Putin starts new term amid tension between Russia, West

Vladimir Putin was sworn in for a new six-year term as Russian president on Tuesday at an inauguration ceremony at the Kremlin, marking the fifth oath of office he has taken since 2000. Chinese experts said that Putin's primary policy agenda will be maintaining the current high level of domestic unity while addressing Western sanctions. 

While Russia's relations with the West have deteriorated to their lowest point since the Cold War ended, with significant divisions within the West over their Russia stance, Russia's ties with China remain stable and unaffected by the rapidly changing global landscape, observers noted. 

During his inauguration speech, Putin assured that the interests and security of the people of Russia will be above all else for him, Russian news agency Sputnik reported.

"I am confident that we will pass through this entire difficult, milestone period with dignity, become even stronger and will definitely implement long-term plans and large-scale projects aimed at achieving development goals," the president said.

In terms of internal affairs, Putin's new term will focus on maintaining the unity, stability and security of his country, as well as the development of the national economy and public welfare, Yang Jin, an associate research fellow at the Institute of Russian, Eastern European and Central Asian Studies at the Chinese Academy of Social Sciences, told the Global Times on Tuesday. "That means tackling a number of problems in the development of industry, trading and agriculture, and improving people's livelihoods," Yang said.

As for external relations, "the first step would be to overcome the challenges brought by the sanctions imposed by the West," the expert said. 

In response to the significant external pressures, Russia will make some diplomatic adjustments with relevant countries, including prioritizing traditional friendly nations and enhancing partnerships with neighboring states. This will extend to bolstering relations with Central Asia and the Caucasus, as well as other traditional allies in the Middle East and Northeast Asia, Yang said. 

Upon the new presidency, how Russia shapes its policy direction with the West and China have become the key focus of the world. 

As Russia-West tensions escalate, Yang said relations between the two sides have dropped to the lowest level since the end of the Cold War and the situation of sanctions and counter-sanctions will not see the tide turned in the short term. 

At the inauguration, Putin declared that Russia does not refuse dialogue with Western countries saying "the choice is theirs." A conversation on security issues, strategic stability is possible, but not from a position of strength, but only on equal terms, Putin stated, Sputnik reported.

In contrast, the relationship between Russia and China remains clear and certain. "As their partnership is strategic despite not being an alliance, this type of relationship provides both parties with significant flexibility. Given the current convergence of interests between the two sides, our outlook on the future of China-Russia relations remains healthy, steady and positive, unaffected by global landscape changes," Cui Heng, a scholar from the Shanghai-based China National Institute for SCO International Exchange and Judicial Cooperation, told the Global Times on Tuesday.

President Aide Yuri Ushakov confirmed on Tuesday after the swearing-in ceremony that Putin's first overseas visit for this term will be to China, according to media reports. 

When Russian Foreign Minister Sergei Lavrov visited China in February, he reaffirmed that deepening the partnership with China is "the top priority for Moscow," the Xinhua News Agency reported. 

Envoys from France, Hungary and Slovakia among several other EU member states were expected to attend the ceremony, Reuters reported on Tuesday, while other Western powers including the US refused to take part. 

French President Emmanuel Macron said on Monday that "We are not at war with Russia or the Russian people, and we have no desire for regime change in Moscow." 

The varying diplomatic response has underscored divisions on how to develop relations with Moscow against the backdrop of the Ukraine crisis. The Western stance toward Russia is not set in stone. Despite attempts to resist Putin's authority, Russia's status as a major global player and Putin's leadership has never been truly negated when it comes to matters concerning global and European interests. The "boycott" is actually a "stage play," Cui said.

However, for countries like France which maintain an independent and pragmatic stance, they have grasped a better initiative for their future dealings with Russia, the expert noted.

Following the inauguration, the Russian government resigned to the newly elected president by a decree signed by Prime Minister Mikhail Mishustin. The cabinet will continue to carry out its duties until a new government is appointed, according to a TASS report.

In 2000, the 47-year-old Putin garnered backing from 52.94 percent of the Russian voters. This support increased to 71.31 percent in 2004, 63.6 percent in 2012, and 76.7 percent in 2018. By the March 2024 elections, the 71-year-old candidate saw a record-high support rate of 87.28 percent.

Nigeria: Embassy diplomats experience the Traditional Chinese Medicine culture

An event to promote Traditional Chinese Medicine (TCM) was held at the Nigerian Embassy in Beijing, themed "Promote Chinese Medicine and Global Health." 

The event was attended by the Nigerian Ambassador to China Baba Ahmad Jidda, Nigerian Deputy Ambassador Fumen Tyeni Dogo, Secretary General of the China Information Association of Traditional Chinese Medicine Kang Xiaofei, and more than 40 experts in the TCM and healthcare industry from all over the country.

Dogo praised the significant contribution made by the culture of TCM to the world, and expressed hopes that the Belt and Road Initiative (BRI) will promote common cooperation and development of the culture in more countries. The Nigerian Embassy in China also took the opportunity to promote cultural exchanges between China and Nigeria, and further strengthen cooperation in the field of TCM.

During the event, a number of invited Chinese medicine experts communicated their experiences and showcased technology, while exchanging Chinese medicine treatment protocols, adding impetus to the high-quality development of the Chinese medicine cause.

In order to let the Nigerian diplomats experience the charm of Chinese medicine culture, Chinese medicine experts carried out a clinical checkups at the end of the activity, further showcasing the therapeutic qualities of the unique Chinese medicine tuina remedial massage.

Journey of two generations of US, China scholars in locating Chinese garden nurtures flower of friendship

One day in the 1950s, in the dimly lit hall of a museum in the US, young James Cahill saw the Zhi Garden Album for the first time.
The album from 17th-century China depicts a Chinese garden called Zhi with extraordinary realistic brushwork, which was uncommon in classical Chinese paintings. Almost every detail of the Zhi Garden was captured by the artist, revealing to Cahill an exquisite, yet unfamiliar Eastern-style beauty.

