Culture

URBANA, Ill. - The transition to middle school is undeniably tough for many sixth-graders, even in the best of times. Mounting academic demands, along with changes in peer dynamics and the onset of puberty, result in a predictable and sometimes irreversible slump in academic performance.

A new University of Illinois study suggests an unexpected but potentially potent remedy: trees.

"Hundreds of studies show a positive link between contact with nature and learning outcomes, but the studies on nature near schools focus on young children or older learners. We wanted to make sure the same pattern was true in this vulnerable and overlooked population," says Ming Kuo, associate professor in the Department of Natural Resources and Environmental Sciences at Illinois.

It was. Even after taking a whopping 17 variables into account including student demographics, school resources, and neighborhood characteristics, Kuo and her co-authors found that the more tree cover around a school, the better its standardized test scores in both math and reading. The study included 450 middle schools and nearly 50,000 students in urban, suburban, and rural communities in Washington State.

But why would trees boost test scores? Kuo's previous work points to a cause-and-effect relationship between nature and learning, with more exposure to nature resulting in improved concentration, greater classroom engagement, and less disruptive behavior. No surprise, then, that greener schools perform better.

Samantha Klein, a master's student who worked with Kuo on the study, made a point to compare different kinds of vegetation at different distances from schools.

"We wanted to offer concrete guidance to landscape architects, principals, and school boards interested in putting the greenness-achievement link to work, giving them clues as to what should be planted, and where," Klein says.

Kuo, Klein, and their team were able to differentiate tree cover from grass and shrubs using satellite imagery. "From a practical standpoint, trees cost more to install than grass. So if school districts could get away with just putting grass everywhere, that would be really helpful to know," Klein explains.

Unfortunately, that wasn't the case. Trees were far and away more impactful for test scores than other types of vegetation. Still, Kuo emphasizes that compared with other school resource investments planting trees around a schoolyard is still an incredibly cheap and effective intervention. But it could take a sea change before school districts accept school greening when other demands seem so much more pressing.

"I think school boards have always been faced with distributing very limited funds, especially in the poorest areas. They might think that, with all the other pressing needs for funding, school landscaping is the least of their concerns. Little do they suspect that a treeless schoolyard may actually be contributing to poor school performance," Kuo says.

The satellite images also helped Kuo's team pinpoint where tree cover mattered most. They compared the importance of greenness in different buffer zones around schools, within 250 meters (around two blocks) and 1000 meters. It turned out trees closer to the schools made all the difference, even when controlling for greenness at farther distances. In other words, even if the larger neighborhood was leafy, students were no better off if the schoolyard wasn't.

These findings extend previous discoveries in Chicago public schools. Kuo's work there showed the importance of tree cover near schools in low-income urban districts. But since her current study includes 450 schools across a wide spectrum of populations, she's confident her results apply more broadly.

"One of the nice things about this study is not only the sheer number of schools and students we're looking at, but the huge range in Washington State. We've captured everything from extremely urban to totally rural areas; rich schools and poor schools; schools with predominately white, Hispanic, Black, or American Indian student bodies; and every level of greenness represented within each of those samples," Kuo says. "The fact that the greenness-achievement link is true here is encouraging to me. It gives us some confidence that our recommendations apply to a whole variety of schools."

How does all this apply against the backdrop of remote learning during the COVID-19 pandemic? School greenness won't make much of a difference if kids aren't leaving the house. But whether they are physically in school or not, Kuo thinks contact with nature could be critical right now.

"I think the need for trees is more acute at this time. One of the big benefits of greenery, and one of the reasons we think it affects academic achievement, is it's a really potent stress reliever. Kids are aware that things are weird and that a lot of adults are kind of freaked out. And so having access to nature might be even more important than usual."

November 9, 2020 - Most young athletes don't get enough sleep - and that may significantly affect their sports performance, according to a paper in the November issue of Current Sports Medicine Reports, official journal of the American College of Sports Medicine (ACSM). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"There's growing evidence to suggest that youth athletes don't get required amount of sleep, and that this negatively affects their performance," comments Mark F. Riederer, MD, of C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, author of the new review. He believes that the trend toward more-intensive training might contribute to a lack of adequate sleep in in young athletes.

Rested and ready? Youth athletes need more sleep to do their best

Faced with competing demands including school, sports, and social life, young athletes tend to put off sleep in favor of other activities. Generally, the evidence suggests that they don't meet recommended guidelines for sleep duration: 9 to 12 hours for children aged 6 to 12 years and 8 to 10 hours for adolescents aged 13 to 18 years. For example, one study found that more than 90 percent of teen gymnasts get less than 8 hours of sleep per night.

Most studies find that young athletes get less sleep than non-athletes; they may sleep longer on the weekends, trying to make up their "sleep debt." The evidence suggests that young female athletes sleep less than their male counterparts. However, elite-level teen athletes of both sexes seem to get more sleep - possibly related to higher sleep need due to higher training loads.

Although studies vary, the evidence suggests that getting less-than-recommended sleep leads to decreased performance on the playing field. Some papers report that inadequate sleep has significant effects on reaction time, strength, speed, cognitive learning, and decision-making.

"[S]tudies consistently demonstrate that lack of recommended sleep results in poor sense of well-being, increased perceived training load, and poor placement in competitions," Dr. Riederer writes. Sleep deficits may also place young athletes at risk for injury and illness.

