A high-stakes lawsuit over the future of a widely used abortion drug is likely heading to the US Supreme Court, set to determine the fate of abortion rights access across the country for a second time within two years. Three Republican-appointed judges on a federal appeals court have determined that the federal government did not follow proper procedures when it amended regulations for a commonly used medication abortion drug in 2016. But the restrictions will not immediately take effect. The panel partially upheld a ruling from a Donald Trump-appointed federal judge in Texas, whose sweeping decision earlier this year threatened to strip access to the drug altogether. Nothing in the ruling from a three-judge panel on 16 August will go into effect until the nation’s highest court weighs in. Wednesday’s ruling argues that the US Food and Drug Administration unlawfully expanded access to mifepristone, which was first approved by the federal government more than 20 years ago. Mifepristone was first approved by the FDA in 2000 and is approved for use up to 10 weeks of pregnancy. A vast majority of abortions occur within the first nine weeks of pregnancy. From 2019 through 2020, nearly 93 per cent of all abortions were performed before the 13th week, according to the US Centers for Disease Control and Prevention. The drug – part of a two-drug protocol for medication abortions, the most common form of abortion care in the US – is the subject of a lawsuit from a group of anti-abortion activists represented by right-wing Christian legal group Alliance Defending Freedom, which joined efforts to overturn Roe v Wade at the Supreme Court last year. In April, US District Judge Matthew Kacsmaryk – a former right-wing activist lawyer who was appointed to the federal judiciary by Mr Trump – issued a ruling to suspend the FDA’s approval, which was immediately challenged by abortion rights advocates, providers, major medical groups, drug manufacturers and President Joe Biden’s administration. An initial ruling at the US Court of Appeals for the Fifth Circuit blocked part of that decision but struck down policies for mail-in prescriptions and rules that expanded the drug’s approval for pregnancies up to 10 weeks. On 21 April, the Supreme Court blocked the lower courts’ rulings from taking effect while the case plays out, retaining the status quo while the legal case plays out. Following the Supreme Court’s conservative supermajority decision to revoke a constitutional right to abortion care in Dobbs v Jackson Women’s Health Organization, at least 15 states – mostly across the US South – have effectively banned most abortions and imposed criminal penalties against providers. Abortion rights advocates and providers have warned that eliminating or restricting access to mifepristone could drastically impact an already-fragile landscape for abortion care. A ruling that undermines the FDA’s drug approval process could also open the door for other activist-driven legal battles over other drugs wrapped up in political debates, potentially inviting other destabilising lawsuits to Covid-19 vaccines, contraception, HIV medication, gender-affirming care, and other life-saving drugs. Read More What is mifepristone? The widely used pill in the abortion rights battle at the Supreme Court Abortion rights advocates win major victory in Ohio as voters reject GOP plan to thwart ballot measure Texas women detailed agonising pregnancies after being denied abortions. The state blames doctors Some abortion drug restrictions upheld by in a case bound for Supreme Court Akram criticizes Pakistan Cricket Board for leaving Imran Khan out of Independence Day video Netanyahu voices support for Israel's military after his allies and son lambaste security officials

Formula 1 returns to one of its most famous races - the Monaco Grand Prix - after the unfortunate cancellation of the Emilia Romagna Grand Prix, with a crucial qualifying session to be held this afternoon. F1 was forced to cancel the Imola race weekend due to adverse weather and flooding in the region, with the event at this stage unlikely to be rescheduled amid the congested 2023 calendar. Yet teams and drivers will now turn their attention to the tight twists and turns of the world-renowned Circuit de Monaco for the next round of the season. PREVIEW: Monaco Grand Prix offers best chance yet of end to Red Bull supremacy Red Bull’s Sergio Perez won last year’s race in wet conditions, with Ferrari’s Carlos Sainz in second and Max Verstappen third. Hometown favourite Charles Leclerc has never been on the podium at his home race, while Mercedes will be eyeing improvements as they introduce upgrades to Lewis Hamilton’s and George Russell’s cars. Carlos Sainz was quickest in first practice on Friday with Max Verstappen top of the timesheets in FP2. Follow F1 qualifying live with The Independent - FP3 is at 11:30am before qualifying at 3pm (BST) Read More Monaco Grand Prix offers best chance yet of end to Red Bull supremacy Lewis Hamilton has shut the door on Ferrari – will he come to regret it? Lewis Hamilton hoped for more from Mercedes updates in Monaco

