The remaining frontiers in fighting hepatitis C

A scientist whose work was key to identifying, studying and finding treatments for this life-threatening virus discusses the scientific journey and challenges that persist

By Daniela Hirschfeld

A, B, C, D, E: It’s a short, menacing alphabet representing the five types of virus causing viral hepatitis, a sickness afflicting some 400 million people around the world today.

Hepatitis viruses are a set of very different pathogens that kill 1.4 million people annually and infect more than HIV and the malaria pathogen do combined. Most of the deaths are from cirrhosis of the liver or hepatic cancer due to chronic infections with hepatitis viruses B or C, picked up through contact with contaminated blood.

Hepatitis B was the first of the five to be discovered, in the 1960s, by biochemist Baruch S. Blumberg. Hepatitis A, which is most commonly spread through contaminated food and water, was next, discovered in 1973 by researchers Stephen Mark Feinstone, Albert Kapikian and Robert Purcell.

Screening tests for those two types of viruses paved the way to discovering a third. In the 1970s, hematologist Harvey Alter examined unexplained cases of hepatitis in patients after blood transfusions and found that only 25 percent of such cases were caused by the hepatitis B virus, and none were linked to the hepatitis A virus. The rest were caused by an unidentified transmissible agent that could persist in the body as a chronic infection and lead to liver cirrhosis and liver cancer.

The agent behind this disease, named non-A, non-B hepatitis, remained a mystery for a decade until Michael Houghton, a microbiologist working at the biotechnology company Chiron Corporation, and his team sequenced the agent’s genome in 1989 after years of intensive investigation. They identified it as a novel virus of the family to which yellow fever virus belongs: the flaviviruses, a group of RNA viruses often transmitted through the bite of infected arthropods.

But there was more to the story. Scientists needed to show that this new virus could, indeed, cause hepatitis C on its own — a feat achieved in 1997, when Charles M. Rice, then a virologist at Washington University in St. Louis, and others succeeded in creating a form of the virus in the lab that could replicate in the only animal model for hepatitis C, the chimpanzee. When they injected the virus into the liver of chimpanzees, it triggered clinical hepatitis, demonstrating the direct connection between hepatitis C and non-A, non-B hepatitis.

The findings led to lifesaving hepatitis C tests to avert infections through transfusions with contaminated blood, as well as for the development of effective antiviral medications to treat the disease. In 2020, in the thick of the SARS-CoV-2 pandemic, Alter, Houghton and Rice received a Nobel Prize in Medicine for their work on identifying the virus.

To learn more about hepatitis C history and the treatment and prevention challenges that remain, Knowable Magazine spoke with Rice, now at the Rockefeller University, at the 72nd Lindau Nobel Laureate Meeting in Germany in June 2023. This conversation has been edited for length and clarity.

What were the challenges at the time you began your research on hepatitis C?

The realization that an agent was behind non-A, non-B hepatitis had initiated a virus hunt to try and figure out what the causative agent was. Michael Houghton and his group at Chiron won that race and reported the partial sequence of the virus in 1989 in Science.

It was an interesting kind of a dilemma for me as an early-stage assistant professor at Washington University in St. Louis, where I’d been working on yellow fever. All of a sudden, we had this new human virus that dropped into our laps and joined the flavivirus family; we had to decide if we were going to shift some of our attention to work on this virus. Initially, people in the viral hepatitis field invited us to meetings, but because we were doing work on the related virus, yellow fever, not because we were considered majors player in the field.

The main challenge was that we could not grow the virus in cell culture. And the only experimental model was the chimpanzee, so it was really difficult for laboratories to study this virus.

There were two major goals. One was to establish a cell culture system where you could replicate the virus and study it. And the other was try and create a system where we could do genetics on the virus. It was shown to be an RNA virus, and the collection of tools available for modifying RNA at that time, in the early 1990s, was not the same as it was for DNA. Now that’s changed to some extent, with modern editing technologies.

If there’s one lesson to be learned from this hepatitis C story, it’s that persistence pays off.

This journey started with an unknown virus and ended up with treatment in a relatively short period of time.

I don’t think it was a short period of time, between all of the failures to actually get a cell culture system and to show that we had a functional clone. From 1989, when the virus sequence was reported, to 2011, when the first antiviral compounds were produced, was 22 years.

And then, that initial generation of treatment compounds was not the greatest, and they were combined with the treatment that we were trying to get rid of — interferon — that made people quite ill and didn’t always cure them. They only had about a 50 percent cure rate.

It was 2014 when the interferon-free cocktails came about. And that was really amazing.

There were people who thought, “You are not going to be able to develop a drug cocktail that can eliminate this virus.” It was presumptuous to think that one could, but it was accomplished by biotech and the pharmaceutical industry. So it is really quite a success story, but I wish it could have been faster.

What are the current challenges in combating hepatitis C?

One thing that was a little sobering and disappointing for me was that when these medical advances are made and shown to be efficacious, it is not possible to get these drugs to everybody who needs them and successfully treat them. It’s a lot more complicated, in part because of the economics — how much the companies decide to charge for the drugs.

Also, it’s difficult to identify people who are infected with hepatitis C, because it’s often asymptomatic. Even when identified, getting people into treatment is challenging given differences in public health capabilties which vary at the local, national and global levels. So we have wonderful drugs that can basically cure anybody, but I think we still could use a vaccine for hepatitis C.

During the first year of the Covid-19 pandemic, you won the Nobel Prize for the discovery of the hepatitis C virus. What was that experience like?

It was December 2020, and we were working on SARS-Cov-2 in the peak of the pandemic in New York City. My spouse and the dogs were off at our house in Connecticut, and I was living in the apartment in Manhattan. And I got this call at 4:30 in the morning. It was pretty shocking.

