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Advancing the Science began in 2012 to document a six-member Mayo Clinic research team on their month-long expedition to climb Mount Everest. The team monitored nine climbers from base camp to the summit, examining the effect of extreme altitude, which puts the climbers in the same conditions experienced by people with heart disease, obesity, or advanced age. Research based on data gathered during the expedition provided new insights into sleep physiology, muscle loss at altitude, lung fluid regulation, and remote cardiac monitoring. 

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Mayo Clinic Advancing the Science editors

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Mayo Clinic has made important contributions to space medicine and research since the dawn of the U.S. space program, and prior to that with aeronautical research during World War II.  

“Historically, Mayo Clinic has been closely involved in aerospace medicine,” says Jan Stepanek, M.D., director of Aerospace Medicine on Mayo Clinic’s Arizona campus. “Former Mayo staff members set up the first testing of the seminal astronaut corps, and Mayo researchers did a lot of work for the moon and space shuttle missions. 

“Our involvement goes back to the beginning of the U.S. space program and continues to the present day.”

A sampling of Mayo Clinic’s work in space medicine includes:

• 1960: Mayo Clinic received grants from the U.S. Air Force and NASA to conduct a series of experiments to study the effect of acceleration during liftoff. Mayo’s research, related to the force of gravity during acceleration, influenced the horizontal position of seats for the Mercury spaceflight program — which sent the first American astronauts to space — as well as the Gemini and Apollo programs. 
   
• 1993: Bernard A. Harris Jr., M.D., became the first Mayo Clinic alumnus to travel to space. He was selected into NASA’s astronaut program in 1990. After two years of training, he climbed aboard the shuttle Columbia for his first 10-day mission. He made history by performing the first physical exam in space. Dr. Harris came to Mayo Clinic after medical school to complete a residency in internal medicine. His experience at Mayo rekindled his childhood dream to become an astronaut. 

• 2017: A research team led by Abba Zubair, M.D., Ph.D., who specializes in transfusion medicine and regenerative medicine on Mayo Clinic’s Florida campus, sent several types of stem cells into space aboard the SpaceX-9 mission to the International Space Station (ISS). The study investigated how microgravity may affect stem cells’ ability to multiply. Previous studies on Earth suggested the conditions of space might yield quantities of stem cells large enough to be used as therapies for conditions such as stroke.  
   
• 2018: Mayo Clinic researchers, led by Dr. Zubair, sent a large sample of stem cells to the ISS to investigate the effects of long-term cosmic radiation on astronauts. The sample hitched a ride on the SpaceX-16 resupply mission, which took off Dec. 5, 2018, from the Kennedy Space Center in Cape Canaveral, Florida. The experiment involved 300 million frozen stem cells, which remained untouched in multiple vials at minus 130 degrees Celsius aboard the ISS for an entire year. The cells were sent back to Earth — still frozen — via a return capsule to be tested at Mayo Clinic.  
   
• 2019: Dr. Stepanek was the primary author of an article in The New England Journal of Medicine that says space medicine will have to adapt to a time when commercial spaceflight companies play a larger role. “Civilian spaceflight is a new frontier. As a frontier, there is a paradigm shift from highly trained, exceptionally fit astronauts to the broader public,” Dr. Stepanek says. “There are a lot of unknowns and reasons to be cautious.”  

• 2021: Among other Mayo Clinic aerospace research underway, Alejandro A. Rabinstein, M.D., medical director of Mayo Clinic’s Neuroscience Intensive Care Unit, and his team are working with NASA to learn more about the effects of extended space travel, such as long trips to Mars, on the human body. Dr. Rabinstein has been investigating the feasibility of putting astronauts into a hypothermic torpor for extended space travel, which could limit metabolic demands on the body and make the trip more psychologically tolerable. 
   
