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South Korea Sets Thursday Deadline for Return of Striking Doctors

SEOUL, South Korea — South Korea’s government gave striking young doctors four days to report back to work, saying Monday that they won’t be punished if they return by the deadline but will face indictments and suspensions of medical licenses if they don’t.

About 9,000 medical interns and residents have stayed off the job since early last week to protest a government plan to increase medical school admissions by about 65%. The walkouts have severely hurt the operations of their hospitals, with numerous cancellations of surgeries and other treatments.

Government officials say adding more doctors is necessary to deal with South Korea’s rapidly aging population. The country’s current doctor-to-patient ratio is among the lowest in the developed world. 

The strikers say universities can’t handle so many new students and argue the plan would not resolve a chronic shortage of doctors in some key but low-paying areas like pediatrics and emergency departments.

Vice Health Minister Park Min-soo said during a televised briefing Monday that the government won’t seek any disciplinary action against striking doctors if they return to work by Thursday.

“We want them to return to work by the end of this month, Feb. 29. If they return to the hospitals they had left by then, we won’t hold them responsible” for any damages caused by their walkouts, Park said.

But he said those who don’t meet the deadline will be punished with a minimum three-month suspension of their medical licenses and face further legal steps such as investigations and possible indictments.

Under South Korea’s medical law, the government can issue back-to-work orders to doctors and other medical personnel when it sees grave risks to public health. Refusing to abide by such an order can bring up to three years in prison or $22,480 in fines, along with revocation of medical licenses.

There are about 13,000 medical interns and residents in South Korea, most of them working and training at 100 hospitals. They typically assist senior doctors during surgeries and deal with inpatients. They represent about 30% to 40% of total doctors at some major hospitals.

The Korea Medical Association, which represents about 140,000 doctors in South Korea, has said it supports the striking doctors, but hasn’t determined whether to join the trainee doctors’ walkouts. Senior doctors have held a series of rallies voicing opposition to the government’s plan.

Earlier this month, the government announced universities would admit 2,000 more medical students starting next year, from the current 3,058. The government says it aims to add up to 10,000 doctors by 2035. 

A public survey said about 80% of South Koreans back the government plan. Critics suspect doctors, one of the best-paid professions in South Korea, oppose the recruitment plan because they worry they would face greater competition and lower income. 

Striking doctors have said they worry doctors faced with increased competition would engage in overtreatment, burdening public medical expenses.

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Japan’s ‘Naked Men’ Festival Succumbs to Aging of Population

Ōshū, Japan — Steam rose as hundreds of naked men tussled over a bag of wooden talismans, performing a dramatic end to a thousand-year-old ritual in Japan that took place for the last time. 

Their passionate chants of “Jasso, joyasa” (meaning “Evil, be gone”) echoed through a cedar forest in northern Japan’s Iwate region, where the secluded Kokuseki Temple has decided to end the popular annual rite. 

Organizing the event, which draws hundreds of participants and thousands of tourists every year, has become a heavy burden for the aging local faithful, who find it hard to keep up with the rigors of the ritual.  

The “Sominsai” festival, regarded as one of the strangest festivals in Japan, is the latest tradition impacted by the country’s aging population crisis that has hit rural communities hard.  

“It is very difficult to organize a festival of this scale,” said Daigo Fujinami, a resident monk of the temple that opened in 729.  

“You can see what happened today — so many people are here and it’s all exciting. But behind the scenes, there are many rituals and so much work that have to be done,” he said.  

“I cannot be blind to the difficult reality.”  

Aging population 

More than 1 in 10 people in Japan are 80 years old or older, and almost a third of its population is older than 65, according to the World Economic Forum’s Future of Jobs Report 2023.

The aging of Japan’s population has forced the closure of countless schools, shops and services, particularly in small or rural communities.  

Kokuseki Temple’s Sominsai festival used to take place from the seventh day of Lunar New Year to the following morning.  

