Culture

Insulin prices are more than eight times higher in the United States than in 32 high-income comparison nations combined, according to a new RAND Corporation study.

The study compared how much different types of insulin sold in the U.S. would cost if bought at prices in other countries. The average price per unit across all types of insulin in the U.S. was $98.70. Other countries would have paid a fraction as much for the same insulins.

U.S. prices were higher than each of the 32 comparison countries individually, ranging from 3.8 times higher than those in Chile to 27.7 times those in Turkey. U.S. prices were 6.3 times higher than those in Canada, 5.9 times higher than those in Japan and 8.9 times higher than those in the United Kingdom.

The study used manufacturer prices for the analysis. The final, net prices paid for insulins are likely to be significantly lower than manufacturer prices in the U.S. because rebates and other discounts often drive down the price paid by individuals in the U.S.

But even if such rebates and discounts drive down prices by as much as 50%, the prices paid by U.S. consumer are likely to be four times the average paid in other high-income nations, according to the study.

"This analysis provides the best available evidence about how much more expensive insulin is in the U.S. than in other nations around the world," said Andrew Mulcahy, the study's lead author and a senior policy researcher at RAND, a nonprofit research organization. "Prices in the U.S. are always much higher than other nations, even if you assume steep discounts to manufacturer prices in the United States."

Insulin list prices in the United States have increased dramatically over the past decade. For example, one federal analysis found that the average U.S. wholesale-acquisition price for rapid-acting, long-acting, and short-acting insulin increased by 15% to 17% per year from 2012 to 2016.

Another study found that among adults with employer-sponsored health insurance, annual insulin spending per person doubled between 2012 and 2016, increasing from $1,432 to $2,853 even after accounting for a 50% rebate.

Insulin is a drug most commonly used to control blood sugar levels in people who have insulin-dependent diabetes. The drug is sold in many different forms, with different chemical properties and different duration of effects.

RAND researchers compiled their estimates of international insulin prices by examining industry-standard IQVIA MIDAS data on insulin sales and volume for 2018, comparing the U.S. to 32 nations that belong to the Organisation for Economic Co-operation and Development.

Although the ratio of U.S. prices to other-country prices varied depending on the comparison country and insulin category, U.S. prices were always higher and often 5 to 10 times higher than those in other countries.

The study found that U.S. prices were relatively higher for analog versus human insulins and for rapid-acting rather than short or long-acting insulins. U.S. prices were even higher when researchers compared prices pooling similar insulin products together, suggesting that the United States uses a more-expensive mix of insulin products.

The study was sponsored by the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services.

The report, "Comparing Insulin Prices in the United States to Other Countries: Results from a Price Index Analysis," is available on the website of the U.S. Department of Health and Human Services and on http://www.rand.org.

Other authors of the report are Daniel Schwam and Nate Edenfield.

RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.

Scientists have long known that the plant hormone auxin controls many aspects of plant growth, development, and responses to the environment. Only more recently have they begun to understand that there is also a link between auxin and leaf spotting diseases.

Several years ago scientists, including Barbara Kunkel, discovered an increased concentration of auxin in leaves inoculated by the bacterial pathogen, Pseudomonas syringae, that causes bacterial spot and speck diseases on many plants.

"We previously demonstrated that auxin promotes disease caused by P. syringae on Arabidopsis thaliana plants, which means that auxin is not acting as a classic plant defense hormone," Kunkel explained. "We were also one group to demonstrate that auxin also suppresses salicylic acid (SA)-mediated plant defense responses."

However, Kunkel and her colleagues knew there was more work to be done. "It was clear that there was a second role for auxin in P. syringae infection, that appeared to be independent of modulating SA-mediated defenses." In a new article published in the MPMI journal, Kunkel and colleagues at Washington University in St. Louis and the University of California San Diego present the first investigation of the role of auxin in regulating pathogen gene expression in plant tissue.

This article makes two new contributions to our understanding of the role of auxin during P. syringae infection of Arabidopsis thaliana plants. First, the research demonstrated that the canonical host auxin signaling pathway is required to suppress SA-mediated host defense and normal diseases susceptibility to P. syringae. Second, auxin plays a second role in promoting disease by regulating virulence gene expression in P. syringae.

"Our data led us to propose a working model in which auxin acts as a signal to the pathogen to switch from an early state of infection to a later stage that requires expression of a second set of virulence genes," Kunkel said. "There have been several reports that bacteria can respond to auxin and auxin has begun to be considered as a potential microbial signaling molecule. However, to the best of our knowledge, this is the first time a biologically relevant example has been demonstrated. This is an exciting breakthrough in plant-microbe interactions."

This work provides another example of how plant hormones can be used by microbes as an environmental cue, which seems to be emerging as a common strategy as scientists learn more about how pathogens and parasites sense their plant hosts. To learn more about this study, read "Dual Role of Auxin in Regulating Plant Defense and Bacterial Virulence Gene Expression During Pseudomonas syringae PtoDC3000 Pathogenesis" published in the August issue of MPMI.

Familiar stars shine, nebulae glow, and nearby galaxies tantalize in a new panorama of the northern sky assembled from 208 pictures captured by NASA's Transiting Exoplanet Survey Satellite (TESS). The planet hunter imaged about 75% of the sky in a two-year-long survey and is still going strong.

TESS has discovered 74 exoplanets, or worlds beyond our solar system. Astronomers are sifting through some 1,200 additional exoplanet candidates, where potential new worlds await confirmation. More than 600 of these candidates lie in the northern sky.

TESS locates planets by simultaneously monitoring many stars over large regions of the sky and watching for tiny changes in their brightness. When a planet passes in front of its host star from our perspective, it blocks some of the star's light, causing it to temporarily dim. This event is called a transit, and it repeats with every orbit of the planet around the star. This technique has proven to be the most successful planet-finding strategy so far, accounting for about three quarters of the nearly 4,300 exoplanets now known. The data collected also allow for the study of other phenomena such as stellar variations and supernova explosions in unprecedented detail.

The northern mosaic covers less of the sky than its southern counterpart, which was imaged during the mission's first year of operations. For about half of the northern sectors, the team decided to angle the cameras further north to minimize the impact of scattered light from Earth and the Moon. This results in a prominent gap in coverage.

The northern panorama represents only a glimpse of the data TESS has returned. The mission splits each celestial hemisphere into 13 sectors. TESS imaged each sector for nearly a month using four cameras, which carry a total of 16 sensors called charge-coupled devices (CCDs). During its primary mission, the cameras captured a full sector of the sky every 30 minutes. This means each CCD acquired nearly 30,800 full science images. Adding in other measurements, TESS has beamed back more than 40 terabytes so far - equivalent to streaming some 12,000 high-definition movies.

