Month: February 2021

Categories : Neurology Obstetrics & GynaecologyTags :

Brain ‘Rewired’ by Sound Early in the Womb

On By ModernMedia

Playing music to foetuses in the womb to enhance their brain development is a popular practice even if thus far not grounded in science, but new research has shown that there may be some effect even at very early stages.

New research from John Hopkins University indicates that ‘wiring changes’ made in response to sounds occur even earlier than thought before. The ear canals of newborn mice only open after 11 days, while in humans, the ear canals open at 20 weeks’ gestation. The researchers used the mice as a model for human foetuses, and examined their neural connections at one week old.

“As scientists, we are looking for answers to basic questions about how we become who we are,” said Patrick Kanold, PhD, professor of biomedical engineering at The Johns Hopkins University and School of Medicine. “Specifically, I am looking at how our sensory environment shapes us and how early in foetal development this starts happening.”

Prof Kanold started out in electrical engineering before switching to neuroscience. His field of research is on the cortex, the outer layer of neurons underneath which lies the white matter which consists of connective neurons.

In developing foetuses, in the white matter, subplate neurons can be found at 12 weeks in human gestation and the second embryonic week in mice. This subplate neurons are the precursors to neurons and die off over a period lasting from before birth to several months old. Before they disappear, they make a connection between the thalamus, which is an important sensory gateway, and the middle layers of the cortex.

“The thalamus is the intermediary of information from the eyes, ears and skin into the cortex,” explained Prof Kanold. “When things go wrong in the thalamus or its connections with the cortex, neurodevelopmental problems occur.”

The subplate neurons respond to sound before the cortical neurons, prompting two questions for Prof Kanold: When sound signals reach the subplate neurons, does anything happen, and can a change in sound signals reflect changes in the brain circuits at these young ages?

To answer these questions, the researchers used mice genetically engineered to be deaf, unable to convert sound into nerve signals. In deaf, week-old mice, there were 25-30% more connections between subplate and cortical neurons.

“When neurons are deprived of input, such as sound, the neurons reach out to find other neurons, possibly to compensate for the lack of sound,” said Prof Kanold. “This is happening a week earlier than we thought it would, and tells us that the lack of sound likely reorganises connections in the immature cortex.”

To compare the difference extra auditory stimuli made, the researchers put 2-day old pups in a quiet enclosure or an enclosure with a constant beeping sound. There were differences between the subplate neuron connections for beeping and quiet enclosure mice, but not as great as between the deaf and hearing mice. The quiet enclosure mice had stronger connections between the subplate and cortical neurons, similar to the deaf mice. The mice in the beeping enclosure also had a greater diversity in neural circuitry.

“In these mice we see that the difference in early sound experience leaves a trace in the brain, and this exposure to sound may be important for neurodevelopment,” explained Prof Kanold.

The researchers are planning to examine how sound in early development impacts the brain in later life, as well as how sounds in the womb influences neural wiring. This has application for cochlear implants for children born deaf. They also plan to study premature infants neural wiring problems and develop biomarkers for abnormal subplate neuron development. 

Source: Medical Xpress

Journal information: Early peripheral activity alters nascent subplate circuits in the auditory cortex, Science Advances (2021). DOI: 10.1126/sciadv.abc9155

Categories : Gender Mental Health NeurologyTags :

Women are Better ‘Mind Readers’ Than Men, Study Finds

On By ModernMedia

Women are better at ‘reading minds’ than men, finds a new study aimed at better understanding social interaction and the challenges faced by people with autism. 

Sometimes known in the field of psychology as ‘mentalising‘, the process is when people try to ascertain what others are really thinking, for example when they are sarcastic or even lying. Mind-reading has some basis in neuroscience: for example, some research indicates that sensitivity to social interactions is associated with the posterior superior temporal sulcus, an area of the brain which is also known to process biological motion. Everybody has some proficiency with mind reading, and some are inherently better than others. However, some lack the ability to a point where it becomes difficult to function in society, for example in autism.

The study made use of a self-report questionnaire asking participants to rate how well, for example, they could relate to others. It used four questions, each with ratings from one to four, giving a maximum total score of 16. The researchers determined that women scored higher than men on the questionnaire, and also confirmed the challenges reported by those with autism. 

