Culture

LUGANO, 6 May, 2021- Researchers have discovered a novel biomarker to identify male COVID-19 patients most at risk for ICU admission. The findings presented today at EADV's 2021 Spring Symposium, suggest that men with genetic characteristics (phenotypes) sensitive to the male sex hormone androgen, are more likely to experience severe COVID-19 disease.

Researchers were driven to study the association between the androgen receptor (AR) gene and COVID-19, after observing the disproportionate number of men hospitalised with COVID-19 presenting with androgenetic alopecia (a common form of hair-loss) compared to the expected number in a similar age-matched population (79% vs. 31-53%).

Androgenetic alopecia is known to be controlled by variations in the AR gene, which affects how sensitive the body is to androgens (hormones such as testosterone). In addition, an enzyme implicated in COVID-19 infection (TMPRSS2) is regulated by an androgen response element - meaning that it too may be affected by variations in the AR gene. As the polyglutamine repeat (CAG repeat) region located in the AR gene is associated with both androgen sensitivity and androgenetic alopecia; this research sought to identify the connection between CAG repeat region length and predisposition to increased COVID disease severity.

A prospective study of 65 hospitalised COVID-19 positive men measured the AR CAG repeat length of each man. Researchers found that male covid patients with a CAG repeat below 22 nucleotides (CAG

Dr. Andy Goren, Chief Medical Officer, Applied Biology, Inc., Irvine, California, USA, explains: "Our data show that longer AR CAG scores are associated with more severe COVID?19 disease and indicate that AR CAG repeat length could be used as a biomarker to help identify male COVID?19 patients most at risk for ICU admissions."

He continues, "The identification of a biomarker connected with the androgen receptor is another piece of evidence highlighting the important role of androgens in COVID-19 disease severity."

Further research conducted by Dr Andy Goren and his team, reported at the EADV Spring Symposium, explores a promising new therapy for COVID-19 using a novel androgen receptor antagonist to regulate TMPRSS2 expression and possibly treat COVID-19 patients. The results of this study were submitted for publication in a peer-reviewed journal.

"This research demonstrates the scientific value of dermatology by offering key insights into the role of genetics and its link to COVID disease. It is an excellent example of some of the pioneering abstracts being showcased at The EADV Spring Symposium this year," says Prof. Lidia Rudnicka, EADV Board Member and Professor at the Medical University of Warsaw.

Proteins are the workhorses of cells, responsible for almost all biological functions that make life possible.

Understanding how specific proteins work is key to disease prevention and treatment, allowing us to lead longer, healthier lives.

Yet scientists still know nothing or very little about thousands of proteins that exist in our bodies and their role in keeping us alive.

Now researchers from Xi'an Jiaotong-Liverpool University have uncovered a new protein analysis tool - coined the Bacterial Growth Inhibition Screen (BGIS) - that could fast-track the process of assessing proteins. The tool allows for quick and efficient basic characterisation of protein function with no special equipment or cost involved.

Dr Ferdinand Kappes of XJTLU's Department of Biological Sciences says while it won't replace more complex and established protein analysis methods, the BGIS tool offers a viable 'pre-screening' method that could save scientists significant time in the lab, in turn accelerating basic science and medical discoveries.

"Many proteins have multiple 'business areas', and finding out these different functions and how they are regulated is essential to understanding how biological processes work," he says.

"Identifying and then manipulating the SARS-CoV-2 spike protein, for example, was crucial in the development of a Covid-19 vaccine.

"We know misfunction or mis-regulation of proteins often results in diseases, but a large portion of human proteins still remain a mystery to us.

"One of the main reasons for this is that proteins are often difficult to study, as each new protein is like exploring a foreign city without a map for the first time - there are often no similar proteins to offer clues or even a starting point.

"The work is time-consuming, and results can be hard to come by, so many researchers avoid studying unknown proteins altogether.

"The tool we have developed provides researchers with a 'compass' of sorts. It allows them to quickly work out if they are on the right path by determining whether a protein has a function worth exploring."

The new tool could substantially facilitate the study of many proteins, according to Dr Kappes, and makes use of an unpopular side effect common in biology labs.

"Our tool uses recombinant protein toxicity, a well-known effect that happens when bacteria are used for the production of human proteins, such as insulin for medication," he says.

"Essentially, we force the bacteria to produce a foreign protein, but this often interferes with the natural biology of the bacteria and causes a number of stress scenarios.

"As we usually only use bacteria as a surrogate for protein production - the negative 'stress scenarios' on the bacteria are considered a burden and are typically not looked at further.

"What we have highlighted is that these negative effects can be harnessed and used as an easy way to gain fundamental functional information by seeing how the bacteria responds to the expression of foreign proteins.

"If bacteria growth is affected by the foreign protein, we know there is some sort of function coded in the protein that warrants further investigation. The BGIS also allows for quick manipulation of the protein at hand exploring the same principle.

"After our initial discovery, we applied this technique to every protein we could find in our labs. It worked every time. It really is like turning lemons into lemonade - it's a byproduct of biological experiments researchers dreaded, but we've been able to turn into a tool to aid discovery.

"In addition, the BGIS allowed us to substantially advance our own research on the oncoprotein DEK, which is a longstanding interest in our own laboratory."

