revenge Dress’ and even has its very personal Wikipedia website page.

Designer Jacques Azagurdy, who created gowns for Diana in the 1990s, testified of the Princess’s wish to costume in revealing outfits more generally.

Pictured: Diana, then 19, leading to a commotion in a black taffetas dress made by the Emanuels for an night at thw Royal Opera Dwelling in 1981, which made her realise the result style can have on individuals

He discusses a blue diamond costume he created for her, which she wore at a functionality of Swan Lake at the Royal Albert Corridor in June 1997.

‘This is probably one of the renowned dresses that the princess wore,’ he suggests. ‘You’ll discover how shorter it is and the princess was 5ft 10 in flat ft, so there was not much costume and there was a large amount of the Princess,’ he jokes.

Pointing to the dress’ cleavage and hemline, he provides: ‘It was quite reduced right here and, really significant there. She really preferred it a bit shorter than this.’

‘At the time she genuinely preferred to set the information throughout that yes, she was a absolutely free woman finally and pretty self-confident in herself and higher than all, incredibly joyful in herself,.’

Diana: Queen of Design, airs tonight at 10pm on Channel 4.

November 16, 2021

Business news live – The Hindu

4:06 P.M.

Rupee gains 9 paise to end at 74.37 against US dollar

The rupee settled 9 paise higher at 74.37 against the US dollar on Tuesday despite a lacklustre trend in the domestic equity market. It closed at 74.46 in the previous session.

4:02 P.M.

Sensex tumbles 396 pts, Nifty slips below 18,000

Sensex tanked 396 points on Tuesday tracking losses in Reliance Industries, ICICI Bank and SBI amid a mixed trend in global markets.

The 30-share index ended 0.65{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} lower at 60,322.37. The Nifty fell 0.61{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} to 17,999.20.

Reliance Industries was the top loser in the Sensex pack, followed by SBI, UltraTech Cement, IndusInd Bank, NTPC and Sun Pharma. On the other hand, Maruti, M&M, Tech Mahindra, Bajaj Finance, Infosys and Bajaj Finserv were among the gainers.

3:55 P.M.

Hero Electric ties up with Charzer to install charging stations

Hero Electric on Tuesday said it has joined hands with Bengaluru-based EV charging startup Charzer to install 1 lakh charging stations across the country over the next three years.

As part of the partnership, Charzer will install 10,000 charging stations across the top 30 cities.

3:52 P.M.

Significant percentage of borrowers prefer online mode for securing loan: Survey

A significant percentage of borrowers led by millennials, prefer online mode to secure loans rather than traditional offline channels, indicating an increase in digital penetration during the COVID-19 period, says a survey.

The duration post the second wave of COVID-19 pandemic, shows a positive consumer borrowing trend reflecting a return to normalcy as consumer sentiments are positive about economic revival, according to an annual survey ‘How India Borrows’ (HIB) conducted by financial firm Home Credit India.

3:45 P.M.

Housing prices may rise 10 to 15{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} if rates of raw material not controlled: CREDAI

Realtors’ apex body CREDAI on Tuesday expressed concern over an increase in the rates of cement and steel during the past one year and predicts housing prices to rise 10 to 15{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} if the cost of raw materials do not fall.

The industry body urged the government to take measures to control the prices and suggested reduction in GST for construction raw materials.

3:41 P.M.

Edible oils import rises 63{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} ₹ to 1.17 lakh crore in 2020-21

India’s import of edible oil remained almost flat at 131.3 lakh tonnes during the 2020-21 marketing year ending October, but in value terms inwards shipments rose 63 per cent to ₹1.17 lakh crore, according to industry data.

Import of edible oil gone up to ₹1,17,000 crore in 2021-21 from ₹71,625 crore in 2019-20, said Solvent Extractors’ Association of India (SEA).

2:40 P.M.

Asian countries on strong economic growth: GAR Corp

Global companies are eager to work in countries like India and Asian countries are going to see an increase in office space demand on the back of strong economic growth, said Abhinav Reddy, managing director of GAR Corp, a Hyderabad-based real esate company.