Senior author Dr Punit Shah, at the University of Bath’s Department of Psychology explained: “We will all undoubtedly have had experiences where we have felt we have not connected with other people we are talking to, where we’ve perceived that they have failed to understand us, or where things we’ve said have been taken the wrong way. Much of how we communicate relies on our understanding of what others are thinking, yet this is a surprisingly complex process that not everyone can do.”

Dr Shah emphasised that there is a different between mind-reading and empathy, saying: “Mind-reading refers to understanding what other people are thinking, whereas empathy is all about understanding what others are feeling. The difference might seem subtle but is critically important and involves very different brain networks. By focussing carefully on measuring mind-reading, without confusing it with empathy, we are confident that we have just measured mind-reading. And, when doing this, we consistently find that females reported greater mind-reading abilities than their male counterparts.”

Lead researcher, Rachel Clutterbuck, emphasised the clinical importance of the questionnaire. She said: “This new test, which takes under a minute to complete, has important utility in clinical settings. It is not always obvious if someone is experiencing difficulties understanding and responding to others—and many people have learnt techniques which can reduce the appearance of social difficulties, even though these remain.

“This work has great potential to better understand the lived experience of people with mind-reading difficulties, such as those with autism, whilst producing a precise quantitative score that may be used by clinicians to identify individuals who may benefit from interventions.”

Dr Shah added that this study was about helping to understand mind-reading capabilities, and had created a freely available questionnaire for other efforts in this regard.

Source: Medical Xpress

Journal information: Rachel A. Clutterbuck et al, Development and validation of the Four-Item Mentalising Index., Psychological Assessment (2021). DOI: 10.1037/pas0001004

Categories : COVIDTags :

Research Shows ‘UK Variant’ is up to 70% Deadlier

On By ModernMedia

A review of research on the COVID variant B.1.1.7, also known as ‘the UK variant’, has shown it to be 30% to 70% more deadly than the original wild-type COVID strain.

Concerns over the deadliness of B.1.1.7 were raised in January, when the UK government’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) presented initial findings suggesting that B.1.1.7 cases were deadlier than non-variant cases. After this, they released an updated report which is available online. The report makes the cases that the earlier linked community testing and mortality data were all based on the same datasets, and so had the same biases. However, the group explained that the new analysis was more valid.

“More recent analyses have added a wider range of data sets and been able to control for additional confounders, increasing confidence in the association of the [variant of concern] with increased disease severity,” the group wrote.  

London School of Hygiene & Tropical Medicine found a relative hazard of mortality within 28 days was 1.58 for variant-infected individuals, while Imperial College London used a case-control weighting method to find a case fatality ratio of 1.36 for variant cases. Public Health England  found a “death risk ratio” of 1.65 in matched cohort analysis for variant cases versus non-variant cases.

A number of other studies investigated the variant’s impact on hospitalisation. Public Health Scotland used S-gene target failure as a proxy for variant case detection. They found that S-gene target failure cases had a higher risk for hospitalisation than the S-gene positive cases.
Some studies did not support the higher fatality risk, such as the UK’s Office for National Statistics (ONS), which said that “the number of deaths are too low for reliable inference.”

A number of limitations were reported in the study, including potential bias in case ascertainment, representativeness, unmeasured confounders and secular trends. They also tried to control for nursing home status in hospital reports, but not all of these could be excluded.

“There are potential limitations in all datasets used but together these analyses indicate that it is likely that … B.1.1.7 is associated with an increased risk of [hospitalisation] and death compared to infection with non-[B.1.1.7] viruses,” the group concluded.

In mid-January, modelling by the CDC indicated that the UK variant would become the dominant strain in the United States by March. At the end of January, President Joe Biden had pledged to increase vaccinations to 1.5 million per day, a target which would still not be able to contain the spread of the variant.

Source: MedPage Today

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Categories : COVID General InterestTags :

WHO Team in China Denied Key COVID Information

On By ModernMedia

The World Health Organization team sent to China to investigate the origins of the COVID virus have been frustrated in their efforts to secure key data.

Team member Dominic Dwyer, infectious disease expert, said that they had only been given a summary instead of the raw patient data that they had requested.

Raw, anonymised patient data is part of standard outbreak investigation, Dwyer said, and this was particularly important because half of the initial 174 patients had no contact with the wet market.

