Culture

The period of time before pregnancy is critically important for the health of a woman and her infant, yet not all women have access to health insurance during this time. New research finds that the expansion of Medicaid for many states under the Affordable Care Act (ACA) had a positive impact on a variety of indicators of maternal health prior to conception.

The study in the journal Health Affairs, conducted by Laura R. Wherry, assistant professor of economics and public service at the Robert F. Wagner Graduate School of Public Service, New York University, Rebecca Meyerson of the University of Wisconsin, Madison, and Samuel Crawford of the University of Southern California, Los Angeles, compared changes in 10 major preconception health indicators for low-income women in both expansion and non-expansion states following the ACA Medicaid expansions.

The researchers found significant improvements in three preconception health indicators associated with the Medicaid expansions:

Increase in preconception health counseling, which provides a valuable opportunity to address key risk factors associated with adverse maternal and infant health outcomes prior to conception.

Increase in daily folic acid intake prior to pregnancy, which is recommended for all women by the U.S. Preventive Services Task Force to reduce the likelihood of neural tube defects among newborns.

Increased use of effective birth control methods after childbirth, which may decrease the likelihood of unplanned pregnancies or short interpregnancy intervals.

They did not find evidence of changes in chronic condition prevalence or health behaviors.

As of October 2020 - ten years after the landmark passage of the ACA, a total of 36 states and the District of Columbia have implemented the expansion of the Medicaid expansion program and healthcare access for the poor.

"We hope these findings can be used to help address some of the risk factors that shape maternal and child health in the U.S.," said Professor Wherry.

Okazaki, Japan -- In baseball, a batter's reaction when he swings and misses can differ depending on whether they were totally fooled by the pitch or simply missed the change-up they expected. Interpreting these reactions is critical when a pitcher is deciding what the next pitch should be. This type of socially interactive decision-making is the topic of a recent brain study led by Masaki Isoda at the National Institute for Physiological Sciences (NIPS) in Japan. They found that this ability requires a specific connection between two regions in the front of the brain, and that without it, monkeys default to making decisions as if they were playing against an inanimate object.

Two regions in the front of the brain--the PMv and the mPFC--contain "self", "partner", and "mirror" neurons that signal self-actions, other-actions, or both, respectively. Scientists believe that these types of neurons are what make social qualities such as empathy possible. However, despite years of research, not much is known about how these brain regions work together. The NIPS team set out to find some answers.

They trained monkeys to play a game with a partner in which they pressed buttons to obtain rewards. Sometimes, the rules of the game changed, and the monkeys made mistakes. Sometimes monkeys made mistakes simply because they were careless. "Monkeys continued using the same rule if they thought the other monkey's mistakes were accidental," says Masaki Isoda. "But, if they thought the mistakes were because the rules had changed, the monkeys adjusted their thinking and switched rules." The researchers included three types of partners: real monkeys, recorded monkeys, and inanimate objects.

They found that the proportion of partner cells was much higher in the mPFC than in the PMv, indicating it could be particularly important for understanding what others are thinking. Partner cells in the mPFC were most active and most affected by the PMv when partners were real and least active and least affected when they were inanimate objects. Thus, it seemed possible that the ability of a monkey to recognize social cues depends on mPFC cells getting social information from the PMv.

To test this hypothesis, the researchers used viral vector technology to temporally silence only neurons in the PMv that connect to the mPFC. In this situation, monkeys made many more mistakes after their partners made careless errors, behaving as if every error was because the rules had changed. "This behavior was reminiscent of an autistic monkey who played the same game," says Taihei Ninomiya. "As difficulty understanding social cues is a hallmark of autism, understanding the role of the PMv-mPFC pathway provides a good direction for future research into autism spectrum disorders."

Scientists at Korea's Daegu Gyeongbuk Institute of Science and Technology (DGIST) and colleagues have uncovered some of the complex molecular mechanisms involved in the formation of the brain's neural circuits. Their findings were published in The Journal of Neuroscience and could be relevant for developing treatments for diseases, such as autism spectrum disorders and schizophrenia.

Synaptogenesis is a complex molecular process that promotes the growth and development of nerve fibre ends so they can recognize and communicate with their appropriate nerve fibre partner via molecules transmitted across specialized junctions, called synapses.

"A comprehensive understanding of synaptogenesis is essential for designing therapeutic approaches against many devastating brain disorders," says DGIST neuroscientist, Professor Jaewon Ko. "So it's really crucial to develop fine-tuned molecular manipulations that can target key synapse components in order to understand their roles."

Professor Ko and his team of scientists specifically looked at two key 'synaptic adhesion molecules' involved in synaptogenesis. Neurexins and leukocyte common antigen-related protein tyrosine phosphatases (LAR-RPTPs) are transmembrane proteins that are located on the 'presynaptic' sending side of a developing nerve junction. They are known to be involved in the formation and maintenance of synapses. But it has been unclear whether they cooperate with each other and how they interact with other synaptic molecules in regulating synapse organization.

To address these questions, the scientists conducted a series of extensive experiments in rodent nerve cell cultures and then in fruit flies in which Drosophila orthologs of neurexins and LAR-RPTPs were deleted. They observed that two members of LAR-RPTPs (termed PTPσ and PTPδ) are required for neurexins to promote presynaptic differentiation. At the sending end of the developing synapse, neurexins bind to either of the two LAR-RPTPs through a distinct set of molecules depending on whether the synapse will be excitatory or inhibitory; in other words if it will send signals to activate or to turn off its receiving nerve end.

