THURSDAY, March 4, 2021 (HealthDay News) -- Who is more likely to relapse after opioid addiction treatment — women or men?

A new study that followed 1,100 recovering opioid users reveals that their risks are different.

The researchers followed the men and women for one year after treatment at more than 100 substance-use treatment facilities across the United States. During that time, 55% of the women and 51.5% of the men used opioids at least once. The study looked at more than 30 potential reasons for relapse.

For women, the greatest risk factors for opioid relapse were depression, more severe withdrawal and post-traumatic stress disorder (PTSD).

For men, the strongest risk factors included use of multiple substances and a history of conduct disorder. That's a behavior problem in which rules or basic rights of others are violated.

For both women and men, younger age was also a relapse risk, the findings showed.

The University of Southern California (USC) study was published online recently in the journal Addiction. The researchers said their findings may point the way to gender-targeted treatments.

"These results suggest that women would particularly benefit from treatments that aggressively address withdrawal symptoms with appropriate medications and cognitive behavioral approaches," said lead author Jordan Davis. He's associate director of the USC Center for Artificial Intelligence in Society, in Los Angeles.

"In contrast, men would likely benefit most from cognitive behavioral and mutual-help interventions that directly target substance use behaviors and support the development of pro-social behaviors," Davis added in a university news release.

During the COVID-19 pandemic, the United States has seen a spike in fatal drug overdoses, with two-thirds involving opioids. Over a 12-month period, the nation recorded 81,000 overdose deaths, according to the U.S. Centers for Disease Control and Prevention.

Treatment for opioid use disorder — which can include both medication and behavioral therapy — can be effective, but the risk of relapse is a persistent challenge, the researchers noted.

Future research should focus on ways to reduce the different and specific relapse risks among women and men, the study authors concluded.

More information

The U.S. National Institute on Drug Abuse has more on drug addiction treatment.

SOURCE: University of Southern California, news release, Jan. 6, 2021

THURSDAY, March 4, 2021 (HealthDay News) -- If your teen seems disinterested in school, new research suggests there's a good chance that things will get better over time.

"Our results point to a more hopeful picture for students who start out with lower levels of motivation," said study senior author Kui Xie, a professor of educational studies at Ohio State University in Columbus

The study included 1,670 students at 11 public high schools in central and northeastern Ohio who were followed for two years. They were in grades 9 to 11 at the start of the study.

Overall, the students' motivation to learn improved during the study period. For example, the percentage of students who were self-motivated to learn rose from 8% in the first year to over 11% in the second year.

Meanwhile, the percentage of students who had no motivation to do well in school fell from nearly 3% in the first year to about 2% in the second year, according to the study published online recently in the Journal of Educational Psychology.

One reason why there was a general positive shift in terms of motivation "may be simply because they're a year older and more developmentally mature," Xie said in a university news release.

Two other factors associated with higher levels of motivation included prior academic achievement and what the researchers called "school belongingness."

"This may be one area where we can help students become more motivated," Xie said. "Belongingness is something schools can change. They can find ways to help students feel like they are part of the school community."

This and a previous study by the same research team suggest that schools should routinely assess students' motivation to identify those most at risk for dropping out or underperforming.

Schools can create personalized intervention programs that target students based on their motivational profile, according to Xie.

"We need to tailor the motivation strategies to specific profiles," he said. "There is no one universal strategy that will work for all groups."

More information

The American Academy of Pediatrics has more on teens and school.

SOURCE: Ohio State University, news release, March 1, 2021

THURSDAY, March 4, 2021 (HealthDay News) -- Women with type 1 diabetes may have a shorter length of time to conceive and bear children compared to those without the disease, new research suggests.

The hormone insulin plays an important part in regulating female reproductive function, and people with type 1 diabetes don't make enough insulin on their own. But little was known about how type 1 diabetes affects the start of menopause, when a woman's ability to bear children ends.

To find out, researchers looked at nearly 300 women and compared women with type 1 diabetes to those without diabetes.

The findings showed that compared to women without diabetes, those with type 1 start menstruating later and enter menopause earlier. The researchers said this is because insulin deficiency and high blood sugar levels disrupt normal function of their reproductive system.