“That’s why we’ve persisted to ask for that,” said Dwyer. “Why that doesn’t happen, I couldn’t comment. Whether it’s political or time or it’s difficult.”

Although Wuhan is the site of the initial outbreak, China has sought to cast doubt on its origin there, pointing to a source outside the country that may have come in with frozen food.

US national security adviser Jake Sullivan said that he had “deep concerns” over the initial findings of the investigation, saying that “It is imperative that this report be independent, with expert findings free from intervention or alteration by the Chinese government.”

Peter Ben Embarek, the WHO delegation leader, said that the virus likely had an animal origin and may have taken a “very long and convoluted path involving also movements across borders”. The possibility that it may have travelled in frozen food is worth investigating, he added.

After their two week quarantine, the WHO team members were only allowed to go on visits organised by their Chinese hosts. Thea Kolsen Fischer, an immunologist and another WHO team member, said to the New York Times that she saw the investigation as “highly geopolitical”.

“Everybody knows how much pressure there is on China to be open to an investigation and also how much blame there might be associated with this,” she said.

Team member Peter Daszak, and president of the EcoHealth Alliance, said that it “was not my experience”.

“As lead of animal/environment working group I found trust and openness with my China counterparts. We did get access to critical new data throughout,” he tweeted.

“New data included environmental and animal carcass testing, names of suppliers to Huanan market, analyses of excess mortality in Hubei, range of Covid-like symptoms for months prior, sequence data linked to early cases and site visits with unvetted live question and answer.”

Source: The Guardian

Categories : Diet and Nutrition PaediatricsTags :

Study Reveals More Sugar in Breakfast Products Aimed at Children

On By ModernMedia

Breakfast products that are aimed at children contain significantly more sugar than those aimed at adults, a Spanish study has revealed.

The researchers analysed a 355 advertisements from 117 different products from 2015 to 2019, and found that the average amount of sugar in the breakfast products analysed and advertised for adults was 10.25%, while for children it was 36.20%.

“Although much of the adult population still adhere to the Mediterranean diet, it is a practice that is waning among children and young people, who are increasingly opting to eat processed industrial products with a high sugar content for breakfast,” explained Mireia Montaña, UOC Faculty of Information and Communication Sciences professor and researcher.

Mònika Jiménez, professor of Advertising and Public Relations at Pompeu Fabra University (UPF) and co-author of another study on breakfast food advertising involving Prof Montaña, warned of persuasive advertising for foods with little nutritional value.

She said, “The less closely a product correlates to that which would be deemed healthy nutritional parameters, the greater the tendency for the advertising discourse to focus on hedonism or happiness and tend towards persuasion.” As Jiménez explained, when such discourse alludes to positive feelings, it stimulates certain areas of the brain that lead us to consume, a strategy which “is especially harmful in relation to certain audiences, such as minors, because they are very susceptible to these kinds of stimuli.”

Profs Montaña and Jiménez found that low nutritional quality breakfast foods were advertised mostly through television (39%), followed by radio (28%), the internet (18%), newspapers (6%), magazines (5%), outdoor advertising (2%) and cinema (0.56%). “TV is the most effective medium when it comes to persuading children. And when is it that children are going to the supermarket with their parents and end up imposing their preferences with regard to what goes into the shopping trolley? Precisely when they are younger, up until preadolescence,” Prof Jiménez pointed out.

Though there are regulations in Spain preventing advertisers from targeting children directly, there are no such restrictions for products which can be aimed at any age group, such as hot chocolate. Advertising aimed at children to use ‘pester power’ on their parents results in food being bought which is then consumed by the entire family. 

Their recommendations included more stringent regulatory frameworks, better nutritional education aimed at parents and children, and added taxes on certain products such as soft drinks.

Source: News-Medical.Net

Journal information: Blasco, M.M., et al. (2021) Breakfast Food Advertisements in Mediterranean Countries: Products’ Sugar Content in the Adverts from 2015 to 2019. Children. doi.org/10.3390/children8010014.

Categories : Medical Research & Technology Neurodegenerative DiseasesTags :

Scientists Develop AI Tool to Detect Parkinson’s Disease

On By ModernMedia

Researchers have developed an AI program that can assist physicians in performing a quantitative analysis when diagnosing Parkinson’s disease. 

