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Researchers Find More Than 1 Million Alternatives to DNA

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Life on Earth uses DNA and RNA to store and utilize genetic information, but what if there’s another way? A new analysis from researchers at Emory University and the Tokyo Institute of Technology suggests a plethora of molecules could serve the same basic task of organizing and storing genetic information. They estimate more than a million possible stand-ins for DNA, some of which could help us fight disease or help us know what to expect as we search for alien life. 

DNA (and RNA) consist of several components that make up the familiar double helix. There are the base pairs like adenine and guanine, a sugar (deoxyribose for DNA and ribose for RNA), and a phosphate group. The sugar and phosphate give nucleic acid an alternating sugar-phosphate backbone. We already know there are many alternatives to the five bases at work in DNA and RNA on Earth, but the new study looks at how the scaffolding of nucleic acid could vary. 

The team used a computer simulation to explore a so-called “chemical space” within certain constraints. To choose the constraints, the team had to distill what makes nucleic acid molecules distinct. They settled on organic molecules that can assemble into a linear polymer with at least two attachment points, plus a place for nitrogen bases to connect. The substructure of the molecule also needs to be stable in a polymer configuration. Since these molecules don’t contain the traditional sugars and phosphorus, you can’t call them DNA — they’re some other kind of nucleic acid with potentially similar properties. 

A few alternate nucleic acids.

The analysis points to more than 1,160,000 potential nucleic acid molecules. That number exceeded even the most extreme estimates beforehand, but researchers can now start looking at these molecules in a laboratory setting to see if they can work as a DNA alternative. The team says this shows evolution on Earth may have experimented with several different molecular designs for storing genetic information before DNA ultimately won out. 

Researchers around the world are working on therapeutic drugs that resemble nucleic acid, some of which could help combat viruses and cancer. A better understanding of these DNA alternatives could make those treatments more effective. And then there’s the importance to exobiology research. If we’re looking for evidence of extraterrestrial life, it might help to remember they could have genetic material using one of the other million possible molecules.

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Push on for fresh, local hospital food across Canada over ‘pitiful’ alternatives

Wild salmon with lemon dill sauce, blueberry soup and bone broth may be high-end restaurant meals but they’re also on the menu at some Canadian hospitals aiming to meet recovering patients’ nutritional and cultural needs.

The recipes are among dozens that have been developed by 26 people, including food-service managers, chefs and dieticians who were offered two-year fellowships at hospitals from British Columbia to Newfoundland and Labrador as part of a campaign called Nourish Health.

Its goal is to help create institutional policies through nourishing meals made from locally bought ingredients for patients who may have been accustomed to powdered mashed potatoes as a mainstay of “hospital food.”

Nourish Health spokeswoman Hayley Lapalme said the initiative, predominately funded by the McConnell Foundation, also aims to elevate the role of food as an important part of healing, though food services are categorized with other expenditures such as laundry and parking.

On the west coast, hospital staff prepare meals from traditional ingredients such as wild salmon as a connection to local culture. (Justin McElroy/CBC)

Two hospitals in Haida Gwaii, B.C., on the province’s west coast, have been part of the program that has allowed staff to use traditional ingredients such as wild salmon, cod and halibut in the region where half the population is Indigenous.

Shelly Crack, a dietician for Northern Health, said much of the food served at the facilities was brought in from other provinces and countries, adding to transportation and environmental costs when fish, berries and vegetables were available locally.

“A lot of our elders like the salmon served lightly seasoned with salt and pepper, with sauces served on the side,” said Crack, adding traditional foods have helped people connect to positive experiences from their early years, and that has promoted healing.

“It almost brings them right back to the land and memories of family and harvesting food. It’s that connection to culture and family, this feeling of well-being.”

Raising patient satisfaction, lowering food waste

Health-care policy leaders, doctors and those involved in the national fellowship will be attending the Food for Health Symposium in Toronto on Wednesday and Thursday to showcase sustainable recipes that could be included on hospital menus in 2030, decades after governments across the country contracted out food services at most facilities as a cost-saving measure.

