WESTERN PERSPECTIVE

Zelensky says NATO membership 'impossible' before end of Russia war

President Volodymyr Zelensky acknowledged on Friday that Ukraine would not be able to join NATO before the end of the Russian invasion. 

Russia's invasion of Ukraine in February last year has galvanised the Western military alliance, set up almost 75 years ago, to face off against the Soviet Union. 

But members of the military bloc are split over Ukraine, with NATO chief Jens Stoltenberg saying all members agree to stick by a 2008 pledge that Ukraine will become a member at some undefined point. 

"We are reasonable people and we understand that we are not going to drag a single NATO country into a war," Zelensky said during a briefing along Estonian President Alar Karis. 

"Therefore, we understand that we will not be members of NATO while this war is going on. Not because we don't want to, but because it's impossible," Zelensky added.

Ukraine is a candidate to join both NATO and the European Union but some European capitals are wary of setting a formal timeline for membership as Russia's invasion continues.

Joining NATO would mean Ukraine would be covered by the alliance's Article 5 collective defence clause that obliges all members to help defend it if attacked. 

Friday's comments were a rare admission by the Ukrainian president, who has stepped up pressure on NATO and the European Union to open their doors to Ukraine since the beginning of Russia's invasion in February, 2022.

On Thursday, Zelensky told a summit in Moldova that any doubts European leaders show before admitting Kyiv into the NATO alliance will embolden Russia to attack more countries. 

An option being weighed is major powers offering Ukraine bilateral security assurances in the years before it becomes a full NATO member. 

** Ukraine repels new Russian air barrage as Moscow contends with cross-border attacks

Ukraine fended off 36 Russian air attacks in and around the capital overnight while pro-Kyiv Russian fighters said they were battling Russian forces for a second day inside Russia, trading blame with Moscow for the deaths of two civilians.

Russia has launched about 20 waves of attacks on Kyiv since the beginning of May, in a surge that Ukraine says appears aimed at derailing its preparations for a major counter-offensive to try to end Russia's invasion.

A child was one of two people injured by falling debris in a region outside the Ukrainian capital as air defences shot down what the air force said on Friday were 15 Russian cruise missiles and 21 drones.

"The occupiers are not stopping their attempts to terrorise the Ukrainian capital with strike drones and missiles," the Ukrainian government said.

Russian officials reported cross-border shelling from several areas of northern Ukraine on Friday in the latest sign that Kyiv is starting to push back beyond its borders after more than 15 months of all-out Russian assault.

The governor of Russia's Belgorod region said two people had been killed and four wounded when Ukrainian forces shelled a road in the town of Maslova Pristan near the Ukrainian border. Shell fragments had struck passing cars.

"Two women were travelling in one of them. They died from their injuries on the spot," governor Vyacheslav Gladkov said on Telegram.

Gladkov said two people had been wounded and an industrial facility had caught fire after shelling in the town of Shebekino.

Shebekino suffered heavy bombardment on Thursday as well as a cross-border incursion, Russian officials said.

Russia said on Thursday it had repelled a second attempted incursion into the Belgorod border region in just over a week by what it casts as pro-Ukrainian militants. Ukraine denies involvement.

The Freedom of Russia Legion blamed Russia for the shelling of cars on Telegram, while posting images of what it said was one of its tanks in the nearby Russian village of Novaya Tavolzhanka and soldiers taking cover behind a wall during a gunfight.

"Near Tavolzhanka, the enemy destroyed a Renault car with civilians, mistaking it for a car with our sabotage group. At least two civilians were killed, and this is a direct consequence of the lack of professionalism of Putin's army," the Legion said on the Telegram messaging app.

The group describes itself as Russians fighting President Vladimir Putin's government to create a Russia that would be part of the "free world". Along with the Russian Volunteer Corps founded by a far-right Russian nationalist, it says they are Russian volunteers attacking under their own steam, and not on the orders of Ukraine.

 

RUSSIAN PERSPECTIVE

Ukraine’s backers running out of available weapons – UK

Western nations’ military stockpiles are being depleted, forcing them to seek armaments elsewhere to prop up Ukraine, UK Defence Secretary Ben Wallace has warned. He also downplayed Kiev’s hopes of joining NATO in the foreseeable future.

In an interview with The Washington Post published on Friday, Wallace commended the West for continuing to send defense aid to Ukraine amid its military standoff with Russia. However, the minister acknowledged that “we have seen reality, which is that we are all running out” of weapons and equipment that can be donated.

The UK and other nations are increasingly being forced to purchase arms on the international market for Ukraine, as opposed to tapping into their existing stockpiles, the official explained.

When asked about the prospects of Ukraine joining NATO, Wallace warned against overpromising to aspirants such as Kiev.

“We have to be realistic and say, ‘It’s not going to happen at Vilnius; It’s not going to happen anytime soon,’” the secretary insisted, referring to a NATO summit slated for this July in Lithuania’s capital.

Wallace revealed that several nations were prepared to sign bilateral or multilateral “mutual defense pacts” with Ukraine as an alternative to membership in the US-led military bloc.

However, the British cabinet minister expressed optimism over the much-anticipated Ukrainian counteroffensive, predicting that Kiev could retake Crimea by the end of this year.

Media reports emerged in late January that a senior US general had privately told Defense Secretary Wallace that the British Armed Forces were no longer considered a top-level military.

Anonymous sources cited in the articles warned that UK Prime Minister Rishi Sunak risked failing in his role as a “wartime prime minister” unless he beefed up London’s defense budget and took several other measures.

In early April, German Defense Minister Boris Pistorius acknowledged that his own country’s army was facing similar problems, and would not be able to bridge gaps in funding and supplies by 2030. He also rejected the idea of sending more arms to Ukraine from Berlin’s stockpiles.

In March, Germany’s Parliamentary Commissioner for the Armed Forces, Eva Hoegl concluded that the “Bundeswehr has too little of everything, and it has even less since February 24, 2022.”

