health

drugmaker-shut-down-after-black-schmutz-found-in-injectable-weight-loss-drug

Drugmaker shut down after black schmutz found in injectable weight-loss drug

It’s unclear how widely the pharmacy’s drugs were distributed. Fullerton Wellness could not be reached for comment.

Bigger battles

This is just the latest warning on weight-loss drugs from the FDA, which has repeatedly cautioned about quality and safety problems related to compounded versions of the drugs. The compounded drugs are intended to be essentially copycat versions of the blockbuster brand-name drugs. Compounding pharmacies can make copycat versions only as long as the drugs are in short supply, acting as a stopgap for patient access. But, with the popularity of the drugs and the high prices of the brand name versions, compounded formulations have become seen as affordable alternatives for many patients.

The situation has become a legal quagmire, with less-than-scrupulous compounding facilities drawing the ire of the FDA, and the big pharmaceutical companies fighting with their compounding competition. Eli Lilly, maker of Zepbound and Mounjaro (tirzepatide), and Novo Nordisk, maker of Wegovy and Ozempic (semaglutide), have both sued multiple compounding pharmacies over copycat versions of their lucrative drugs, which they claim are unsafe and fraudulent.

Meanwhile, in October, a trade organization for large-scale compounding pharmacies sued the FDA after the regulator removed tirzepatide from the drug shortage list, a move that blocks compounders from making copycat versions of the drug. But, the FDA quickly backpedaled in court, saying it would reconsider the removal and would allow compounders to keep producing off-brand versions in the meantime.

Also in October, Novo Nordisk asked the FDA to stop letting compounders make copycat versions of semaglutide, arguing that the drug is too complex for compounders to make and poses too many safety risks to patients. In response, the trade organization for compounders, the Outsourcing Facilities Association, submitted a letter to the FDA asking it to require Novo Nordisk to provide an economic impact statement to assess the cost and price increases that could occur if semaglutide were no longer available through compounding pharmacies.

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Here are 3 science-backed strategies to rein in election anxiety

In this scenario, I encourage my patients to move past that initial thought of how awful it will be and instead consider exactly how they will respond to the inauguration, the next day, week, month, and so on.

Cognitive flexibility allows you to explore how you will cope, even in the face of a negative outcome, helping you feel a bit less out of control. If you’re experiencing a lot of anxiety about the election, try thinking through what you’d do if the undesirable candidate takes office—thoughts like “I’ll donate to causes that are important to me” and “I’ll attend protests.”

Choose your actions with intention

Another tool for managing your anxiety is to consider whether your behaviors are affecting how you feel.

Remember, for instance, the goal of 24-hour news networks is to increase ratings. It’s in their interest to keep you riveted to your screens by making it seem like important announcements are imminent. As a result, it may feel difficult to disconnect and take part in your usual self-care behavior.

Try telling yourself, “If something happens, someone will text me,” and go for a walk or, better yet, to bed. Keeping up with healthy habits can help reduce your vulnerability to uncontrolled anxiety.

Post-Election Day, you may continue to feel drawn to the news and motivated to show up—whether that means donating, volunteering, or protesting—for a variety of causes you think will be affected by the election results. Many people describe feeling guilty if they say no or disengage, leading them to overcommit and wind up overwhelmed.

If this sounds like you, try reminding yourself that taking a break from politics to cook, engage with your family or friends, get some work done, or go to the gym does not mean you don’t care. In fact, keeping up with the activities that fuel you will give you the energy to contribute to important causes more meaningfully.The Conversation

Shannon Sauer-Zavala, Associate Professor of Psychology & Licensed Clinical Psychologist, University of Kentucky. This article is republished from The Conversation under a Creative Commons license. Read the original article.

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as-hospitals-struggle-with-iv-fluid-shortage,-nc-plant-restarts-production

As hospitals struggle with IV fluid shortage, NC plant restarts production

The western North Carolina plant that makes 60 percent of the country’s intravenous fluid supply has restarted its highest-producing manufacturing line after being ravaged by flooding brought by Hurricane Helene last month.

While it’s an encouraging sign of recovery as hospitals nationwide struggle with shortages of fluids, supply is still likely to remain tight for the coming weeks.