Alex Munter, CEO of the Children’s Hospital of Eastern Ontario, said the Ottawa facility became the first in Canada to introduce room service 15 years ago.

He said offerings like dim sum, butter chicken and tacos drove up patients’ satisfaction with food from 30 per cent to 98 per cent while lowering expenses because food was being eaten, not tossed in the garbage.

“We’re about healing and nourishing and not about feeding,” Munter said of the room-service model most common in the United States.

“Since 2015, we’ve been providing local and sustainable menus for patients and families,” he said. “If your child is here you can order off the menu as well as in the cafeteria.”

Munter said the hospital’s chef, Simon Wiseman, is among the 26 “innovators” in the Nourish initiative and last week created a tofu dish as a potential contender in a competition at the symposium.

The focus was zero waste, and even the plate was made of wheat, Munter said.

Nutritionally adequate but falling short

Toronto chef Joshna Maharaj said she helped create a healthy menu at the Scarborough Hospital in Ontario as part of a one-year pilot project in 2011, when she cooked food on site with staff whose cooking skills had gone to waste after years of reheating trucked-in frozen meals.

However, she said the program was not continued due to unrelated policy changes.

Maharaj said food served at most hospitals may be deemed nutritiously adequate, but it falls far short of what is healthy for sick people, as she recently learned after a day surgery that required a tube to be put down her throat.

She said a slushie or a sorbet would have been ideal but she decided ice cubes and ginger ale would suffice after “a most pitiful egg salad sandwich with dry corners” got stuck to the roof of her mouth.

“The deep insult of it was what hit me,” Maharaj said, adding she’s decided to spend her career advocating for healthy hospital food.

“Once we deal with the food on the plate there’s a much broader opportunity for institutions to support health and wellness and make wonderful financial impacts in the local economy and the agriculture economy. We have a sad, sad lack of vision about this in the country, which is why I’m attempting to scream and yell so loudly.”

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Stronger action urged against homeopathic products touted as alternatives to vaccines

Health Canada's recent warning that homeopathic remedies are not an alternative to vaccines doesn't go far enough to prevent the damage the products could do as the country fights off a resurgence of measles, doctors and health policy experts say. 

'It's nonsensical to have these products licensed by Health Canada," said Dr. Mark Loeb, director of the infectious diseases division at McMaster University in Hamilton.

The federal government is investigating reports that some homeopathic and naturopathic practitioners in British Columbia have promoted homeopathic products called "nosodes" (also marketed as "homeoprophylaxis") as alternatives to conventional vaccinations.

"Nosodes are not, and never have been, approved by Health Canada to be vaccine alternatives," a safety alert issued by the department earlier in March said. "No homeopathic products should be promoted as an alternative to vaccines because there are no substitutes for vaccines."  

Children given homeopathic remedies instead of vaccinations "are at risk of developing serious and potentially fatal childhood illnesses such as measles, mumps, rubella, polio and whooping cough," the statement said. 

Health Canada requires labels on homeopathic nosodes to include statements that the product is "neither a vaccine nor an alternative to vaccination," that it "has not been proven to prevent infection" and that "Health Canada does not recommend its use in children," it said. 

The warning comes as at least 17 cases of measles have been confirmed in B.C. this year, as well as cases in Nunavut and Ontario and several outbreaks in the U.S.

Public health officials on both sides of the border say false information spread by anti-vaccination groups is fuelling fear among parents, making them hesitant to vaccinate their children.

Dr. Mark Loeb, director of the infectious diseases division at McMaster University in Hamilton, hopes the results of his study showing that homeopathic alternatives have no immunization effect will help convince hesitant parents that vaccination is the only way to protect their children against diseases such as measles. (McMaster University)

According to the Public Health Agency of Canada, communities need a vaccination rate of 95 per cent to be adequately protected against measles. If vaccination coverage drops below that, the risk of infection rises — along with the risk of undoing decades of progress that led to measles elimination in Canada back in 1998.  

