Features

WASHINGTON — Your next doctor could very well be a bot. And bots, or automated programmes, are likely to play a key role in finding cures for some of the most difficult-to-treat diseases and conditions.

Artificial intelligence (AI)  is rapidly moving into healthcare, led by some of the biggest technology companies and emerging startups using it to diagnose and respond to a raft of conditions.

Consider these examples:

— California researchers detected cardiac arrhythmia with 97 per cent accuracy on wearers of an Apple Watch with the AI-based Cariogram application, opening up early treatment options to avert strokes.

— Scientists from Harvard and the University of Vermont developed a machine learning tool — a type of AI that enables computers to learn without being explicitly programmed — to better identify depression by studying Instagram posts, suggesting “new avenues for early screening and detection of mental illness”.

— Researchers from Britain’s University of Nottingham created an algorithm that predicted heart attacks better than doctors using conventional guidelines.

While technology has always played a role in medical care, a wave of investment from Silicon Valley and a flood of data from connected devices appear to be spurring innovation.

“I think a tipping point was when Apple released its Research Kit,” said Forrester Research analyst Kate McCarthy, referring to a programme letting Apple users enable data from their daily activities to be used in medical studies.

McCarthy said advances in artificial intelligence has opened up new possibilities for “personalised medicine” adapted to individual genetics.

“We now have an environment where people can weave through clinical research at a speed you could never do before,” she said.

Predictive analytics

AI is better known in the tech field for uses such as autonomous driving, or defeating experts in the board game Go. 

But it can also be used to glean new insights from existing data such as electronic health records and lab tests, says Narges Razavian, a professor at New York University’s Langone School of Medicine who led a research project on predictive analytics for more than 100 medical conditions.

“Our work is looking at trends and trying to predict [disease] six months into the future, to be able to act before things get worse,” Razavian said.

— NYU researchers analysed medical and lab records to accurately predict the onset of dozens of diseases and conditions including type 2 diabetes, heart or kidney failure and stroke. The project developed software now used at NYU which may be deployed at other medical facilities.

— Google’s DeepMind division is using artificial intelligence to help doctors analyse tissue samples to determine the likelihood that breast and other cancers will spread, and develop the best radiotherapy treatments.

— Microsoft, Intel and other tech giants are also working with researchers to sort through data with AI to better understand and treat lung, breast and other types of cancer.

— Google parent Alphabet’s life sciences unit Verily has joined Apple in releasing a smartwatch for studies including one to identify patterns in the progression of Parkinson’s disease. Amazon meanwhile offers medical advice through applications on its voice-activated artificial assistant Alexa.

IBM has been focusing on these issues with its Watson Health unit, which uses “cognitive computing” to help understand cancer and other diseases.

When IBM’s Watson computing system won the TV game show Jeopardy in 2011, “there were a lot of folks in healthcare who said that is the same process doctors use when they try to understand healthcare”, said Anil Jain, chief medical officer of Watson Health.

Systems like Watson, he said, “are able to connect all the disparate pieces of information” from medical journals and other sources “in a much more accelerated way”.

“Cognitive computing may not find a cure on day one, but it can help understand people’s behaviour and habits” and their impact on disease, Jain said.

It’s not just major tech companies moving into health.

Research firm CB Insights this year identified 106 digital health startups applying machine learning and predictive analytics “to reduce drug discovery times, provide virtual assistance to patients, and diagnose ailments by processing medical images”.

Maryland-based startup Insilico Medicine uses so-called “deep learning” to shorten drug testing and approval times, down from the current 10 to 15 years.

“We can take 10,000 compounds and narrow that down to 10 to find the most promising ones,” said Insilico’s Qingsong Zhu.

Insilico is working on drugs for amyotrophic lateral sclerosis, cancer and age-related diseases, aiming to develop personalised treatments.

Finding depression

AI is also increasingly seen as a means for detecting depression and other mental illnesses, by spotting patterns that may not be obvious, even to professionals.

A research paper by Florida State University’s Jessica Ribeiro found it can predict with 80 to 90 per cent accuracy whether someone will attempt suicide as far off as two years into the future. 

Facebook uses AI as part of a test project to prevent suicides by analysing social network posts.

And San Francisco’s Woebot Labs this month debuted on Facebook Messenger what it dubs the first chatbot offering “cognitive behavioural therapy” online — partly as a way to reach people wary of the social stigma of seeking mental health care.