The study authors noted that these findings only apply to women who were diagnosed with type 1 diabetes before they started having periods, a milestone known as menarche.

Menopause is associated with a number of changes in metabolism and physical function, and early natural menopause is linked to increased risk of heart disease and death. As such, there is a need to identify factors that may help predict when a woman will enter menopause, the researchers noted.

In addition, more research is needed to identify modifiable factors that contribute to early menopause in women with diabetes in order to improve their reproductive health, according to study author Yan Yi, of the University of Pittsburgh, and colleagues.

The findings were published online March 1 in Menopause, the journal of the North American Menopause Society (NAMS).

"This study found that women with the onset of type 1 diabetes before menarche were at increased risk for a shorter reproductive lifespan. Thus, these women are not only at risk for premature ovarian aging because of early-onset type 1 diabetes, they are also at increased risk for cardiovascular disease, osteoporosis, and early mortality because of early natural menopause," said Dr. Stephanie Faubion, NAMS medical director.

"Understanding these risks and targeting appropriate risk-reducing strategies are key to optimizing the health and quality of life of these women," she added in a society news release.

More information

The U.S. Office on Women's Health has more about menopause.

SOURCE: North American Menopause Society, news release, March 3, 2021

WEDNESDAY, March 3, 2021 (HealthDay News) -- Teenagers who vape pot are more likely to wheeze and cough than those who smoke or vape nicotine, new survey data reveals.

Reports from U.S. kids 12 to 17 show they have a higher risk of wheezing, suffering from a dry cough, and having their sleep, speech or exercise impeded by wheezing if they vape marijuana products, according to results from the U.S. federally funded Population Assessment of Tobacco and Health Study.

These are all symptoms strongly related to lung injury, and it's unclear how long they will last, said lead researcher Carol Boyd, co-director of the University of Michigan's Center for the Study of Drugs, Alcohol, Smoking and Health.

"We found, and it was something that surprised us a bit, that it was the lifetime vaping cannabis that was associated with a far greater number of symptoms and a higher likelihood of having each of these symptoms than using either e-cigarettes or cigarettes," Boyd said. "Lifetime" referred to any past use.

Survey responses from nearly 15,000 teens showed that vaping pot increased their risk of wheezing or whistling in the chest by 81%, compared with a 15% increased risk from cigarettes and a 9% increased risk from nicotine e-cigarettes.

Vaping pot also increased teens' risk of:

• Sleep disturbed by wheezing by 71%
• Speech limited due to wheezing by 96%
• Wheezing during or after exercise by 33%
• Dry coughing at night by 26%.

Smoking and nicotine e-cigarette use also increased risks for these indications of lung injury, just not by as much, Boyd said.

"I think that industry would probably like to show that vaping e-cigarettes is healthier, that it's the cannabis vaping causing these respiratory symptoms, not the e-cigarettes. This is not true. E-cigarette vaping also causes symptoms among youth," Boyd said. "However, in our study, and when we took into account their e-cigarette use, we found higher odds of having these respiratory symptoms among youth who had vaped cannabis."

The survey was taken between December 2016 and January 2018 -- prior to the wave of lung injuries among young people that occurred in 2019. It was given the name EVALI, or e-cigarette or vaping use-associated lung injury.

Boyd thinks some of these lung problems reported in the survey were probably due to EVALI, which has been linked to pot-laced e-liquids and particularly those containing vitamin E acetate.

According to the U.S. Centers for Disease Control and Prevention, 4 out of 5 patients with EVALI had vaped cannabis, versus only about 16% who said they were only vaping nicotine.

In addition, vitamin E acetate was found in the lung fluid of all patients with EVALI, but never in people who weren't suffering from lung injury related to vaping, Boyd noted.

"It could be a lot of things that cause respiratory symptoms among vapers, including cannabis vapers," Boyd said. "There are other things in these compounds. But right now, there appears to be a notable association between EVALI and vitamin E acetate."

Dr. Albert Rizzo, chief medical officer of the American Lung Association, says that vaping products remain largely unregulated, despite promises by the U.S. Food and Drug Administration to enforce product standards among e-cigarette manufacturers.