As human populations continue to age due to improved medical care, there is an impending ‘Parkinson’s disease pandemic’ where numbers of individuals suffering this age-related neurodegenerative disease threaten to overwhelm healthcare systems. There is a need to distinguish between Parkinson’s and other diseases which have similar motor symptoms.
Assistant Professor Andrey Somov at the Skolkovo Institute of Science and Technology and colleagues developed a machine learning algorithm to analyse video recordings of patients performing certain tasks.

“As part of the research process, we had the opportunity to closely interact with doctors and medical personnel, who shared their ideas and experience. It was fascinating observing how two seemingly different disciplines came together to help people. We also had the opportunity to monitor all parts of the research, from designing the methodology to data analysis and machine learning,” Kovalenko said.

The advantages of the video analysis approach is that it is simple, objective, noninvasive, quick, inexpensive and versatile.

To develop the machine learning algorithm, the researchers recorded 83 patients with and without Parkinson’s performing 15 tasks that they had designed, such as filling a glass with water. These tasks were developed in a prior feasibility study using wearable sensors. The machine learning technology allows for objective analysis which picks up certain features of the disease which may not be visible to the naked eye.

Coauthor of the study Sklotech Assistant Professor Dmitry Dylov, and “Machine learning and computer vision methods we used in this research are already well established in a number of medical applications; they can be trusted, and the diagnostic exercises for Parkinson’s disease have been in development by neurologists for some time. What is truly new about this study is our quantitative ranking of these exercises according to their contribution to a precise and specific final diagnosis. This could only be achieved in collaboration between doctors, mathematicians and engineers.”

“This collaboration between doctors and scientists in data analysis allows for many important clinical nuances and details that help achieve the best results. We as doctors see great potential in this; apart from differential diagnosis, we need objective tools to assess motor fluctuation in patients with PD. These tools can provide a more personalized approach to therapy and help make decisions on neurosurgical interventions as well as assess the outcomes of surgery later,” noted coauthor of the paper, neurologist Ekaterina Bril.

Source: News-Medical.Net

Journal information: Kovalenko, E., et al. (2021) Distinguishing Between Parkinson’s Disease and Essential Tremor Through Video Analytics Using Machine Learning: a Pilot Study. IEEE Sensors.doi.org/10.1109/JSEN.2020.3035240.

Categories : NeurologyTags :

Geometric Model of Sherlock Episode Reveals How We Recall Events

On By ModernMedia

Using a TV episode and a geometrical model, researchers at Dartmouth have come up with a new way to understand how the brain evaluates which experiences to store as memories and which to discard.

The researchers based their study around participants’ recall of a BBC episode of Sherlock against a geometric model of the events that happened in it. Their results allowed new insights into how memories are stored and then related to others.

Senior author Jeremy R Manning, an assistant professor of psychological and brain sciences, and director of the Contextual Dynamics Lab at Dartmouth, explained: “When we represent experiences and memories as shapes, we can use the tools provided by the field of geometry to explore how we remember our experiences, and to test theories of how we think, learn, remember, and communicate.

“When you experience something, its shape is like a fingerprint that reflects its unique meaning, and how you remember or conceptualise that experience can be turned into another shape. We can think of our memories like distorted versions of our original experiences. Through our research, we wanted to find out when and where those distortions happen (i.e. what do people get right and what do people get wrong), and examine how accurate our memories of experiences are.”

Using a public dataset of brain recordings from 17 participants who had viewed the same Sherlock episode and described what had happened. This dataset also contained detailed notes on what took place in that episode. They took these notes to create a list of 32 topics, which were then represented as a 32-dimensional model. Visualised in 2 dimensions, a dot-to-dot shape emerges, to which the shapes made by the participants’ recall of events can be compared.

Using the episode’s shape as a structure, they were able to see at what points the participants’ memories matched the episode, and what points they forgot or had distorted recollections. The shape also featured extraneous elements of fine detail, like architectural embellishments such as carvings, which reflected low-conceptual details. Some participants accurately recounted these low-conceptual details while others could only recall high-level plot points.

“One of our most intriguing findings was that, as people were watching the episode, we could use their brain activity patterns to predict the distorted shapes that their memories would take on when they recounted it later,” explained Manning. “This suggests that some of the details about our ongoing experiences get distorted in our brains from the moment they are stored as new memories. Even when two people experience the same physical event, their subjective experiences of that event start to diverge from the moment their brains start to make sense of what happened and distill that event into memories.”

