In a Dec. 3 report, HRL exposed Russia’s deliberate and systematic program of forcibly deporting Ukrainian children into coerced adoption and fostering — a program that researchers describe as one of the largest missing persons crises since World War II.

“The evidence compiled by the Humanitarian Research Lab researchers could lead to additional charges against Russian President Vladimir Putin; Maria Lvova-Belova, presidential commissioner for children’s rights; and other officials involved in the extensive forced relocation program in the International Criminal Court for war crimes and crimes against humanity,” Oona Hathaway, a professor of international law at Yale Law School, told the News.

Yale HRL found at least 314 Ukrainian children, primarily from the Eastern Donbas region, who since the start of Russia’s full-scale invasion of Ukraine in 2022 have been forcibly deported and listed in Russian adoption databases. The program aimed to assimilate these children into Russian society, erasing their Ukrainian identities.

Many of these children were nationalized as Russian citizens and placed with families under a program ordered and directed by Putin.

“This whole program is an act of deception by Russia,” Nathaniel Raymond, the executive director of the HRL, explained. “Underlying it was the placement of children in a database where it looked as if they came from places in Russia … when in fact, they were from Ukraine.”

The deception extended beyond databases. According to the HRL, Russia had altered personally identifiable information, or PII, and even manipulated adoption profiles to disguise the Ukrainian origin of the children, presenting them instead as Russian citizens. 

“This was a game of cat and mouse between the HRL researchers and the Russians,” Raymond said. “We were constantly worried that the databases would be taken down, but through incredible dedication, our team uncovered children hiding in plain sight.”

Connecting the dots: A wall that exposed the Russian operation

Yale’s investigation into Russia’s forced adoption program was anything but straightforward. Over 20 months, researchers meticulously pieced together fragments of data scattered across open sources, relying on sharp observation and advanced technology. Among the breakthroughs in their work was a single clue that changed the course of the investigation: the discovery of a wall.

“The original lead was paint on a wall,” Raymond recounted. The image, taken in a Russian facility, featured children standing in front of a teal and yellow wall. This wall matched the backdrop of another photograph that had surfaced online of children being transported to a “temporary accommodation center” in Russia.

“Russia had made a mistake in their tradecraft. By not changing the location, they unintentionally left a visual breadcrumb,” Raymond said.

Yet the wall was only the starting point of HRL’s investigation. 

Researchers utilized high-resolution satellite imagery and database cross-referencing to confirm children’s movements across Russia. 

“The critical use of satellite imagery in this report was the planes,” Raymond explained. “Being able to use archival, commercially available imagery to identify planes at locations … we correlated these findings with visual data from on-the-ground sources to build a complete picture of how these children were moved.”

Later, investigators also uncovered evidence of deliberate obfuscation by Russian authorities. 

Leaked government documents detailed meetings where the relocation of children was discussed. These documents provided insight into how Russian officials coordinated efforts to move children, create legal justifications for their adoption and hide the children’s Ukrainian origin.

From linguistics to satellite image analysis, team members came together to discover and reconstruct the movements and identities of the 314 Ukrainian children. Half of these children were siblings, further complicating efforts to track and confirm their identities.

“Each child identified had to meet a high-confidence standard,” Raymond said. “We used the NATO Admiralty system for evaluating evidence and corroborated findings with independent sources.”

This included verifying the children’s origins in Ukraine, matching their presence at transit locations, and identifying them in Russian databases and records while keeping the investigation absolutely confidential.

The team created detailed dossiers on each kid they could identify for Ukrainian law enforcement, the Ukrainian government and the International Criminal Court to facilitate the children’s return.

The toll of deportations and path to accountability

The forced deportation and coerced adoption of Ukrainian children have inflicted profound psychological and emotional harm on both the children and their families. As detailed in the HRL report, the program has “separated siblings, erased cultural identities, and placed children in unfamiliar and hostile environments” where they were subjected to “Russification” efforts.

Caitlin Howarth, an HRL researcher, said that the team found records of children who experienced “acute and prolonged psychological distress.”

“One child was forced to choose between accepting a guardianship and losing her three younger siblings,” Howarth said. “Another showed signs of social withdrawal and depression after being placed with a Russian family.”

At the program’s core was an effort to sever the children’s ties to their Ukrainian heritage. The systemic renunciation of Ukrainian citizenship, combined with the imposition of Russian identities, cut off children from their families, language, and homeland.

Such an account only represents a sliver of the larger issue. “We know that what we have documented is only the tip of the iceberg,” Howarth noted.

According to Hathway, the report aims to provide facts and figures to accountability mechanisms such as the International Criminal Court and Ukrainian criminal courts. 

“The HRLs’ legal analysis of the evidence they collected establishes a basis for potential crimes against humanity, war crimes and perhaps even part of a broader case of genocide,” Hathway explained in the School of Public Health Q&A about the report.

By providing evidence of the ongoing forced deportation, the HRL can provide evidence for the courts to take action against Putin, Maria Lyova-Belova and other officials who have been involved in this process. 

Previously, HRL research reports have been the basis of the Criminal Court’s prosecutions of senior Russian officials, including Russian President Vladimir Putin.

This Wednesday,  Raymond appeared before the United Nations to present the HRL’s findings.

“The real credit goes to the investigators, who worked with incredible dedication to ensure these children were not lost in the shadows,” Raymond said.

The Russo-Ukrainian War began in February 2014.

The post Yale HRL uncovers Russian forced deportation and adoption of Ukrainian children appeared first on Yale Daily News.

The $838 million, 500,000-square-foot center, located on the Saint Raphael Campus, is scheduled to open in 2027. It will include the Neurosciences Intensive Care Unit, Neuro Rehabilitation Area and Epilepsy Center and will house 184 inpatient beds and single-patient rooms.

“Today symbolizes Yale New Haven Health’s continued commitment and investment to provide exceptional, advanced destination, neurosciences care, to serve the health needs of the communities we serve,” Dr. Katherine Heilpern, president of Yale New Haven Hospital said at the ceremony.

The new center will consist of two towers, the Sherman Tower adjacent to Sherman Avenue and the McGivney Tower built atop the existing McGivney Center. The towers will share spaces on the first through third floors.

The center will provide physicians and experts with access to next-generation technology, equipment and programs designed to help patients overcome neurological deficits.

According to Dr. Murat Günel, chief of neurosurgery at YNHH and professor of neurosurgery, the center is designed to advance the treatment of neurological ailments.

“What we’re looking to do is map individual brains [to] give really cutting-edge, precision treatment and personalized approaches to each patient for their complex neurological disorders,” Günel told the News. “So that’s the idea that, of course, starts with the infrastructure.”

According to Günel, the building was constructed with two goals in mind. One is providing holistic care for neurological disorders. The second is advancing a fundamental understanding of neurological disorders to develop treatments and harnessing the engineering insights at Yale to transform patient care.