Cahill's eyes and heart were captured. This US student in Chinese art, who later became a famous art historian and one of the world's foremost scholars of Chinese painting, started his decades-long journey in search of the real Zhi Garden. For half a century, he visited China several times, and mentioned the Zhi Garden in his books and on many academic occasions, but never got concrete information about this mysterious garden.

Did this remote Chinese garden really exist, or was it just a Xanadu on paper? The question has long gnawed at Cahill's mind.

One summer day in 2010, on the other side of the globe, two Chinese students studying landscape architecture wrote an email to the then 84-year-old Cahill. This email, which shared the exciting news of the Zhi Garden's probable existence, was the very beginning of a beautiful story that saw Chinese and US scholars make joint efforts to discover and study the Zhi Garden, leading to their lasting friendship.

A dialogue across time and space

This 2010 email was sent by Liu Shanshan and Huang Xiao, who were then students of renowned Chinese professor of architecture Cao Xun.

In 2009, Cao came across the Zhi Garden Collection at the National Library of China, a book of poems and essays written by Wu Liang, a garden artist in the Ming Dynasty (1368-1644). Through careful study, Cao became certain that Wu was the owner of the Zhi Garden, and the garden was most likely located in Wu's hometown in present-day Changzhou, East China's Jiangsu Province.

Under Cao's encouragement, Liu and Huang wrote an email to Cahill. They shared with Cahill that they might have found the owner and the possible location of the Zhi Garden, and asked him about the images of the Zhi Garden Album

Cahill's fast response surprised Liu and Huang. "We emailed him at around 10 pm Beijing time, and the next morning we found that he had replied," recalled Liu, who is now an associate professor at the Beijing University of Civil Engineering and Architecture.

They soon felt Cahill's excitement about and his strong passion for the Zhi Garden. In the following days, they received a couple of Cahill's emails, which were "too many to reply to in time." Moreover, after learning that Liu and Huang were also interested in the Zhi Garden and were willing to engage in related studies on it, Cahill soon mailed them a big package from the US, which included a complete set of duplicates of the Zhi Garden Album, as well as some 400 pages of literature and two CDs containing images of paintings of gardens that Cahill had collected throughout the years.

What made Liu and Huang more surprising was that Cahill suggested writing a book with them, sharing insights from their studies on Chinese gardens including the Zhi Garden from the Eastern and Western perspectives, as well as art history and garden architecture.

This idea sounded like a Nobel Prize winner inviting university students to work together on a thesis. "We could hardly believe it," Liu told the Global Times. "Professor Cahill was a leading figure in the study of Chinese art, but we were just postgraduate students at that time. There was a big gap between us."

Cahill's trust and encouragement gave them courage. In the following year, the two sides exchanged more than 100 emails to discuss the book's contents and forms. In 2012, the Chinese edition of their book Garden Paintings in Old China was published, becoming an influential work among international scholars of Chinese art.

Cahill described the book as the result of "a dialogue across time and space." It was the fruit of a yearlong online collaboration between two generations of Chinese and US scholars specialized in different fields, echoed Liu.

In July 2013, Liu and Huang handed the book to Cahill in their first offline meeting at the latter's home in the US. At that time, Cahill was already suffering from cancer.

During their one-month stay in the US, Liu and Huang visited many museums and art galleries with the help of recommendations from Cahill, and saw part of the original copy of the Zhi Garden Album at the Los Angeles County Museum of Art. They celebrated Cahill's 87th birthday with him, which was tragically the last birthday of his life.

Cahill passed away in February 2014. "Working with Liu and Huang, learning that the Zhi Garden had indeed existed, and writing a book together, brought such contentment and happiness to the last years of his life," Cahill's daughter, Sarah Cahill, told the Global Times via email.

Moving story behind pictures 

In April 2011, Liu and Huang found the specific location of the Zhi Garden based on historical materials and topographic maps. It had been turned into a commercial residential area in Changzhou, with a shopping mall downstairs.

They emailed the area's satellite imagery to Cahill, who immediately confirmed it as the original location of the Zhi Garden. Huang explained that Cahill had probably read the Zhi Garden Album hundreds of times, as he was very familiar with the garden's terrain and topography as depicted in the album. "So when he looked at the satellite imagery, it was as if he was looking at an old friend," said Huang, who is now an associate professor at the Beijing Forestry University.

The garden has been lost to centuries of change and urbanization. But fortunately, its beauties can be seen again today thanks to the unremitting efforts of many Chinese and foreign scholars. In 2013, a digital model of Zhiyuan was completed. In 2015, one year after Cahill had passed away, the Museum of Chinese Gardens and Landscape Architecture made an intricate model of the Zhi Garden, to serve as a representative example of the private gardens in the regions south of the Yangtze River during the Ming Dynasty (1368-1644).

Sarah visited the model in 2018 when attending a Zhi Garden-themed symposium in Beijing organized by Liu and Huang. "The model is miraculous; so detailed and lifelike, and truly expresses the beauty and perfect proportions of the original garden," praised Sarah.

Sarah voluntarily took over some follow-up work related to the Zhi Garden after Cahill's passing. Her father's love for Chinese gardens has deeply impressed and influenced her. "I have only been to one Chinese classical garden, but have long admired the beauty and ingenuity of Chinese gardens, from paintings and photographs," she told the Global Times. "The balance and harmony of humanity within nature makes Chinese gardens so perfect for reflection and inspiration."

The story does not end with the finding of the Zhi Garden's location and the departure of Cahill. In 2022, after years of studying the garden, Liu and Huang published their two books: The Zhi Garden AlbumA Portrait of Peach Blossom Spring and Rediscovering a Ming Dynasty Peach Blossom Spring: A Study on the Zhi Garden. In September 2023, at the 3rd Conference of the European Association for Asian Art and Archaeology (EAAA) in Slovenia, Liu and Huang shared the story of the Zhi Garden with participating global scholars.

The beautiful set of pictures in the Zhi Garden Album is like a dream, Katherine Anne Paul, Curator of Asian Art at the Birmingham Museum of Art, said at the conference. "I love the beautiful garden in the pictures, and I love the moving story behind the pictures and the garden more," she said with excitement.

Envoys of culture exchanges

Cahill's life was deeply connected with China.