"The FDA doesn't make sure that these substances have in them what they say on the label, so you're always at the mercy of the manufacturer," Rizzo said. "They've really not been taking the action they need to. The dates have gone by when some of the products on the market should have been submitting data to the FDA. They're not keeping to the timeline they said they would as far as removing products from the market."

Folks thinking about vaping pot should keep in mind that they could be drawing just about anything into their lungs, Rizzo said.

"Rather than trying to pigeonhole a specific term like EVALI as a concern for some of this cannabis use in electronic devices, I think it's more important to look at the broader picture of what inhaling any substance like this can do to the airways and the lungs," Rizzo said.

The study appears in the March 3 Journal of Adolescent Health.

More information

The American Lung Association has more about EVALI.

SOURCES: Carol Boyd, PhD, co-director, University of Michigan's Center for the Study of Drugs, Alcohol, Smoking and Health, Ann Arbor; Albert Rizzo, MD, chief medical officer, American Lung Association; Journal of Adolescent Health, March 3, 2021

WEDNESDAY, March 3, 2021 (HealthDay News) -- The first U.S. case of a Brazilian COVID-19 variant that doctors fear can re-infect the previously sick surfaced in Minnesota in early January 2021, and the more infectious variant has since been found in four other states, a new government report says.

Known as the P.1 variant, it first appeared in a Minnesotan who'd recently traveled to southeastern Brazil, according to Melanie Firestone of the the Minnesota Department of Health and the U.S. Centers for Disease Control and Prevention, and colleagues.

That patient was hospitalized for nine days with COVID-19, and another person in the household who traveled with the person also developed symptoms and was diagnosed with the P.1 variant, the CDC report said. But contact tracing among fellow flight passengers and health professionals who cared for the Minnesota patient found no further infections.

The findings were published online March 3 in the CDC's Morbidity and Mortality Weekly Report.

As of Wednesday, the CDC has reported 10 cases of the Brazil variant in the United States across five states: five in Florida; two in Minnesota; and one case each in Alaska, Maryland and Oklahoma.

Compared to two other more contagious variants first spotted in the United Kingdom and South Africa, research on P.1 has been slower to come since its discovery in late December, so scientists don't really know how much to worry about it, The New York Times reported.

"I've been holding my breath," Bronwyn MacInnis, an epidemiologist at the Broad Institute in Cambridge, Mass., told the newspaper.

But a series of unpublished studies reported this week that the P.1 variant has infected some people who developed natural immunity from previous bouts of COVID-19, the Times reported. Lab experiments also suggest the variant could weaken the protection provided by a Chinese vaccine now being distributed in Brazil.

P.1 was first discovered in late December in the Brazilian city of Manaus, in the Amazon Jungle. The variant is currently spreading across Brazil and has been found in 24 other countries, according to the Times.

"The P.1 variant is particularly notable because of its ability to evade both vaccine-induced and natural immunity," said Dr. Amesh Adalja, a senior scholar with the Johns Hopkins Center for Health Security, in Baltimore.

"However, it is important to remember that when it comes to this variant, vaccines -- while they may not be able to stop symptomatic infection -- halt what is important: serious disease, hospitalization and death," Adalja said.

If vaccinated people start having breakthrough COVID-19 infections, that's when we should start worrying and looking to tweak vaccines to enhance their protective capabilities, Adalja explained.

"That has not occurred yet to my knowledge, and may not occur," Adalja said. "Nevertheless, it is important to study alternative vaccine strategies for this variant."

More information

The U.S. Centers for Disease Control and Prevention has more about COVID-19 variants.

SOURCES: Amesh Adalja, MD, senior scholar, Johns Hopkins Center for Health Security, Baltimore; The New York Times; Morbidity and Mortality Weekly Report, March 3, 2021, online

WEDNESDAY, March 3, 2021 (HealthDay News) -- College students with attention-deficit/hyperactivity disorder (ADHD) have a harder time making it to graduation than their peers do, a new study suggests.

Researchers found that of 400 students they followed, those with ADHD had a lower grade-point average (GPA) -- about half a grade lower -- than students without the disorder. The gap emerged freshman year, and persisted throughout college.