The new center aligns with YNHH’s increased investment in the Saint Raphael Campus. 

“There were a number of folks that were commenting that this would just be a peripheral campus … and it wouldn’t have a level of service that York Street has been known for,” YNHH CEO Christopher O’Connor said. “Wow, if they could see it now, a billion dollars in additional investments going on right now on this campus.”

O’Connor cited doubling the emergency department size, investing in heart and vascular technology to support the care in the tower and building a large new parking garage.

A significant part of the funding for the center came from its namesakes, Stephen and Denise Adams. As Mr. Adams struggled with Parkinson’s, he and Mrs. Adams decided to support efforts to improve care for patients with neurological conditions.

Drawing from their personal experiences, they envisioned a center to bridge the gap between research and clinic care. 

New Haven Mayor Justin Elicker described the Adams Neurosciences Center as having both economic and healthcare benefits for the community.

The center promises to create hundreds of jobs in New Haven. The construction phase has already generated jobs and building permit revenue for the city. Once operational, the center is expected to create more permanent positions in healthcare and research.

In addition to economic contributions, Elicker explained, the center may also establish New Haven as a regional hub for advanced neurological care and research, reflecting broader investments in the city’s healthcare infrastructure. 

“With this building, not only will you begin expanding the amount of love and care that you give to our community,” Elicker said, “but you will be researching and developing cutting-edge research to help so many more people live more fulfilled lives, and for that, we are grateful.”

The Adams Neurosciences Center will be located at 659 George St.

The post YNHH tops off largest healthcare construction project in Connecticut history appeared first on Yale Daily News.

The Yale New Haven Health System alleges that Prospect’s neglect, mismanagement and irresponsible financial practices violate prior agreements. These violations include failing to meet safety and sanitization standards, mismanaging medical samples and drugs, neglecting infrastructure repairs, incorrectly administering treatments and breaching abuse policy. 

Additionally, the healthcare system cited cybersecurity concerns and financial shortcomings at the Prospect hospitals, including millions in unpaid compensation to hospital workers and debt stemming from rent, interest and unpaid taxes. 

“We simply cannot jeopardize the sustainability of our health system by moving forward with the acquisition as it stands,” Dana Marnane, director of public relations at Yale New Haven Health, wrote in a press release statement sent to the News. 

The network’s negotiations with Prospect for the acquisition of Waterbury Hospital, Rockville General Hospital and Manchester Memorial Hospital started on Feb. 4, 2022, when the Yale New Haven Health System signed a letter of intent to acquire the Prospect Hospitals. After months of negotiations, the parties signed a purchasing agreement on Oct. 5, 2022.

In order to close the acquisition deal, the healthcare system outlined requirements that Prospect needed to satisfy, which included maintaining consistent business practices, protecting patient and employee personal data, remaining current on all payment obligations and complying with all relevant state and federal regulations. 

“Prospect has proven unwilling to make a good faith effort to reach an agreement, leaving YNHHS no choice but to pursue a complaint to obtain a declaration that Prospect is in breach of the Asset Purchase Agreement (APA) and that Yale New Haven Health does not have an obligation to close the transaction on the original terms,” Marnane wrote to the News. 

In a written statement reported on in the CT Mirror, Prospect officials called the suit “a blatant, 11th hour attempt by Yale Health to back out” of the contract and that they will be seeking legal action, “including completion of transaction,” to ensure Yale completes the deal. 

Prospect did not immediately respond to requests for comment.

A Pattern of Repeated Regulatory Violations

According to Friday’s complaint written by the Yale New Haven Health Services Corporation, state and federal regulators issued notices that regulatory violations at Waterbury Hospital, Rockville General Hospital and Manchester Memorial Hospital jeopardized the health and safety of patients, subsequently violating the ordinary course of business. 

In June 2023, the Connecticut Department of Public Health uncovered that a patient died after the Waterbury Hospital Laboratory failed to process the patient’s blood work in a timely manner, per the complaint. 

The department also identified 20 violations of the Regulations of Connecticut State Agencies to Waterbury Hospital.

The violations include failing to sanitize operating room equipment, leaving it rusty; failing to properly label medication, resulting in staff being unable to identify expiration dates; and failing to complete criminal background checks on 25 new hires who had direct access to patients and their records.

On Oct. 11, 2023, the Centers for Medicare & Medicaid Services issued a notice to Manchester Memorial Hospital as a result of the hospital failing to investigate allegations that a registered nurse engaged in intimate relations with patients in hospital rooms before and after discharge. According to the complaint, this nurse was not removed from patient care areas or placed on administrative leave, violating Manchester Memorial Hospital’s abuse policy. 

Additionally, the state’s Department of Public Health identified 13 regulatory violations at Manchester Memorial Hospital, including losing a sample of potentially cancerous cells collected during a surgery, using an incorrect implant during a knee surgery and failing to ensure that patients with infections received antibiotics. 

In November 2023, the department issued another notice of noncompliance to the hospital for failing to implement continuous safety precautions to prevent infant abductions.

Like Manchester Memorial Hospital, Waterbury Hospital faced consequences from both the department and the Centers for Medicare & Medicaid Services. On Jan. 3, 2024, the state’s Department of Public Health issued a notice of noncompliance to Waterbury Hospital for allegedly neglecting to ensure that the breakers feeding electrical power to the system were replaced, resulting in the heating, ventilation and air conditioning system losing power. Instead of paying to repair the system, the hospital did not take action for five months. 

In addition to leaving patients and staff without air conditioning during the summer months, the heating, ventilation and air conditioning system failure also led to the cancellation of surgeries because of an inability to maintain adequate humidity and temperature levels. 

On Jan. 26, 2024, the Centers for Medicare & Medicaid Services reported that, because of substantial noncompliance, Waterbury Hospital no longer met the requirements for participation in Medicare, and was placed under a state survey agency. 

Then, on March 11, 2024, the Health Department identified 18 violations at Waterbury Hospital, citing patient abuse and improper administration of anesthesia.

Cybersecurity Concerns

On the morning of Aug. 1, 2023, the three Prospect hospitals fell prey to ransomware as an unauthorized party entered the Prospect hospitals’ electronic environments, gaining access to the protected health information or indefinable information of approximately 110,000 patients and employees, per the complaint.

“Defendants’ insufficient cybersecurity measures and investment have further contributed to the downturn of the hospitals,” read Friday’s complaint.

The complaint notes that, prior to the breach, Prospect’s chief information security officer resigned, but that Prospect is still yet to fill the position. 

Weeks after the cyberattacks, Manchester Memorial Hospital lost over 30 percent of its patient population, as the hospital could not receive new patients until Aug. 28, 2023. Patients arriving at the hospital had to be moved to facilities in Connecticut and in neighboring states, per the report.