In Alzheimer's disease, neurons in the brain die. Largely responsible for the death of neurons are certain protein deposits in the brains of affected individuals: So-called beta-amyloid proteins, which form clumps (plaques) between neurons, and tau proteins, which stick together the inside of neurons. The causes of these deposits are as yet unclear. In addition, a rapidly progressive atrophy, i.e. a shrinking of the brain volume, can be observed in affected persons. Alzheimer's symptoms such as memory loss, disorientation, agitation and challenging behavior are the consequences.

Scientists at the DZNE led by Prof. Michael Wagner, head of a research group at the DZNE and senior psychologist at the memory clinic of the University Hospital Bonn, have now found in a study that a regular Mediterranean-like dietary pattern with relatively more intake of vegetables, legumes, fruit, cereals, fish and monounsaturated fatty acids, such as from olive oil, may protect against protein deposits in the brain and brain atrophy. This diet has a low intake of dairy products, red meat and saturated fatty acids.

A nationwide study

A total of 512 subjects with an average age of around seventy years took part in the study. 169 of them were cognitively healthy, while 343 were identified as having a higher risk of developing Alzheimer's disease - due to subjective memory impairment, mild cognitive impairment that is the precursor to dementia, or first-degree relationship with patients diagnosed with Alzheimer's disease. The nutrition study was funded by the Diet-Body-Brain competence cluster of the German Federal Ministry of Education and Research (BMBF) and took place as part of the so-called DELCODE study of the DZNE, which does nationwide research on the early phase of Alzheimer's disease - that period before pronounced symptoms appear.

"People in the second half of life have constant eating habits. We analyzed whether the study participants regularly eat a Mediterranean diet - and whether this might have an impact on brain health ", said Prof. Michael Wagner. The participants first filled out a questionnaire in which they indicated which portions of 148 different foods they had eaten in the past months. Those who frequently ate healthy foods typical of the Mediterranean diet, such as fish, vegetables and fruit, and only occasionally consumed foods such as red meat, scored highly on a scale.

An extensive test series

The scientists then investigated brain atrophy: they performed brain scans with magnetic resonance imaging (MRI) scanners to determine brain volume. In addition, all subjects underwent various neuropsychological tests in which cognitive abilities such as memory functions were examined. The research team also looked at biomarker levels (measured values) for amyloid beta proteins and tau proteins in the so-called cerebrospinal fluid (CSF) of 226 subjects.

The researchers, led by Michael Wagner, found that those who ate an unhealthy diet had more pathological levels of these biomarkers in the cerebrospinal fluid than those who regularly ate a Mediterranean-like diet. In the memory tests, the participants who did not adhere to the Mediterranean diet also performed worse than those who regularly ate fish and vegetables. "There was also a significant positive correlation between a closer adherence to a Mediterranean-like diet and a higher volume of the hippocampus. The hippocampus is an area of the brain that is considered the control center of memory. It shrinks early and severely in Alzheimer's disease," explained Tommaso Ballarini, PhD, postdoctoral fellow in Michael Wagner's research group and lead author of the study.

Continuation of nutrition study is planned

"It is possible that the Mediterranean diet protects the brain from protein deposits and brain atrophy that can cause memory loss and dementia. Our study hints at this," Ballarini said. "But the biological mechanism underlying this will have to be clarified in future studies." As a next step, Ballarini and Wagner now plan to re-examine the same study participants in four to five years to explore how their nutrition - Mediterranean-like or unhealthy - affects brain aging over time.

Ultrasound is an indispensable tool for the life sciences and various industrial applications due to its non-destructive, high contrast, and high resolution qualities. A persistent challenge over the years has been how to increase the resolution of an acoustic endoscope without drastically increasing the footprint of the probe, or risking the robustness of the ultrasonic transducer. In recent years, a host of all-optical ultrasonic imaging techniques have emerged - which generally utilise pulsed lasers and optical cavities to excite and detect ultrasound waves - without sacrificing device footprint, sensitivity, or the integrity of the transducer. Thus far these powerful techniques have achieved imaging resolutions on microscopic-mesoscopic length scales, however there is great interest in creating an ultrasonic fibre-probe which can probe disease on the nanoscopic-microscopic length scales inhabited by biological cells and tissue.

In a new paper published in Light: Science & Application, a team of scientists, led by Professor Matt Clark at the University of Nottingham, UK, has developed the first optical fibre ultrasonic imaging device which operates in the GHz range of the acoustic spectrum. At these frequencies the wavelength of sound becomes comparable to ultraviolet optical wavelengths and therefore provides an opportunity for high resolution imaging. Their phonon probe device makes use of a pump-probe technique called time-resolved Brillouin scattering, which pumps GHz frequency ultrasound from the tip of a 125 μm diameter optical fibre into a specimen, and uses a pulsed laser to "watch" one of the ultrasound waves (with a frequency of approximately 5 GHz) as it travels through the specimen. This time-of-flight acoustic signature simultaneously encodes two types of information about the specimen: its local mechanical properties and spatial profile. By scanning the device, these properties can be resolved in 3D with optical lateral resolution, and with axial resolution dictated by the sub-micrometre acoustic wavelengths.