As proponents of homeopathic remedies claimed they could provide a "natural" alternative to vaccines, Loeb led a randomized, blinded, placebo-controlled trial to do a "head-to-head comparison" between homeopathic nosodes and conventional vaccines given to university students.   

The results, published in the journal Vaccine last November, found "absolutely no antibody response" to either the homeopathic remedies or placebos, compared to "a robust response to the vaccine," Loeb said.   

Apprehensive parents who had not vaccinated their children but are aware of the growing risk of measles have emailed him to ask about his findings.   

"It's a prime example of vaccine hesitancy," Loeb said. "They seem to be on the fence, you know? They're worried about measles outbreaks and they're worried about conventional vaccines."

Loeb hopes his research will put their doubts to rest and help them understand there are no alternatives to conventional vaccines when it comes to protecting their children's health.   

Health Canada needs to help reinforce that point, he said, by ceasing approval for homeopathic nosodes — not just warning people about them. 

"They should not be sold. There's no reason for these to remain on the market," Loeb said. 

'Can contribute to vaccine hesitancy'

The promotion of homeopathic remedies in general can play into common strategies used by anti-vaccination proponents to spread misinformation, said Dr. Vinita Dubey, the city of Toronto's associate medical officer of health. 

That misinformation includes "false logic that natural things are good and safe, while unnatural things are not … the argument that governments promote vaccination because of influence from pharmaceutical companies [and] selectivity in choosing which scientific papers to focus on," Dubey said in an email to CBC News. 

"Homeopathy can contribute to [the] vaccine hesitancy issue in so far as it uses the above techniques to falsely convince the public that vaccines are not safe," she said.

Homeopathic claims can play into the kind of misinformation spread by anti-vaccination groups, says Dr. Vinita Dubey, associate medical officer of health for Toronto Public Health. (Keisha Mair/Toronto Public Health)

"The research and evidence show that vaccines are safe and effective and a necessary public health intervention that has saved millions of lives."

Homeopathy is based on an unproven theory rejected by modern science — that water can be exposed to bacteria, viruses, plants or minerals and then retain a memory of them, even after all traces of the substances have been eliminated through dilution — and that the water's "memory" can treat diseases. There is no evidence to show that the water products have any medical benefit beyond a placebo effect.

Health Canada itself says that homeopathic remedies are not approved "for the treatment of any medical condition or to prevent infection."

But it still continues to license them as "natural health products," which have a different threshold for evidence than medications or vaccines.  

For homeopathic remedies, "evidence usually consists of references to traditional homeopathic textbooks, which are not based on modern science," a spokesperson for Health Canada said in an email.   

Even though Health Canada bans the promotion of homeopathic remedies as vaccine alternatives, the fact that it licenses them at all is harmful, especially in the midst of a vaccine misinformation crisis, said Timothy Caulfield, Canada research chair in health law and policy at the University of Alberta. 

"It's this kind of token of legitimacy that can be used by those marketing homeopathy," Caulfield said. "Even if they're not necessarily saying it's an alternative to vaccines, it's often implied, right? 'Boost your immune naturally' — a lot of naturopaths claim that you can do that and then they offer a homeopathic treatment."

The rise of vaccine hesitancy highlights the importance of tougher regulations to curb unproven health products, Caulfield said.

"It's kind of a warning sign of how the spread of misinformation is starting to have a tangible impact," he said.   

Timothy Caulfield, Canada research chair in health law and policy at the University of Alberta, says Health Canada needs to stop licensing unproven homeopathic remedies and that naturopaths should take homeopathy off their roster of therapies. (Timothy Caulfield/University of Alberta)

Caulfield agrees with Loeb that Health Canada should stop licensing homeopathic remedies. But he also thinks naturopaths — as a regulated health profession — should take responsibility.  

"If they really are a science-based profession, then their regulatory body should say, 'stop providing homeopathy, period,'" he said. "If the colleges [of naturopathy] aren't willing to do this … then I think we need to revisit how we regulate these kinds of professions."    