She pointed out that donations of howitzers, multiple rocket launchers and Leopard tanks to Ukraine had left “big holes” in Germany’s own military stockpiles.

 

AFP/Reuters/RT

Sudanese forces clash in Khartoum after talks break down

Sudan's warring parties fought in the capital on Friday after the collapse of talks to maintain a ceasefire and ease a humanitarian crisis.

Residents of Khartoum and Omdurman across the Nile said the army had resumed air strikes and was using more artillery. But said there was no sign the paramilitary Rapid Support Forces (RSF) was retreating from streets and homes it had occupied, they said.

"We are suffering so much from this war. Since this morning there have been sounds of violence. We're living in terror. It is a real nightmare," said Shehab al-Din Abdalrahman, 31, in a southern district of Khartoum.

Seven weeks of warfare between the army and RSF have smashed up parts of central Khartoum, threatened to destabilise the wider region, displaced 1.2 million people inside Sudan and sent 400,000 others into neighbouring states.

The United Nations Security Council on Friday condemned attacks on civilians and called on the factions to cease hostilities and ensure humanitarian access throughout the country, according to a statement.

The United States and Saudi Arabia on Thursday suspended truce talks after a ceasefire they had mediated fell apart, accusing both sides of occupying homes, businesses and hospitals, carrying out air strikes, other attacks and making prohibited military movements.

Washington imposed sanctions on businesses belonging to the army and RSF and threatened more action "if the parties continue to destroy their country", a senior U.S. official said.

The army said on Friday it was "surprised" by the U.S. and Saudi decision to suspend the negotiations after it had made proposals for implementing the agreement, blaming the RSF for breaching the truce. The RSF on Friday blamed the army for the talks' collapse, accusing it of repeated violations.

Sudan's ambassador to Washington, Mohamed Abdallah Idris, said the government and army remained committed to the truce and any penalties should be "imposed on the party that did not abide by what it signed" - a reference to the RSF.

REFUGEES FLEE TO CHAD

Since the overthrow of longtime ruler Omar al-Bashir in 2019 Sudan's government has been headed by a sovereign council under army chief General Abdel-Fattah al-Burhan with the RSF head Mohamed Hamdan Dagalo, known as Hemedti, as his deputy.

After they went to war on April 15 Burhan said he had dismissed Hemedti from the council, and government departments have remained aligned with the army.

Outside Khartoum, the worst fighting has been in the Darfur region, where a civil war in which about 300,000 people have been killed has simmered since 2003.

More than 100,000 people have fled militia attacks in Darfur in the west to neighbouring Chad since the latest fighting began, and the numbers could double in the next three months, the U.N. refugee agency UNHCR said on Thursday.

A truce was aimed at enabling aid to be delivered to civilians caught in the war that has disabled power and water networks, ruined hospitals and hampered food distribution.

Aid workers in Sudan say fierce fighting, rampant looting and reams of red tape are hampering aid. The United Nations called on all parties to respect humanitarian work.

Egypt and Qatar will work together on humanitarian support for refugees, Egypt said on Friday.

The WFP said it had recorded losses of more than $60 million since the fighting began. The UNHCR said two of its offices in Khartoum were pillaged and its warehouse in El Obeid was targeted on Thursday.

Khartoum residents are bracing for more problems.

"Since yesterday one telecom network has been down. Today another one is down. The power is out but the water has come back. It's like they're alternating forms of torture," said Omer Ibrahim, who lives in Omdurman.

 

Reuters

 

 

The young woman was catatonic, stuck at the nurses' station - unmoving, unblinking and unknowing of where or who she was.

Her name was April Burrell.

Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia, an often devastating mental illness that affects approximately 1 percent of the global population and can drastically impair how patients behave and perceive reality.

"She was the first person I ever saw as a patient," said Sander Markx, director of precision psychiatry at Columbia University, who was still a medical student in 2000 when he first encountered April. "She is, to this day, the sickest patient I've ever seen."

It would be nearly two decades before their paths crossed again. But in 2018, another chance encounter led to several medical discoveries reminiscent of a scene from "Awakenings," the famous book and movie inspired by the awakening of catatonic patients treated by the late neurologist and writer Oliver Sacks.

Markx and his colleagues discovered that although April's illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments - and more than two decades trapped in her mind - April woke up.

The awakening of April - and the successful treatment of other people with similar conditions - now stand to transform care for some of psychiatry's sickest patients, many of whom are languishing in mental institutions.

Researchers working with the New York State mental healthcare system have identified about 200 patients with autoimmune diseases, some institutionalized for years, who may be helped by the discovery.

And scientists around the world, including Germany and Britain, are conducting similar research, finding that underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.

Although the current research probably will help only a small subset of patients, the impact of the work is already beginning to reshape the practice of psychiatry and the way many cases of mental illness are diagnosed and treated.

"These are the forgotten souls," said Markx. "We're not just improving the lives of these people, but we're bringing them back from a place that I didn't think they could come back from."

- - -

Losing April

Even as a teenager growing up in Baltimore, April showed signs of the college accounting student she would later become. She balanced her dad's checkbook and helped collect the rent on his properties.

She lived with her father, who had served in the Army, and her stepmother and is one of seven siblings. She was keenly focused on academics and would be disappointed if she received a B in a class. She played volleyball in high school, and her family remembers her as being profoundly capable in all things. She helped her dad renovate his dozens of rental properties and could even wire outlets and climb on roofs to tar and repair them.

By all accounts, she was thriving, in overall good health and showing no signs of mental distress beyond the normal teenage growing pains.

"April was a high achiever," said her older half-brother, Guy Burrell. "She was very friendly, very outgoing. She just loved life."

But in 1995, her family received a nightmarish phone call from one of her professors. April was incoherent and had been hospitalized. The details were hazy, but it appeared that April had suffered a traumatic experience, which The Post isn't describing to protect her privacy.

