Culture

SAN FRANCISCO, CA--August 28, 2020-- TK Adenosine triphosphate, or ATP, is the cellular energy currency that is as valuable to the human body as the dollar is to the US economy. Too high or too low levels of ATP in some cell types have been linked to a variety of diseases. However, scientists have lacked an understanding of how cells regulate ATP levels on a broad scale and how cells' energy levels can be protected or restored in the setting of disease.

Now, researchers at Gladstone Institutes have performed a massive and detailed cellular energy audit; they analyzed every gene in the human genome to identify those that drive energy production or energy consumption. The result is a collection of data they call the "ATPome," which not only provides new directions for the field of metabolism research, but also identifies genes and proteins that can be targeted to manipulate cellular energy and treat disease.

"Essentially all cellular functions require energy but, before our study, we had very little knowledge about how to restore energy to cells when levels have gone awry," said Gladstone Associate Investigator Ken Nakamura, MD, PhD, the senior author of the study published online in the journal Nature Communications. "Our findings have implications for treating a broad array of disorders, including neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease, mitochondrial disorders, heart disease, diabetes, and cancer."

When cells need energy, they turn the energy you consume in food into ATP molecules. Then, the cell breaks apart the ATP molecule to release the energy, which is used to fuel chemical reactions. When cells don't have enough ATP, disease can result. Dysregulated energy production may also play a central role in some cancers. But a lack of understanding of how cells regulate energy has made it difficult to target these energy imbalances therapeutically.

In the new study, Nakamura and his colleagues leveraged a screening approach they had previously developed that uses a chemical sensor to quantify how much ATP is present in individual cells. In addition, they turned to CRISPR gene-editing technology to selectively turn down--or turn up--the expression of nearly every gene in the human genome, one at a time. This way, the team could measure the effect of altering each gene on ATP levels. They repeated the experiments under three different metabolic conditions, forcing the cells to rely on different pathways to produce ATP.

The set of experiments revealed new genes and pathways that help boost cellular energy by either promoting energy production or slowing energy consumption. It also showed that the cell's fuel source is a critical factor in determining which genes are needed to maintain ATP levels.

"Before this study, we knew a lot more about how energy is produced than about how it is consumed," said Neal Bennett, PhD, a Gladstone postdoctoral scholar and first author of the study. "A better understanding of how energy is consumed could lead to truly novel ways of regulating ATP levels in diseases of energy dysregulation. For instance, in diseases such as stroke or heart attack where cells experience an acute deficiency of energy supply, our study may point to ways to temporarily preserve energy levels by reducing the amount of energy they consume."

The team was also surprised to observe a new role for a critical molecular pathway called HIF1. The pathway has long been linked to the production of ATP when cells are in low-oxygen conditions. But Nakamura's group found that the HIF1 pathway strongly suppresses ATP production even under normal oxygen conditions. This means that putting the brakes on HIF1 could be one way to increase energy production by mitochondria.

Nakamura believes that the new ATPome database his group generated will likely have far-reaching utility for scientists studying the role of cellular energy in disease. Being able to manipulate cellular energy could help biologists limit the amount of energy available to cancer cells, or increase ATP in brain cells affected by neurodegeneration, among other therapeutic applications.

"What we've done is put together a basic blueprint for how genes play a role in energy production, consumption, and possibly energy dysfunction," said Nakamura, who is also an associate professor of neurology at UC San Francisco (UCSF). "From here, we have to extend the results into other cell types and gain an understanding of how this basic blueprint is altered by different diseases, in order to develop novel therapeutic approaches to manipulate energy metabolism."

Nakamura's lab is collaborating with other researchers at Gladstone and UCSF to study how energy usage might differ in brains affected by Parkinson's or Alzheimer's disease; in the heart--an organ that requires high amounts of energy and is prone to energy failure; and in cancer, which may be fueled by excessive energy.

UNIVERSITY PARK, Pa. -- Small-scale poultry farmers in Vietnam tend to respond to viral outbreaks of highly pathogenic avian influenza (HPAI) by rapidly selling their birds as a way to avoid financial loss, according to a new study by an international team of researchers. As these birds are commingled with other birds in markets and trading networks, this practice may increase the likelihood of widespread disease transmission. The findings could have implications for government policymaking in the many regions of the world where small-scale poultry farming and avian influenza risk co-occur.

"Avian influenza is deadly to humans, with a case fatality rate between 25% and 50%," said Maciej Boni, associate professor of biology, Penn State. Fortunately, reports of human-to-human transmission over the past 15 years have been either absent or anecdotal. COVID-19 took us by surprise, but with HPAI we have a known threat with the potential to become pandemic. If we ignore the active role that poultry farmers play in the control and dissemination of avian influenza, we may miss another opportunity to curtail an emerging disease outbreak at a stage when it is still controllable."

Lead author Alexis Delabouglise, an animal health economist at CIRAD-Agricultural Research for Development in France who was a postdoctoral scholar at Penn State when the research was performed, explained that small-scale poultry farming is practiced by millions of Vietnamese households and by millions more throughout southeast Asia, mostly on a scale of fewer than 100 birds per farm. These farmers make decisions on a daily basis -- often in response to economic incentives -- about when and where to sell their flocks. And their decisions can influence disease spread.