More and more companies are looking to work in India, especially in the digitalisation space, he said in an international conference in Singapore on Monday.

2:34 P.M.

India received record FDI in last seven years: Goyal

India attracted “record” foreign direct investments in the last seven years and the trend is expected to continue in the coming years on account of major structural reforms being undertaken by the government, Commerce and Industry Minister Piyush Goyal said on Tuesday.

He also said that India is focusing on integrating its quality standards with the world and the nation needs to let go of the mindset of a particular product being for the domestic market and others for the export market.

2:13 P.M.

Kotak Mahindra Bank, PVR launch co-branded debit card

Kotak Mahindra Bank and multiplex chain operator PVR on Tuesday launched a co-branded debit card, claiming to be the first ones to offer such a product in the movie and entertainment genre.

Customers will earn reward points on all spends on the debit cards, including 10 reward points for every ₹100 spent at PVR Cinemas and 0.50 reward points for every ₹100 spent on all other transactions, with one reward point equivalent to ₹1.

“We cater to about 100 million people coming into the cinemas. Our core audience is between 14 and say about 35 (years of age) and a debit proposition would work brilliantly because a lot of people, consumers in India do not qualify for a credit card,” said PVR CEO Gautam Dutta.

2:04 P.M.

World’s largest spirits maker Diageo forecasts 5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}-7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} sales growth for fiscal 2023-25

Diageo expects organic sales growth to be between 5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} and 7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} for fiscal 2023-2025, compared with the 4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} to 6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} growth during 2017-2019.

The Johnnie Walker whisky maker, expects organic net sales growth of at least 16{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} in the first half of fiscal 2022.

1:53 P.M.

Kia plans to expand product range in India; to drive in new model next year

Automaker Kia India is looking to strengthen its product portfolio as it gears up to introduce a new model in the country in the first quarter of next year. The company, which currently sells three products in India, Seltos, Sonet and Carnival, is all set to unveil its fourth model.

“We are happy to announce that Kia India will introduce its new product ‘KY’ in Q1 of 2022,” said Tae-Jin Park, Kia India MD and CEO.

1:02 P.M.

Vodafone raises free cash flow guidance

Vodafone raised its forecast for this year’s free cash flow to at least 5.3 billion euros from at least 5.2 billion after it reported 6.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} growth in adjusted core earnings in its first half.

The British company raised the floor of its full-year earnings guidance to 15.2 billion from 15.0 billion euros, with the top remaining at 15.4 billion.

12:53 P.M.

Chinese Yuan hits 5-month high; dollar near 16-month peak

The yuan touched a five-month peak in Asia as traders welcomed dialogue between the U.S.-China talks, while the dollar held near a 16-month high against the euro ahead of U.S. retail sales data that could give signs of any impact inflation has had on consumer spending.

12:44 P.M.

Real estate firm Macrotech raises $541 million

Indian real estate firm Macrotech Developers, formerly known as Lodha Developers, has raised ₹40.28 billion ($540.71 million) through issue of 34 million shares via a qualified institutional placement.

The company set a floor price for the issue at ₹1,184.70 per share, a 7.8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} discount to its closing price on Monday. Since listing, shares have rallied over 188{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

12:16 P.M.

Bitcoin drops more than 4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}

Bitcoin dropped over 4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} to $60,350 as it extended a decline through a week that also included an upgrade to its blockchain.

The world’s biggest cryptocurrency’s value has more than doubled since June. It hit an all-time high following the launch of the first U.S. bitcoin futures exchange-traded fund.

Ether, the second-biggest cryptocurrency by market value, was down 4.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} at $4,355.4.

11:58 A.M.

Saudi sovereign wealth fund nearly triples U.S. stock holdings

Saudi Arabia’s sovereign wealth fund has almost tripled its holdings of U.S.-listed stocks to $43.45 billion in the third quarter from nearly $16 billion in the previous quarter.