After April spent a few months at a short-term psychiatric hospital, she was eventually diagnosed with schizophrenia.

Her family tried their best to take care of her, but April required constant attention, and, in 2000, she went to Pilgrim Psychiatric Center for long-term care. Her family visited as often as they could, making the four-hour drive from Maryland to Long Island once or twice a month. But April was locked in her own world of psychosis, often appearing to draw with her fingers what appeared to be calculations and having conversations with herself about financial transactions.

April was unable to recognize, let alone engage with, her family. She did not want to be touched, hugged or kissed. Her family felt they had lost her.

- - -

A promising medical student

When April was diagnosed with schizophrenia, Markx was still a promising medical student, an ocean away at the University of Amsterdam. His parents were both psychiatrists and he had grown up around psychiatry and its patients. Markx remembers playing as a child in the long-term psychiatric facilities where his parents worked; he was never afraid of the patients or the stigma associated with their illnesses.

As a visiting Fulbright Scholar to the United States, he made the decision not to head to more well-known institutes, but instead chose Pilgrim Psychiatric Center, a state hospital in Brentwood, N.Y., where many of the state's most severe psychiatric patients live for months, years or even the rest of their lives.

It was during his early days at Pilgrim that he met April, an encounter that "changed everything," he said.

"She would just stare and just stand there," Markx said. "She wouldn't shower, she wouldn't go outside, she wouldn't smile, she wouldn't laugh. And the nursing staff had to physically maneuver her."

As a student, Markx was not in a position to help her. He moved on with his career, but always remembered the young woman frozen at the nurses' station.

- - -

Bringing back April

Almost two decades later, Markx had a lab of his own. He encouraged one of his research fellows to work in the trenches and suggested he spend time with patients at Pilgrim, just as he had done years earlier.

In an extraordinary coincidence, the trainee, Anthony Zoghbi, encountered a catatonic patient, standing at the nurse's desk. The fellow returned to Markx, shaken up, and told him what he had seen.

"It was like déjà vu because he starts telling the story," said Markx. "And I'm like, 'Is her name April?'"

Markx was stunned to hear that little had changed for the patient he had seen nearly two decades earlier. In the years since they had first met, April had undergone many courses of treatment - antipsychotics, mood stabilizers and electroconvulsive therapy - all to no avail.

Markx was able to get family consent for a full medical work-up. He convened a multidisciplinary team of more than 70 experts from Columbia and around the world - neuropsychiatrists, neurologists, neuroimmunologists, rheumatologists, medical ethicists - to figure out what was going on.

The first conclusive evidence was in her bloodwork: It showed that her immune system was producing copious amounts and types of antibodies that were attacking her body. Brain scans showed evidence that these antibodies were damaging her brain's temporal lobes, brain areas that are implicated in schizophrenia and psychosis.

The team hypothesized that these antibodies may have altered the receptors that bind glutamate, an important neurotransmitter, disrupting how neurons can send signals to one another.

Even though April had all the clinical signs of schizophrenia, the team believed that the underlying cause was lupus, a complex autoimmune disorder where the immune system turns on its own body, producing many antibodies that attack the skin, joints, kidneys or other organs. But April's symptoms weren't typical, and there were no obvious external signs of the disease; the lupus appeared to only be affecting her brain.

The autoimmune disease, it seemed, was a specific biological cause - and potential treatment target - for the neuropsychiatric problems April faced. (Whether her earlier trauma had triggered the disease or was unrelated to her condition wasn't clear.)

The diagnosis made Markx wonder how many other patients like April had been missed and written off as untreatable.

"We don't know how many of these people are out there," Markx said. "But we have one person sitting in front of us, and we have to help her."

- - -

Waking up after two decades

The medical team set to work counteracting April's rampaging immune system and started April on an intensive immunotherapy treatment for neuropsychiatric lupus. Every month for six months, April would receive short, but powerful "pulses" of intravenous steroids for five days, plus a single dose of cyclophosphamide, a heavy-duty immunosuppressive drug typically used in chemotherapy and borrowed from the field of oncology. She was also treated with rituximab, a drug initially developed for lymphoma.

The regimen is grueling, requiring a month-long break between each of the six rounds to allow the immune system to recover. But April started showing signs of improvement almost immediately.

As part of a standard cognitive test known as the Montreal Cognitive Assessment (MoCA), she was asked to draw a clock - a common way to assess cognitive impairment. Before the treatment, she tested at the level of a dementia patient, drawing indecipherable scribbles.

But within the first two rounds of treatment, she was able to draw half a clock - as if one half of her brain was coming back online, Markx said.

Following the third round of treatment a month later, the clock looked almost perfect.

Despite this improvement, her psychosis remained. As a result, some members of the team wanted to transfer April back to Pilgrim Psychiatric Center, Markx said. At the time, Markx had to travel home to the Netherlands, and feared that in his absence, April would be returned to Pilgrim.

On the day Markx was scheduled to fly out, he entered the hospital one last time to check on his patient, who he typically found sitting in the dining room in her catatonic state.

But when Markx walked in, April didn't seem to be there. Instead, he saw another woman sitting in the room.

"It didn't look like the person I had known for 20 years and had seen so impaired," Markx said. "And then I look a little closer, and I'm like, 'Holy s—. It's her.'"

It was as if April had awakened after more than 20 years.

- - -

A joyful reunion

"I've always wanted my sister to get back to who she was," Guy Burrell said.

In 2020, April was deemed mentally competent to discharge herself from the psychiatric hospital where she had lived for nearly two decades, and she moved to a rehabilitation center.

Because of visiting restrictions related to covid, the family's face-to-face reunion with April was delayed until last year. April's brother, sister-in-law and their kids were finally able to visit her at a rehabilitation center, and the occasion was tearful and joyous.