And in the end, students with ADHD were less likely to make it through four years.

The findings start to fill in a knowledge gap, the researchers said.

Even though the college years are a critical time for young people with ADHD, fairly little has been known about how they fare.

"The transition to college is difficult, even for students without ADHD," said Christopher La Lima, a child and adolescent psychologist who was not involved in the study.

That's partly because college involves more than academics, according to La Lima, who is based at NYU Langone Health's Hassenfeld Children's Hospital, in New York City.

In sharp contrast to their high school days, he said, college students are on their own in managing their time and staying organized, without parents or teachers keeping close watch.

Then there are the many distractions that come with new independence, new living conditions and making new friends.

Even the academic part is different from high school, La Lima noted. Deadlines, for example, may stretch out over long periods, which can easily lead to procrastination and last-minute "cramming."

A disorder of self-regulation

George DuPaul, a professor of school psychology at Lehigh University in Bethlehem, Penn., is the lead researcher on the study.

He, too, said that even when kids with ADHD do well academically -- well enough to get into a four-year college -- they can still struggle with the distractions of college life.

"ADHD is a disorder of self-regulation," DuPaul said. And when the support system of parents and teachers is no longer there, it's challenging, he added.

For the study, DuPaul and colleagues at the University of North Carolina-Greensboro, University of Nebraska-Lincoln and University of Rhode Island followed 406 students across eight semesters. As freshman, 97 had ADHD and were taking medication, while another 104 had the disorder but were not on medication. The rest (205) did not have ADHD.

On average, students with ADHD maintained a lower GPA over all four years. Those on medication were particularly behind, with a GPA hovering around 2.5 in their final two years. In contrast, students without ADHD generally maintained a GPA above 3.0.

The reasons are not clear. But, DuPaul said, students who needed medication might have had more severe symptoms.

When it came to completing four years, students with ADHD again lagged. Of those not taking medication, 49% either graduated or finished eight semesters, versus 59% of the students without ADHD.

That figure was somewhat higher -- 54% -- among students who were on ADHD medication.

It's not that colleges offer no support to students with ADHD. DuPaul said campuses do have services, including academic help and accommodations such as written instructions (rather than just verbal), permission to record lectures, or extra time for test-taking.

Will they ask for help?

But since college students are adults, they have to seek the services.

One of the striking findings in this study, DuPaul said, was how few students with ADHD participated.

"More than half did not receive any academic support," he said.

It's not clear why, but DuPaul said some students may have been unaware the services existed, while others may have passed.

Sometimes, he noted, students resist help because they want to be "independent" or don't want to appear "weak."

But both DuPaul and La Lima encouraged students to get the services they need. Parents can do their part, they said, by talking to their kids -- before they leave for college -- about the challenges that may come up, and how to get help.

It's also important that kids with ADHD not beat themselves up over lackluster performance, La Lima said.

"At some point, you're going to drop the ball," he said. "Nobody's perfect."

DuPaul noted that students' overall mental health is critical. People with ADHD commonly have co-existing conditions, he said, including depression. And in this study, students with depression symptoms generally had more difficulty with studying.

Getting psychological services to those students is also key, DuPaul said.

The study findings were published online Feb. 2 in the Journal of Clinical Child & Adolescent Psychology.

More information

The Attention Deficit Disorder Association has more on ADHD and college services.

SOURCES: George DuPaul, PhD, professor, school psychology, College of Education, Lehigh University, Bethlehem, Penn.; Christopher La Lima, PhD, child and adolescent psychologist, Hassenfeld Children's Hospital, NYU Langone Health, New York City; Journal of Clinical Child & Adolescent Psychology, Feb. 2, 2021, online

WEDNESDAY, March 3, 2021 (American Heart Association News) -- Stuck in traffic, with a nasty storm making a stressful commute even worse, Joanne Loewy reached for the car radio.

"I felt my heartbeat rise," said Loewy, director of the Louis Armstrong Center for Music and Medicine at Mount Sinai Beth Israel in New York City. "So I switched to the Bach cello suite in my 'traffic burden' playlist. I just … said, 'I'm not going to worry. I'm just going to breathe and release it all.'"