• 2022: Mayo Clinic research is once again headed to space — Mayo Clinic Philanthropic Partner Larry Connor took part in Axiom Space’s first private mission to the ISS in April. He worked with Mayo researchers to identify important research projects in the fields of aging and regenerative medicine to conduct in the microgravity environment of space. Larry was one of four civilians from around the world to take part in the flight. Michael F. Harrison, M.D., Ph.D., an emergency medicine and critical care physician on Mayo Clinic’s Florida campus, will served as a flight surgeon for the mission. It’s a role Dr. Harrison has taken on for four previous commercial spaceflights. As flight surgeon, Dr. Harrison monitors the astronauts’ health during takeoff and landing and mitigate risk to ensure they are as safe as possible. 

The Experiential Learning Center at Mayo Clinic in Florida provides training for the medical teams responsible for launches and astronaut recovery at the John F. Kennedy Space Center on Florida’s east coast. 

This article was originally published in Mayo Clinic Magazine.

Read more about Mayo Clinic in Space: Learn how Mayo is conducting research to make space travel safer.

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As part of its inaugural mission, Exos Aerospace Systems & Technologies Inc., will take a version of the vital signs monitoring camera to space in its test of a SARGE suborbital rocket. The rocket is scheduled to be launched on Aug. 25 from Spaceport America in New Mexico near the U.S. Army’s White Sands Missile Range.

The Center for Applied Space Technology, a Florida not-for-profit organization dedicated to advancing the science of space travel, is coordinating the flight opportunity. Exos is donating the ride, and NASA is donating use of the canister that will hold the camera.

For the purposes of this study, the camera will not be pointed at a human due to the unmanned flight. Rather, the study will assess the movements of a second hand of a watch that will float within the canister.

“This can simulate how well the camera can pick up minute movements of the second hand while on a watch face floating in zero gravity,” says Michelle Freeman, M.D., a pulmonologist and critical care specialist at Mayo Clinic’s Florida campus. “In humans, the device tracks subtle pulsations in the blood vessels of the skin, telling us heartbeat and respiration rate.  The second hand of the watch will be our pulse for this trip.”

The second phase would be to test the camera on humans in simulated microgravity on a parabolic flight, and then potentially on astronauts onboard the International Space Station or commercial space ventures.

“Not only will this tool help ensure the health of astronauts and space tourists, on Earth, it could be beneficial in telemedicine and home health care,” says William D. Freeman, M.D., a neurologist at Mayo Clinic’s Florida campus who is partnering with his wife Dr. Michelle Freeman on the monitoring project.

The technology is being developed by Oxehealth, a spinoff from Oxford University in the U.K. The Drs. Freeman will work with this team to help evaluate the health monitoring capability and vital sign signals in microgravity.

The software works by finding the patient in the camera lens, locating a region of interest, such as the face, and analyzing the color change in the face from each time the heart beats and provides blood flow. The device also can determine breathing rate.  The technology’s accuracy has been demonstrated in research studies in a wide range of healthcare settings in the UK, including acute and mental health hospitals.  A version of the device is currently undergoing medical device certification before being placed on the market in Europe.

“Imagine how helpful this technology would be for remote health monitoring of astronauts and tourists traveling into space through programs such as Elon Musk’s Space X mission to Mars, Sir Richard Branson’s Virgin Galactic, and Jeff Bezos’ Blue Origin,” Dr. William D. Freeman says. “Ultimately, what we prove works during extremes of gravity and in microgravity someday will have direct application to remote health monitoring for patients on Earth.”

The Drs. Freemans say their work fits well with Northeast Florida’s burgeoning space industries, such as those at Cecil Spaceport here in Jacksonville, as well as the Kennedy Space Center in Cape Canaveral, Florida.

Mayo Clinic also has a long history of work in aeromedicine. Mayo Clinic scientists and physicians developed the G suit to protect fighter pilots in World War II from blacking out during extreme maneuvers. A SpaceX rocket launch from NASA’s Kennedy Space Center earlier in 2017 included a payload of several samples of donated adult induced-pluripotent stem cells from a research laboratory at Mayo Clinic’s Florida campus. Mayo researchers are analyzing these special cells, which are derived from the body’s fat tissue, to learn if they can be more quickly mass-produced in microgravity and used to treat strokes.