Other recent findings include:

Studies of napping and other sleep interventions show inconsistent effects on athletic performance.
Young athletes with symptoms of insomnia may be at increased risk of burnout, along with a higher risk of dropping out of their sport due to injury.
Levels of the stress hormone cortisol are increased after competitive matches, leading to reduced sleep time and quality.
Poor sleep may be linked to obstructive sleep apnea among college football linemen.
Inadequate sleep might be a risk factor for bony stress injuries (such as stress fractures).
Although it has been suggested that using smartphones or other electronic devices before bed can lead to impairments of sleep or athletic performance, one recent study found no such effects.

"The message for young athletes is, getting recommended sleep can improve your performance," Dr. Riederer comments. He notes that an emphasis on increasing training workload to improve skill and performance may adversely affect young athletes in other ways.

"Trends like early-morning training schedules, two-a-day practices, and late night practices and competitions come at the expense of good sleep habits - as well as leaving kids less time to socialize and do homework," Dr. Riederer adds. "We need to ensure our youth athletes are getting adequate amounts of sleep, and there is evidence to support this claim."

A biologist from RUDN University studied the development of the immune response in prepubertal male and female animals. According to her, the severity and mortality of infectious and inflammatory diseases at this age depend not on the sex hormones, but mainly on the chromosome set or karyotype. The results of the study were published in the Scientific Reports journal.

The amount of sex hormones in an animal's body changes during its life along with the state of its immune system. The correlation between these two processes hasn't been fully understood yet. It is yet unknown how sex hormones affect the immune systems of animals in the prepubertal period (in humans, this term refers to the age from 6-7 to 11-12 years). A biologist from RUDN University was the first to describe the differences in the immune response in prepubertal male and female rats. The results of the study can help find more effective treatment methods for children's diseases and increase the safety of vaccines.

"Understanding the peculiarities of the immune response in prepubertal animals can lead to the development of more effective immunotherapeutic approaches and help minimize the side effects of vaccination in children. That is why we decided to focus on the sex differences in the inflammatory response in prepubertal rats," said Anna Kosyreva, a Ph.D. in Biology, and an Assistant Professor at the Department of Histology, Cytology, and Embryology, RUDN University.

The team used 51 10-day-old rats (21 females and 30 males) in their experiment. 35 of them (12 females and 23 males) were injected with lipopolysaccharide (LPS), a toxic structural component of bacterial cell walls, to imitate septic shock--a common complication of severe infectious diseases. The administered dose (15 mg per one kg of weight) is deadly for adult animals but in the pups, the mortality rate amounted to 17% (2 out of 12) in females and 56% (13 out of 23) for males. 24 hours after the injection the team conducted a histological analysis of the lungs, livers, and thymuses of the survivors as well as the pups from the control group that hadn't received an injection. Before and after the injection the biologists measured the levels of the sex hormones estradiol and testosterone, as well as corticosteroids (hormones produced only by the adrenal cortex, not the genital glands) in all animals.

According to the team, the sex differences in the immune response to LPS in female and male rats did not depend on sex hormones. However, the progress of the inflammation in males was more severe: the area of liver necrosis in them was seven times larger than in females. Almost all injected pups developed pulmonary edema, but the number of neutrophils (inflammation-targeting cells) in males was 1.5 times higher. This more active inflammatory reaction is likely to be the cause of higher mortality among male rats. This difference could not have been explained by sex hormones. Therefore, the team assumed that the X chromosome could be the case.

The X chromosome contains immune response genes, including the regulators of NF-κB--a factor in charge of the synthesis of inflammation mediators. Females have two X chromosomes, one from each parent. If the genes responsible for NF-κB turn out to be dominant in one of the chromosomes, it takes over the other, and the dominant genes start to determine the production of inflammation mediators. In such a case, an animal has more chances to effectively fight infections. However, the males don't have this advantage because they only have one X chromosome with a single group of immune response genes.

A randomized clinical trial of Greek High Phenolic Early Harvest Extra Virgin Olive Oil in mild cognitive impairment: the MICOIL pilot study

Thessaloniki, Greece, November 9, 2020 - Greek researchers and clinicians investigated for the first time the effect of High Phenolic Early Harvest Extra Virgin Olive Oil (HP-EH-EVOO) versus Moderate Phenolic (MP-EVOO) and Mediterranean Diet (MeDi) as a therapeutic pharmaceutical natural compound for older adults with amnestic Mild Cognitive Impairment (aMCI). Amnestic MCI is usually a prodromal condition of Alzheimer's disease (AD) and is characterized by memory loss and inability to execute very complex Activities of Daily Living. While there is no treatment for MCI and symptomatic only treatment for AD, the global effort against cognitive disorders is focused on early detection and management of AD at the stage of aMCI.

Scientists from the Aristotle University of Thessaloniki (AUTH) and the Greek Association of Alzheimer's Disease and Related Disorders (GAADRD) have succeeded in making the shift to MCI therapy via robust natural remedies that can be used in order to forestall cognitive deterioration. In an article published in the Journal of Alzheimer's Disease, the researchers conducted a randomized prospective study so as to examine the HP-EH-EVOO and MP-EVOO versus MeDi. Moreover, genetic predisposition (APOE ε4) to Alzheimer's Disease (AD) was tested and an extensive neuropsychological battery was administered at baseline and after 12 months. Each participant was randomized and assigned to one of three groups i) Group 1 received the HP-EH-EVOO (50 mL/day) plus MeDi, ii) Group 2 received the MP-EVOO (50 mL/day) plus MeDi, and iii) Group 3 received only the MeDi instructions.