Remarkably, these numbers will rise sharply over the next year. TESS has now begun its extended mission, during which it will spend another year imaging the southern sky. The satellite will revisit planets discovered in its first year, find new ones, and fill in coverage gaps from its initial survey. Improvements to the satellite's data collection and processing now allow TESS to return full sector images every 10 minutes and measure the brightness of thousands of stars every 20 seconds - all while continuing its previous strategy of measuring the brightness of tens of thousands of stars every two minutes.

"These changes promise to make TESS's extended mission even more fruitful," said Padi Boyd, the mission's project scientist at NASA's Goddard Space Flight Center in Greenbelt, Maryland. "Making high-precision measurements of stellar brightness at these frequencies makes TESS an extraordinary new resource for studying flaring and pulsating stars and other transient phenomena, as well as for exploring the science of transiting exoplanets."

TESS is a NASA Astrophysics Explorer mission led and operated by MIT in Cambridge, Massachusetts, and managed by NASA's Goddard Space Flight Center. Additional partners include Northrop Grumman, based in Falls Church, Virginia; NASA's Ames Research Center in California's Silicon Valley; the Harvard-Smithsonian Center for Astrophysics in Cambridge, Massachusetts; MIT's Lincoln Laboratory; and the Space Telescope Science Institute in Baltimore. More than a dozen universities, research institutes, and observatories worldwide are participants in the mission.

For more information on TESS, visit:

https://www.nasa.gov/tess

New York, NY--October 6, 2020--Columbia Engineering researchers report that Sofosbuvir-terminated RNA is more resistant to the proofreader of SARS-CoV-2, the virus that causes COVID-19, than Remdesivir-terminated RNA. The results of the new study, published today by the Nature Research journal Scientific Reports, support the use of the FDA-approved hepatitis C drug EPCLUSA--Sofosbuvir/Velpatasvir--in combination with other drugs in COVID-19 clinical trials.

The SARS-CoV-2 exonuclease-based proofreader maintains the accuracy of viral RNA genome replication to sustain virulence. Any effective antiviral targeting the SARS-CoV-2 polymerase must therefore display a certain level of resistance to this proofreading activity.

"We found that the RNA terminated by Sofosbuvir resists removal by the exonuclease to a substantially higher extent than RNA terminated by Remdesivir, another drug being used as a COVID-19 therapeutic," says the team's lead PI Jingyue Ju, Samuel Ruben-Peter G. Viele Professor of Engineering; professor of Chemical Engineering and Pharmacology; director, Center for Genome Technology & Biomolecular Engineering.

The new study builds upon earlier work the researchers have conducted. Last January, before COVID-19 reached pandemic status, the team posited that EPCLUSA might inhibit SARS-CoV-2, the virus responsible for COVID-19. Their reasoning was based on the analysis of the molecular structures and activities of hepatitis C viral inhibitors and a comparison of hepatitis C virus and coronavirus replication.

In a subsequent study, the researchers demonstrated that the active drug Sofosbuvir triphosphate is incorporated by SARS-CoV and SARS-CoV-2 polymerases, shutting down the polymerase reaction. Other investigators have since demonstrated the ability of Sofosbuvir to inhibit SARS-CoV-2 replication in lung and brain cells; currently, COVID-19 clinical trials with a number of hepatitis C drugs such as EPCLUSA and the combination of Sofosbuvir and Daclatasvir (which is similar to Velpatasvir) are ongoing in several countries.

Ju notes that a recent preprint from UC Berkeley indicates that a combination of Remdesivir and EPCLUSA increases Remdesivir's efficacy 25-fold in inhibiting SARS-CoV-2, the virus that causes COVID-19: "These results offer a molecular basis supporting the study of EPCLUSA in combination with Remdesivir for COVID-19 clinical trials."

In their efforts to identify the genetic basis for differences in mate choice that keep two co-existing species of butterfly separate, evolutionary biologists at Ludwig-Maximlians-Universitaet (LMU) in Munich have identified five candidate genes that are associated with divergence in visual mating preferences.

The evolution of a new species often involves a change in mating preference. This happens, for instance, when members of different populations of a given species cease to mate with each other because they no longer find potential partners sufficiently attractive.  Two closely related species of tropical butterflies, Heliconius melpomene und Heliconius cydno, provide an interesting example of this phenomenon. The two species are often seen flying together, and crosses between them can result in fertile hybrid offspring. - Nevertheless, individuals of the two species hardly ever mate with each other in the wild. How such behaviorally induced barriers to reproduction emerge is largely unknown. "When changes in behaviour are genetically hard-wired, as mate choice seems to be in our butterflies, they must involve alterations in sensation, that is, the stimuli they can detect, or changes in how these stimuli are  processed," says LMU evolutionary biologist Dr. Richard Merrill. Together with members of his group, and collaborators at the Smithsonian Tropical Research Institute in Panama and at the University of Cambridge, he has now identified five genes that are linked to the different mating preferences of H. melpomene and H. cydno. As the authors report in the open access journal Nature Communications, these genes are likely to change how visual stimuli are processed during courtship, without altering how the butterflies perceive the world in other contexts.

H. melpomene and H. cydno differ in the striking color patterns of their wings, which serve to warn off potential predators that they are distasteful. H. melpomene has black wings with red bars and thin yellow stripes, while H. cydno's wings feature white bars on a black background. Notably the males of each species show a marked attraction for females with the same 'color scheme' as themselves. In their quest for the genetic factors that underlie differences in these mating preferences, Merrill and his colleagues had previously identified three genomic regions which were associated with the different mating behaviors. One of these regions, on chromosome 18, had an especially strong effect on the degree of persistence with which the male pursues the female of his choice. Strikingly, a gene called optix, which controls the expression of the red bars on the wings of H. melpomene, lies within this same chromosomal segment. However, although this research revealed that one or more genes in this relatively short region of the chromosome must affect mate preference behaviors, the interval in question contains more than 200 genes.

In the new study, Matteo Rossi, a PhD student working in Merrill's group, compared the sequences and activity of these genes in neural tissues - including the central brain, optic structures and the 'ommatidia' (the retinal units that form the facets of the eye) - of H. melpomene and H. cydno. They were able to identify five genes located within this interval that differed between the two species and were associated with their different visual preferences. Most importantly, three of these genes code for proteins that play key roles in neural signal transmission. "Overall, the nature of our candidate genes suggests that the different preferences for the wing coloration of potential partners are likely to be based on differences in the processing of the visual information. - It seems that the two species do not differ with respect to what they see, but they react differently to the different color patterns," says Rossi. "In this way, over the course of evolution, mating preferences can change without affecting perceptions of other aspects of the environment."