These findings could be used as the basis for research into improving educational delivery, as well as patients’ understanding of matters explained to them by their doctors.

Source: Medical Xpress

Journal information: Geometric models reveal behavioural and neural signatures of transforming experiences into memories, Nature Human Behavior (2021). DOI: 10.1038/s41562-021-01051-6

Categories : COVIDTags :

SA to Expedite 80 000 Doses of J&J Vaccine

On By ModernMedia

South Africa will accelerate the rollout of the Johnson & Johnson vaccine, it has been reported.

SA has secured orders for 9 million doses of the vaccine, of which the first 80 000 are expected to arrive in the country next week. Since immunity with the Johnson & Johnson vaccine is achieved with a single dose, this will be enough for 9 million people in South Africa, barring some inevitable wastage. Results from clinical trials in South Africa show that the vaccine has an effectiveness of 57%, 28 days after vaccination.

Professor Linda-Gail Bekker at the Desmond Tutu HIV Centre, University of Cape Town, who was involved in a South African trial last year, explained that there is a delay between the results of a clinical trial and the licence being granted for commercial use. She has urged the need for rapid vaccine rollout, and had also tested positive for COVID herself along with her family during the festive season. As a stopgap measure, an interim vaccination plan with 80 000 doses will be put into action at 32 locations around the country.

Explaining the programme, Prof Bekker said: “Can we together bring this expedited plan forward so that we can make sure we, as quickly as possible, rollout phase one recipients – mainly healthcare workers – into a kind of emergency programme.”

Prof Bekker describes the expedited rollout as being different to a clinical trial.

She continued, “This is not clinical research in the clinical trial concept; it really is programme evaluation, and many eyes are on it at the moment to make sure that we have covered all aspects – ethical, safety and scientific. We will not move without those approvals.”

Source: Eyewitness News

Categories : Neurology PaediatricsTags :

No Evidence for Strep Exacerbating Chronic Tics in Kids

On By ModernMedia

A new study has found that children with chronic tic disorders, mainly Tourette syndrome, do not have tic exacerbations when exposed to group A Streptococcus.

No significant association with tic exacerbations emerged across four definitions of pharyngeal strep exposure with a mean follow-up of 16 months, though a weak link was observed in trend, reported Davide Martino, MD, PhD, of the University of Calgary, and co-authors.

Strep was however significantly associated with longitudinal changes in hyperactivity-impulsivity symptom severity of 17% to 21%.
“The link between Streptococcus and tics in children is still a matter of intense debate,” Martino stated. “We wanted to look at that question, as well as a possible link between strep and behavioral symptoms like obsessive-compulsive disorder and attention deficit hyperactivity disorder.

“While our findings suggest that strep is not likely to be one of the main triggers for making tics worse, more research is needed into other possible explanations. For example, the social stress of having this disorder could be implicated in making tics worse more than infections. It’s also possible another pathogen might be triggering an immune response associated with tic worsening.”

In an invited editorial, Andrea Cavanna, MD, PhD, of the University of Birmingham, and Keith Coffman, MD, of Children’s Mercy Hospital in Kansas City, observed that group A Streptococcus had been posited as a potential environmental factor in tic disorders for the past two decades.

The editorialists noted that, on the basis of isolated clinical observations, tic disorders should be included as a collateral feature in conditions which are known as pediatric autoimmune neuropsychiatric disorders associated with Streptococcus (PANDAS) infections. However, the results of longitudinal clinical studies were inconclusive, with a case control study even arguing against the association.

Drawing data from the EMTICS study, recruiting children with chronic tic disorders from 2013 to 2016, one arm of the study prospectively examined associations between new group A Streptococcus throat exposures and tic exacerbations, obsessive-compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD) symptoms.

Four definitions of strep exposure were used: new definite (newly positive throat swab regardless of serological results), new possible (elevated anti-streptolysin O [ASOT] or anti-DNAseB [ADB] titers with negative or no throat swab), ongoing definite, and ongoing possible.

Initially, 59 children had a positive throat swab; as the study progressed, 103 children had new definite strep exposure. During follow-up, 308 children (43%) had tic exacerbations. The proportion of exacerbations temporally associated with strep exposure ranged from 5.5% to 12.9%, depending on exposure definition. No association between OCD symptoms and strep exposure was seen.