Recent literature paves the way to investigate natural compounds as alternative treatments of MCI due to AD. The MeDi is not a single prescribed diet, but rather a general food-based eating pattern, which is characterized by local and cultural differences throughout the Mediterranean region. Recent studies have proposed that more adherence to MeDi improved cognitive functions, decreased the possibility to develop MCI, and lessened the risk of MCI progression to AD. A Spanish longitudinal study showed that EVOO keeps the cognitive function better than nuts. A recent study suggests that intake of EVOO might offer a protective effect and/or slow AD pathology in transgenic mice. The results of this study suggest that the long-term consumption of an EVOO-containing diet starting at early age provides a protective effect against AD and its related disorder cerebral amyloid angiopathy (CAA), while a long-term intervention with an EVOO-rich MedDiet in 285 participants with high vascular risk resulted in better cognitive functioning when compared to a control diet.

The MICOIL study revealed better follow-up performance in Group 1 compared to Group 2 and Group 3 in almost all cognitive domains. Moreover, Group 2 showed also significant improvement compared to Group 3 in ADAS-cog (p=0.001) and MMSE (p=0.05), whereas Group 3 exhibited worse or similar to baseline performance in almost all domains. In particular, Group 1 and Group 2 had better outcomes with regards to ADAS-cog (p=0.003), Digit Span (p=0.006) and letter fluency (p=0.003). Moreover, there was a significant difference (p=0.001) in the presence of APOΕ ε4 between the Groups 1 and 2 vs. Group 3. Therefore, MICOIL showed that long-term intervention with HP-EH-EVOO or MP-EVOO was associated with significant improvement in cognitive function compared to MeDi, independent of the presence of APOE ε4.

Our study revealed in all measures we used better performance of treatment group compared with control group in the second assessment after 12 months of follow-up. Until today there is no other study which has examined in such detailed manner the effects of Greek EVOO in elders with MCI as an effective solution for cognitive impairment.

Gender discrimination continues to plague organizations, and "gig economy" businesses, which have thrived over the last decade, are not immune, according to new research from the University of Notre Dame.

Gig economy businesses, including Uber and Airbnb, offer temporary positions to independent workers while relying on consumer ratings and reviews as part of their advertising and marketing strategies.

But the system has its flaws. While digital brokerages provide a more efficient method for the exchange of goods and services and an improved way for consumers to voice their opinions about the quality of work they receive, bias and discrimination can emerge as part of the review process, according to "How unbecoming of you: Online experiments uncovering gender biases in perceptions of ridesharing performance," forthcoming in the Journal of Business Ethics from Nathan Meikle, postdoctoral research and teaching associate, and Corey Angst, professor of information technology, analytics and operations at Notre Dame's Mendoza College of Business.

For the study, the team created an ostensibly new ride-sharing service called Agile Rides with a publicly available mock website to reinforce its legitimacy. The team asked 919 participants from the crowdsourcing website Amazon MTurk to help them understand what makes a good rider experience and to imagine going through a detailed experience based on a recent customer experience with a driver. The vignette varied by gender and whether the rider had a good or bad experience. Participants then rated driver performance.

"In the online experiment, we examined participants' perceptions of the drivers," said Meikle, who specializes in social perception and its implications for organizations. "When driver performance was high-quality, participants rated female and male drivers equally. However, when driver performance was low-quality, participants rated female drivers significantly lower than male drivers."

In the gig economy, the traditional manager-subordinate relationship is absent and drivers receive their "performance evaluations" from customers.

The team points out that because digital platforms represent new, rapidly growing work environments capable of subjecting workers to bias and discrimination from a wide number of evaluators, companies should -- for moral, strategic and legal reasons -- consider algorithmic weightings based on gender to combat discrimination.

"If customers discriminate against female drivers, the female drivers may be dismissed from the platform, or at least punished financially, for performing equal quality work as men," Meikle said. "When employees' compensation and job security depend on the ratings of customers rather than on the ratings of managers, companies should examine whether customers are rating employees fairly and adjust the ratings accordingly."

Found in more than 60 countries, cruciferous clubroot disease is one of the most destructive plant diseases, causing so-called tumors on the roots of Brassicaceae crops and resulting in huge yield losses annually. The causal agent of this disease, Plasmodiophora brassicae, was first discovered by Russian biologist M. S. Woronin in 1878. Despite this early discovery, the life history of the pathogen remains a mystery.

"Although P. brassicae has been identified as the causal agent of cruciferous clubroot disease for 142 years, much earlier than the discovery of most plant pathogens, we were astonished that the full life cycle of this pathogen remained unclear when we started our investigation on this plant disease in 2015," said Lijang Liu, a scientist based at the University of Saskatchewan and the Chinese Academy of Agricultural Sciences. "The limited knowledge of P. brassicae biology greatly hinders the progress of studies on the cruciferous clubroot disease, which drove us to conduct this research."

The life history of the pathogen is very complex, comprising many different life forms. Liu and colleagues clarified the life history of P. brassicae in the root tissues of host Arabidopsis in a recently published article.

"Using confocal and electron microscopic imaging, we provide compelling evidence to support the proposed life cycle of P. brassicae, making it more convincing and acceptable to the community," explained Liu. "Notably, and most surprisingly, we discovered the existence of a sexual life stage of P. brassicae, starting from the fusion of two secondary zoospores within the infected epidermal cells."

Their other major findings include defining the development of zoosporangia and secondary zoospores and the sexual behavior between secondary zoospores in root epidermal cells and elucidating the growth and development of secondary plasmodia in root cortical cells, as well as the resultant physiological disturbances to host cortical cells.