After then US president Richard Nixon visited China in 1972, the country sent its first art and archaeology delegation to China the following year. As a member of the delegation, Cahill participated in the first-ever important cultural exchange between China and the US since the founding of the People's Republic of China in 1949. In 1977, Cahill led an ancient Chinese painting delegation to China. 

In his lifetime, Cahill visited China for academic events and cultural exchanges many times, and established friendships with lots of Chinese scholars. He also helped many Chinese students.

"When Chinese publishers and publications paid Cahill for the manuscripts, he often asked me and Huang to give some of the money to the Chinese students who had [financial] difficulties," Liu said. "He was also pleased to write letters of recommendation for Chinese students and scholars who wished to go on academic visits to the US, helping them get some subsidies or grants."

Generous and warm-hearted Cahill was among the expanding pool of overseas scholars and ordinary people who are interested in Chinese culture and art, especially traditional Chinese garden art, and who are friendly to Chinese people. 

Liu said in 2024, she and Huang will cooperate with the California-based Huntington Library to hold an exhibition under the theme of Chinese gardens and plants, at the Chinese Garden (also known as or the Garden of Flowing Fragrance) of the library. The garden usually holds public activities related to Chinese culture, said Liu.

As an art form that represents Chinese cultural characteristics, and a current display and communication space of Chinese culture, the Chinese-style garden plays an important role in the cultural exchanges between China and foreign countries, Liu said.

"Today, there are more than 100 Chinese-style gardens outside China, and they offer global people [a platform] to enjoy Chinese garden culture and artistic life," she told the Global Times. "The gardens are hailed as envoys of culture exchanges."

The year of 2024 marks the 45th anniversary of the establishment of diplomatic relations between China and the US. A pianist and radio host herself, Sarah is glad to see more people-to-people cultural exchanges between the US and China. She said that the San Francisco Conservatory of Music, where she is a faculty member, has a close relationship with the Shanghai Conservatory of Music.

Sarah also feels fortunate to develop friendships with her father's good friends in China, including Liu and Huang. 

"It is so true that friendships and collegial relationships can strengthen and reinforce political relationships," she told the Global Times. "Music and art are of the best ways to bring us together!"

Airports in Xinjiang and Xizang see record transport volume last year

Major Chinese airports saw record transport resulting from rising demand in 2023, with airports in Xinjiang and Xizang in particular welcoming record volumes of passenger throughput.

Xinjiang Airport Group Co reported record high of passenger throughput of 40.61 million as of December 31, 2023, facilitating 490,000 takeoffs and landings. Annual passenger throughput and takeoffs and landings have returned to 108.2 percent and 113.2 percent of 2019 levels, respectively, the group said. 

Among the airports in Xinjiang, passenger throughput across nine airports in Northwest China's Xinjiang Uygur Autonomous Region including Urumqi, Kashi, Korla and Aksu all exceeded that of 2019. Annual passenger throughput at Urumqi Diwopu International Airport exceeds the 25 million mark for the first time, reaching 25.08 million passengers.

In 2023, Xinjiang Airport Group launched a total of 451 domestic routes and 20 international routes.

Xizang Autonomous Region Administration of the Civil Aviation Administration of China (CAAC) also reported a record high of 6.897 million passenger trips in 2023, representing growth of 106.1 percent over 2022, also marking a record high. Among the airports in Xizang, annual passenger throughput at Lhasa Gonggar International Airport reached 5.47 million, a year-on-year increase of 111.8 percent. Annual passenger throughput of Qamdo Bangda Airport reached 424,000, a year-on-year increase of 60 percent, the bureau said. 

Currently, there are 12 airlines operating in Xizang, with the flying footprint covering 169 routes across 74 cities.

The rapid recovery of aviation industry has provided a solid foundation greater airport activity, market watchers said. 

CAAC data showed that the scale of domestic route passenger traffic in 2023  exceeded  pre-epidemic levels, with an increase of 1.5 percent compared to 2019, and the fastest recovery among all types of transportation modes in China. 

Guangzhou Baiyun International Airport reported a passenger turnover of 65 million in 2023, ranking first for domestic airports. In July alone, the airport handled 6.05 million passenger trips, becoming the first domestic airport to handle more than six million passengers in a single month since 2020.

In 2024, China's domestic passenger transport will continue to grow steadily, passenger volume on domestic routes is expected to reach 630 million throughout the year, exceeding 2019 levels by 7.7 percentage points, the CAAC said.

The CAAC predicted that China's international passenger traffic will continue to rebound, with the number of flights expected to reach 6,000 flights per week at the end of 2024, recovering to the 80 percent of levels seen before the epidemic. 

China's civil aviation will enter a new cycle of sustained, rapid and healthy development, as the country's transport sector returns to a period of natural growth, the CAAC said.

Cheerful Tibetan lifestyle ‘linka’ lives on

What special apps does a young Tibetan living on the snowy plateau have on their phone? Recently, a new app called "Linka" has appeared on the phones of young people. Using it, you can easily browse and learn information about the Tibetan culture. Additionally, you can find both the oldest and the latest Tibetan songs, and learn about their origins and historical background. Most importantly, you can share your joy and sorrow in life and build your own neighborhood online.

Of course, we are not here to advertise any social app. However, the name of this app is indeed well chosen. It encompasses all the meanings and uses of the Tibetan word "linka." 

For thousands of years before the advent of online social platforms, linka was the primary social bond between Tibetan people, their communities, and nature. Through these activities, ­Tibetans stay cheerful, optimistic, and lively even in the challenging high-altitude and oxygen-deficient natural environment.

In Tibetan, linka means gardens and groves. However, in a daily context, "linka running" is similar to outings or picnics. Linka running exists as a long-standing Tibetan tradition of ­being close to nature, a habit developed by Tibetan compatriots living in a high-altitude climate and unique environment. 

In the Xizang Autonomous Region in Southwest China, severe cold and snow are the norm. So, any day with good weather is never wasted. They are seen as gifts from Heaven. 

