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Frontiers Dec 4 2024

The prevalence of MASLD (metabolic dysfunction-associated steatotic liver disease) is exploding in most regions of the world, boosted by increased obesity and sedentary lifestyles. MASLD (formerly known as non-alcoholic fatty liver disease) is already the most common liver disorder: it affects 30% of adults and between 7% and 14% of children and adolescents, and this prevalence is predicted to rise to more than 55% of adults by 2040. People with MASLD run a heightened risk of diabetes, hepatocellular carcinoma, non-liver cancers, chronic kidney disease, age-related muscle loss, and cardiovascular disease.

Earlier studies have implicated disturbances in the circadian clock and in the sleep cycle in the development of MASLD. But the American Academy of Sleep Medicine has recommended that objective measures – rather than subjective ones such as sleep questionnaires – be used to prove this hypothetical link between disorders of sleep and the circadian rhythm, MASLD, and MASH. MASH is a more severe form of MASLD, where the liver suffers damage from inflammation and tissue scarring, caused by abnormal accumulation of fat.

"Here we show for the first time with an objective method, 24/7 actigraphy, that the sleep-wake rhythm in patients with MASLD does indeed differ from that in healthy individuals: those with MASLD demonstrated significant fragmentation of their nightly sleep due to frequent awakenings and increased wakefulness," said Dr Sofia Schaeffer, a postdoctoral researcher at the University of Basel and Basel's University Center for Gastrointestinal and Liver Diseases, and the corresponding author of a new study in Frontiers in Network Physiology.

Actigraphy involves tracking gross motor activity with a sensor worn on the wrist. Don't lose any sleep

Between 2019 and 2021, Schaeffer and colleagues recruited 46 adult women and men diagnosed with either MASLD, MASH, or MASH with cirrhosis. A further eight patients with non-MASH-related liver cirrhosis served as comparisons, while a second comparator group consisted of 16 age-matched healthy volunteers. Each study participant was equipped with an actigraph, to be worn at all times, which tracked light, physical activity, and body temperature.

Participants visited the clinic as outpatients at the start, midpoint, and end of the four-week follow-up. Both at the start and end of this period, they underwent clinical investigation, were interviewed through sleep questionnaires about their sleep habits. They also kept a sleep diary.

All patients with MASLD were obese, and 80% had metabolic syndrome. Patients with MASLD further had significantly higher levels of triglycerides, fasting glucose, and insulin in their blood than healthy participants, but lower levels of total cholesterol, 'bad' LDL cholesterol, and 'good' HDL cholesterol. Rude awakening

Actigraph measurements didn't reveal any differences between patients with MASLD and healthy participants when it came to things such as sleep duration or the amount of time spent in bed.

But importantly, the actigraphs showed that patients with MASLD woke 55% more often at night, and lay 113% longer awake after having first fallen asleep, compared to healthy volunteers. Patients with MASLD also slept more often and longer during the day. Sleep patterns and quality as measured by actigraph were similarly impaired in patients with MASH, MASH with cirrhosis, and non-MASH-related cirrhosis.

Subjectively, patients with MASLD self-reported their disrupted and inefficient sleep as shorter sleep with a delayed onset. In their sleep diaries, 32% of patients with MASLD reported experiencing sleep disturbances caused by psychological stress, compared to only 6% of healthy participants. We concluded from our data that sleep fragmentation plays a role in the pathogenesis of human MASLD. Whether MASLD cause sleep disorders or vice versa remains unknown."

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"The underlying mechanism presumably involves genetics, environmental factors, and the activation of immune responses – ultimately driven by obesity and metabolic syndrome."

Schaeffer and colleagues also tried to improve the sleep of participants with a single sleep hygiene education session, performed at the study's midpoint. Here, they were taught practical measures to improve their sleep habits. However, the results showed that the session didn't improve the actigraphy or self-reported measures of sleep quality and quantity.

"A single sleep hygiene education session didn't suffice to sustainably impact on the circadian rhythm in either patients with MASLD or healthy controls. Future studies should explore perpetual sleep counselling sessions or interventions such as light therapy in combination with other lifestyle changes to improve the sleep-wake cycle in patients with MASLD," recommended Dr Christine Bernsmeier, a professor at the University of Basel and the study's senior author. Source:

FrontiersJournal reference:

Schaeffer, S., et al. (2024) Significant nocturnal wakefulness after sleep onset in metabolic dysfunction–associated steatotic liver disease. Frontiers in Network Physiology. doi.org/10.3389/fnetp.2024.1458665.

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Festival season is here, but does politics have a place on the stage?

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Festival season is here, but does politics have a place on the stage?

Festival season is under way, and leading the charge: the Isle of Wight Festival – dubbed “Europe’s Woodstock” – with headliners including Sting and the Stereophonics.

Former N-Sync star Justin Timberlake – a man who’s crooned about his love of “dance, dance, dance” and has recently become a meme for his mic-centric moves on stage – is a headliner too.