New technologies are also offering hope for rare diseases.

Boston-based startup FDNA uses facial recognition technology matched against a database associated with over 8,000 rare diseases and genetic disorders, sharing data and insights with medical centres in 129 countries via its Face2Gene application.

Cautious optimism

Lynda Chin, vice chancellor and chief innovation officer at the University of Texas System, said she sees “a lot of excitement around these tools” but that technology alone is unlikely to translate into wide-scale health benefits.

One problem, Chin said, is that data from sources as disparate as medical records and Fitbits is difficult to access due to privacy and other regulations.

More important, she said, is integrating data in healthcare delivery where doctors may be unaware of what is available or how to use new tools.

“Just having the analytics and data get you to step one,” said Chin. “It’s not just about putting an app on the app store.”

A small Swedish study of stroke patients finds that activities such as horseback riding and rhythm-and-music therapy can help them feel like they are recovering faster, even if their stroke occurred years earlier.

After 12 weeks of twice-weekly lessons, 56 per cent in the riding group and 38 per cent in the music group said they had experienced meaningful recovery compared to 17 per cent who were not given any extra activity. The self-reported benefit persisted six months after the lessons stopped.

Co-author Dr Michael Nilsson told Reuters Health by phone that the results counter the attitude that stroke patients can’t improve if a year has passed since their brain damage occurred.

“For a big, big, big group of stroke survivors, it’s highly unethical to say nothing can be done after 12 months,” said Nilsson, who directs the Hunter Medical Research Institute in New South Wales, Australia. That attitude can “kill the motivation for further rehabilitation”.

The findings are “interesting from a variety of standpoints,” said Dr Daniel Lackland, a professor of epidemiology and neurology at the Medical University of South Carolina in Charleston, who was not involved in the study.

“Most stroke recovery research seems to take place in the acute phase,” he told Reuters Health in a phone interview. “This is doing it at a later phase, which is very much needed.”

On average, the 123 Swedish volunteers started the study nearly three years after suffering their stroke.

The Nilsson team, writing in the journal Stroke, speculated that the physical and social aspects of riding or moving to the music were responsible for the improvements. However, it did not compare them to patients who were given other types of extra attention, such as twice-weekly group outings.

In addition, the study measured how the patients thought their rehabilitation was progressing, not how well they scored on more objective tests designed to measure their improvement.

Such tests of gait, balance, hand strength and memory sometimes did not show enough consistent benefit to rule out the possibility it was due to chance.

Nilsson said self-reported improvement was the point of the test. “We wanted their opinion” because positive self-perception “is the key for long term improvement. It is getting the patients engaged and motivated to participate, and to do that in an intense way.

“Why? We must understand that you need to be prepared to invest in training and rehabilitation over a long period of time to relearn and learn in new ways to master your disability,” Nilsson said.

The interventions were done on patients who were moderately debilitated. All could walk, use transportation services for the disabled and use the toilet without assistance.

Horseback riding sessions — which lasted four hours and included special exercises, grooming, equipping the therapy horse and 30 minutes of sitting on the horse as it was being led — produced an immediate jump in perceived improvement.

It was not until three months after the end of music therapy — where people were asked to move their hands and feet in time with the music in sessions lasting 90 minutes — that patients showed a comparable improvement in how they thought their recovery was going.

But when it came to more objective measures, the benefits were less clear.

Horseback riding produced immediate and significant improvements in gait and balance in all three tests used by the researchers, but by the sixth month of follow-up, only one of the three tests was still showing better performance. In the rhythm-and-music group, only one of the three tests showed a benefit, either immediately or at the six-month follow-up point.

Although limited, the data might help doctors tease out the best types of activities for retraining the brain, Lackland said. 

Nilsson, who is also a professor at the University of Newcastle in Australia and University of Gothenburg in Sweden said a larger follow-up study is being planned to confirm the findings. The results are also being analysed to see if the time elapsed since the stroke influenced how well individual patients did.

That from afar and to the untrained eye, the new Jeep Compass seems uncannily similar to the iconic off-road brand’s largest Grand Cherokee flagship is something that is not wholly unintentional. Capturing the uncompromisingly capable yet advanced and luxurious Grand Cherokee’s visual cues in somewhat miniature scale, the range-topping Compass Trailhawk version also encapsulates the off-road ability and rugged sense of freedom at the heart of the SUV phenomenon and particularly the Jeep brand. 