Tibetan people deeply adhere to the belief that "Every day in which you do not dance is a day wasted in life." Therefore, during such days, Tibetans often gather with family and friends, bringing along some food, and head to lush linka areas. There, they set up tents, lay out carpets, set out barley wine and various snacks, and indulge in merrymaking, celebrating the joys of nature with singing and feasting.

Over time, linka running has become a unique daily way of life for ­Tibetans. In Lhasa, whether in urban areas or the outskirts of the city, there are incredibly beautiful linka sites everywhere. Under the intense plateau sunshine, they appear as green as emeralds, turning Lhasa into a mythological world. 

Follow along and step into the world of Lhasa's linka to experience the unique ethnic customs and folk culture of the Tibetan people.

Having lived in Xizang for many years, I have heard the most beautiful songs, the most captivating stories, and the most entertaining jokes at linka running events. We believe that any cultural identity is a product of negotiation and interaction between people and nature.

It can be said that linka running reconciles the innate human desire to be close to nature with the challenges of the harsh natural environment. 

Tibetan people have a natural inclination toward outdoor life, camping, and picnics, and they love the forests, rivers, flowers, and meadows. 

At linka sites they set up tents of various colors and lavish or simple curtains, build stoves, prepare food and tea, and sometimes, they stay for a day, several days, or even up to half a month.

During these days, they sing, dance, play cards, roll dice, tell stories, perform Tibetan opera, entertain guests, feast, drink, and celebrate. There are also various games, sports, and archery activities.

The most touching crystallization of their culture naturally emerges during these carefree moments. The most popular sport during these times is archery, known as bishao in Tibetan. The target is made of cowhide, with a movable center. The arrowheads are carved from wood with many holes, producing a sharp sound when released from the bowstring. Hitting the bull's-eye causes the center to drop, indicating victory for the archer. 

During every archery competition, men and women standing on both sides of the competitors sing and dance enthusiastically to cheer and support them. This type of song is called dhashei, meaning arrow song.

In today's urban life in Xizang, this atmosphere has also spread extensively. Colleagues in the workplace, business partners, teachers and students in schools, guests and hosts, tourists and locals - more and more social relationships are influenced by Tibetan culture. 

People have learned to place the trivial matters of daily life under the vast starry sky and the scene of bonfire dances, giving everything a pastoral and idyllic filter.

We cannot deny that it is in one of the harshest natural environments on the plateau that the Tibetan people have created this most optimistic and relaxed way of life. This is rarely seen in cultures around the world. 

No matter how grand and lavish gatherings are organized in other places, they ultimately remain mere embellishments in the daily routine. But in the linka culture of Xizang, it seems that the Tibetan people have turned this around. 

It is said that in some families, the linka can last for up to a month. Family members with work or other obligations can leave at any time and naturally return to the festivities after finishing their tasks. This is indeed a very appealing way of life: Bothersome jobs and tasks are merely interludes in a grand feast.

Confusion lingers over health-related pros and cons of marijuana

No one knows whether chronic marijuana smoking causes emotional troubles or is a symptom of them…. This dearth of evidence has a number of explanations: serious lingering reactions, if they exist, occur after prolonged use, rarely after a single dose; marijuana has no known medical use, unlike LSD, so scientists have had little reason to study the drug…. Also, marijuana has been under strict legal sanctions … for more than 30 years. – Science News, October 7, 1967

In 29 states and in Washington, D.C., marijuana is now commonly prescribed for post-traumatic stress disorder and chronic pain. But the drug’s pros and cons remain hazy. Regular pot use has been linked to psychotic disorders and to alcohol and drug addiction (SN Online: 1/12/17). And two recent research reviews conclude that very little high-quality data exist on whether marijuana effectively treats PTSD or pain. Several large-scale trials are under way to assess how well cannabis treats these conditions.

The Arecibo Observatory will remain open, NSF says

The iconic Arecibo Observatory has survived a hurricane and dodged deep budget cuts. On November 16, the National Science Foundation, which funds the bulk of the observatory’s operating costs, announced that they would continue funding the radio telescope at a reduced level.

It’s not clear yet who will manage the observatory in the long run, or where the rest of the funding will come from. But scientists are celebrating. For example:
Arecibo, a 305-meter-wide radio telescope located about 95 kilometers west of San Juan, is the second largest radio telescope in the world. It has been instrumental in tasks as diverse as monitoring near-Earth asteroids, watching for bright blasts of energy called fast radio bursts and searching for extraterrestrial intelligence.

But the NSF, which covers $8.3 million of the observatory’s nearly $12 million annual budget, has been trying to back away from that responsibility for several years. After Hurricane Maria hit Puerto Rico on September 20, damaging the telescope’s main antenna, the observatory’s future seemed unclear (SN: 9/29/17).

On November 16, the NSF released a statement announcing it would continue science operations at Arecibo “with reduced agency funding,” and would search for new collaborators to cover the rest.、
“This plan will allow important research to continue while accommodating the agency’s budgetary constraints and its core mission to support cutting-edge science and education,” the statement says.

Hormone replacement makes sense for some menopausal women

Internist Gail Povar has many female patients making their way through menopause, some having a tougher time than others. Several women with similar stories stand out in her mind. Each came to Povar’s Silver Spring, Md., office within a year or two of stopping her period, complaining of frequent hot flashes and poor sleep at night. “They just felt exhausted all the time,” Povar says. “The joy had kind of gone out.”

And all of them “were just absolutely certain that they were not going to take hormone replacement,” she says. But the women had no risk factors that would rule out treating their symptoms with hormones. So Povar suggested the women try hormone therapy for a few months. “If you feel really better and it makes a big difference in your life, then you and I can decide how long we continue it,” Povar told them. “And if it doesn’t make any difference to you, stop it.”
At the follow-up appointments, all of these women reacted the same way, Povar recalls. “They walked in beaming, absolutely beaming, saying, ‘I can’t believe I didn’t do this a year ago. My life! I’ve got my life back.’ ”

That doesn’t mean, Povar says, that she’s pushing hormone replacement on patients. “But it should be on the table,” she says. “It should be part of the discussion.”