But during the Covid pandemic, it was scaled down to prayer ceremonies and smaller rituals. 

The final festival was a shortened version, ending around 11 p.m., but it drew the biggest crowd in recent memory, local residents said.  

As the sun set, men in white loincloths came to the mountain temple, bathed in a creek and marched around temple’s ground. 

They clenched their fists against the chill of a winter breeze, all the while chanting “Jasso, joyasa.” 

Some held small cameras to record their experience, while dozens of television crews followed the men through the temple’s stone steps and dirt pathways. 

As the festival reached its climax, hundreds of men packed inside the wooden temple shouting, chanting and aggressively jostling over a bag of talismans. 

Changing norms

Toshiaki Kikuchi, a local resident who claimed the talismans and who helped organize the festival for years, said he hoped the ritual would return in the future.  

“Even under a different format, I hope to maintain this tradition,” he said. “There are many things that you can appreciate only if you take part.” 

Many participants and visitors voiced both sadness and understanding about the festival’s ending. 

“This is the last of this great festival that has lasted 1,000 years. I really wanted to participate in this festival,” Yasuo Nishimura, 49, a caregiver from Osaka, told AFP. 

Other temples across Japan continue to host similar festivals where men wear loincloths and bathe in freezing water or fight over talismans. 

Some festivals are adjusting their rules in line with changing demographics and social norms so that they can continue to exist — such as letting women take part in previously male-only ceremonies.  

Starting next year, Kokuseki Temple will replace the festival with prayer ceremonies and other ways to continue its spiritual practices. 

“Japan is facing a falling birthrate, aging population, and lack of young people to continue various things,” Nishimura said. “Perhaps it is difficult to continue the same way as in the past.” 

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Study Finds Seniors Enjoy Virtual Reality 

POMPANO BEACH, Florida — Retired Army Colonel Farrell Patrick taught computer science at West Point during the 1970s and then at two private universities through the 1990s, so he isn’t surprised by the progress technology has made over the decades. 

But when the 91-year-old got his first virtual reality experience recently, he was stunned. Sitting in a conference room at John Knox Village, a suburban Fort Lauderdale, Florida, retirement community, Patrick sat up straight as his eyes and ears experienced what it would be like to be in a Navy fighter jet flying off the Florida coast. 

“Oh, my God, that’s beautiful,” he blurted before the VR program brought the jet in for a landing on an aircraft carrier. 

John Knox Village was one of 17 senior communities around the country that participated in a recently published Stanford University study that found that large majorities of 245 participants between 65 and 103 years old enjoyed virtual reality, improving both their emotions and their interactions with staff. 

The study is part of a larger effort to adapt VR so it can be beneficial to seniors’ health and emotional well-being and help lessen the impact dementia has on some of them. 

Variety of experiences

During the testing, seniors picked from seven-minute virtual experiences such as parachuting, riding in a tank, watching stage performances, playing with puppies and kittens, or visiting places like Paris or Egypt. The participants wore headsets that gave them 360-degree views and sounds, making it seem as if they had been all but dropped into the actual experience. 

“It brought back memories of my travels and … brought back memories of my experience growing up on a farm,” Terry Colli, a former public relations director at the Canadian Embassy in Washington, D.C., said of his 2022 experience. Colli, 76, liked swiveling in a chair to get a panoramic view. “That was kind of amazing.” 

Anne Selby, a 79-year-old retired counselor and artist, found VR “stimulated virtually every area of my brain, all of the senses.” 

“I particularly enjoyed the ones dealing with pets because I have a cat and I’ve had pets most of my life,” she said. 

Stanford’s peer-reviewed study, working with the company Mynd Immersive, found that almost 80% of seniors reported having a more positive attitude after their VR session and almost 60% said they felt less isolated socially. The enjoyment lessened somewhat for older respondents whose sight and hearing had deteriorated. Those who found VR less enjoyable were also more likely to dislike technology in general. 