The scientists also found that PTPσ and neurexin directly interact through specific glycans, called heparan sulphates, to direct the formation of the receiving nerve end at excitatory synapses.

"We believe that our findings have significance in terms of proposing a novel molecular model underlying synapse organization, and possibly have implications for understanding neural circuit architecture and brain functions," says Professor Ko.

The team is now investigating downstream mechanisms underlying interactions of neurexins with LAR-RPTPs in vertebrate neurons, and is working to pinpoint a set of intracellular proteins involved in trans-synaptic signalling in presynaptic neurons. Further studies are essential before these findings can be translated into clinical studies.

Banning a harmful ingredient from the Australian food supply could prevent thousands of deaths from heart disease according to new research from The George Institute for Global Health.

Trans fatty acids - made during the industrial process that converts vegetable oils into a solid form of fat - are a well-known risk factor for heart disease. But it has been argued that eliminating them completely - as required by law in many overseas countries - would be too costly for both government and the food industry.

Dr Jason Wu, Program Head of Nutrition Science at The George Institute said that while the intake of trans fatty acids in Australia is generally low, levels continue to exceed health guidelines for some people, mostly those with less education and income.

"Despite the known health risks, our previous research shows progress on reducing trans fats in Australia's packaged food supply has slowed to a halt," he said.

While trans fats occur naturally at low levels in meat and cow's milk, people in most countries can also get them from partially hydrogenated vegetable oils in processed foods such as pastries. But avoiding them isn't easy because in Australia, it's not compulsory for manufacturers to list the amount of trans fats on the nutrition information panel on packaged foods.

Researchers from The George Institute for Global Health set out to calculate the potential costs and health benefits of a nationwide ban on industrial trans-fatty acids in Australia food supply.

The modelling study found that such a ban could prevent around 2,000 deaths and 10,000 heart attacks over the first ten years and up to 42,000 deaths from heart disease over the lifetime of the adult population (the time from when the ban starts to when all individuals died or reached 100 years of age).

The cost of implementing this legislative measure was estimated to be A$22 million during the first ten years and A$56 million over the population lifetime, most of which was down to government costs for monitoring implementation of the ban.

However, the estimated heart disease-related healthcare cost savings, compared to no ban, reached A$80 million over ten years and A$538 million over a lifetime.

Overall, the elimination of trans fatty acids in Australia was estimated to be cost-saving to highly cost-effective during the first ten years, and highly cost-effective over the population lifetime.

Lead author and Senior Research Fellow at The George Institute Dr Matti Marklund said the results supported the call by the WHO to eliminate trans fats from the food supply around the world.

"Our modelling study suggests that even in countries like Australia where intake is low, elimination of industrial trans-fatty acids can improve public health," he said.

"We also found that socioeconomically disadvantaged groups and Australians outside major cities could potentially have the greatest health gains from such legislation."

In the meantime, in order to minimise your intake of trans fatty acids Dr Marklund advised checking the labels of the packaged foods before buying.

"Any products that include partially hydrogenated fat or partially hydrogenated vegetable oil on the ingredient list are more likely to contain trans fats," he said.

Osaka, Japan - A research team from Osaka University has developed an innovative new animal-borne data-collection system that, guided by artificial intelligence (AI), has led to the witnessing of previously unreported foraging behaviors in seabirds.

Bio-logging is a technique involving the mounting of small lightweight video cameras and/or other data-gathering devices onto the bodies of wild animals. The systems then allow researchers to observe various aspects of that animal's life, such as its behaviors and social interactions, with minimal disturbance.

However, the considerable battery life required for these high-cost bio-logging systems has proven limiting so far. "Since bio-loggers attached to small animals have to be small and lightweight, they have short runtimes and it was therefore difficult to record interesting infrequent behaviors," explains study corresponding author Takuya Maekawa.

"We have developed a new AI-equipped bio-logging device that allows us to automatically detect and record the specific target behaviors of interest based on data from low-cost sensors such as accelerometers and geographic positioning systems (GPS)." The low-cost sensors then limit the use of the high-cost sensors, such as video cameras, to just the periods of time when they are most likely to capture the specific target behavior.

The use of these systems in combination with machine learning techniques can focus data collection with the expensive sensors directly onto interesting but infrequent behaviors, greatly increasing the likelihood that those behaviors will be detected.

The new AI-assisted video camera system was tested on black-tailed gulls and streaked shearwaters in their natural environment on islands off the coast of Japan. "The new method improved the detection of foraging behaviors in the black-tailed gulls 15-fold compared with the random sampling method," says lead author Joseph Korpela. "In the streaked shearwaters, we applied a GPS-based AI-equipped system to detect specific local flight activities of these birds. The GPS-based system had a precision of 0.59—far higher than the 0.07 of a periodic sampling method involving switching the camera on every 30 minutes."

There are many potential applications for the use of AI-equipped bio-loggers in the future, not least the further development of the systems themselves. "These systems have a huge range of possible applications including detection of poaching activity using anti-poaching tags," says Maekawa. "We also anticipate that this work will be used to reveal the interactions between human society and wild animals that transmit epidemics such as coronavirus."