"If the price of poultry goes up, farmers might expand their farming activities, which could create more outbreak risk," said Delabouglise. "If there is an outbreak on a neighboring farm, they might choose to sell their poultry early to avoid their own birds from being infected and to avoid lower prices. And if there is an outbreak on their own farm, the evidence in our study shows that they would be likely to sell their birds early to avoid both monetary loss and epidemiological risk."

Boni and colleagues, including researchers at the Oxford University Clinical Research Unit (OUCRU) in Ho Chi Minh City, conducted a longitudinal study of small-scale poultry farms in the Mekong river delta region of southern Vietnam with a goal of characterizing the effects of disease outbreaks on poultry harvest rates, as well as on two prevention practices -- vaccination and farm disinfection. The team followed 53 farmers and their management of more than 1,000 poultry flocks for a period of two years -- from 2015 to 2017.

"Working with partners in endemic countries day-in and day-out on study details and public health priorities is key to establishing collaborations that allow these long-term follow-up studies to succeed," said Boni, who led a research group at OUCRU for eight years.

Delabouglise, the statistical lead on the project, used mixed-effects general additive models to investigate farmers' probabilities of harvesting -- either selling or slaughtering -- flocks, of performing avian influenza vaccination on flocks that were not previously vaccinated and of disinfecting farm facilities when faced with an outbreak. Their findings appeared in eLife on August 25.

"We found that farmers did send their chickens to market early when there were outbreaks occurring on their farms," said Delabouglise. "Specifically, small-scale farmers increased their harvest of broiler chickens by 56% during outbreaks with no sudden deaths and by 214% during outbreaks with sudden deaths. This has the potential to exacerbate the outbreak and spread the virus even further."

The team noted that sudden deaths -- the deaths of chickens less than one day after the onset of clinical symptoms -- are considered to be indicative of HPAI infection. Interestingly, the team found that the probability of disinfection was not affected by the occurrence of outbreaks.

Finally, the team found that the likelihood of vaccination against avian influenza strongly increased with flock size. The probability of vaccination was almost zero for flocks of 16 birds or fewer and nearly 100% for flocks of more than 200 birds. According to Delabouglise, one reason that millions of small-scale poultry farmers may not be vaccinating their birds could be their desire to avoid transaction costs associated with declaring flocks to governmental veterinary services before vaccination. Another reason could be that due to their small size, their vaccination status is not controlled and, therefore, vaccination is less worthwhile from the farmers' perspective.

"Crucially, it is these smaller flocks that are more likely to be sold into trading networks during outbreaks," he said. "The rapid sale of sick birds can contaminate other birds at traders' storage places and those at live bird markets. It also exposes consumers and traders, slaughterers and retailers to an increased risk of infection."

Delabouglise noted that, on the flip side, a massive arrival of underage birds in a live bird market, or a price decrease due to the temporary oversupply of poultry, may be a sign that an outbreak is occurring.

"This is an interesting area for surveillance of livestock diseases," he said.

Delabouglise said that the team's results could help governmental agencies create policies that aim to avoid the spread of HPAI.

"Small-scale farmers could play an active role in the control of emerging infectious diseases if they are given the opportunity to depopulate their farm upon disease detection without disseminating pathogens in trade circuits," he said. "Policymakers could encourage the establishment of formal trade agreements that encourage such 'virtuous' management of disease outbreaks in poultry."

One such "virtuous" management strategy could be for farmers to sell their sick chickens as feed for pythons and crocodiles raised on neighboring farms. Another could be to set up agreements with neighboring large commercial farmers who can give them financial indemnities to destroy the birds as a way of protecting their own flocks.

"It would be impossible to have reliable public-health control over the millions of small-scale poultry flocks in a place like Vietnam," said Delabouglise, "but providing economic incentives to responsibly manage birds during disease outbreaks is feasible."

Other authors on the paper include Nguyen Thi Le Thanh, Wellcome Trust Major Overseas Programme; Huynh Thi Ai Xuyen, Ca Mau Sub-Department of Livestock Production and Animal Health; Benjamin Nguyen-VanYen, Wellcome Trust Major Overseas Programme and Ecole Normale Superieure; Phung Ngoc Tuyet, Ca Mau Sub-Department of Livestock Production and Animal Health; and Ha Minh Lam, Wellcome Trust Major Overseas Programme and University of Oxford.

The Defense Threats Reduction Agency, the Wellcome Trust and the Pennsylvania State University supported this research.

Researchers from the University of Minnesota, with support from Medtronic, have developed a groundbreaking process for multi-material 3D printing of lifelike models of the heart's aortic valve and the surrounding structures that mimic the exact look and feel of a real patient.

These patient-specific organ models, which include 3D-printed soft sensor arrays integrated into the structure, are fabricated using specialized inks and a customized 3D printing process. Such models can be used in preparation for minimally invasive procedures to improve outcomes in thousands of patients worldwide.

The research is published in Science Advances, a peer-reviewed scientific journal published by the American Association for the Advancement of Science (AAAS).

The researchers 3D printed what is called the aortic root, the section of the aorta closest to and attached to the heart. The aortic root consists of the aortic valve and the openings for the coronary arteries. The aortic valve has three flaps, called leaflets, surrounded by a fibrous ring. The model also included part of the left ventricle muscle and the ascending aorta.

