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Why Doctors Aren’t So Sure Trump Is Feeling Better From Covid-19

Standing on the steps of Walter Reed National Military Medical Center on Monday, with a phalanx of white-coated doctors behind him, the White House physician, Dr. Sean P. Conley, ticked off President Trump’s encouraging vital signs: no fever, only slightly elevated blood pressure and a blood oxygen level in the healthy range.

“He’s back,” Dr. Conley said later in the news conference.

But when reporters asked him for results of Mr. Trump’s chest X-rays and lung scans — crucial measures of how severely the president has been sickened by Covid-19 — Dr. Conley refused to answer, citing a federal law that restricts what doctors can share about patients.

Without critical data about his lung function, medical experts in Covid-19 and lung disease said they were struggling to piece together an accurate picture of how Mr. Trump is faring. They noted that while most patients with the virus do recover, it was premature to declare victory over an unpredictable, poorly understood virus that has killed more than 210,000 people in the United States.

Less than a month from Election Day, Dr. Conley’s patient, Mr. Trump, is presenting himself as strong and unfazed by the coronavirus, and seems to have instructed his doctor to steer clear of disclosing health details that might puncture his image of invulnerability.

Dr. Conley said on Tuesday that Mr. Trump was experiencing no symptoms of the disease and doing “extremely well,” though he himself cautioned on Monday that the president was not “out of the woods” and that “we will all take that final deep sigh of relief” if he still feels well next Monday.

Far from having vanquished Covid-19, the outside doctors said, Mr. Trump is most likely still struggling with it and entering a pivotal phase — seven to 10 days after the onset of symptoms — in which he could rapidly take a turn for the worse. He’s 74, male and moderately obese, factors that put him at risk for severe disease.

“I don’t need to get in the president’s business,” said Dr. Talmadge E. King Jr., a specialist in pulmonary critical care and the dean of the UCSF School of Medicine. However, he said, “if their goal is for us to understand more completely what is going on, they have left a lot of very useful information off the table.”

Several medical experts said that based on the incomplete information Mr. Trump’s medical team had provided, the president appeared to have at least at some point experienced a severe form of Covid-19, with impairment of the lungs and a blood oxygen level below 94 percent, which is a cutoff for severe disease.

But again, Dr. Conley has not been fully forthcoming about Mr. Trump’s oxygen levels. He said that the president’s blood oxygen had dipped to 93 percent on Saturday. He was evasive about an earlier episode of low oxygen on Friday, though. When a reporter asked if Mr. Trump was ever below 90 percent, Dr. Conley said that his oxygen level had

Dogs’ brains aren’t hardwired to care about human faces, study shows

Researchers measured brain activity in dogs and humans as they showed them videos of faces and backs of heads, a press release from Eötvös Loránd University, in Hungary, said.

While faces are hugely important for visual communication in humans, the same can’t be said for our canine companions.

Experiments involving functional magnetic resonance imaging on 20 dogs were carried out at Eötvös Loránd University and the National Autonomous University of México, Querétaro, Mexico, two of very few facilities that can scan dogs’ brains when they are awake and unrestrained.

Results revealed large dedicated neural networks in human brains are used to differentiate faces from non-faces. In dogs there are no brain regions that fire to differentiate faces.

Instead, dogs use more information from smell or larger parts of the body, study co-author Attila Andics of Eötvös Loránd University, told CNN.

Germans could legally have to let their dogs out twice a day

“In dogs, for kin recognition and mate selection facial cues are not more important than non-facial bodily cues, acoustic or chemical signals,” Andics said.

The full study, described by researchers as the first one of its kind, was published in the Journal of Neuroscience Monday.

Andics told CNN that dogs do care about human faces, even if their brains aren’t specifically tuned into them.

“I think it is amazing that, despite apparently not having a specialized neural machinery to process faces, dogs nevertheless excel at eye contact, following gaze, reading emotions from our face, and they can even recognize their owner by the face,” Andics said.

“During domestication, dogs adapted to the human social environment, and living with humans they quickly learn that reading facial cues makes sense, just as humans learn to pay attention to little details, of let’s say, a phone, without having specialized phone areas in their brain.”

Researchers will now compare how dog and human brains process other visual categories such as body parts, various species and everyday objects, said Andics.

The team will also investigate whether dog brains have developed different specializations as a result of living with humans, Andics added.

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Covid-19 patients aren’t usually checking themselves into hospitals like Chris Christie, experts say

Christie’s announcement, which followed news that Trump, first lady Melania Trump and other Republican leaders had tested positive for the virus, sparked a flurry of reactions online. Chief among them: confusion.

“Regarding Chris Christie, can someone please tell me how one checks into a hospital as a ‘precautionary measure’?” one person wrote on Twitter.

Another person asked, “Can an ordinary citizen with mild symptoms just check themselves into a hospital out of an abundance of caution? Is that how this works?”

Not exactly, experts say.

“What occurred over the weekend with Governor Christie sharing on social media that he was checking himself into the hospital because of his covid-19 diagnosis, that would be extraordinarily uncommon,” said Mark Shapiro, associate medical director for hospital services at St. Joseph Health Medical Group of Sonoma County, Calif.

The process of being admitted to a hospital with covid-19, the disease caused by the virus, is much more complex than Christie’s tweet may have suggested, Shapiro added. He, and other experts, urged people who test positive for the coronavirus and are asymptomatic or exhibiting mild symptoms not to show up at hospitals seeking to be admitted for treatment.

Christie, who may have an increased chance of developing a more severe case of covid-19 because of his asthma and other potential risk factors, declined to comment on the specifics of his hospital admittance.