New research from north-west England published in Anaesthesia (a journal of the Association of Anaesthetists) shows that during the first wave of COVID-19, the proportion of caesarean section deliveries carried out under general anaesthesia approximately halved, from 7.7% to 3.7%. This lower rate of general anaesthesia (also 3.7%) was also found among the small number of women having caesarean sections who had tested positive for COVID-19.

"At the onset of the global pandemic of COVID-19 (SARS-CoV-2), guidelines recommended using regional anaesthesia for caesarean section in preference to general anaesthesia, in order to reduce the risk of SARS-CoV-2 infection in healthcare workers," say the authors, who include Dr Kailash Bhatia, Saint Mary's Hospital (part of Manchester University NHS Foundation Trust), and The University of Manchester; Dr Malachy Columb, Wythenshawe Hospital (part of Manchester University NHS Foundation Trust), UK, and colleagues. "Anaesthetic decision-making, recommendations from these anaesthetic guidelines, and the regular presence of an on-site anaesthetic consultant in the delivery suite throughout the first wave could be among the key factors that influenced this decline."

National figures from the UK show that almost 170,000 caesarean sections were carried out in 2016-17 and approximately 8.75% (around 15,000) were performed under a general anaesthetic. In this new study, the authors explored whether general anaesthesia rates for women having caesarean sections changed during the peak of the pandemic across six maternity units* in the north-west of England.

They analysed data for 2480 caesarean sections across these six maternity units* from 1 April to 1 July 2020 and compared this information with data from 2555 caesarean sections performed at the same hospitals over a similar period in 2019.

The data revealed a significant reduction (7.7% to 3.7%) in general anaesthetic rates for women having caesarean sections, with analysis showing that a woman having a caesarean section birth during this period in 2020 was half as likely to have it under general anaesthetic than a woman having the procedure in 2019. The authors also found that the rate of conversion from local to general anaesthesia (done for emergency reasons during the procedure) also halved from 1.7% to 0.8% from 2019 to 2020.

Their analysis found no differences between 2019 and 2020 for the obstetric indications for caesarean sections. However, the overall rate of caesarean sections in all births in these samples increased from 28.3% in 2019 to 29.7% in 2020.

Dr Bhatia said: "It has been known for a long time that regional anaesthesia - i.e. a spinal epidural - is safer than general anaesthesia for caesarean sections. It has other benefits which include better pain relief; both partners being able to share in the birth experience in theatre during the procedure and earlier skin to skin contact with the baby.

"However, during the current COVID-19 pandemic, there are additional concerns that if a woman who has the virus is given a general anaesthetic, she could develop more serious respiratory problems than if she had a regional anaesthetic, and it is therefore even more important that general anaesthetics are avoided where possible. Women in labour may require a caesarean section before the team caring for them know whether she has COVID-19 or not, and therefore in these women, it is also important to avoid general anaesthesia if possible.

"General anaesthesia not only puts the woman having the caesarean section at risk of respiratory problems, but also anaesthetic staff and other healthcare workers in theatre, as tracheal intubation is an aerosol-generating procedure which poses a high risk of viral transmission from a suspected or confirmed case. It is therefore not surprising that anaesthetists were keen to avoid general anaesthesia - unless regarded as essential - in order to ensure the safest possible care for patients, and a safe working environment for staff."

In the paper, the authors also stress that general anaesthesia was still used when required in emergency situations, termed category one caesarean sections (which represent around one in six of all caesarean sections in the UK), and include situations such as fetal distress that require immediate action. In this study, the rate of general anaesthesia in the 2020 group was 12% among these category one caesarean sections, well above the overall 2020 group average of 3.7%, but also well below the rate of 25% rate for category one caesarean sections seen in the 2019 group.

Also of note was that anaesthetic staffing changed during the pandemic. On-site out-of-hours anaesthetic consultant support systems were established in 80% of the hospitals analysed. "During the first wave of the COVID-19 pandemic, most of the maternity units we studied benefitted from the presence of more experienced and skilled personnel in the delivery suite, leading to improved on-site immediate and local supervision. This possibly contributed to the high regional anaesthesia rates and lower regional to general anaesthesia conversion rates compared to the pre-COVID group," explain the authors.

They add: "Personal protective equipment (PPE) recommendations were different for women needing regional anaesthesia and at low risk of a conversion to a general anaesthesia (droplet precautions) compared with those having general anaesthesia from the commencement of caesarean section or those at high risk of conversion (airborne precautions). Donning of PPE for general anaesthesia takes time, which could theoretically result in adverse fetal outcomes in urgent/emergency caesarean sections. It is possible that this factor may have contributed to decision-making by anaesthetists."

The authors also discuss specific findings on women who tested positive for COVID-19. A total of 76 of 2480 (3%) of women tested positive in this study and the caesarean section rate for COVID-19 positive women was 36% (27 women), higher than the 29.7% reported for the 2020 group overall, but much lower than reported in other studies. Just one of these 27 women had general anaesthesia, the same proportion (3.7%) as in the 2020 group overall.

However the authors caution: "We would not want to draw any specific conclusions as we do not have the details for these women. We do not know the number of women who were swabbed for COVID-19 across hospitals regionally, and cannot therefore estimate the incidence of COVID-19 in these hospitals. We would like to highlight the fact that our dataset has one of the lowest caesarean section rates reported for COVID-19 positive pregnant women."