Hormone replacement therapy toppled off the table for many menopausal women and their doctors in 2002. That’s when a women’s health study, stopped early after a data review, published results linking a common hormone therapy to an increased risk of breast cancer, heart disease, stroke and blood clots. The trial, part of a multifaceted project called the Women’s Health Initiative, or WHI, was meant to examine hormone therapy’s effectiveness in lowering the risk of heart disease and other conditions in women ages 50 to 79. It wasn’t a study of hormone therapy for treating menopausal symptoms.

But that nuance got lost in the coverage of the study’s results, described at the time as a “bombshell,” a call to get off of hormone therapy right away. Women and doctors in the United States heeded the call. A 2012 study in Obstetrics & Gynecology showed that use plummeted: Oral hormone therapy, taken by an estimated 22 percent of U.S. women 40 and older in 1999–2000, was taken by fewer than 12 percent of women in 2003–2004. Six years later, the number of women using oral hormone therapy had sunk below 5 percent.
Specialists in women’s health say it’s time for the public and the medical profession to reconsider their views on hormone therapy. Research in the last five years, including a long-term follow-up of women in the WHI, has clarified the risks, benefits and ideal ages for hormone therapy. Medical organizations, including the Endocrine Society in 2015 and the North American Menopause Society in 2017, have released updated recommendations. The overall message is that hormone therapy offers more benefits than risks for the relief of menopausal symptoms in mostly healthy women of a specific age range: those who are under age 60 or within 10 years of stopping menstruation.

“A generation of women has missed out on effective treatment because of misinformation,” says JoAnn Pinkerton, executive director of the North American Menopause Society and a gynecologist who specializes in menopause at the University of Virginia Health System in Charlottesville. It’s time to move beyond 2002, she says, and have a conversation based on “what we know now.”

End of an era
Menopause, the final menstrual period, signals the end of fertility and is confirmed after a woman has gone 12 months without having a period. From then on she is postmenopausal. Women reach menopause around age 51, on average. In the four to eight years before, called perimenopause, the amount of estrogen in the body declines as ovarian function winds down. Women may have symptoms related to the lack of estrogen beginning in perimenopause and continuing after the final period.

Probably the best-known symptom is the hot flash, a sudden blast of heat, sweating and flushing in the face and upper chest. These temperature tantrums can occur at all hours. At night, hot flashes can produce drenching sweats and disrupt sleep.

Hot flashes arise because the temperature range in which the body normally feels comfortable narrows during the menopause transition, partly in response to the drop in estrogen. Normally, the body takes small changes in core body temperature in stride. But for menopausal women, the slightest uptick in degree can be a trigger for the vessels to dilate, which increases blood flow and sweating.

About 75 to 80 percent of menopausal women experience hot flashes and night sweats, on and off, for anywhere from a couple of years to more than a decade. In a study in JAMA Internal Medicine in 2015, more than half of almost 1,500 women enrolled at ages 42 to 52 reported frequent hot flashes — occurring at least six days in the previous two weeks — with symptoms lasting more than seven years.

A sizable number of women have moderate or severe hot flashes, which spread throughout the body and can include profuse sweating, heart palpitations or anxiety. In a study of 255 menopausal women, moderate to severe hot flashes were most common, occurring in 46 percent of women, during the two years after participants’ last menstrual period. A third of all the women still experienced heightened hot flashes 10 years after menopause, researchers reported in 2014 in Menopause.

Besides hot flashes and night sweats, roughly 40 percent of menopausal women experience irritation and dryness of the vulva and vagina, which can make sexual intercourse painful. These symptoms tend to arise after the final period.

Alarm bells
In the 1980s and ’90s, researchers observed that women using hormone therapy for menopausal symptoms had a lower risk of heart disease, bone fractures and overall death. Some doctors began recommending the medication not just for symptom relief, but also for disease prevention.

Observational studies of the apparent health benefits of hormone therapy spurred a more stringent study, a randomized controlled trial, which tested the treatment’s impact by randomly assigning hormones to some volunteers and not others. The WHI hormone therapy trials assessed heart disease, breast cancer, stroke, blood clots, colorectal cancer, hip fractures and deaths from other causes in women who used the hormones versus those who took a placebo. Two commonly prescribed formulations were tested: a combined hormone therapy — estrogen sourced from horses plus synthetic progesterone — and estrogen alone. (Today, additional U.S. Food and Drug Administration–approved formulations are available.)
The 2002 WHI report in JAMA, which described early results of the combined hormone therapy, shocked the medical community. The study was halted prematurely because after about five years, women taking the hormones had a slightly higher risk of breast cancer and an overall poor risk-to-benefit ratio compared with women taking the placebo. While the women taking hormones had fewer hip fractures and colorectal cancers, they had more breast cancers, heart disease, blood clots and strokes. The findings were reported in terms of the relative risk, the ratio of how often a disease happened in one group versus another. News of a 26 percent increase in breast cancers and a 41 percent increase in strokes caused confusion and alarm.

Women dropped the hormones in droves. From 2001 to 2009, the use of all hormone therapy among menopausal women, as reported by physicians based on U.S. office visits, fell 52 percent, according to a 2011 study in Menopause.

But, researchers say, the message that hormone therapy was bad for all was unwarranted. “The goal of the WHI was to evaluate the balance of benefits and risks of menopausal hormone therapy when used for prevention of chronic disease,” says JoAnn Manson, a physician epidemiologist at Harvard-affiliated Brigham and Women’s Hospital in Boston and one of the lead investigators of the WHI. “It was not intended to evaluate its role in managing menopausal symptoms.”

Along with the focus on prevention, the WHI hormone therapy trials were largely studies of older women — in their 60s and 70s. Only around one-third of participants started the trial between ages 50 and 59, the age group more likely to be in need of symptom relief. Hormone therapy “was always primarily a product to use in women entering menopause,” says Howard Hodis, a physician scientist who focuses on preventive medicine at the University of Southern California’s Keck School of Medicine in Los Angeles. “The observational studies were based on these women.”