At the other end of the metronome, Dr. David Alter, who studies the use of music in promoting cardiac health, uses the Rolling Stones to help him power through a workout.

"It's almost like a medicine," said Alter, a cardiologist at University Health Network in Toronto, and a senior scientist at its KITE Research Institute. "Our research, recently published in the journal Psychology of Sport and Exercise, has shown that music can distract us from the pain of exercise. That's why we may be able to exercise longer or more intensively with music."

Such is the therapeutic power of music. Even in ancient times, Greek physicians used flutes and stringed instruments for healing. Today, researchers are still sorting out the health benefits.

"There is an overall perception that music does us good," Alter said. "But we need to prove it scientifically. I do think we're getting more rigorous in our scientific approach."

Recent studies underscore the point. A 2020 study published in the Journal of Cardiothoracic Surgery showed music therapy eased pain, anxiety and depression among people recovering from coronary bypass surgery.

Similarly, people with episodes of chest pain soon after a heart attack who listened to music for 30 minutes a day over seven years reported less anxiety and chest pain – and had a lower rate of cardiac death – than those who did not. Those preliminary findings were released last March at the American College of Cardiology's virtual conference.

A 2018 study in Scientific Reports even suggests music therapy could make high blood pressure medication more effective.

In general, Alter said, there are two schools of thought about why music is effective.

"One says the music itself can stimulate all the healthy hormones and body functions to lower blood pressure and improve heart rates," he said. "But the other school of thought says it's really the behaviors we're doing that are helping our heart, and music is just helping us improve those behaviors."

The latter argument, Alter said, is especially true for one of the most important things people can do for their heart: exercise.

"We know that exercise is a game changer in terms of survival, longevity and quality of life," he said. "I don't think those are governed directly by the music, but music can help us with those healthy lifestyle choices and behaviors, and they improve our heart function."

The rhythms of music, Loewy said, can influence breathing, which also affects heart function. Besides the benefits of lowering stress, she said, "breathing and heart rates go hand in hand. We know if we can slow the pulmonary function and have stronger inhalations where more oxygen is absorbed in the blood, we'll have better cardiac outcomes."

The clear conclusion, Loewy said, is music should be part of everyone's health plan. Her center serves people of all ages and many conditions, from developmentally delayed children to young people with emotional issues and adults with chronic illnesses.

"Every person may benefit from a different kind of music based on their culture, their past history, their genes and their resilience," she said. "A music therapist can help figure out what is healthiest for you."

Even without consulting a professional, healthy people can put music to work for them every day – and night. Find the right accompaniment to charge up a workout, then play a more soothing tune to ease into a good night's sleep.

"I like Eminem, but it activates me. So, I know I shouldn't be listening to that before I go to sleep," said Loewy, who suggests turning off TVs and devices an hour before bedtime. "Find some music that relaxes you."

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Michael Precker

WEDNESDAY, March 3, 2021 (Healthday News) -- The United States is now poised to have enough COVID-19 vaccines for every American adult by the end of May, President Joe Biden said Tuesday.

The announcement, which came during a brief speech at the White House, accelerates the country's vaccination goals by two months.

"As a consequence of the stepped-up process that I've ordered and just outlined, this country will have enough vaccine supply -- I'll say it again -- for every adult in America by the end of May," Biden said. "By the end of May. That's progress -- important progress."

How was it possible to speed up the U.S. vaccine rollout?

Biden said his administration provided support to Johnson & Johnson so the company and its partners can make vaccines around the clock, The New York Times reported. In addition to that, the administration brokered a deal in which the pharmaceutical giant Merck & Co. would help manufacture the newly approved Johnson & Johnson single-shot coronavirus vaccine.

Although its own attempt at making a COVID-19 vaccine failed, Merck is the world's second-largest vaccine manufacturer, according to the Times. White House officials described the partnership between the two competitors as historic and said it harkens back to the wartime manufacturing campaigns that former President Franklin D. Roosevelt put into place.

Biden also said Tuesday that he wanted all teachers to receive at least one shot by the end of this month, the Times reported.