They conclude: "Overall, we conclude that the general anaesthesia rate for women having caesarean sections declined significantly during the peak of the COVID-19 pandemic. Anaesthetic decision-making recommendations from anaesthetic guidelines and presence of an on-site anaesthetic consultant in the delivery suite could be among the key factors that potentially influenced this decline."

"One of the important questions this study raises is: why do trainees seemingly choose general anaesthesia more frequently when they are working solo?" adds Dr Tim Meek of the Association of Anaesthetists, a consultant anaesthetist based at James Cook University Hospital, Middlesbrough, UK. "Possible explanations include lack of confidence in their regional anaesthesia skills, a perception that general anaesthesia is always quicker and, perhaps most importantly, a disproportionate focus on target decision to delivery times as the key marker of success. We should now aim to identify what enables consultants to provide regional anaesthesia confidently and focus on equipping trainees with those tools to the benefit of the women and babies we all care for."

Simply comparing the total number of deaths across countries may provide a misleading representation of the underlying level of transmission of SARS-CoV-2, the virus that causes COVID-19, because of large differences in reported COVID-19 death rates in elderly populations in different countries.

The research, conducted by scientists at the University of Cambridge and the Institut Pasteur, was published today in the leading journal Nature. It highlights how large COVID-19 outbreaks in European nursing homes, and the potential for missing deaths in some Asian and South American countries, have skewed COVID-19 death data for older age groups, rendering cross-country comparisons of the scale of the pandemic inaccurate.

The researchers say that reporting of deaths from COVID-19 among those under the age of 65 is likely to be far more reliable, and can therefore give clearer insights into the underlying transmission of the virus and enable better comparisons between countries - crucial in guiding government strategies to try to get COVID-19 under control.

"Simply comparing the total number of deaths across countries can be misleading as a representation of the underlying level of transmission of SARS-CoV-2. Most deaths are in older people, but they are the least comparable across countries," said Megan O'Driscoll, a PhD researcher in the University of Cambridge's Department of Genetics and first author of the paper.

In countries including the UK, Canada and Sweden, the COVID-19 pandemic has disproportionately affected nursing home residents, who account for over 20% of all reported COVID-19 deaths. The level of SARS-CoV-2 transmission among the general population can be difficult to disentangle from these large outbreaks.

By contrast, some countries in Asia and South America have far fewer reported COVID-19 deaths in older people than expected. One potential explanation for these 'missing deaths' is that causes of deaths in elderly populations may be less likely to be investigated and reported as countries struggle to contain the epidemic.

"Nursing homes are enclosed communities of people, and once the virus gets in it can spread quickly resulting in higher levels of infection than in the general population. We're seeing an excessively large number of deaths from COVID-19 in this older age group, particularly in countries that have many nursing homes," said Dr Henrik Salje in the University of Cambridge's Department of Genetics, the senior author of the report.

He added: "It's not just that residents are older than the general population, they are also generally more frail, so a 70-year old living in a nursing home is often more likely to die of COVID-19 than a 70-year old in the general population. To reduce the overall number of COVID-19 deaths it is vital to protect vulnerable elderly communities."

In their new model, the researchers integrated age-specific COVID-19 death data from 45 countries with 22 national-level seroprevalence surveys. Governments of many countries are using seroprevalence surveys to estimate the number of people in a population with antibodies against the coronavirus. Antibodies indicate if a person has been infected with SARS-CoV-2 at some point, so are a good indicator of population-wide infection rates.

"Our model shows that the number of COVID-19 deaths by age, in people under 65 years old, is highly consistent across countries and likely to be a reliable indicator of the number of infections in the population. This is of critical use in a context where most infections are unobserved," said O'Driscoll.

The model can be used at a country-wide level to predict a person's likelihood of dying from COVID-19 following infection, depending on their age. It also works in reverse, to estimate a country's total number of infections given its number of COVID-19 deaths in an age group, which is particularly useful in places where seroprevalence studies have not been conducted.

Using death data from under-65 age groups only, which is most representative of transmission in the whole population, it shows that by the 1 September this year an average of 5% of the population of a country had been infected with SARS-CoV-2. However, in some places it was much higher, especially South America.

For example, using Peru's COVID-19 death figures, which equate to 0.01% of the country's population, the model suggests that over half of the population of Peru has now been infected with SARS-CoV-2 - a figure far higher than expected. This indicates particularly high rates of transmission of the virus in Peru.

But even after excluding data from the over 65's, the model shows that COVID-19 death rates cannot be compared between some countries, because the relationship between infections and deaths is not consistent when other widespread 'co-morbidity' factors are involved.

"It seems that people living in places such as Slovenia and Denmark have a low probability of death following infection with SARS-CoV-2, even after accounting for the ages of their populations, which is very different to what we've seen in New York, for example. There are likely to be fundamental differences in the populations across countries, which might include their underlying health," said Salje.

The model also revealed a strong pattern across countries in the 5-9 year age group, which consistently has the lowest probability of death following SARS-CoV-2 infection.

The work demonstrates how age-specific death data alone can be used to reconstruct the underlying level of SARS-CoV-2 infection in a country and how it has changed over time. The researchers say this approach could be applied at sub-national scale, and may be of particular use in settings where large seroprevalence studies might not be feasible.

Russian and British scientists study the approaches to mathematical modeling of electromechanical processes in neurons of the brain.