"Our goal with these 3D-printed models is to reduce medical risks and complications by providing patient-specific tools to help doctors understand the exact anatomical structure and mechanical properties of the specific patient's heart," said Michael McAlpine, a University of Minnesota mechanical engineering professor and senior researcher on the study. "Physicians can test and try the valve implants before the actual procedure. The models can also help patients better understand their own anatomy and the procedure itself."

This organ model was specifically designed to help doctors prepare for a procedure called a Transcatheter Aortic Valve Replacement (TAVR) in which a new valve is placed inside the patient's native aortic valve. The procedure is used to treat a condition called aortic stenosis that occurs when the heart's aortic valve narrows and prevents the valve from opening fully, which reduces or blocks blood flow from the heart into the main artery. Aortic stenosis is one of the most common cardiovascular conditions in the elderly and affects about 2.7 million adults over the age of 75 in North America. The TAVR procedure is less invasive than open heart surgery to repair the damaged valve.

The aortic root models are made by using CT scans of the patient to match the exact shape. They are then 3D printed using specialized silicone-based inks that mechanically match the feel of real heart tissue the researchers obtained from the University of Minnesota's Visible Heart Laboratories. Commercial printers currently on the market can 3D print the shape, but use inks that are often too rigid to match the softness of real heart tissue.

On the flip side, the specialized 3D printers at the University of Minnesota were able to mimic both the soft tissue components of the model, as well as the hard calcification on the valve flaps by printing an ink similar to spackling paste used in construction to repair drywall and plaster.

Physicians can use the models to determine the size and placement of the valve device during the procedure. Integrated sensors that are 3D printed within the model give physicians the electronic pressure feedback that can be used to guide and optimize the selection and positioning of the valve within the patient's anatomy.

But McAlpine doesn't see this as the end of the road for these 3D-printed models.

"As our 3D-printing techniques continue to improve and we discover new ways to integrate electronics to mimic organ function, the models themselves may be used as artificial replacement organs," said McAlpine, who holds the Kuhrmeyer Family Chair Professorship in the University of Minnesota Department of Mechanical Engineering. "Someday maybe these 'bionic' organs can be as good as or better than their biological counterparts."

Overcoming the nation's opioid epidemic will require clinicians to look beyond opioids, new research from Oregon Health & Science University suggests.

The study reveals that among patients who participated in an in-hospital addiction medicine intervention at OHSU, three-quarters came into the hospital using more than one substance. Overall, participants used fewer substances in the months after working with the hospital-based addictions team than before.

The study published in the Journal of Substance Abuse Treatment.

"We found that polysubstance use is the norm," said lead author Caroline King, M.P.H., a health systems researcher and current M.D./Ph.D. student in the OHSU School of Medicine's biomedical engineering program. "This is important because we may need to offer additional support to patients using multiple drugs. If someone with opioid use disorder also uses alcohol or methamphetamines, we miss caring for the whole person by focusing only on their opioid use."

About 40% of participants reported they had abstained from using at least one substance at least a month after discharge - a measure of success that isn't typically tracked in health system record-keeping.

Researchers enrolled 486 people seen by an addiction medicine consult service while hospitalized at OHSU Hospital between 2015 and 2018, surveying them early during their stay in the hospital and then again 30 to 90 days after discharge.

Treatment of opioid use disorder can involve medication such as buprenorphine, or Suboxone, which normalizes brain function by acting on the same target in the brain as prescription opioids or heroin.

However, focusing only on the opioid addiction may not adequately address the complexity of each patient.

"Methamphetamine use in many parts of the U.S., including Oregon, is prominent right now," said senior author Honora Englander, M.D., associate professor of medicine (hospital medicine) in the OHSU School of Medicine. "If people are using stimulants and opioids - and we only talk about their opioid use - there are independent harms from stimulant use combined with opioids. People may be using methamphetamines for different reasons than they use opioids."

Englander leads the in-hospital addiction service, known as Project IMPACT, or Improving Addiction Care Team.

The initiative brings together physicians, social workers, peer-recovery mentors and community addiction providers to address addiction when patients are admitted to the hospital. Since its inception in 2015, the program has served more than 1,950 people hospitalized at OHSU.

The national opioid epidemic spiraled out of control following widespread prescribing of powerful pain medications beginning in the 1990s. Since then, it has often been viewed as a public health crisis afflicting rural, suburban and affluent communities that are largely white.

Englander said the new study suggests that a singular focus on opioids may cause clinicians to overlook complexity of issues facing many populations, including people of color, who may also use other substances.

"Centering on opioids centers on whiteness," Englander said. "Understanding the complexity of people's substance use patterns is really important to honoring their experience and developing systems that support their needs."

Researchers say the finding further reinforces earlier research showing that hospitalization is an important time to offer treatment to people with substance use disorder, even if they are not seeking treatment for addiction when they come to the hospital.

Researchers from Sechenov University together with Russian and Iranian colleagues described currently known approaches to the treatment of SARS-CoV-2 infection. In the paper published in Journal of Molecular Medicine, they wrote about how different groups of drugs worked and how promising each approach was.