A collaboration between scientists at the U.S. Department of Energy's National Renewable Energy Laboratory (NREL), the University of Portsmouth in the United Kingdom, and other partners has yielded further insight into the workings of plastic-eating enzymes.

The research determined two synergistic enzymes--PETase and MHETase--work effectively in tandem to break down polyethylene terephthalate (PET), which is a type of plastic used to make single-use beverage bottles, clothing, and carpeting. The research follows an earlier collaboration between these partners focused on PETase.

A bacterium, Ideonella sakaiensis 201-F6, was discovered in the soil outside of a Japanese PET bottle recycling plant in 2016 and was shown to secrete both PETase and MHETase. Researchers at NREL and Portsmouth were able to engineer PETase to increase its ability to digest PET, although still not fast enough to make the process commercially viable to handle the tons of discarded bottles littering the planet.

Gregg Beckham, a senior research fellow at NREL and co-lead of a new paper outlining the latest findings, said MHETase and PETase degrade PET faster than PETase alone. "They are better together than they are separate. PETase conducts the initial breakdown of the PET polymer, and MHETase further deconstructs the soluble products of PETase to produce the building blocks of PET," he said. Genetically linking the separate enzymes makes them function even better. By itself, MHETase does not act upon PET.

The paper, "Characterization and engineering of a two-enzyme system for plastics depolymerization," appears in the journal Proceedings of the National Academy of Sciences of the United States of America. The University of Portsmouth's John McGeehan co-led the study.

Additional authors from NREL are Brandon Knott, Erika Erickson, Japheth Gado, Isabel Pardo, Ece Topuzlu, Jared Anderson, Graham Dominick, Christopher Johnson, Nicholas Rorrer, Caralyn Szostkiewicz, and Bryon Donohoe.

"The team assembled here is incredibly diverse and multidisciplinary," said Knott, a chemical engineer. That enables hypotheses generated in one area to be immediately followed up on via computational or laboratory experiments.

MHETase has not been studied to date to the same extent as PETase. The new research combined structural, computational, biochemical, and bioinformatics approaches to reveal molecular insights into its structure and how it functions.

"Now we know in molecular-level detail how the enzyme actually works on MHET," Beckham said.

Additional research discovered two other bacteria that contain enzymes like MHETase, bringing the total known enzymes that act on this synthetic substrate to three.

HOUSTON - (Oct. 6, 2020) - Fat bacteria? Skinny bacteria? From our perspective on high, they all seem to be about the same size. In fact, they are.

Precisely why has been an open question, according to Rice University chemist Anatoly Kolomeisky, who now has a theory.

A primal mechanism in bacteria that keeps them in their personal Goldilocks zones -- that is, just right -- appears to depend on two random means of regulation, growth and division, that cancel each other out. The same mechanism may give researchers a new perspective on disease, including cancer.

The "minimal model" by Kolomeisky, Rice postdoctoral researcher and lead author Hamid Teimouri and Rupsha Mukherjee, a former research assistant at Rice now at the Indian Institute of Technology Gandhinagar, appears in the American Chemical Society's Journal of Physical Chemistry Letters.

"Everywhere we see bacteria, they more or less have the same sizes and shapes," Kolomeisky said. "It's the same for the cells in our tissues. This is a signature of homeostasis, where a system tries to have physiological parameters that are almost the same, like body temperature or our blood pressure or the sugar level in our blood.

"Nature likes to have these parameters in a very narrow range so that living systems can work the most efficiently," he said. "Deviations from these parameters are a signature of disease."

Bacteria are models of homeostasis, sticking to a narrow distribution of sizes and shape. "But the explanations we have so far are not good," Kolomeisky said. "As we know, science does not like magic. But something like magic -- thresholds -- is proposed to explain it."

For bacteria, he said, there is no threshold. "Essentially, there's no need for one," he said. "There are a lot of underlying biochemical processes, but they can be roughly divided into two stochastic chemical processes: growth and division. Both are random, so our problem was to explain why these random phenomenon lead to a very deterministic outcome."

The Rice lab specializes in theoretical modeling that explains biological phenomena including genome editing, antibiotic resistance and cancer proliferation. Teimouri said the highly efficient chemical coupling between growth and division in bacteria was far easier to model.

"We assumed that, at typical proliferation conditions, the number of division and growth protein precursors are always proportional to the cell size," he said.
T

he model predicts when bacteria will divide, allowing them to optimize their function. The researchers said it agrees nicely with experimental observations and noted manipulating the formula to knock bacteria out of homeostasis proved their point. Increasing the theoretical length of post-division bacteria, they said, simply leads to faster rates of division, keeping their sizes in check.

"For short lengths, growth dominates, again keeping the bacteria to the right size," Kolomeisky said.

The same theory doesn't necessarily apply to larger organisms, he said. "We know that in humans, there are many other biochemical pathways that might regulate homeostasis, so the problem is more complex."

However, the work may give researchers new perspective on the proliferation of diseased cells and the mechanism that forces, for instance, cancer cells to take on different shapes and sizes.

"One of the ways to determine cancer is to see a deviation from the norm," Kolomeisky said. "Is there a mutation that leads to faster growth or faster division of cells? This mechanism that helps maintain the sizes and shapes of bacteria may help us understand what's happening there as well."

Nuclear clocks could make our time measurement even more accurate than atomic clocks. The key to this lies in thorium-229, an atomic nucleus whose lowest excited state has very low energy. A research team from the Kirchhoff Institute for Physics at the University of Heidelberg, TU Wien, Johannes Gutenberg University Mainz (JGU), the Helmholtz Institute Mainz (HIM), and GSI Helmholtzzentrum in Darmstadt has now succeeded in measuring this low energy. Using an extremely accurate detector, it was possible to detect the tiny temperature increase due to the energy released during the de-excitation of the atomic nucleus. This brings the realization of a nuclear clock a big step closer.

In radioactive decay, atomic nuclei spontaneously re-arrange, eject some part of their building blocks, and transform into a nucleus of a different atom. In this process, the new "daughter atom" usually has internally stored energy that is released in the form of gamma rays. The energies of these rays are characteristic for each type of nucleus - just like fingerprints. Researchers learn a lot about atomic nuclei by characterizing these gamma-ray fingerprints.