Prof. Clark's team applied this new technology to the parallel elastography-profilometry of objects as small as 10 x 2 μm (radius and height). The device was capable of 2.5 μm lateral resolution and could measure object height with 45 nm precision, which is over an order of magnitude smaller than the system's optical wavelength. The team also demonstrated that the technology is fully compatible with optical fibre imaging bundles - containing tens of thousands of imaging pixels - which shows the scalability of the technique and its compatibility with standard endoscopy equipment.

According to the team, the development and application towards biological metrology and healthcare is most exciting. "The phonon probe is poised to supplement state-of-the-art bench-top profilometry equipment such as atomic force microscopy (AFM), stylus profilometry, and optical profilometry. It offers a combination of non-contact operation, label-free contrast, and high resolution, which is unique compared with the state-of-the-art. However, we believe that its ability to measure sub-surface mechanical properties, its bio-compatibility, and its endoscopic-potential are what set it apart. These features set the technology up for future in vivo measurements towards the ultimate goal of minimally invasive point-of-care diagnostics. The building blocks of disease can be traced down to the sub-cellular level, and are closely intertwined with mechanical properties. Having an endoscopic device that can access this regime will accelerate the development of elasticity-based diagnostics."

Researchers at the University of Eastern Finland have discovered previously unknown non-coding RNAs (ncRNAs) involved in regulating the gene expression of vascular endothelial growth factors (VEGF), the master regulators of angiogenesis. The study, conducted by the research groups of Associate Professor Minna Kaikkonen-Määttä and Academy Professor Seppo Ylä-Herttuala, provides a better understanding of the complex interplay of ncRNAs with gene regulation, which might open up novel therapeutic approaches in the future. The results were published in the Molecular and Cellular Biology Journal.

Over the past years, the development of next generation sequencing techniques has revealed that around 97% of the human transcriptome is transcribed as non-coding RNAs, and although the role of the vast majority remains uncharacterized, many functions such as gene regulation have been proven.

On the other hand, endothelial growth factors VEGF-A and VEGF-C are the main regulator of angiogenesis, i.e., new blood vessel formation. Due to their important role in vasculature development, they constitute a potential target for the treatment of several diseases, such as atherosclerosis. Therapeutic angiogenesis has been developed as a promising strategy to rescue ischemic tissues by induction of new blood vessels sprouting from existing vasculature but so far, very few results with clinical significance have been achieved. Therefore, a deeper understanding of the regulatory mechanisms underlying the expression of these key angiogenic factors is needed for the future therapeutic avenues.

In this study, researchers performed in-depth characterization of the genomic loci around the VEGFA and VEGFC genes and identified novel non-coding RNAs, in particular enhancer RNAs (eRNAs) and long non-coding RNAs (lncRNAs). While the enhancers clearly upregulated gene expression, lncRNAs demonstrated various functions. Interestingly, lncRNAs were also regulating other targets including factors related to endothelial functions, such as angiogenesis and cell proliferation.

A new study has shown that most patients discharged from hospital after experiencing severe COVID-19 infection appear to return to full health, although up to a third do still have evidence of effects upon the lungs one year on.

COVID-19 has infected millions of people worldwide. People are most commonly hospitalised for COVID-19 infection when it affects the lungs - termed COVID-19 pneumonia. Whilst significant progress has been made in understanding and treating acute COVID-19 pneumonia, very little is understood about how long it takes for patients to fully recover and whether changes within the lungs persist.

In this new study, published in The Lancet Respiratory Medicine, researchers from the University of Southampton worked with collaborators in Wuhan, China, to investigate the natural history of recovery from severe COVID-19 pneumonia up to one year after hospitalisation.

83 patients were recruited after they were discharged from hospital following severe COVID-19 pneumonia and were followed up after three, six, nine and twelve months. At each time point they underwent clinical assessment as well as measures of how well the lungs function, a CT scan of their chest to take a picture of the lungs, and a walking test.

Over 12 months in most patients there was an improvement in symptoms, exercise capacity, and COVID-19 related CT changes. By 12 months the majority of patients appeared to have fully recovered although about 5% of patients still reported breathlessness. A third of patients' measures of lung function were still reduced - in particular how efficiently oxygen is transferred in the lungs into the blood - and this was more frequently found in women than in men. In around a quarter of patients CT scans showed there were still small areas of change in the lungs, and this was more common in patients with more severe lung changes at time of hospitalisation.

Dr Mark Jones, Associate Professor in Respiratory Medicine at the University of Southampton and NIHR Southampton Biomedical Research Centre who co-led the study said, "the majority of patients with severe COVID-19 pneumonia appeared to fully recover, although for some patients this took many months. Women were more likely to have persistent reductions in lung function tests and further investigation is needed to understand if there is a sex specific difference in how patient's recover. We also don't yet know what happens beyond 12 months and this will need ongoing study."

The researchers acknowledged that this study only involved a small number of patients and the findings will require confirmation in additional studies, however they have identified a number of important implications.