“So many things that have been developed for space have found wonderful uses on Earth — everything from scratch-resistant lenses and water purifiers to memory foam and GPS — as well as important insights into heart, lung and blood physiology and treatment,” says Dr. Michelle Freeman. “I think that when this continuous contact-free vital signs monitoring camera is fully functional, its uses will be limitless.”

Drs. Michelle and William D. Freeman are not supported by these industry collaborators. They are applying for NASA research funds.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, comprehensive care to everyone who needs healing. Learn more about Mayo Clinic. Visit the Mayo Clinic News Network.

Media contact:

• Kevin Punsky, Mayo Clinic Public Affairs, 904-953-0746, punsky.kevin@mayo.edu

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ROCHESTER, Minn. — Starting today, private and recreational pilots across the country can access the new online Mayo Clinic BasicMed Course, a free education program for pilots pursuing medical qualification through FAA BasicMed. This alternative to traditional aeromedical certification, which was announced in May, is administered by the Federal Aviation Administration (FAA). Mayo is one of two organizations in the nation to offer a course necessary to obtain this alternative medical qualification.

“We’re pleased to be able to provide this new option for pilots,” says Clayton Cowl, M.D., director of the Mayo Clinic BasicMed Course and chair of the Division of Preventive, Occupational and Aerospace Medicine. “This course has been a culmination of efforts of many colleagues at Mayo dedicated to aviation safety. A wide range of medical experts across the organization as well as with input from experts with civil aviation medical associations across the country have contributed medical knowledge to help pilots recognize medical risks in an effort to keep them, and the passengers who they fly, safe.”

The online medical course is one part of the required steps for pilots seeking aeromedical qualification through the new FAA program. A pilot must first obtain a physical examination from a state-licensed physician, who must attest that the pilot is physically and mentally fit to fly.

In addition to the conversations a pilot may have with his or her physician in the physical exam, Mayo Clinic’s online course is a resource for pilots to learn and recognize the signs of certain health conditions that may affect his or her ability to fly.

The course is separated into six topical modules outlined in the legislation that led to the creation of the alternative qualification pathway. These areas include conducting medical self-assessments, warning signs of serious medical conditions, mitigating medical risks, awareness of prescription and over-the-counter drugs, the importance of regular medical examinations, and details regarding requirements on pilots if a medical deficiency exists.

The course, which takes approximately 90 minutes to complete, is followed by an online examination. It is accessible at basicmed.mayo.edu. The link is also on the FAA’s BasicMed website. Pilots must undergo the physical exam prior to taking the course and will submit evidence of the passed physical exam online prior to beginning the online course. Once the course is completed and a passing quiz score achieved, the pilots can print a certificate that they will retain in their logbooks. Certification information is transmitted to the FAA to confirm participation.

Direct questions regarding Mayo Clinic’s course or FAA BasicMed requirements to basicmed@mayo.edu.

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About Mayo Clinic Aerospace Medicine
This is the 75th anniversary of the Mayo Clinic Section of Aerospace Medicine. Mayo Clinic has been a leader in pilot health and safety, and aerospace physiology with its locations in Rochester; Scottsdale, Arizona; and Jacksonville, Florida. For more information about aerospace medicine or the Mayo Clinic ProPilot Program, visit aeromedical overview.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, comprehensive care to everyone who needs healing. For more information, visit mayoclinic.org/about-mayo-clinic or newsnetwork.mayoclinic.org.

MEDIA CONTACT
Kelley Luckstein, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

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Skiles is best known as the first officer to Capt. Chesley “Sully” Sullenberger on US Airways Flight 1549, which encountered multiple bird strikes. This resulted in engine failure and forced a water landing on the Hudson River in New York City in January 2009. All 155 people aboard the plane survived in the successful landing, which is known as the “Miracle on the Hudson.”

Skiles served as vice president of the Coalition of Airline Pilots Associations, representing over 28,000 pilots in airline safety and security issues. His leadership also extends to his tenure as vice president of Communities and Member Programs for the pilot association Experimental Aircraft Association.