The Public Investment Fund, which manages $430 billion in assets, is at the centre of Saudi Arabia’s plans to transform the economy by creating new sectors and diversifying revenues away from oil. It added shares of Alibaba Group, Walmart, Pinterest, among others in the quarter.

11:40 A.M.

Goods trade slowing due to supply issues, cooler demand: WTO

Following its sharp rebound from the initial shock of the COVID-19 pandemic, global merchandise trade is slowing, with production and supply disruptions in critical sectors dampening growth alongside cooling import demand, the World Trade Organization said.

The WTO noted its goods trade barometer dropped to 99.5 points, close to the baseline of 100, in November following a record reading of 110.4 in August.

“Cooling import demand could help ease port congestion, but backlogs and delays are unlikely to be eliminated as long as container throughput remains at or near record levels,” the WTO said.

11:15 A.M.

Evergrande effect | Shares of Kaisa unit plunge

Shares of Kaisa Prosperity, a property services unit of Chinese developer Kaisa Group, plunged 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} as trading resumed a day after the company said its parent’s liquidity issues would not impact operations.

Kaisa Group has the most offshore debt of any Chinese developer after China Evergrande Group. Kaisa Group’s trading remains suspended.

11:05 A.M.

Oil prices bounce back

Oil prices bounced back after dropping earlier in the session as worries over tight inventories underpinned prices. Brent futures gained 0.74{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, to $82.66 a barrel, while U.S. WTI crude climbed 0.67{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, to $81.42 a barrel.

10:40 A.M.

Rupee slips against U.S. dollar

The Indian rupee depreciated against the U.S. dollar. The domestic unit opened on a weak note at 74.49, then lost further ground and touched 74.53 against the greenback in initial deals, registering a decline of 7 paise from the last close. The Indian currency was weighed down by a lacklustre trend in the domestic equity market and firm American dollar.

9:25 A.M.

Markets update

Indian indices opened flat amid mixed global cues. The Sensex opened at 60,755.38 up 36.67 points after ending marginally higher in the previous session. Similarly, the Nifty opened at 18,127.05, up 17.6 points.

Major Asian share indices edged higher as relief in China’s property sector supported investor sentiment. Chinese blue chips rose 0.4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} and Hong Kong’s Hang Seng added 0.7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

MSCI’s broadest index of Asia-Pacific shares outside Japan rose 0.27{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} to a 2-1/2 week high. Japan’s Nikkei gained 0.22{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} and Topix added 0.38{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} in the morning trade. South Korea’s Kospi rose 0.12{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

In U.S., the Dow Jones Industrial Average fell 12.86 points, or 0.04{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, to 36,087.45, the S&P 500 lost 0.05 point, or flat, to 4,682.80 and the Nasdaq Composite dropped 7.11 points, or 0.04{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, to 15,853.85.

—- Edited by John Xavier

(With inputs from Reuters, PTI and other news agencies.)

November 16, 2021

Xbox Game Pass is Losing 6 Games Today

While new games are added to Xbox Game Pass regularly, Microsoft also removes games from the service as well, giving six titles the boot today.

Microsoft makes sure that it’s always adding more games to its Xbox Game Pass subscription service than it’s removing, but games still leave the service sometimes regardless. Generally, Xbox Game Pass games leave at the middle of the month and the end of the month, and since today is November 15, six games are being removed from Xbox Game Pass. Anyone interested in the games has until November 16 to play them, and they can also purchase them at a discount for a limited time.

Whenever Microsoft removes games from Xbox Game Pass, it gives subscribers the opportunity to purchase the games at a discount. So right now any Xbox Game Pass subscriber could purchase the games that are leaving for 20{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} less than their usual asking price, just in case they didn’t have time to finish them while they were available on the service.

GAMERANT VIDEO OF THE DAY

RELATED: Xbox Game Pass Adding Evo One Next Week

The six Xbox Game Pass games leaving on November 15, 2021 are headlined by Final Fantasy 8 Remastered, the enhanced version of the PS1 JRPG classic. Final Fantasy 8 Remastered brings the original game to modern consoles with some huge quality of life improvements, such as the ability to speed up the gameplay so that players can get through grindier sections at a much faster rate than they could before.