“Waterbury Hospital’s emergency department diverted so many patients to Saint Mary’s Hospital that Saint Mary’s emergency department became overrun, with patients sitting on the floor and waiting on gurneys in hallways for days before being admitted,” read the report.

After the breach, the three hospitals were unable to bill Medicaid and other insurance providers, resulting in the state Department of Social Services advancing the hospitals $7.5 million.

Following the cyberattack, Yale New Haven Health submitted a certificate of need application to the state with a recovery plan for the hospitals, including a request for financial support from the state. The Connecticut Office of Health Strategy signed off on the certificate. 

Financial Shortcomings

The Yale New Haven Health System’s decision to sue is also fueled by the Prospect hospitals’ failures to pay vendors and physicians. Lawyers representing the corporation cited a report revealing the hospitals owed $5.9 million to local vendors and $5.18 million in unpaid compensation to physicians in November 2023.

According to the complaint, these financial failures resulted in nurses and physicians from the three Prospect hospitals rallying at the state capitol in Hartford to protest their lack of payment. 

“The value of the assets has declined dramatically due to Prospect’s failure to pay physicians and vendors including Yale Medicine, the non-payment of state provider and municipal taxes, and the impact of a massive cybersecurity event caused in part by a lack of investment in technology which exposed patient, employee and dependent data and rendered Prospect CT unable to bill for services,” Marnane wrote to the News.

Additionally, the complaint states that neither Waterbury Hospital nor Manchester Memorial Hospital have been able to pay for elevator services, resulting in staff carrying patients up and down the stairs. 

Prospect also owes millions in rent, interest and unpaid taxes. According to the report, Prospect owed $56 million in accrued rent and interest and $400 million in loans. In December 2023, the state of Connecticut filed three tax liens against Prospect for failing to pay provider taxes since March 2020. In total, the report reads, the three hospitals owe $67.39 million.

According to the complaint, Prospect’s mismanagement and financial irresponsibility diminished the hospitals’ values.

In the Prospect statement, they wrote that despite what Yale wrote in the complaint, Prospect was only notified that there had been “material adverse effect on the hospitals’ finances and operations” on March 27, 2024, and that they made a “good-faith price reduction in an attempt to move the negotiations forward.”

Prospect further wrote that their Connecticut hospitals’ patient volumes and finances had “rebounded significantly.” 

Prospect Medical Holdings owns 16 hospitals in four states. 

The post Yale New Haven Health System to sue Prospect Medical Holdings appeared first on Yale Daily News.

As a result, doctors treating obesity combat the chronic condition on the physiological and mental fronts. Their most effective tool is bariatric surgery, a procedure that stimulates weight loss by making modifications to the body’s digestive system.

And though the surgery is effective at reducing weight and weight-related comorbidities, some patients suffer from mental health complications — even after the procedure wraps up, doctors say. Find out the best weight loss supplements that really work.

“What we see with bariatric surgery is that it’s safe, effective and for the vast majority of people, they do well,” said John Morton, division chief for bariatric and minimally invasive surgery in Yale-New Haven Health. “But there is a subset, just like there is in any field of medicine, that can have issues … around depression, suicidal ideation and alcohol abuse. The biggest predictor for those issues is having those same issues before.”

The operation

Inside the operating room, the most commonly performed type of bariatric surgery is the sleeve gastrectomy. 

The procedure takes roughly 45 minutes, Morton said. A surgeon makes four incisions, each less than three-quarters of an inch. Then, the surgeon uses a surgical stapler to remove two-thirds of the stomach, shrinking it from the size of a football to the size of a banana. 

The portion of the stomach removed is not essential for digestion, Morton said. Removing it leaves patients feeling more full, more quickly. The procedure also treats the comorbidities of obesity, like type 2 diabetes and high blood pressure.

Gynecomastia surgery, another common procedure in the realm of cosmetic surgery, addresses the condition of enlarged male breasts.

The surgery typically involves liposuction or excision techniques to remove excess glandular tissue and fat, providing a more contoured chest appearance. Las Vegas Gynecomastia has gained popularity among men seeking to enhance their self-confidence and achieve a more masculine silhouette.

This procedure is often performed under general anesthesia, and the recovery time varies, but most patients can return to regular activities within a few weeks.

The surgery’s capacity to reduce mental health challenges, however, is less certain. 

“We’re able to improve, or put into remission diabetes about 80 percent of the time and high blood pressure about 70 percent of the time,” Morton told the News. “ For depression, it’s a mixed bag, it’s probably maybe 50 percent. Some people get better, but some might get worse.”

That’s because the success of bariatric surgery isn’t just about modifying the digestive process. For sustained weight loss, patients need to commit to several behavioral and dietary changes to help keep weight off in the long run. 

Two weeks before bariatric surgery, for instance, patients switch to a liquid diet, which helps shrink the patient’s liver and kick-starts weight loss in the patient, Morton said.

After the surgery, patients begin a process of diet escalation, Morton said, shifting from a liquid to a puréed diet over several weeks. Once patients return to regular eating, he said, they need to exercise, consume more protein and eat fewer carbohydrates and sugars.

But if a patient’s mental health challenges limit their ability to follow those post-operative guidelines, the prospect of sustainably losing weight might be in jeopardy.

Mental health screenings

At Yale, mental health is embedded into standard patient care for obesity. Before the surgery, Morton said, patients meet twice with the surgeons, twice with nurses and six times with nutritionists and psychiatrists, allowing his team to establish rapport with his patients.

And to screen patients for mental health challenges, individuals seeking bariatric surgery also undergo a psychological evaluation, he said.

Mary Motwani, a psychologist at Yale-New Haven Hospital who performs mental health evaluations, describes the process as looking for “red flags” like untreated or undertreated mental health issues that could interfere with a patient’s ability to follow strict surgical guidelines.

Most mental health challenges that patients face after bariatric surgery also exist prior to the surgery, Motwani said. The bariatric population suffers from depression, body image shame, social anxiety, body dysmorphia, eating disorders and general impulse control disorders — a tendency of addictions to substances or other compulsive habits such as shopping or gambling, she said.

And according to Joshua Hrabosky, a psychologist who helps lead Morton’s bariatric mental health care, it is especially common to encounter patients with bipolar disorder and schizophrenia in the New Haven area.

But mental health challenges do not preclude patients from undergoing bariatric surgery.

“I don’t want to be a gatekeeper,” Hrabosky said. “Our role as psychologists, psychiatrists and clinical social workers is not to prevent a person from having surgery.”

Instead, Morton and Hrabosky’s goal is to catch patients who could be at-risk for mental health challenges before the bariatric surgery and ensure that they have resources in place to avoid issues stemming from untreated conditions.

By identifying these red flags, the team hopes to identify obstacles that patients may need to overcome to have positive outcomes after surgery. If a patient’s mental health condition makes it difficult for them to observe the doctor’s patient-care instructions, then patients may receive a referral to therapy as part of their postoperative care recommendations, Hrabosky said.