Back in 1976, L. A. Kroger and C. W. Reich investigated the decay of uranium-233, which is an artificial nucleus of uranium that decays to thorium-229 by emitting an alpha-particle; this is immediately followed by the emission of characteristic gamma-rays that occur in distinct and generally well-understood patterns. Kroger and Reich, however, registered an anomaly: one gamma-ray that was predicted by all nuclear theories was missing in the measured signals. The best explanation was that the internal energy stored in the lowest nuclear excitation of thorium-229 was too low to be observed by the detectors. Over the following decades, many attempts were made to observe this low-energy gamma-ray without success, constraining it to ever-lower energies.

New perspectives for constructing a nuclear clock

Nowadays, we know that the lowest excited-energy state of the thorium-229 nucleus, called an isomer state, is located at the lowest known energy among all nuclei, at an energy that is orders of magnitudes lower than usual excitation energies. Consequently, the energy of the associated gamma-ray is so low that it is placed in the ultraviolet region of the electromagnetic spectrum rather than in the typical gamma-ray region. This leads to the unique situation that the opposite process of the de-excitation by the emission of this "ultraviolet gamma-ray", namely the excitation of the lower state is possible by shining ultraviolet light onto the nucleus. It is the only nuclear system that could be excited with "table-top" laser light. This opens up exciting prospects, including the construction of a "nuclear" clock, in which time is measured by oscillations of the nucleus between these two states. The precision of such a clock is predicted to be better than that of the best current atomic clocks, which rely on oscillations between states in the electron shell, which is more susceptible to external perturbations than the 10.000 times smaller nucleus.

The key problem is, though, that the energy of the isomer state is not yet known with sufficient precision to know which ultraviolet light is needed to stimulate the oscillation. A consortium of researchers from Heidelberg, Vienna, Mainz, and Darmstadt have now repeated the iconic gamma spectroscopy measurement of Kroger and Reich, but using a highly advanced state-of-the-art gamma spectrometer, designed explicitly for registering rays of such low energy.

Cool studies give the highest precision

For this, the research team of Professor Christian Enss and Dr. Andreas Fleischmann at the Kirchhoff Institute for Physics at the University of Heidelberg developed a magnetic microcalorimeter named maXs30. This detector is cooled to minus 273 degrees Celsius and measures the minuscule temperature rise that occurs when a gamma-ray is absorbed. The temperature increase leads to a change in the detector's magnetic properties, which is then converted into an electric signal using SQUID magnetometers similar to those that are commonly used in magnetic resonance tomography. The maXs30 detector has unprecedented energy resolution and gain linearity; still, it took about 12 weeks of continuous measurement to obtain the gamma-ray spectrum with sufficient precision.

To make this challenging measurement possible, the team of Professor Christoph Düllmann in Mainz and Darmstadt produced a special sample of uranium-233. First, they chemically removed all decay daughter products that had built up over time before the sample was used. They also removed unwanted radioisotopes, the decay of which leads to an unwanted background in the measured data. Then they designed a source geometry and sample container that led to minimum interference of the weak signals on their way from the sample to the maXs30 calorimeters. These steps were required for the success of the measurement because only one in 10,000 decay processes produces a signal that is useful for the determination of the isomer energy. The measurement produced the most precise gamma-ray spectrum of uranium-233 to thorium-229 decay to date. The team of Professor Thorsten Schumm at TU Wien, together with the Heidelberg team, employed four different schemes to derive the energy of the isomer state from this data. The most precise one yielded a value of 8.10(17) electronvolts, which corresponds to light of a wavelength of 153.1(32) nanometers, with the number in parentheses indicating the uncertainty of the last digits. This measurement paves the way for a direct laser excitation of the thorium-229 isomer.

Information security policies (ISP) that are not grounded in the realities of an employee's work responsibilities and priorities exposes organizations to higher risk for data breaches, according to new research from Binghamton University, State University of New York.

The study's findings, that subcultures within an organization influence whether employees violate ISP or not, have led researchers to recommend an overhaul of the design and implementation of ISP, and to work with employees to find ways to seamlessly fit ISP compliance into their day-to-day tasks.

"The frequency, scope and cost of data breaches have been increasing dramatically in recent years, and the majority of these cases happen because humans are the weakest link in the security chain. Non-compliance to ISP by employees is one of the important factors," said Sumantra Sarkar, associate professor of management information systems in Binghamton University's School of Management. "We wanted to understand why certain employees were more likely to comply with ISP than others in an organization."

Sarkar, with a research team consisting of Anthony Vance of Temple University, Balasubramaniam Ramesh of Georgia State University, Menelaos Demestihas of Wellstar Kennestone Hospital and Daniel Thomas Wu of Emory University School of Medicine, sought to determine how subcultures influence compliance, specifically within healthcare organizations.

"Every organization has a culture that is typically set by top management. But within that, you have subcultures among different professional groups in the organization," said Sarkar. "Each of these groups are trained in a different way and are responsible for different tasks."

Sarkar and his fellow researchers focused on ISP compliance within three subcultures found in a hospital setting - physicians, nurses and support staff.

The expansive study took years to complete, with one researcher embedding in a hospital for over two years to observe and analyze activities, as well as to conduct interviews and surveys with multiple employees.

Because patient data in a hospital is highly confidential, one area researchers focused on was the requirement for hospital employees to lock their electronic health record (EHR) workstation when not present.

"Physicians, who are dealing with emergency situations constantly were more likely to leave a workstation unlocked. They were more worried about the immediate care of a patient than the possible risk of a data breach," said Sarkar. "On the opposite end, support staff rarely kept workstations unlocked when they were away, as they felt they were more likely to be punished or fired should a data breach occur."

Researchers concluded that each subculture within an organization will respond differently to the organization-wide ISP, leaving organizations open to a higher possibility of data breaches.

Their recommendation - consult with each subculture while developing ISP.

"Information security professionals should have a better understanding of the day-to-day tasks of each professional group, and then find ways to seamlessly integrate ISP compliance within those job tasks," said Sarkar. "It is critical that we find ways to redesign ISP systems and processes in order to create less friction."

In the context of a hospital setting, Sarkar recommends touchless, proximity-based authentication mechanisms that could lock or unlock workstations when an employee approaches or leaves a workstation.

Researchers also found that most employees understand the value of ISP compliance, and realize the potential cost of a data breach. However, Sarkar believes that outdated ISP compliance measures have the potential to put employees in a conflict of priorities.

"There shouldn't be situations where physicians are putting the entire hospital at risk for a data breach because they are dealing with a patient who needs emergency care," he said. "We need to find ways to accommodate the responsibilities of different employees within an organization."

Brazil has more than 286,000 community health workers integrated into the national primary healthcare program. These professionals form a broad network serving 75% of the population, especially low-income families who lack medical insurance and are the most adversely affected by the COVID-19 pandemic.