In addition, almost 75% of caregivers said residents’ moods improved after using VR. More than 80% of residents and almost 95% caregivers said talking about their VR experience enhanced their relationships with each other. 

“For the majority of our respondents, it was their first time using virtual reality. They enjoyed it. They were likely to recommend it to others, and they looked forward to doing it again,” said Ryan Moore, a Stanford doctoral candidate who helped lead the research. 

“We are proving VR to be a tool that really does help with the well-being of our elders,” said Chris Brickler, Mynd’s CEO and co-founder. The Texas-based company is one of a handful that specializes in virtual reality for seniors. “It is far different than a two-dimensional television or an iPad.” 

Residents with dementia

Separate from the study, John Knox Village uses virtual reality in its unit that houses seniors who have Alzheimer’s disease and other dementia. It helps spur memories that lead to conversations with caregivers. 

“It is like they come back to life when they tell their story.” said Hana Salem, the facility’s meaningful-life coordinator. She said others who don’t talk much perk up when given a VR experience putting them in nature. 

“They’ll start laughing and saying, ‘Ooh, I’m going to catch the butterflies,’ ” Salem said. Catching butterflies is also part of a game Mynd developed that helps seniors enhance their mobility and flexibility as they stand and reach for objects. 

“It’s more fun for these seniors to come in and catch butterflies and work on shoulder rehab than it is to go pick up a weight,” Brickler said. 

Brickler said his company’s systems will soon attach to Google Earth, so seniors can virtually visit neighborhoods where they lived, schools they attended and places they have visited, sparking further conversations with caregivers. 

Such virtual visits “can bring back a tremendous amount of joy, a tremendous amount of memories. And when the therapist or the other caregiver can work with that older adult and talk through things we see, we definitely see that it provides an uplift,” Brickler said. 

The company has worked on the biggest complaints seniors in the study had about VR — the headsets were too heavy, the heat they generated made their foreheads sweat, and sometimes the experience created nausea, he said. The new headsets weigh about 6 ounces (189 grams) instead of a pound (454 grams), they have a built-in fan for cooling, and the videos aren’t as jumpy. 

The findings that seniors in their 80s and 90s enjoy VR less than those in their 70s might lead to changes for them, such as requiring less neck rotation to see all of the scenery and making the visuals bigger, Moore said. 

On a recent afternoon at John Knox, a handful of seniors who live independently took turns again using virtual reality. Pete Audet experienced what it would be like to fly in a wingsuit, soaring over show-capped mountains before landing in a field. 

“Oooh, running stop!” exclaimed Audet, a 76-year-old retired information technology worker. He thinks other seniors “will really enjoy it. But they just need to learn how to use it.” 

His wife, Karen, “played” with puppies and was so entranced by her virtual walk around Paris that she didn’t hear questions being asked of her. 

“I was there. But I was here!” said Karen Audet, an 82-year-old retired elementary school teacher. 

Farrell, the retired Army computer expert, said he hopes to live to 100 because he believes the next five years will see momentous change in VR. Still a technology enthusiast, he believes the cost of systems will drop dramatically and become part of everyday living, even for seniors. 

“It is not going to be as elementary as it is now. It is going to be very realistic and very responsive,” he said. “It will probably be connected to your brain.” 

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Army Doctor, Black Hawk Pilot Holds Record for Longest US Spaceflight 

pentagon — U.S. Army Colonel Frank Rubio, who holds the record for the longest U.S. spaceflight, recounted the “awesome” experience of re-entering Earth’s atmosphere on Thursday during a Pentagon ceremony honoring his achievement.

“Colonel Rubio is a stellar example of someone who has made the absolute most of every opportunity,” Army Secretary Christine Wormuth said as she presented him with an honor known as the Army Astronaut Device. “It’s truly a privilege to have him representing the Army and the United States.”

The Army awards the astronaut device to soldiers who complete at least one mission in space. Rubio joins Colonel Anne McClain and Colonel Andrew Morgan as the only active-duty soldiers authorized to wear it.