"This research provides a fundamental understanding of the pathogen's biology as well as its cellular interactions with host plants. The knowledge gained from this investigation may further illuminate cellular mechanisms underlying host resistance and susceptibility and offers insights into the management practices against clubroot disease," said Liu. "Our article will help readers understand how such a lower eukaryotic microorganism performs a complex and sophisticated life history, giving a rise to a 'tumor' disease on plant roots."

Their article also highlights microscopic techniques coupled with live microbial fluorescence staining, which can be widely used in studying host-pathogen interactions. For more information, read "Refining the Life Cycle of Plasmodiophora brassicae" published in the October issue of Phytopathology.

A new study from researchers at Columbia University Vagelos College of Physicians and Surgeons has found evidence of a potential neurobiological mechanism for hallucinations and delusions that fits within the hierarchical model of psychosis and can explain their clinical presentation.

The study was published in eLife.

Columbia researchers Kenneth Wengler, PhD, a Postdoctoral Research Fellow and Guillermo Horga, MD, PhD, Florence Irving Associate Professor of Psychiatry, investigated the neurobiological mechanisms of two symptoms of schizophrenia: hallucinations and delusions. These two symptoms form the syndrome of psychosis, an immensely disabling psychiatric condition where patients lose their ability for reality testing.

"Typically, patients with more severe hallucinations also have more severe delusions, and these two symptoms respond similarly to antipsychotic medications. But this is not always the case; some patients have very prominent hallucinations but less severe delusions and vice versa," says Wengler. "This suggests that these symptoms may share a common neurobiological mechanism while simultaneously depending on symptom-specific pathways."

Some experts in the field believe that a hierarchical perceptual-inference model can explain the mechanisms behind psychosis. Wengler explains, "In its simplest form, the hierarchical model has two levels to the hierarchy: low and high. The low level makes inferences about basic features of stimuli and the high level makes inferences about their causes. An intuitive example of this is inferring the weather. In this scenario, you must decide if you are going to take an umbrella with you when you leave the house. The stimulus in this scenario is what you see when you look out the window; let's say it's cloudy. The context in this scenario is what you expect the weather to be like on a given day in the city you are in; let's say you are in Seattle. Although it is not currently raining, because it's cloudy and you are in a city where it often rains, you may decide to take an umbrella with you. The hierarchical model of psychosis frames hallucinations as resulting from dysfunction at the lower levels of the hierarchy and delusions as resulting from dysfunction at the higher levels of the hierarchy. Critically, these levels of inference are distinct but interconnected, so a dysfunction at one level would likely propagate upwards or downwards to other levels, therefore explaining why these symptoms tend to co-occur."

To investigate the neurobiological mechanisms of hallucinations and delusions within the framework of the hierarchical model, the researchers used functional magnetic resonance imaging to measure intrinsic neural timescales throughout the brain. These neural timescales reflect how long information is integrated in a given brain region. Most importantly, these neural timescales are organized hierarchically, making it a fitting measure to test the hierarchical model of psychosis.

The researchers collected data from 127 patients with schizophrenia from various online databases and determined how an individual's neural timescales related to their hallucination and delusion severities together. They found that neural timescales in the lower levels of the hierarchy tended to be longer in patients with more severe hallucinations, while neural timescales in the higher levels tended to be longer in patients with more severe delusions. These results provide the first direct evidence of a potential neurobiological mechanism for hallucinations and delusions that fits within the hierarchical model of psychosis and can explain their clinical presentation. The common neurobiological mechanism for both symptoms could result in increased neural timescales, but the symptom-specific pathways are the level of the hierarchy at which the neural timescales are increased. "Our findings open the door for the development of treatments to target specific symptoms of psychosis depending on an individual subject's symptom profile, in line with the current push for individualized medicine," says Horga.

The paper is titled "Distinct Hierarchical Alterations of Intrinsic Neural Timescales Account for Different Manifestations of Psychosis."

Adolescent and young adult (AYA) patients treated for acute myeloid leukemia (AML) have a high risk of developing several long-term health complications, a study led by UC Davis Comprehensive Cancer Center researchers has found.

The most common complications among AYA survivors (ages 15–39) were cardiovascular, endocrine and respiratory diseases. The complications - known as late effects - were more present among non-white AYA patients and those living in more deprived neighborhoods.

“Our study shed light on the high burden of late effects among young survivors of AML,” said Renata Abrahão, the study’s lead author. Abrahão is a postdoctoral fellow at the UC Davis Comprehensive Cancer Center and the Center for Healthcare Policy and Research.

According to the American Cancer Society, around 20,000 cases of AML will be diagnosed in 2020 in the U.S. alone. With AML, the myeloid cells produced inside the bone marrow grow abnormally. The main treatment for most types of AML is chemotherapy. In some cases, it might be followed by a stem cell transplant.

Late effects of AML linked to health disparities

The study used comprehensive information from 1168 AYA patients with AML. These patient cases were reported to the California Cancer Registry from all non-federal hospitals in California between 1996 and 2012.

The researchers found that after 10 years of AML diagnosis, some patients developed an endocrine disease (26%), a cardiovascular disease (19%) and a respiratory disease (7%). Other late effects were less frequent but included serious illnesses such as another cancer. The study found that AYA survivors who underwent bone marrow transplant were at least twice as likely to experience most of the late effects.

Hispanic, Black and Asian/Pacific Islander survivors were at a higher risk of many of the late effect diseases. The study showed that AYA survivors who lived in poorer neighborhoods at the time of AML diagnosis had more of these late effects.

According to the researchers, many factors can lead to the disparities in disease burden. These include differences in therapeutic management, patient’s response to treatment, AML with high-risk mutations, coexisting diseases and socioeconomic factors.