Dr Yihua Wang, Lecturer in Biomedical Sciences at the University of Southampton and NIHR Southampton Biomedical Research Centre who co-led the study explained, "firstly, our research provides evidence that routine respiratory follow-up of patients hospitalised with COVID-19-pneumonia is required. Secondly, given the length of time it takes for some patients to recover it suggests that research into whether exercise programmes help patients recover more quickly is required. Finally, it highlights the need for treatment strategies to prevent the development of long term COVID-19 related lung changes."

Oxygen is essential for the development of higher life. However, it was hardly present in the oceans of the young Earth. It was not until the evolution of photosynthetic bacteria that the oceans saw a significant increase in oxygen levels. By measuring tungsten isotope composition, an international research team with the participation of scientists from the University of Cologne's Institute of Geology and Mineralogy has now laid the foundation for a more precise determination of the development of oxygen levels in the early oceans over time. Prospectively, they expect more precise insights into the evolution of life. In cooperation with scientists from ETH Zurich, the Universities of Bern and Tübingen, and the Leibniz Institute for Baltic Sea Research Warnemünde (IOW), geologists led by Dr Florian Kurzweil at the University of Cologne analysed the chemical element tungsten, which could act as an indicator element for oxygen, in today's seawater. The results have been published in the Proceedings of the National Academy of Sciences (PNAS) under the title 'Redox control on the tungsten isotope composition of seawater'. The research is part of the German Research Foundation's priority programme 'Building a Habitable Earth'.

Tungsten is present only in very small amounts in the oceans, making it difficult to accurately determine its concentration. It is even more difficult to determine the abundance of individual tungsten isotopes in seawater. Isotopes of an element have the same number of protons, but different numbers of neutrons. Hence, there are heavy tungsten isotopes with many neutrons and lighter tungsten isotopes with fewer neutrons. The analytical methods developed at the University of Cologne enable the most precise measurement of relative tungsten isotope abundances currently available worldwide.

In a basin more than 400 metres deep in the Baltic Sea, the research team took various water samples, both in the oxygen-rich surface water and in the oxygen-deficient deep water. Oxide minerals form along the boundary of both water layers, preferentially binding the light tungsten. The tungsten remaining in the seawater thus becomes relatively heavier. Oxygen is required to form oxide minerals, so the oxygen concentration of the oceans ultimately correlates with the tungsten isotope composition of the seawater.

'Increasing oxygen concentrations in the oceans of the early Earth should have led to increased formation of the oxide minerals, and thus to isotopically heavier marine tungsten,' said the head of the research expedition Dr Florian Kurzweil. The scientists now want to show that this development has been preserved in marine sediments. The composition of tungsten isotopes of the oldest sediments on Earth could then trace the development of marine oxygen levels over the course of Earth's history like a genetic fingerprint.

The health benefits of sardines and oily fish are widely known: their high levels of unsaturated fats help to regulate cholesterol levels and prevent the onset of cardiovascular diseases. However, the benefits don't end there. A study led by Diana Diaz Rizzolo, lecturer and researcher of the Universitat Oberta de Catalunya's (UOC) Faculty of Health Sciences and the August Pi i Sunyer Biomedical Research Institute (IDIBAPS), has discovered that the regular consumption of sardines helps to prevent the onset of type 2 diabetes. Nutrients found in high quantities in sardines - such as taurine, omega 3, calcium and vitamin D - help to protect against this disease which, according to CIBERDEM's Di@betes study, affects around 14% of the Spanish population over the age of 18.

"Not only are sardines reasonably priced and easy to find, but they are safe and help to prevent the onset of type 2 diabetes. This is a huge scientific discovery. It is easy to recommend this food during medical check-ups, and it is widely accepted by the population", explained Diana D. Rizzolo.

Researchers from the Diabetes and Obesity Research Laboratory and the Primary Care Research Group, both from IDIBAPS; the IMIM, the Fatty Acid Research Institute (EUA), the Universitat de Barcelona, CIBERDEM and the Department of Endocrinology and Nutrition of the Hospital Clínic de Barcelona also participated in the research project. The results of the study were published openly in the prestigious Clinical Nutrition journal.

Two cans of sardines a week

The study enrolled 152 patients aged 65 years and older who had been diagnosed with prediabetes (blood glucose levels between 100-124 mg/dl) from three different Primary Care centres. All of these patients were put on a nutritional programme that sought to reduce the risk of them developing the disease, but only the intervention group added 200 grams of sardines to their diet every week (two cans of sardines in olive oil). To facilitate this consumption, and with thanks to the Alicia Foundation, these study participants received a list of recipes including canned sardines. Participants were advised to eat the sardine whole, without removing the bones, as these are particularly rich in calcium and vitamin D.

Of the group that did not include sardines in their diet, 27% of the members were at a high risk of suffering from diabetes (measured via the FINDRISC questionnaire). After one year, 22% found themselves in the same category. Of the group that included sardines in their diet, 37% of the members were at a high risk of suffering from diabetes at the start of the study. After one year, only 8% remained at a very high risk. Improvements were also seen in other important biochemical parameters, such as a reduced insulin resistance index (HOMA-IR), increased "good" cholesterol (HDL), increased hormones that accelerate the breakdown of glucose (adiponectin) and decreased triglycerides and blood pressure, amongst others.