Researchers from Peter the Great St.Petersburg Polytechnic University (SPbPU) in collaboration with colleagues from the University College London under the framework of "Project 5-100" study the effect of neural stimulation by ultrasonic waves and analyzing the influence of ultrasonic wave parameters on the excitation of electrical signals in the nerves. The obtained results have a great practical value for further studies related to the issues of human brain modeling. These results are aimed at the improvement of the methods used to treat a range of severe neurological and mental disorders, including epilepsy and chronic depression.

According to the World Health Organization, about 50 million people worldwide suffer from epilepsy, one of the most common neurological diseases on a global scale. Besides, more than 264 million people from all age groups suffer from depression. Dysfunction of neurons in the brain can be the cause of both diseases.

"We have proposed and tested various hypotheses regarding the physics of the process of ultrasonic neural stimulation, - explains Vladimir Filkin, a member of the scientific group, a graduate student of the Higher School of Mechanics and Control Processes SPbPU" Currently, the researchers obtained a mathematical model of this fundamental process, which will be useful for the effective algorithm of using the ultrasound to treat patients and conduct all kinds of research.

The research method used is the same as that employed in the testing of drugs for medicine. This means applying randomization methods in the analysis of electric energy consumption in households: a randomly selected sample group, made up of hundreds of thousands of people that are all clients of the same Italian company Eni gas e luce, were sent a document containing a comparison of their energy consumption with that of other households, with positive messages aimed at those that were more efficient. In what ways did people assimilate this information and consequently change their behaviour and energy consumption?

This is the question that lies at the heart of the research conducted by the Italian team from the RFF CMCC European Institute on Economics and the Environment (EIEE), composed of Jacopo Bonan, Cristina Cattaneo, Giovanna d'Adda and Massimo Tavoni, and published in the latest edition of the prestigious Nature Energy journal with the title "The interaction of descriptive and injunctive social norms in promoting energy conservation".

The results obtained from the study outline how a variation in the contents of the document sent to the sample group influenced their energy consumption. For example, the less efficient clients discovered through these documents that they were consuming more than other similar households, and that efficiency was a prized attribute. These clients, that were shown consistent social norms, then went on to have the largest decrease in energy consumption after receiving the document. To the contrary, the document received by the more efficient households, on top of approval for having saved on energy also revealed that conforming to the behaviour of other families would have meant increasing their energy consumption. This led the more efficient clients to have a smaller decrease in energy use in response to the document, as the two social norms were in contrast with each other. A detailed analysis was able to distinguish and isolate the impact of the specific contents of the document from that of the characteristics of individual clients, particularly with regards to initial consumption.

The results demonstrate a synergy between different types of social norms: the people that most reduced their consumption were those that, from the information received, understood that they were using more electric energy than their neighbours, and at the same time learnt that less consumption of energy is a socially recognised value.

Another important result that emerges from the study, exemplified by the virtuous client, reveals the hidden risks of messages that are based on social norms and how they can become ineffective if they contain contrasting messages. In fact, these clients learnt that energy conservation is a valued social norm but at the same time discovered that the behaviour of their neighbours didn't reflect this value. To induce the virtuous clients to further reduce their consumption it was therefore necessary to strengthen the message in favour of energy efficiency.

The authors explain that the results of the study contain important lessons for the realization of information campaigns that aim to maximise behavioural change. Areas in which these could be applied effectively include tax evasion, philanthropy or the use of water resources. In all these cases the Italian team's research has a high scientific relevance. It is an innovative study not only in the application of methods, theories and competences of behavioural science to research on energy, but also in its engagement with energy providers that took an active role in the research efforts. Public and private policymakers in the energy sector are therefore among the parties interested in understanding how messages and information can contribute to change the behaviour and consumption patterns of people.

This level of innovation and multidisciplinarity, that brings together experts in energy technology and behavioural science, is one of the characteristics that defines the RFF CMCC European Institute on Economics and the Environment (EIEE). Born from a collaboration between the CMCC Foundation and the US based think tank RFF, this institution combines different competences in the study of environmental economics in support of sustainable development.

There were 54.6 million more days of poor mental health among adults in states that voted for Hillary Clinton in December 2016, compared to October 2016, according to a study published in the Journal of General Internal Medicine. No such increase in poor mental health following the 2016 US election was observed in states that voted for Donald Trump. The increase in average number of poor mental health days per person in Clinton-voting states largely persisted in the six months after the election.

Comparing states in which Trump had received the most votes with states in which Clinton had received the most votes, a team of researchers from the University of California, San Francisco, USA, and Duke University, Durham, NC, USA found that in Clinton-voting states, the average number of days on which adults reported experiencing poor mental health in the last 30 days increased by 0.50 days, from 3.35 days in October to 3.85 days in December 2016.

Brandon Yan, the corresponding author said: "The additional half a day per adult translated into 54.6 million more days of poor mental health in December 2016 alone for the 109.2 million adults living in Clinton-voting states."

The rise in poor mental health days in Clinton-voting states in December 2016 was primarily observed in adults aged 65 and older, women, and white individuals. No changes in poor mental health days were statistically detected among younger age groups, men, or racial and ethnic minority groups in December 2016 in either Clinton- or Trump-voting states.

In states that voted for Clinton, the authors also observed a 2 percentage point increase in the number of people who reported at least 14 days of poor mental health in the last 30 days in December 2016, compared to October 2016, while no such rise was observed in Trump-voting states.

Brandon Yan said: "It is notable that following the election the proportion of those with 14 or more days of poor mental health also increased, which may suggest that some individuals may newly meet diagnostic criteria for major depressive disorder."