“What we would like to do within Yale-New Haven Health System is for the pre-bariatric psych eval[uation] to be educational,” said Hrabosky. “[It’s] an opportunity for patients to be aware of how some of these risk factors can impact their post-surgical outcomes because we want them to have the best outcome possible.”

Sometimes, Hrabosky said, red flags during the psychological evaluation might mean that bariatric surgery may not be the best outcome or a patient struggling with mental health challenges. In these cases, Hrabosky works with the hospital’s medical weight loss program if a patient is a better fit for weight-loss medication — like Wegovy or Zepbound — instead of surgery. 

“Our goal is never to discharge … or dismiss patients from the program,” Hrabosky told the News. “We really want to support them in any way possible, whether it’s through surgery or medical avenues.” 

Emotional aftermath

For many patients, the improved health and weight loss resulting from the surgery can help alleviate symptoms of depression and anxiety, Motwani said. 

For others, however, lifestyle changes after the surgery can exacerbate mental health struggles. Large changes to an individual’s body weight and shape can make them feel self-conscious — making existing anxiety symptoms, for example, worse.

It’s the reason that, after the surgery, patients have access to a bariatric treatment support group led by Gregory Berlin, a clinical psychologist and the YNHH Center for Behavioral and Nutritional Health. 

“Oftentimes people will lose a significant amount of weight, and then folks will comment on their body and say that they look underweight, and then people can feel really self-conscious about both their pre- and post-operative body,” Berlin said. “So if anxiety and depression are there preoperatively, and you’re undergoing all the postoperative changes, there’s definitely a chance that you can struggle after surgery.”

To combat emotional complications after the surgery, Berlin teaches bariatric patients techniques to be more emotionally aware. Those lessons include methods for patients to better identify locations of physical tension in their body, how their thinking patterns change depending on their stress level and how to accurately label their emotions at any given moment.

Berlin also teaches patients how to take control of aspects of their physical wellbeing: promoting better sleep, maintaining treatment goals and eating mindfully.

For Berlin, postoperative care is as transformative psychologically as it is physically. He emphasized that patients going through bariatric treatment are not alone: staying in contact with medical providers can help patients navigate the emotional aftermath of bariatric surgery.

“You’re not alone in feeling that and the very best thing you can do postoperatively is stay in close connection with your medical team,” Berlin told the News. “They’re there to help, and it’s not unexpected to have issues after surgery.”

The first weight loss surgery was conducted in 1954.

The post How Yale’s obesity experts help weight-loss surgery patients navigate their mental health appeared first on Yale Daily News.

The FDA’s decision now allows authorized healthcare professionals to administer the drug to immunocompromised persons over 12 years old who are unlikely to mount an effective immune response to COVID-19 vaccination. According to Shiv Gandhi, an infectious diseases clinical fellow at the School of Medicine, Pemgarda may help immunocompromised patients avoid suffering from any severe symptoms or infection.

“There is a subset of patients that, despite a number of vaccines, still failed to mount a meaningful immune response,” Gandhi told the News. “For those patients, products like this could be useful.” 

Pemgarda is a monoclonal antibody infusion, meaning that doctors administer lab-made clones of an antibody found in the immune system to the body via an IV tube. These proteins then act like the cloned antibody, defending the body against foreign invaders. The infusion, Gandhi said, maintains a protective antibody level for about three months, providing immunocompromised patients with the antibody for COVID-19 they can’t produce on their own. 

However, after those three months, antibody levels wane, and patients are again at risk for infection. Due to this dip in antibodies, the FDA declared that patients may receive Pemgarda infusions every three months.

How does Pemgarda work?

After Pemgarda is administered into the body, antibodies latch onto the SARS-CoV-2 — the name of the virus that causes COVID-19 — receptor binding domain on the virus’ exterior. Normally, the virus receptor tries to bind to a receptor on the outside of a human cell to grant the virus entry. To prevent this, the infused antibody binds to the spike protein of the virus that binds to the human cell receptor, acting as a buffer to prevent the virus binding domain from properly connecting and entering the cell. 

According to Akiko Iwasaki, an immunobiology professor at the School of Medicine, these monoclonal antibody measures have been effective against COVID-19, but they still have limitations.

“Previous monoclonal antibodies were excellent in preventing and treating COVID-19 at the time they were developed,” Iwasaki wrote in an email to the News. “However, variants of concern keep emerging with spike proteins that have undergone significant mutations, enabling them to evade detection by such antibodies.”

SARS-CoV-2 is constantly evolving, and it continues to mutate and change the morphology of its spike protein. While antibodies can recognize these spike proteins and neutralize the virus, if the spike proteins change following a mutation, the virus can evade detection and enter cells.

For Gandhi, these high mutation rates have rendered previous monoclonal antibody treatments ineffective. 

“There was a product that was designed similarly to this that was used for pre-exposure prophylaxis in immunocompromised patients called ‘Evusheld,’ and these preventative measures were all pulled from the market because SARS-CoV-2 evolved and developed mutations in the spike protein that preempted their activity,” Gandhi said.

Though this limitation is inherent to all monoclonal antibody treatments, Gandhi said Pemgarda is still effective against all previous SARS-CoV-2 variants.

Still, Pemgarda produces certain side effects, including redness and swelling at the infusion site, feelings of illness after the infusion and a risk of a severe — even life-threatening — allergic reaction.

“I think for those reasons, the patient population that this will be useful for is quite limited to the most severe immunocompromised patients where the benefits would outweigh the risks,” Gandhi said.

Gandhi noted that patients born with hereditary mutations in their immune system and those who develop conditions — such as blood cancers — or are receiving treatment that suppresses their immune system could all benefit from Pemgarda. 

According to Albert Ko, professor of public health at the School of Public Health, the development of monoclonal antibodies infusions for COVID-19 like Pemgarda will help inform how future viruses are handled, despite the limitations of the infusions.

“What we’ve learned over the pandemic, [such as] how we could make monoclonal antibodies to a pandemic threat really gave us new insights,” Ko told the News. “The knowledge we’ve made from COVID is really going to be able to help us think about how we can use that advice not only to treat patients but also with prophylaxis to protect vulnerable populations, such as the immunocompromised.”

Pemgarda was developed by Invivyd, a biopharmaceutical company founded in 2020. 

The post Yale researchers weigh in on new COVID-19 drug  appeared first on Yale Daily News.

In similar projects, commercial fitout Sydney specialists bring an acute awareness of both design trends and preservation needs, transforming aged venues into inviting, state-of-the-art spaces that resonate with today’s visitors without compromising the essence of their historic roots.