The pandemic made people more aware of what a highly infectious, disease-causing virus can do to our world. It encouraged the rapid dissemination of research results and more open publications. It also really made us appreciate how the same virus does different things depending upon who’s infected: In the case of Covid-19, it’s not good to be old, for example.

After many decades working with viruses, what would you say is the next frontier in virology?

There’s a lot that we don’t understand about these viruses. The more we study them, the more we understand about ourselves, our cells and our antiviral defense systems.

And there’s also great power in terms of being able to diagnose new viruses. The sequencing technology, the functional genomics technologies, all of those things, when applied to virology, give us a much richer picture of how these viruses interact with cells. I think it’s a golden age.

You have been working with flaviviruses (dengue, Zika, yellow fever and hepatitis C) for many decades. Zika and dengue pose an ongoing threat worldwide and, in particular, Latin America. Based on the successful example of hepatitis C, what can scientific research do to mitigate the impact of these viruses?

For viruses like Zika, developing a vaccine is probably going to be fairly straightforward — except that since Zika is so transient, it makes it hard to prove that your vaccine works. You would have to do a human challenge study, in which volunteers are deliberately exposed to an infection in a safe way with health-care support.

For dengue, it’s much more difficult, because there are four different serotypes — different versions of the same virus — and infection with one serotype can put you at increased risk of more severe disease if you get infected with a second serotype. Eliciting a balanced response that would protect you against all four dengue serotypes is the holy grail of trying to develop a dengue vaccine.

People are using various approaches to accomplish that. The classic one is to take live attenuated versions — weakened forms of viruses that have been modified so they can’t cause severe illness but can still stimulate the immune system — of each of the four serotypes and mix them together. Another is to make chimeric viruses: a combination of genetic material from different viruses, resulting in new viruses that have features of each of the four dengue serotypes, engineered into the backbone of the yellow fever vaccine. But this hasn’t worked as well as people have hoped. I think the cocktail of live, attenuated dengue variants is probably the most advanced approach. But I would guess that given the success of Covid-19 mRNA vaccines, the mRNA approach will also be tried out.

These diseases are not going to go away. You can’t eradicate every mosquito. And you can’t really immunize every susceptible vertebrate host. So occasionally there’s going to be spillover into the human population. We need to keep working on these because they are big problems.

You began your career at the California Institute of Technology studying RNA viruses, such as the mosquito-borne Sindbis virus, and then flaviviruses that cause encephalitis, polyarthritis, yellow fever and dengue fever. Later on, you also studied hepatitis C virus. Is there any advantage for virologists in changing the viruses they study throughout their career?

They’re all interesting, right? And they are all different in their own ways. I say that my career has been a downward spiral of tackling increasingly intricate viruses. Initially, the alphaviruses — a viral family which includes chikungunya virus, for example — were easy. The classical flaviviruses — like yellow fever, dengue fever, West Nile viruses and Zika virus, among others — were a little more difficult, but the hepatitis C virus was impossible for 15 years, until we, and others, finally achieved a complete replication system in the laboratory.

We coexist daily with viruses, but the pandemic may have given people the idea that all these microorganisms are invariably life-threatening.

We have to treat them with respect. We’ve seen what can happen with the emergence of a novel coronavirus that can spread during an asymptomatic phase of infection. You can’t be prepared for everything, but in some respects our response was a lot slower and less effective than it could have been.

If there’s anything that we’ve learned over the last 10 years with the new nucleic acid sequencing technologies, it’s that our past view of the virosphere was a very narrow. And if you really look at what’s out there, the estimated virus diversity is a staggering number, like 10³¹ types. Although most of them are not pathogenic to humans, some are. We have to take this threat seriously.

Is science prepared?

I think so, but there has to be an investment, a societal investment. And that investment has to not only be an investment in infrastructure that can react quickly to something new, but also to establish a repository of protective antibodies and small molecules against viruses that we know could be future threats.

Often, these things go in cycles. There’s a disaster, like the Covid-19 pandemic, people are changed by the experience, but then they think “Oh, well, the virus has faded into the background, the threat is over.” And that’s just not the case. We need a more sustained plan rather than a reactive stance. And that’s hard to do when resources and money are limited.

What is the effect of science illiteracy, conspiracy theories and lack of science information on the battle against viruses?

These are huge issues, and I don’t know the best way to combat them and educate people. Any combative, confrontational kind of response — it’s just not going to work. People will get more resolute in their entrenched beliefs and not hear or believe compelling evidence to the contrary.

It’s frustrating. I think that we have amazing tools and the power to make really significant advances to help people. It is more than a little discouraging for scientists when there’s a substantial fraction of people who don’t believe in things that are well-supported by facts.

It’s in large part an educational problem. I think we don’t put enough money into education, particularly early education. A lot of people don’t understand how much of what we take for granted today is underpinned by science. All this technology — good, bad or ugly — is all science.

Daniela Hirschfeld is a science journalist from Uruguay. You can follow her @danielaht.

This article originally appeared in Knowable Magazine, an independent journalistic endeavor from Annual Reviews.

What is a virtual power plant? An energy expert explains

A large-scale battery storage system in Long Beach, Calif., provides renewable electricity during peak demand periods. Patrick T. Fallon/AFP via Getty Images

Daniel Cohan, Rice University

After nearly two decades of stagnation, U.S. electricity demand is surging, driven by growing numbers of electric cars, data centers and air conditioners in a warming climate. But traditional power plants that generate electricity from coal, natural gas or nuclear energy are retiring faster than new ones are being built in this country. Most new supply is coming from wind and solar farms, whose output varies with the weather.

That’s left power companies seeking new ways to balance supply and demand. One option they’re turning to is virtual power plants.

These aren’t massive facilities generating electricity at a single site. Rather, they are aggregations of electricity producers, consumers and storers – collectively known as distributed energy resources – that grid managers can call on as needed.