"When she came in there, you would've thought she was a brand new person," Guy Burrell said. "She knew all of us, remembered different stuff from back when she was a child."

A video of the reunion shows that April was still tentative and fragile. But her family said she remembered her childhood home in Baltimore, the grades she got in school, being a bridesmaid in her brother's wedding - seemingly everything up until when the autoimmune inflammatory processes began affecting her brain. She even recognized her niece, whom April had only seen as a small child, now a grown young woman. When her father hopped on a video call, April remarked "Oh, you lost your hair," and burst out laughing, Guy Burrell recalled.

The family felt as if they'd witnessed a miracle.

"She was hugging me, she was holding my hand," Guy Burrell said. "You might as well have thrown a parade because we were so happy, because we hadn't seen her like that in, like, forever."

"It was like she came home," Markx said. "We never thought that was possible."

- - -

Finding more forgotten patients

Markx talked about how, as a teenager, he saw the movie adaptation of Oliver Sacks's "Awakenings," featuring Robin Williams and Robert DeNiro, and how it had haunted him. "The notion that people are gone in these mental institutes and that they come back still, that has always stuck with me," he said.

Before his death in 2015, Sacks had spoken to Markx about the discoveries involving patients like April. Sacks, also a professor at Columbia University, had a personal interest in the work. He had a brother with schizophrenia.

"Your work gives me hope about the outcomes we can achieve with our patients that I never before would have dreamed possible, as these are true cases of 'Awakenings' where people get to go back home to their families to live out their lives," Sacks said, according to contemporaneous notes kept by Markx. (The statement was confirmed by Kate Edgar, Sacks's long-term personal editor and executive director of the Oliver Sacks Foundation.)

After April's unexpected recovery, the medical team put out an alert to the hospital system to identify any patients with antibody markers for autoimmune disease. A few months later Anca Askanase, a Columbia rheumatologist who had been on April's treatment team, approached Markx. "I think we found our girl," she said.

- - -

Bringing back Devine

When Devine Cruz was 9, she began to hear voices. At first, the voices fought with one another. But as she grew older, the voices would talk about her. One night, the voices urged her to kill herself.

For more than a decade, the young woman moved in and out of hospitals for treatment. Her symptoms included visual and auditory hallucinations, as well as delusions that prevented her from living a normal life.

Devine was eventually diagnosed with schizoaffective disorder, which can result in symptoms of both schizophrenia and bipolar disorder. She also was diagnosed with intellectual disability.

She was on a laundry list of drugs - two antipsychotic medications, lithium, clonazepam, Ativan and benztropine - that came with a litany of side effects but didn't resolve all her symptoms. She was often unaware of what was going on; her hair was disheveled, and her medications caused her to shake and drool, her doctors said.

She also had lupus, which she had been diagnosed with when she was about 14, although doctors had never made a connection between the disease and her mental health.

When Markx and his team found Devine, she was 20 and held the adamant delusion that she was pregnant despite multiple negative pregnancy tests.

"That's when she was probably at her worst," said Sophia Chaudry, a precision psychiatry fellow at Columbia University Medical Center and physician who was closely involved in Devine's care.

Last August, the medical team prescribed monthly immunosuppressive infusions of corticosteroids and chemotherapy drugs, a regime similar to what April had been given a few years prior. By October, there were already dramatic signs of improvement.

"She was like 'Yeah, I gotta go,'" Markx said. "'Like, I've been missing out.'"

After several treatments, Devine began developing awareness that the voices in her head were different from real voices, a sign that she was reconnecting with reality. She finished her sixth and final round of infusions in January.

In March, she was well enough to meet with a reporter. "I feel like I'm already better," Devine said during a conversation in Markx's office at the New York State Psychiatric Institute, where she was treated. "I feel myself being a person that I was supposed to be my whole entire life."

Her presence during the interview was at first timid and childlike. She said her excitement and anxiety about discussing her story reminded her of how she felt in school the day before a big field trip.

Although she had lost about 10 years of her life to her illness, she remembers many details. As a child, she did not know how to explain what she was going through to her family and often isolated herself in her room.

"Because the crisis was so bad, it felt like I was being mute," Devine said. "I was talking without making any sense, so they wouldn't understand what I was saying."

Devine still remembers what the voices sounded like and the often disturbing images she hallucinated: a hand reaching down from the ceiling as she lay in bed, the creepy nurse with the crooked head and black teeth who approached her in the hospital.

She remembers the paranoia she felt at times. "I thought that the world was ending, I thought that the police were out to get me."

But she also remembers that fateful first phone call with Markx when she learned that her lupus could be affecting her brain. She remembers asking, "If it affects my brain, what does this have to do with my mental illness?"

Her recovery is remarkable for several reasons, her doctors said. The voices and visions have stopped. And she no longer meets the diagnostic criteria for either schizoaffective disorder or intellectual disability, Markx said.

In a recent neuropsychiatric evaluation, Devine not only drew a perfect clock, but also asked how the physician was doing, a level of engagement that the doctor found so surprising that she noted it in the patient report.

But more importantly, Devine now recognizes that her previous delusions weren't real. Such awareness is profound because many severely sick mental health patients never reach that understanding, Chaudry said.

Today, Devine lives with her mother and is leading a more active and engaged life. She helps her mother cook, goes to the grocery store and navigates public transportation to keep her appointments. She is even babysitting her siblings' young children - listening to music, taking them to the park or watching "Frozen 2" - responsibilities her family never would have entrusted her with before her recovery.

She is grateful for her treatment and the team that made it possible. "Without their help, I wouldn't be here," Devine said.

"I feel more excited," she said. "Like a new chapter is beginning."

- - -

Expanding the search for more patients

While it is likely that only a subset of people diagnosed with schizophrenia and psychotic disorders have an underlying autoimmune condition, Markx and other doctors believe there are likely many more patients whose psychiatric conditions are caused or exacerbated by autoimmune issues.