SARS-CoV-2 - a coronavirus that caused the pandemic in early 2020 - is a close relative of two other viruses (SARS-CoV and MERS-CoV) that triggered epidemics in 2003 and 2013-2015. Most often, the disease is accompanied by fever, dry cough, increased fatigue, and loss of taste and smell. Most symptoms are associated with an overreaction of the patient's immune system, which, in severe cases, causes damage to lung tissue and systemic inflammation.

The first approach considered in the article is immunotherapy. It is known that antibodies contained in the serum of people who have had a viral disease can speed up the recovery of other patients. Despite the simplicity of this method, it has several limitations: the number of potential donors is still small, the activity of antibodies decreases over time (which is why the serum from the patients who had the disease long ago is less valuable), and the antibodies themselves can help the virus spread in the body - a phenomenon known as antibody-dependent enhancement of infection.

Similarly, we can use T-lymphocytes - cells that can destroy damaged or infected cells of the body. Scientists have noticed that the number of T-cells of the CD8+ subpopulation is significantly reduced in patients with COVID-19, and the more severe the disease the lower this number. T-cells directed against a specific virus can be produced in vitro and offered to patients as therapy.

Another area of research is related to the suppression of certain enzymes, in particular AAK1 and GAK, which are needed for the virus to enter a cell. Some of the drugs that act as inhibitors of these enzymes have already been tested and used, although for another purpose, such as, for example, the treatment of rheumatoid arthritis (this approach is called 'drug repurposing').

'Analysis of clinical trials registered in ClinicalTrials.gov has shown a wide variety of therapeutic agents offered for the treatment of COVID-19. And, of course, most of them are associated with the use of previously known drugs used in the treatment of other diseases,' commented Anastasia Shpichka, one of the authors of the study, a leading researcher at the Institute for Regenerative Medicine, Sechenov University.

There are other ways to prevent the virus from entering cells. Since the receptor that is built into the cell membrane and lets the virus inside is known (this is the ACE2 protein), it is possible to create an analogue that will bind to viral particles and 'distract' them from the patient's cells. Such analogues of the ACE2 receptor have already been developed, tested and shown to slow down the spread of the virus in the body, but not stop it, which indicates the presence of other entry points into human cells.

The use of antiviral drugs gives contradictory results. Remdesivir, which showed good efficacy against SARS-CoV-2 in some studies, did not bring noticeable benefits in others. Chloroquine, used to treat malaria, was considered a promising drug, but its side effects do not allow it to be recommended for the treatment of COVID-19. Attempts to use HIV medications against SARS-CoV-2 also yield mixed results.

One more direction in the fight against COVID-19 is suppression of excessive immune system reaction, which especially affects the lung tissue. One treatment option may be mesenchymal stem cells, used in the treatment of inflammatory and autoimmune diseases. Studies of the effectiveness of this method in the treatment of COVID-19 are already underway. Another class of drugs that limit inflammatory response is corticosteroids. They can reduce mortality among patients with severe disease.

Despite the efforts of scientists from all over the world, aimed at finding an effective COVID-19 treatment, the optimal algorithm has not yet been found. The key to creating a drug can be either a discovery as part of one of these approaches or a new solution, for example, found at the intersection of scientific disciplines or borrowed from the experience of treating other diseases.

DARIEN, IL – A new study of sleep, religious affiliation, and perceptions of heaven found that atheists and agnostics are significantly more likely to be better sleepers than Catholics and Baptists.

Preliminary results show that 73% of atheists and agnostics reported getting seven or more hours of nightly sleep, which is recommended by the American Academy of Sleep Medicine to promote optimal health. In contrast, 63% of Catholics and only 55% of Baptists reported sleeping at least seven hours per night. Atheists and agnostics also reported experiencing less difficulty falling asleep.

“Mental health is increasingly discussed in church settings — as it should be — but sleep health is not discussed,” said lead author Kyla Fergason, a student at Baylor University in Waco, Texas. “Yet we know that sleep loss undercuts many human abilities that are considered to be core values of the church: being a positive member of a social community, expressing love and compassion rather than anger or judgment, and displaying integrity in moral reasoning and behavior. Could getting better sleep help some people grow in their faith or become better Christians? We don’t know the answer to that question yet, but we do know that mental, physical and cognitive health are intertwined with sleep health in the general population.”

The study involved a population-based sample of 1,501 participants in the Baylor Religion Survey, which includes questions on religious affiliation, behaviors, and perceptions. Participants also rated their difficulty falling asleep and their average total sleep time.

Results also show that those participants who reported sleeping seven or more hours per night were significantly more likely to believe that they would get into heaven. However, these perceptions of heaven were unrelated to difficulty falling asleep at night. According to the authors, this pattern indicates that better sleep leads to a more optimistic outlook, which in this case is manifesting as positive expectations of getting into heaven.

The research abstract was published recently in an online supplement of the journal Sleep and will be presented as a poster Aug. 28-30 during Virtual SLEEP 2020. SLEEP is the annual meeting of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

DARIEN, IL – An experimental study suggests that sleep restriction may hinder information disclosure during criminal interviews, contradicting widespread assumptions about the effectiveness of sleep deprivation as an interrogation tool.

Preliminary results show that even mildly sleep-restricted participants provided around 7% less information during their initial disclosure. Sleep-restricted individuals also reported less overall motivation to recall information.

