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FAYETTEVILLE, Ark. - Fine-grained location data gleaned from mobile phones shows that people living in less affluent neighborhoods spent less time at home during the early lockdown and first several months of the coronavirus pandemic.

Researchers tracked data from millions of mobile phone users in the largest U.S. metropolitan areas. Their findings contribute to a growing body of research suggesting that low-wage earners -- a vulnerable group already at greater risk for contracting COVID-19 -- could not afford to comply with stay-at-home orders or worked in professions that prohibited working from home.

"Our study reveals the luxury nature of stay-at-home orders, which lower income groups cannot afford to comply with," said Xiao Huang, assistant professor of geosciences in the Fulbright College or Arts and Sciences. "This disparity exacerbates long-standing social inequality issues present in the United States, potentially causing unequal exposure to a virus that disproportionately affects vulnerable populations."

By mid-March of 2020, weeks after the first coronavirus case in the U.S., most states ordered some form of lockdown. Officials advised people to stay home to slow the spread of the virus. Non-essential businesses closed, and millions of people were asked to work from home.

Huang and his colleagues wanted to understand the extent of compliance with these orders. They analyzed anonymous tracking data from 45 million mobile-phone users and calculated how much time residents in the cities of New York, Los Angeles, Chicago, Dallas, Houston, Washington, Miami, Philadelphia, Atlanta, Phoenix, Boston and San Francisco spent at home between Jan. 1 and Aug. 31 of 2020.

The researchers then compared these data with demographic information about neighborhoods within these major cities. The demographic information was obtained from the American Community Survey, a demographics survey program conducted by the U.S. Census Bureau.

People living in areas with a higher percentage of wealth and higher average household income level spent more time at home during the stay-at-home orders than people living in poor communities, the researchers found. This finding was valid for all cities.

The study also demonstrated a correlation between education and stay-at-home compliance. People who lived in neighborhoods with a high percentage of college degrees spent more time at home.

Huang said the findings could lead to a reassessment of the long-term impact of COVID-19 on geographically and socially disadvantaged groups.

"The disparity in responses to stay-at-home orders reflects long-standing social inequity issues in the United States, potentially causing unequal exposure to COVID-19 that disproportionately affects vulnerable populations," said Huang.

TAMPA, Fla. - Moffitt Cancer Center, a national leader in cancer care and research and the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, is presenting new data from dozens of clinical research studies at this year's American Society of Clinical Oncology (ASCO) Annual Meeting, the world's largest clinical cancer research meeting. Moffitt investigators will lead 25 abstract presentations, five education sessions, two cancer-based panels and two clinical science symposia. The virtual meeting is June 4-8.

Highlights include:

Oral Presentations:

Dr. Bijal Shah will present phase 2 results from the ZUMA-3 trial evaluating CAR T-cell therapy for adults with acute lymphoblastic leukemia, a challenging malignancy to treat in this patient population.
- Abstract 7002 - Phase 2 results of the ZUMA-3 study evaluating KTE-X19, an anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, in adult patients (pts) with relapsed/refractory B-cell acute lymphoblastic leukemia (R/R B-ALL).

Dr. Taiga Nishihori will present phase 2 results evaluating the efficacy of ixazomib maintenance therapy after allogeneic hematopoietic cell transplantation using reduced intensity fludarabine/melphalan/bortezomib-based conditioning regimen to treat patients with high risk multiple myeloma.
- Abstract 7003 - The results of multicenter phase II, double-blind placebo-controlled trial of maintenance ixazomib after allogeneic hematopoietic cell transplantation (alloHCT) for high-risk multiple myeloma (MM) from the Blood and Marrow Transplant Clinical Trials Network (BMT CTN 1302).

Dr. Kosj Yamoah will present results of a prospective study evaluating a genomic classifier in a subset of African American men with prostate cancer. The classifier provides information on underlying biology and independently predicts individual patients' risk of metastasis.
- Abstract 5005 - A prospective validation of the genomic classifier to define high-metastasis risk in a subset of African American men with early localized prostate cancer: VanDAAM study.

Dr. Jonathan Zager will present results of a phase 3 trial evaluating the use of percutaneous hepatic perfusion for ocular melanoma patients with liver metastasis. To date, there is no standard of care for this patient population.
- Abstract 9510 - Percutaneous hepatic perfusion (PHP) with melphalan for patients with ocular melanoma liver metastases: Preliminary results of FOCUS (PHP-OCM-301/301A) phase III trial.