Some of these sources, such as batteries, may deliver stored electric power. Others may be big electricity consumers, such as factories, whose owners have agreed to cut back their power use when demand is high, freeing up energy for other customers. Virtual power sources typically are quicker to site and build, and can be cleaner and cheaper to operate, than new power plants.

Virtual power plants are more resilient against service outages than large, centralized generating stations because they distribute energy resources across large areas.

A growing resource

Virtual power plants aren’t new. The U.S. Department of Energy estimates that there are already 30 to 60 gigawatts of them in operation today. A gigawatt is 1 billion watts – roughly the output of 2.5 million solar photovoltaic panels or one large nuclear reactor.

Most of these virtual power plants are industrial customers that have agreed to reduce demand when conditions are tight. But as growing numbers of homes and small businesses add rooftop solar panels, batteries and electric cars, these energy customers can become not only consumers but also suppliers of power to the grid.

For example, homeowners can charge up their batteries with rooftop solar when it’s sunny, and discharge power back to the grid in the evening when demand is high and prices sometimes spike.

As smart thermostats and water heaters, rooftop solar panels and batteries enable more customers to participate in them, DOE estimates that virtual power plants could triple in scale by 2030. That could cover roughly half of the new capacity that the U.S. will need to cover growing demand and replace retiring older power plants. This growth would help to limit the cost of building new wind and solar farms and gas plants.

And because virtual power plants are located where electricity is consumed, they’ll ease the burden on aging transmission systems that have struggled to add new lines.

A battery display panel inside a model home in Menifee, Calif., where 200 houses in a development are all-electric, equipped with solar panels and batteries and linked by a microgrid that can power the community during outages. Watchara Phomicinda/MediaNews Group/The Press-Enterprise via Getty Images

New roles for power customers

Virtual power plants scramble the roles of electricity producers and consumers. Traditional power plants generate electricity at central locations and transmit it along power lines to consumers. For the grid to function, supply and demand must be precisely balanced at all times.

Customer demand is typically assumed to be a given that fluctuates with the weather but follows a fairly predictable pattern over the course of a day. To satisfy it, grid operators dispatch a mix of baseload sources that operate continuously, such as coal and nuclear plants, and more flexible sources such as gas and hydropower that can modulate their output quickly as needed.

Output from wind and solar farms rises and falls during the day, so other sources must operate more flexibly to keep supply and demand balanced. Still, the basic idea is that massive facilities produce power for millions of passive consumers.

Virtual power plants upend this model by embracing the fact that consumers can control their electricity demand. Industrial consumers have long found ways to flex their operations, limiting demand when power supplies are tight in return for incentives or discounted rates.

Now, thermostats and water heaters that communicate with the grid can let households modulate their demand too. For example, smart electric water heaters can heat water mostly when power is abundant and cheap, and limit demand when power is scarce.

In Vermont, Green Mountain Power is offering its customers incentives to install batteries that will provide power back to the grid when it’s needed most. In Texas, where I live, deadly blackouts in 2021 highlighted the importance of bolstering our isolated power grid. Now, utilities here are using Tesla Powerwalls to help turn homes into virtual power sources. South Australia aims to connect 50,000 homes with solar and batteries to build that country’s largest virtual power plant.

People line up to refill propane tanks in Houston after a severe winter storm caused electricity blackouts and a catastrophic failure of Texas’ power grid in February 2021. Go Nakamura/Getty Images

Virtual power, real challenges

Virtual power plants aren’t a panacea. Many customers are reluctant to give up even temporary control of their thermostats, or have a delay when charging their electric car. Some consumers are also concerned about the security and privacy of smart meters. It remains to be seen how many customers will sign up for these emerging programs and how effectively their operators will modulate supply and demand.

There also are challenges at the business end. It’s a lot harder to manage millions of consumers than dozens of power plants. Virtual power plant operators can overcome that challenge by rewarding customers for allowing them to flex their supply and demand in a coordinated fashion.

As electricity demand rises to meet the needs of growing economies and replace fossil fuel-burning cars and furnaces, and reliance on renewable resources increases, grid managers will need all the flexibility they can get to balance the variable output of wind and solar generation. Virtual power plants could help reshape electric power into an industry that’s more nimble, efficient and responsive to changing conditions and customers’ needs.

Daniel Cohan, Associate Professor of Civil and Environmental Engineering, Rice University

This article is republished from The Conversation under a Creative Commons license. 

What makes an ideal main street? This is what shoppers told us

Irina Grotkjaer/Unsplash

Louise Grimmer, University of Tasmania; Martin Grimmer, University of Tasmania, and Paul J. Maginn, The University of Western Australia

A lot of dedication and effort goes into making main streets attractive. Local governments, planners, place makers, economic development managers, trade associations and retailers work hard to design, improve and revitalise main streets. The goal is to make them attractive places to increase shopper numbers, provide pleasant places for communities, and boost local economies.

Despite the efforts that go into planning, maintaining and marketing local shopping areas, the people who use these places are often not consulted about what they actually want and need on their main street. Our research is the only-known Australian study to ask shoppers about the key elements, and shops and services, they regard as contributing to the ideal main street.

So what types of stores and services do they want?

Pharmacies are the top choice. Intriguingly, four types of stores/services that are disappearing from main streets around Australia – the post office, bank, department store and newsagent – are in the top ten (out of 45 choices in our survey).

What are the key shops and services?

We wanted to find out what consumers see as their ideal local shopping street. What kinds of shops and services matter most for them? Which other elements of local shopping places do they want?

Curiously, users are often not asked these questions. Yet their answers are essential if we are to design new towns, suburbs and regional centres, and improve existing ones, so more people want to work, shop and visit them.

