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#Antibody_Drug_Conjugates (ADCs) are a class of targeted cancer therapies that combine an antibody with a cytotoxic (cell-killing) drug.
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Ramucirumab is a monoclonal antibody used to treat advanced cancers by inhibiting VEGFR-2, preventing tumor growth. It’s approved for gastric, lung, colorectal, and liver cancers, often combined with chemotherapy for effectiveness.

Get More Insights: https://wemarketresearch.com/reports/ramucirumab-market/1550

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STRESS-
Inequities Poison Us All.
How inequities chronically inflame everyone’s bodies, even the most privileged.
Reviewed by Michelle Quirk

KEY POINTS-
Social inequities are a powerful predictor of health.
Inequities increase our risk of many health conditions through chronic inflammation.
We need to heal not only the individuals who are harmed but also the systems that make us sick.
Nothing has been more convincing of our interconnectedness than COVID-19 and our climate crisis. We can no longer pretend that what happens somewhere else won’t impact us all.

But it’s not only physical threats we share. Social inequities hurt everyone, too. We are in this together: The inequities experienced by some will poison everyone’s health, even the most privileged.

Simone Schenkman and Aylene Bousquat, researchers at the School of Public Health at Universidade de São Paulo, Brazil, compared countries around the world to evaluate the role of inequity in determining health outcomes. Their 2021 study showed that countries with the most inequity of income, education, and health dimensions—regardless of the country’s wealth—had the worst health outcomes.1

Living in an inequitable country doesn’t only affect those with the least privilege; it harms those at the top, too, they found. They concluded that policies that lead to inequities are “a disastrous political choice for society.”

Not only do the inequities lead to poor health outcomes and lower life expectancies for everyone but also higher levels of mental illness, substance use, incarceration, segregation, disrespect, violence, social distrust, and poor cohesion, they showed. “Inequity deteriorates the whole of society and not just the marginalized groups,” they concluded.

The Double-Edged Sword of Inflammation
Scientists now understand how inequity harms our health: because it’s stressful for everyone, says Robert M. Sapolsky, professor of biology and neurology at Stanford, who researches how stress damages our biology. “Basically, more unequal societies have a worse quality of life,” he says.2 “When inequality increases, everyone’s health suffers.”

Inequality creates stress, and stress creates the “double-edged biological sword” of inflammation, continues Sapolsky. Our stress response system is an essential adaptation to living in a world of threats around every corner or flick of our phones. When we anticipate a threat, our bodies are built to ramp up inflammatory responses, preparing them to repair the potential wound from a scary creature with big teeth and sharp claws.

Steve Cole, a genomics professor at UCLA, studies how social stresses affect our gene expression. His research, in collaboration with the late John Cacioppo, who was a social scientist at the University of Chicago, provided the first indication that social stress could increase inflammation—at the expense of immune function—in all our body’s cells.

Perceived danger sets off a stress response that signals to every tissue in our bodies to favour inflammation and sacrifice our immune response to get ready for a wounding injury, Cole says.

Cole, Cacioppo, and their colleagues repeated these findings time and time again, identifying the cellular mechanisms of how it happens—that social stress consistently activates a process in our bodies that increases the expression of genes that promote inflammation and decreases the expression of antiviral and antibody-related genes.3

This stress system works well if what we are fighting is a saber-toothed tiger, says Cole, but not if the threat is the complex social stresses that we face in modern society. This is because our stress response isn’t that specific; it’s still largely stuck in the Stone Age by assuming the most helpful response to all threats is preparing the body to heal from a physically wounding injury.

Adaptation is a slow process, and we haven’t yet evolved to the stresses that affect us most in modern society, Cole says—be they emotional or social stresses instead of physical wounds, or the long-term stress of inequities over brief injuries.

When our stress response is constantly going off, our body gets stuck in a state of chronic inflammation, which hurts our bodies and brains. While a brief burst of inflammation can be helpful to repair our body in the short term, countless studies show that chronic inflammation damages our bodies over time, increasing our risk of inflammatory-mediated diseases such as cardiovascular disease, diabetes, Alzheimer’s, depression, cancer, and many other illnesses, says Cole.

Molecular biologist and Nobel Prize winner Elizabeth Blackburn joined health psychologist Elissa Epel to study how stress affects the health of our telomeres—the bits at the end of our chromosomes that protect our DNA from damage. The length of our telomeres indicates our biological “age”—a sign of the body’s wear and tear. As we age and our cells divide, our telomeres shorten. Blackburn and Epel’s research kept finding the same conclusion: that stress makes our telomeres shorten faster. And, once again, one of the big stressors we face is inequality, which they found to shorten the telomeres of those on both the top and bottom of unequal societies. They offer a “Telomere Manifesto,” listing ways to protect our telomeres and, thus, aging.4 High on the list? Reduce inequality, they argue.