The cases of April and Devine also helped inspire the development of the SNF Center for Precision Psychiatry and Mental Health at Columbia, which was named for the Stavros Niarchos Foundation, which awarded it a $75 million grant in April.The goal of the center is to develop new treatments based on specific genetic and autoimmune causes of psychiatric illness, said Joseph Gogos, co-director of the SNF Center.

Markx said he has begun care and treatment on about 40 patients since the SNF Center opened. The SNF Center is working with the New York State Office of Mental Health, which oversees one of the largest public mental health systems in America, to conduct whole genome sequencing and autoimmunity screening on inpatients at long-term facilities.

For "the most disabled, the sickest of the sick, even if we can help just a small fraction of them, by doing these detailed analyses, that's worth something," said Thomas Smith, chief medical officer for the New York State Office of Mental Health. "You're helping save someone's life, get them out of the hospital, have them live in the community, go home."

Discussions are underway to extend the search to the 20,000 outpatients in the New York state system as well. Serious psychiatric disorders, like schizophrenia, are more likely to be undertreated in underprivileged groups. And autoimmune disorders like lupus disproportionately affect women and people of color with more severity.

- - -

Changing psychiatric care

How many people ultimately will be helped by the research remains a subject of debate in the scientific community. But the research has spurred excitement about the potential to better understand what is going on in the brain during serious mental illness.

"I think we, as basic neuroscientists, are now in a position, both conceptually and technologically, to contribute, and it's our responsibility to do so," said Richard Axel, Nobel laureate and co-director of Columbia's Zuckerman Mind Brain Behavior Institute.

Emerging research has implicated inflammation and immunological dysfunction as potential players in a variety of neuropsychiatric conditions, including schizophrenia, depression and autism.

"It opens new treatment possibilities to patients that used to be treated very differently," said Ludger Tebartz van Elst, a professor of psychiatry and psychotherapy at University Medical Clinic Freiburg in Germany.

In one study, published last year in Molecular Psychiatry, Tebartz van Elst and his colleagues identified 91 psychiatric patients with suspected autoimmune diseases, and reported that immunotherapies benefited the majority of them.

Belinda Lennox, head of the psychiatry department at the University of Oxford, is enrolling patients in clinical trials to test the effectiveness of immunotherapy for autoimmune psychosis patients.

In addition to more common autoimmune conditions, researchers also have identified 17 diseases, many with different neurological and psychiatric symptoms, in which antibodies specifically target neurons, said Josep Dalmau, a neurologist at the University of Barcelona Hospital Clinic. Dalmau first identified one of the most common of these diseases, called anti-NMDA receptor autoimmune encephalitis.

As a result of the research, screenings for immunological markers in psychotic patients are already routine in Germany, where psychiatrists regularly collect samples from cerebrospinal fluid.

Markx is also doing similar screening with his patients. He believes highly sensitive and inexpensive blood tests to detect different antibodies should become part of the standard screening protocol for psychosis.

Also on the horizon: more targeted immunotherapy rather than current "sledgehammer approaches" that suppress the immune system on a broad level, said George Yancopoulos, the co-founder and president of the pharmaceutical company Regeneron.

"I think we're at the dawn of a new era. This is just the beginning," said Yancopoulos.

In June, Markx will present the findings at a conference organized by the Stavros Niarchos Foundation.

And Devine will be there to share her story in her own words.

"The message I want to give people is that there is time to heal," Devine said. "There's time to heal yourself from many obstacles you've been facing in life."

The future for patients like April and Devine

April, who is turning 50 this year, has lived in a rehabilitation center for the past three years. Her family continues to visit, but she has recently regressed because she was not receiving adequate maintenance care, Markx said. Markx and April's family remain optimistic that she will improve after resuming treatment.

"She would not want society to give up on her or people like her," Guy Burrell said.

Devine, now 21, is still living with her family, writing poetry and hopes for a future helping others, possibly as an art therapist. She still needs support after losing more than a decade of her childhood.

Her experience is akin psychologically to being in a coma for 10 years, and then waking up "and the world's moved on," said Steven Kushner, co-director of the SNF Center. The treatment team is working to help Devine and other patients to catch up on lost time and navigate life after recovery.

Devine said she wants to help motivate others in their struggles. When asked to share a piece of her poetry, she picked "The Healing," which reads, in part:

"Hello Dear,

I know you're struggling, struggling to find out what's wrong from right.

Figuring out is it even too late to start anything.

Going off based on fear

Is it even real.

Take your time dear one there's no need to rush in a hurry.

You are precious to those around you…

You are not alone for the world has beautiful creations made just for you."

 

The Washington Post

One of Italy's most remarkable archaeological finds in decades goes on show this month - Etruscan and Roman statues pulled from the mud in Tuscany thanks in part to the intuition of a retired garbage man.

About two dozen bronze statues from the third century BC to the first century AD, extracted from the ruins of an ancient spa, will go on display in Rome's Quirinale Palace from June 22, after months of restoration.

When the discovery was announced in November, experts called it the biggest collection of ancient bronze statues ever found in Italy and hailed it as a breakthrough that would "rewrite history".

The statues were found in 2021 and 2022 in the hilltop village of San Casciano dei Bagni, still home to popular thermal baths, where archaeologists had long suspected ancient ruins could be discovered.

Initial attempts to locate them, however, were unsuccessful.

Digging started in 2019 on a small plot of land next to the village's Renaissance-era public baths, but weeks of excavations revealed "only traces of some walls", San Casciano Mayor Agnese Carletti said.

Then former bin man and amateur local historian Stefano Petrini had "a flash" of intuition, remembering that years earlier he had seen bits of ancient Roman columns on a wall on the other side of the public baths.

The columns could only be seen from an abandoned garden that had once belonged to his friend, San Casciano's late greengrocer, who grew fruit and vegetables there to sell in the village shop.

When Petrini took archaeologists there, they knew they had found the right spot.