The authors analyzed data on 499,201 adults collected in 2016 and 2017 as part of the Behavioral Risk Factor Surveillance System, a joint state and federal annual household survey. By comparing each monthly cohort of survey respondents, they studied changes in three mental health indicators - total days of poor mental health in the last 30 days, 14 days or more of poor mental health in the last 30 days and being diagnosed with a depressive disorder - in Clinton- and Trump-voting states in the six months following the November 2016 election, compared to the six months before the election.

The authors also found that a 10-percentage point higher margin of victory for Trump in the state was associated with 0.41 fewer days of poor mental health in Trump-voting states. The inverse is also statistically true. In Clinton-states, a 10-percentage point higher margin of victory for Clinton in the state predicted 0.41 more days of poor mental health.

Overall, the findings suggest that the outcome of the 2016 election had a negative impact on mental health for voters of the candidate that lost the election.

Brandon Yan said: "Depression rates - which were assessed by asking people if they had ever been diagnosed with a depressive disorder - also started rising in January 2017 in Clinton-voting states and in February 2017 in Trump-voting states. These increases in depression rates continued into the second quarter of 2017." The authors suggest that the rise in depression rates in Trump states suggests that there were likely other coinciding factors contributing to depression, such as rising opioid deaths which especially affected many states that voted for Trump.

The authors caution that the cross-sectional observational nature of the study does not allow for conclusions about cause and effect. Because the respondents' candidate preference and party affiliation were unknown, the authors relied on the candidate's margin of victory or loss in a state to assess which candidate's voters experienced changes in mental health.

Brandon Yan said: "Given our findings for 2016, primary care providers, mental health professionals, and the public should not overlook the potential effects from the 2020 election. Health care providers could play a proactive role in monitoring for clinically relevant signs of mental health deterioration and offering appropriate support and intervention following the 2020 election."

In a study recently published in the top journal "Allergy", a team of MedUni Vienna scientists led by immunologist Winfried F. Pickl and allergologist Rudolf Valenta (both from the Center for Pathophysiology, Infectiology and Immunology) showed that there are seven "forms of disease" in COVID-19 with mild disease course and that the disease leaves behind significant changes in the immune system, even after 10 weeks. These findings could play a significant role in the treatment of patients and in the development of a potent vaccine.

In the study involving 109 convalescents and 98 healthy individuals in the control group, the researchers were able to show that various symptoms related to COVID-19 occur in symptom groups. They identified seven groups of symptoms: 1) "flu-like symptoms" (with fever, chills, fatigue and cough), 2) ("common cold-like symptoms" (with rhinitis, sneezing, dry throat and nasal congestion), 3) "joint and muscle pain", 4) "eye and mucosal inflammation", 5) "lung problems" (with pneumonia and shortness of breath), 6) "gastrointestinal problems" (including diarrhoea, nausea and headache) and 7) "loss of sense of smell and taste and other symptoms".

"In the latter group we found that loss of smell and taste predominantly affects individuals with a 'young immune system', measured by the number of immune cells (T lymphocytes) that have recently emigrated from the thymus gland. This means that we were able to clearly distinguish systemic (e.g., groups 1 and 3) from organ-specific forms (e.g. groups 6 and 7) of primary COVID-19 disease," says Pickl.

COVID-19 fingerprint in the blood

At the same time, the scientists established that COVID-19 leaves behind long detectable changes in the blood of convalescents, very similar to a fingerprint. For example, the number of granulocytes, which are otherwise responsible in the immune system for fighting bacterial pathogens, is significantly lower than normal in the COVID-19 group. Pickl explains: "However, both the CD4 and CD8 T cell compartment developed memory cells and CD8 T cells remained strongly activated. This indicates that the immune system is still intensively engaged with the disease several weeks after initial infection. At the same time, the regulatory cells are greatly diminished - and that is likely a dangerous mix, which could lead to autoimmunity." Furthermore, increased levels of antibody-producing immune cells were detected in the blood of convalescents - the higher the fever of the affected patient during the mild course of the disease, the higher were the antibody levels against the virus.

"Our findings contribute to a better understanding of the disease and help us in the development of potential vaccines, since we now have access to promising biomarkers and can perform even better monitoring," the scientists emphasize. "Above all, the study shows that the human immune system "doubles up" when defending against COVID-19 with the combined action of immune cells and antibodies - like the defence in a modern soccer team - and that the cells are also able to memorise certain "moves" on the part of the virus (Note: "memory") and respond to them. Now it is a matter of implementing these findings and using them for the development of highly-effective COVID-19 vaccines."

Political and social engagement is a relevant topic for European business leaders. CEOs are increasingly making public statements on political issues in order to make a positive contribution to socially relevant topics. These are the findings of a recent study conducted by ESMT Master's in Management graduate Christoph Cewe in cooperation with United Europe e.V. The study surveyed 40 leaders of large European companies. Of those surveyed, 77.5 per cent believe that managing directors should take a stand on political issues, and 62.5 per cent state that they are also (very) likely to express themselves in sociopolitical terms. The most frequently reported motives for taking a public stance are to contribute to society (78 %) and to express corporate values (72 %).

The study entitled "The political CEO: Rationales behind CEO sociopolitical activism" explores the question of how and why CEOs and managing directors of European companies increasingly take a public stance on political and social issues that have no direct connection to their core business. Examples are climate change, immigration policy and the unconditional basic income.