We surveyed a representative sample of 655 shoppers from around Australia about their local shopping preferences.

We provided a list of 45 different stores and services. Participants were asked to rank them in order of importance from one to 45.

Overwhelmingly, participants considered the pharmacy the most important store or service for an ideal main street. Across gender, age and location, pharmacies were consistently number one.

Similarly, four types of stores and services – the post office, bank, department store and newsagent – appeared in the top ten most important, regardless of demographics.

The top ten stores and services in an ideal main street. Louise Grimmer

What other key elements are important?

We then asked participants about the importance of different elements of main streets. We provided 21 elements and participants were asked to rate each on a Likert scale from 1, “not at all important”, to 7, “extremely important”.

Shoppers rated “cleanliness” as the most important element for their ideal shopping area. It was followed by “safety and security” and “parking”.

Aside from the “retail mix”, in most areas local councils have control over nine of the ten top elements. “Safety and security” also involves police and individual security services that centres and some stores employ.

The top ten elements of an ideal main street. Louise Grimmer

Motivation for shopping affects choices

We also tested for shoppers’ levels of hedonic and utilitarian orientation. Hedonic shoppers really enjoy the act of shopping. They experience euphoria and pleasure and they buy so they can go shopping, rather than shopping so they can buy.

Utilitarian shoppers, on the other hand, are rational and cognitive and they view shopping as a task or chore. Buying products they need is simply a “means to an end”. They get no great satisfaction from the activity.

Hedonic shoppers are more often women. Men tend to be more utilitarian. We tend to become more utilitarian as we get older.

We were interested to find out if people’s responses to our questions were different depending on whether they were hedonic (shop for pleasure) or utlilitarian (shop for practical needs) shoppers.

For the most important store or service, hedonic and utilitarian shoppers both rated a pharmacy as number one. And they ranked similar stores and services in their top ten.

Top ten stores and services for hedonic shoppers. Louise Grimmer

But there were some differences. Hedonic shoppers included a lifestyle/gift store and department store in their top ten. Utilitarian shoppers did not. Instead they rated the post office and the newsagent as important.

This finding makes sense. Lifestyle stores, gift shops and department stores offer the hedonic shopper the chance to browse and enjoy quality surroundings and service. The post office and newsagent allow the utilitarian shopper to complete tasks quickly and easily – no browsing required.

Top ten stores and services for utilitarian shoppers. Louise Grimmer

Despite similarities in their top-ranked shops and services, hedonic and utilitarian shoppers’ rankings of the most important elements of local shopping areas were starkly different.

For hedonic shoppers, the complete visitor experience, including the surroundings and atmosphere, is an important aspect of their ideal shopping area. Their top ten elements reflected this. They selected a combination of tangible elements, including public art, aesthetics, greenery and lighting, to complement the more ephemeral such as events and activities, night-time economy, sustainability and history and culture.

The top ten elements for hedonic shoppers. Louise Grimmer

Utilitarian shoppers rated elements that help make a task-oriented shopping trip easier. Wayfinding (all the ways to help people navigate a space), signage and information, walkability, retail mix, and services and amenities were important for them.

The only two elements both groups agreed should be in the top ten were lighting, and seating and tables.

The top ten elements for utilitarian shoppers. Louise Grimmer

Making main streets the best they can be

There is an increasing understanding that retailing will not continue to be the main or sole reason people visit town centres. While still important, retail will more often complement services, attractions and “experiences” as the major factors that entice visitors.

This requires local councils, chambers of commerce and marketing organisations to perform a juggling act. They need to market shopping precincts as being attractive for shoppers while showcasing a range of services and attractions in these areas that appeal to other types of visitors.

Making shopping areas the best they can be is challenging work. Different people want different things from main streets.

Our findings provides insights for local councils, which have a primary policy responsibility for main streets, as well as developers, investors and individual store owners. This knowledge can help them better plan and improve the retail and service mix for everyone.

Louise Grimmer, Retail Scholar, University of Tasmania; Martin Grimmer, Pro Vice-Chancellor and Professor of Marketing, University of Tasmania, and Paul J. Maginn, Interim Director, UWA Public Policy Institute; Associate Professor & Programme co-ordinator (Masters of Public Policy), The University of Western Australia

This article is republished from The Conversation under a Creative Commons license. 

Smart Solutions for School

Must-have essentials for back-to-school season

With school bells ringing for students of all ages, it’s important to make sure your student has all the necessities to be successful this year.

While that often means running from store to store in search of supplies, stylish clothes and other essentials, these top picks for securing valuables, decorating dorm rooms, planning out schedules, getting necessary nutrition and staying hydrated can help ensure your student is geared up for success in the classroom and beyond.

Find more back-to-school essentials and tips for success in the classroom at eLivingtoday.com.

Protect New Purchases on Campus

A new school year brings plenty of excitement, but it can also be stressful for students moving away from home who need to safeguard valuables like tablets, smartphones, passports, or an emergency credit card. To help alleviate back-to-school worries, SentrySafe, a leading name in fire-resistant and security storage for more than 90 years, offers solutions to provide peace of mind for parents and students. An affordable, convenient, and fireproof option, the 1200 Fire Chest protects items against fires up to 1,500 F for 30 minutes. It also features a built-in key lock and convenient handle for added security and simplified transport. Find more back-to-school security solutions at sentrysafe.com.

Quick and Easy Meals That Deserve an A+

Keeping weeknight dinners and school lunches simple means more time for family and less stress during the week. Cook up quick and easy weeknight dinners, school lunches or on-the-go snacks with Minute Rice Cups. Ready in only 1 minute, the BPA-free cups are available in a variety of flavors such as Chicken & Herb, Cilantro & Lime, Jalapeno and more. Visit MinuteRice.com to get meal ideas today.