"It all started from there, from the columns," Petrini said.

'SCRAWNY BOY' PULLED FROM MUD

Emanuele Mariotti, head of the San Casciano archaeological project, said his team was getting "quite desperate" before receiving the tip that led to the discovery of a shrine at the centre of the ancient spa complex.

The statues found there were offerings from Romans and Etruscans who looked to the gods for good health, as were the coins and sculptures of body parts like ears and feet also recovered from the site.

One of the most spectacular finds was the "scrawny boy" bronze, a statue about 90 cms (35 inches) high, of a young Roman with an apparent bone disease. An inscription has his name as "Marcius Grabillo".

"When he appeared from the mud, and was therefore partially covered, it looked like the bronze of an athlete ... but once cleaned up and seen properly it was clear that it was that of a sick person," said Ada Salvi, a Culture Ministry archaeologist for the Tuscan provinces of Siena, Grosseto and Arezzo.

Salvi said traces of more unusual offerings were also recovered, including egg shells, pine cones, kernels from peaches and plums, surgical tools and a 2,000-year-old lock of curly hair.

"It opens a window into how Romans and Etruscans experienced the nexus between health, religion and spirituality," she said. "There's a whole world of meaning that has to be understood and studied."

MORE TREASURES TO BE FOUND

The shrine was sealed at the beginning of the fifth century AD, when the ancient spa complex was abandoned, leaving its statues preserved for centuries by the warm mud of the baths.

Excavation will resume in late June. Mariotti said "it is a certainty" that more will be found in the coming years, possibly even the other six or 12 statues that an inscription says were left behind by Marcius Grabillo.

"We've only just lifted the lid," he said.

After the Rome exhibition, the statues and other artefacts are to find a new home in a museum that authorities hope to open in San Casciano within the next couple of years.

Petrini hopes the treasures will bring "jobs, culture and knowledge" to his 1,500-strong village, which is struggling with depopulation like much of rural Italy.

But he is reluctant to take credit for their discovery.

"Important things always happen thanks to several people, never thanks to only one," he said. "Never."

 

Reuters

Ever wonder why you just can't seem to sleep in anymore? Experts reveal the real reason why this happens as we age.

There are many jokes that center around older adults waking up before the sun, and even more about teenagers’ late-sleeping habits. Turns out there’s truth to them: The time our body naturally goes to sleep and wakes up is not only part of our genetics, but part of the natural aging process, too.

As we age, our bodies change both internally and externally, which is a major factor behind the sleep changes that come later in life. “Like most of the things that change with age, there’s not just one reason, and they are all interconnected,” said Cindy Lustig, a professor of psychology at the University of Michigan.

We asked Lustig and other experts to break down the main reasons why this occurs, and what you can do to push back if you just want those few extra hours of Zzzs.

Earlier wake times are part of the natural aging process

Like other aspects of our physical and mental health, the brain becomes less responsive as we age. 

“The wiring of the brain is likely not sensing ... and responding to the inputs as well as it should because it’s an aging brain,” said Dr. Sairam Parthasarathy, the director of the Center for Sleep and Circadian Sciences at the University of Arizona Health Sciences. These inputs include sunset, sunlight, meals, social cues and physical activity that help mark where we are in a day.

“These are all what we call time givers, or they give time to the brain,” he said. In other words, they help the brain sense where it is in the 24-hour circadian cycle. 

So, for a younger person, dinner time may help the brain understand that bedtime is in a few hours; for someone older, this connection may not happen.

The nerves that are supposed to give the brain time cues have undergone the same amount of degeneration as the brain, Parthasarathy said. This inability to sense time cues is part of the reason why older people tend to get tired before their children or grandchildren. And, as a result, wake up fully rested and earlier than the rest of the world.

The light our eyes take in is part of it, too

“Interestingly, one of [the reasons] seems to be that the vision changes that come with age reduce the intensity of the degree of light stimulation that our brain receives, which plays an important role in ‘setting’ our circadian clock and keeping it on track,” Lustig said.

Parthasarathy explained that this is especially true for people with cataracts, a common eye condition that impacts more than 50% of Americans ages 80 and up, according to the National Institutes of Health. Cataracts cause blurred vision, double vision and general trouble seeing.

“If there’s cataracts, the evening light doesn’t go into the eyes as much, so, according to the brain, sunset is earlier than when it actually set,” Parthasarathy said. 

Why does this matter? Since there is less light getting into the eyes because of the vision issues cataracts cause, the body starts to release melatonin (the sleep hormone) earlier than it should. For younger people, melatonin “starts rising after sunset,” Parthasarathy said, which is why you generally feel tired a few hours after. For people with cataracts whose brain thinks sunset was earlier, their perceived sunset is earlier, which makes them tired sooner in the evening. And going to bed sooner means waking up earlier.

“There is some evidence that cataract removal surgery can help improve sleep quality and duration by helping those light cues get through,” Lustig said.

If this is you, there are a few steps you can take to sleep better

According to Parthasarathy, if you struggle with this issue, you should ignore the advice to put away the screens and instead expose yourself to bright light in the late evening. This can mean going for a walk outside before the sun sets, reading a book on a bright iPad, getting artificial lights for your home or watching TV on a bright screen.

These bright lights will tell the brain that the sun hasn’t set yet, which will hold the melatonin production, he said. To help yourself stay up a little later (and sleep a little later as a result), Parthasarathy said you should try these things 30 to 60 minutes before sunset, which will vary depending on the time of year and where you live in the U.S.

The exact amount of time you should expose yourself to bright light varies, and might take a bit of trial and error, but he said you should aim for about two hours of exposure — and should certainly keep the light on after sunset.

Lustig added you should avoid alcohol before bed — “while that nightcap might make you sleepy, it actually disrupts the quality of your sleep.” Additionally, she said exercise can help you get better sleep and the morning sun can help your circadian clock follow the sun’s rise and set cues. 