“Historically, sleep has been used as a tool to compel disclosure or confessions, while sleep loss remains common among interview subjects such as victims or witnesses,” said lead author Zlatan Krizan, who has a doctorate in personality and social psychology and is a professor of psychology at Iowa State University in Ames, Iowa. “However, there was little direct, scientific evidence on whether sleep enhances or inhibits intelligence disclosures during investigative interviews prior to this study. These findings carry direct implications for science and practice of investigative interviewing and contradict longstanding assumptions about the role of sleep in gathering human intelligence.”

The study involved 120 healthy participants who were recruited from the university community. They were assigned to maintain or restrict their sleep for two days, with objective estimates of sleep duration gathered using actigraphy. Sleep-restricted participants slept 4.5 hours less on average, losing about one night of sleep over two days. Following the sleep manipulation, participants were interviewed about past illegal acts they admitted to.

According to the authors, the results suggest that even moderate sleep loss can inhibit criminal disclosure during interviews.

We are conscious beings, yet most of the activity in our brains remains nonconscious. Can we harness this hidden pool of information? Notably, one important challenge is the astronomical vastness and complexity of such nonconscious information. How can the human brain 'know' what aspects of such complex activity may be relevant, given that it is by definition nonconscious and thereby 'unknown'? There is no magic formula to solve this problem, and research in artificial intelligence suggests that even the best of our current algorithms struggle to handle this vastness of dimensionality in everyday, real-life problems.

The international team used a state-of-the-art method to read nonconscious brain states in real-time. This technique used brain scanning to monitor and detect the occurrence of specific complex patterns of activity, that were then used to determine the optimal answer to a simple action selection. In the learning sessions, participants received a small monetary reward if they selected the correct option, which was determined based on their nonconscious brain activity. This experiment allowed researchers to show how participants can learn to use the nonconscious contents of their mind to make profitable decisions. Interestingly, although based on their self-reports, participants were not aware of the learning, when they were confident in their choices, they were also more likely to be correct and receive a reward. This suggests an unexpected form of nonconscious metacognition; the participants were not aware of learning per se, but somehow, some brain mechanisms must 'know'. These striking results illustrate the incredible power of the nonconscious mind and how important our feeling of confidence may be in our everyday life.

Dr. Aurelio Cortese, Senior Researcher at the Advanced Telecommunications Research Institute International, Kyoto, led the research:

"Strikingly, participants were taught to make rational choices on their own nonconscious brain activity through a very simple trial-and-error learning procedure. The extent of this learning was predicted by participants' ability to self-introspect in their decisions. Such approaches may be used in the future to improve 'dormant' skills".

Dr. Hakwan Lau, Professor in the UCLA Psychology Department, a co-author on the study and a leading expert in confidence and metacognition:

"This study is unique in its kind in that it shows, for the first time, the depth of the human brain's ability to reconfigure and learn in conditions we would have thought as impossible until recently. The fact that confidence seemed to support participant's ability to learn the task nonconsciously opens new questions on its function and role in guiding behaviour".

Dr. Mitsuo Kawato, Director of the Computational Neuroscience Laboratories at ATR, Kyoto, was the senior author on the study, and has pioneered the state-of-the-art technology that led to the inception of this study. He explained:

"One of the most challenging questions in modern neuroscience and artificial intelligence is how can the brain solve the 'curse of dimensionality'. There are billions of neurons in the brain, and most of its activity is complex and nonconscious. How to efficiently make the best decisions when time and experience are generally so limited? Here we provide a first indication by showing that our feeling of confidence may be part of the answer".

The sample size was relatively small (18 people), but carried over 3 sessions, making the total (54 neuroimaging sessions) in line with basic science investigations of similar kinds.

Sophia Antipolis, France - 27 Aug 2020: Weight loss is most successful in heart attack survivors when partners join in the effort to diet, according to research presented today at ESC Congress 2020.1

"Lifestyle improvement after a heart attack is a crucial part of preventing repeat events," said study author Ms. Lotte Verweij, a registered nurse and PhD student, Amsterdam University of Applied Sciences, the Netherlands. "Our study shows that when spouses join the effort to change habits, patients have a better chance of becoming healthier - particularly when it comes to losing weight."

The RESPONSE-2 trial previously found that heart attack survivors referred to programmes for weight reduction, physical activity, and smoking cessation were more likely to modify behaviours compared to those receiving usual care.2 In both groups, living with a partner was linked with greater success in shifting bad habits. The most notable improvements were in patients who took part in lifestyle programmes and lived with a partner.

This follow-up study investigated whether partner involvement in lifestyle programmes had an impact on behaviour change. "If partners contribute to adopting healthy habits, it could become an important recommendation to avoid recurrent heart attacks," explained Ms. Verweij.

A total of 824 patients were randomly assigned to the intervention group (lifestyle programmes on top of usual care) or control group (usual care alone).3,4

This analysis focused on the 411 patients in the intervention group, who were referred to up to three lifestyle programmes for weight reduction, physical activity, and smoking cessation depending on their needs and preferences. Partners could attend for free and nurses encouraged them to participate. Partner participation was defined as attending at least once.