Pic: Reuters
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Justin Timberlake – and his trusty mic stand. Pic: Reuters

Meanwhile, Glastonbury Festival will see headline acts including Olivia Rodrigo, the 1975, and Charli XCX.

But along with the headline stars and hot weather, politics has also found its way into the spotlight.

Youth culture and political expression have long been part of the festival experience, with Vietnam, nuclear disarmament, Brexit and the Russian invasion of Ukraine all attracting attention over the decades.

This year, with geopolitics seemingly at a boiling point, the Israel-Hamas war has had far-reaching implications. As the Israel-Iran war follows in its wake, the conflict has prompted strong opinions on both sides.

Irish-language rap trio Kneecap‘s upcoming Glastonbury Festival set has become a flashpoint for robust debate, drawing protests from those calling for their set to be cancelled, as well as those championing their right to speak out.

More on Glastonbury

The root of the contention? Kneecap band member Liam O’Hanna, 27, was charged with a terror offence earlier this year, accused of displaying a flag in support of Hezbollah, a proscribed organisation in the UK, at a gig last year.

Kneecap's Liam Og O Hannaidh leaves Westminster Magistrates' Court in London
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Kneecap’s Liam Og O hAnnaidh leaves Westminster Magistrates’ Court in London. Pic: PA

Hezbollah was proscribed in its entirety in 2019 because the government classed it as a terrorist organisation and said its attacks on Israel were “attempts to destabilise the fragile situation in the Middle East”.

On Saturday, Prime Minister Sir Keir Starmer said he did not think Kneecap’s planned Glastonbury Festival performance was “appropriate” and Conservative Party leader Kemi Badenoch said she thought the BBC “should not be showing” the band’s performance at the festival next weekend.

Read more:
‘Scary spotlight’ on music stars amid Kneecap charge
Kneecap release new single after member charged

Glastonbury Festival at Worthy Farm, Somerset, 2019. Photo by Joel C Ryan/Invision/AP
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Glastonbury Festival at Worthy Farm, Somerset. Pic: PA

Although “removed” from playing at Scottish music festival TRNSMT next month due to “safety concerns”, Kneecap have remained on the Glastonbury bill, prompting the question: Is the stage a place for political opinion?

‘If we think we’re separate from world events, we’re kidding ourselves’

Faithless star Sister Bliss, who performed at the first of the re-instated Isle of Wight Festivals and is performing again this year, tells Sky News: “If we think that we’re separate from world events, we’re absolutely kidding ourselves. Our lives are tied intrinsically to everybody else’s on the planet.

“You can have certain people that express that in a way that is perhaps a tad crass, but I love that lyrically – especially on our records, in songs that we’ve made over the last 30 years – I feel that you can combine the personal and political in a way that’s not tub-thumping or simplistic. These issues are very nuanced that are going on in the world right now.”

Sister Bliss of Faithless. Pic: Callum Baker
Image:
Sister Bliss of Faithless. Pic: Callum Baker

Speaking to Sky News at the Isle of Wight Festival, Clean Bandit star Grace Chatto says artists are right to use the stage to amplify their voice.

“It is such a great place for political speech, like when Jeremy Corbyn spoke at Glastonbury – it was the most attended thing of the whole event, and it just brought such a feeling of unity and hope in that field on that day”.

The 39-year-old cellist adds: “Then recently, Kneecap and Massive Attack have just been so important, I think, and amazing.”

Earlier this month, Massive Attack, who have previously been critical of Israel, included footage of Hamas leader Yahya Sinwar and his family as part of a video montage at one of their concerts.

(R-L) Grace Chatto and Jack Patterson of Clean Bandit. Pic: @photosbychloeh
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(R-L) Grace Chatto and Jack Patterson of Clean Bandit. Pic: @photosbychloeh

‘I’ve got loads of friends who are absolute idiots politically’

Fresh from the Isle of Wight Main Stage, Mae Muller tells Sky News: “With what’s happening in Gaza, I know that’s been a very prominent theme with people saying, ‘Should we speak out about it or not?’ But that’s not political, it’s a human rights issue.

“It’s important for us to use our voice, because not everybody can. If we feel strongly about something, and we can stand behind it, I think [the stage is] definitely a place to do it.”

Pic: Sarah Louise Bennett
Image:
Mae Muller. Pic: Sarah Louise Bennett

Muller, who represented the UK at last year’s Eurovision Song Competition – which became a highly politicised event despite the attempts of the organisers to keep it from the stage – continues: “Art is inherently political, and you can’t really escape it. And we shouldn’t want to escape it. It can be two things at once. [Politics] and fun can coexist.

Meanwhile, Razorlight front-man Johnny Borrell, ahead of his Main Stage performance, tells Sky News: “Why not say what you believe in? Why does everyone get so precious?

“You can disagree with people. I’ve got loads of friends who are absolute idiots politically – they think the earth is flat. I like them as people, but I completely disagree with them in politics”.

Pic: Sarah Louise Bennett
Image:
Johnny Borrell. Pic: Sarah Louise Bennett

Borrell adds: “We don’t have a problem with disagreeing, but if everyone’s tapping away [mimes typing on a phone] and they’re like, ‘No, I’m really angry, I’m going to tap back,’ that’s a different thing. That’s what’s changed recently.”