Xbox Game Pass Games Leaving November 2021

Final Fantasy 8 Remastered
Planet Coaster: Console Edition
Star Renegades
Streets of Rogue
River City Girls
The Gardens Between

Another notable game leaving Xbox Game Pass on November 15 is Planet Coaster: Console Edition. While theme park simulation games may be relatively niche, Planet Coaster: Console Edition earned mostly positive reviews at the time of its release and is generally considered one of the better games in the genre. Other titles being removed on November 15 include Star Renegades, Streets of Rogue, River City Girls, and The Gardens Between.

Even more games will be leaving Xbox Game Pass at the end of the month, though Microsoft not revealed what they are at the time of this writing. However, it has touched on some of the games that will be added to the service in the second half of November 2021. For example, UnDungeon and Evil Genius 2: World Domination are coming on November 18 and November 30, respectively.

Looking ahead, there’s even more for Xbox Game Pass subscribers to look forward to in December, with Among Us coming to Xbox Game Pass on December 14 and of course, Halo Infinite dropping on December 8.

MORE: The Best Games On Xbox Game Pass (November 2021)

Fortnite Reveals X-Men Dark Phoenix Marvel Skin

Continuing its trend of adding comic book characters, Fortnite reveals the latest Marvel addition of Dark Phoenix from X-Men.

Tesla beats Mercedes for No. 3 spot in U.S. luxury registrations through Sept.

Tesla has passed Mercedes-Benz for the No. 3 place in luxury-auto registrations this yr by means of September, according to knowledge from Experian.

The electric automobile maker appears to have ample momentum to close the gap with No. 2 Lexus and U.S. luxury chief BMW before the calendar year is in excess of.

Tesla totaled 230,855 motor vehicle registrations by the to start with a few quarters of the yr, passing Mercedes with 213,708, Experian facts showed. Lexus was in next spot with 245,864 and BMW was primary the market with 259,237 in the 9-month period of time.

In very last month’s Experian report evaluating registrations via August, Mercedes was still in 3rd spot but Tesla was surging. This month’s report exhibits that Tesla gross sales rose 76 {cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} in contrast with the January-September interval final year, while Lexus is up 33 per cent and BMW 36 p.c.

The California automaker’s remarkable rise will come amid a chip shortage that has released supply constraints into the struggle for luxury consumers. Tesla has been in a position to temperature the semiconductor lack improved than some rivals, partly by employing application for capabilities previously controlled by chips.

“It may well be a little bit early to say Tesla is surpassing Mercedes in sales completely, but the point that it is really managed to do so with a significantly far more constrained product or service line is impressive,” mentioned Jessica Caldwell, executive director of insights at Edmunds. She also claimed Mercedes has been struggling commonly with customers.

“Presented where by we are with the chip lack, it is likely untimely to make any sweeping extended-phrase declarations as automakers are grappling with various levels of problems, but it does present the power of Tesla,” Caldwell explained.

Tesla is also making ready to open up its 2nd U.S. manufacturing unit in the vicinity of Austin, Texas, and is expanding its operations in California, according to CEO Elon Musk.

In addition to its present lineup of two sedans and two crossovers, Tesla strategies to start the Cybertruck pickup next 12 months from the Texas plant, with a huge backlog of pre-orders. Musk has reported source is the trouble, not desire.

Tesla has also been steadily increasing rates, frequently sharply and abruptly. Rivals, way too, have been charging much more for their motor vehicles at the supplier amount, with substantially higher transaction costs than very last year since of provide constraints.

Caldwell reported Tesla’s red-warm streak may perhaps not final eternally, but that the EV maker evidently has momentum in contrast with legacy rivals as consumer tastes change.

“Tesla will sooner or later eliminate some of its cachet no brand name can be the ‘it brand’ endlessly,” Caldwell reported in an e mail to Automotive News.