Whether through carefully selected materials, tailored lighting, or creative layout solutions, these experts strike a balance that meets the functional demands of modern businesses and the aesthetic expectations of discerning visitors. The result is an environment where tradition and innovation coexist, offering a distinctive and memorable experience for everyone who enters.

The reopening of the Peabody Museum is a testament to the power of thoughtful renovation, where history is honored while modern enhancements elevate the visitor experience. Just as commercial fitout specialists in Sydney masterfully blend preservation with contemporary design, the role of paint in any renovation is equally transformative. The right color palette can redefine a space, whether through warm, inviting tones that celebrate heritage or bold, modern hues that inject fresh energy.

Beyond aesthetics, high-quality paints provide durability and protection, ensuring that walls withstand the test of time while maintaining their visual appeal. In large-scale restoration projects, paint is more than just a finishing touch—it’s a crucial element that ties together the architectural vision. Companies like Nebraska Elite Painting understand this delicate balance, offering expertise in selecting and applying finishes that enhance both the structural integrity and aesthetic value of a space.

Whether reviving intricate moldings in a historic building or introducing sleek, modern coatings to a commercial fitout, their approach ensures that every surface contributes to the overall atmosphere. The fusion of expert craftsmanship and premium materials results in a polished, enduring transformation—one that welcomes visitors with a sense of sophistication and purpose while preserving the essence of what makes a place truly remarkable.

But while exploring the renovated Peabody, visitors may have missed the cadre of museum staff standing around the edges of exhibits and on the second-floor walkway overlooking Burke Hall. These staff members spent years building the Peabody back from bare walls in 2020. The museum had been stripped of all but three displays that remained only because they were too large to move.

When the museum opened, staff members like museum director David Skelly watched with excitement as visitors interacted with exhibits that they had spent years redeveloping.

“I’m so excited to see all of these people who work so hard in the galleries, watching crowds of people come in and enjoy all of this work,” Skelly told the News. “Personally, selfishly, like walking in and seeing the Brontosaurus remounted, there’s a little five-year-old part of me that couldn’t be any more just completely excited about all this.”

The renovation has added museum gallery space and additional exhibition space to display artifacts, fossils and meteorites. The renovated space also includes new research facilities, classrooms and an educational center for K-12 students in the New Haven area.

A theme of the renovation was bringing the exhibits to life, said Vanessa Rhue, the museum’s collection manager of vertebrate paleontology. Fossils from the archosaur, a predecessor to crocodiles, are exhibited in a running pose with its arms behind its body. The long-necked brontosaurus in the museum’s Burke Hall of Dinosaurs now has a cocked and turned head, peering at visitors with a “bird-like” tilt, said Rhue. 

Marilyn Fox, the chief preparator of the museum’s vertebrate paleontology division, said that these modifications comprise an effort to align the displays with newer research in the field of paleontology. Before the renovations, for instance, the brontosaurus bones had been displayed in the same static pose since the Peabody first opened, reflecting the previous paleontological belief that the dinosaur lived “[sitting] in the water all day,” Fox said.

The new brontosaurus exhibit changes reflect the understanding that the creature was likely much livelier and had a lifestyle more similar to a modern-day elephant.

“I grew up in Connecticut, I’ve been going to this museum since I was about five,” Skelly told the News. “And there were exhibits that we just took down that had not changed one bit since I was a kid. That’s a comforting nostalgia thing for me, but that’s nowhere a modern museum can be. We need to be giving people access to stories that reflect current understanding.”

To accomplish this, Fox said, workers cleared out the Peabody in 2020 by dismantling displays and ensuring the fossils’ safe removal and storage, leaving only three displays on the site. Many of the materials were transported to an off-site facility at Yale’s West Campus for restoration and storage. 

Some specimens required specialized treatments that were beyond the scope of the Peabody staff. Their restoration was outsourced to contractors — including the company Research Casting International based in Trenton, Ontario. 

Once the fossils arrive at West Campus or in Trenton, preparators are tasked with removing the grime and dust from the fossils. Specialists use solvents such as alcohol, ethanol and acetone to clean the bones. Then, they use brushes called air scribes to remove plaster that may have previously covered the bones.

After the bones are cleaned by the preparators, they are handed off to the blacksmiths, who prop the fossils up in a sandbox. The blacksmiths take the clean bones and design removable armatures — metal frameworks that hold the bones in place — that fit each bone on a mount. Once the armatures are complete, they build a steel support system and weld the armatures together to set up a fossil exhibit in a desired pose. 

Often, Rhue told the News, scientists don’t have access to complete skeletons: bones can decay over millions of years, for instance, or predators can pick them apart. To work around this, Peabody staff can make plaster approximations of what the structure may have looked like. 

According to Rhue, to revamp these plaster approximations, researchers from around the world visit the Peabody’s specimens and determine whether the existing plaster sculpture is similar to what the latest research indicates. 

They also compare the missing fossils with complementary bones in similar animals, Rhue said, which gives scientists a better idea of what a given structure may have looked like.

“These are much more interesting,” Fox told the News. “It brings the animal to life.”

Making decisions about how to re-display the fossils, Rhue added, was a team effort.

Throughout the renovation, outside collaborators, postdoctoral associates and graduate students added their input on restoration decisions on a Google Slides file. By the end, the slideshow had over 653 slides, covered with notes and comments from experts.

The Peabody’s staff used this document to capture conversations from Zoom meetings, display photographs indicating the progress of the restorations and receive comments from paleontologists within and beyond Yale to inform the design decisions, Rhue said.

By the end, the Peabody re-displayed nearly 250 curated specimens in thematic sections, with each designed around a specific scientific concept or a period from fossil history. According to Rhue, curators gave considerable attention to the positioning, completeness and support of each specimen to represent each museum exhibit as a storyline.

According to Skelly, those updates have allowed the Peabody to catch up to new developments in the field of paleontology. The process required extensive collaboration among various stakeholders, including curators, preparers, assistants, managers, registrars, conservators, interns, contractors and designers, Rhue added. 

“We’re all responsible for making decisions and trying to have as much information as possible for the future generations to use and enjoy,” Rhue told the News. “That’s really the exciting part of my job — being able to make that contribution in the best way that we can.”

The Peabody Museum is located at 170 Whitney Ave.

The post How to build a dinosaur: exploring the Peabody Museum’s renovation process appeared first on Yale Daily News.

Released on Thursday, the HRL produced the report as part of the Conflict Observatory — a U.S. State Department-funded program that collects and analyzes evidence of atrocities using open-source data and satellite imagery.

The report identifies 223 instances of damage to power generation and transmission infrastructure over seven months in the past year. According to the research, the damage appears consistent with a “widespread and systematic effort to cripple vital power generation and transmission infrastructure across Ukraine.”