"Back in March, researchers at Imperial College London noted Brazil's network of community health workers as a valuable asset that could assure an effective response to the pandemic. According to the article, the service they provide sets an example to be followed by other countries. But the response was not effective, there was no national plan, and the service provided by community health workers wasn't considered essential to control the disease until July. They weren't even considered health professionals and so weren't given personal protective equipment [PPE], just to take one example," said Gabriela Lotta, a professor at Getúlio Vargas Foundation (FGV). Lotta is affiliated with the Center for Metropolitan Studies (CEM) , one of the Research, Innovation and Dissemination Centers (RIDCs) funded by São Paulo Research Foundation - FAPESP.

In collaboration with researchers at Oswaldo Cruz Foundation (Fiocruz, a leading public health research institution linked to the Brazilian Ministry of Health), the University of York (UK) and the London School of Economics, Lotta authored an article published in the Comment section of The Lancet warning that community health workers in Brazil were being treated with neglect during the pandemic.

"Several countries have community health workers, but the researchers at Imperial College London focused on Brazil's advantage in this respect because it was one of the first countries to create such a network as an integral part of primary care and the national health system [in Brazil, Sistema Único de Saúde, SUS]. In most countries community health workers aren't part of the official health system but belong to NGOs or civic associations," Lotta told.

Thanks to this structural feature, she added, Brazil's community health workers would have been able to perform important functions during the pandemic, "provided they had PPE, training, the backing of governmental policy, support, and recognition of their significance".

Three tiers of government

For Lotta, neglect of community health workers exemplifies the effect on cities of the lack of a national plan to combat the pandemic: although the service they provide is run by local authorities, the federal government is responsible for funding and other support mechanisms.

"There are huge disparities among Brazilian cities," Lotta said. "Municipalities find their hands are tied if they lack the funding and other resources to determine a strategy on their own. There has to be a national plan, with substantial transfers from the federal government to fund community health workers. It's up to local government to execute. Of course, if a city has resources it can use them, but the federal government should shoulder most of the burden and set the policy. That includes defining whether community health workers are health professionals or not and whether they should get hazard pay. All these decisions have to apply to the entire national health service."

During the first four months of the pandemic, Lotta continued, community health workers received neither training nor PPE. They were at last classed as key workers only on July 21, 2020, when President Bolsonaro signed Law 14,023/2020.

"Because there was no national plan and they weren't even classed as health professionals, only 9% received infection control training and PPE. Their union says some 100 have died from COVID-19, but the actual number may be three times higher," Lotta said.

Brazil has one of the world's highest death tolls of nurses, nursing assistants, and nurse technicians affected by COVID-19, according to the International Council of Nurses (ICN). In its last update, Brazil's Federal Nursing Council (COFEN) pointed to 441 deaths. The number of physicians who died from the disease had reached 244 by September, according to the São Paulo Physicians Union.

"The law is positive, although it has yet to be implemented," Lotta said. "Better late than never. At least there's a legal measure that says community health workers are entitled not to go out to work if they aren't given PPE. They had no such right before. They were very vulnerable."

Nevertheless, she added, the law does not automatically solve the problems of community health workers or ensure they play an effective role in combating the pandemic. "It's an important contribution, but it won't necessarily translate into better policy," she said. "Even with this law in place, local governments lack the means to prioritize community health workers in fighting the pandemic until a strategic plan and a funding scheme are established."

Key functions, key workers

Among the functions that could be performed by community health workers during the pandemic, Lotta highlighted key activities such as tracing contacts of infected people, combating fake news by disseminating trustworthy information, and monitoring social isolation in confirmed cases.

"They already act as health educators. They live in the communities where they work and are seen as trustworthy and legitimate," she said. "Keeping their neighbors well-informed about personal hygiene, and the importance of face covering and social isolation is an effective way to neutralize fake news. A few cities have community health workers circulating in cars with loudspeakers to give out this kind of information."

Contact tracing would not be a problem for them, Lotta argued. "They already did something very similar to contact tracing when they monitored people's healthcare requirements. In the few Brazilian cities that have had contact tracing it's been done by community health workers," she said.

They could staff telephone banks to call patients with the disease who are isolated at home and assess their need for hospitalization if local authorities supplied thermometers and pulse oximeters, she added.

They could also man the roadblocks set up at the entrances to many cities. "The disease was transmitted to many small and medium towns by visitors who were infected but had no symptoms, especially if the locality was a tourist attraction," Lotta said. "Some local authorities installed roadblocks manned by community health workers, who took people's temperature as they arrived by car and told them about the measures in place to deal with the pandemic. Of course, in this case, they will have had to supply PPE and support of other kinds. We have the structure, and if such apparently simple but crucial measures were universally applied they would have a positive impact in terms of containing transmission of the virus."

DURHAM, N.C. - Researchers know that texting programs can greatly benefit young children's literacy. Now new research shows that parents' participation in such programs can be boosted exponentially with one simple tweak: automatic enrollment, combined with the ability to opt out.

The new research from the Center for Child and Family Policy at Duke University's Sanford School of Public Policy appears in the Journal of Child and Family Studies.

In recent years, mounting research evidence has shown texting to be an effective, low-cost, scalable approach for engaging parents in their children's learning. Some studies suggest text message interventions via tips for parents on how to support their child's development can put young children's learning 2-3 months ahead.

Yet getting parents to enroll in these beneficial programs can be challenging. With that in mind, researchers designed a study to test strategies for increasing program participation.

In the study, researchers from Duke, New York University and Brooklyn College compare different enrollment options for the text-based early literacy program, Talk to Your Baby. The text-based 26-week course is designed to promote early language development for children from birth to age 3.

The researchers studied 405 mothers who were receiving newborn home visiting services through a free, city-wide program in New York City. Using a randomized controlled study, the researchers tested whether changing the enrollment option from opt-in to opt-out affects mothers' take up and completion of the early literacy program. Participants were predominantly low-income and racially and ethnically diverse.

Results show that when automatically enrolled with a voluntary option to opt out, 88.7 percent of study participants stayed in the program for the full 26 weeks. In contrast, only 1 percent of mothers in the control group -- who heard about the program through conventional recruitment flyers -- voluntarily enrolled in the program. The findings suggest parents' desire to participate in the program may be high but their ability to follow through is challenging, researchers said.

During the COVID-19 pandemic, these programs and other digital strategies for reaching parents can be especially beneficial, the researchers say.