Make Organization Personal

Help your student keep notes, study times and test dates organized with a quality planner that also showcases his or her personality. Available in a myriad of trendy colors and patterns – like polka dots, stripes or chevron – as well as various calendar layouts like daily, weekly or monthly, the right planner can help students of all ages stay on track, achieve goals and preserve memories in one stylish and organized place.

Sleep in Style

Where a student sleeps may be one of the last things on his or her mind when thinking about the excitement that awaits in college but getting plenty of sleep is key to success. Amp the appeal of the dorm-issue mattress with stylish and comfy bedding that reflects your personality. Look for quality threads you can snuggle into, and coordinate with pillows to make your bed a cozy place to sit and study by day.

Take H2O on the Go

A durable reusable water bottle can make your back-to-school routine even easier. With a variety of sizes and styles available in a multitude of colors and designs, there’s almost certain to be an option for students of all ages and activity levels. Look for durable, leak-proof stainless steel or hard plastic options that offer different lid styles, including wide-opening or those with retractable straws, to make hydrating on the walk between classes a breeze.

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Minute Rice

Despite his government’s failure to anticipate Hamas’ deadly attack, don’t count Netanyahu out politically

Brent E Sasley, University of Texas at Arlington

Since the brutal Hamas attack on Israel on Oct. 7, 2023, news analysts and the public have focused on Israeli Prime Minister Benjamin Netanyahu and his role in the intelligence failure that preceded the attack, in which 1,400 people were killed.

In other parliamentary democracies, a failure of this magnitude would normally cost leaders their jobs, or at least spark challenges to their leadership.

But a closer look at Netanyahu’s political history shows that he is not like other leaders.

Over the last 24 years, he has been able not only to survive the rough and hard-hitting Israeli political arena, but to stay on top of it. Despite numerous setbacks and challenges that might well have terminated the career of other leaders, Netanyahu has come back to lead his party and take the prime minister’s office, again and again. His first term, 1996 to 1999, ended in a humiliating defeat. But he returned to his party’s leadership at the end of 2005. Between 2009 and 2023, he was able to form a coalition government five times.

It is possible that this time might be different, and that the government’s failure has been so devastating for Israelis that Netanyahu will be unable to recover. A week after the Israel-Hamas war began, a small majority of Israelis wanted Netanyahu to resign.

But based on his history, he might survive this scandal.

In 2012, Time ran a cover story that called Benjamin Netanyahu ‘King Bibi.’ Screenshot, Time Magazine

Mr. Security?

Netanyahu won his first election in May 1996, beating Labor leader Shimon Peres by a narrow margin. It was the country’s first split-ticket vote, in which citizens voted for both a party to represent them in parliament and for an individual for prime minister. Netanyahu won by claiming he could better protect Israelis in the wake of a surge of terrorist attacks in February and March of that year that had killed over 50 citizens.

Since then, commentators, especially those abroad, have referred to him as something like a protector of Israel. In 2012, Time ran a cover story that called Netanyahu “King Bibi.” A post-Oct. 7 piece in Foreign Policy referred to him as “Mr. Security,” a name it was said that Israelis themselves used.

Netanyahu has never presided over any military or diplomatic process that strengthened Israeli security; quite the opposite. His tenures have been marked by several intelligence failures and miscalculations, by the Oct. 7 attack and an inconclusive war with Hamas in 2014. He was indicted on corruption charges in 2019, but his trial has yet to conclude.

As a scholar of Israeli politics, I have watched Netanyahu ride a right-wing wave to win power several times since the mid-1990s.

It’s clear to me that his ability to win elections is rooted not in his own political foresight and reputation as a successful defender of Israel, but more a function of Israel’s political system and his ability to make wild promises to prospective coalition partners.

Route to power

Netanyahu’s political successes have often been the result of the public’s apparent decision that he is the best out of a set of poor choices.

The Israeli electoral system produces fragmented outcomes. It is common for dozens of parties to run in an election, and for 10 to win representation in the Knesset, Israel’s legislative body. A government is formed through bargaining between the parties, until a coalition obtains 61 votes – a simple majority – in the 120-seat Knesset.

The existence of so many parties, representing a range of views on religion in the public sphere, the Israeli-Palestinian conflict, Zionism and the relationship between the Jewish state and its Arab citizens, gives the person who aims to be prime minister options when trying to cobble together a coalition.

Because all the parties know this, and they know they can threaten to join a government under someone else, promises must be made to these parties by would-be leaders to secure their place in the government and their support in the Knesset.

These promises can include offering ministerial posts to leaders of the parties or commitments to provide more government funding to certain religious communities.

Protesters in Tel Aviv, Israel, call for a cease-fire, a hostage deal and, in Hebrew, Benjamin Netanyahu’s resignation, on Oct. 28, 2023. Alexi J. Rosenfeld/Getty Images

Promises made

Netanyahu has excelled at making promises in order to stay in or gain power, even when they have gone against what the majority of Israelis want and his own prior commitments.

The most egregious example occurred after the 2022 elections when Netanyahu formed a government with far-right and fascist parties. Some of his promises included creating a militia under the control of Itamar Ben Gvir, leader of the Otzma Yehudit party, widely known for its anti-Arab racism.

Another promise Netanyahu made to entice Knesset members to join him in a coalition was to overhaul the judiciary, reducing its independence and making it a tool of the government. This promise became legislation and sparked what has become weekly protests against the policy as a threat to Israeli democracy, drawing hundreds of thousands of Israelis.

Netanyahu’s increasingly extreme promises indicate a desperation born out of fear of losing power. This is not surprising, since in every election since 2009, his party barely got a plurality of votes. If he could not form a majority coalition, another party and its leader could.

The highest percentage of the popular vote his Likud party has ever won was 29%, in 2020. Even then, Likud’s main rival, the Blue and White Party, won 27% of the vote. In other elections since then, Likud has won around 24% or 25%.