“The report is a critical first step toward accountability for Russia’s attacks on Ukraine’s energy infrastructure — attacks that have affected the lives of ordinary Ukrainians throughout the country,” Oona Hathaway, the Gerard C. and Bernice Latrobe Smith Professor of International Law and a contributor to the report, wrote to the News. “It sets out a roadmap for prosecutors, which they will be able to use as they build their cases.”

The Yale researchers focused on the period between Oct. 1, 2022, and April 30, 2023, when Russian officials claimed that a wave of attacks on Ukrainian energy infrastructure was in retaliation for an explosion at the Kerch Bridge in Russian-occupied Crimea on Oct. 8, 2022. 

Damage to civilian energy infrastructure — which controls electricity and heating for Ukrainians — is particularly dangerous to civilians during Ukraine’s cold winter months, the report says. 

According to the report, the timing and location of the attacks, along with statements from Russian public officials, are consistent with a deliberate attempt to destroy power infrastructure across Ukraine. But the attacks that the HRL report documented are not concentrated in active military zones.

Instead, the attacks on Ukrainian power infrastructure are spread across nearly all of Ukraine’s administrative regions, including in regions that are removed from the frontlines of combat. The report also determined that the Russian military had targeted power infrastructure beyond the extent needed to achieve a military advantage.

As a result, the researchers believe that Russian attacks may violate international humanitarian law, which requires combatants to take “all feasible precaution to minimize injury to civilians and damage to civilian objects,” the report says. 

The researchers also documented statements from Russian officials that described the attacks as political retaliation and intended to cause widespread civilian suffering, motives that might place the Russian attacks in violation of international law, including the terms of the Fourth Geneva Convention.

“These statements, together with the aggregate data, indicate that Russia’s attacks on Ukraine’s power generation and transmission infrastructure may constitute deliberate targeting that is inconsistent with international humanitarian law,” the report said.

To obtain the data, HRL used what they describe as a “fusion methodology,” which combines open-source data analysis and high-resolution satellite imagery to document conflict-related damage to power generation and transmission infrastructure. 

These tools use artificial intelligence models to filter through large sets of data and flag imagery that might indicate damage.

To dig through large quantities of data, the researchers feed the AI approximate parameters for imagery — like that of tanks or an explosion — that they expect to find. Attaching these general characteristics to pinpoint a target, Raymond said, is a lot like describing a stolen bike to the police.  

“Say you had your bike stolen at Claire’s Corner Copia and had to do a police report to the police department,” Raymond said. “What make or model was it? What color was it? What are other attributes about the bike? That’s going to help us find it.” 

In the two years since the start of the Russian invasion of Ukraine, the HRL has produced reports that have documented alleged Russian war crimes and humanitarian atrocities in the public eye. Their research has been cited by over 4,000 media outlets, the United States House of Representatives, the U.S. Department of State and the International Criminal Court. The ICC has used their findings as the basis of prosecutions of senior Russian officials, including Russian President Vladimir Putin.

Last February, Raymond and Kaveh Khoshnood, an associate professor of epidemiology and the faculty director of the HRL, authored a report that documented the systematic, forced transfer and deportation of thousands of Ukrainian children to Russia across a network of 43 re-education and adoption facilities. They presented their results, including that the Russian deportation network could constitute a violation of international human rights law, at a United Nations summit later that month. 

Since then, the HRL has documented the deportation of children to Belarus by the Lukashenka regime, has located detention facilities for Ukrainian civilians, assessed the destruction of Ukraine’s crop storage infrastructure and identified mass graves. Raymond’s team has documented damage to hospitals and schools, mapped torture and detention facilities and tracked the forced passportization of Ukrainians — mandating that civilians adopt Russian nationality —  in occupied areas.

Producing these reports, Raymond told the News, is a paradoxical experience. 

“If you do it right, you feel two things at once. One is an immense professional satisfaction on having achieved, hopefully the highest scientific standard of assessment of an incident or trend that can be done through these methods,” Raymond said. “The other feeling is the exact opposite: it is a mixture of horror at what happened and frustration, often about a lack of response to it.”

Raymond’s journey to the HRL began with firsthand experiences in disaster response. As an aid worker during Hurricane Katrina, he said he noticed a lack of remote data and communication networks for disaster response. The absence prompted him to begin developing fusion methodologies integrating open source and remote sensing data, just as the HRL used in Thursday’s report. 

By 2011, Raymond moved to Harvard University, where he directed the Harvard Humanitarian Initiative’s Satellite Sentinel Project, a program backed by actor George Clooney that used satellite imagery to create an early warning system against mass atrocities in Sudan and South Sudan. The next year, he helped establish Harvard’s Signal Program on Human Security and Technology, which began developing ethical and technical standards digital atrocity monitoring.

Having been at Yale since 2018, Raymond leads the HRL’s efforts to navigate a deluge of data. His team of researchers includes linguists, imagery analysts and epidemiologists to parse information and identify monitoring objectives. Developing these methodologies, Raymond said, is like being a professional golfer.

“My job is to figure out: do we use the nine wood? A putter? A five iron? And on some holes, you may use multiple golf clubs,” Raymond said. “The ability to know how to select the clubs is as important as swinging, and that comes from the experience of having tried to get a lot of different types of targets in a lot of different ways.”

For Raymond, the objective of digital atrocity monitoring is not to replace witness testimony. Instead, by cross-corroborating sources and creating a “scientifically validated” record of events with high confidence, he said he hopes to elevate witness testimony of humanitarian atrocities. 

“I am deeply grateful for their science-informed approach to action,” Megan Ranney, Dean of Yale School of Public Health, wrote in an email to the News.

The Russian invasion of Ukraine started on Feb. 24, 2022.

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Lipska is a professor of medicine at the School of Medicine who specializes in endocrinology and diabetes. On Dec. 14, she testified at the Senate Health, Education, Labor and Pensions Committee hearing titled “What is Fueling the Diabetes Epidemic?” During the hearing, she underscored the need for the federal government to negotiate with pharmaceutical companies to lower drug prices to address the root causes of diabetes and obesity. 

Many of Lipska’s patients suffering from Type I Diabetes — a chronic condition where the pancreas produces little-to-no insulin, the hormone responsible for regulating blood sugar levels — spend nearly half of their household income on insulin, which is vital for them to stay alive. Many also struggle to afford medications such as Ozempic — the brand name for semaglutide, which the FDA approved to treat Type II Diabetes — or Wegovy, another brand name for a similar drug approved for weight management. 

“I see patients in clinic who struggle paying for the medicines and often don’t take their medicines because they cost too much — and I see the consequences,” Lipska said in an interview with the News. “I get very upset about this, and I get very angry at our healthcare system because people suffer when they cannot afford the medications they need.”

On the stand, Lipska presented evidence from a 2017 survey conducted at the Yale Diabetes Center which showed that one in four diabetes patients who were prescribed insulin had to ration the medication due to cost. According to Lipska, though recent advocacy efforts have led to a decrease in insulin prices, the medication remains expensive.