All in all, changes in sleep patterns are a part of life. While some of these factors are out of your control, you can also counteract them with healthy habits so you can get your best rest.

 

HuffPost

Central Bank of Nigeria dismissed a report that it had devalued the naira as traders raised bets for it to weaken by almost a third, days after President Bola Tinubu said his administration will seek to end the nation’s multiple-currency regime

The CBN said a media report claiming it had devalued the naira by 26% to 630 per dollar was inaccurate. The exchange rate is N465 per dollar and “has been stable around that rate for a while,” it said on Twitter.

Tinubu announced plans to adopt a uniform exchange rate in his inauguration speech on May 29. Nigeria has numerous exchange rates, dominated by a tightly controlled official rate, that cuts off access to many businesses and individuals, which in turn drives demand to the unauthorized black market. The spread between the managed and parallel markets is almost 60%. Tinubu’s proposal may help attract investors who had shunned Africa’s biggest economy. 

Non-deliverable forward contracts on the naira are pricing in a depreciation of about 21% over the next three months and those with a 12-month tenor 32%. 

The moves reflect speculation by some market participants that authorities will allow for a steep decline in the naira.

Lagos-based brokerage, Chapel Hill Denham said that the naira should be weakened above its fair value of N606.58 to the dollar. It should be devalued close to the N650 to N700 range to the dollar it trades at in the parallel market “to restore investor confidence,” analyst Tajudeen Ibrahim said in an emailed note on Wednesday.

Nigeria's state owned oil company NNPC will soon end its monopoly on petrol supplies, its chief executive told local television on Thursday, a day after it nearly tripled prices at its fuel stations countrywide.

Newly inaugurated President Bola Tinubu pledged to remove fuel subsidies, a popular but costly benefit that has drained billions annually from government coffers.

Mele Kyari told Arise TV that prices were expected to come down once new companies started supplying petrol, bringing more competition.

"All we did was to set variable prices depending on our costs by location and knowing full well that NNPC is the single supplier of the market and we are seeing that exit coming very, very quickly," said Kyari.

"There will be no monopoly, NNPC will not continue being supplier of this product alone."

Kyari has previously said the corporation was owed $6 billion in petrol subsidy payments by the federal government.

Under the Petroleum Industry Act signed into law two years ago, NNPC cannot supply more than 30% of gasoline in Nigeria.

"As soon as the market stabilises, oil marketing companies are able to come in. Competition will surely come in ... and you will see changes in prices downwards," said Kyari.

Nigeria imports most of its refined petroleum products because it has run down its refineries over the years.

The 650,000 barrel per day Dangote Refinery was commissioned last month, amid hopes of transforming the country into a net exporter of petroleum products.

 

Reuters

Candidate of the Labour Party, LP, Peter Obi, who is insisting that he won the presidential election held on February 25, on Thursday, produced certified copies of results of the election from six states of the federation, to support his claim.

Obi tendered the results, which were obtained from 115 Local Government Areas, LGAs, in evidence before the Presidential Election Petition Court, PEPC, sitting in Abuja.

Though Obi’s legal team was led by Awa Kalu, however, the election results, which were contained in Forms EC8A, were tendered from the Bar by one of his lawyers, Emeka Opoko.

The first set of results of the election that was tendered before the court by the LP candidate who came third in the presidential election was from 15 out of 22 LGAs of Rivers State.

Despite opposition by all the respondents in the matter, Haruna Tsammani-led’s five-member panel admitted the Rivers state results and marked them as Exhibits PD 1 to PD 15.

Obi and the LP equally tendered results from 23 LGAs in Benue state, which were also admitted in evidence and marked as Exhibits PC 1 to PC 23, while results from 18 LGAs in Cross River State were added in evidence as Exhibits PD1 – PD 18.

On Niger state, Obi tendered Forms EC8A from 23 LGAs and they were admitted in evidence as Exhibits PE-1 to PE 23, as well as that of 20 LGAs in Osun state which were marked as Exhibits PF 1 – PF 20.

The last set of results the petitioners adduced and tendered in evidence before the court were from 16 LGAs in Ekiti and they were marked as Exhibits PG 1 to PG 16.

The Tsammani-led panel subsequently adjourned further proceedings in the matter till Friday.

All the respondents said they would give reasons why they challenged the admissibility of the presidential election results that Obi and the LP tendered in evidence, in their final written address.

Cited as 1st to 4th respondents in the petition, are; the Independent National Electoral Commission, INEC, Bola Tinubu, Kashim Shettima and the All Progressives Congress, APC.

It would be recalled that Obi and the LP had indicated their decision to call a total of 50 witnesses in the matter.

Specifically, Obi, in the joint petition he filed with the LP, is contending that Tinubu was not the valid winner of the election.

The petitioners, in the case, marked: CA/PEPC/03/2023, equally maintained that Tinubu was not qualified to participate in the presidential contest.

According to the petitioners, at the time Tinubu’s running mate, Shettima, became the Vice Presidential candidate, he was still the nominated candidate of the APC for the Borno Central Senatorial election.

The petitioners further challenged Tinubu’s eligibility to contest the presidential election, alleging that he was previously indicted and fined the sum of $460,000.00 by the United States District Court, Northern District of Illinois, Eastern Division, in Case No: 93C 4483, for an offence involving dishonesty and drug trafficking.

On the ground that the election was invalid by reason of corrupt practices and non-compliance with the provision of the Electoral Act, 2022, the petitioners argued that INEC acted in breach of its own Regulations and Guidelines.

The Petitioners argued that the electoral body was in the course of the conduct of the presidential poll, mandatorily required to prescribe and deploy technological devices for the accreditation, verification, continuation and authentication of voters and their particulars as contained in its Regulations.

They are, therefore, praying the court to among other things, declare that all the votes recorded for Tinubu and the APC, were wasted votes owing to his non-qualification/disqualification.