November 15, 2021

How insulin has changed diabetes care, 100 years on

This November, we celebrate 100 years since the discovery of insulin, the hormone that provides the key to understanding and treating diabetes. In this Special Feature and podcast, we look at how far insulin research has come, and we consider what its future may hold.

Insulin is the hormone that helps regulate blood sugar levels, keeping them at healthy concentrations. The pancreas is the organ that produces this hormone, which is normally released in quantities dependent on the levels of blood sugar present in the system at any one time.

People whose bodies are unable to regulate blood sugar levels have diabetes mellitus, which can be of two types, depending on why this regulation does not occur.

In type 1 diabetes, the body does not produce insulin, while in type 2 diabetes, it does not respond to the insulin produced and released by the pancreas.

Around the world, hundreds of millions of people live with a form of this chronic condition, and insulin treatments are key to its management, particularly to the extent that type 1 diabetes is concerned.

People with type 1 diabetes must take insulin, as their bodies do not produce it. Individuals with type 2 diabetes control their blood sugar levels typically through special medication and dietary and lifestyle interventions.

However, some may also require insulin treatment if the cells that produce insulin — called pancreatic beta cells — deteriorate in time and stop producing sufficient insulin.

In this Special Feature and associated “In Conversation” podcast, we offer an overview of the importance of insulin, its history, and what future research likely holds for insulin therapy and the management of diabetes.

To find out more about the impact of type 1 diabetes and the challenges of using insulin, we spoke to Virginie, a woman who received a diagnosis for this condition in her 30s.

For insights into current insulin research and potential future developments, we interviewed Dr. Thomas Barber, honorary consultant endocrinologist and assistant professor at the Warwick Medical School in the United Kingdom.

Diabetes was known — as a collection of symptoms — over 3,500 years ago, as a papyrus dating from 1550 before the common era (BCE) was already describing a condition consistent with the symptoms of diabetes.

Even though physicians have encountered and treated diabetes throughout history, researchers only discovered the reason behind it around 100 years ago: insulin, the hormone that regulates blood sugar levels.

In 1889, Joseph von Mering and Oskar Minkowski, two researchers at the University of Strasbourg in France, removed the pancreases of dogs and found that the animals would then go on to develop diabetes.

As we now know, the pancreas is the organ that produces insulin. However, von Mering and Minkowski were not able to establish this connection at the time.

It was a little over 30 years later, in 1921, that Sir Frederick Banting and Charles Best — working in the laboratory of John Macleod — from the University of Toronto in Canada extracted insulin from the hormone-producing cells found in the pancreases of healthy dogs.

They then injected dogs with diabetes with this “extract” and thereby made the discovery that changed the face of type 1 diabetes treatment forever.

In 1922, Banting and Best treated a young boy with type 1 diabetes by injecting him with insulin. This saved his life — at the time, type 1 diabetes became a terminal illness more often than not — and cemented the importance of the researchers’ discovery.

Banting and Macleod won the Nobel prize in medicine “for the discovery of insulin” in 1923.

In 1946, researchers discovered intermediate-acting insulin, also known as Neutral Protamine Hagedorn (NPH) insulin, which persists in the body for 14–24 hours, which means that people who take it require fewer injections. This is still one of the most widely used types of insulin to this day.

At present, however, NPH insulin is no longer extracted from animal sources. Instead, researchers synthesize artificial human NPH insulin in the lab.

At present, there are several different types of therapeutic insulin, and people may have taken one or several of these, depending on their individual needs.

These types are:

fast-acting insulin, which starts to take effect around 15 minutes after entering the body
short-acting or regular insulin, which takes effect around 30 minutes after entering the body
intermediate-acting insulin, which starts to work 2–4 hours after entering the body
long-acting insulin, which starts to work several hours after entering the body and has a longer effect

Depending on their needs and what is accessible to them, people may receive therapeutic insulin through:

syringe injections, the traditional delivery method
an insulin pen, which also injects insulin but is easier to use than a syringe
an insulin pump, which automates the process of insulin delivery throughout 14 hours

While the subcutaneous delivery of insulin may make it harder for some people to adhere to the correct treatment regimen, other delivery methods have so far proved unsuccessful.