“This higher risk may relate to the financial hardship that patients with cancer often experience. As a result of cancer, AYA survivors and their families may miss work, experience income loss and incur substantial out-of-pocket expenses,” said Theresa Keegan. Keegan is an associate professor at the UC Davis Comprehensive Cancer Center and the study’s senior author.

AYA patients suffer a higher financial burden compared to younger or older cancer survivors. They may forgo treatment and long-term follow-up visits that could mitigate the impact of late effects. Their risk of late effects may be compounded by unhealthy lifestyle habits such as smoking, excessive alcohol consumption, lack of exercise, non-protected sun exposure and poor diet.

“Our findings can help clinicians and policymakers develop better survivorship care plans to reduce suffering and death among AYA survivors of AML,” Abrahão said.

The study was published Nov. 9 in the International Journal of Epidemiology.

This study was supported by the Rich and Weissman Family Lymphoma and Survivorship Fund, St. Baldrick’s Research Grant, the National Research Service Award (NRSA) for Primary Medical Care, from the Health Resources and Services Administration (HRSA) [T32HP300370401].

The co-authors on this work are Jasmine C. Huynh and Qian W. Li from the UC Davis Comprehensive Cancer Center; David J. Benjamin of University of California, Irvine; Lena E. Winestone of University of California, San Francisco; and Lori Muffly of Stanford University.

Article: Abrahão et al. (2020) Chronic medical conditions and late effects after acute myeloid leukemia in adolescents and young adults: a population-based study. International Journal of Epidemiology. Doi: 10.1093/ije/dyaa184

Journal

International Journal of Epidemiology

DOI

10.1093/ije/dyaa184

HERSHEY, Pa. -- Doctors may soon be able to more accurately diagnose concussions by measuring the number of certain molecules in a person's saliva, according to Penn State College of Medicine researchers. The results of a recent clinical study confirmed that a patient's spit may be used to aid concussion diagnosis in a non-invasive, non-biased fashion.

Researchers analyzed the saliva of more than 500 study participants for tiny strands of genetic material called micro ribonucleic acid (microRNA). These molecules play an important role in cellular processes and exist in high amounts in the brain. The investigators hypothesized that due to the presence of cranial nerves in the mouth, altered microRNA levels could indicate whether a patient is experiencing a concussion.

Concussions occur as a result of physical injury to the head and may result in short-lived symptoms including headaches, dizziness and confusion. Physicians currently use symptom scales and neurocognitive tests to assess patients and diagnose concussions. Researchers say these methods may not be reliable because they can be subject to patient and physician bias. For example, athletes may underreport a symptom's severity to return to the field.

"Current methods rely on accurate symptom reporting and honest performance on neurocognitive testing," said Dr. Steve Hicks, associate professor of pediatrics and principal investigator. "Analyzing microRNA profiles in saliva following a head trauma is a non-invasive way to test for concussion that can't be influenced by a patient's feelings or motives."

To develop the diagnostic approach, researchers recruited 538 participants across 11 clinical sites. Approximately half the participants had a concussion reported within two weeks of starting the study, while the other half of participants did not, but had conditions that might mimic concussion symptoms including anxiety, depression, attention deficit hyperactivity disorder, exercise-related fatigue or chronic headaches.

The researchers used RNA sequencing to evaluate saliva samples from half of the participants, then used statistical modeling and machine learning to identify noticeable differences between the RNA profiles of participants with concussions and those without. Once they knew what RNA changes to look for, they tested more than 200 additional participants and were able to successfully identify which patients had concussions. The accuracy of the saliva approach performed favorably when compared with currently available tests involving balance and reaction time. The results were published in the journal Clinical and Translational Medicine.

"This method has lots of promising applications," Hicks said. "A rapid, reliable diagnostic means that early, appropriate action can be taken to alleviate the symptoms of patients with concussions."

Hicks said the work expands upon a smaller pilot study that showed microRNA could be used to predict the duration of concussion symptoms and that further effort is needed to develop the test into a portable technology that can be used field-side by athletic trainers immediately after an injury occurs, by emergency responders at the scene of an accident, or by army medics on a battlefield. He is working with Quadrant Biosciences, who recently received a grant to do a larger clinical study to validate the method and further develop the technology.

COLUMBUS, Ohio - A new study of kindergarteners in one Midwestern state identified seven different pathways the children took in their early education and care before arriving at school.

The researchers were surprised by the diverse experiences that kids brought with them to kindergarten: While some received care only in their home or mainly in a child care center, others switched back and forth between different types of care, or had other arrangements.

This study is one of the few that has looked at kids' child care experiences all the way from birth to kindergarten, which allowed the researchers to capture the broad range of pathways, said Nathan Helsabeck, lead author of the study and a graduate research associate in educational studies at The Ohio State University.

"There are more nuanced differences in children's experiences before kindergarten than we originally thought," said Helsabeck, who is also an associate of Ohio State's Crane Center for Early Childhood Education and Policy.

"Looking at how children get to kindergarten could help us better consider what they need when they are entering school."

The study was published online in the journal Early Education and Development.

The study is part of a larger federally funded project designed to improve understanding of what happens in classrooms from pre-school to third grade. Data was collected from two large, suburban school districts including 25 schools, 152 classrooms and 3,472 students. A subsample of 568 students was used in this study.

One part of the study involved having parents complete questionnaires about their children's education and care from birth to 5 years old.

The researchers found that the largest group of children - 44% - received care only in the home over the first five years of life.