Posters:

Dr. Bijal Shah will present initial results of a novel allogeneic CAR T product that incorporates gene editing technology to delete any donor genes that may cause a patient's immune system to attack the donor CAR T cells.
- Abstract 7516 - Preliminary safety and efficacy of PBCAR0191, an allogeneic, off-the-shelf CD19-targeting CAR-T product, in relapsed/refractory (r/r) CD19+ NHL.

Dr. Hatem Soliman will present phase 2 results evaluating the use of a modified form of the herpes simplex 1 virus that is injected directly into triple-negative breast cancer tumors while patients are undergoing chemotherapy.
- Abstract 578 - A phase 2 trial of talimogene laherparepvec (TVEC) in combination with neoadjuvant chemotherapy for the treatment of nonmetastatic triple-negative breast cancer.

Dr. Frederick Locke will present data from the ALPHA2 study evaluating ALLO-501, an allogeneic CAR T therapy product, in combination with ALLO-647, a monoclonal antibody that depletes lymphocytes in the body to help prepare the patient for the new immune cells, in patients with large B-cell lymphoma.
- Abstract 2529 - First-in-human data of ALLO-501A, an allogeneic chimeric antigen receptor (CAR) T-cell therapy and ALLO-647 in relapsed/refractory large B-cell lymphoma (R/R LBCL): ALPHA2 study.

June 1, 2021 - A new type of penile traction therapy (PTT) device can increase penile length and preserve erectile function in men who have undergone prostate cancer surgery (prostatectomy), reports a clinical trial in The Journal of Urology®, Official Journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"Our randomized trial suggests penile traction therapy using a new type of device provides an effective new option for penile rehabilitation after prostatectomy," comments senior author Landon Trost, MD, of Male Fertility and Peyronie's Clinic in Orem, Utah. "These objective findings are backed by men reporting an increase in their sexual satisfaction."

While nerve-sparing approaches have reduced the risk of erectile dysfunction and other sexual complications after prostate cancer surgery, men may still experience these issues - sometimes including a reduction in penis size, as well as functioning. Medications and vacuum devices are commonly used, but with limited success.

Originally developed to treat penile curvature due to Peyronie's disease, the new device (marketed under the brand name RestoreX) works by applying gentle, dynamic pressure to stretch and shape the penis. Studies in men with Peyronie's disease have shown the new device can produce significant straightening and increased penile length with as little as 30 minutes of daily use - compared to several hours with previous PTT devices.

Could the same approach be used to improve penile form and functioning after prostate cancer surgery? In the new trial, 82 men (average age 59 years) who had undergone prostatectomy were randomly assigned to six months of daily PTT using the new device or no treatment. Six-month follow-up data were available for 30 men in the PTT group and 25 in the control group.

"Men receiving PTT had significant improvements in most of the objective or subjective measures evaluated," according to Dr. Trost. That included a significant increase in penile length: an average gain of 1.6 centimeters in the PTT group, compared to little or no change (average 0.3 cm) in the control group.

Erectile function was also improved with PTT: men assigned to the study treatment had no change on a standard erectile function score, compared to a significant decline in the control group. Patients assigned to PTT were also less likely to use other treatments for erectile dysfunction, including medications and injection therapies.

The PTT group also had higher scores for sexual satisfaction, including satisfaction with intercourse. Average patient satisfaction score was 8 out of 10; more than 90 percent of patients said they would recommend the treatment to a friend. The outcomes of PTT were similar on two treatment schedules, with average device use of 90 or 150 minutes per week. Discomfort and other side effects were mild and generally temporary.

The authors note some limitations of their study, including the relatively low follow-up rate, partly due to the COVID-19 pandemic. They plan a further three-month evaluation, including offering the new approach to PTT to men originally assigned to no treatment.

The study is the first randomized clinical trial of any treatment to preserve erectile function after prostatectomy. "Our findings need to be validated in further studies," says Dr. Trost. "If they are, PTT would be the first treatment with high-quality research data showing improvement in penile length and erectile function in men who have undergone prostatectomy, without medications or other on-demand therapies."

Senior author Landon Trost, MD, developed RestoreX during his time at the Mayo Clinic in cooperation with Mayo Clinic Ventures. PathRight Medical has licensed the technology from Mayo Clinic and maintains rights to the technology.

Amsterdam, June 1, 2021 - The Treatabolome project is a research initiative to develop a freely available, interoperable online platform dedicated to disseminating rare disease and gene-specific treatment information to healthcare professionals regardless of their level of specialized expertise. Developed under the Solve-RD European Research Project, it is intended to reduce treatment delays for patients with rare diseases by directly linking diagnosis and treatment information. This initiative is highly relevant to neuromuscular disorders as they are rare diseases by definition. In this special issue of the Journal of Neuromuscular Diseases, experts contribute Treatabolome-feeding systematic literature reviews on rare neurological and neuromuscular disorders.