A Society Inflamed
In medical school, we learned risk factors for illnesses—being Indigenous, for example, was listed as a risk factor for a vast number of health problems, from type 2 diabetes to depression. But it is not an inherent characteristic of being Indigenous to be vulnerable to these health conditions. The health disparities between certain cultural or racial groups can often be explained by the intersecting social and structural determinants of health, such as intergenerational trauma, systemic racism, socioeconomic status, colonialization, exposure to environmental toxins, and access to health care and other resources.

“To wonder why some things settle in some bodies and not others is to begin to ask questions about power, injustice, and inequity,” writes Rupa Marya, a physician and associate professor of medicine at the University of California, San Francisco, and Raj Patel, a public health researcher and professor at the University of Texas, in Inflamed: Deep Medicine and the Anatomy of Injustice.

As the world faced the pandemic, we uncovered the shocking injustices and inequities that we’d been observing for decades, this time in the graves of people who lost their lives to COVID-19. “Black, Indigenous, and people of color (BIPOC) were over-represented, their bodies subject to inflammation of all kinds, long before the SARS-CoV-2 virus ever settled into their lungs,” argued Marya and Patel. “Not only the lack of access to health care, but systemic social and economic disenfranchisement rendered their bodies more susceptible to Covid when it hit,” they add.

Severe COVID-19 and other inflammatory-mediated conditions are more common in oppressed groups because of the cumulative burdens of toxic stress. And the majority of these stresses are involuntary. No amount of “self-care” or advice to reduce stress or focus on one’s health can erase the weight of systemic and intergenerational oppression. And, yet, so often we blame individuals, groups, or ourselves for poor health.

Perhaps it helps some of us sleep at night to think that we’re healthy because of our own merits, rather than unfairly hoarded privileges. Or maybe we feel more empowered if it’s our own fault that we’re sick, because, then, it's within our power to fix it, even if the added burden of stigma and blame hurts us more.

The only thing harder than recognizing and holding empathy for the unjust distribution of toxic stress that hurts the health of others is carrying these toxins in our own bodies. Inequality hurts us all, but it gravely harms the health of those who are most oppressed.

That’s why social justice is the most important medicine I can prescribe as a physician. Rather than putting Band-Aids on the illnesses caused by inequities to individuals, we need to heal the larger systems that are making them sick. As Seth Godin advises, “Don’t save the canary. Fix the coal mine.”

PREGNANCY-
Born to Bond: Vaginal Birth Boosts Physical, Mental Health.
And why C-sections can disadvantage mothers and infants.
Reviewed by Tyler Woods

KEY POINTS-
Vaginal birth biologically primes parenting behavior and bonding, and physically alters the newborn to ready it for life outside the womb.
These changes trigger a virtuous cycle of behavior and response that supports the parent-child relationship and healthy infant development.
Unfortunately, these processes are disrupted by C-section birth, which can save lives, but sometimes has negative long-term repercussions.

In the shadow of America’s shameful maternal death rate lies another pervasive health crisis: nearly one-third of U.S. births are by Cesarean section. This means that over a million new Americans start life facing risks to their development every year, often unbeknownst to their parents.

Vaginal birth is not just a means of moving an infant from the uterus to the outside world. Rather, it is a complex interaction between the fetus and the mother’s body that profoundly alters the neurobiology and physiology of each, preparing them for the new stage of life ahead. Vaginal birth impacts everything from the mother’s instinctive reaction to her baby’s cries to the newborn’s organ maturation.

Parenting a newborn is incredibly difficult and demanding, so nature has given mothers a helping hand, beginning with hormonal changes during pregnancy that rewire the brain in preparation for parenthood. Then, vaginal birth builds on that foundation by releasing a flood of hormones which transform new mothers’ brains, altering their cognitive, salience, and reward systems. This makes bonding and new parental behaviors easier and exceptionally rewarding, and radically alters their sense of themselves and their well-being. A virtually unbreakable lifelong bond is rapidly formed between mother and infant, so strong that while romantic love frequently ends in a breakup, women seldom “divorce” their children.

The Impact of Vaginal Birth on Newborns
For the newborn, the impact of vaginal birth is at least as profound. Birth does not naturally take place when a fetus is ready to breathe air, nurse, and digest milk, but instead when it is ready for the vaginal birth process itself to add the finishing touches that prepare it for those new tasks.

In infants, the physical stress of the journey through the birth canal alters the immune cells in blood plasma and releases hormones which promote the maturation of the lungs and intestines. It also deactivates fetal genes and triggers postnatal epigenetic changes, including those that support antibody production, stress responses and glucose regulation. Vaginal birth washes the newborn in the microbiome of the mother’s birth canal, seeding its body with beneficial microorganisms which will aid its digestion, immune response, and much more.

Additionally, the vaginal birth process initiates new, unlearned behaviors in newborns, including breathing air, suckling for nutrition, seeking physical closeness and warmth, and crying when distant from their mothers.

The Impact of C-Section Births
After C-section birth, infants may display these same behaviors, but often less vigorously, because C-sections eliminate or reduce (depending upon timing) these vital processes and the profound neuro-physiological reorganization they trigger. This increases such newborns’ risk for conditions ranging from post-birth hypothermia to lifelong disorders including asthma, obesity, diabetes, celiac disease, juvenile arthritis, autism, cognitive difficulties, and mental illness.