"A lot of time is spent in developing excellent and developmentally appropriate content for these programs and relatively little time is spent understanding how to make it easy for parents to engage," said Lisa A. Gennetian, lead author of the study and Pritzker Associate Professor of Early Learning Policy Studies at Duke's Sanford School of Public Policy. "Preserving parents' choice to enroll in programs, especially those that are universally accessible and free, matters and we learned from this study that automatic enrollment minimizes burden on parents and can have enormous benefits in ways that do not interfere with their freedom."

The study is the among the first to show that automatic enrollment is a promising strategy for increasing participation in early language and learning programs.

The study also showed the decision to stay in the program or opt out remained consistent for various subgroups. For instance, it made no difference whether this was a first birth or whether the other received public benefits. Such characteristics are sometimes cited as interfering with program participation.

"Opt-out strategies are liberally used in many aspects of our life, from organ donations to decisions about retirement benefits, and they are effective when done carefully," Gennetian said. "Why wouldn't we make life easier for parents and apply the same strategy of automatic enrollment with the ease of opting out?"

BOSTON - The COVID-19 pandemic has impacted virtually every aspect of cancer care and research- from introducing new risks for cancer patients to disrupting the delivery of cancer treatment and the continuity of cancer research, a review of scientific literature shows. The report, by researchers at Dana-Farber Cancer Institute and other institutions, suggests that while COVID-19 has complicated the treatment of cancer patients, it has also spurred creative solutions to challenges in clinical care, and research into the new disease is benefiting from insights gained over years of cancer research.

While much remains to be learned about the intersection of cancer and COVID-19, the new paper, published online by Cancer Cell, represents the most comprehensive survey to date about what physicians have learned, and what research is suggesting, about the interrelationship between the two diseases, the authors say.

"COVID-19 has been responsible for killing more than one million people worldwide. Among those most at risk of developing severe forms of the illness are patients with cancer," says Ziad Bakouny, MD, MSc, of Dana-Farber, the co-lead author of the study with Jessica Hawley, MD, of Columbia University Medical Center. "Research into why patients with cancer are at heightened risk is moving very quickly. In this paper, we look at the state of the science in this area and others related to these two illnesses."

The paper summarizes findings in four areas: the interconnected biology of cancer and COVID-19; changes in patient care prompted by the pandemic; effects on cancer research; and insights from cancer research applicable to the treatment of COVID-19.

COVID-19 and cancer biology

In patients with cancer, COVID-19 can be especially harsh. This is likely because many patients have a weakened immune system - either as a result of the cancer itself or the therapies used to treat it - and are therefore less able to fight off infection by the novel coronavirus. Several studies have examined whether systemic cancer therapies such as chemotherapy and targeted therapies increase patients' vulnerability to COVID-19. The results so far are mixed, Bakouny says, possibly because such studies have focused on systemic therapies as a group rather than on specific agents. Future studies will attempt to tease out the effects of particular drugs.

One of the most dangerous consequences of COVID-19 is an overaggressive immune response known as a "cytokine storm," which can damage lung and other tissues. Patients with cancer treated with immune-stimulating therapies such as immune checkpoint inhibitors, chimeric antigen receptor (CAR) T-cell therapies and bi-specific T-cell engagers (BiTEs) are at risk for complications if the immune response produced by these therapies results in an attack on normal, healthy tissue. Patients treated with CAR T-cell therapies and BiTEs, in particular, can develop a side effect known as cytokine release syndrome, which is similar to the cytokine storm in patients with COVID-19. Researchers have theorized that COVID-19 could exacerbate cytokine release syndrome in patients treated with certain immunotherapies, but studies have not definitely shown that this is happening, the new report states.

Although patients may be understandably concerned about facing an increased risk from COVID-19 as a result of cancer therapy, they shouldn't let this deter them from seeking treatment for their cancer, Bakouny says. "Therapies for cancer can prolong life and even be curative in many cases," he remarks. "It's very important to be mindful of the goals of therapy and discuss with your doctor the risks and benefits of therapy in your own particular case."

COVID-19 and cancer care

Around the world, efforts to thwart the spread of COVID-19 included steps to decrease in-person visits between patients and physicians. Among these was a jump in the use of telemedicine, which, some studies indicate, can be just as effective as in-person meetings. One study involving patients with breast cancer found that telehealth was associated with a higher quality of life and less depression and distress compared with usual care. While virtual visits offer a variety of benefits - less need to travel to physician appointments and incur the costs and inconvenience associated with travel - they're valuable only insofar as they don't take the place of in-person visits for exams, treatment, or diagnosis, research shows.

"It is also important to consider the unintended consequences of widespread adoption of technology," Bakouny says. "There is a serious potential risk of compounding health disparities between patients of different socioeconomic status, if telehealth services are mandated."

On the negative side, studies have shown a sharp decline in cancer diagnoses and screening during the peak of the pandemic. One study found that routine screening dropped by 85-90%. Delays in diagnosing cancer are likely to have long-term ripple effects. A British study estimates that, because of diagnostic delays, deaths five years from now may be 4-17% higher, depending on tumor type, than they would have been had the pandemic not occurred.

COVID-19 and cancer research

To limit the opportunities for viral transmission, many research centers enacted policies limiting the number of lab workers allowed on-site, putting many studies on hold. For the most part, research projects funded by government appropriations have not been hobbled by the pandemic, but some projects supported by private philanthropy face a funding gap. COVID-19 has drastically decreased donations to cancer-focused philanthropic organizations. The American Cancer Society, for example, expects a $200 million decrease in donations this year and has not been able to accept applications for research grants for the Fall grant cycle.

Clinical cancer research, in which potential new therapies are tested in patients, has also experienced difficulties as a result of COVID-19. Some cancer centers halted enrollment on clinical trials entirely during the height of the pandemic. A survey of dozens of clinical investigators in March found that nearly 60% of respondents had halted screening and/or enrollment in certain trials, and that half of their institutions had ceased collection of blood and other tissue for research purposes.

Despite these challenges, investigators found a variety of ways to adapt to straitened circumstances so trials could continue. These included leveraging telehealth to limit in-person visits, use of e-signatures for trial documentation, shipping oral medications to trial participants rather than requiring them to be picked up at the clinic, and allowing laboratory tests to be done at outside labs.

"The relaxation of some of the regulatory requirements associated with clinical research has been accomplished without compromising patient safety," Bakouny remarks. "Many investigators see this as a plus - something that could be part of clinical research going forward, to reduce the cost of trials and facilitate the arrival of new therapies for patients."

COVID-19 and lessons from cancer

Some promising approaches to treating COVID-19 have come, perhaps surprisingly, from cancer research, the paper's authors write. While cancer and COVID-19 are fundamentally different in their origin, development, and effect on the body, some of the insights gained in decades of research in cancer are showing relevance to fighting the new coronavirus.