Rubio returned to Earth late last year on a Russian spacecraft after 371 days in the International Space Station.

The doctor and Black Hawk helicopter pilot flew more than 600 hours in dangerous combat deployments in Bosnia, Afghanistan and Iraq before joining NASA in 2017 to become an astronaut.

While becoming an astronaut is a childhood dream for many who go to space, Rubio said he fell in love with the space mission much later in life.

“It’s few things where you can say, ‘Hey, my job helps represent humanity.’ And that’s a pretty powerful thing to be a part of,” Rubio told reporters at the Pentagon.

While he now holds the record for longest spaceflight by an American, he certainly wasn’t trying to earn that title. Rubio’s six-month mission was extended to 371 days after his initial ride home sprang a leak.

His year in space led to incredible highlights, he said, from hurtling into space on top of 300 tons of rocket fuel during the launch, to spacewalks, to re-entering Earth’s atmosphere.

“You essentially become a meteorite, right, and you have a plasma layer a couple of inches below you, because of the heat that’s generated. All those things were awesome,” he said in response to a question from VOA.

Rubio is the son of Salvadoran immigrants, and he credits the Army for giving him the chance to reach for the stars.

“I think it is the American Dream. It really represents the fact that we have so many opportunities, and again, I really value the fact that it’s the opportunity that’s given, not the results,” he said. “And I think if you put in the hard work, if you dedicate yourself and you sacrifice, really almost anything is possible.”

Rubio told reporters on Thursday that he hopes to continue contributing to NASA’s mission on the ground and back in space. 

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Second IVF Provider in Alabama Pauses Some Services After Ruling on Embryos

montgomery, alabama — A second in vitro fertilization provider in the U.S. state of Alabama is pausing parts of its care to patients after the state Supreme Court ruled that frozen embryos are legally considered children. 

Alabama Fertility Services said in a statement Thursday that it has “made the impossibly difficult decision to hold new IVF treatments due to the legal risk to our clinic and our embryologists.” 

The decision comes a day after the University of Alabama at Birmingham health system said in a statement that it was pausing IVF treatments so it could evaluate whether its patients or doctors could face criminal charges or punitive damages. 

“We are contacting patients that will be affected today to find solutions for them and we are working as hard as we can to alert our legislators as to the far reaching negative impact of this ruling on the women of Alabama,” Alabama Fertility said. “AFS will not close. We will continue to fight for our patients and the families of Alabama.” 

Doctors and patients have been grappling with shock and fear this week as they try to determine what they can and can’t do after the ruling by the all-Republican Alabama Supreme Court that raises questions about the future of IVF. 

Alabama Fertility Services’ decision left Gabby Goidel, who was days from an expected egg retrieval, calling clinics across the South looking for a place to continue IVF care. 

“I freaked out. I started crying,” Goidel said. “I felt in an extreme limbo state,”

The Alabama ruling came down Friday, the same day Goidel began a 10-day series of injections ahead of egg retrieval, with the hopes of getting pregnant through IVF next month. She found a place in Texas that will continue her care and plans to travel there Thursday night. 

Goidel experienced three miscarriages and she and her husband turned to IVF as a way of fulfilling their dream of becoming parents. 

“It’s not pro-family in any way,” Goidel said of the Alabama ruling. 

Dr. Michael C. Allemand, a reproductive endocrinologist at Alabama Fertility, said Wednesday that IVF is often the best treatment for patients who desperately want a child, and the ruling threatens doctors’ ability to provide that care. 

“The moments that our patients are wanting to have by growing their families — Christmas mornings with grandparents, kindergarten, going in the first day of school, with little backpacks — all that stuff is what this is about. Those are the real moments that this ruling could deprive patients of,” he said. 

Justices — citing language in the Alabama Constitution that the state recognizes the “rights of the unborn child” — said three couples could sue for wrongful death when their frozen embryos were destroyed in an accident at a storage facility. 