Nearly half (48%) of partners participated in the lifestyle interventions. Compared to those without a partner, patients with a participating partner were more than twice as likely (odds ratio 2.45) to improve in at least one of the three areas (weight loss, exercise, smoking cessation) within a year.

When the influence of partners was analysed on the three areas separately, patients with a participating partner were most successful in reducing weight compared to patients without a partner (odds ratio 2.71).

"Patients with partners who joined the weight loss programme lost more weight compared to patients with a partner who did not join the programme," said Ms. Verweij.

She continued: "Couples often have comparable lifestyles and changing habits is difficult when only one person is making the effort. Practical issues come into play, such as grocery shopping, but also psychological challenges, where a supportive partner may help maintain motivation."

Ms. Verweij noted that the study did not find more improvement in smoking cessation or physical activity when partners actively participated. "These lifestyle issues might be more subject to individual motivation and persistence, but this hypothesis needs more investigation," she said.

Body mass index (BMI) trajectories in the first years of life may be associated with lung function in later childhood. For example, children with accelerated BMI gain before age four years have higher lung function at age seven years, although they also exhibit airflow limitation. This is the conclusion of a new study by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, which has been published in the European Respiratory Journal.

Early childhood is a key period for lung function development. Previous studies have found an association between weight in the first years of life and lung health in infancy and childhood. "These studies had certain limitations in terms of defining weight gain," explained Gabriela P. Peralta, researcher at ISGlobal and lead author of the study. "Most of them only considered the difference in weight between two points in time and did not take the overall trajectory into account. That's why we decided to carry out this new study."

The study used data on more than 1,200 children living in three areas of Spain--Sabadell, Valencia and Gipuzkoa--who were enrolled in birth cohort of the INMA Environment and Childhood Project. "First, we determined the children's BMI trajectory from birth to age four years and classified them in five categories. The trajectories differed in terms of weight at birth (which could be lower, average or higher) and speed of BMI gain (which could be slower or accelerated)," explained Peralta. BMI is an indicator based on weight in relation to height that is frequently used to classify overweight and obesity. The authors then analysed the relationship between BMI trajectory and lung function, which was measured by spirometry at age seven years. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio were measured.

The findings showed that children with accelerated BMI gain before age four years, regardless of weight at birth, had higher lung function at age seven years but also airflow limitation, which indicates difficulty expelling air from the lungs. In contrast, children with lower weight at birth and slower BMI gain in early childhood had lower lung function at age seven years.

Maribel Casas, a researcher at ISGlobal and co-coordinator of the study, commented: "Our findings have important implications for research and public health." She added: "This study shows that BMI trajectories in early childhood are a useful tool for identifying growth patterns associated with poor respiratory health."

"Since weight gain is affected by modifiable factors, public health interventions in early childhood that promote healthy lifestyles--for example, healthy eating and physical activity--can help improve lung function and reduce respiratory morbidity in adulthood," concluded Judith Garcia-Aymerich, head of the Non-Communicable Diseases and Environment Programme at ISGlobal and co-coordinator of the study. "Public health strategies aimed at reducing respiratory health problems may need to focus on early weight gain."

Although most voters say they believe that voting will be safe and that their ballot will be counted despite the coronavirus pandemic, those who question election safety and some who question election integrity appear less likely to vote, according to a new RAND Corporation survey.

In addition, people who identify as Republicans are more likely to express concerns about the integrity of the 2020 elections, while Democrats are more likely to be concerned about safety -- underscoring the need for election officials to communicate to the public about both issues.

Researchers found that Black and Hispanic respondents tended to be less likely than White respondents to expect their vote to be counted accurately given the challenges posed by the coronavirus pandemic. Hispanic respondents also were less likely to report confidence in the preparedness of local officials.

Despite misgivings among some groups, the survey found that for most people there is no major change in their intention to vote in November. However, a smaller group of respondents reported that they were less likely to vote -- these same people are more likely to be those with safety concerns and in some cases integrity concerns.

"Many respondents are making plans to vote using remote methods -- such as vote-by-mail -- where they are available," said Jennifer Kavanagh, lead author of the study and a senior political scientist at RAND, a nonprofit, nonpartisan research organization. "We found that overall few people who voted in 2016 plan to opt out in 2020, but vote intentions do appear to be lower on average among those with safety concerns."

The survey found widespread support for sanitation and social distancing at poll locations, but lower support for sending mail-in ballots to all registered voters or using online voting.

Researchers say that policymakers who are interested in ensuring that pandemic-related concerns do not deter people from voting should prioritize safety and election integrity equally and clearly communicate with constituents about the steps being taken.

The study reports results of a survey of 2,389 people conducted during May and June about public safety, election integrity and preparedness of local officials to manage the November 2020 election during the pandemic.

Some of the participants, who are all part of RAND's American Life Panel, took part in a RAND election survey during 2016, allowing researchers to track attitudes over time. An update to the survey conducted in August is currently being completed.

Other finding from the survey include:

All else being equal, older voters had higher perceptions of safety and preparedness, and more confidence in election integrity than did younger voters.

Respondents who reported higher levels of education tended to be more supportive of social distancing and sanitation at the polls, as well as of expanded distribution of mail-in ballots to all registered voters as a way to address pandemic-related risks.

About one-third of survey participants reported they had some concerns about public safety, election integrity and preparedness of local officials to conduct elections during the pandemic.