For example, in the 1990s, some companies have also developed and attempted to commercialize insulin inhalers, which would deliver the hormone in aerosolized form.

However, these never took off, most likely because they are less effective than delivering insulin subcutaneously, as some of the insulin gets lost in the process.

So what does the future hold for insulin research and therapy? In some ways, we could say, the future is now, as people are already using smartphone technology to assist them in adhering to their treatments and determining how much insulin they need to use.

Today, individuals use mHealth technology — referring to the practice of healthcare supported by mobile smart devices — to help them monitor their blood sugar levels, so they know how much insulin to take. Glucose monitors are currently available — these are small sensors placed under the skin that pick up on variations in blood sugar levels.

These connect to a smart device and allow the person to read their blood sugar levels at any time and share them with a doctor in real-time.

Some fully automated insulin delivery systems are also available. These are called “closed-loop insulin systems,” also known as “artificial pancreases.” They work by transmitting real-time blood sugar level data to a smart device that then communicates with a person’s insulin pump, regulating how much insulin enters the system at any one time.

However, some challenges remain that future developments need to address. These include insufficiently accurate glucose monitoring devices, as well as concerns regarding user data collection. Current closed-loop systems also rely on user control, while researchers are yet to develop fully independently running artificial pancreases.

Dr. Barber noted that independently functioning artificial pancreases are akin to the “Holy Grail” of diabetes therapy.

“There is some fascinating research to suggest that [the independent artificial pancreas] can be done,” Dr. Barber told us.

“It’s been shown that can actually reduce hypoglycemic rates by having that kind of technology in place. But we’re some way away from actually being able to have an artificial pancreas, which doesn’t rely on the patient at all. And really, […] I think it will come, but we’re not quite there yet.”

– Dr. Thomas Barber

Another pathway for future research is gene therapy that would trigger the expression of insulin-producing cells, thereby tackling the cause of type 1 diabetes at the root. The research so far, while it has garnered some interest, has been in animal models, and scientists are yet to take this to the next step: clinical trials in humans.

Finally, scientists are also looking at ways of developing better insulin, and several areas of investigation appear to hold promise.

One option is developing glucose-responsive or “smart” insulin. One of the main challenges in treating type 1 diabetes and severe type 2 diabetes remains administering insulin doses that accurately “match” blood sugar levels.

If blood sugar levels become or remain too high, a person can experience hyperglycemia. This, in turn, can lead to various complications in the long term, such as eye problems or diabetic ketoacidosis.

Yet if a person takes too much insulin, they can develop hypoglycemia, where their blood sugar levels are too low. Its symptoms can include heart palpitations, dizziness, and blurred vision. It can also lead to further complications, such as seizures and loss of consciousness.

Smart insulin would help address the risk of hyperglycemia and hypoglycemia by responding to changes in a person’s blood sugar levels in a way that would mimic healthy insulin function.

Eliminating or attenuating insulin fibrillation and aggregation — a process that renders insulin manufacturing more difficult — would make it easier to produce and store insulin.

Another area of development looks at ultrarapid insulin, which starts acting sooner after delivery. It helps improve the management of fast changes in blood sugar from before to after a meal — a process known as “postprandial glucose excursions.”

Another issue that needs addressing in the near future is the lack of accurate and consistent information regarding both insulin therapy and the unexpected factors that can influence a person’s blood sugar levels, besides diet.

Virginie, for instance, wondered how much researchers and clinicians know about the relationship between anxiety and blood sugar levels and how this might affect people with diabetes who require insulin therapy.

In answer to her question, Dr. Barber explained that “glucose control is far more complex than simply what [a person’s] levels of insulin are, and indeed how much insulin you inject.”

“There’s actually 101 things [that] can influence blood sugar levels. And in fact, one of those is mental and emotional status at the time. And if you’re worried, or stressed, or anxious, that in itself can actually push your blood sugar levels up, because it’s associated with the release of the stress hormone cortisol and also the sympathetic response as well, which is the fight or flight adrenaline release, both of which act to raise your blood sugar levels.”