Uniquely combining genuine and extensive ability in a thoroughly modern package pitched at the increasingly more popular yet more car-like compact SUV and crossover segments, the Compass is refined, comfortable and efficient on-road, and packed with contemporary gadgets and tech. 

Rugged and authentic

Launched globally last week and expected to arrive in Middle East markets after a regional debut at the Dubai Motor Show in November, the Jeep Compass is offered in a range guises, engines and specification levels, but the pick of the crop is undoubtedly the strongly off-road biased Trailhawk, which carries the brand’s coveted “Trail Rated” badge of honour to indicate its off-road abilities. 

Shod with more off-road biased and forgiving tyres instead of bling items, the Trailhawk also receives underbody skid plates, higher 216mm ground clearance, and re-styled fascia for much enhanced 30° approach, 24.4° break-over and 33.6° departure angles to easily tackle treacherous off-road conditions, ruts, rocks and peaks.

Bearing an aesthetic relation to the Grand Cherokee, rather than styled as homage to the brand’s iconic Wrangler — as the original Compass circa 2006 and contemporary entry-level Renegade — the new Compass is compact yet wide, with short overhangs for improved off-road and on-road driving. With moody squinting headlamps flanking Jeep’s signature seven-slot grille, the Compass also features flared trapezoidal wheel-arches for a more assertive road stance. 

In rugged Trailhawk specification, it receives unique 43cm alloy wheels, rear tow hook and a higher more steeply angled bumper to dramatically improve its approach angle. An optional black roof and contrasting matt bonnet finish also lend it a sportier, more rugged and urgent charisma. 

Versatile delivery

Available with only two four-cylinder engine options in Trailhawk guise, the Compass is due to arrive in regional markets with Jeep’s naturally-aspirated 180BHP and 175lb/ft ‘Tigershark’ 2.4-litre petrol. However, at launch in Portugal and as driven, the Trailhawk was powered by the wider Fiat Chrysler Group’s gutsy, capable and frugal 2-litre common-rail turbo-diesel “Multijet” engine developing 167BHP at 3750rpm and 280lb/ft at 1750rpm.

Quick-spooling, responsive and with a broad sweet spot by turbo-diesel standards, the Trailhawk “Multijet” also benefits from a slick 9-speed automatic gearbox, with a wide range of ratios to minimise turbo-lag from standstill, improve responses, flexibility and high speed refinement and consistency and fluency in delivery. 

The right engine for the right vehicle with plenty of grunt for versatile overtaking on the highway and for climbing inclines and off-road trails easily, one hopes that Jordanian restrictions on modern turbo-diesel passenger vehicles will be eased in the future. Capable of carrying the 1615kg Trailhawk through the 0-100km/h sprint in 9.5-seconds and onto 196km/h, the 2.0 Multijet nevertheless delivers low 5.7l/100km combined cycle fuel efficiency. 

Driving the front wheels in normal conditions when in its default ‘‘auto’’ driving mode to help achieve such efficiency, the Trailhawk, however, automatically diverts power to the rear axle as and when needed to ensure, traction, safety and stability through corners of on low traction surfaces.

Mountain goat

Built on a stiff frame using 65 per cent high strength steel construction for on-road refinement and handling precision, as well as rugged off-road durability, the Compass is underpinned by all-independent suspension, with front MacPherson and rear Chapman struts, allowing for long wheel travel. 

With 170mm front and 200mm rear axle articulation, the Compass Trailhawk easily overcame deep ruts and steep inclines during off-road driving on a rocky, dusty and narrow trail at Sintra national park with mountain goat like proficiency. Meanwhile, the Trailhawk’s driveline can be locked four-wheel-drive mode for added traction and selectable low gear transfer allows for a 20:1 crawl ratio to traverse especially steep, loose and rough terrain. 

Leveraging the electronic stability and traction controls, ABS, throttle and four-wheel-drive systems, the Trailhawk’s Active Drive Low and Selec-Terrain off-road assistance systems work in tandem to tailor off-road ability for various conditions and to maintain stability and traction, and can send up to 100 per cent torque to an individual wheel when necessary. 

In addition to Auto, Mud and Sand modes, the Trailhawk uniquely features a Rock mode, which in conjunction with low gear ratios, allows for maximum off-road ability. The compass also features a hill descent function to regulate speed on loose off-road descents, while the infotainment system features a Jeep Skills function, which actively displays various off-road driving indexes. 