A variety of drugs used to alleviate cytokine release syndrome in cancer patients are being evaluated for effectiveness against cytokine storm in patients with COVID-19. Other drugs in the anti-cancer arsenal are undergoing tests of their potential value against COVID-19. An example is acalabrutinib, which is used in the treatment of lymphoid cancers. In one trial, it resulted in rapid improvements in oxygen requirements and a sharp drop in inflammation in patients with COVID-19.

Another potential point of connection between cancer and COVID-19 involves a protein called TMPRSS2. When the coronavirus is breathed in, it binds to lung cells and is split by TMPRSS2, allowing it to enter and infect the cells. Research has shown that in prostate cancer, TMPRSS2 is regulated by the androgen receptor, a cell structure that signals the cell to grow in response to androgen. The androgen receptor is found not only on prostate cells but on cells of the lung as well. It isn't clear yet whether the receptor regulates TMPRSS2 in lung tissue, but if it does, it could open the way to a new treatment for COVID-19. Androgen-targeting therapies already used to treat prostate cancer could block TMPRSS2 from entering lung cells, preventing COVID-19 at its source.

"Since the start of the pandemic, we've accumulated a substantial amount of evidence about the dynamic between cancer and COVID-19," Bakouny remarks. "This review gave us an opportunity to take a step back and take stock of what we've learned - to get a sense of the most promising directions for patients, as well as where more study is needed, what we need to dig deeper into."

WEST LAFAYETTE, Ind. -- Robots can be amazing tools for search-and-rescue missions and environmental studies, but eventually they must return to a base to recharge their batteries and upload their data. That can be a challenge if your robot is an autonomous underwater vehicle (AUV) exploring deep ocean waters.

Now, a Purdue University team has created a mobile docking system for AUVs, enabling them to perform longer tasks without the need for human intervention.

The team also has published papers on ways to adapt this docking system for AUVs that will explore extraterrestrial lakes, such as those of Jupiter and Saturn's moons.

"My research focuses on persistent operation of robots in challenging environments," said Nina Mahmoudian, an associate professor of mechanical engineering. "And there's no more challenging environment than underwater."

Once a marine robot submerges in water, it loses the ability to transmit and receive radio signals, including GPS data. Some may use acoustic communication, but this method can be difficult and unreliable, especially for long-range transmissions. Because of this, underwater robots currently have a limited range of operation.

"Typically these robots perform a pre-planned itinerary underwater," Mahmoudian said. "Then they come to the surface and send out a signal to be retrieved. Humans have to go out, retrieve the robot, get the data, recharge the battery and then send it back out. That's very expensive, and it limits the amount of time these robots can be performing their tasks."

Mahmoudian's solution is to create a mobile docking station that underwater robots could return to on their own. A video describing this research is available on YouTube at https://www.youtube.com/watch?v=_kS0_-qc_r0.

"And what if we had multiple docks, which were also mobile and autonomous?" she said. "The robots and the docks could coordinate with each other, so that they could recharge and upload their data, and then go back out to continue exploring, without the need for human intervention. We've developed the algorithms to maximize these trajectories, so we get the optimum use of these robots."

A paper on the mission planning system that Mahmoudian and her team developed has been published in IEEE Robotics and Automation Letters. The researchers validated the method by testing the system on a short mission in Lake Superior.

"What's key is that the docking station is portable," Mahmoudian said. "It can be deployed in a stationary location, but it can also be deployed on autonomous surface vehicles or even on other autonomous underwater vehicles. And it's designed to be platform-agnostic, so it can be utilized with any AUV. The hardware and software work hand-in-hand."

Mahmoudian points out that systems like this already exist in your living room. "An autonomous vacuum, like a Roomba, does its vacuum cleaning, and when it runs out of battery, it autonomously returns to its dock to get recharged," she said, "That's exactly what we are doing here, but the environment is much more challenging."

If her system can successfully function in a challenging underwater environment, then Mahmoudian sees even greater horizons for this technology.

"This system can be used anywhere," she said. "Robots on land, air or sea will be able to operate indefinitely. Search-and-rescue robots will be able to explore much wider areas. They will go into the Arctic and explore the effects of climate change. They will even go into space."

Findings from a new study among mice show a diet high in dried plum (prunes) completely prevents bone loss associated with spinal cord injury (SCI), while also restoring some of the bone lost following SCI. These findings are a remarkable addition to a decades-long, growing body of evidence that indicates a positive connection between dried plums and bone health.

In addition to the new SCI study, previous clinical research has demonstrated a favorable bone response to prunes among post-menopausal women, along with animal-based research that shows a similar positive response among those exposed to radiation - such as astronauts in space.

"We are seeing an exciting 'dried plum effect' on bones," said Bernard Halloran, Ph.D., Professor Emeritus, University of California - San Francisco (UCSF). "In a variety of unique research scenarios, dried plum is consistently associated with a favorable bone response. No other compound appears to have the same degree of
positive impact."

The latest study, Dried Plum Mitigates Spinal Cord Injury-induced Bone Loss in Mice, was published in the July 2020 issue of the Journal of the Orthopaedic Research Society - Spine. The research was led by Halloran and Xuhui Liu, M.D., San Francisco Veterans Affairs Medical Center, Department of Veterans Affairs and the Department of Orthopedic Surgery, UCSF.

The researchers conducted two separate experiments. In a prevention experiment, they looked at dietary supplementation with dried plum for mitigating the loss of bone induced by SCI. Then, in a recovery experiment, they examined if a dried plum diet could restore bone lost after SCI.

"This evaluation is particularly important as individuals who suffer SCI experience extremely rapid bone loss," said Liu. "The SCI-related bone loss then leads to an increased risk of fractures, osteoporosis, and overall morbidity and mortality."

Experiment #1: Dried Plum Prevents SCI-related Bone Loss

Liu explains that in the prevention evaluation, mice underwent SCI and were fed a diet containing 25% dried plum by weight or a control diet for up to four weeks. In vivo microCT scanning was performed three times, including at base line (immediately before SCI) and two and four weeks after SCI.

According to the findings, the dried plum diet completely prevented bone loss compared to control diets. In contrast, the control group diet resulted in 53% and 71% loss of bone volume at two and four weeks post injury, respectively.

Experiment #2: Dried Plum Restores Some SCI-related Bone Loss

In the recovery experiment, mice were divided into groups and fed a control diet for two or four weeks. Another group was fed a control diet for two weeks to allow bone loss and then switched to the dried plum diet for an additional two weeks. The findings reveal that after only two weeks, the dried plum diet partially restored bone that had already been lost to the SCI. Bone strength was also greater in the mice switched to the dried plum diet when compared to the mice fed the control diet for four weeks.