"The results of the study show that managing directors express themselves publicly, primarily on political issues, so that they can use their influence to make a positive contribution on socially relevant topics. Personal motives and potential advantages for shareholders do not play a greater role," says Christoph Cewe. "European CEOs want to add value to the substantive discourse with their public statement, but do not want to take a party-political stance. Thus, ecological, economic and social issues are identified as the most suitable topics for public comment. Less than one in ten of the CEOs surveyed stated that it is appropriate to take a party political stance in public.

Leonhard Birnbaum, member of the board of management of E.ON SE, Günther H. Oettinger, former EU commissioner and president of United Europe e.V., and Jörg Rocholl, president of ESMT, engaged in an intensive exchange on the study "The Political CEO" on Monday, October 26. "At United Europe we support business leaders who are committed to the European idea. For many European CEOs, political commitment is a relevant topic, but CEOs do not bear political responsibility. They must be able to maintain a balance between business competence, public credibility, and an understandable interest in social processes," says Günther H. Oettinger.

Jörg Rocholl adds, "Authenticity and competence are the most important prerequisites for a public statement by managing directors. Lack of credibility can have immediate negative consequences, not only for the CEO personally, but for the entire company." The discussion was moderated by Ulrike Guérot, professor for European politics and democracy research at the Danube University Krems.

A bacterium found among the soil close to roots of ginseng plants could provide a new approach for the treatment of Alzheimer's. Rhizolutin, a novel class of compounds with a tricyclic framework, significantly dissociates the protein aggregates associated with Alzheimer's disease both in vivo and in vitro, as reported by scientists in the journal Angewandte Chemie.

The area around the roots of plants is a complex ecosystem with numerous interactions between plants and diverse microorganisms. The so-called rhizosphere has been neglected in the search for new drugs, though it has much to offer. A team working with YoungSoo Kim (Yonsei University, Incheon, South Korea) and Dong-Chan Oh (Seoul National University, South Korea) has now identified a natural substance called rhizolutin that may provide a basis for novel Alzheimer's disease treatments. Rhizolutin is produced by a Streptomyces strain that grows in the root zone of ginseng plants. Ginseng is an Asian plant used in traditional medicine, where it is said to be a tonic.

Through cultivation in a medium fortified with ginseng powder, the researchers were able to increase the rhizolutin production of the bacterium by a factor of ten. This allowed them to determine the structure of this novel compound, which turns out to be a unique framework made of three rings bound together (a 7/10/6-tricyclic dilactone flanked by a seven-membered and a six-membered lactone ring).

A screening of natural product libraries indicated that rhizolutin is a drug lead that can dissociate amyloid-β (Aβ) plaques and tau tangles (fiber-like aggregates of tau proteins), both of which are typical hallmarks of Alzheimer's disease. Such deposits form when amyloid-β proteins fold incorrectly to form β-sheets, which can aggregate to form insoluble plaques and fibers. These lead to the death of nerve cells, nerve inflammation, brain atrophy, and the cognitive losses these entail. No effective treatment for Alzheimer's disease has been found.

Through a variety of in vitro and in vivo experiments, the team was able to demonstrate that rhizolutin leads to clear dissociation of insoluble Aβ and tau aggregates. In cultures of neuronal and glial cells, rhizolutin was able to markedly reduce the inflammatory processes and cell death caused by Aβ. Rhizolutin was also able to significantly dissociate the Aβ plaques present in the brains of mice with Alzheimer's. The process seems to be similar to the removal of incorrectly folded proteins through immunotherapy. Computer simulations suggest that rhizolutin enters into the hydrophobic regions of the aggregated β-sheets, initiating the dissociation.

Pasadena, CA-- The Sloan Digital Sky Survey's fifth generation collected its very first observations of the cosmos at 1:47 a.m. on October 24, 2020. This groundbreaking all-sky survey will bolster our understanding of the formation and evolution of galaxies--including our own Milky Way--and the supermassive black holes that lurk at their centers.

The newly-launched SDSS-V will continue the path-breaking tradition set by the survey's previous generations, with a focus on the ever-changing night sky and the physical processes that drive these changes, from flickers and flares of supermassive black holes to the back-and-forth shifts of stars being orbited by distant worlds. SDSS-V will provide the spectroscopic backbone needed to achieve the full science potential of satellites like NASA's TESS, ESA's Gaia, and the latest all-sky X-ray mission, eROSITA.

"In a year when humanity has been challenged across the globe, I am so proud of the worldwide SDSS team for demonstrating--every day--the very best of human creativity, ingenuity, improvisation, and resilience. It has been a challenging period for the team, but I'm happy to say that the pandemic may have slowed us, but it has not stopped us" said SDSS-V Director Juna Kollmeier.

As an international consortium, SDSS has always relied heavily on phone and digital communication. But adapting to exclusively virtual communication tactics was a challenge, as was tracking global supply chains and laboratory availability at various university partners while they shifted in and out of lockdown during the final ramp-up to the survey's start. Particularly inspiring were the project's expert observing staff, who worked in even-greater-than-usual isolation to shut down, and then reopen, operations at the survey's mountain-top observatories.

Funded primarily by member institutions, along with grants from the Alfred P. Sloan Foundation, the U.S. National Science Foundation, and the Heising-Simons Foundation, SDSS-V will focus on three primary areas of investigation, each exploring different aspects of the cosmos using different spectroscopic tools. Together these three project pillars--called "Mappers"--will observe more than six million objects in the sky, and monitor changes in more than a million of those objects over time.