Well-packaged and equipped

Refined, relaxed and stable on highway and in traffic, the compact Compass Trailhawk also proved agile and nimble, by comparison with most SUVs, through Sintra park’s narrow and winding hill climbs and switchbacks, where its 10.76-metre turning circle made it manoeuvrable. 

With its quick 2.76-turn steering, rigid structure and precise chassis tuning, the Trailhawk proved direct for its class, yet well refined from road imperfections, which were dispatched in a forgiving and supple manner, and remained settled over sudden crests and dips. Through corners there is some body lean, but this is restrained and well controlled for a rugged and capable off-road SUV, while driving position was alert, comfortable and well adjustable.

Well-packaged and spacious inside, the Compass easily accommodated taller passengers, front and rear, while visibility for the most part is good, and cargo capacity generous, even with the Trailhawk version’s full size spare tyre, rather than tyre repair kit. User-friendly inside, the Compass also features good build quality and materials for its segment, with soft textures in prominent places and good use of interior design and colours. 

Well equipped with an exhaustive list of optional and standard features, including two choices of intuitive and technologically advanced infotainment systems, the Trailhawk’s driver assistance and safety system suite includes lane departure, and collision warnings, parking assistance, blindspot and rear crosspath detection and adaptive cruise control.

TECHNICAL SPECIFICATIONS

Engine: 2-litre, transverse, turbo-diesel 4-cylinders

Bore x Stroke: 83 x 90.4mm

Compression ratio: 16.5:1

Valve-train: 16-valve, common-rail, variable timing

Gearbox: 9-speed automatic, four-wheel-drive, low ratio transfer

Gear ratios: 1st 4.713:1; 2nd 2.842:1; 3rd 1.909:1; 4th 1.382:1; 5th 1:1; 6th 0.808:1; 7th 0.699:1; 8th 0.58:1; 9th 0.48:1

Reverse/final drive/crawl ratios: 3.81:1/4.334:1/20:1

Power, BHP (PS) [kW]: 167.6 (170) [125] @3750rpm

Specific power: 85.6BHP/litre

Power-to-weight: 103.7BHP/tonne

Torque, lb/ft (Nm): 280.2 (380) @1750rpm

Specific torque: 194.2Nm/litre

Torque-to-weight: 235.3Nm/tonne

0-100km/h: 9.5-seconds

Top speed: 196km/h

Fuel consumption, urban/extra-urban/combined; 6.6-/5.1-/5.7-litres/100km

CO2 emissions, combined: 148g/km

Length: 4394mm

Width: 1819mm

Height: 1638mm

Wheelbase: 2636mm

Ground clearance: 216mm

Approach/break-over/departure angles: 30°/24.4°/33.6°

Wheel articulation, F/R: 170/200mm

Trunk height, length, width: 691, 605, 1069mm 

Loading height: 754mm

Cargo volume min/max, with full-size spare tyre: 368-/1181-litres

Fuel capacity: 60-litres

Unladen weight: 1615kg

Trailer towing maximum: 1500kg

Steering: Electric-assisted rack & pinion

Steering ratio: 16.5:1

Lock-to-lock: 2.76-turns

Turning circle: 10.76-metres

Suspension, F/R: MacPherson struts/Chapman struts

Brakes, F/R: Ventilated disc, 305 x 28mm/disc, 278 x 12mm

Tyres: 215/65R17

The Return: Father, sons and the land in between

Hisham Matar

UK: Penguin Books, 2017

Pp. 280

This is an intensely personal memoir, yet Hisham Matar reveals not only his innermost thoughts and feelings, but much about the history and culture of his native Libya. The bridge between the private and public aspects of the narrative is his search for his father, Jaballa Matar. Poet, military officer, diplomat and businessman, the elder Matar became a major opponent of Qadhafi’s regime, and was imprisoned and later “disappeared”. 

The book opens in March 2012, as the author waits in Cairo’s airport, with his wife and mother, to fly to Benghazi, returning to Libya after 33 years. There he will reunite with his extended family, not least uncles and cousins who were with his father in prison, and follow other leads as to what happened to him. Along with anticipation, his ambivalence is palpable. He wants to return, yet he does not; he wants the truth, yet fears it. 