In Europe, rare diseases are defined as those that affect one in two thousand individuals or fewer. Although they are individually rare, globally they affect around 6% of the population. Collectively, healthcare providers deal with a considerable number of patients with a rare disease, over 70% of which are genetically determined. Historically, around 25% of patients with rare diseases have endured a diagnostic odyssey that can last up to 30 years, according to Eurordis, an alliance of over 900 patient organizations that work together to improve the lives of people living with a rare disease.

Next generation sequencing has made it possible to efficiently diagnose a growing number of rare diseases. At the same time, new and frequently specific treatments are emerging following decades of expectant wait by patients, their families, and caretakers. To deliver such treatments to patients in an expedient manner, diagnosis and treatment now need to be linked consistently.

"The Treatabolome project arises from the improved availability of genetic diagnosis and the rapidly growing number of rare disease treatments," explained Guest Editor Gisèle Bonne, PhD, Sorbonne Université, Inserm, Institut de Myologie, Centre de Recherche en Myologie, Paris, France. "There are treatments available for an increasing number of rare diseases, but there is often a substantial delay before patients receive the right treatment. Although targeted treatments are currently only available to a minority of patients with rare diseases, recent developments point towards a steep increase in the coming years, as suggested by the development of multiple gene therapies and the steady increase in the number of orphan drug applications."

This EU project involves four European Reference Networks or ERNs: ERN-RND for Rare Neurological Diseases; ERN Euro-NMD for Rare Neuromuscular Diseases; ERN-ITHACA for rare congenital malformations and syndromes with intellectual and other neurodevelopmental disorders; and ERN-GENTURIS for patients with one of the rare genetic tumor risk syndromes.

The special issue covers gene and variant-specific treatments for rare neurological and neuromuscular disorders, highlighting the important premise that a precise genetic diagnosis may result in an equally precise therapeutic approach. It includes systematic reviews from internationally leading centers representing a concentration of rare diseases expertise involved in producing Treatabolome-feeding literature reviews, which cover:

Genetic forms of Parkinson's disease

Skeletal muscle ion channelopathies

Hereditary peripheral neuropathies

Metabolic myopathies related to glycogen storage and lipid metabolism

Laminopathies

The issue also includes a review of the underlying disease mechanisms, potential therapeutic approaches, and the state of trial readiness of future clinical trials in facioscapulohumeral muscular dystrophy (FSHD).

The intention is that as the Treatabolome platform is finalized, the main body of data will be derived from expert-led systematic literature reviews such as those published in the current issue. They bring state-of-the-art, evidence-based information in a standardized format that is FAIR-compatible and easily uploadable to the Treatabolome database.

"When combined with diagnosis support tools like RD-Connect's Genome-Phenome Analysis Platform (GPAP), the Treatabolome prevents treatment-onset delays," noted Dr. Bonne. "It puts flesh of content onto the bones of the platform."

One of the next steps of the Treatabolome project will be to extend it to rare diseases experts from all 24 European Reference Networks and the whole scientific community, producing other datasets to enrich the database and facilitate treatment awareness for rare diseases. The project is also exploring artificial intelligence (AI) pathways for the future updates of the database that involve machine-led text mining of publications to improve the life cycle of the information displayed in the database.

"The main challenges are involving all significant rare disease groups to produce the Treatabolome datasets of their expertise, guaranteeing a yearly life cycle for updating that information, and finding continued funds to ensure the sustainability of the Treatabolome platform," commented Dr. Bonne. "Additionally, research on automated information update relying on AI is fundamental for long-term platform sustainability."

"We must strive to work towards a world with progressively fewer 'undiagnosed' and 'not yet diagnosed' rare disease and ultra-rare disease patients. Most importantly, once a diagnosis is reached, if a treatment exists for the disease/gene/variant, one should not have to wait for it to be offered to the patient," she concluded.

A new miniature 3D model of human bone marrow has been described today in the open-access eLife journal.

The model may help clinicians predict which patients will benefit from a new therapy for blood platelet disorders, such as Inherited Thrombocytopenias - a group of familial disorders that inhibit the production of platelets. It could also enable further study of these disorders and give scientists a new tool to test experimental treatments.