Respondents who said they do not expect elections to be physically safe also were more likely to question whether their vote will be counted accurately and whether officials will be prepared.

"Different groups have different perceptions of safety, election integrity and preparedness of local officials for the 2020 election, and the relationship between perceptions and
intention to vote similarly varies across demographic groups," Kavanagh said.

Although election officials and other policymakers might wish to communicate broadly about their preparations for the 2020 election, the RAND analysis suggests that the effects of such a campaign would be maximized by targeting messages at specific groups that seem most prone to such concerns.

"Elections pose major challenges to local officials, even under the best of circumstances," Kavanagh said. "On top of the regular challenges election officials face, this year they will also have to manage issues like sanitation, ensuring social distancing, and processing larger numbers of absentee ballots. In addition, a significant number of people have concerns about safety and security of the elections.

"Those who are interested in ensuring that voters are not deterred by such concerns should consider targeted messages to different groups in order to best address their concerns."

[Vienna, 27 August 2020] To know which non-pharmaceutical interventions against the spread of coronavirus worked best, researchers and health authorities need data. In March, the Complexity Science Hub Vienna (CSH) started a comprehensive worldwide collection of governmental measures, which is now published in the Nature journal Scientific Data.

The CSH COVID-19 Control Strategies List (CCCSL) to date includes information on 6,068 interventions from 56 countries: 33 European, 12 Asian, five South American, two North American, three African, and one Oceanian countries, plus the cruise ship Diamond Princess. For the US, data were collected at the state level for 24 US states.

Highly detailed data for in-depth analyses

"The special value of our dataset is its granularity," says project leader and first author Amelie Desvars-Larrive (CSH and Univ of Veterinary Medicine Vienna). "To our knowledge, it is to date the most detailed classification of government measures against COVID-19."

On the most general level (L1), the scientists divided the measures in seven groups: case identification; contact tracing and related measures; environmental measures, such as disinfection and cleaning of common surfaces (public transports, markets); healthcare and public health capacity (e.g. increase of the hospital capacity or of the healthcare workforce); resource allocation (like operations involved in the allocation of budgets, deployment of resources, and distribution of goods for controlling a disease outbreak); risk communication; social distancing; travel restriction; and, a newer category, returning to normal life.

Each intervention is coded into four levels, from a broad categorisation of the measures (L1) to a very specific description (L4). "As an example, we have seven categories of travel restrictions, which are further divided into more than 50 subcategories," says Desvars-Larrive. Moreover, the use of self-explanatory codes makes the dataset readily comprehensible, even for non-experts.

The coding scheme of the dataset exhibits a great analytical flexibility and makes it especially valuable for computer-aided techniques like Machine Learning.

Dealing with a pandemic

"With the CCCSL, we hope to contribute to a better management of the corona crisis or similar epidemics in the future," says David Garcia (CSH & Medical Univ of Vienna), one of the co-authors. "With comprehensive data, scientists and politicians will be able to better assess individual risks, to develop tailor-made containment strategies or approaches how to end strict measures, for instance."

For example, scientists at the CSH were combining the CCCSL data with publicly available data on COVID-19 cases. "We quantified the impact of individual control policies and came up with a ranking according to their effectiveness in reducing coronavirus spread," explains Amelie Desvars-Larrive. These findings are currently under review.

The data were collected from public sources, including official government sources, scientific papers, press releases, government communications and social media. All records were hand-coded and are updated on a regular basis.

During the COVID-19 crisis, other research teams have concomitantly tracked data on government policies. Joining forces to fight the pandemic, the CCCSL and six other international datasets have been integrated into the global dataset Tracking Public Health and Social Measures (PHSM) aggregated by the World Health Organization.

COLUMBUS, Ohio - Lower-income households that received mortgages through state affordable mortgage programs were less likely to default or foreclose than similar households that received conventional financing, a national study found.

Researchers examined the outcomes of homeownership programs administered by Housing Finance Agencies (HFAs), which are state chartered agencies operating in all 50 states that work to provide affordable housing to low- and moderate-income households.

The study of 140,000 households showed that HFA borrowers had a 29 percent lower risk of default and a 32 percent lower risk of foreclosure than similar households they were matched with that didn't receive loans through HFAs. Within the first two years after closing on the home, this translates into just over a 2-percentage point reduction in the default rate of 8 percent.

Surprisingly, it wasn't the structure of the loan itself - such as the lower interest rates offered to HFA customers - that was the main driver in their better performance, said Stephanie Moulton, lead author of the study and associate professor in The Ohio State University's Glenn College of Public Affairs.

It had to do with the supportive services HFAs provided customers, including direct loan servicing and homebuyer education and counseling.

"There's been a lot of talk that where you get your loan doesn't matter - you just have to get a good loan," Moulton said.

"But at least with these lower-income borrowers, it does seem to matter where they get their loans."

Moulton conducted the study with Eric Hembre of the University of Illinois-Chicago and Matthew Record of San Jose State University. Their results were published online recently in the Journal of Policy Analysis and Management.

The researchers used data from Fannie Mae, the government-sponsored mortgage financier, on 30-year, fixed-rate mortgages for single-family homes from across the country that were originated between 2005 and 2014.