Also lost in the coverage of the 2002 study results was the absolute risk, the actual difference in the number of cases of disease between two groups. The group on combined hormone therapy had eight more cases of breast cancer per 10,000 women per year than the group taking a placebo. Hodis notes that that absolute risk translates to less than one extra case for every 1,000 women, which is classified as a rare risk by the Council for International Organizations of Medical Sciences, a World Health Organization group. There was also less than one additional case for every 1,000 women per year for heart disease and for stroke in the hormone-treated women compared with those on placebo.

In 2004, researchers published results of the WHI study of estrogen-only therapy, taken for about seven years by women who had had their uteruses surgically removed. (Progesterone is added to hormone therapy to protect the uterus lining from a risk of cancer seen with estrogen alone.) The trial, also stopped early, reported a decreased risk of hip fractures and breast cancer, but an increased risk of stroke. The study didn’t change the narrative that hormone therapy wasn’t safe.

Timing is everything
Since the turn away from hormone therapy, follow-up studies have brought nuance not initially captured by the first two reports. Researchers were finally able to tease out the results that applied to “the young women — and I love saying this — young women 50 to 59 who are most apt to present with symptoms of menopause,” says Cynthia Stuenkel, an internist and endocrinologist at the University of California, San Diego School of Medicine in La Jolla.

In 2013, Manson and colleagues reported data from the WHI grouped by age. It turned out that absolute risks were smaller for 50- to 59-year-olds than they were for older women, especially those 70 to 79 years old, for both combined therapy and estrogen alone. For example, in the combined hormone therapy trial, treated 50- to 59-year-olds had five additional cases of heart disease and five more strokes per 10,000 women annually compared with the same-aged group on placebo. But the treated 70- to 79-year-olds had 19 more heart disease cases and 13 more strokes per 10,000 women annually than women of the same age taking a placebo. “So a lot more of these events that were of concern were in the older women,” Stuenkel says.

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A Danish study reported in 2012 of about 1,000 recently postmenopausal women, ages 45 to 58, also supported the idea that timing of hormone treatment matters. The randomized controlled trial examined the use of different formulations of estrogen (17β-estradiol) and progesterone than the WHI. The researchers reported in BMJ that after 10 years, women taking hormone therapy — combined or estrogen alone — had a reduced risk of mortality, heart failure or heart attacks, and no added risk of cancer, stroke or blood clots compared with those not treated.

These findings provide evidence for the timing hypothesis, also supported by animal studies, as an explanation for the results seen in younger women, especially in terms of heart disease and stroke. In healthy blood vessels, more common in younger women, estrogen can slow the development of artery-clogging plaques. But in vessels that already have plaque buildup, more likely in older women, estrogen may cause the plaques to rupture and block an artery, Manson explains.

Recently, Manson and colleagues published a long-term study of the risk of death in women in the two WHI hormone therapy trials — combined therapy and estrogen alone — from the time of trial enrollment in the mid-1990s until the end of 2014. Use of either hormone therapy was not associated with an added risk of death during the study or follow-up periods due to any cause or, specifically, death from heart disease or cancer, the researchers reported in JAMA in September 2017. The study provides reassurance that taking hormone therapy, at least for five to seven years, “does not show any mortality concern,” Stuenkel says.

Both the Endocrine Society and the North American Menopause Society state that, for symptom relief, the benefits of FDA-approved hormone therapy outweigh the risks in women younger than 60 or within 10 years of their last period, absent health issues such as a high risk of breast cancer or heart disease. The menopause society position statement adds that there are also benefits for women at high risk of bone loss or fracture.

Today, the message about hormone therapy is “not everybody needs it, but if you’re a candidate, let’s talk about the pros and cons, and let’s do it in a science-based way,” Pinkerton says.

Hormone therapy is the most effective treatment for hot flashes, night sweats and genital symptoms, she says. A review of randomized controlled trials, published in 2004, reported that hormone therapy decreased the frequency of hot flashes by 75 percent and reduced their severity as well.

More than 50 million U.S. women will be older than 51 by 2020, Manson says. Yet today, many women have a hard time finding a physician who is comfortable prescribing hormone therapy or even just managing a patient’s menopausal symptoms, she says.

Stuenkel, who says many younger doctors stopped learning about hormone therapy after 2002, is trying to play catch up. When she teaches medical students and doctors about treating menopausal symptoms, she brings up three questions to ask patients. First, how bothersome are the symptoms? Some women say “fix it, get me through the day and the night, put me back in order,” Stuenkel says. Other women’s symptoms are not as disruptive. Second, what does the patient want? Third, what is safe for this particular woman, based on her health? If a woman’s health history doesn’t support the use of hormone therapy, or she just isn’t interested, there are nonhormonal options, such as certain antidepressants, and also nondrug lifestyle approaches.

Menopause looms large for many women, Povar says, and discussing a patient’s expectations as well as whether hormone therapy is the right approach becomes a unique discussion with each patient, she says. “This is one of the most individual decisions a woman makes.”

When it’s playtime, many kids prefer reality over fantasy

Young children travel to fantasy worlds every day, packing just imaginations and a toy or two.

Some preschoolers scurry across ocean floors carrying toy versions of cartoon character SpongeBob SquarePants. Other kids trek to distant universes with miniature replicas of Star Wars robots R2-D2 and C-3PO. Throngs of youngsters fly on broomsticks and cast magic spells with Harry Potter and his Hogwarts buddies. The list of improbable adventures goes on and on.

Parents today take for granted that kids need toys to fuel what comes naturally — outlandish bursts of make-believe. Kids’ flights of fantasy are presumed to soar before school and life’s other demands yank the youngsters down to Earth.
Yet some researchers call childhood fantasy play — which revolves around invented characters and settings with no or little relationship to kids’ daily lives — highly overrated. From at least the age when they start talking, little ones crave opportunities to assist parents at practical tasks and otherwise learn how to be productive members of their cultures, these investigators argue.