Since his father’s letters stopped in 1996, the same year that 1,270 prisoners were killed in the notorious Abu Salim prison where he was being held, his fate has been unknown. His absence and the uncertainty involved has unsettled Hisham ever since, affecting his ideas on life and death, love, family and exile: “It turns out that I have spent all the time since I was eight years old, when my family left Libya, waiting… my bloody-minded commitment to rootlessness… was my feeble act of fidelity to the old country, or maybe not even to Libya but to the young boy I was when I left.” (p. 25)

Matar weaves an engrossing narrative that moves back and forth between past and present — often collapsing the two, between real events, dreams and contemplation, between hopes, self-doubt and fears. There are happy childhood memories and the

anguish of losing a father. There are strikingly beautiful descriptions of European as well as Libyan landscapes. There are vivid blow-by-blow accounts of the 2011 revolution as Matar follows it via cell phone from London, where he has lived most of his life. The day revolutionaries broke into Abu Salim, releasing the prisoners, Matar talked with a man who was hammering away at the steel doors of the prison. Hopes of finding his father rose once again, only to be dashed. One prisoner had a photo of Jaballa, but had lost his memory entirely.

Though emotionally perilous, Matar’s return produces precious cameos of Libyans like his cousin, Marwan, who was transformed by the revolution: “He went from being a prosecutor infamous for not being able to get out of bed before noon to one of the most energetic and articulate campaigners for human rights.” (p. 107)

Matar introduces his uncles, well-versed in literature, some of them poets. A portrait of his grandfather, who fought with Omar Al Mukhtar against the Italian occupation, highlights a chapter in Libya’s history that — aside from Moustapha Akkad’s film — has received scant attention in the West. There are many other examples of Libyans’ rich history and culture that have been obscured from world view, whether by Qadhafi’s suppression or the recent chaos. 

Most compelling, however, is Matar’s frank admission of the deep psychological scars he has incurred: “We need a father to rage against. When a father is neither dead nor alive, when he is a ghost, the will is impotent.” (p. 34)

At the same time, he developed an acute sense of justice and awareness of the misuse of power: “Pain shrinks the heart. This, I believe, is part of the intention. You make a man disappear to silence him but also to narrow the minds of those left behind, to pervert their soul and limit their imagination. When Qadhafi took my father, he placed me in a space not much bigger than the cell Father was in.” (p. 246)

Reading such words, one might think that Matar let his life slide, but no. Inspired by his father’s integrity and productivity, he completed his education, became a literary scholar, university lecturer and successful author, though he mentions these things only in passing. Meanwhile, he mounted a sustained campaign demanding information about his father and his release, along with other political prisoners. 

Yet these accomplishments do not assuage the anger, guilt and sense of absurdity that coloured all his relationships and experiences: “Rage, like a poisoned river, had been running through my life ever since we left Libya. It made itself into my anatomy, into the details. Grief as a virus.” (p. 119)

Perhaps most of all, he grapples with hope, following up any hint, however fragile, that his father might still be alive, yet, fearful that he cannot survive more disappointment, or never knowing the truth for certain. 

The Return is a hauntingly beautiful book because of Matar’s deeply sensitive prose. It is also haunting in a negative sense because his father’s fate remains unresolved, and the cruelty involved in his case was meted out to so many. Matar does not pretend to draw grand conclusions; in fact, it is his total lack of pretentiousness that makes the book so genuine and compelling. Still, it could be interpreted as saying that although justice does not always win out, one must keep fighting for it, if life is to have any value.

“Where are the fan dancers?” I wondered aloud as I descended into a cave-like nightclub-cum-cabaret on the left bank. My friends and I sat down across from one another at a long table that spanned the rock-walled room. It was after midnight, and save for one other tipsy group, we had the place to ourselves.

At the far end of the room, beyond an archway, was a small stage at table height. Under blue lights, a middle-aged man crooned a vaguely Russian-sounding pop song in front of a two-piece band. He wore an untucked denim shirt and a blazer, over which his Kenny G-curly hair cascaded down to his elbows.

The Moulin Rouge, this was not.

It takes little persuading to get people to visit Paris, even if they’ve already been. The city has so much to offer that it takes repeated viewings to take it all in. Besides, once the big stuff is out of the way, there is more time on return trips to go off the beaten path. Which is how I wound up in this basement, wondering whether I’d made a mistake. (Spoiler alert: I had not.)

I had been to Paris before, in my early 20s, when I was broke and sleeping on the floor of a friend’s studio apartment. It was not the chic Paris that travellers dream of, yet I would still managed to get in the highlights: the Eiffel Tower, the Louvre, walks along the Seine.