The study was carried out on participants aged 65 and above because the incidence of diabetes is much higher in elderly people than in the young population: "As we get older, restrictive diets (in terms of calories or food groups) can help to prevent the onset of diabetes. However, the cost-benefit ratio is not always positive, as we found in other studies", stated doctor Rizzolo. "However, the results lead us to believe that we could obtain an equally significant preventive effect in the younger population."

The protective role of food, but not of supplements

The fact that foods such as sardines - which are rich in taurine, omega 3, calcium and vitamin D - have a clear protective effect against the onset of diabetes does not mean that taking these supplements in isolation will have the same effect. "Nutrients can play an essential role in the prevention and treatment of many different pathologies, but their effect is usually caused by the synergy that exists between them and the food that they are contained in. Sardines will therefore have a protective element because they are rich in the aforementioned nutrients, whereas nutrients taken in isolation in the form of supplements won't work to the same extent", claimed Rizzolo.

Researchers have begun studying the effect of sardines on the intestinal microbiota in a second phase of the study, "since it affects the regulation of many biological process, and we need to understand if they have played a part in this protective effect against diabetes 2", she added. They have also initiated studies on the modulation of the expression of certain genes related to inflammation, which could play a role in the onset of diabetes 2 and various other diseases.

The world's first-ever 'academic paper which is not a paper' is due to be presented by a Lancaster University research team at the premier international conference on human-computer interaction.

Dr Joseph Lindley, a researcher at Lancaster University's ImaginationLancaster design-led research laboratory, Dr Miriam Sturdee, from the University's School of Computing and Communications, Senior Research Associate Dr David Green and Research Associate Hayley Alter have been invited to take part in the 2021 ACM CHI Virtual Conference on Human Factors in Computing Systems in May.

Using the innovative 'Gather Town' online video-calling and conferencing platform, they have experimented in setting up a conference paper as an interactive but virtual space.

The unique part of this type of video-calling is the ability for multiple people to hold separate conversations in parallel, and to walk in and out of those conversations just as easily as they would in a real room.

"So, with this, you can actually walk 'in' to the paper. Each 'room' is a page or section within the paper where you can read the text, but also talk to other conference delegates about it," explains Dr Lindley, a lecturer in design research.

Quirky egg-themed graphics (eggs are used as they are a symbol of new life) give the 'page-spaces' character as different destinations, while the menu page is inspired by Piet Mondrian's map-like painting, 'Broadway Boogie Woogie'.

"The beauty with this approach is that you don't have to read from start to finish, you can experience it in any order you like," Dr Lindley explains.

Instead of hearing a formal presentation, participants will be asked to don their choice of avatar before being invited into the two-dimensional spaces to meet, chat and 'explore' the egg.

"This is the world's first paper that is not an actual paper," says Dr Lindley. "It's a video conferencing platform that hosts 20 interconnected 'rooms' with a 'poster' in each one. People can mill about and discuss each poster and, by leaving additional comments they can effectively help to keep 'writing' the paper as they go.

"This prototype is about collapsing barriers between video conferencing, research conferences, and publication traditions. It's about exploring creative ways of using technology and bringing them together."

"It's looking at how the research landscape will evolve. The pandemic is making people look at that again."

"We are now in a state of comprehensive flux as 'new normals' emerge, begin to solidify, and may evolve into an--as yet undetermined--futures.

"This 'not paper' is a facet and exploration of that flux as it relates to publication and conference culture, video conferencing systems, and how we both conduct, and share, research."

Step inside the paper if you dare...

https://gather.town/app/EpkqTfKctHPjRS0m/the_egg (NOTE: Please use a Chrome or Firefox based browser).

Clinical practice guidelines for dealing with the physical and mental health of transgender people highlight the current lack of a solid research base which must be improved, according to a new study published in the journal BMJ Open.

A team of researchers from Anglia Ruskin University (ARU) and King's College London searched world literature for all international clinical practice guidelines on the healthcare needs of gender minority and trans people.

Results showed that higher quality guidelines tended to focus mainly on HIV, and most others were on transition-related interventions. There were noticeable gaps in the topics of guidelines, with none addressing primary care or more general health needs of gender minority and trans people. There was little information on mortality and quality of life, and there was no patient-facing material.

Sex hormones in trans people can affect susceptibility to some conditions, including various cancers. However, the authors found little research on how much these hormones affect rates and treatment regimens. There was also no advice on how these hormones affect rates, hospitalisations and mortality due to COVID-19.

Researchers concluded that gaps can be filled by better research, resulting in improved healthcare guidance for gender minority/trans people.

This was the first review of its kind to examine international clinical practice guidelines addressing gender minority/trans health.

Catherine Meads, Professor of Health at ARU and senior author of the paper, said: "We were pleased to find high quality guidelines on HIV from the World Health Organisation, but disappointed there was little else on the long term physical and mental health of trans people.

"There are clear gaps in clinical practice guidance related to gender minority and trans people, and as such clinicians should proceed with caution and explain any uncertainties to patients, who should also be engaged in the process of updating practice guidelines. More needs to be done to ensure that patient-facing material relevant to trans people is made available.

"We've presented the study at the main international specialist societies, who are due to update their guidance, and we hope this will encourage them to aim as high as the WHO."