IV fluid maker Baxter Inc, which runs the Marion plant inundated by Helene, said Thursday that the restarted production line could produce, at peak, 25 percent of the plant’s total production and about 50 percent of the plant’s production of one-liter IV solutions, the product most commonly used by hospitals and clinics.

“Recovery progress at our North Cove site continues to be very encouraging,” Baxter CEO and President José Almeida said. “In a matter of weeks, our team has advanced from the depths of Hurricane Helene’s impact to restarting our highest-throughput manufacturing line. This is a pivotal milestone, but more hard work remains as we work to return the plant to full production.”

Overall, Baxter said it is ahead of its previously projected timeline for getting the massive plant back up and running. Previously, the company said it had aimed to produce 90–100 percent of some products by the end of the year. Still, the initial batches now under production are expected to start shipping in late November at the earliest.

One of the many challenges to restoring the facility was the lack of access to the site; Helene had damaged an access bridge. In its latest announcement, Baxter said that a temporary bridge—built with support from North Carolina’s Department of Transportation and the federal Administration of Strategic Preparedness and Response (ASPR)—has allowed the transport of more than 885 truckloads of existing inventory out of the plant since Helene.  A second temporary bridge, expected to be completed in early November, will enable further access of traffic and equipment to the site.

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a-new-dental-scam-is-to-pull-healthy-teeth-to-sell-you-expensive-fake-ones

A new dental scam is to pull healthy teeth to sell you expensive fake ones


It turns out you may not have needed those implants after all.

Becky Carroll was missing a few teeth, others were stained or crooked. Ashamed, she smiled with lips pressed closed. Her dentist offered to fix most of her teeth with root canals and crowns, Carroll said, but she was wary of traveling a long road of dental work.

Then Carroll saw a TV commercial for another path: ClearChoice Dental Implant Centers. The company advertises that it can give patients “a new smile in as little as one day” by surgically replacing teeth instead of fixing them.

So Carroll saved and borrowed for the surgery, she said. In an interview and a lawsuit, Carroll said that at a ClearChoice clinic in New Jersey in 2021, she agreed to pay $31,000 to replace all her natural upper teeth with pearly white prosthetic ones. What came next, Carroll said, was “like a horror movie.”

Carroll alleged that her anesthesia wore off during implant surgery, so she became conscious as her teeth were removed and titanium screws were twisted into her jawbone. Afterward, Carroll’s prosthetic teeth were so misaligned that she was largely unable to chew for more than two years until she could afford corrective surgery at another clinic, according to a sworn deposition from her lawsuit.

ClearChoice has denied Carroll’s claims of malpractice and negligence in court filings and did not respond to requests for comment on the ongoing case.

“I thought implants would be easier, and all at once, so you didn’t have to keep going back to the dentist,” Carroll, 52, said in an interview. “But I should have asked more questions … like, Can they save these teeth?”

Dental implants have been used for more than half a century to surgically replace missing or damaged teeth with artificial duplicates, often with picture-perfect results. While implant dentistry was once the domain of a small group of highly trained dentists and specialists, tens of thousands of dental providers now offer the surgery and place millions of implants each year in the US.

Amid this booming industry, some implant experts worry that many dentists are losing sight of dentistry’s fundamental goal of preserving natural teeth and have become too willing to remove teeth to make room for expensive implants, according to a months-long investigation by KFF Health News and CBS News. In interviews, 10 experts said they had each given second opinions to multiple patients who had been recommended for mouths full of implants that the experts ultimately determined were not necessary. Separately, lawsuits filed across the country have alleged that implant patients like Carroll have experienced painful complications that have required corrective surgery, while other lawsuits alleged dentists at some implant clinics have persuaded, pressured, or forced patients to remove teeth unnecessarily.

The experts warn that implants, for a single tooth or an entire mouth, expose patients to costs and surgery complications, plus a new risk of future dental problems with fewer treatment options because their natural teeth are forever gone.

“There are many cases where teeth, they’re perfectly fine, and they’re being removed unnecessarily,” said William Giannobile, dean of the Harvard School of Dental Medicine. “I really hate to say it, but many of them are doing it because these procedures, from a monetary standpoint, they’re much more beneficial to the practitioner.”

Giannobile and nine other experts say they are combating a false public perception that implants are more durable and longer-lasting than natural teeth, which some believe stems in part from advertising on TV and social media. Implants require upkeep, and although they can’t get cavities, studies have shown that patients can be susceptible to infections in the gums and bone around their implants.