About 10% spent their first two years at home and in the third year became increasingly likely to be in center-based care. Another 7% spent these early years mostly in center-based care.

Those were the three pathways that the researchers had hypothesized would occur before they conducted the study, said Kelly Purtell, co-author of the study and associate professor of human sciences at Ohio State and faculty associate at the Crane Center.

But they found four other pathways as well: The second-largest group, 21%, were at home most of the early years, but were enrolled in a preschool or pre-kindergarten program in the last year before kindergarten. Other groups included children mostly cared for in informal settings (5%); those who went between home and informal care (8%); and those had both home and center care through the whole 5 years (5%).

Why were there so many different pathways?

"It reflects the patchwork availability of child care in this country," Purtell said.

"Child care for infants and young kids is expensive, so there are not a lot of affordable options for parents. Parents have to find different ways to take care of their kids while they work."

Helsabeck said he was particularly struck by the children whose care shifted from year to year, often from home to informal care, as their parents' situations changed.

"There was more than I expected in this category," he said.

"We need to realize that some kids face a lot of instability and their child care situations may change a lot. That may affect how they do in school."

The study also looked at how children who took different pathways did in kindergarten.

Findings did not show differences in test scores between children from different pathways. That was surprising, because most studies show an advantage to kids who spent more time in center-based care, Helsabeck said.

But he cautioned against making too much of that finding. It could be that there were not enough children in each of the seven groups to reveal differences in this study.

Results confirmed other studies that found children who spent most of their time in center-based care during their first five years had more teacher-reported social and behavioral problems in kindergarten.

That may be because these kids are already comfortable in school-like settings and are not as shy about acting out, Purtell said. They may also be more easily bored because for them, the experience is not novel.

"This is a real challenge for kindergarten teachers to navigate children who are brand new to this setting with those kids who are already familiar with the classroom setting," she said.

The researchers said that the seven pathways to kindergarten found in this study may not be the same everywhere.

"We looked at only two school districts in one state. That's not going to represent the whole country," Helsabeck said.

"But what we can take away from this is the wide range of experiences kids bring to kindergarten. It is going to affect how they do in school."

Research has shown that dexamethasone, a widely available steroid, can significantly reduce the chance of death from COVID-19. However, because of the way dexamethasone is transmitted throughout the body, it may be less effective in patients with diabetes, according to new research performed at the Advanced Photon Source (APS), a U.S. Department of Energy (DOE) Office of Science User Facility at DOE’s Argonne National Laboratory.

A research team led by scientists at the University of Virginia studied the way a blood protein, called serum albumin, picks up and transports dexamethasone throughout the body. The team used powerful X-rays from the APS to get a full picture of the structure of serum albumin combined with dexamethasone. Their work was published in the Journal of the International Union of Crystallography.

Low levels of albumin may already make it more difficult for some patients to get the benefits of dexamethasone. This research shows that patients with diabetes may experience the same difficulty, since high blood sugar changes the way albumin binds with dexamethasone. These findings, researchers say, may lead to physicians rethinking how they prescribe the drug for certain patients.

The X-ray macromolecular crystallography work was performed at Life Sciences Cooperative Access Team (LS-CAT) beamline 21-ID-F at the APS. The research team made use of remote access technology to control the APS beam without visiting the site.

“Gaining new insight into the mechanisms of this drug will help doctors design more effective treatments,” said Argonne’s Bob Fischetti, life sciences advisor to the APS director. “Since the start of this pandemic, the APS has been a powerful tool for gaining insights into the virus itself, and into methods for combating it.”

This research is the latest of many contributions the APS has made to the battle against COVID-19. Since January the APS has devoted more than 8,000 hours of experimental time across multiple X-ray beamlines to research on the SARS-CoV-2 virus. As of October 2020, more than 70 groups of researchers have used the APS to learn more about the virus, and lay the groundwork for treatments and vaccines.

PHILADELPHIA - Patients who shared the same racial or ethnic background as their physician were more likely to give the maximum patient rating score, according to a new analysis of 117,589 patient surveys from 2014 to 2017. The findings, from a team of Penn Medicine researchers, were published today in JAMA Network Open.

"What it comes down to is that patients who see physicians of their own race or ethnicity are more likely to rate their physicians higher than patients who see physicians of a different race or ethnicity," said the study's corresponding author Junko Takeshita, MD, PhD, MSCE, an assistant professor of Dermatology and Epidemiology in the Perelman School of Medicine at the University of Pennsylvania.

The study's findings underscore the need for health systems to address issues of implicit biases and to diversify the physician workforce, she added. "In a healthcare setting, racial and ethnic biases can affect health care delivery and ultimately, lead to health disparities."

In order to improve patient-centered care, health systems have made strides to both measure and publicly share patient ratings for individual physicians, sometimes linking these ratings to promotion and compensation decisions. The Press Ganey Outpatient Medical Practice Survey is one such tool used by many practices to evaluate the patient experience. Despite its wide use, the relationships between the patient experience and patient, physician, and clinical encounter characteristics are not completely understood, particularly when it comes to whether racial/ethnic concordance leads to higher Press Ganey scores.

To explore the relationships between race/ethnicity, as well as gender, and patient experience, the research team examined 117,589 Press Ganey surveys collected following adult outpatient visits across various medical specialties within the University of Pennsylvania Health System between July 2014 and May 2017. The patients were predominantly white (81.6 percent), followed by Black (12.8 percent), Asian (3.4 percent), and Hispanic (2.3 percent).