Netanyahu himself is more popular than his party, but not by much. In most of the elections that Netanyahu competed in as head of Likud, results commonly showed that a little more than half of voters supported him over his closest rivals.

In part, this support stems from his long years in politics. Netanyahu is a well-established figure, so there is some comfort for voters in choosing a candidate who is well known.

As head of Likud, he has been leader of one of the country’s oldest major parties. And though its share of seats has dropped over the years, Likud remains firmly entrenched in Israel’s political constellation. It can be difficult for observers to disentangle support for Netanyahu from support for the party.

Finally, no Israel government has lasted its full four-year term since 1988, forcing new elections to be called. There is a constant fear among coalition partners that a new election will weaken them. Supporting Netanyahu and Likud has often been the best way to avoid another election.

It may be, then, that contrary to expectations, Netanyahu will be able to outlast disasters as he has before, and remain a player in Israeli politics.

Brent E Sasley, Associate Professor of Political Science, University of Texas at Arlington

This article is republished from The Conversation under a Creative Commons license. 

How to Make Higher-Quality Choices at the Grocery Store

Grocery shopping can be stressful when there are so many options, especially if you’re making a conscious effort to make high-quality food choices while you shop. Arming yourself with a plan and plenty of information can help you make smarter choices and feel good about the meals you prepare for your family.

According to the Food Marketing Institute’s Power of Meat Report, 62% of consumers are looking for better-for-you meat and poultry options. Consider these ways you can pick up higher-quality products on your next trip to the grocery store.

Make a list and stick to it. Going shopping without a plan is a surefire way to make the trip to the grocery store less productive. Creating a list and identifying high-quality products that fit your needs can help you avoid impulse purchases. Plus, list-making can also help save money if you plan meals that let you use ingredients across multiple recipes for minimal waste.

Pay attention to labels. Food labels contain insightful details that can help you make well-informed decisions about the foods you buy. Especially when it comes to fresh products, like protein, you can learn a lot about how the food was raised, simply from its label. For example, Perdue’s “No Antibiotics Ever” label is the gold standard when it comes to reducing antibiotic use in chicken farming, compared to the “no hormones or steroids” label, which shows adherence solely to federal regulations.

“You can feel good about purchasing our products labeled No Antibiotics Ever knowing they were raised and fed in such a way that no antibiotics were ever needed,” said Dr. Bruce Stewart-Brown, senior vice president of technical services and innovation at Perdue Farms. “In order to achieve No Antibiotics Ever raised chickens, we worked hard to change our feed and care approach over the last 20 years.”

Know how to select fresh foods. If you find yourself overwhelmed when it comes to selecting produce and fresh meat, you’re not alone. When choosing fruits and vegetables, you generally want produce with a consistent color that is firm but not hard to the touch. Many fresh fruits and veggies emit an appealing fragrance at their peak ripeness.

When it comes to meat and poultry products, you can use a similar approach. For example, if you’re shopping for chicken, press down on the chicken in the package. If it’s plump and somewhat resilient, reverting to its shape, it’s a fresher pack. Also be wary of excess liquid in the pack, which can dilute the flavor or contribute to a soggy texture. You may also wonder which cuts are best. For a formal family meal, consider cooking a whole bird, which offers white and dark meat to please all appetites and can serve as a beautiful mealtime centerpiece.

Take some shortcuts. Even if you aim to prepare fresh, home-cooked meals most nights, there are sure to be some evenings when you need to squeeze in a quick meal around work, school and extracurriculars. Having a few simple go-to recipes can help. For example, an easy stir-fry with fresh chicken and frozen veggies can shave off prep time while still providing a hot, well-balanced meal. If you’re meal prepping for the week, marinate pre-cut chicken thighs or legs in different spices and seasonings to make cooking throughout the week simpler. Or try an option like Perdue’s Short Cuts, which include a variety of ready-to-eat, roasted, perfectly seasoned chicken breast strips.

Shop the store’s perimeter last. In most stores, fresh foods are located in refrigerated sections around the perimeter of the store. This is where you’ll find produce, fresh meat, poultry and dairy, giving you most of the essential ingredients for wholesome, well-balanced meals. Saving this section of the store for your last stop can help ensure perishable items spend less time away from refrigeration before you check out.  

Find chicken recipes and poultry shopping tips at perdue.com.

SOURCE:
Perdue Farms

States sue Meta for knowingly hurting teens with Facebook and Instagram − here are the harms researchers have documented

Instagram’s emphasis on filtered photos of bodies harms girls’ self-image. Thomas Barwick/DigitalVision via Getty Images

Christia Spears Brown, University of Kentucky

Forty-one states and the District of Columbia filed lawsuits against Meta on Oct. 24, 2023, alleging that the company intentionally designed Facebook and Instagram with features that harm teens and young users.

Meta officials had internal research in March 2020 showing that Instagram – the social media platform most used by adolescents after TikTok – is harmful to teen girls’ body image and well-being. But the company swept those findings under the rug to continue conducting business as usual, according to a Sept. 14, 2021, Wall Street Journal report. The report was based on documents provided by Facebook whistleblower Frances Haugen.

Meta’s record of pursuing profits regardless of documented harm has sparked comparisons to Big Tobacco, which knew in the 1950s that its products were carcinogenic but publicly denied it into the 21st century. Those of us who study social media use by teens didn’t need a suppressed internal research study to know that Instagram can harm teens. Plenty of peer-reviewed research papers show the same thing.

Understanding the impact of social media on teens is important because almost all teens go online daily. A Pew Research Center poll shows that 77% of teens report they use social media daily.