“Just because somebody can afford implants doesn’t necessarily mean that they’re a good candidate,” said George Mandelaris, a Chicago-area periodontist and member of the American Academy of Periodontology Board of Trustees. “When an implant has infection, or when an implant has bone loss, an implant dies a much quicker death than do teeth.”

In its simplest form, implant surgery involves extracting a single tooth and replacing it with a metal post that is screwed into the jaw and then affixed with a prosthetic tooth commonly made of porcelain, also known as a crown. Patients can also use “full-arch” or “All-on-4” implants to replace all their upper or lower teeth—or all their teeth.

For this story, KFF Health News and CBS News sought interviews with large dental chains whose clinics offer implant surgery—ClearChoice, Aspen Dental, Affordable Care, and Dental Care Alliance—each of which declined to be interviewed or did not respond to multiple requests for comment. The Association of Dental Support Organizations, which represents these companies and others like them, also declined an interview request.

ClearChoice, which specializes in full-arch implants, did not answer more than two dozen questions submitted in writing. In an emailed statement, the company said full-arch implants “have become a well-accepted standard of care for patients with severe tooth loss and teeth with poor prognosis.”

“The use of full-arch restorations reflects the evolution of modern dentistry, offering patients a solution that restores their ability to eat, speak, and live comfortably—far beyond what traditional dentures can provide,” the company said.

Carroll said she regrets not letting her dentist try to fix her teeth and rushing to ClearChoice for implants.

“Because it was a nightmare,” she said.

“They are not teeth”

Dental implant surgery can be a godsend for patients with unsalvageable teeth. Several experts said implants can be so transformative that their invention should have contended for a Nobel Prize. And yet, these experts still worry that implants are overused, because it is generally better for patients to have their natural teeth.

Paul Rosen, a Pennsylvania periodontist who said he has worked with implants for more than three decades, said many patients believe a “fallacy” that implants are “bulletproof.”

“You can’t just have an implant placed and go off riding into the sunset,” Rosen said. “In many instances, they need more care than teeth because they are not teeth.”

Generally, a single implant costs a few thousand dollars while full-arch implants cost tens of thousands. Neither procedure is well covered by dental insurance, so many clinics partner with credit companies that offer loans for implant surgeries. At ClearChoice, for example, loans can be as large as $65,000 paid off over 10 years, according to the company’s website.

Despite the price, implants are more popular than ever. Sales increased by more than 6 percent on average each year since 2010, culminating in more than 3.7 million implants sold in the US in 2022, according to a 2023 report produced by iData Research, a health care market research firm.

Some worry implant dentistry has gone too far. In 10 interviews, dentists and dental specialists with expertise in implants said they had witnessed the overuse of implants firsthand. Each expert said they’d examined multiple patients in recent years who were recommended for full-arch implants by other dentists despite their teeth being treatable with conventional dentistry.

Giannobile, the Harvard dean, said he had given second opinions to “dozens” of patients who were recommended for implants they did not need.

“I see many of these patients now that are coming in and saying, ‘I’ve been seen, and they are telling me to get my entire dentition—all of my teeth—extracted.’ And then I’ll take a look at them and say that we can preserve most of your teeth,” Giannobile said.

Tim Kosinski, who is a representative of the Academy of General Dentistry and said he has placed more than 19,000 implants, said he examines as many as five patients a month who have been recommended for full-arch implants that he deems unnecessary.

“There is a push in the profession to remove teeth that could be saved,” Kosinski said. “But the public isn’t aware.”

Luiz Gonzaga, a periodontist and prosthodontist at the University of Florida, said he, too, had turned away patients who wanted most or all their teeth extracted. Gonzaga said some had received implant recommendations that he considered “an atrocity.”

“You don’t go to the hospital and tell them ‘I broke my finger a couple of times. This is bothering me. Can you please cut my finger off?’ No one will do that,” Gonzaga said. “Why would I extract your tooth because you need a root canal?”

Jaime Lozada, director of an elite dental implant residency program at Loma Linda University, said he’d not only witnessed an increase in dentists extracting “perfectly healthy teeth” but also treated a rash of patients with mouths full of ill-fitting implants that had to be surgically replaced.