Atlantic Health System, which operates the hospital where Christie is receiving care, also declined to provide additional details. “Every patient we care for is carefully assessed by a physician to determine their clinical needs,” the hospital said in a statement. “Those determinations, including where care needs to take place, are based on their expert clinical judgment.”

The procedure at most hospitals, according to Shapiro, is that people who fall ill after contracting the coronavirus are admitted through emergency departments following an assessment by a team of health-care providers.

At Mayo Clinic hospitals, for instance, members of the covid-19 front-line care team, many of whom are primary care providers, call patients with positive test results and ask them questions about their condition, which helps with “risk stratification,” said John O’Horo, an infectious-disease specialist with the clinic in Rochester, Minn. In the event that hospitalization may be needed, people usually are processed through the clinic’s emergency room, where they will receive a more thorough assessment to see if they should be admitted.

“We’ll check their vitals, usually get some imaging like a chest X-ray to see if there is a clear pneumonia developing, and check some bloodwork to see how their markers of inflammation and immune function are doing,” O’Horo said. “Based on that, the sum total of looking at all of those things, plus the questions about their ability to continue this kind of care at home, a decision can be made to admit the patient to a special covid unit.”

Still, O’Horo noted, “there are no hard and fast rules really when it comes to deciding if somebody needs to be hospitalized.”

Ask the Dentist: Make sure your kids aren’t fooled by online DIY ‘dentistry’

DO YOU know where your nail files, toilet bleach and power drill are at the moment? Well maybe you should make sure that these items are where you believe them to be and not in the hands of your children.

Videos on TikTok have young people promoting home remedies to improve the appearance of practically all body parts and the teeth are not escaping this Alice in Wonderland sorcery.

One of the suggestions being punted on the short videos is taking a nail file to smooth down the front teeth to “even them out” or level a jaggedy edge. Do not pass go or collect £200 – this should go straight into the big bag of bad ideas. Irreversible damage is being caused by this moment of fadness.

Maybe check with your children that they are aware that this can cause long-term sensitivity and try to explain that teeth are meant to be a certain shape so that they function properly. When teeth are their intended shape, they fit together and slide around in harmony, which protects other teeth from breaking and stops the jaw joints from hurting.

However, the nail-filing concept is a mere amoeba in the bad ideas bag in comparison with the corn on the cob challenge. This involves putting a corn on the cob on the drill bit of a power tool. While the cob is rotating full tilt, the person has to eat all the corn off at nauseating speed. Jason Derulo, the American singer, posted a prank video where his front two teeth “snapped off” during the challenge. While funny, it does highlight the inherent craziness of the challenge and other TikTokers have actually had their front teeth totally knocked out or been scalped completing it.

Eye of newt, toe of bat and anything else in the kitchen cupboard is mixed enthusiastically in varying quantities by the TikTokers and then wrapped with misplaced optimism in tinfoil around the teeth in the quest for whiter teeth which predictably doesn’t materialise.

What can actually happen when using household bleach or other non-dental products as a tooth whitener is severe burns to your gums, palate and oesophagus, leaving permanent scarring and damage – nothing to smile about.

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Nursing Home Inspectors In The D.C. Region Aren’t Required To Take COVID-19 Tests : NPR

Staff and vendors in nursing homes have to get regular COVID-19 tests. State nursing home inspectors don’t.

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Maryland, D.C. and Virginia are not mandating COVID-19 tests for the inspectors examining conditions in local nursing homes, public health spokespeople from all three jurisdictions confirmed. The lack of testing for the inspectors, nursing home leaders say, stands in contrast to state and federal testing requirements for nearly anyone entering a nursing home these days.

For the past several months, inspectors were focused on completing federally mandated infection control surveys to evaluate long term care facilities’ responses to the coronavirus pandemic. Some of the inspectors’ findings have resulted in citations and fines for nursing homes found to have inadequate screening, social distancing or sanitizing practices.

Nursing home leaders are worried that inspectors are entering facilities without knowing their COVID-19 status, said Allison Ciborowski, the president of LeadingAge Maryland, a long-term care industry group.

The inspectors work on behalf of the federal government’s Centers for Medicare and Medicaid Services but are employed by state jurisdictions. Ciborowski said CMS hasn’t required or recommended that inspectors be tested. Maryland, Virginia and the District have chosen to follow that lead.

“It’s a concern for our members just because they are really trying to carefully track the spread of the virus,” she told WAMU/DCist. “It seems strange that the agency that is citing nursing homes if they’re not appropriately testing staff is not testing the surveyors that are going in to fight those kinds of things.”

Inspectors may not be required to undergo coronavirus testing, but almost everyone else going in and out of nursing homes is. CMS and state governments regulate how frequently long-term care facilities should be testing staff, residents and regular outside visitors. For much of the summer, CMS required nursing home staff to be tested for COVID-19 every week (in Maryland, weekly testing is still the case).

When inspectors enter facilities, they are expected to comply with temperature checks, answer screening questions, and wear masks, gloves and gowns. Once inside, they walk around the facility, but do not enter sick resident rooms.

Last month, CMS revised its testing guidance, tying the frequency of staff testing to the positivity rate of the county where the nursing home is located. The definition of who counts as staff is still broad: it includes “employees, consultants, contractors, volunteers and caregivers who provide care and services to residents on behalf of the facility, and students in the facility’s nurse aide training programs or from affiliated academic institutions,” according to the guidance.

Missing from that long cast of characters: inspectors. And while fewer than half of all states are requiring inspectors to get tested despite the omission in CMS guidelines, Maryland, Virginia and D.C. are not.

Spokespeople for the Maryland Department of Health, Virginia Department of Health and D.C. Health pointed to a number of reasons for not requiring tests. Virginia Department of Health spokeswoman Tammie Smith emailed the following