“Unborn children are ‘children’ … without exception based on developmental stage, physical location, or any other ancillary characteristics,” Justice Jay Mitchell wrote in Friday’s majority ruling. Mitchell said the court had previously ruled that a fetus killed when a woman is pregnant is covered under Alabama’s Wrongful Death of a Minor Act and nothing excludes “extrauterine children from the Act’s coverage.” 

While the court case centered on whether embryos were covered under the wrongful death of a minor statute, some said treating the embryo as a child — rather than property — could have broader implications and call into question many of the practices of IVF. 

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New Clues Discovered About Silent Brain Changes That Precede Alzheimer’s 

WASHINGTON — Alzheimer’s quietly ravages the brain long before symptoms appear, and now scientists have new clues about the dominolike sequence of those changes — a potential window to one day intervene. 

A large study in China tracked middle-aged and older adults for 20 years, using regular brain scans, spinal taps and other tests. 

Compared to those who remained cognitively healthy, people who eventually developed the mind-robbing disease had higher levels of an Alzheimer’s-linked protein in their spinal fluid 18 years prior to diagnosis, researchers reported Wednesday. Then every few years afterward, the study detected another so-called biomarker of brewing trouble. 

Scientists don’t know exactly how Alzheimer’s forms. One early hallmark is that sticky protein called beta-amyloid, which over time builds up into brain-clogging plaques. Amyloid alone isn’t enough to damage memory — plenty of healthy people’s brains harbor a lot of plaque. An abnormal tau protein that forms neuron-killing tangles is one of several co-conspirators. 

The new research, published in The New England Journal of Medicine, offers a timeline for how those abnormalities pile up. 

The study’s importance “cannot be overstated,” said Dr. Richard Mayeux, an Alzheimer’s specialist at Columbia University who wasn’t involved in the research. 

“Knowledge of the timing of these physiological events is critical” for testing new ways of treating and maybe eventually even preventing Alzheimer’s, he wrote in an accompanying editorial. 

The findings have no practical implications yet. 

First treatment

More than 6 million Americans, and millions more worldwide, have Alzheimer’s, the most common form of dementia. There’s no cure. But last year, a drug named Leqembi became the first to be approved, with clear evidence that it could slow the worsening of early Alzheimer’s — albeit for a few months. 

It works by clearing away some of that gunky amyloid protein. The approach also is being tested to see if it’s possible to delay Alzheimer’s onset if high-risk people are treated before symptoms appear. Still, other drugs are being developed to target tau. 

Tracking silent brain changes is key for such research. Scientists already knew that in rare, inherited forms of Alzheimer’s that strike younger people, a toxic form of amyloid starts accumulating about two decades ahead of symptoms, and at some point later, tau kicks in. 

The new findings show the order in which such biomarker changes occurred with more common old-age Alzheimer’s. 

Researchers with Beijing’s Innovation Center for Neurological Disorders compared 648 people eventually diagnosed with Alzheimer’s and an equal number who remained healthy. The amyloid finding in future Alzheimer’s patients was the first, 18 years or 14 years prior to diagnosis depending on the test used. 

Differences in tau were detected next, followed by a marker of trouble in how neurons communicate. A few years after that, differences in brain shrinkage and cognitive test scores between the two groups became apparent, the study found. 

“The more we know about viable Alzheimer’s treatment targets and when to address them, the better and faster we will be able to develop new therapies and preventions,” said Claire Sexton, the Alzheimer’s Association’s senior director of scientific programs. She noted that blood tests are coming soon that promise to also help by making it easier to track amyloid and tau. 

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Medics Set Up Blood Transfusion Station Near Donbas Front Line

When Ukrainian soldiers are wounded during combat, they are taken to what is called a stabilization point, where combat medics take care of them. Now, thanks to overseas donors, medics at one of the stabilization points in Ukraine’s Donbas region can perform blood transfusions. Anna Kosstutschenko has the story. VOA footage by Pavel Suhodolskiy.

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