Lozada said in August that he’d treated seven such patients in just three months.

“When individuals just make a decision of extracting teeth to make it simple and make money quick, so to speak, that’s where I have a problem,” Lozada said. “And it happens quite often.”

When full-arch implants fail, patients sometimes don’t have enough jawbone left to anchor another set. These patients have little choice but to get implants that reach into cheekbones, said Sohail Saghezchi, an oral and maxillofacial surgeon at the University of California-San Francisco.

“It’s kind of like a last resort,” Saghezchi said. “If those fail, you don’t have anywhere else to go.”

“It was horrendous dentistry”

Most of the experts interviewed for this article said their rising alarm corresponded with big changes in the availability of dental implants. Implants are now offered by more than 70,000 dental providers nationwide, two-thirds of whom are general dentists, according to the iData Research report.

Dentists are not required to learn how to place implants in dental school, nor are they required to complete implant training before performing the surgery in nearly all states. This year, Oregon started requiring dentists to complete 56 hours of hands-on training before placing any implants. Stephen Prisby, executive director of the Oregon Board of Dentistry, said the requirement—the first and only of its kind in the US—was a response to dozens of investigations in the state into botched surgeries and other implant failures, split evenly between general dentists and specialists.

“I was frankly stunned at how bad some of these dentists were practicing,” Prisby said. “It was horrendous dentistry.”

Many dental clinics that offer implants have consolidated into chains owned by private equity firms that have bought out much of implant dentistry. In health care, private equity investment is sometimes criticized for overtreatment and prioritizing short-term profit over patients.

Private equity firms have spent about $5 billion in recent years to buy large dental chains that offer implants at hundreds of clinics owned by individual dentists and dental specialists. ClearChoice was bought for an estimated $1.1 billion in 2020 by Aspen Dental, which is owned by three private equity firms, according to PitchBook, a research firm focused on the private equity industry. Private equity firms also bought Affordable Care, whose largest clinic brand is Affordable Dentures & Implants, for an estimated $2.7 billion in 2021, according to PitchBook. And the private equity wing of the Abu Dhabi government bought Dental Care Alliance, which offers implants at many of its affiliated clinics, for an estimated $1 billion in 2022, according to PitchBook.

ClearChoice and Aspen Dental each said in email statements that the companies’ private equity owners “do not have influence or control over treatment recommendations.” Both companies said dentists or dental specialists make all clinical decisions.

Private equity deals involving dental practices increased ninefold from 2011 to 2021, according to an American Dental Association study published in August. The study also said investors showed an interest in oral surgery, possibly because of the “high prices” of implants.

“Some argue this is a negative thing,” said Marko Vujicic, vice president of the association’s Health Policy Institute, who co-authored the study. “On the other hand, some would argue that involvement of private equity and outside capital brings economies of scale, it brings efficiency.”

Edwin Zinman, a San Francisco dental malpractice attorney and former periodontist who has filed hundreds of dental lawsuits over four decades, said he believed many of the worst fears about private equity owners had already come true in implant dentistry.

“They’ve sold a lot of [implants], and some of it unnecessarily, and too often done negligently, without having the dentists who are doing it have the necessary training and experience,” Zinman said. “It’s for five simple letters: M-O-N-E-Y.”

Hundreds of implant clinics with no specialists

For this article, journalists from KFF Health News and CBS News analyzed the webpages for more than 1,000 clinics in the nation’s largest private equity-owned dental chains, all of which offer some implants. The analysis found that more than 70 percent of those clinics listed only general dentists on their websites and did not appear to employ the specialists—oral surgeons, periodontists, or prosthodontists—who traditionally have more training with implants.

Affordable Dentures & Implants listed specialists at fewer than 5 percent of its more than 400 clinics, according to the analysis. The rest were staffed by general dentists, most of whom did not list credentialing from implant training organizations, according to the analysis.

ClearChoice, on the other hand, employs at least one oral surgeon or prosthodontist at each of its more than 100 centers, according to the analysis. But its new parent company, Aspen Dental, which offers implants in many of its more than 1,100 clinics, does not list any specialists at many of those locations.

Not everyone is worried about private equity in implant dentistry. In interviews arranged by the American Academy of Implant Dentistry, which trains dentists to use implants, two other implant experts did not express concerns about private equity firms.