“Mr. Skiles’ commitment to aviation safety and understanding of teamwork in a safety-sensitive environment was a primary driver for the successful outcome in what could have been a terrible tragedy. His experience in one of the most historical moments in aviation history makes him an exemplary speaker featured in the Hickman Lectureship series,” says Clayton Cowl, M.D., division chair of Preventive, Occupational and Aerospace Medicine at Mayo Clinic. “We are honored to have him speak and extend his expertise to a Mayo Clinic audience, where those same values of safety and teamwork are experienced on a daily basis.”

As a writer of over 100 aviation industry articles, Skiles has shared his experiences across the industry, including air safety presentations, to multiple audiences. He focuses on the development of safety management systems and looks at how that has led to significant changes in airline operations over the past 20 years.

The Hickman Lectureship is dedicated to the career and work of Dr. J. Richard Hickman Jr., who formerly served as division chair of Preventive, Occupational and Aerospace Medicine at Mayo Clinic. He served as a colonel in the U.S. Air Force prior to his career at Mayo Clinic. He was an expert in altitude physiology, aerospace medicine and preventive cardiology.

The fourth Hickman Lectureship takes place during the 75th anniversary year of Mayo Clinic’s Aeromedical Unit, which was established in the early years of World War II to provide aviation research for the U.S. military. The top-secret products of this research include the high-altitude mask, five-bladder G-suit, M-1 straining maneuver of fighter pilots and groundwork for better understandings of the human body in relation to aviation.

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About the J. Richard Hickman Jr., M.D., M.P.H., Lectureship
The J. Richard Hickman Jr., M.D., M.P.H., Lectureship is an event sponsored by the Mayo Clinic Division of Preventive, Occupational and Aerospace Medicine in honor of its fifth chair, who led by example in delivering Mayo Clinic core values to each patient undergoing care. Dr. Hickman’s compassion for patients and faculty, diagnostic and clinical treatment excellence, and visionary leadership has inspired a generation of physicians working in Aerospace Medicine and Preventive Medicine. The lectureship was created to feature individuals from all walks of life performing research in the field; serving individuals in the aerospace sciences; or having an inspirational story related to physiology, preventive cardiology or aviation.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, comprehensive care to everyone who needs healing. For more information, visit mayoclinic.org/about-mayo-clinic or newsnetwork.mayoclinic.org.

MEDIA CONTACT
Kelly Reller, Mayo Clinic Public Affairs, 507-284 5005, newsbureau@mayo.edu

The post First officer in Miracle on the Hudson landing to speak at Mayo Clinic appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Beginning Monday, May 1, private and recreational pilots across the country operating certain light aircraft will be able to seek medical qualification through BasicMed, a new pathway offered by the Federal Aviation Administration (FAA). Mayo Clinic will be one of two organizations in the nation to offer a course necessary to obtain this alternative medical qualification.

Mayo Clinic’s Aerospace Medicine program has finalized an agreement with the FAA to provide the free online medical education course for pilots pursuing BasicMed qualification. The course is set to launch the same day that BasicMed goes into effect.

“BasicMed will transfer some of the liability for recognizing and assessing medical conditions with the potential for inflight incapacitation to the pilot,” says Clayton Cowl, M.D., chair of Mayo Clinic’s Division of Preventive, Occupational and Aerospace Medicine. “Our multidisciplinary team has worked together to provide valuable information that pilots will be able to incorporate into their own self-assessment prior to every flight. We emphasize that risk is something to be managed, and that the pilot and his or her health is the most important part of the safety chain.”

Watch: Dr. Clayton Cowl discusses BasicMed and how it affects pilots, physicians.

The online medical course is one part of the required steps for pilots seeking qualification through BasicMed. Pilots must first obtain a physical examination from a state-licensed physician and a signed attestation from a physician that he or she is physically fit to fly.

In addition to the conversations a pilot may have with his or her doctor in the physical exam, Mayo Clinic’s online course is a resource for pilots to learn and recognize the signs of certain health conditions that may affect his or her ability to fly. The course is separated into six topical modules outlined in the legislation that led to the creation of BasicMed. These areas include conducting medical self-assessments, warning signs of serious medical conditions, mitigating medical risks, awareness of prescription and over-the-counter drugs, the importance of regular medical examinations, and details regarding requirements on pilots if a medical deficiency exists.