A ‘disruptor’ festival, showing the world that anything is possible’

Regardless of the polarised times, Isle of Wight Festival promoter John Giddings, 72, says the Isle of Wight Festival experience should be a break from activism rather than a call to arms.

The 72-year-old, who represents artists ranging from Blondie to Phil Collins, told Sky News: “We’re purely about music and entertainment, and we are to switch off from politics for three or four days. We’re in the business of entertaining people, not preaching to people. And I don’t understand why people attempt to. That’s a different forum.”

Isle of Wight Festival promotor, John Giddings. Pic: PA
Image:
Isle of Wight Festival promotor, John Giddings. Pic: PA

Giddings, who relaunched the iconic festival after it was outlawed by authorities in 1970, fearing the crowds and rowdy behaviour could detract from the island, may be keen to avoid political controversy, but he’s keen to break the mould in other areas.

Following a long line of stars before him, including Bob Dylon, Jimi Hendrix and Joni Mitchell, singer Emmanuel Kelly has become the first physically differently-abled artist to perform on the Isle of Wight Festival’s Main Stage.

The 31-year-old former X Factor star, who supported Coldplay on their Music Of The Spheres tour last year, says as far as accessibility is concerned, the Isle of Wight Festival is a trailblazer.

Emmanuel Kelly – Pic: James Millington Photography
Image:
Emmanuel Kelly. Pic: James Millington Photography

Kelly tells Sky News: “Somebody that’s different is on the stage and is able to show the world that anything’s possible.”

Echoing the festival’s early rebel roots, he credits it with being a “disruptor”, adding, “They make the extra effort to teach the others around the world to make the extra effort as well… It’s important and it’s happening and I’m excited for it.”

In response to Sir Keir’s call for Kneecap to be removed from the line up at Glastonbury next weekend, and whether the performance would be available on any BBC platforms if it goes ahead, a BBC spokesperson said: “As the broadcast partner, the BBC will be bringing audiences extensive music coverage from Glastonbury, with artists booked by the festival organisers.

“Whilst the BBC doesn’t ban artists, our plans will ensure that our programming will meet our editorial guidelines. Decisions about our output will be made in the lead up to the festival.”

The Isle of Wight Festival runs until Sunday 22 June, with the Glastonbury Festival kicking off on 25 June.

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Ancient Tel Dan Temple Reveals Centuries-Old Phoenician Ritual Bathing Traditions

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Ancient Tel Dan Temple Reveals Centuries-Old Phoenician Ritual Bathing Traditions

A new archaeological find proves that ritual cleansing was a component of religious practice at an ancient sanctuary in northern Israel in the time of the kingdom of Israel. The sanctuary was equipped with a unique bathhouse, thought to have been used by the priests for ritual bathing. There, the diggers discovered two spaces — one room with yellow plaster, which had a dressing area, and another with walls of blue plaster and a basin — that offer a rare glimpse into how water was used in rituals of sacred purification. The discovery adds new depth to understanding Near Eastern religious practices linked to city-based deity worship.

Ancient Tel Dan Sanctuary Reveals Ritual Bathing Traditions Linked to Mysterious Deity Worship

According to a report published in Levant by Dr. Levana Tsfania-Zias, the sanctuary included a modest two-part bathing unit—featuring a yellow-plastered dressing room and a blue-plastered basin—suggesting ritual use by the priestly class. Unlike full-immersion baths, and because it is not heated, the basin’s size means worshippers might have washed themselves while standing, with cold spring water that flows into the Jordan from outlets nearby.

The first temple, constructed on a Middle Bronze Age rampart, had a tripartite plan of porch, cella, and adyton. A limestone fragment with inscriptions in both Greek and Aramaic, discovered in 1976, names an obscure deity and was almost certainly invoked in the central sanctuary of Dan. Scholars believe the deity’s identity remains uncertain due to the regional naming customs of ancient Near Eastern cities.

Following the destruction of the first temple by the Seleucids, a new temple was erected in its place, which preserved the bathing. After a 2-century gap, the site re-emerged in the Middle–Late Roman period for new purposes. Pilgrims were cleansed in a Fountain House, using primitive clay vessels that were likely smashed after use — a process mirrored in biblical texts describing ritual purity.

As so much of the sanctuary at Tel Dan remains in question, the scholars emphasised the significance of the site for the region. Dr. Tsfania-Zias believes the site would have been an attraction for both locals and visitors, something reinforced by imported ceramics and multilingual inscriptions that hint at a wider spiritual attraction. Deeper excavations could yet reveal what other deity or practices characterised this sacred spot in ancient times.

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Break Singapore’s new crypto rules and you could face $200K fine or jail

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Break Singapore’s new crypto rules and you could face 0K fine or jail

Break Singapore’s new crypto rules and you could face 0K fine or jail

Singapore is tightening its grip on crypto misconduct. Under new rules, unlicensed promotions or shady practices could lead to steep fines or prison time.

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