Brian Jackson, a former academy president and implant specialist in New York, said he believed dentists are too ethical and patients are too smart to be pressured by private equity owners “who will never see a patient.”

Jumoke Adedoyin, a chief clinical officer for Affordable Care, who has placed implants at an Affordable Dentures & Implants clinic in the Atlanta suburbs for 15 years, said she had never felt pressure from above to sell implants.

“I’ve actually felt more pressure sometimes from patients who have gone around and been told they need to take their teeth out,” she said. “They come in and, honestly, taking a look at them, maybe they don’t need to take all their teeth out.”

Still, lawsuits filed across the country have alleged that dentists at implant clinics have extracted patients’ teeth unnecessarily.

For example, in Texas, a patient alleged in a 2020 lawsuit that an Affordable Care dentist removed “every single tooth from her mouth when such was not necessary,” then stuffed her mouth with gauze and left her waiting in the lobby as he and his staff left for lunch. In Maryland, a patient alleged in a 2021 lawsuit that ClearChoice “convinced” her to extract “eight healthy upper teeth,” by “greatly downplay[ing] the risks.” In Florida, a patient alleged in a 2023 lawsuit that ClearChoice provided her with no other treatment options before extracting all her teeth, “which was totally unnecessary.”

ClearChoice and Affordable Care denied wrongdoing in their respective lawsuits, then privately settled out of court with each patient. ClearChoice and Affordable Care did not respond to requests for comment submitted to the companies or attorneys. Lawyers for all three plaintiffs declined to comment on these lawsuits or did not respond to requests for comment.

Fred Goldberg, a Maryland dental malpractice attorney who said he has represented at least six clients who sued ClearChoice, said each of his clients agreed to get implants after meeting with a salesperson—not a dentist.

“Every client I’ve had who has gone to ClearChoice has started off meeting a salesperson and actually signing up to get their financing through ClearChoice before they ever meet with a dentist,” Goldberg said. “You meet with a salesperson who sells you on what they like to present as the best choice, which is almost always that they’re going to take out all your natural teeth.”

Becky Carroll, the ClearChoice patient from New Jersey, told a similar story.

Carroll said in her lawsuit that she met first with a ClearChoice salesperson referred to as a “patient education consultant.” In an interview, Carroll said the salesperson encouraged her to borrow money from family members for the surgery and it was not until after she agreed to a loan and passed a credit check that a ClearChoice dentist peered into her mouth.

“It seems way backwards,” Carroll said. “They just want to know you’re approved before you get to talk to a dentist.”

CBS News producer Nicole Keller contributed to this report.

This story originally appeared on KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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idaho-health-district-abandons-covid-shots-amid-flood-of-anti-vaccine-nonsense

Idaho health district abandons COVID shots amid flood of anti-vaccine nonsense

Slippery slope

In the hearing, board member Jennifer Riebe (who voted to keep COVID-19 vaccinations available) worried about the potential of a slippery slope.

“My concern with this is the process because if this board and six county commissioners and one physician is going to make determinations on every single vaccine and pharmaceutical that we administer, I’m not comfortable with that,” she said, according to Boise State Public Radio. “It may be COVID now, maybe we’ll go down the same road with the measles vaccine or the shingles vaccine coverage.”

Board Chair Kelly Aberasturi, who also voted to keep the vaccines, argued that it should be a choice by individuals and their doctors, who sometimes refer their patients to the district for COVID shots. “So now, you’re telling me that I have the right to override that doctor? Because I know more than he does?” Aberasturi said.

“It has to do with the right of the individual to make that decision on their own. Not for me to dictate to them what they will do. Sorry, but this pisses me off,” he added.

According to Boise State Public Radio, the district had already received 50 COVID-19 vaccines at the time of the vote, which were slated to go to residents of a skilled nursing facility.

The situation in the southwest district may not be surprising given the state’s overall standing on vaccination: Idaho has the lowest kindergarten vaccination rates in the country, with coverage of key vaccinations sitting at around 79 percent to 80 percent, according to a recent analysis by the Centers for Disease Control and Prevention. The coverage is far lower than the 95 percent target set by health experts. That’s the level that would block vaccine-preventable diseases from readily spreading through a population. The target is out of reach for Idaho as a whole, which also has the highest vaccination exemption rate in the country, at 14.3 percent. Even if the state managed to vaccinate all non-exempt children, the coverage rate would only reach 85.7 percent, missing the 95 percent target by nearly 10 percentage points.