Teens are more likely to log on to Instagram than any other social media site except TikTok. It is a ubiquitous part of adolescent life. Yet studies consistently show that the more often teens use Instagram, the worse their overall well-being, self-esteem, life satisfaction, mood and body image. One study found that the more that college students used Instagram on any given day, the worse their mood and life satisfaction were that day.

Meta has taken steps to make Instagram less harmful to teens, but experts say the changes are not enough.

Unhealthy comparisons

But Instagram isn’t problematic simply because it is popular. There are two key features of Instagram that seem to make it particularly risky. First, it allows users to follow both celebrities and peers, both of whom can present a manipulated, filtered picture of an unrealistic body along with a highly curated impression of a perfect life.

While all social media allows users to be selective in what they show the world, Instagram is notorious for its photo editing and filtering capabilities. Plus, the platform is popular among celebrities, models and influencers. Facebook has been relegated to the uncool soccer moms and grandparents. For teens, this seamless integration of celebrities and retouched versions of real-life peers presents a ripe environment for upward social comparison, or comparing yourself to someone who is “better” in some respect.

People, as a general rule, look to others to know how to fit in and judge their own lives. Teens are especially vulnerable to these social comparisons. Just about everyone can remember worrying about fitting in in high school. Instagram exacerbates that worry. It is hard enough to compare yourself to a supermodel who looks fantastic (albeit filtered); it can be even worse when the filtered comparison is Natalie down the hall.

Negatively comparing themselves to others leads people to feel envious of others’ seemingly better lives and bodies. Recently, researchers even tried to combat this effect by reminding Instagram users that the posts were unrealistic.

It didn’t work. Negative comparisons, which were nearly impossible to stop, still led to envy and lowered self-esteem. Even in studies in which participants knew the photos they were shown on Instagram were retouched and reshaped, adolescent girls still felt worse about their bodies after viewing them. For girls who tend to make a lot of social comparisons, these effects are even worse.

Objectification and body image

Instagram is also risky for teens because its emphasis on pictures of the body leads users to focus on how their bodies look to others. My colleagues’ and my research shows that for teen girls – and increasingly teen boys – thinking about their own bodies as the object of a photo increases worrying thoughts about how they look to others, and that leads to feeling shame about their bodies. Just taking a selfie to be posted later makes them feel worse about how they look to others.

Being an object for others to view doesn’t help the “selfie generation” feel empowered and sure of themselves – it can do exactly the opposite. These are not insignificant health concerns, because body dissatisfaction during the teen years is a powerful and consistent predictor of later eating disorder symptoms.

Meta has acknowledged internally what researchers have been documenting for years: Instagram can be harmful to teens. Parents can help by repeatedly talking to their teens about the difference between appearance and reality, by encouraging their teens to interact with peers face-to-face, and to use their bodies in active ways instead of focusing on the selfie.

The big question will be how Meta handles these damaging results. History and the courts have been less than forgiving of the head-in-the-sand approach of Big Tobacco.

This story has been updated to include news of state attorneys general filing lawsuits against Meta claiming the company knowingly put children at risk.

Christia Spears Brown, Professor of Psychology, University of Kentucky

This article is republished from The Conversation under a Creative Commons license. 

‘I see no happy ending’ − a former national security leader on the Gaza hostage situation

Israelis whose relatives are being held hostage demonstrate on October 26, 2023 in front of the Defense Ministry building in Tel Aviv, demanding the government to bring back their loved ones. Mostafa Alkharouf/Anadolu via Getty Images

Gregory F. Treverton, USC Dornsife College of Letters, Arts and Sciences

Hamas took more than 200 people hostage during its deadly rampage in Israeli border towns on Oct. 7, 2023. Among the hostages are children and the elderly. While four of them have been released, the fate of the rest is unknown, as Qatar serves as an intermediary in working to free the hostages. In this interview with Naomi Schalit, The Conversation U.S. senior politics and democracy editor, Gregory F. Treverton of USC Dornsife, a former chairman of the National Intelligence Council in the Obama administration, says most hostage-taking has specific goals. This one, says Treverton, “is basically an adjunct of warfare, and that makes it very different” – and very hard to solve.

How do people in your field think about hostage-taking? I would imagine that the feeling is, “Oh, my god, please let nothing like that happen.”

It’s an utter dilemma, because on the one hand you feel for the hostages. And as we’ve seen in the past, the Israelis have been prepared to – and did – release a thousand hostages to get one Israeli back.

On the other hand, when you do a deal to get hostages released, you’re only encouraging more hostage-taking. So you’re damned if you do and damned if you don’t. As a result, every government, including the United States, says, “We never deal with hostage-takers.” But of course, they all do – and they have to.

I think it’s one of the hardest parts of being in the national security business. You want to free the people – but you’re also going to get criticized. Every time President Biden has gotten somebody out of Russia, people have said, “Oh, he’s paid too high a price” or “He’s rewarded hostage-taking,” and to some extent, that’s true. You are basically rewarding the hostage-takers. But we still have to deal with them. We want to get our people out. And at some some point – as the Israelis have shown – they’re prepared to pay almost any price to get them back.

Keren Shem, the mother of hostage Mia Shem, holds a photograph of her daughter as she speaks to the press in Tel Aviv on Oct. 17, 2023. Gil Cohen-MAGEN/AFP via Getty Images

Israel released more than 1,000 prisoners in 2011 in exchange for Israeli soldier Gilad Shalit, whom Hamas captured and held for five years. This is more than 200 times the number of hostages, so how do you even think about that?

At least in my professional experience, this is without precedent. The closest parallel would be the 1976 Entebbe hijacking and hostage-taking by two Germans and two Palestinians on a flight from Tel Aviv to Paris. Hijackers held 103 Israeli hostages, once they released the 148 non-Israeli hostages. Hamas holds twice the number of hostages, and in very, very different circumstances. In Entebbe, the Israeli government knew where they were, they were in a single place – the airplane – which had been forced to land in Entebbe, Uganda, after taking off from Tel Aviv. And that’s where Israeli commandos were able to rescue the hostages.