"There are two types of cells involved with bone metabolism - osteoblasts and osteoclasts. Osteoblasts help to build new bone, while osteoclasts are essentially 'bone eaters,'" and function to tear down bone," said Liu. "At this time, we believe that dried plum functions to inhibit the bone-eating osteoclasts and this results in more bone."

Following the animal study, a pilot clinical trial providing SCI patients with dried plum did not show bone response among those experiencing SCI years prior to the trial. However, investigators indicate that additional research is needed among patients immediately following SCI to determine if dried plum can mitigate the loss of bone and bone strength as it did in the newly injured mice.

Dried Plum Polyphenols Potentially Key in Positive Bone Response

According to Halloran and Liu, it remains unclear what bioactive compounds in dried plum are responsible for the beneficial effects on bone. However, the researchers suggest that the polyphenol content in dried plums may play a role.

Non-polyphenolic compounds in dried plum may also be involved, such as vitamin K and manganese. Both nutrients are recognized as contributing to the maintenance of normal bone. Future work will focus on identifying and isolating the bioactive factors in dried plums.

"In summary, dietary supplementation with dried plum or products derived from dried plum may prove to help slow the loss of bone induced by SCI, as well as to improve other bone-related conditions," said Halloran. "The consistency of bone response to dried plum is remarkable, especially considering that dried plums are a whole food approach to healthy eating, as well as being readily available, economical, safe and - by all indications - effective in supporting healthy bones."

Researchers from the University of Iowa may have discovered a safe new way to manage blood sugar non-invasively. Exposing diabetic mice to a combination of static electric and magnetic fields for a few hours per day normalizes two major hallmarks of type 2 diabetes, according to new findings published Oct. 6 in Cell Metabolism.

"We've built a remote control to manage diabetes," says Calvin Carter, PhD, one of the study's lead authors and a postdoc in the lab of senior author Val Sheffield, MD, PhD, professor of pediatrics, and of ophthalmology and visual sciences at the UI Carver College of Medicine. "Exposure to electromagnetic fields (EMFs) for relatively short periods reduces blood sugar and normalizes the body's response to insulin. The effects are long-lasting, opening the possibility of an EMF therapy that can be applied during sleep to manage diabetes all day."

The unexpected and surprising discovery may have major implications in diabetes care, particularly for patients who find current treatment regimens cumbersome.

The new study indicates that EMFs alter the balance of oxidants and antioxidants in the liver, improving the body's response to insulin. This effect is mediated by small reactive molecules that seem to function as "magnetic antennae."

Serendipity and Collaboration

The initial finding was pure serendipity. Sunny Huang, Carter's co-lead author and an MD/PhD student interested in metabolism and diabetes, needed to practice taking blood from mice and measuring blood sugar levels. Carter offered to let her borrow some of the mice he was using to study the effect of EMFs on brain and behavior in the animals.

"It was really odd because normally these animals have high blood sugar and type 2 diabetes, but all of the animals exposed to EMFs showed normal blood sugar levels," Huang says. "I told Calvin, 'There's something weird going on here.'"

The finding that these mice had normal blood sugar levels after EMF exposure was doubly strange because the mice had a genetic modification which made them diabetic.

"That's what sparked this project," Carter confirms. "Early on, we recognized that if the findings held up, they could have a major impact on diabetes care."

The findings held up. Carter and Huang, working with Sheffield and UI diabetes expert Dale Abel, MD, PhD, chair of the UI Department of Internal Medicine, found that the combined wireless application of static magnetic and electric fields modulates blood sugar in three different mouse models of type 2 diabetes. The team also showed that exposure to such fields, approximately 100 times that of the Earth's, during sleep, reversed insulin resistance within three days of treatment.

EMFs and Redox Biology

EMFs are everywhere; telecommunications, navigation, and mobile devices all use them to function. EMFs are also used in medicine, in MRIs and EEGs, for example. However, very little is known about how they affect biology. On their hunt for clues to understand the mechanisms underlying the biological effects of EMFs on blood sugar and insulin sensitivity, Carter and Huang reviewed literature from the 1970s investigating bird migration. They found that many animals sense the Earth's electromagnetic field and use it to orient themselves as well as for navigation.

"This literature pointed to a quantum biological phenomenon whereby EMFs may interact with specific molecules. There are molecules in our bodies that are thought to act like tiny magnetic antenna, enabling a biological response to EMFs," Carter says. "Some of these molecules are oxidants, which are studied in redox biology, an area of research that deals with the behavior of electrons and reactive molecules that govern cellular metabolism."

The team collaborated with Douglas Spitz , PhD, and Gary Buettner, PhD, UI professors of radiation oncology, and Jason Hansen, PhD, from Brigham Young University, all internationally recognized experts in redox biology, to help probe the action of an oxidant molecule called superoxide, which is known to play a role in type 2 diabetes.

Their experiments suggest that EMFs alter the signaling of superoxide molecules, specifically in the liver, which leads to the prolonged activation of an antioxidant response to rebalance the body's redox set point and the response to insulin.

"When we remove superoxide molecules from the liver, we completely block the effect of the EMFs on blood sugar and on the insulin response. The evidence suggests that superoxide plays an important role in this process," Carter adds.

Aiming for Human Studies

In addition to the mouse studies, the researchers also treated human liver cells with EMFs for six hours and showed that a surrogate marker for insulin sensitivity improved significantly, suggesting that the EMFs may also produce the same anti-diabetic effect in humans.

Carter and Huang are energized by the possibility of translating the findings to human patients with type 2 diabetes. In terms of safety, the World Health Organization considers low energy EMFs safe for human health. The UI study also found no evidence of any adverse side effects in mice.

The team is now working on a larger animal model to see if the EMFs produce similar effects in an animal that has a more similar size and physiology to humans. They also plan to conduct studies to understand the redox mechanism underlying the effects of EMFs. Their ultimate goal is to move into clinical trials with patients to translate the technology into a new class of therapies. With that goal in mind, Carter, Huang, and Carter's twin brother, Walter, have created a startup company called Geminii Health, with help from the UI Office for the Vice President of Research.

"Our dream is to create a new class of non-invasive medicines that remotely take control of cells to fight disease," Carter says.

The multidisciplinary research team also included scientists from the UI Departments of Radiology, Neuroscience and Pharmacology, Molecular Physiology and Biophysics, and Physics and Astronomy, as well as colleagues from Vanderbilt University.