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slivered-onions-are-likely-cause-of-mcdonald’s-e.-coli-outbreak,-cdc-says

Slivered onions are likely cause of McDonald’s E. coli outbreak, CDC says

Slivered onions are the likely source of the multi-state E. coli outbreak linked to McDonald’s Quarter Pounder burgers that continues to grow, the Centers for Disease Control and Prevention announced Wednesday.

Onions were one of two primary suspects when the CDC announced the outbreak on October 22, with the other being the beef patties used on the burgers. But onions quickly became the leading suspect. The day after the CDC’s announcement, McDonald’s onion supplier, Taylor Farms, recalled peeled and diced yellow onion products and several other fast food chains took onions off the menu as a precaution. (No other restaurants have been linked to the outbreak to date.)

According to the CDC, traceback information and epidemiological data collected since then have all pointed to the onions and, according to McDonald’s, state and federal testing of the beef patties has all come back negative.

In the CDC’s update Wednesday, the agency reported that 15 more people were identified as sickened in the outbreak, including five who were hospitalized. In all, that brings the outbreak to 90 cases, including 27 hospitalizations and one death, which collectively span 13 states.

All the newly reported illnesses had onsets prior to the October 23 onion recall. The most recent illness onset was October 16. Additional illnesses may be reported, as it can take three to four weeks to link illnesses to an outbreak.

“Due to the product actions taken by McDonald’s and Taylor Farms, the CDC believes the continued risk to the public is very low,” the agency said in a media alert.

McDonald’s says that Quarter Pounders—without onions—will return to the menus of affected restaurants this week. Prior to the recall, 900 restaurants had received onions from Taylor Farms, including in Colorado, Kansas, and Wyoming, as well as portions of Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico, Oklahoma, and Utah.

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person-accidentally-poisoned-46-coworkers-with-toxin-loaded-homemade-lunch

Person accidentally poisoned 46 coworkers with toxin-loaded homemade lunch

For some, microwaving fish in the employee lunch room is the ultimate work faux pas. But for one (likely mortified) employee of a seafood distribution plant in Maryland, it’s probably causing a mass poisoning with the homemade noodle dish they brought to share for lunch. The dish sickened 46 employees, spurring their employer to hastily release a statement assuring customers that it wasn’t the company’s food that caused the illnesses.

On October 21, first responders and paramedics arrived at the NAFCO Wholesale Fish Distribution Facility in Jessup, where dozens of employees had abruptly fallen ill about three hours after lunch. Helicopter footage of the event captured images of workers around picnic tables outside the plant, some doubled over and with their heads down.

Ultimately, 46 people were sickened, and at least 26 were treated at an area hospital with symptoms of food poisoning, according to The Baltimore Banner. They all recovered.

“NAFCO maintains the highest standards of food safety and regularly undergoes rigorous inspections by health authorities,” NAFCO said in a written statement. “Its products continue to be safely produced and consumed by customers nationwide, and there are no issues related to its supply chain.”

Enterotoxins

In an update on Tuesday, the Maryland Department of Health announced that testing found that Staphylococcus aureus was the cause of the illnesses. S. aureus is often thought of as a skin bacterium, but the pathogen can spread to food from unwashed hands, the Centers for Disease Control and Prevention notes. In food that isn’t thoroughly cooked or is held at warm temperatures (between 40° F and 140° F) conducive to bacterial growth, the germ can grow and produce toxins.

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a-candy-engineer-explains-the-science-behind-the-snickers-bar

A candy engineer explains the science behind the Snickers bar

It’s Halloween. You’ve just finished trick-or-treating and it’s time to assess the haul. You likely have a favorite, whether it’s chocolate bars, peanut butter cups, those gummy clusters with Nerds on them, or something else.

For some people, including me, one piece stands out—the Snickers bar, especially if it’s full-size. The combination of nougat, caramel, and peanuts coated in milk chocolate makes Snickers a popular candy treat.

As a food engineer studying candy and ice cream at the University of Wisconsin-Madison, I now look at candy in a whole different way than I did as a kid. Back then, it was all about shoveling it in as fast as I could.