Biden's announcement came days after the U.S. Food and Drug Administration authorized the emergency use of the Johnson & Johnson vaccine. As of Wednesday, 78.6 million Americans had been vaccinated, with just over 26 million getting their second shot.

Even as vaccinations ramp up, public health officials worry about another surge of coronavirus cases, as new, more infectious variants emerge and states like Texas and Mississippi lift their mask mandates and roll back many of their coronavirus restrictions. Although cases have dropped significantly since January, they are now leveling off, the Times reported.

"We cannot let our guard down now or assure that victory is inevitable," Biden said Tuesday. "We can't assume that."

U.S. will stick with two doses of Pfizer, Moderna vaccines: Fauci

The United States will stick with its plan to give millions of Americans two doses of the Pfizer and Moderna coronavirus vaccines, Dr. Anthony Fauci said Monday.

The nation's top infectious diseases expert told the Washington Post that shifting to a single-dose strategy for those two vaccines could leave people less protected, allow more contagious variants to spread and make Americans already hesitant to get the shots even more wary.

"We're telling people [two shots] is what you should do … and then we say, 'Oops, we changed our mind'?" Fauci said. "I think that would be a messaging challenge, to say the least."

Fauci said he spoke on Monday with health officials in the United Kingdom, who are delaying second doses to give more people shots more quickly. He said that although he understands the strategy, it wouldn't make sense in America. "We both agreed that both of our approaches were quite reasonable," Fauci told the Post.

Some public health experts have asked U.S. policymakers to reconsider whether millions of doses intended as second shots could be distributed as first doses instead — to offer at least some protection to a greater number of people. The issue gained steam after an advisory committee to the U.S. Centers for Disease Control and Prevention on Monday tackled the question while approving Johnson & Johnson's single-shot coronavirus vaccine.

About 80 percent of adults have yet to get a single dose, according to CDC data.

Fauci told the Post the science shows that a two-shot regimen creates enough protection to fend off more contagious coronavirus variants, while a single shot could leave Americans at risk from these variants. There is insufficient data showing how long the immunity provided by one shot would last. "You don't know how durable that protection is," he noted.

Fauci also argued that Pfizer's and Moderna's recent commitment to deliver 220 million total doses by the end of March, in addition to Johnson & Johnson's pledge to deliver nearly 20 million shots this month, should make the issue moot.

"Very quickly the gap between supply and demand is going to be diminished and then overcome in this country," he said. "The rationale for a single dose -- and use all your doses for the single dose -- is when you have a very severe gap between supply and demand."

FDA Approves J&J's single-dose COVID vaccine

The U.S. Food and Drug Administration on Saturday approved Johnson & Johnson's single-shot coronavirus vaccine for emergency use after its advisory panel unanimously backed the vaccine a day earlier.

Adding a third vaccine to the country's arsenal will help boost the nation's limited supply of the two authorized shots, from Pfizer and Moderna.

Nearly 4 million doses of the newest COVID-19 vaccine were shipped Sunday night, and will begin to be delivered to states for injections starting on Tuesday, the Associated Press reported.

The White House said the entire stockpile of the newly approved single-dose Johnson & Johnson vaccine will go out immediately. J&J will deliver about 16 million more doses by the end of March and 100 million total by the end of June.

Advisory panel members said the J&J approval made sense.

"It's a relatively easy call; it clearly gets way over the bar, and it's nice to have a single-dose vaccine," said Eric Rubin, an infectious diseases specialist at the Harvard T.H. Chan School of Public Health and a member of the FDA advisory panel.

Infectious disease experts also welcomed the approval.

"The addition of a third COVID-19 vaccine substantially reduces the time it takes the U.S. to reach herd immunity -- when a high enough proportion of the population is immunized and we can disrupt the spread of this disease," said Dr. Lisa Lee, a public health expert who specializes in infectious diseases.

"Getting 75-85% of the population vaccinated will be easier with this additional vaccine option, especially because it, unlike the first two, does not require a complex frozen or ultra-frozen transport and storage system, and requires only one shot, instead of the two required by the others," said Lee, who is associate vice president for research and innovation at Virginia Tech.