The survey's Local Volume Mapper will enhance our understanding of galaxy formation and evolution by probing the interactions between the stars that make up galaxies and the interstellar gas and dust that is dispersed between them. The Milky Way Mapper will reveal the physics of stars in our Milky Way, the diverse architectures of its star and planetary systems, and the chemical enrichment of our galaxy since the early universe. The Black Hole Mapper will measure masses and growth over cosmic time of the supermassive black holes that reside in the hearts of galaxies as well as the smaller black holes left behind when stars die.

"We are thrilled to start taking the first data for two of our three Mappers," added SDSS-V Spokesperson Gail Zasowski of the University of Utah. "These early observations are already important for a wide range of science goals. Even these first targets cover goals from mapping the inner regions of supermassive black holes and searching for exotic multiple-black hole systems, to studying nearby stars and their dead cores, to tracing the chemistry of potential planet-hosting stars across the Milky Way."

"SDSS-V will continue to transform astronomy by building on a 20-year legacy of path-breaking science, shedding light on the most fundamental questions about the origins and nature of the universe. It demonstrates all the hallmark characteristics that have made SDSS so successful in the past: open sharing of data, inclusion of diverse scientists, and collaboration across numerous institutions," said Evan Michelson, program director at the Sloan Foundation. "We are so pleased to support Juna Kollmeier and the entire SDSS team, and we are excited for this next phase of discovery."

SDSS-V will operate out of both Apache Point Observatory in New Mexico, home of the survey's original 2.5-meter telescope, and Carnegie's Las Campanas Observatory in Chile, where it uses the 2.5-meter du Pont telescope.

"SDSS V is one of the most important astronomical projects of the decade. It will set new standards not only in astrophysics but also in robotics and big data," said the observatory's Director Leopoldo Infante. "Consequently, to ensure its success, the Las Campanas Observatory is prepared to carry out the project with all the human and technical resources available on the mountain."

SDSS-V's first observations were gathered in New Mexico with existing SDSS instruments, as a necessary change of plans due to the pandemic. As laboratories and workshops around the world navigate safe reopening, SDSS-V's own suite of new innovative hardware is on the horizon---in particular, systems of automated robots to aim the fiber optic cables used to collect the light from the night sky. These will be installed at both observatories over the next year. New spectrographs and telescopes are also being constructed to enable the Local Volume Mapper observations.

"Carnegie has enabled SDSS to expand its reach to the Southern Hemisphere. I'm so pleased to see our role in this foundational effort expand with this next generation," concluded Carnegie Observatories Director John Mulchaey.

When a virus enters the body, it is picked up by certain cells of the immune system. They transport the virus to the lymph nodes where they present its fragments, known as antigens, to CD8+ T cells responsible control of viral infections. Each of these cells carries a unique T cell receptor on the surface that can recognize certain antigens. However, only very few T cell receptors match a given viral the antigen.

To bring the infection under control and maximize the defenses against the virus, these few antigen-specific T cells start dividing rapidly and develop into effector T cells. These kill virus-infected host cells and then die off themselves once the infection is cleared. Some of these short-lived effector cells - according to the generally accepted theory - turn into memory T cells, which persist in the organism long term. In case the same pathogen enters the body again, memory T cells are already present and ready to fight the invader more swiftly and effectively than during the first encounter.

Memory cells and their origin

"Prevailing scientific opinion says that activated T cells first become effector cells and only then gradually develop into memory cells," says Dr. Veit Buchholz, a specialist in microbiology and working group leader at the Institute for Medical Microbiology, Immunology and Hygiene at TUM. "In our view, however, that isn't the case. It would mean that the more effector cells are formed after contact with the pathogen, the more numerous the memory cells would become." However, Buchholz and his colleagues observed a different course of events and have now published their results in the journal Nature Immunology.

"We investigated the antiviral immune responses resulting from individual activated T cells in mice and traced the lineage of the ensuing memory cells using single-cell fate mapping," reports first author Dr. Simon Grassmann. "Based on these experiments, we were able to show that certain 'T cell families' descended from individual cells form up to 1000 times more 'memory' than others. However, these long-term dominating T cell families only contributed little to the magnitude of the initial immune response, which was dominated by effector cells derived from other shorter-lived T cell families."

At the level of individual cells, it therefore became evident that development of effector and memory cells segregates at a much earlier stage than previously believed: "Already in the first week after the confrontation with the pathogen, we saw major differences in the transcriptomes of the detected T cell families," says Lorenz Mihatsch, also a first author of the study. "Normally at this time of the immune response CD8+ T cells are enriched in molecules that help to kill virus infected cells. However, we found no indication of these cytolytic molecules in the long-term dominating T cell families. Instead, they were already geared exclusively towards memory development at this early stage."

Optimization of vaccines

These results could help to improve vaccine development in the future, says Veit Buchholz: "To generate an optimal immune response through vaccination, the body needs to produce as many memory cells as possible. For that purpose, it is important to have a precise understanding of how individual T cells are programmed." Buchholz's study might also prove useful in helping to recognize sooner whether a new vaccine is effective. "To determine the long-term strength of an immune response, it could be helpful to measure the number of memory precursors within a few days of administering a vaccine," says Buchholz.