Now, as a scientist who has made a career studying and writing books about confections, I have a very different take on candy. I have no trouble sacrificing a piece for the microscope or the texture analyzer to better understand how all the components add up. I don’t work for, own stock in, or receive funding from Mars Wrigley, the company that makes Snickers bars. But in my work, I do study the different components that make up lots of popular candy bars. Snickers has many of the most common elements you’ll find in your Halloween candy.

Let’s look at the elements of a Snickers bar as an example of candy science. As with almost everything, once you get into it, each component is more complex than you might think.

Snickers bars contain a layer of nougat, a layer of caramel mixed with peanuts, and a chocolate coating.

Credit: istarif/iStock via Getty Images

Snickers bars contain a layer of nougat, a layer of caramel mixed with peanuts, and a chocolate coating. Credit: istarif/iStock via Getty Images

Airy nougat

Let’s start with the nougat. The nougat in a Snickers bar is a slightly aerated candy with small sugar crystals distributed throughout.

One of the ingredients in the nougat is egg white, a protein that helps stabilize the air bubbles that provide a light texture. Often, nougats like this are made by whipping sugar and egg whites together. The egg whites coat the air bubbles created during whipping, which gives the nougat its aerated texture.

A boiled sugar syrup is then slowly mixed into the egg white sugar mixture, after which a melted fat is added. Since fat can cause air bubbles to collapse, this step has to be done last and very carefully.

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pizza-place-accidentally-spiked-dough-with-thc,-sickening-dozens

Pizza place accidentally spiked dough with THC, sickening dozens

In a statement on its website, Yeti’s co-owner Cale Ryan said that police testing “confirmed that pizza had been sold with dough mistakenly prepared with Delta-9-contaminated oil. The oil accidentally used in the product originated from a shared storage space in the on-site cooperative commercial kitchen.”

Oil jug with no label

Over the weekend, Ryan explained further to the Wisconsin State Journal that when Famous Yeti’s ran out of olive oil for its pizza dough, one of the cooks went across the hall to borrow some. “It’s not normal to do, but you borrow a cup of sugar from a neighbor,” Ryan said. “We went over to borrow some oil and grabbed the wrong one.” The contamination affected one batch of dough, which makes 60 pizzas, he said.

According to the health department, the oil the cook took “was in a clear plastic jug that looks like other cooking oils. There was a label on the cap that had manufacturer’s information, use by date, and noted it contained Delta-9 cannabis. The operator did not notice the label on the cap. There was no additional labeling on the body of the bottle.” The health department said it doesn’t know what dosages ended up in the pizza.

THC exposure can cause dizziness, increased blood pressure, increased heart rate, nausea, vomiting, anxiety, panic attacks, paranoia, hallucinations, short-term memory impacts, time distortion, and sleepiness. “Keep in mind each person’s reaction may be different, and the concentration of THC in the pizza can vary by piece,” the health department cautioned.

In a letter posted to Facebook Friday, Ryan apologized and took full responsibility for the contamination. “We put people and families at risk and frightened and confused children and parents. … I am incredibly sorry that I allowed us to act this irresponsibly and ended up hurting the people who have made Yetis [sic] the wonderful place it has been.”

According to America’s Poison Centers, cannabis edible exposures have been increasing among children and teens since at least 2019. Much like what happened at Yeti’s, the trend in accidental poisonings can be blamed on poor labeling and cannabis products that resemble common foods, including candies.  To date, Poison Centers have tracked nearly 7,000 exposures in children this year. “While edible cannabis does not typically result in serious problems for adults, children have more severe reactions and are more likely to require medical attention” the poison centers say. In children, severe reactions to cannabis can include slowed breathing, seizure, and coma.

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hospitals-adopt-error-prone-ai-transcription-tools-despite-warnings

Hospitals adopt error-prone AI transcription tools despite warnings

In one case from the study cited by AP, when a speaker described “two other girls and one lady,” Whisper added fictional text specifying that they “were Black.” In another, the audio said, “He, the boy, was going to, I’m not sure exactly, take the umbrella.” Whisper transcribed it to, “He took a big piece of a cross, a teeny, small piece … I’m sure he didn’t have a terror knife so he killed a number of people.”