Platelets are cells that are necessary for the blood to clot and stop bleeding. Having too few platelets can lead to internal or serious bleeding after surgery or injuries, which is usually treated with therapies that cause clotting. Recent studies have shown that a drug called Eltrombopag increases the production of platelets, but not all patients appear to benefit from it. "Patients with the same apparent form of platelet disorder may respond differently to treatment with Eltrombopag," says first author Christian Di Buduo, Research Assistant Professor at the Department of Molecular Medicine, University of Pavia, Italy.

To help determine which patients might benefit from the drug, Di Buduo and colleagues developed a mini 3D model of human bone marrow that combines a scaffolding of silk protein and culture of patient-derived cells to recreate the human bone marrow environment where platelets are produced. "This device is a significant improvement over previous models, requiring only a very small sample of blood to recreate platelet production," Di Buduo explains.

The team then tested what happened when they added Eltrombopag to a blood sample from a patient with a platelet disorder that had previously been treated with the drug. Their results showed that the number of platelets produced in the model corresponded to how each patient had responded to treatment with Eltrombopag. The increase in the number of platelets collected from the model was comparable to the increase in the number of platelets in patients' blood following treatment.

The authors say the model could eventually lead to personalised treatment for platelet disorders by helping clinicians match patients to the best treatment.

"This easy-to-reproduce system may also help scientists better understand what goes wrong in these disorders and how treatments work, as well as provide them with a new tool for testing new drugs that may lead to improved therapies in the future," concludes senior author Alessandra Balduini, Principal Investigator and Professor at the University of Pavia.

ANN ARBOR, Mich. - Fibroid symptoms, such as heavy menstrual bleeding and abdominal pain, are increasingly driving women to the emergency room.

In fact, tens of thousands of women were seen annually in the emergency department for the condition, which involves benign growths in the uterus, over a 12-year period.

But only 1 in 10 of these visits led to a hospital admission, suggesting that many cases may have been managed in an alternative, non-urgent health setting, according to recent Michigan Medicine research.

"Fibroids are often a chronic disease, so we have opportunities to treat this through established care with a trusted health provider. Yet, we've seen a big increase in women using the emergency room for fibroid care," says senior author Erica E. Marsh, M.D., chief of the division of reproductive endocrinology and infertility at the Center for Reproductive Medicine at Michigan Medicine Von Voigtlander Women's Hospital.

"Our study suggests that patients are potentially using the emergency department for care that could and should be obtained in a long-standing trusted environment with a healthcare provider."

Researchers analyzed more than 487 million emergency visits by women ages 18-55 between 2006 and 2017. The number of ED visits for fibroids among this age group more than doubled during the study period, up from 28,732 to 65,685 visits.

Meanwhile, hospital admissions for these types of visits decreased from about 24% to 11%, according to the study in Obstetrics & Gynecology "The Green Journal."

Study findings also reinforced that fibroid care is among the costliest types of ED care, which has been estimated to be generally twice as expensive as other visits among similarly aged women. This is likely to due to imaging studies and other tests to address bleeding.

Over the study period, median ED visit charges for fibroids more than doubled, with the average charge more than $6,000 per visit and a total of $500 million during 2017.

Many of these patients were likely appropriate candidates for outpatient imaging, which potentially could have saved significant costs and resources, Marsh says.

"We should be focused on interventions that improve access to outpatient care for this group of women in order to help mitigate unnecessary, costly ED utilization," Marsh says.

Emergency department visits for fibroids were highest among women who were aged 36-45 years (about 45%) and with lower incomes. Women who came to the ED for bleeding related issues were also 15 times more likely to be admitted.

Marsh notes that while bleeding symptoms should be addressed right away, there are several interventions that can help manage bleeding through regular office visits.
Hospital admission was least likely for uninsured patients who came to the ED with fibroid symptoms.

"The apparent disparity in likelihood of admission based on insurance type is concerning and certainly warrants further study," Marsh says.

"We must constantly call out and investigate disparities in care."

Improving equitable fibroid care

Uterine fibroids are the most common benign gynecologic condition in the U.S., affecting up to 70% of all women by age 50 and a disproportionate number of African Americans. Although the majority of fibroids are asymptomatic, between a quarter and half of patients will experience symptoms, most commonly heavy menstrual bleeding and pelvic pain or pressure that can be disruptive to daily life.

Fibroids are also the leading cause of hysterectomies, which is the surgical procedure involving removal of the uterus.

Many potential factors may help explain the ED trends highlighted in the new study, Marsh says. It could be that patients are using the ED because they don't have a primary healthcare home or trusted relationship with an outpatient provider for their gynecological care.

Many women may also delay treatment for uterine fibroids because they think their symptoms are "normal" or are unaware of what types of non-surgical treatments are available.