These novel medications are not cheap. Patients with Type II Diabetes — a condition in which insulin is unable to lower a patient’s blood sugar — often pay over $900 per month for Ozempic. Similarly, patients suffering from obesity have to pay $1,300 a month for Wegovy. Patients must take these medications continuously for an indefinite period in order to maintain their ongoing effects. 

“Patients are looking at a potentially lifelong treatment and could be facing the most expensive subscription service in the history of medicine,” Lipska told the News.

In the hearing, Lipska noted that if Medicare were to cover Wegovy for its beneficiaries with obesity, American taxpayers would have to pay $268 billion. 

Further, according to a study conducted by Luan Yu, a cardiologist and assistant professor of medicine at the School of Medicine, the populations least able to afford these treatments are the ones who need them the most.

“We found that these minority populations who have higher prevalence of obesity also have more financial barriers, in terms of accessing healthcare and afford[ing] the medications,” Lu told the News.

However, other countries are avoiding these steep costs. Lipska testified that Ozempic costs $100 per month in Sweden and just $80 in Australia and France.

In contrast, patients in the U.S. must pay 10 times that amount. For Lipska, the lessons learned from insulin affordability should inform how the government negotiates prices with pharmaceutical companies for novel medications like Ozempic.

“The Inflation Reduction Act already authorizes the Secretary of the Department of Health and Human Services to negotiate prices with pharmaceutical companies under specific provisions, and for a limited set of drugs,” Lipska told the Senate.

According to Lipska, this process involves aligning the launch price with the drug’s value and what patients can afford. She argued the government should sit at the negotiating table with pharmaceutical companies such as Novo Nordisk, the developer of Ozempic which has a market value higher than Denmark’s GDP. 

Still, Lipska emphasized the need to tackle diabetes and obesity upstream, instead of relying on drugs. For her, more long-term preventative solutions, such as reducing food deserts, are more favorable than using weight-loss medications. 

“In cardiovascular disease prevention, we always talk about prevention being more cost-effective than management or treatment,” Lu told the News. “It’s better to prevent people from becoming obese. Then, if they become obese, you treat them.”

In the hearing, Senator Bernie Sanders — chair of the Senate Health, Education, Labor and Pensions Committee — underscored Lipska’s call to action. 

“Nearly 30 years ago as I think we all know and the American people know, Congress had the extraordinary courage to take on the tobacco industry whose products killed nearly 400,000 Americans every year including my father,” he said. “Now is the time for us to seriously combat the Type II Diabetes and obesity epidemics in America.” 

Over one in 10 people in the United States suffer from diabetes.

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Led by Dr. Hong-Bo Zhao, professor of otolaryngologic surgery at the School of Medicine, the research explores the link between hearing loss and developing Alzheimer’s, the progressive brain disease that results in memory loss and cognitive impairment.

According to Zhao, many scientists in the field recognize that hearing loss can preempt cognitive decline. How exactly hearing dysfunction may be linked to Alzheimer’s, though, is still unclear — a topic that Zhao aims to study through a new $2.4 million grant from the National Institute on Aging announced earlier this month. 

“They encouraged us to perform this kind of study because early diagnosis is crucial for the disease,” Zhao said. “Now maybe we can find a way to block such a degenerative process.”

Currently, there is no effective method to treat or prevent Alzheimer’s disease, and existing treatments depend on detecting the disease as early as possible, Zhao said. An early Alzheimer’s diagnosis and corresponding intervention that delays dementia — the progressive decline of cognitive capability — by just one year could decrease the amount of dementia worldwide by 10 percent.

Zhao believes that even before dementia and other Alzheimer’s symptoms arise, changes in the way the brain processes sound might be an early warning sign for Alzheimer’s disease. His new research aims to explore the link between auditory processing and Alzheimer’s, especially since hearing loss commonly occurs 5-10 years before dementia symptoms show up in patients.

“Very few people study the auditory system changes in Alzheimer’s disease,” Zhao told the news. “Our lab is one of the few labs to perform such a study in the United States.”

With the new grant, Zhao’s lab plans to use mouse models in which researchers modify mouse genes to increase the number of times they are expressed. When the mice overexpress these genes, they show dementia symptoms — effectively guaranteeing that the mice will develop Alzheimer’s.

As the mice grow, Zhao’s team plans to perform RNA sequencing tests on the parts of the mice’s brains linked to auditory processing. The sequencing tests measure genetic changes in the brain areas linked to hearing.

If these changes happen in consistent patterns before the mice exhibit dementia symptoms, the gene changes could be an early indicator for Alzheimer’s — a “biomarker,” Zhao said. 

And just as human patients often have hearing loss before developing Alzheimer’s symptoms, Zhao’s team also plans to evaluate the mice’s hearing before they display signs of dementia, measuring changes in the mice’s brain activity in response to external sounds.

“We basically conduct hearing tests. said Dr. Yang Yang, a postdoctoral associate in Zhao’s lab. “And we do testing like the EEG [electroencephologram] … and try to see if there is any difference.”

One of the challenges the researchers face, though, is to distinguish the symptoms of Alzheimer’s from those of natural aging. According to Yang, age-related hearing loss is difficult to distinguish from hearing loss linked to Alzheimer’s, making it difficult to pinpoint a precise relationship between the two conditions.

For the researchers, overcoming that confounding variable was one reason to opt for the mouse model, where young mice can be evaluated for hearing and memory loss before the symptoms of age set in. 

Even in genetically modified mice as young as three months old, Zhao’s team has observed hearing loss. Their onset of Alzheimer’s occurred at nine months, indicating that dementia — not age — was tied to hearing loss.

Identifying Alzheimer’s biomarkers through auditory pathways may pave the way for advancements in early detection and intervention strategies, Zhao explained. Even if doctors can’t cure the disease, creating reliable ways to detect Alzheimer’s earlier — in this case, through changes in the hearing pathway — could help patients better manage their symptoms and slow the progression of dementia. 

For Zhao’s peers, it’s a promising goal.

“Our Department is very excited that his work may offer breakthrough understanding of Alzheimer’s, a devastating disease that definitely involves the auditory system,” Dr. Joseph Santos-Sacchi, a professor of otolaryngologic surgery, cellular and molecular physiology and neuroscience, wrote to the News.

According to the World Health Organization, one in ten people will have disabling hearing loss by 2050.

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In middle school, Hereen said, a classmate followed her around and threw paper at her, calling her “a whale.” Heeren said that during a doctor’s visit, one health provider told Heeren’s mom, “just don’t feed her cookies for dinner.” 

Hereen told the News that ever since she can remember, she has consistently measured in the 99th percentile for her weight. 

Heeren’s family implemented dietary changes — she avoided foods with additives and preservatives and packed healthy snacks whenever she went to social events — but, she said, the weight never seemed to come off. 