The surveys query patients on six domains: access, moving through your visit, nurse/assistant, care provider, personal issues, and overall assessment. Patients can rate their experience in each domain, ranging from one (very poor) to five (very good). For their study, the researchers focused on the responses for the "likelihood of your recommending this care provider to others" in the care provider domain of the survey.

They found that 87.6 percent of physicians from racially/ethnically concordant patient-physician pairs received the maximum score for this question, while only 82.1 percent of physicians from discordant pairs received the maximum score.

At the level of specific patient-physician racial/ethnic pairs, among Black patients, for example, the average ratings for white physicians were 0.03 points lower than those for Black physicians. According to Takeshita, these seemingly small differences are significant.

"Even a 0.02 difference in the mean score for the Press Ganey survey could take a physician from the 100th percentile down to the 70th percentile in terms of rankings," Takeshita said.

Along with examining racial/ethnic concordance, the authors also investigated gender concordance as a factor that might affect the patient experience. However, unlike the racial/ethnic concordance data, analyses incorporating gender did not reveal statistically significant differences in ratings.

While a valuable tool and reflection of the patient experience, there are limitations to the Press Ganey survey, said study senior author Deirdre Sawinski, MD, an associate professor of Renal-Electrolyte and Hypertension in the Perelman School of Medicine. In particular, it was not meant to be used to evaluate and compare individual physicians to one another, she said.

"Misapplication of these evaluations on an individual level can disadvantage some physicians in terms of survey data being used for promotions or bonuses," Sawinski said. "Misinterpreting the data can contribute to physician burnout or job dissatisfaction and not get at the heart of what's important for the patient experience. This study is an important step towards understanding how different factors contribute to create the patient experience, but clearly there is still more work to do. Most of all, we do not want our findings to discourage physicians from caring for a diverse patient population."

Even so, the study's findings suggest that racial/ethnic concordance does in fact play a role in patient-physician interactions, and the team hopes this will generate discussion and action to improve cultural competency among all physicians, so that they are prepared to care for a diverse patient population.

"Our data highlights why it's more important than ever to have a diverse physician workforce who looks like all the different types of patients we take care of, including different genders and different races," Sawinski said.

CLEVELAND - Results from a new Cleveland Clinic-led study suggest that melatonin, a hormone that regulates the sleep-wake cycle and is commonly used as an over-the-counter sleep aid, may be a viable treatment option for COVID-19.

As COVID-19 continues to spread throughout the world, particularly with cases rising during what some have termed the "fall surge," repurposing drugs already approved by the U.S. Food and Drug Administration for new therapeutic purposes continues to be the most efficient and cost-effective approach to treat or prevent the disease.
According to the findings published today in PLOS Biology, a novel artificial intelligence platform developed by Lerner Research Institute researchers to identify possible drugs for COVID-19 repurposing has revealed melatonin as a promising candidate.

Analysis of patient data from Cleveland Clinic's COVID-19 registry also revealed that melatonin usage was associated with a nearly 30 percent reduced likelihood of testing positive for SARS-CoV-2 (the virus that causes COVID-19) after adjusting for age, race, smoking history and various disease comorbidities. Notably, the reduced likelihood of testing positive for the virus increased from 30 to 52 percent for African Americans when adjusted for the same variables.

"It is very important to note these findings do not suggest people should start to take melatonin without consulting their physician," said Feixiong Cheng, Ph.D., assistant staff in Cleveland Clinic's Genomic Medicine Institute and lead author on the study. "Large-scale observational studies and randomized controlled trials are critical to validate the clinical benefit of melatonin for patients with COVID-19, but we are excited about the associations put forth in this study and the opportunity to further explore them."

Here, the researchers harnessed network medicine methodologies and large-scale electronic health records from Cleveland Clinic patients to identify clinical manifestations and pathologies common between COVID-19 and other diseases. Specifically, they measured the proximity between host genes/proteins and those well-associated with 64 other diseases across several disease categories (malignant cancer and autoimmune, cardiovascular, metabolic, neurological and pulmonary diseases), where closer proximity indicates a higher likelihood of pathological associations between the diseases.

They found, for example, that proteins associated with respiratory distress syndrome and sepsis, two main causes of death in patients with severe COVID-19, were highly connected with multiple SARS-CoV-2 proteins. "This signals to us, then," explained Dr. Cheng, "that a drug already approved to treat these respiratory conditions may have some utility in also treating COVID-19 by acting on those shared biological targets."

Overall, they determined that autoimmune (e.g., inflammatory bowel disease), pulmonary (e.g., chronic obstructive pulmonary disease and pulmonary fibrosis) and neurological (e.g., depression and attention-deficit hyperactivity disorder) diseases showed significant network proximity to SARS-CoV-2 genes/proteins and identified 34 drugs as repurposing candidates, melatonin chief among them.

"Recent studies suggest that COVID-19 is a systematic disease impacting multiple cell types, tissues and organs, so knowledge of the complex interplays between the virus and other diseases is key to understanding COVID-19-related complications and identifying repurposable drugs," said Dr. Cheng. "Our study provides a powerful, integrative network medicine strategy to predict disease manifestations associated with COVID-19 and facilitate the search for an effective treatment."

Twitter's impact is not limited to news, sports and political opinions.

Posts on the social media platform can influence stock returns, according to research led by a West Virginia University financial expert.

Alexander Kurov, Fred T. Tattersall Research Chair and Professor of Finance in the John Chambers College of Business and Economics, found that firm-level Twitter content has information useful for predicting next-day stock returns, and that it is a stronger predictor of returns for firms with less analyst coverage.