New findings support the view that children are geared more toward helping than fantasizing. Preschoolers would rather perform real activities, such as cutting vegetables or feeding a baby, than pretend to do those same things, scientists say. Even in the fantastical realm of children’s fiction books, reality may have an important place. Young U.S. readers show signs of learning better from human characters than from those ever-present talking pigs and bears.
Studies of children in traditional societies illustrate the dominance of reality-based play outside modern Western cultures. Kids raised in hunter-gatherer communities, farming villages and herding groups rarely play fantasy games. Children typically play with real tools, or small replicas of tools, in what amounts to practice for adult work. Playgroups supervised by older children enact make-believe versions of what adults do, such as sharing hunting spoils.
These activities come much closer to the nature of play in ancient human groups than do childhood fantasies fueled by mass-produced toys, videos and movies, researchers think.
Handing over household implements to toddlers and preschoolers and letting them play at working, or allowing them to lend a hand on daily tasks, generates little traction among Western parents, says psychologist Angeline Lillard of the University of Virginia in Charlottesville. Many adults, leaning heavily on adult-supervised playdates, assume preschoolers and younger kids need to be protected from themselves. Lillard suspects that preschoolers, whose early helping impulses get rebuffed by anxious parents, often rebel when told to start doing household chores a few years later.

“Kids like to do real things because they want a role in the real world,” Lillard says. “Our society has gone overboard in stressing the importance of pretense and fantasy for young children.”

Keep it real
Lillard suspects most preschoolers agree with her.

More than 40 years of research fails to support the widespread view that playing pretend games generates special social or mental benefits for young children, Lillard and colleagues wrote in a 2013 review in Psychological Bulletin. Studies that track children into their teens and beyond are sorely needed to establish any beneficial effects of pretending to be other people or acting out imaginary situations, the researchers concluded.

Even the assumption that kids naturally gravitate toward make-believe worlds may be unrealistic. When given a choice, 3- to 6-year-olds growing up in the United States — one of many countries saturated with superhero movies, video games and otherworldly action figures — preferred performing real activities over pretending to do them, Lillard and colleagues reported online June 20 in Developmental Science.
One hundred youngsters, most of them white and middle class, were tested either in a children’s museum, a preschool or a university laboratory. An experimenter showed each child nine pairs of photographs. Each photo in a pair featured a boy or a girl, to match the sex of the youngster being tested. One photo showed a child in action. Depicted behaviors included cutting vegetables with a knife, talking on a telephone and bottle-feeding a baby. In the second photo, a different child pretended to do what the first child did for real.

When asked by the experimenter whether they would rather, say, cut real vegetables with a knife like the first child or pretend to do so like the second child, preschoolers chose the real activity almost two-thirds of the time. Among the preschoolers, hard-core realists outnumbered fans of make-believe, the researchers found. Whereas 16 kids always chose real activities, only three wanted to pretend on every trial. Just as strikingly, 48 children (including seven of 26 of the 3-year-olds) chose at least seven real activities of the nine depicted. Only 14 kids (mostly the younger ones) selected at least seven pretend activities.

Kids often said they liked real activities for practical reasons, such as wanting to learn how to feed babies to help mom. Hands-on activities also got endorsed for being especially fun or novel. “I’ve never talked on the real phone,” one child explained. Reasons for choosing pretend activities centered on being afraid of the real activity or liking to pretend.

In a preliminary follow-up study directed by Lillard, 16 girls and boys, ages 3 to 6, chose between playing with 10 real objects, such as a microscope, or toy versions of the same objects. During 10-minute play periods, kids spent an average of about twice as much time with real items. That preference for real things increased with age. Three-year-olds spent nearly equal time playing with genuine and pretend items, but the older children strongly preferred the real deal.

Lillard’s findings illustrate that kids want and need real experiences, says psychologist Thalia Goldstein of George Mason University in Fairfax, Va. “Modern definitions of childhood have swung too far toward thinking that young children should live in a world of fantasy and magic,” she maintains.

But pretend play, including fantasy games, still has value in fostering youngsters’ social and emotional growth, Goldstein and Matthew Lerner of Stony Brook University in New York reported online September 15 in Developmental Science. After participating in 24 play sessions, 4- and 5-year-olds from poor families were tested on empathy and other social skills. Those who played dramatic pretend games (being a superhero, animal or chef, for instance) were less likely than kids who played with blocks or read stories to become visibly upset upon seeing an experimenter who the kids believed had hurt a knee or finger, the researchers found. Playing pretend games enabled kids to rein in distress at seeing the experimenter in pain, the researchers proposed.

It’s not known whether fantasy- and reality-based games shape kids’ social skills in different ways over the long haul, Goldstein says.

True fiction
Even on the printed page, where youngsters gawk at Maurice Sendak’s goggle-eyed Wild Things and Dr. Seuss’ mustachioed Lorax, the real world exerts a special pull.

Consider 4- to 6-year-olds who were read either a storybook about a little raccoon that learns to share with other animals or the same storybook with illustrations of human characters learning to share. Both versions told of how characters felt better after giving some of what they had to others. A third set of kids heard an illustrated storybook about seeds that had nothing to do with sharing. Each group consisted of 32 children.

Only kids who heard the realistic story displayed a general willingness to act on its message, reported a team led by psychologist Patricia Ganea of the University of Toronto in a paper published online August 2 in Developmental Science. On a test of children’s willingness to share any of 10 stickers with a child described as unable to participate in the experiment, listeners to the tale with human characters forked over an average of nearly three stickers, about one more than the kids had donated before the experiment.

Children who heard stories with animal characters became less giving, sharing an average of 1.7 stickers after having originally donated an average of 2.3 stickers. Sticker sharing declined similarly among kids who heard the seed story. These results fit with several previous studies showing that preschoolers more easily apply knowledge learned from realistic stories to the real world, as opposed to information encountered in fantasy stories.

Even for fiction stories that are highly unrealistic, youngsters generally favor realistic endings, say Boston University psychologist Melissa Kibbe and colleagues. In a study from the team published online June 15 in Psychology of Aesthetics, Creativity and the Arts, an experimenter read 90 children, ages 4 to 6, one of three illustrated versions of a story. In the tale, a child gets lost on the way to a school bus. A realistic version was set in a present-day city. A futuristic science fiction version was set on the moon. A fantasy version occurred in medieval times and included magical characters. Stories ended with descriptions and illustrations of a child finally locating either a typical school bus, a futuristic school bus with rockets on its sides or a magical coach with dragon wings.
When given the chance, 40 percent of kids inserted a typical school bus into the ending for the science fiction story and nearly 70 percent did so for the fantasy tale. “Children have a bias toward reality when completing stories,” Kibbe says.
Hands on
Outside Western cultures, children’s bias toward reality takes an extreme turn, especially during play.