The course, which takes approximately 90 minutes, is followed by an online examination. Pilots must undergo the physical exam prior to taking the course and will submit evidence of the passed physical exam online prior to beginning the online course.

Dr. Cowl will host a Facebook Live event on Tuesday, May 9, to discuss BasicMed and Mayo Clinic’s course.

Beginning May 1, Mayo Clinic’s online medical education course can be found by visiting the FAA’s BasicMed website. Direct questions regarding Mayo Clinic’s course or BasicMed requirements to basicmed@mayo.edu.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

MEDIA CONTACT
Kelly Reller, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

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ROCHESTER, Minn. — Today, Mayo Clinic announces ProPilot, a new program for corporate flight departments that offers bundled services designed to keep and get pilots back on the flight deck quickly and safely.

Mayo Clinic also announces today that the first member organization of ProPilot is the Young Presidents Organization (YPO). Pilots from hundreds of corporate flight departments belonging to YPO now will have access to a premium preventive health screening program provided by Mayo Clinic.

Mayo Clinic’s Section of Aerospace Medicine is launching the Mayo Clinic ProPilot Program on its Rochester, Minnesota, campus. The program features an age-tiered model of predetermined preventive health services offered to pilots annually. Member aviators have access to Mayo Clinic experts in Aviation Medicine, along with a team of nurses who provide a comprehensive preventive screening assessment in conjunction with their required Federal Aviation Administration (FAA) certification examination. If a medical condition is detected, it is often identified earlier in its course to prevent a lapse in certification eligibility, and Mayo flight physicians expedite any necessary medical waivers if a condition is detected.

MEDIA CONTACTS:
Ginger Plumbo, Mayo Clinic Public Affairs, 507-284-5005, Email: newsbureau@mayo.edu

Linda Fisk, YPO, Office: +1 972-629-7305 (United States), Mobile: +1 972-207-4298, Email: press@ypo.org

“The goal of Mayo Clinic ProPilot is to mesh the very best of what we offer — a detailed preventive screening examination with the flight physical,” says Clayton Cowl, M.D., chair of the Division of Preventive, Occupational and Aerospace Medicine at Mayo Clinic and president of the Civil Aviation Medical Association. “Too often, pilots get substandard medical care, because they are worried about losing their medical certificate. They are flying some of the most valuable resources of a company to destinations around the globe. With ProPilot, we are able to advocate for the pilot with the FAA, allowing a pilot to keep [his or her] medical. We want nothing more than for our pilots to have an uninterrupted, long, healthy career.”

Corporate flight departments sign up for the program, after which appointments are prescheduled with a streamlined itinerary. Mayo Clinic flight physicians take on the role of flight department medical director by sending a dashboard of medically related information to the chief pilot at the end of the year.

“Many firms understand the importance of the annual inspection for their aircraft,” explains Mitch Nelson, program manager for Mayo Clinic ProPilot. “Premium flight departments also recognize that the most valuable part of the aircraft is the pilot. That’s our focus.”

Once enrolled, YPO members will have access to Mayo Clinic Aviation Medicine virtual education sessions that feature cutting-edge clinical information and the latest updates regarding FAA aeromedical certification information. “For YPO member pilots and those who manage a large flight department, this collaboration provides access to world-class health resources, enabling pilots to be proactive about their individual health,” says Scott Mordell, CEO of YPO.

“Before we came to the Mayo Clinic, some of our pilots were wondering if Mayo’s thoroughness would slow the process down or uncover irrelevant issues that would lead to delays and denials,” says Glenn Jones, director of aviation at Steelcase, Inc., a client of Mayo Clinic Aviation Medicine. “But, now we ask, ‘Why wouldn’t you come to Mayo, have great care, be able to trust your examiner and preserve your ability to fly?’”