An OpenAI spokesperson told the AP that the company appreciates the researchers’ findings and that it actively studies how to reduce fabrications and incorporates feedback in updates to the model.

Why Whisper confabulates

The key to Whisper’s unsuitability in high-risk domains comes from its propensity to sometimes confabulate, or plausibly make up, inaccurate outputs. The AP report says, “Researchers aren’t certain why Whisper and similar tools hallucinate,” but that isn’t true. We know exactly why Transformer-based AI models like Whisper behave this way.

Whisper is based on technology that is designed to predict the next most likely token (chunk of data) that should appear after a sequence of tokens provided by a user. In the case of ChatGPT, the input tokens come in the form of a text prompt. In the case of Whisper, the input is tokenized audio data.

The transcription output from Whisper is a prediction of what is most likely, not what is most accurate. Accuracy in Transformer-based outputs is typically proportional to the presence of relevant accurate data in the training dataset, but it is never guaranteed. If there is ever a case where there isn’t enough contextual information in its neural network for Whisper to make an accurate prediction about how to transcribe a particular segment of audio, the model will fall back on what it “knows” about the relationships between sounds and words it has learned from its training data.

Hospitals adopt error-prone AI transcription tools despite warnings Read More »

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Ars Live: What else can GLP-1 drugs do? Join us Tuesday for a discussion.

News and talk of GLP-1 drugs are everywhere these days—from their smash success in treating Type 2 diabetes and obesity to their astronomical pricing, drug shortages, compounding disputes, and what sometimes seems like an ever-growing list of other conditions the drugs could potentially treat. There are new headlines every day.

However, while the drugs have abruptly stolen the spotlight in recent years, researchers have been toiling away at developing and understanding them for decades, stretching back to the 1970s. And even since they were developed, the drugs still have held mysteries and unknowns. For instance, researchers thought for years that they worked directly in the gut to decrease blood sugar levels and make people feel full. After all, the drugs mimic an incretin hormone, glucagon-like peptide-1, that does exactly that. But, instead, studies have since found that they work in the brain.

In fact, the molecular receptors for GLP-1 are sprinkled in many places around the body. They’re found in the central nervous system, the heart, blood vessels, liver, and kidney. Their presence in the brain even plays a role in inflammation. As such, research on GLP-1 continues to flourish as scientists work to understand the role it could play in treating a range of other chronic conditions.

Ars Live: What else can GLP-1 drugs do? Join us Tuesday for a discussion. Read More »

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McDonald’s E. coli outbreak grows by 50% in 3 days as lawsuits mount

Twenty-six more cases have been identified in a multistate E. coli O157:H7 outbreak linked to McDonald’s Quarter Pounder burgers, the Centers for Disease Control and Prevention announced Friday.

The 26 new cases represent a 50 percent increase in the case count from October 22, bringing the total to 75 cases. With the new cases, health officials also reported 12 more hospitalizations, including one new adult case of hemolytic uremic syndrome (HUS), a severe complication to an E. coli O157:H7 infection. Three more states are also newly affected: Michigan, New Mexico, and Washington.

In all, the outbreak now stands at 75 cases, including 22 hospitalizations and two cases of HUS, across 13 states. The number of deaths linked to the outbreak remains at one. The most recent illness onset for the cases identified so far is October 10.

The states with cases now include: Colorado (26 cases), Montana (13), Nebraska (11), New Mexico (5), Utah (5), Missouri (4), Wyoming (4), and Michigan (2), and one case each in Iowa, Kansas, Oregon, Washington, and Wisconsin.

The source of the outbreak has not yet been confirmed, but investigators have focused on the beef patties and slivered onions used on McDonald’s Quarter Pounders. McDonald’s immediately pulled the popular burger off the menu and paused distribution of the slivered onions from affected restaurants when the CDC announced the outbreak Tuesday. McDonald’s considered the affected areas to be Colorado, Kansas, Utah, and Wyoming, as well as portions of Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico, and Oklahoma.

Onions recalled and destroyed

On Wednesday, one of McDonald’s onion suppliers, Taylor Farms, recalled peeled and diced yellow onion products. Taylor Farms told Bloomberg earlier this week that its testing had not turned up E. coli, but that it decided to issue the recall anyway.

McDonald’s E. coli outbreak grows by 50% in 3 days as lawsuits mount Read More »