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People can go years with no idea they have something wrong with their heart. Symptoms can be vague and subtle and many heart conditions are ‘hidden’ – meaning they’re not obvious from the outside. “Hidden heart conditions often go undiagnosed for too long, until something goes wrong or it’s too late,” says Sindy Jodar, senior cardiac nurse at the British Heart Foundation (BHF). “That’s why it is important to never ignore the signs of heart disease and get yourself checked, just to be sure.” While some warning signs are easy to spot – such as severe chest pain and collapse – there are also many little indicators that something could be wrong with your heart or circulatory system. These won’t necessarily mean you have a heart problem, but it’s always best to have them investigated. From tiredness and nausea to fainting, here are some of the less obvious symptoms everyone needs to know about… 1. Feeling unusually tired Dr M Adil U Khan, a GP at Pall Mall Medical, says you should not “ignore or downplay unusual levels of tiredness”. While it’s normal to feel exhausted if you’ve been very busy or lacking sleep, he adds: “Feeling unusually tired, especially if it’s not related to exertion, should be investigated.” It could be due to something like anaemia, a virus, or even linked to mental health. It could also be related to your heart, so it is important to have it investigated. 2. Subtle discomfort “Look out for subtle discomfort in different areas of your body, including discomfort or pain in the jaw, neck, back, or stomach, which can be associated with a heart problem,” says Khan. If symptoms are out of the norm for you and aren’t going away, it’s always best to get them checked. 3. Unusual swelling Perhaps you have noticed your ankles look particularly puffy, or maybe it’s your general tummy area that’s constantly swollen for no apparent reason. “Unexplained swelling, known as oedema, in the legs, ankles or abdomen, may also be signs of heart failure,” explains Khan. 4. Vomiting and a choking sensation Sudden vomiting or a choking sensation in your throat is something to be wary of too. “While not every bout of nausea means there could be something serious happening, feeling sick combined with other aches and pains, such as severe chest pain, should ring an alarm bell,” says Jodar. Yes, it could be a stomach bug, but if you are having sudden spells of vomiting and nausea more regularly and you’re not sure why, don’t delay in get things checked out. 5. Fainting If you experience sudden fainting, this is a big indicator of something being awry. “If fainting or any other symptom becomes a problem, consult a healthcare provider and schedule an appointment with a doctor or cardiologist,” says Khan. “Discuss your symptoms, medical history and risk factors with them. “Your healthcare provider will assess your vital signs and perform a physical examination. Depending on your symptoms and risk factors, you may undergo diagnostic tests like ECGs, echocardiograms, stress tests, blood tests, or more specialised cardiac assessments,” he adds. 6. Shortness of breath Struggling to catch your breath is not a trivial matter. “Anyone experiencing shortness of breath during everyday activities or at rest should see their doctor,” says Khan. This is especially the case if it’s accompanied by chest pain – even if it doesn’t seem especially severe. Khan adds: “Mild chest discomfort should always be investigated, but some people mistake this for indigestion or muscular pain.” 7. Unusual sweating “Feeling hot, clammy and quite sweaty when you haven’t been doing strenuous exercise shouldn’t be ignored,” adds Jodar. “If this is combined with chest pains, it’s important you get yourself looked at.” 8. Heart rate irregularities Does your pulse sometimes feel jumpy or too fast? Get it checked with your doctor. Khan says: “Smartwatches and fitness trackers can provide valuable data about your heart rate and may detect irregularities to some extent. They can help track general trends in heart rate, especially during physical activity or rest. “However, they are not a substitute for medical-grade monitoring and evaluation… Any concerning symptoms should be evaluated by a healthcare professional for a comprehensive assessment and diagnosis,” Khan adds. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Breast Cancer Awareness Month: 9 brilliant beauty buys supporting good causes Smokers 2.6 times more likely to give birth prematurely Female students ‘more than twice as likely’ to be affected by poor mental health, research shows

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TV presenter Fiona Phillips has revealed she has been diagnosed with Alzheimer’s disease at the age of 62. The presenter and Daily Mirror columnist said the disease has “ravaged” her family and she had long feared being given the diagnosis. According to the Mirror, Phillips was diagnosed more than a year ago and is undergoing trials for a new drug that could slow the effects of the disease. Phillips, who is an Alzheimer’s Society ambassador, told the Mirror: “This disease has ravaged my family and now it has come for me. “And all over the country there are people of all different ages whose lives are being affected by it – it’s heartbreaking. “I just hope I can help find a cure which might make things better for others in the future.” As well as her column in the national newspaper, Phillips anchored GMTV for more than a decade from 1997. She also competed in the BBC’s Strictly Come Dancing in 2005. She is married to Martin Frizell, editor of ITV’s flagship programme Good Morning Britain. Phillips told the Mirror that, despite fearing she would one day be diagnosed with Alzheimer’s, the news was still a “gut-punching, shuddering shock”. The presenter