“That it is determined that on the basis of the remaining votes (after discountenancing the votes credited to the 2nd Respondent) the 1st Petitioner (Obi) scored a majority of the lawful votes cast at the election and had not less than 25% of the votes cast in at least 2/3 of the States of the Federation, and the Federal Capital Territory, Abuja, and satisfied the constitutional requirements to be declared the winner of the 25th February 2023 presidential election.

“That it be determined that the 2nd Respondent having failed to score one-quarter of the votes cast at the presidential election in the Federal Capital Territory, Abuja was not entitled to be declared and returned as the winner of the presidential election held on 25th February 2023.

In the alternative, the petitioners, want an order cancelling the election and compelling INEC to conduct a fresh election in which Tinubu, Shettima and the APC, listed as 2nd, 3rd and 4th Respondents, respectively, shall not participate.

They urged the court to declare that since Tinubu was not duly elected by a majority of the lawful votes cast in the election, therefore, his return as the winner of the presidential election, was unlawful, unconstitutional and of no effect whatsoever.

In a further alternative prayer, the petitioners want the court to hold that the presidential election was void on the ground that it was not conducted substantially in accordance with the provisions of the Electoral Act 2022, and the 1999 Constitution, as amended.

Likewise, the applied for an order, “cancelling the presidential election conducted on 25th February 2023 and mandating the 1st Respondent to conduct a fresh election for the President, the Federal Republic of Nigeria”.

Meanwhile, both Obi and his Vice Presidential candidate, Baba Ahmed Datti, were in court on Thursday to observe the proceeding.

 

Vanguard

Presidential candidate of the Peoples Democratic Party (PDP), Atiku Abubakar, on Thursday, presented his first witness at the Presidential Election Petition Court in Abuja.

Atiku, who came second in the February presidential election, is challenging the victory of Bola Tinubu of the All Progressives Congress (APC) in the 25th February election.

Tinubu was sworn in Monday as Nigeria’s president, while three petitioners, including Atiku, continue to pursue their separate cases to challenge his victory.

Led in his evidence-in-chief by Chris Uche, Atiku’s lawyer, the witness, Joe Agada, informed the five-member panel of the court headed by Haruna Tsammani that there were rampant cases of manipulation of electoral records by officials of the Independent National Electoral Commission (INEC) during the February poll.

Agada, a retired army captain, served as PDP’s State Collation agent in Kogi for the presidential election.

Agada said he monitored the polls in 20 polling units across two senatorial districts in Kogi.

Under cross-examination by INEC’s lawyer, Abdullahi Aliyu, Agada said Bimodal Voters Accreditation System “BVAS machines were manipulated during the conduct of the (presidential) election.”

“I was forced to sign the collated result sheets in Lokoja,” Agada added.

He explained that he signed the electoral documents under duress without further explaining the situation.

Agada is one of the 100 witnesses Atiku intends to call in support of his petition at the court.

The electoral documents earlier tendered by Atiku’s team comprise printouts of data from BVAS machines and result sheets tendered before the court.

But Tinubu and the electoral umpire objected to the admissibility of the documents.

They did not disclose any rationale for their objections but promised to do so at the close of arguments in the petition.

Lawyers to parties in the petitions had pledged not to object to certified true copies of electoral documents from INEC. However, the respondents have opposed the admissibility of many of the electoral records.

Atiku is challenging the outcome of the presidential election over allegations of INEC’s manipulation of the electoral process in favour of Tinubu.

But the legal battle to overturn Tinubu’s victory continues at the court.

 

PT

Nine people were killed in Senegal on Thursday in clashes between riot police and supporters of opposition leader Ousmane Sonko after a court sentenced him to two years in jail, casting serious doubt on his chances of running for president next year.

Sonko, 48, did not attend the hearing over an alleged sexual assault. The justice ministry said the opposition leader could now be taken to prison at any time. Police remained stationed around his home Dakar as unrest flared in the capital and elsewhere after the verdict.

Sonko was accused of raping a woman who worked in a massage parlour in 2021, when she was 20, and making death threats against her. He denies wrongdoing and says the charges are politically motivated.

A criminal court cleared Sonko of rape, but found him guilty of a separate offence described in the penal code as immoral behaviour towards individuals younger than 21.

"With this sentence Sonko cannot be a candidate," said one of his lawyers, Bamba Ciss, citing Senegal's electoral law.

Sonko's PASTEF party said the verdict was part of a political plot and called on citizens in a statement to "stop all activity and take to the streets".

Nine people were killed in the protests that broke out in parts of Dakar and other cities after the verdict, Interior Minister Antoine Felix Abdoulaye Diome said on state television in the early hours of Friday.

Earlier, thick black smoke had billowed from a central university campus in Dakar, where protesters set several buses alight in the afternoon and threw rocks at riot police who responded by firing tear gas.

Government spokesperson Abdou Karim Fofana said security forces had the situation under control in the capital.

Several social media and messaging platforms were restricted in Senegal late on Thursday - a move "likely to significantly impact the public's ability to communicate," the Netblocks internet observatory said.

University law professor Ndiack Fall said Sonko could demand a retrial if he turns himself in to authorities.

The case has triggered sporadic violent protests in the West African country since 2021. Sonko's supporters denounce the charges as a ploy to prevent him from running in elections scheduled for February. The government and the justice system deny this.

A former tax inspector who came third in the last election, Sonko has tapped into frustrations with President Macky Sall that have grown since he was elected in 2012.

Critics say Sall has failed to create jobs and has stifled opposition criticism amid rumours he may seek to bypass presidential term limits and run again next year. Sall has neither confirmed nor denied this.

Demonstrations are not uncommon in Senegal and typically increase around elections. But Sall's second term has been particularly turbulent for a country usually viewed as one of West Africa's strongest democracies.

Separately, Sonko is appealing against a six-month suspended prison sentence for libel - an offence he also denies.

 

Reuters