“Our study of the largest prospective cohort of youth with chronic tic disorders ever documented to date provides evidence against a temporal association between group A Streptococcus exposure and clinically relevant tic exacerbations,” the researchers wrote.

“This result indicates that specific diagnostic work-up or active management of group A Streptococcus infections in the context of worsening of tic severity in patients with chronic tic disorders is not warranted,” the researchers added.

The researchers noted that limitations included the data being collected from specialist centres in different countries, and that some cases of strep may have been missed.

Source: MedPage Today

Journal information (article): Martino D, et al “Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders: A Multinational Prospective Cohort Study” Neurology 2021; DOI: 10.1212/WNL.0000000000011610.

Journal information (editorial): Cavanna A, Coffman K “Streptococcus and Tics: Another Brick in the Wall?” Neurology 2021. DOI: 10.1212/WNL.0000000000011608.

Categories : COVID General InterestTags :

Chinatowns around the World Battle COVID and Xenophobia

On By ModernMedia

The BBC explores how the various Chinatowns around the world have been battling loss of business caused by COVID lockdowns, along with fear and xenophobia.

Sam Wo’s, a restaurant in San Francisco’s Chinatown, had been hit hard by COVID just like other businesses there.

The lockdowns had not yet happened but anti-Asian sentiment kept customers away. “All the Italian restaurants in North Beach were still busy and packed and then you went through the tunnel to Union Square and those guys had lines waiting to get in. And then you drive around Chinatown and it’s completely empty,”  Sam Wo’s co-owner Steven Lee told the BBC.

“So we know that xenophobia was affecting small businesses. Why would other districts be busy and we’re not?”

In the 12 months since, it has been forced to cut its staff numbers from 23 to three due to a lack of customers.

“People wouldn’t show up, they were just scared,” Mr Lee tells the BBC. “We had to rally and tell people to fight the virus, not the people and all this kind of stuff – but it didn’t help much.”

In the Japanese city of Yokohama, this went beyond mere avoidance; anti-Chinese notes were left on the doors of restaurants in March. Sales had plummeted to 10% of what they were the year before. The mayor of Yokohama railed against these notes, and locals voiced their support for their Chinatown, telling businesses to “hang in there” and promising to visit again.

In many Chinatowns, the lockdowns then worsened an already dire situation. 

“I know many businesses in Chinatown have closed. It’s terrifying,” Ying Hou, who runs Shandong MaMa in the Australian city of Melbourne, told the BBC. “There are gift houses where tourists come to buy souvenirs – most of them didn’t make it and have closed down.”

Ms Ying says her business is down 50%, but fortunately the shop is the only one in Chinatown to sell fish dumplings. Melbourne gave rent relief to many businesses, but this is now coming to an end. And now Melbourne is about to be plunged into a new five day lockdown surrounding the Australian Open. 

However, many are finding new answers to the problems posed by COVID. In New York, after Chinatown turned into a “ghost town” with the lockdowns closing down even essential businesses by May, Karho Leung took a page out of Hong Kong barber shops’ reactions to COVID and installed dividers and other measures. He advertised these safety enhancements, which went viral and resulted in a surge of business from pent-up demand.

Mr Leung added to his business and others that were struggling by embracing social media and online delivery companies such as Uber Eats. 
Organisations made up of ordinary citizens are also helping to keep their cities’ Chinatowns afloat as well. Send Chinatown Love is helping Chinatown businesses there with their online and social media presence to help generate business, creating “food crawls” to drum up foot traffic.

“Everything started happening around January, February of last year, which is the most lucrative and joyous and festive times for Chinatown. They took a hit with that business and lost most of it,” said Louise Palmer, who is a representative for the group. “So they ended up going into lockdown in March at a deficit, which kind of set a really terrible precedent for what the rest of the year would look like.”

Meanwhile, in San Francisco, in a hopeful development, business is picking up again since outdoor dining became allowed. Mr Lee said that Chinatown is booming again, and is planning to open a nightclub.

“We’re the oldest Chinatown in the country. We’re the tourist attraction that everybody comes to when they come to San Francisco. So we have to preserve it,” Mr Lee said.

Source: BBC News