For my return, more than 10 years later, I didn’t need to see the landmarks. Instead, I wanted to explore a different, more offbeat side of the City of Lights. The rules I made for myself were:

1. Stay in a neighbourhood that does not have a Hard Rock Cafe.

2. Do not stand on any lines with other tourists to see art.

3. Stay out all night at a “real” Parisian cabaret.

This wasn’t the trip for every Paris traveller. But for me, it was perfect. So, if you have already done Paris, here is how to do it again — differently.

Our group of eight, all friends from the gym, decided to share an apartment through Airbnb rather than get a hotel. Because of our size, we could not confine our search to a single neighbourhood. But when we did find what appeared to be the perfect apartment — spacious, and Haussmann-style glamorous — we passed on it because it was in central Paris, on a busy boulevard with an H&M and, yes, a Hard Rock.

Instead, we chose an apartment in the 12th arrondissement, a slice of eastern Paris beyond Place de la Bastille. Our modern home with a huge kitchen, loft and courtyard was on a metro and bus line to all the main sights in the city, and was just as easily walkable to the hip, crowded Marais neighbourhood. But there was little need to leave.

Around the corner was the Rue d’Aligre, an epicerie-studded street leading to one of Paris’ only daily markets, the Marche d’Aligre. The market is the nucleus of a Parisian foodie paradise. Every morning one of us would venture out into the neighbourhood to pick up a bag of the city’s best croissants at Ble Sucre. In the evening, we’d all spread out for warm baguettes, olives, Alsatian wine, Portuguese sausage, cheese from the Alps, and heavenly meringue puffs from Aux Merveilleux pâtisserie, and meet back at the apartment with our wares for a bountiful appetiser.

On Sundays, the streets explode with shoppers who come for fresh fish and produce, for oysters shucked on the sidewalk at wine bar Le Baron Rouge, or to browse vintage items at the flea market. Because this area does not get top billing in Paris guidebooks, there seem to be few other English-speakers in the crowd. That was never a concern, except when it came time to bargain for an immaculate red wool coat my partner spotted at the market. I nervously asked the seller in broken French how much it cost. We were relieved when he stuck up a single thumb to indicate 1 euro. No bargaining necessary.

Instead of standing in line to see a painting encased in bullet-resistant glass, peering through the heads of other tourists, I ventured to a wholly different kind of museum, where I had the chance not just to touch the art, but ride it.

The Musee des arts Forains, the museum of carnival arts, is located in Bercy, a far eastern district of Paris that was once home to wine storage warehouses for the city. A few of those old warehouses have been converted into a campus housing a massive private collection of fair rides and games from across Europe, dating to the 19th century.

The tour is in French and mainly populated with schoolchildren. But handouts in English cover everything, and our guide, an actor who could pass for a carnival barker himself, gave impromptu translations.

Each cavernous room is filled with artefacts such as wooden skee-ball-like games, mannequins adorned in the costumes of the Folies Bergere, animatronic opera singers and a whimsical hand-cranked organ. The funhouse highlights, however, are three working carousels. A Venetian scene has gondolas for seats. A more traditional German carousel has the standard horses. And the final, spectacular centrepiece of the museum is an entirely human-powered bicycle carousel, complete with brass pedals.

The bicycles are slanted inward, so they ride in a circle instead of a straight line. They make for a precarious balancing act, but once everyone’s feet get into rhythm, all riders contribute to the remarkably fast whirl. It is an exhilarating feat of cooperation, in stark contrast to elbowing your way to the front of the pack at the Louvre.

Did the Moulin Rouge? Try Aux Trois Mailletz.

On a tour through Montmartre, Paris’ fabled arts village, even our guide — someone who makes a living off selling Paris — could not muster any enthusiasm for the famous Moulin Rouge cabaret. “Go if it’s on your bucket list,” he said. Then he grimaced.

Sure, the red windmill is famous the world over for a kind of Paris fantasy out of a Toulouse-Lautrec poster. But its can-can kicks and snake dancers come with a high price tag and a fast turnaround; watch the show and you are kicked out for the next round of patrons.

On a quest for another Paris fantasy I had brought my group of friends to Aux Trois Mailletz. The two-level piano bar and cabaret, around the corner from Shakespeare and Company bookstore and near Notre Dame, does not seem to be on the radar of the many tourists passing by for more traditional watering holes.