Sara Dahlen, of King's College London, who co-ordinated the project, said: "We didn't know what we'd find until we looked. We hope future guidelines for trans and gender minority people will look to the examples of high-quality so they can improve healthcare."

Philadelphia, May 6, 2021--Researchers have found an independent association between COVID-19-related income loss and financial strain and depression, according to the latest study from the COVID-19 Resilience Project, run by the Lifespan Brain Institute (LiBI) of Children's Hospital of Philadelphia (CHOP) and Penn Medicine. This association was found in two separate cohorts - one primarily in the United States and one in Israel - and the depressive symptoms worsened over time in participants who were hit financially, above and beyond pandemic-related anxiety. The findings were published today in the Journal of Affective Disorders.

"This study is an important first step in understanding the unique association between pandemic-related income loss and financial strain and depression, which we observed in two entirely unrelated cohorts," said senior author Ran Barzilay, MD, PhD, an assistant professor at LiBI. "Our findings may suggest that the 'financial COVID-19' could have a serious impact on mental health, and this is especially relevant as the post-vaccine world faces the challenges of COVID-19's long-term financial impact."

To analyze the link between financial strain and mental health during the pandemic, researchers at LiBI collected data longitudinally from participants via a survey that asked questions related to COVID-19-related worries, financial changes (like losing a job or getting a pay cut), and mental health. In parallel, a separate, similar study was conducted at the Sheba Medical Center in Israel, led by Nimrod Hertz-Palmor. Participants in the first, predominately American cohort provided initial answers between April 6 and May 5, 2020 and provided follow up answers between May 12 and June 21, 2020. The Israeli cohort responded between March 18 and 26, 2020 and again between April 22 and May 7, 2020.

Across these two independent studies, the researchers found a specific link between financial factors and depression, above and beyond anxiety, which was greater than the association between COVID-19 health-related worries and depression. The researchers also found that participants from both cohorts who reported a decrease in their income over the study period reported an increase in depressive symptoms over time.

"The fact that the findings were similar in two different cohorts - from two different cultures, using different research measures - supports the generalizability of these findings and may suggest that the financial COVID-19 is a specific risk factor for depression globally," Barzilay said.

Notably, the findings were independent of pre-COVID-19 income, suggesting people from all backgrounds who report stress about their financial situation during the pandemic, including those with high income, are vulnerable to the effects of the financial crisis on mental health. Although anxiety also increased with prolonged income loss, the association did not increase to the same extent.

"Given what we know about the connection between depression and suicidality, healthcare providers should actively probe patients for a change for the worse in their income and ask them specifically about their stress regarding the financial impact of COVID-19, as these individuals are at higher risk for mental health deterioration," Barzilay suggests. "We have collected similar data at five different time points from April 2020 to April 2021, and we will continue to study this issue to better understand what makes up resilience during the pandemic and how we can identify and support those at risk for adverse mental health outcomes."

Epithelial cells form the covering of most internal and external surfaces of the human body. This protective layer acts as a defense against invaders - including bacteria, viruses, environmental toxins, pollutants and allergens. If the skin and mucosal barriers are damaged or leaky, foreign agents such as bacteria can enter into the tissue and cause local, often chronic inflammation. This has both direct and indirect consequences.

Chronic diseases due to defective epithelial barriers

Cezmi Akdis, Director of the Swiss Institute of Allergy and Asthma Research (SIAF), which is associated with the University of Zurich (UZH), has now published a comprehensive summary of the research on epithelial barrier damage in Nature Reviews Immunology. "The epithelial barrier hypothesis proposes that damages to the epithelial barrier are responsible for up to two billion chronic, non-infectious diseases," Professor Akdis says. In the past 20 years, researchers at the SIAF alone published more than 60 articles on how various substances damage the epithelial cells of a number of organs.

Rise in allergic and autoimmune conditions

The epithelial barrier hypothesis provides an explanation as to why allergies and autoimmune diseases have been increasing for decades - they are linked to industrialization, urbanization and westernized lifestyle. Today many people are exposed to a wide range of toxins, such as ozone, nanoparticles, microplastics, household cleaning agents, pesticides, enzymes, emulsifiers, fine dust, exhaust fumes, cigarette smoke and countless chemicals in the air, food and water. "Next to global warming and viral pandemics such as COVID-19, these harmful substances represent one of the greatest threats to humankind," emphasizes Akdis.

Asthma, Alzheimer's et al.

Local epithelial damage to the skin and mucosal barriers lead to allergic conditions, inflammatory bowel disorders and celiac disease. But disruptions to the epithelial barrier can also be linked to many other diseases that are characterized by changes in the microbiome. Either the immune system erroneously attacks "good" bacteria in healthy bodies or it targets pathogenic - i.e. "bad" - invaders. In the gut, leaky epithelial barriers and microbial imbalance contribute to the onset or development of chronic autoimmune and metabolic diseases such as diabetes, obesity, rheumatoid arthritis, multiple sclerosis or ankylosing spondylitis. Moreover, defective epithelial barriers have also been linked to neurodegenerative and psychiatric diseases such as Parkinson's disease, Alzheimer's disease, autism spectrum disorders and chronic depression, which may be triggered or aggravated by distant inflammatory responses and changes in the gut's microbiome.