– Dr. Thomas Barber

This is one of the many reasons why it is so important for doctors to listen closely to the experiences of people living with diabetes.

“[W]hen I’m seeing patients in clinic, I’m acutely aware of the fact that they have far more insight into their own diabetes than I do,” Dr. Barber noted. “They’ve been living with this [condition] day after day, hour after hour, week, months, years, sometimes even decades. And I think it’s really important that as healthcare professionals, we’re aware of this and we respect that.”

Virginie further noted that anxiety regarding insulin treatments can also affect those living with diabetes in another way. Often, those around her are anxious about how the condition affects her and whether she has been able to take the correct insulin dose at the correct time.

Diabetes can also take a heavy toll on the friends and families of those with this condition, she pointed out.

Dr. Barber acknowledged the real human impact of a diabetes diagnosis and the serious lifestyle adjustments that come with having to undergo insulin therapy.

One of these is the necessity of self-injecting insulin, which, he said, causes anxiety in many patients. “And understandably, because of all of these factors, there’s often quite a lot of resistance to the idea of going on to [insulin] therapy,” he admitted.

The solution? Empathetic sensitive, and mental health-aware care, according to Dr. Barber:

“There is a relative lack of proper psychology and talking-based therapies for patients with diabetes, and one almost feels as if there’s a need for these patients not just to have the standard education on diabetes, but to have the focused psychological support, which is really a separate thing from education. I think they should have, obviously, the two together, but the psychological support is often lacking. And I think that really is an unmet need. And I think it’s something we could certainly do a lot more on in the future.”

Perhaps the greatest challenge going forward, however, is ensuring equitable access to appropriate care and education for the management of diabetes.

While this condition is common worldwide, it does not affect everyone in the same way, and not everyone has timely access to diagnosis and care.

Black, Hispanic, and American Indian individuals have a higher likelihood of developing diabetes compared with people of other races and ethnicities.

Yet, people from these groups face the highest rate of disparities in access to appropriate healthcare, often due to systemic racism and socioeconomic factors.

To this day, Dr. Barber told us, lack of access to insulin remains the number one cause of death among children with type 1 diabetes worldwide:

“Did you know that globally, the most common cause of death for a child living with type 1 diabetes is actually [the] lack of access to insulin? That’s an incredible fact. It’s a tragic fact. And it’s actually quite shameful that after 100 years of having insulin, [which the World Health Organization (WHO) classes] as an essential medication, that children around the world with type 1 diabetes are dying because they don’t have access to this therapy. Something needs to be done.”

However, solving the issue of inequitable access to insulin therapy, glucose monitoring systems, and even basic education about diabetes is going to be no mean feat, according to Dr. Barber.

“[I]t’s a hugely complex issue,” he pointed out. “It’s not just the case of providing insulin, […] there [are the] huge complexities of […] infrastructure, data collection, [taking] cultural differences [into account] and so on.”

Some initiatives do exist to address these disparities. One example is the 100 Campaign, “which is aiming to improve the situation for patients around the world to have access to insulin,” Dr. Barber told us. However, we are still a long way away from solving this problem.

Virginie emphatically expressed a hope that going forward, healthcare decision-makers will work to improve access to care, health education, and diagnosis for people living with diabetes.

“I think it’s very important that […] we make sure we provide the access for all […] not just […] to insulin, but access to the diagnosis, and to actually think about our own assumptions [about diabetes],” she told us.

“Certainly, I didn’t know that thrush could be a symptom of diabetes. I also had a foot drop, which I didn’t know could be a symptom. I was thirsty all the time. [Before my diagnosis,] I was drinking more than 6 liters [of liquid] per day and only stopping because I knew 6 liters — that’s a lot. […] So my hope is that […] any sort of worry and concern is taken seriously. […] It has taken a while for me to get the diagnosis, and we’re only talking months. So I’m thinking about people who have to wait for years for [a] diagnosis. And I think it’s really important that […] we consider that as well.”

– Virginie