said she feels “more angry than anything else” due to the disease having already affected her family life. “My poor mum was crippled with it, then my dad, my grandparents, my uncle. It just keeps coming back for us,” she said. Though she previously kept the news private, Phillips said she has decided to share her story to help end the stigma around Alzheimer’s. “There is still an issue with this disease that the public thinks of old people, bending over a stick, talking to themselves,” she said. “But I’m still here, getting out and about, meeting friends for coffee, going for dinner with Martin and walking every day.” She is taking part in clinical trials at University College Hospital in London, which aim to revolutionise future treatment. Hilary Evans, chief executive of Alzheimer’s Research UK, said: “We’re sending our love and support to Fiona and her family following her announcement that she’s living with Alzheimer’s disease. “Fiona’s been a friend of Alzheimer’s Research UK for well over a decade, and her support has shone such a valuable spotlight on the importance of research in overcoming the diseases that cause dementia. “There are around 70,800 people with dementia in the UK who, like Fiona, are under 65 and we’re determined to find a cure to end the heartbreak it causes.” It is thought at least five in every 100 people with Alzheimer’s are under 65. Though this figure may be higher, as it can be more difficult to get an accurate diagnosis at a younger age. So, is there anything you can actually do to help prevent dementia? 1. Stop drinking fizzy drinks Drinking too much coke or lemonade could increase your chances of developing dementia. People who consume the highest amounts of ultra-processed foods, like fizzy drinks and chocolate, may have a higher risk of developing dementia than those who eat the lowest amounts, a study by Huiping Li, of Tianjin Medical University in China, published in the Neurology journal, has indicated. 2. Say no to UPFs Sadly, lots of our go-to ingredients like sausages, ketchup and baked beans are highly processed, making them a risk-factor if consumed too frequently. Li, the author of the study, said: “These foods may also contain food additives, or molecules from packaging or produced during heating, all of which have been shown in other studies to have negative effects on thinking and memory skills. “Our research not only found that ultra-processed foods are associated with an increased risk of dementia, it found replacing them with healthy options may decrease dementia risk.” 3. Reduce your treats Too much chocolate and things like biscuits aren’t good for you, because they are highly processed and sugary. In fact, according to the study, for every 10% increase in daily intake of ultra-processed foods, people had a 25% higher risk of dementia. So, even just having a few extra biscuits or chocolates at work each day can heighten your risk. 4. Keep moving We all know being slumped at a desk, staring at a screen all day, isn’t great for your health, but it turns out sedentary jobs actually increase your risk of getting dementia. Dr Sara Imarisio, head of strategic initiatives at Alzheimer’s Research UK, said: “Our brains are incredibly complex, responsible for our memory, as well as what we think, feel and do. “Keeping our brains healthy as we age can help stave off diseases like Alzheimer’s, which physically attack brain cells, tearing away at the very essence of who we are. “We know that being physically and socially active can help us feel happier, healthier and more positive in general. “Lifting weights and running marathons aren’t for everyone, but there are many ways that we can stay physically active in our lives.” Noting more research published in the Neurology Journal, by Huan Song of Sichuan University in China, Imarisio continued: “This self-reported study adds to evidence that finding something you can stick to, that keeps you physically and socially active, is likely to have the greatest benefit to your health, rather than the activity itself. “The researchers found that even people with a high genetic risk for Alzheimer’s, the most common cause of dementia, could benefit from keeping physically active.” 5. Make an effort to see family and friends Social interaction is a really important way to keep your brain sharp and reduce your risk of dementia. If you avoid it, you are risking your health. According to Song’s research, people who were highly engaged in activity patterns, including frequent exercise and daily visits of family and friends, had 35% and 15% lower risk respectively, compared with people who were the least engaged. 6. Do the chores According to the same study, carrying out household chores is associated with a 21% reduced risk of dementia. Perhaps just increasing your brain activity a little, even just by washing up or changing your sheets, can help keep your mind active. 7. Play an instrument According to several studies, musicians are 64% less likely to develop mild cognitive impairment or dementia. So, if you’ve ever fancied playing the piano, guitar or ukulele, now’s the time – it’s never too late to learn something new. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live 7 popular destinations that will soon be in London’s ULEZ Kate’s best Wimbledon looks, as she steps out in retro outfit for the tennis How tennis could be harming your body – and why it does you good

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