Naturopaths are pro-vaccine, colleges say

According to the Canadian Association of Naturopathic Doctors, naturopathy "blends modern scientific knowledge with traditional and natural forms of medicine" through a variety of therapies — of which homeopathy is one.    

But the association "recognizes the value of vaccines" and "fully supports Health Canada's position on nosodes — they are not an alternative to vaccines," said executive director Shawn O'Reilly in an email to CBC News. 

"In fact the childhood immunization schedule is taught in the curriculum of the accredited naturopathic medical programs and students must meet the clinical competencies for immunization education in order to graduate," he said. 

The College of Naturopathic Physicians of British Columbia — where some naturopaths were promoting homeopathic alternatives — says that conduct is in violation of its "immunization standard" and that it supports vaccination. 

"Naturopathic doctors are part of the effort to reduce vaccine hesitancy. They are uniquely positioned to educate patients who, due to misinformation and fear, may otherwise forego or have limited contact with allopathic [conventional] medical care, including access to and information about vaccinations," said PhillipaStanaway, the college's registrar and CEO, in an email to CBC News.    

"When patients inquire about the use of nosodes instead of vaccinations, naturopathic doctors are obliged to inform them that nosodes are not a safe or effective alternative to vaccinations," she said.  



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Epipen and EpiPen Jr. in short supply, no alternatives available

EpiPen injectors used to treat life-threatening allergic reactions are currently running short, and EpiPen Jr. products may soon do the same, Health Canada said on Thursday.

Health Canada said Pfizer Canada had advised the agency of the short supplies.

The auto-injector is a handheld device that treats life-threatening allergic reactions by automatically injecting a dose of epinephrine.

“A shortage does not necessarily mean that there is no supply available in pharmacies. At this time, the company has indicated that limited inventory of both products remains available and is being carefully managed nationally,” the regulator said. 

There are currently no alternative auto-injectors available in Canada.

Pfizer said the current supply constraints of its 0.3 mg and 0.15 mg products are due to delays at the manufacturing facility.

“It’s related to manufacturing delays as well as limited third-party quantities of a component for the product,” Christina Antoniou, Pfizer Canada corporate affairs manager said. “Unfortunately, I don’t have a lot of detail on what that component is.”

It is not unusual for EpiPen to be on back order for limited periods of time, Antoniou said.

Company offers help to find EpiPens

If the supply is limited at a pharmacy then Antoniou encouraged consumers to visit another pharmacy or to contact Pfizer at 1-877-374-7361 for up-to-date information about the shortage, estimated re-supply dates, and to secure the product.

Health Canada reminded patients and caregivers that EpiPen products expire on the last day of the month indicated on the product packaging. That means if a product is marked as expiring in January, it remains valid and not expired until Jan. 31.

Generally, people are advised to have more than one auto-injector with different expiry dates.

“However, in this shortage situation, if you are experiencing an anaphylactic reaction and have only an expired auto-injector, use the expired product and immediately contact 911. Regardless of whether the product is expired, you should get to the nearest hospital as soon as possible following the administration of the product, as instructed in the product labelling.”

The EpiPen Jr. (0.15 mg) (DIN 00578657) is expected to be in shortage as of Friday, the company said. 

The company reported that the shortage for both products is anticipated to be resolved on May 31, Health Canada said in an email. Pfizer later updated the information in an email to CBC News saying it cannot say exactly when the situation will be resolved.

Patients with questions or concerns about the shortage may also wish to speak to their health professional.

Dr. Supriya Sharma, Health Canada’s chief medical adviser, said many factors aligned to create this situation.

“Emergency situation, one producer, no other global supply. So it is unusual,” Sharma said in an interview. “Having said that, we are seeing globally more and more consolidation on the manufacturing side.”

The announcement follows a series of shortages in EpiPens.

In 2017, the U.S. Food and Drug Administration sent a warning letter to Pfizer’s facility, Meridian Medical Technologies, regarding complaints of its EpiPen products failing to operate during life-threatening emergencies.

The product is manufactured at Meridian but the current shortage does not relate to the U.S. regulator’s warning letter, Antoniou said. 

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