FDA briefing documents showed the J&J vaccine had an overall efficacy rate of 72 percent in the United States and 64 percent in South Africa, where a concerning variant emerged in the fall and has since spread to the United States, the Times reported.

The vaccine was particularly effective at preventing severe illness or death: It showed 86 percent efficacy against severe forms of COVID-19 in the United States, and 82 percent against severe disease in South Africa. None of the nearly 22,000 vaccinated people in the trial died of COVID-19.

A global scourge

By Wednesday, the U.S. coronavirus case count passed 28.7 million while the death toll passed 515,700, according to a Times tally. On Wednesday, the top five states for coronavirus infections were: California with nearly 3.6 million cases; Texas with more than 2.6 million cases; Florida with over 1.9 million cases; New York with over 1.6 million cases; and Illinois with nearly 1.2 million cases.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

In India, the coronavirus case count was more than 11.1 million by Wednesday, a Johns Hopkins University tally showed. Brazil had over 10.6 million cases and more than 257,000 deaths as of Wednesday, the Hopkins tally showed.

Worldwide, the number of reported infections passed 114.8 million on Wednesday, with over 2.5 million deaths recorded, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

SOURCES: The New York Times; Associated Press; Washington Post

Texas, Mississippi Drop Mask Mandates

Texas has lifted its mask mandate and all businesses can reopen next Wednesday with no seating limits, Gov. Gregg Abbott announced Tuesday.

Abbott's moves came as federal health officials have cautioned governors against easing restrictions because nationwide progress against the COVID-19 pandemic has plateaued in the last week, The New York Times reported.

"To be clear, COVID has not, like, suddenly disappeared," Abbott acknowledged. "COVID still exists in Texas and the United States and across the globe."

However, "state mandates are no longer needed," because better treatments are now available for COVID-19 patients, the state can conduct large numbers of tests each day and Texans have already received 5.7 million vaccine shots, according to Abbott, theTimes reported.

While saying that most state restrictions would be lifted, Abbott did not specify which mandates would remain in place. He said Texans could decide for themselves what precautionary measures they want to take to limit the spread of the virus and that top elected officials in each county could reimpose restrictions if hospital capacities passed 15 percent, the Times reported.

"At this time, however, people and businesses don't need the state telling them how to operate," he said, the Times reported.

Shortly after Abbott's announcement, Gov. Tate Reeves announced that he would end Mississippi's statewide mask mandate, effective Wednesday, NBC News reported.

On Monday, CDC Director Rochelle Walensky strongly cautioned against the rollbacks that Abbott and Reeves were about to announce.

"I am really worried about reports that more states are rolling back the exact public health measures we have recommended to protect people from COVID-19," Walensky said during a White House briefing, NBC News reported.

"Please hear me clearly," Walensky said. "At this level of cases with variants spreading, we stand to completely lose the hard-earned ground we have gained."

Dolly Parton Gets Shot of COVID-19 Vaccine She Backed

Dolly Parton has received a shot of the COVID-19 vaccine whose development she helped fund.

The 75-year-old country music star received her first dose of the Moderna vaccine on Tuesday from her friend Dr. Naji Abumrad, CBS News reported.

Parton tweeted a video of herself getting vaccinated, saying she and Abumrad have been "friends forever."

"I thought it was only appropriate that you should be the one to give me my shot today," she said.

Tennessee began vaccinating those aged 70 and older at the beginning of February. Parton is 75.

Less than a year ago, Parton donated $1 million to help Abumrad develop the vaccine at Vanderbilt University. When she got vaccinated, Parton said quipped that she "got a shot of her own medicine."

Parton also had a message for those who may plan on avoiding getting vaccinated.

"I'm old enough to get it and I'm smart enough to get it. ...The sooner we get to feeling better, the sooner we are going to get back to being normal," Parton said during the video. "So I just wanna say to all of you cowards out there, don't be such a chicken squat, get out there and get your shot."

"Dolly's generous support helped fund early research at Vanderbilt Health into what is now a vaccine that's helping end the pandemic," the Vanderbilt University Medical Center tweeted.