Physical activity during and after pregnancy improves psychological well being and may protect against postpartum depression, according to a new analysis of existing research.

Even low-intensity exercise, such as walking with a baby stroller, was linked to a lower likelihood of depressive symptoms in new mothers, researchers found.

“The negative consequences of postpartum depression not only affect the mother but also the child, who can suffer poor emotional and cognitive development,” said study co-author Celia Alvarez-Bueno of the University of Castilla-La Mancha in Cuenca, Spain.

Postpartum depression, the most common complication of bearing a child, affects 1 in 9 women, according to the US Centres for Disease Control and Prevention. Symptoms can include anxiety attacks, insecurity, irritability, fatigue, guilt, fear of harming the baby and a reluctance to breastfeed. 

The symptoms start within four weeks of delivery and are considered severe when they last for more than two weeks, the study team writes in the journal Birth.

“That’s why it’s important to test the most effective strategies to prevent this disorder or mitigate the consequences,” Alvarez-Bueno told Reuters Health by email.

The study team analysed data from 12 controlled trials of exercise interventions during or after pregnancy between 1990 and 2016 that addressed the effects of physical activity on postpartum depression. The studies included a total of 932 women and all examined the severity of postpartum depression as well as including basic information about the length, frequency, type and intensity of the exercise.

The exercises used in the various studies included stretching and breathing, walking programs, aerobic activity, Pilates and yoga.

Compared to women who did not exercise, those who did had lower scores on depression symptom tests during the postpartum period, the researchers found. The apparent benefit of having fewer depression symptoms was seen even among women who did not meet the cutoff for a depression diagnosis.

“We expected that physical activity could reduce postpartum depressive symptoms,” Alvarez-Bueno said. “However, we were pleasantly surprised when we found that exercise after pregnancy also reduced depression among the women who didn’t have diagnosable symptoms.”

Most intervention programs lasted for three months or longer and recommended three to five exercise sessions per week, but the current study didn’t draw conclusions or provide recommendations about the type or length of exercise that would be most beneficial.

The American College of Obstetrics and Gynaecology recommended in 2009 that pregnant and postpartum women engage in 30 minutes of moderate physical activity most days of the week. 

“We know that exercise is just as effective as anti-depressants for adults. The trick is to get them to do the physical activity,” said Beth Lewis of the University of Minnesota in Minneapolis, who wasn’t involved with the study.

 “With postpartum depression, it’s even more complicated due to the increased stress and sleep deprivation after having a baby,” she told Reuters Health. “We’re starting to learn more about exercise and how it helps.”

Future studies should include more data about the types of physical activity programmes that could reduce depression, the study authors write. Health providers should know more about the duration, intensity and frequency of exercise to recommend to new mothers, Alvarez-Bueno noted.

“It remains unanswered how these characteristics improve postpartum depression prevention,” she said. “More research addressing this issue is urgently necessary because of the influence on both the mother and child.”

Lewis and colleagues are conducting a randomized trial that analyses home-based exercise and home-based wellness programmes among 450 mothers with a history of depression. In another study, they’re analysing exercise programs among low-income women at risk for postpartum depression.

“Exercise is often the first thing that gets crossed off the list when there’s a new baby,” Lewis said. “It’s important to take care of yourself through exercise to keep that well-being high.”

LOS ANGELES — Zombies from the television series “The Walking Dead” and other demons are coming to life for video game players in virtual worlds.

With new virtual reality systems, gamers will be climbing into colossal war machines to battle high-tech armies, wandering mutant-infested post-apocalyptic wastelands and going toe-to-toe with demons in new offerings unveiled at the Electronic Entertainment Expo this week.

While play on consoles or Windows-powered personal computers continued to dominate the annual industry gathering, virtual reality flourished as game makers invested in the future.

The number of E3 exhibitors involved with virtual or augmented realities more than doubled to 126 from 53 last year, according to the Entertainment Software Association behind the event.

“This by far, is the most exciting E3 as it comes to virtual reality,” said YouTube director of gaming Ryan Wyatt.

Bathing in carnage

Virtual reality versions of blockbuster video games “Fallout”, “Doom”,

 and “Skyrim” were part of a line-up unveiled by Bethesda Softworks.

“Virtual reality is something we have been at the forefront of for a while now,” said Bethesda vice president of marketing Pete Hines.

Later this year, shooter game “Doom” will “bathe you in virtual carnage” as a cybernetic survivor fighting off a demon invasion.