Prevention, intervention - and more research

"There is a great need to continue research into the epithelial barrier to advance our understanding of molecular mechanisms and develop new approaches for prevention, early intervention and therapy," says Akdis. Novel therapeutic approaches could focus on strengthening tissue-specific barriers, blocking bacteria or avoiding colonization by pathogens. Other strategies to reduce diseases may involve the microbiome, for example through targeted dietary measures. Last but not least, the focus must also be on avoiding and reducing exposure to harmful substances and developing fewer toxic products.

Philadelphia, May 6, 2021 - Misunderstanding food date labeling is common and educational communications are needed to improve consumer understanding, according to a new study in the Journal of Nutrition Education and Behavior, published by Elsevier.

Does it mean "spoiled - throw it out," or "might not taste as good as it could anymore?" Food date labels (e.g., "USE By August 16") can play an important role in helping consumers make informed decisions about food, and ultimately prevent unsafe consumption and waste of food. Researchers surveyed 2,607 adults in the United States to assess consumer understanding of the streamlined 2-date labeling system and explore the relative effectiveness of educational messages in increasing understanding.

"Our study showed that an overwhelming majority of consumers say that they use food date labels to make decisions about food and say they know what the labels mean," said Catherine Turvey, MPH, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA. "Despite confidently using date labels, many consumers misinterpreted the labels and continued to misunderstand even after reading educational messaging that explained the labels' meaning."

Less than half (46 percent) of study respondents knew that the "BEST If Used By" label specifically indicates that food quality may deteriorate after the date on the label. Less than one-quarter (24 percent) of study respondents knew that the "USE By" label means that food is not safe to eat after the date on the label.

Researchers explored if framing the messages with values like saving money or avoiding waste, would impact the effectiveness of messages at increasing consumer understanding. None of the seven value frames tested was significantly more effective at increasing understanding than another, but all messages significantly increased consumer's general understanding of the labels.

After viewing educational messages, 37 percent of consumers still did not understand the specific meaning of the "BEST If Used By" label and 48 percent did not understand the specific meaning of the "USE By" label.

"Responses to the survey suggest that date labels are so familiar that some consumers believe they are boring, self-explanatory, or common sense despite misunderstanding the labels," said Ms. Turvey. "Unwarranted confidence and the familiarity of date labels may make consumers less attentive to educational messaging that explains the food industry's labeling system."

Future communication campaigns will have to capture the attention of people who think they already know what date labels mean, find the information tedious, or are satisfied with a rough understanding of labels. Educating consumers about the meaning of the labels has growing implications for food waste and food safety as the 2-date labeling system becomes more widely adopted and gains support from non-profits and government institutions.

(MAY 6, 2021) New York, NY - With around 30 percent of the U.S. population now fully vaccinated, the rate of daily vaccinations has started to slow, raising concerns that greater efforts and investments may be needed to reach higher coverage levels. A study published in the Journal of Infectious Diseases on May 6 shows the lives, hospitalizations, and costs that can be saved by even relatively small increases in vaccination coverage and reaching higher vaccination coverage levels sooner (e.g., by the end of the summer versus fall/winter).

The study was led by researchers from PHICOR (Public Health Informatics, Computational, and Operations Research) at CUNY Graduate School of Public Health & Health Policy, the National School of Tropical Medicine at Baylor College of Medicine, and Johns Hopkins Center for Health Security. The team developed a computer simulation model of the entire U.S. and the spread of the COVID-19 coronavirus throughout the country. Using the model, the team could simulate vaccinating different proportions of the population at different rates with different types of COVID-19 vaccines. Like real people, each of these virtual people could become infected with the virus and develop different symptoms over time and, depending upon the severity of those symptoms, visit clinics, emergency departments, or hospitals. These in turn would have associated costs, allowing the tracking of various medical costs and productivity losses.

The study showed that going from a 30 percent vaccination coverage to a 40 percent coverage could save 24.3 million cases and $33.1 billion in direct medical costs and productivity losses. Going from a 50 percent to 70 percent coverage could save 9.5 million cases and 10.8 billion in direct medical costs and productivity losses.

In fact, even relatively small increases in vaccine coverage can prevent thousands of cases and lives and hundreds of millions in costs. For example, results from the model showed each 1 percent increase between 40 and 50 percent of the U.S. population being vaccinated by the fall can prevent 1.6 million cases, 60,190 hospitalizations, and 7,100 deaths and save $674.2 million in direct medical costs and $1.5 billion in productivity losses. Each 1 percent increase between 50 and 70 percent can prevent 473,900 cases, 17,600 hospitalizations, 2,000 deaths, and 537 million in direct medical costs and productivity losses.

The study also emphasized the importance of reaching higher coverage levels as soon as possible. For example, speeding up vaccinations to reach a 50 percent coverage by July 2021 instead of October 2021 could save an additional 5.8 million cases, 215,790 hospitalizations, 26,370 deaths, $3.5 billion in direct medical costs, and $4.3 billion in productivity losses.