In Gaza, we don’t know where they are. We know for sure they’re scattered throughout the tunnels, likely in lots of different small groups. Hamas will presumably then use them as shields if fighting begins on the ground. They might think that that would encourage the Israelis not to make a major attack – to keep Hamas from killing all the hostages. We know that Israeli Prime Minister Benjamin Netanyahu isn’t keen on a major ground assault, and this really puts the onus on the Israelis for how the hostage situation ends.

When you think about the history of hostage negotiations, do you see something that has any relevance to what’s going on now?

It seems to me it’s a really different category. Even Entebbe was hostage-taking for some political aim – the hijackers wanted Israel to release a large number of prisoners who were Palestinian. A colleague of mine used to say that the point of terrorism was to do the least amount of violence with the most people watching it. But Entebbe was political theater, basically, and this is not political theater. This is basically an adjunct of warfare, and that makes it very different. It’s not the usual kind of tit for tat, with “How much am I willing to pay?” or “Can I take a hostage to get somebody else out?”

Buses carrying Palestinian prisoners on Oct. 16, 2011, who were being exchanged for Israeli hostage Gilad Shalit, held by Hamas for five years. Jack Guez/AFP via Getty Images

What does Israel’s heavy bombing of Gaza and the beginning of a ground invasion tell you about the government’s approach to the hostage situation?

It suggests either that they have a pretty good fix on where the hostages are located, which seems unlikely given the network of Hamas tunnels, or that they have decided they must proceed in any case and will try their best to safeguard and free hostages as they go. Given the Hamas practice of using civilians as human shields, the outcome is likely to be very ugly.

Where do you see this going?

I see no happy ending. I don’t think there’s a deal that Israel could conceivably make, given its own politics. Or that Hamas would accept. So it does seem to me that at some point there is going to be that ground attack and the hostages are going to be caught in the middle of it. I see almost no alternative, given what Israel has pledged – to destroy Hamas. The Biden administration maintains that Israel doesn’t really have a strategy. They have a desire, which is to destroy Hamas. But that’s not a strategy for dealing with the hostages or for Gaza after the attack.

Gregory F. Treverton, Professor of Practice in International Relations, USC Dornsife College of Letters, Arts and Sciences

This article is republished from The Conversation under a Creative Commons license. 

Be Ready to Save a Life: Understanding the 2 steps of Hands-Only CPR

Every year, 350,000 people die from cardiac arrest in the United States. However, hands-on emergency intervention like cardiopulmonary resuscitation – or CPR – from a bystander can make the difference between life and death in sudden cardiac arrest emergencies.

In fact, immediate CPR can double or triple a cardiac arrest victim’s chance of survival, according to the American Heart Association. During the first few minutes an individual is suffering from cardiac arrest, chest compressions can help keep blood flow active and push remaining oxygen through the body to keep vital organs alive, which extends the opportunity for a successful resuscitation once trained medical staff arrive.

Because 88% of cardiac arrests – electrical malfunctions in the heart that cause an irregular heartbeat (arrhythmia) and disrupt the flow of blood to the brain, lungs and other organs – occur at home, it is often a friend or family member who witnesses a child, spouse, parent or friend going into cardiac arrest. As survival can depend on how quickly CPR is started, compression-only CPR, or Hands-Only CPR, is recommended for use by people who see a teen or adult suddenly collapse in an out-of-hospital setting such as at home, work or in a park.

“By equipping people with Hands-Only CPR training, we are empowering them to spring into action if a loved one needs help, as the majority of cardiac arrests occur at home,” said Dr. Anezi Uzendu, M.D., interventional cardiologist and American Heart Association volunteer.

As part of the World Restart a Heart Day initiative, the American Heart Association aims to increase awareness about the importance of bystander CPR through its Hands-Only CPR campaign, nationally supported by the Elevance Health Foundation, and offers these two simple steps:

• Call 911 (or send someone to do that).
• Push hard and fast in the center of the chest of the individual experiencing cardiac arrest.

Using the beat of a familiar song with 100-120 beats per minute, such as “Stayin’ Alive” by the Bee Gees, can help you stay on pace with the necessary compressions.

“Being able to efficiently perform Hands-Only CPR in the moment can mean the difference between life and death, and by following these two simple steps we can increase someone’s chance of survival from cardiac arrest,” said Shantanu Agrawal, M.D., board certified emergency medicine doctor and chief health officer at Elevance Health. “As a longstanding supporter of the American Heart Association, we remain focused on working together to improve health inequities in our communities by expanding access to training and increasing the number of people who learn and feel confident performing Hands-Only CPR to save lives.”

To find more information and resources, visit heart.org/CPR.

6 Links in the Adult Out-of-Hospital Chain of Survival
When properly executed, a strong chain of survival – or series of actions – can improve the chances of survival and recovery for victims of sudden cardiac arrest. Hands-Only CPR is a critical step in the American Heart Association’s Chain of Survival, which also includes:

• Activation of Emergency Response: Recognize symptoms of cardiac arrest and call 911.
• High-Quality CPR: Push hard and fast in the center of the victim’s chest until emergency personnel arrive.
• Defibrillation: Use an automated external defibrillator (AED) to restart the victim’s heart and reset it to a healthy rhythm.
• Advanced Resuscitation: Medical professionals provide additional life-saving medical services.
• Post-Cardiac Arrest Care: Transport victim to an appropriate hospital or treatment facility to optimize survival, organ function and neurological recovery.
• Recovery: Survivors receive additional treatment, observation, rehabilitation and psychological support to aid in recovery and help prevent recurrent cardiac arrest.

 

SOURCE:
American Heart Association