A VR version of “Fallout” will put players into a world destroyed by nuclear war, while they will face dragons in a full-length, open-world version of “Skyrim,” according to Bethesda.

Sony built on its library of games for its PlayStation VR gear, which works with top-selling PlayStation 4 consoles.

More than a million PS VR units have been sold, along with some 5.25 million VR games.

‘Breaking Bad’

Along with games, Sony is working on a VR “experience” spinning off the television series “Breaking Bad” in a partnership with producer Vince Gilligan.

Skybound Entertainment meanwhile announced it is collaborating on virtual reality games spinning off “The Walking Dead”, the post-apocalyptic television series.

“Our goal is to honour the visceral world that [Robert] Kirkman has created while giving the Walking Dead’s fans something to really sink their teeth into with robust games,” Skydance media chief executive David Ellison and operating officer Jesse Sisgold said in a statement.

A Skydance game titled “Archangel” shared behind closed doors at E3 let players take command a six-story-tall mechanised battle suit in a fight against a tyrannical corporation.

“Archangel” is to be released later this year.

“We decided to jump headfirst into the business of VR with ‘Archangel’ because we saw an emerging market and want Skydance to help write this story,” Skydance interactive president Peter Akemann told AFP.

“We know we’re only at the tip of the iceberg with what VR can ultimately deliver as a gaming medium but we believe wholeheartedly in its long term potential and are investing in it as such.”

Pushing the envelope

Sony, HTC and Facebook-owned Oculus are the top players in virtual reality head gear, each striving to stake out territory in the budding market.

And even though the VR audience is lean compared with the hundreds of millions of people with consoles or personal computers, game makers are prone to embracing new technologies and understand that compelling content can inspire consumers to follow suit.

“If you don’t start pushing the envelope, people won’t think about upgrading hardware,” YouTube’s Wyatt said of the drive toward richer graphics and immersive worlds in gaming.

“Publishers know the long-term payout that VR will have and are investing.”

Ultra-high definition graphics and virtual reality in games has been a bright spot in the personal computer, which is seeing that segment grow while the market overall declines.

While Sony’s VR headsets work with PS 4 consoles, competing gear requires computers that handle the demand of processing rich, immersive graphics in real-time.

This has created opportunity for chipmakers.

“We want to work with partners to get gaming titles that are really worthy... and to grow the player base for virtual reality,” Intel senior vice president Gregory Bryant said at an E3 press event the chip maker held in a Los Angeles theater.

“A lot of the technology and experiences we are showcasing transcend gaming; you can expect entertainment, music, sports and more.”

Gaming computer star Alienware and parent-company Dell boasted of continued investment in virtual reality and eSports.

“Virtual reality will never go away,” said Jon Peddie Research video game industry analyst Ted Pollak.

“But at the end of the day, game makers want to see a big install base of these headsets.”

SAN DIEGO — Text messages can help motivate Type 2 diabetics to lower their blood sugar levels, according to a new paper from a researcher at the Scripps Whittier Diabetes Institute.

Researchers worked randomly assigned 126 people whose blood sugar levels were not well controlled into two groups, one that received standard care and a second that received up to three motivational diabetes-related text messages per day for six months.

At the end of the period, those who received the texts had reduced their “A1c” blood glucose levels from 9.5 per cent to 8.5 per cent, a full one percentage point drop. Those who received standard care saw only a 0.2 percentage point decrease.

While the change was judged statistically significant, neither group was able to bring its average glucose level down to the recommended threshold of 5.7 per cent.

Still, text messages, which offered motivational messages around diet and exercise or reminded participants to check their blood sugar levels, had about the same sugar-lowering effects as some glucose-lowering medications.

Some of the text messages sent regularly to participants asked them to text back their blood sugar numbers after checking them, and those who did, researchers found, had better success at lowering glucose.

Dr Athena Philis-Tsimikas, the study’s co-author, presented the results Sunday at the American Diabetes Association’s annual meeting in San Diego.

“Taken together, these findings suggest that, on a wider scale, a simple, low-cost text message-based approach like the one offered through Dulce Digital has the potential to significantly benefit many people who struggle every day to manage their diabetes and maintain their health,” Tsimikas said in a statement.

Research took place with patients living in California’s San Diego and Riverside counties from October 2012 through August 2014. Participants were generally middle-aged, female and born in Mexico and reported, on average, less than ninth-grade education levels.