The researchers matched 70,000 households that received HFA mortgages with similar households in the same geographic area with comparable income, credit, and other characteristics but who got their mortgages through the private market.

"Despite their reported superior performance, there had been no rigorous studies comparing HFA mortgages with loans of similar borrowers," Moulton said. "That's what we were trying to do here."

The fact that HFA borrowers had lower rates of default and foreclosure suggests big impacts on local economies, the researchers found.

Applying the results of the study to the 800,000 HFA loans originated between 2005 and 2014 suggests that there would have been 53,000 more defaults and 33,000 more foreclosures had those loans been originated through private lenders.

That translates to up to $232 million in saved local costs, Moulton said.

"That is a significant benefit to communities hit hard by the housing crisis during the time of our study," she said.

The researchers identified two ways that HFAs helped consumers. One was the structural characteristics of the loans themselves, including lower interest rates. But that corresponds to only about a 5.5 percent reduction in mortgage default. Specific types of down payment assistance and having loans originated through banks rather than third party originators also helped HFA borrowers.

The other type of impact came from the service delivery practices of HFAs, Moulton said. Each state's HFA services its loans differently, so the researchers were able to examine changes in practices over time and between HFAs to see which ones were most successful.

Some states require home buyer education and counseling, which helped HFA borrowers. "Some states match you with a counselor who you can contact even after the purchase if you run into problems. That helps a lot," she said.

In some of the state HFAs interviewed for the study, for example, counselors reach out to borrowers as soon as they miss a payment to see what's going on, Moulton said. In contrast, most private servicers wait until mortgage holders are 60 days behind, by which time it may be more difficult to help the homeowners.

"Those HFAs that build in these channels of communication mean that when something goes wrong, there is more likely to be quick action that can keep borrowers from spiraling into foreclosure," Moulton said.

These results suggest that government can have a significant impact in helping low- and moderate-income households afford and keep their own homes, she said.

"These HFAs are still leveraging the private market to originate the loans. But they have an important role in delivering services that make sure that these lower-income households have the help they need to succeed."

WASHINGTON -- Misconceptions about the way climate and weather impact exposure and transmission of SARS-CoV-2, the virus that causes COVID-19, create false confidence and have adversely shaped risk perceptions, say a team of Georgetown University researchers.

"Future scientific work on this politically-fraught topic needs a more careful approach," write the scientists in a "Comment" published today in Nature Communications.

The authors include global change biologist Colin J. Carlson, PhD, an assistant professor at Georgetown's Center for Global Health Science and Security; senior author Sadie Ryan, PhD, a medical geographer at the University of Florida; Georgetown disease ecologist Shweta Bansal, PhD; and Ana C. R. Gomez, a graduate student at UCLA.

The research team says current messaging on social media and elsewhere "obscures key nuances" of the science around COVID-19 and seasonality.

"Weather probably influences COVID-19 transmission, but not at a scale sufficient to outweigh the effects of lockdowns or re-openings in populations," the authors write.

The authors strongly discourage policy be tailored to current understandings of the COVID-climate link, and suggest a few key points:

1. No human-settled area in the world is protected from COVID-19 transmission by virtue of weather, at any point in the year.

2. Many scientists expect COVID-19 to become seasonal in the long term, conditional on a significant level of immunity, but that condition may be unmet in some regions, depending on the success of outbreak containment.

3. All pharmaceutical and non-pharmaceutical interventions are currently believed to have a stronger impact on transmission over space and time than any environmental driver.

"With current scientific data, COVID-19 interventions cannot currently be planned around seasonality," the authors conclude.

China's FengYun-3 (FY-3) satellite programme is an important part of the Earth observing system and provides observations for numerical weather prediction (NWP), reanalyses, and climate studies. The latest platform in the programme, FY-3D, carries the Microwave Temperature Sounder 2 (MWTS-2), the Microwave Humidity Sounder 2 (MWHS-2), and the Microwave Radiation Imager (MWRI). Together, these instruments have radiometric capability spanning the microwave domain from 10 to 183 GHz and provide valuable information on surface and atmospheric temperature, humidity, and wind.

Data quality assessment is a fundamental step that leads to the optimal use of a new instrument, helps NWP centres define assimilation strategies, and guides the climate community in the generation of climate data records. In a new study published in Advances in Atmospheric Sciences, Dr Fabien Carminati of the UK Met Office and his colleagues build upon the maturity and experience gained from the assessment of previous platforms from the FY-3 programme to evaluate the instruments onboard FY-3D and to support China in generating high-quality satellite data for a wide range of weather and climate applications. The analysis shows that the data quality of all three instruments has improved with respect to the instruments onboard FY-3C and generally compares well to that of reference U.S. instruments. The assimilation of FY-3D microwave observations in the Met Office NWP system has a positive impact, reducing the error of global weather forecasts by a small but significant 0.1% on average.

Observations from FY-3D microwave instruments not only benefit both the NWP and climate communities by complementing the current observing system but also ensure the continuity of Earth observations between FY-3C and FY-3E. The assimilation of microwave observations at the Met Office and other NWP centres leads to improved weather forecasts, better resilience to extreme weather events, and more accurate climate predictions and monitoring. This also has the potential to improve downstream activities in sectors as varied as economics, agriculture, or energy, and provide a firmer basis for management and decision making.