Things reached a breaking point when she attended her brother’s science olympiad tournament, Heeren said. Sitting in the crowd, she said she felt the sides of the chairs pushing into her thighs.

 “It felt like me and my body were at war,” Heeren told the News. 

Though Heeren and her family thought they had already done everything they could, Heeren said they decided that she needed a more dramatic intervention: bariatric surgery. 

Following her surgery, Heeren founded OCEANS Lifestyles — a support group for teens who have received a gastric bypass surgery. She now advocates for teens’ right to make their own decisions and to be fully informed about their treatment options for obesity.

Bariatric surgery describes various medical procedures that help manage obesity. Sleeve gastrectomy — one of the most common types — permanently reduces the size of a patient’s stomach, restricting how much food they can eat in one sitting. The surgery also reduces the amount of hunger hormones the stomach produces. 

This January, the American Academy of Pediatrics included bariatric surgery in their clinical guidelines for treating children with obesity, which emphasized providing immediate, intensive obesity treatment shortly after a diagnosis. 

Previously the AAP advocated for a policy of “watchful waiting,” which some experts have said failed to recognize obesity as a chronic illness. The new policies state that pediatric healthcare specialists should refer adolescents 13 years of age or older with severe obesity — referring to a BMI greater than or equal to 120 percent of the 95th percentile — for evaluation for bariatric surgery. 

Surgery and recovery process

Since the AAP released the guidelines, Alan Hornick, an assistant professor of surgery in pediatrics at the Yale School of Medicine, told the News he has seen an uptick in adolescents and parents interested in bariatric surgery — especially in younger patients. 

“I think people are now more inclined to think of surgery as a kind of a first line in slightly younger patients,” Hornick said.

According to John Morton, the medical director for bariatric surgery at Yale New Haven Health System, the most common bariatric surgeries performed on adolescents is a sleeve gastrectomy.

At Yale, adolescents seeking bariatric surgery first enter the adolescent weight loss program, supervised by Michelle Van Name, an assistant professor of pediatrics in endocrinology, and her team. In this program, Van Name said, the patients undergo a comprehensive evaluation, including nutrition, psychological assessment and physical and emotional maturation. 

Van Name and her team refer the patient to bariatric surgery only if all the criteria are met and there is full family and patient support. The patient or their family can opt out of the surgery at any point during this process, she added.

“We want our patients and their families to be making an informed decision,” Van Name told the News. “It’s also important for them to know what medications are currently approved to treat the disease of obesity, and make sure everybody has up to date information so that they can decide if this is the right time in this adolescent’s life for them to follow this treatment path.”

After the initial evaluation, Morton and Hornick conducted further observation, typically meeting with the patient six times before the surgery to offer habit-change encouragement and ensure rigorous preparation, Morton told the News. 

According to Morton, he will choose not to perform the surgery if the patient has an active substance abuse or an untreated mental illness, or if the family is not willing to implement lasting changes in the household.

“Otherwise, it’s a very difficult problem,” Morton said. “It would be like sending home an asthmatic child to smokers.”

Morton said that before the surgery some patients are prescribed weight-loss drugs, such as Wegovy or Mounjaro, to lower the patient’s weight before surgery. Two weeks before surgery, patients adhere to a liquid diet, which he said helps shrink the patient’s liver and kick starts weight loss in the patient.

According to Morton, the procedure takes roughly 45 minutes. He said that he makes four incisions, each less than three-quarters of an inch. Morton said that he then takes the stomach —  roughly the size of a football — and uses a surgical stapler to remove two-thirds of the stomach, leaving it about the size of a banana.

“The portion of the stomach we removed is not essential for digestion,” Morton said. “Its main role is to allow us to eat more. That rendered an evolutionary advantage to us many years ago, when we weren’t sure where our next meal was coming from. Now with all the food availability, we don’t need it.”

After the surgery, patients recover in the hospital for one or two days, he said. 

Then, according to Morton, they are put on a gradual diet escalation. For two weeks, he said, the patients only consume liquids and go on a puréed diet for a couple of weeks. Morton said that once patients return to regular eating, physicians recommend that they exercise and consume more protein and fewer carbohydrates and sugars.

“Once they are discharged from the hospital, we talk to them nearly daily, once they are discharged from the hospital, and then we see them monthly,” Van Name said. “Adolescents tend to need support.” 

According to the AAP guidelines, bariatric surgery can result in weight loss and improvements in multiple conditions associated with obesity, such as hypertension, Type 2 Diabetes and cardiovascular disease.

Morton said he has also conducted a study that found that the surgery produces a “halo effect,” where family members tend to lose weight when a patient undergoes the surgery.

Weight loss, transformations, and criticisms

Heeren said the surgery transformed her relationship with her body. 

“Afterwards, I finally was able to live my life in a healthy way and have my body be able to go on runs and be able to play tennis,” Heeren said. “It felt like we were a little bit more at peace.”

Heeren said that she had to overcome several hurdles during her surgery journey. She said that had to miss school days, and her mother had to miss work so she could attend pre-operative visits that took up multiple hours.

Heeren said that some people in her community criticized her parents for allowing her to have the surgery.

“There’s a lot of people who thought that [my parents] were doing something that was going to be putting me in danger instead of helping me,” Heeren said. “A lot of times, people criticize parents of kids living with obesity and blame them for why their children are struggling. My parents had it coming from a bunch of different directions growing up.”

Many patients also struggle to receive insurance coverage for bariatric surgery, forcing patients to pay for the surgery out of pocket, which limits access to the surgery. 

Balancing benefits and concerns 

Potential complications that come with the surgery include bleeding, infection, reflux for sleeve procedures, blood clots and nutritional deficiencies, according to Morton. Yet, he said the surgery is as safe as a knee or hip replacement.

“I’ve had the good fortune of, over the last 22 years, not having any operative mortality, and that’s been over 6,000 cases,” Morton told the News.

Despite the relatively safe track record for bariatric surgery that Morton described, some people have criticized the AAP for including it in their guidelines. After they first released the guidelines, both the New York Times and Mental Health America published opinion articles that expressed concern about the surgery. 

Mona Sharifi, an associate professor of pediatrics and biostatistics at the Yale School of Medicine, helped write the AAP’s guidelines. According to Sharifi, to produce the guidelines, a team of clinicians sifted through thousands of scientific articles and generated a summary of the results, which they translated into policy. 

Sharifi said she felt that some of the initial criticisms focused too much on the medication and surgery recommendations, failing to recognize that the AAP also promoted various weight treatments within the context of a family’s preferences and options.

“We very carefully placed the recommendation on making a referral or connecting families with a program — not that surgery should be done,” said Sharifi. “They don’t necessarily mean that when you’re referred, you’re gonna have bariatric surgery.”

About 2,000 adolescents receive gastric bypass surgeries every year in the United States.

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