Kurov co-authored the study, "Informational role of social media: Evidence from Twitter sentiment," with Chen Gu, a 2018 graduate of the WVU finance doctoral program. Their findings are being published in the Journal of Banking and Finance.

In reaching their conclusions, Kurov and Gu obtained data from Bloomberg, which classifies individual tweets about a given company, aggregates them and calls the resulting variable "Twitter sentiment."

"Academic research in finance generally shows that investor sentiment tends to be driven by investor beliefs or feelings not justified by fundamentals, such as facts and rational expectations that should determine the value of a stock," Kurov said. "Our results show, however, that Twitter sentiment contains relevant information not yet reflected in stock prices.

"In particular, we show that Twitter sentiment contains information about upcoming analyst recommendation changes, analyst target price changes, quarterly earnings surprises and opening prices of stock initial public offerings."

Since 2013, the Securities and Exchange Commission has allowed public firms to distribute news, such as quarterly earnings, to the public via Twitter. The increased use of Twitter by firms and investors - including famous names like Warren Buffett - spurred Kurov and Gu to research the matter and determine how social media can be employed as part of an investment strategy.

Kurov also pointed to events in which information was prematurely revealed on Twitter, leading to large moves in stock prices.

For example, at a 2016 conference of the American Diabetes Association, the results of a clinical trial of Victoza, a new diabetes drug produced by Novo Nordisk, were announced during a presentation. While the ADA asked attendees to keep that information confidential, pictures of presentation slides showing those results popped up on several Twitter accounts within minutes.

Novo's stock price fell by 5.6 percent the following day because the new drug appeared less effective than expected.

"On the one hand, it is possible that tweets mentioning companies have little new relevant information," Kurov said. "In that case, Twitter content is just random noise that should have no permanent effect on stock prices. On the other hand, Twitter may aggregate bits and pieces of relevant information from diverse sources. We wanted to see which of these two plausible stories has more support in the data. Some previous studies have looked at information content of Twitter messages, but we were the first to test systematically if these messages contain useful information about thousands of individual stocks."

These findings have important implications for market participants, Kurov added. Traders should now analyze social media content carefully, and entities should continue to improve transparency and market efficiency by utilizing social media, he said.

And despite the evidence that tweets can influence stock prices, Kurov said it is unlikely that firms or investors can systematically manipulate stocks through Twitter activity.

"If a Twitter feed consistently disseminates information that is not factual, investors will quickly figure this out," he said. "Furthermore, spreading false information with intent to manipulate security prices is illegal and could make the person doing that a target of an investigation by the Securities and Exchange Commission."

The World Health Organization calls the spread of false information about the coronavirus (COVID-19) an "infodemic," and the results are broadly visible across society. The refusal of some people to wear a mask or socially distance, or self-quarantine when exposed to the virus, is often motivated by false information or conspiracy theories that are popular on social media.

So what are public health officials to do?

In a pair of newly published studies, University of Delaware researchers shed new light on the stigma, stereotypes and conspiracy theories that have spread alongside the novel coronavirus.

Understanding the impact of misinformation "is important for identifying potential barriers to public health efforts" to combat the virus, said Valerie Earnshaw, associate professor in UD's Department of Human Development and Family Sciences and lead author on both studies.

"Evidence suggests that people are more likely to believe conspiracy theories when they feel anxious, powerless, and unable to control their outcomes, as well as in times of crisis and when faced with large-scale events with serious consequences," she said. "Pandemics such as COVID-19 are powerful contexts wherein individuals may turn to conspiracy theories in an attempt to restore feelings of safety and control."

Ultimately, the more prominent the misinformation, the more difficult it will be for communities to bring the pandemic under control.

The first study, "Anticipated Stigma, Stereotypes, and COVID-19 Testing," which appeared in the journal Stigma and Health, suggests that stereotypes and anticipated stigma may be barriers to COVID-19 testing efforts. The results, Earnshaw said, are very similar to previous studies about HIV and Ebola stigma.

"We know from studies on mental illness and HIV that stigma will keep people from getting tested," said Earnshaw. "And stereotypes are one way that people experience stigma. Stereotypes are how stigma gets into our heads and shapes our views. Stereotypes help people feel safe. Stereotypes help people believe that those who get COVID, or HIV, are unlike them or doing the wrong thing. Stereotypes can sometimes give people a false security blanket."

Participants who anticipated more stigma, and those who endorsed more harmful stereotypes, reported that they would be less likely to get tested for COVID-19. By contrast, participants who demonstrated greater knowledge of COVID-19 reported that they would be more likely to get tested.

The second study, "COVID-19 conspiracy beliefs, health behaviors, and policy support," which appeared in the journal Translational Behavioral Medicine, found that one-third of participants believed in one or more conspiracies about COVID-19, and the results suggest that belief in conspiracy theories makes a person less likely to support public health policies designed to slow the spread of the virus. Participants who believed in conspiracy theories said that they were less likely to get vaccinated and trusted public health experts less.

The results of both studies were derived from an online survey of 845 U.S. adults that was conducted in April 2020. The survey was posted to Amazon Mechanical Turk, a crowdsourcing marketplace that researchers use to "collect rapid, high-quality data for psychological studies," said Earnshaw.

Despite the prevalence of misinformation, both studies suggest that people trust their personal doctor, regardless of their conspiracy beliefs. In the first study, most participants agreed that they would get tested if ordered by their doctor. In the second study, over 90% said they trusted information about COVID-19 from their doctor.

"Medical doctors are highly trusted sources of medical information," said Earnshaw. "Doctors can play a leading role in combating misinformation because even people who believe conspiracy theories still believe information about COVID from their doctors."