Nothing keeps it real like a child merrily swinging around a sharp knife as adults go about their business. That’s cause for alarm in Western households. But in many foraging communities, children play with knives and even machetes with their parents’ blessing, says anthropologist David Lancy of Utah State University in Logan.

Lancy describes reported instances of youngsters from hunter-gatherer groups playing with knives in his 2017 book Raising Children. Among Maniq foragers inhabiting southern Thailand’s forests, for instance, one researcher observed a father looking on approvingly as his baby crawled along holding a knife about as long as a dollar bill. The same investigator observed a 4-year-old Maniq girl sitting by herself cutting pieces of vegetation with a machete.

In East Africa, a Hadza infant can grab a knife and suck on it undisturbed, at least until an adult needs to use the tool. On Vanatinai Island in the South Pacific, children freely experiment with knives and pieces of burning wood from campfires.

Yes, accidents happen. That doesn’t mean hunter-gatherer parents are uncaring or indifferent toward their children, Lancy says. In these egalitarian societies, where sharing food and other resources is the norm, parents believe it’s wrong to impose one’s will on anyone, including children. Hunter-gatherer adults assume that a child learns best through hands-on, sometimes risky, exploration on his or her own and in groups with other kids. In that way, the adults’ thinking goes, youngsters develop resourcefulness, creativity and determination. Self-inflicted cuts and burns represent learning opportunities.

In many societies, adults make miniature tools for children to play with or give kids cast-off tools to use as toys. For instance, Inuit boys have been observed mimicking seal hunts with items supplied by parents, such as pieces of sealskin and miniature harpoons. Girls in Ecuador’s Conambo tribe mold clay balls provided by their mothers into various shapes as a first step toward becoming potters.
Childhood games and toys in foraging groups and farming villages, as in Western nations, reflect cultural values. Hunter-gatherer kids rarely engage in rough-and-tumble or competitive games. In fact, competition is discouraged. These kids concoct games with no winners, such as throwing a weighted feather in the air and flicking the feather back up as it descends. Children in many farming villages and herding societies play basic forms of marbles, in which each player shoots a hard object at similar objects to knock the targets out of a defined area. The rules change constantly as players decide among themselves what counts and what doesn’t.

Children in traditional societies don’t invent fantasy characters to play with, Lancy says. Consider imaginative play among children of Aka foragers in the Central African Republic. These kids may pretend to be forest animals, but the animals are creatures from the children’s surroundings, such as antelope. The children aim to take the animals’ perspective to determine what route to follow while exploring, says anthropologist Adam Boyette of Duke University. Aka youngsters sometimes pretend to be spirits that adults have told the kids about. In this way, kids become familiar with community beliefs and rituals.
Aka childhood activities are geared toward adult work, Boyette says. Girls start foraging for food within the first few years of life. Boys take many years to master dangerous tasks, such as climbing trees to raid honey from bees’ nests (SN: 8/20/16, p. 10). By around age 7, boys start to play hunting games and graduate to real hunts as teenagers.

In 33 hunter-gatherer societies around the world, parents typically take 1- to 2-year-olds on foraging expeditions and give the youngsters toy versions of tools to manipulate, reported psychologist Sheina Lew-Levy of the University of Cambridge and her colleagues in the December Human Nature. Groups of children at a range of ages play make-believe versions of what adults do and get in some actual practice at tasks such as toolmaking. Youngsters generally become proficient food collectors and novice toolmakers between ages 8 and 12, the researchers conclude. Adults, but not necessarily parents, begin teaching hunting and complex toolmaking skills to teens. For the report, Lew-Levy’s group reviewed 58 papers on childhood learning among hunter-gatherers, most published since 2000.

“There’s a blurred line between work and play in foraging societies because children are constantly rehearsing for adult roles by playing,” Boyette says.

Children in Western societies can profitably mix fantasy with playful rehearsals for adult tasks, observes George Mason’s Goldstein, who was a professional stage actor before opting for steadier academic work. “My 5-year-old son is never happier than when he’s helping to check us out at the grocery store,” she says. “But he also likes to pretend to be a robot, and sometimes a robot who checks us out at the grocery store.”

Not too far in the future, preschoolers pretending to be robots may encounter real robots running grocery-store checkouts. Playtime will never be the same.

The mystery of Christiaan Huygens’ flawed telescopes may have been solved

17th century scientist Christiaan Huygens set his sights on faraway Saturn, but he may have been nearsighted.

Huygens is known, in part, for discovering Saturn’s largest moon, Titan, and deducing the shape of the planet’s rings. But by some accounts, the Dutch scientist’s telescopes produced fuzzier views than others of the time despite having well-crafted lenses.

That may be because Huygens needed glasses, astronomer Alexander Pietrow proposes March 1 in Notes and Records: the Royal Society Journal of the History of Science.
To make his telescopes, Huygens combined two lenses, an objective and an eyepiece, positioned at either end of the telescope. Huygens experimented with different lenses to find combinations that, to his eye, created a sharp image, eventually creating a table to keep track of which combinations to use to obtain a given magnification. But when compared with modern-day knowledge of optics, Huygens’ calculations were a bit off, says Pietrow, of the Leibniz Institute for Astrophysics Potsdam in Germany.

One possible explanation: Huygens selected lenses based on his flawed vision. Historical records indicate that Huygens’ father was nearsighted, so it wouldn’t be surprising if Christiaan Huygens also suffered from the often-hereditary affliction.

Assuming that’s the reason for the mismatch, Pietrow calculates that Huygens had 20/70 vision: What someone with normal vision could read from 70 feet away, Huygens could read only from 20 feet. If so, that could be why Huygens’ telescopes never quite reached their potential.