Mother-child bonding can also become more difficult, increasing the mother’s risk for postpartum depression and potentially impacting the child’s long-term development.

Fortunately, many children born by C-section go on to have normal lives, and primary caretakers who don’t experience vaginal birth can develop alternate pathways for developing parental bonds by means of conscientious, focused efforts. However, it isn’t automatic or easy. The unfortunate consequences of our excessive C-section rate may be hidden in plain sight, ranging from news of rising perinatal and postpartum depression and reduced infant-maternal bonds, to a teen mental health crisis.

The Link Between Vaginal Birth and Parenting
The importance of the vaginal birth process and the consequences of missing out on it have to do with our nature as mammals. Ruth Feldman, the Simms/Mann professor of social neuroscience and director of the Center for Developmental Social Neuroscience at Reichman University, with a joint appointment at Yale Child Study Center, is a leading researcher of the human capacities for love, empathy, and resilience.

“Being born a mammal implies that the brain is immature at birth and develops in the context of the mother's body and caregiving behavior,” she wrote. “Infants rely on the provisions embedded in the mother's body, such as smell, touch, heat, or movements, and the expression of caregiving behavior for maturation of neurobiological systems that sustain participation in the social world.”

From blind, mewling kittens to monkey infants clamped onto to their mothers’ backs, mammalian young require intensive parenting as soon as they are born. Human babies are especially dependent because they are born without fully developed brains or endocrine, temperature regulation, sleep, hormonal, digestive and cardio-pulmonary systems, and require near-constant physical contact with a caregiver to regulate them. Even an hour of separation from their mothers causes two-day-old infants physiological stress and interferes with their sleep. Human infants are closer in some ways to kangaroo joeys, which mature in their mothers’ pouches, than to alert, clinging baby monkeys—indeed, we would have to gestate for another nine to 12 months to catch up with other primate newborns.

Although mammals rely on mothering for species survival, no one teaches a lioness or a horse how to parent. Instead, vaginal birth itself unleashes tides of hormones and neurotransmitters that activate specific neural pathways, triggering automatic responses so powerful that even first-time mothers will display brand new behaviors upon giving birth, from licking their babies, to assuming the right position for nursing, to responding to infant cries.

These changes also transform the normal adult aversion to crying infants into an attraction to them and a desire to care for them. Vaginal birth even triggers both mothers’ and infants’ ability to recognize and bond with each other based on scent.

How does vaginal birth accomplish all this? Through the most intense and rapid brain alternations in adult life—and the intense feelings they create. Many human mothers experience the greatest high of their lives when their infants are born. They are often floating on cloud nine, and fall in love with their infants the moment the newborn is placed, skin to skin, on their chests. That euphoria, an extreme surge of oxytocin, dopamine, and other neurotransmitters caused by labor and delivery, is necessary for mammals like us to overcome the strain, pain, and exhaustion of childbearing to immediately nurse and care for our infants. Nursing produces a milder form of the same high.

In this way, vaginal birth triggers a virtuous cycle, where the mother and infant are drawn to each other and instinctively engage in mutually rewarding behaviors. This close, affectionate physical contact facilitates the infant’s neurophysiological maturation and supports normal social, cognitive, and emotional development, as well as the mother-child bond.

Implications for C-Section Parents
C-section birth suppresses both the neuro-remodeling that promotes new parenting behaviors and the hormonal surge that makes them so rewarding. Of course, parents who don’t give birth vaginally (including fathers and adoptive parents) can still provide lots of close physical contact and bond with their babies—they just don’t have the same hormonally-enhanced motivations and behavioral prompts that vaginal birth provides, so they must sometimes make deliberate efforts to compensate.

Summarizing some of his vast body of research, Larry Young, Director of the Center for Translational Social Neuroscience at the Silvio O. Conte Center for Oxytocin and Social Cognition, and the William P. Timmie Professor of Psychiatry and Behavioral Sciences at the School of Medicine at Emory University, says “…this does not mean mothers with C-section cannot bond, they can nurse to release oxytocin, and skin-to-skin contact and eye-gazing can also stimulate oxytocin release, it just might not be the flood that happens with vaginal birth, which animals need to drive their behavior.” In other words, with consistent interventions (discussed further in Part 2), it is possible for parents to overcome the deficits caused by C-section birth.

Though C-sections are sometimes essential and life-saving for both mother and child, their potential mental and physical health repercussions are often not fully understood by either parents or physicians, who may take decisions about birth method too lightly. Caesarian sections remain far more prevalent than medical necessity demands, with the result that millions of American families may struggle to overcome unrecognized deficits.

Every child deserves a start in life that enables their full flourishing and psychological health, and every mother deserves to understand how her body’s capacity to give birth was evolutionarily designed to jumpstart her parenting brain and prepare her emotionally and neurologically for successful mothering. In part 2, we will explain how the biological processes set in motion by vaginal birth lead to the positive early experiences essential for healthy child development—as well as what happens when it goes wrong, and how parents of C-section or premature babies can improve their outcomes.