Results suggested that getting as many people fully vaccinated as possible before the early winter would be particularly important. The model incorporated changes in the transmission of the virus that occurred with the changing seasons in 2020, when surges occurred during the winter months, and projected what may happen in 2021. For example, when 50 percent of the U.S. population is vaccinated by October 2021 instead of the end of December 2021, 6.6 million cases, 252,260 hospitalizations, 29,380 deaths, $4.0 billion direct medical costs, and $8.0 billion productivity losses were saved.

"The results of this study can give policymakers, community leaders, and other decision makers a sense of how much can be invested into vaccinating those who may be harder to get vaccinated," explained Sarah Bartsch, MPH, the study's lead author and project director for PHICOR. "Such investments may end up paying for themselves. For example, the potential cost savings exceed the $1.5 billion Biden Administration community outreach and media campaign. Our results show that increasing total vaccination coverage by just one percent could cover the costs of this effort."

"The longer it takes to reach higher vaccination coverage levels and herd immunity thresholds, the more the virus can spread," said Bruce Y Lee, senior author of the study, executive director of PHICOR, and CUNY SPH professor. "It may be particularly important to reach higher coverage levels before the late fall to prevent another winter surge."

Additionally, the study showed how increasing vaccination coverage levels was more valuable than using vaccines with higher effectiveness. For example, we found that achieving a 70 percent coverage with a 70 percent effective vaccine can save 2.1 million cases and 5.5 billion in medical costs and productivity losses compared to achieving a 50 percent coverage with a 90 percent effective vaccine over the same period. This shows the value of using all Covid-19 vaccines that are available to get more people vaccinated as soon as possible, rather than focusing only on those with the highest effectiveness. Moreover, as more contagious variants circulate, potentially decreasing the effectiveness of the existing Covid-19 vaccines, this can help address concerns about continuing with the existing vaccines or waiting for an updated version.

WASHINGTON, DC - MAY 6, 2021 - One out of every six adult workers (16%) in the United States are staying in jobs they might otherwise leave out of fear of losing their employer-sponsored health insurance, according to a new West Health-Gallup survey of more than 3,800 U.S. adults.

The survey finds the fear is even more pronounced among Black workers, who are 50% more likely to remain in an unwanted job than their White and Hispanic counterparts (21% to 14% and 16%, respectively).

But the most likely to stay in a job they would rather leave are those workers in households earning less than $48,000 a year -- roughly 3 in 10 (28%) say they will not leave and risk losing their health benefits. Workers in lower income households are nearly three times more likely to stay in an unwanted job than are workers living in households earning at least $120,000 per year. According to a report by the Congressional Research Service, 37% of U.S. households earned less than $50,000 in 2019. Approximately 158 million people receive health insurance via their own employer or via the employer of a household member.

"Healthcare costs have become so high that many Americans are unwilling to risk any disruption in their coverage even if that means higher and higher premiums and deductibles and sticking with a job they may not like," said Tim Lash, chief strategy officer for West Health, a family of nonprofit and nonpartisan organizations dedicated to lowering healthcare costs to enable successful aging. "Americans are increasingly concerned that they will get priced out of the U.S. healthcare system and are struggling to hang on in any way they can."

Earlier this year, an estimated 46 million or 18% of the U.S. population reported that they could not afford healthcare if they needed it today. In this latest survey, three times as many Americans or approximately135 million adults, are worried that they will eventually be priced out of healthcare if they are not already.

Specifically, more than half of respondents report they are "concerned" or "very concerned" the cost of healthcare services (53%) and prescription drugs (52%) will become unaffordable. More Americans worry about rising healthcare costs even more than losing one's home (25%) or job (29%).

Black and Hispanic adults have modestly elevated concerns about the rising costs of healthcare compared to White adults. Two-fifths (42%) of respondents, in turn, report concern that they would not be able to pay for a major health event, including 49% of Hispanic adults and 47% of Black adults.

Majorities Support Select Government Action to Contain Cost of Care

Substantial concerns about the rising cost of care and medicine likely play a role in explaining why most respondents in the survey support the federal government taking a bigger role in lowering healthcare costs regardless of their political affiliation, racial background, or type of insurance.

About three-quarters favor setting limits on prescription drug price increases (77%), capping hospital prices in areas with few or no other hospitals (76%), and having the government negotiate lower prices for some high-cost drugs without lower-priced alternatives (74%).

Another 65% support placing government limits on prices for out-of-network care (65%). Those with private insurance were just as likely as those on public health plans including Medicare and Medicaid to favor government intervention.

"Polling data from West Health and Gallup continue to demonstrate that most Americans are supportive of an elevated government role in curtailing the rising costs of care," said Dan Witters, Gallup senior researcher. "How elected officials respond to this is unfolding, but there seems to be substantive public support for a number of specific proposals that are on the table."

This latest West Health-Gallup survey was conducted by web between March 15 and March 21, 2021 with 3,870 adults, ages 18+, living in all 50 U.S. states and the District of Columbia as part of the Gallup Panel. For results based on this sample of national adults, the margin of sampling error at the 95% confidence level is +2.2 percentage points for response percentages around 50% and is +1.3 percentage points for response percentages around 10% or 90%, design effect included. For reported sub-groups, the margin of error will be larger, typically ranging from ±3 to ±4 percentage points.