For information regarding enrollment in the program, contact Mayo Clinic ProPilot at 507-266-2080, or email propilot@mayo.edu. Learn more at http://www.mayoclinic.org/propilot.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

About YPO
YPO is a not-for-profit, global network of young chief executives connected through the shared mission of becoming Better Leaders Through Education and Idea Exchange. Founded in 1950, YPO today provides 23,000 peers and their families in 130 countries with access to unique experiences, extraordinary educational resources, access to alliances with leading institutions, and participation in specialized networks to support their business, community and personal leadership. Altogether, YPO member-run companies employ more than 15 million people around the world and generate U.S. $6 trillion in annual revenues. For more information, visit http://www.ypo.org.

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Lift off with us Saturday, May 24, when we have out of this world researchers on Mayo Clinic Radio!

Abba Zubair M.D., Ph.D., from Mayo Clinic in Florida, and Jan Stepanek, M.D., from Mayo Clinic in Arizona, will join us to discuss research happening in one of the new frontiers of medicine — SPACE! Dr. Zubair will tell us about an experiment on the International Space Station which could help patients recover from stroke, and Dr. Stepanek will share the latest science research in aerospace medicine. Please join us! 

To hear the program LIVE on Saturday, click here.
Follow #MayoClinicRadio and tweet your questions.
Mayo Clinic Radio is available on iHeart Radio.

Listen to this week’s Medical News Headlines: News Segment May 24, 2014 (right click MP3)  

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

For future topics, click on Upcoming Programs.
To listen to archived shows, click on Episodes.
If there is a topic you would like us to address, drop us a note.  Click here to create a guest account.

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The findings are published as the lead article in the October issue of Aviation, Space, and Environmental Medicine.

Read news release.

The post High-Altitude Hypoxia Can be Detected Before Symptoms are Apparent appeared first on Mayo Clinic News Network.

"This study opens the door for objective assessments of hypoxia and additional safeguards for military and commercial pilots and others working in high altitudes," says Jan Stepanek, M.D., the Aerospace Medicine Program Director and Co-Director of the Aerospace Medicine & Vestibular Research Laboratory.

Hypoxia is a lower than normal level of oxygen in your blood. To function properly, your body needs a certain level of oxygen circulating in the blood to cells and tissues. When this level of oxygen falls below a certain amount, hypoxia can cause a variety of symptoms including shortness of breath, impaired speech, slowed reaction time and passing out.

Historically, the most common way to detect hypoxia is by physical signs and individual symptoms and one of the most commonly studied effects of hypoxia is reaction time. The Mayo Clinic study team used the King-Devick neurocognitive performance test, which is commonly used to identify cognitive changes related to sports-related concussions, and to assess cognitive function under conditions of low oxygen-simulating altitude. The King-Devick test assesses the time in viewing, identifying and reading aloud a series of numbers on three consecutive test cards. Based on test times of 25 participants, the study concluded that the King-Devick test is an effective tool to detect "impairment of cognitive performance at a presymptomatic stage of hypoxia."

"This study provides an objective indication of hypoxia that is involuntary, reliable and repeatable," Dr. Stepanek says. "This means that people can be tested for cognitive declines before having symptoms, because often people won't have symptoms until it is too late."

This study is the latest in a long line of contributions from the Mayo Clinic Aerospace Medicine efforts since the inception of this line of work in Rochester in the 1930s. Mayo Clinic physiologists and altitude scientists developed several life support systems and strategies vital to military pilot safety in the World War II era and that are in use until today. Prior to pressurized aircraft cabins for commercial airline passenger flights, aircraft flew at relatively low altitudes to avoid hypoxic (low oxygen) conditions. Mayo scientists developed an oxygen mask for pilots and passengers to wear during flights, allowing travel at higher altitudes above turbulent weather conditions, making flights smoother and more tolerable to travelers.

Today, a team of Mayo physicians and scientists are continuing to investigate problems related to altitude, spatial disorientation and acceleration protection in dedicated laboratories at Mayo Clinic in Arizona.

Clinical care and consultation for pilots and passengers with Aerospace Medicine related conditions are treated by board-certified specialists in Aerospace Medicine at all three Mayo Clinic campuses in Arizona, Florida and Rochester.

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About Mayo Clinic

Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit MayoClinic.com or MayoClinic.org/news.

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