Insurance gaps and access barriers may also be issues.

"We need to better understand gaps in fibroid care and why so many patients are turning to the ED to receive care for a condition that could be managed in the outpatient setting," Marsh says.

"We have a diverse team looking at these data to identify opportunities to re-envision care for women with fibroids and barriers we can reduce to improve their care in the outpatient setting.

"Ultimately, we want to ensure patient centered and equitable care for all individuals with this chronic condition."

CHAPEL HILL, NC - Research published by JAMA Network Open shows how non-pharmaceutical interventions (NPIs) like mask wearing and physical distancing can help prevent spikes in COVID-19 cases as populations continue to get vaccinated. The study, led by Mehul Patel, PhD, a clinical and population health researcher in the department of Emergency Medicine at the UNC School of Medicine, focuses on the state of North Carolina. Similar modeling studies have been used in different states, and can serve as guidance to leaders as they make decisions to relax restrictions and safety protocols.

"The computer simulation modeling allows us to look at multiple factors that play a role in decreasing the spread of COVID-19 as vaccines are distributed," Patel said. "We looked at vaccine effectiveness, percent of population vaccinated, and adherence to precautions like mask wearing and physical distancing over a set period of time."

The image from the simulation is a model of multiple scenarios within the state of North Carolina. Knowing that the Pfizer and Moderna vaccines are more than 90% effective at preventing severe COVID-19, you can follow the black, purple and blue lines to see what could happen if non-pharmaceutical interventions (NPIs) like mask wearing and physical distancing are not followed while communities are vaccinated. Furthermore, the simulation also demonstrates how important it is for as many people as possible to get fully vaccinated.

For example, looking at scenario A1, if 75% of our population gets fully vaccinated and we continue to adhere to NPIs, we see a sustained decline down to very few new COVID cases over a six month period. In contrast, looking at scenario C0, if only 25% of our population gets fully vaccinated and does not adhere to NPIs, we could see a sustained increase in daily COVID cases, peaking around 8,000 before we see another decline. For reference, as of June 1, 2021, 38.9% of the entire North Carolina population has been fully vaccinated.

"As soon as you start relaxing mask wearing and physical distancing with any percent of the population vaccinated, you see an increase in cases," Patel said. "Until we reach around 50% of the population vaccinated, there is more potential to have disease spread if we remove NPIs."

Army scientists working as part of an international consortium have developed and tested an antibody-based therapy to treat Crimean-Congo hemorrhagic fever virus (CCHFV), which is carried by ticks and kills up to 60 percent of those infected. Their results are published online today in the journal Cell.

Using blood samples donated by disease survivors, the study's authors characterized the human immune response to natural CCHFV infection. They were able to identify several potent neutralizing antibodies that target the viral glycoprotein--a component of the virus that plays a key role in disease development. Several of these antibodies, administered individually or in combination, protected mice from CCHFV when given prior to virus exposure.

To treat mice that had already been infected, the team created "bispecific" antibodies that combined potency with the ability to bind to two separate sites on the CCHFV glycoprotein. One of these bispecific antibodies, called DVD-121-801, overcame CCHFV infection in mice with just a single dose administered 24 hours after challenge with live virus.

Efforts are underway to develop DVD-121-801 as a potential therapeutic for human patients, according to co-first author Andrew H. Herbert, Ph.D., of the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID).

CCHFV is the most prevalent tick-borne virus that causes human disease, and is endemic in countries across Europe, Asia, and Africa. Despite its high lethality and widespread distribution, no vaccines or specific treatments are available. It has been designated a priority pathogen by the World Health Organization.

"Rodent models of CCHFV infection are useful in testing and down-selecting neutralizing antibodies," commented Herbert. "However, to advance a lead candidate for therapeutic use, it will be necessary to conduct studies in larger animal models that more faithfully recapitulate human disease."

A new study carried out in pig cells suggests previous infection with swine influenza virus (SIV) can protect against the development of porcine respiratory coronavirus (PRCoV) if there is a zero- or three-day interval between infections.

The findings, published in the peer-reviewed journal Virulence, may also be relevant to influenza and coronavirus infection in humans.

Ju-Yi Peng of the University of Veterinary Medicine Hannover and colleagues used air liquid interface cultures of cells taken from pigs' windpipes to investigate the interactions between the two viruses.

They found that prior infection by swine influenza virus completely inhibited coronavirus infection when the cells were infected on the same day or three days apart. By contrast, infecting cells with coronavirus then swine influenza virus had little effect on the replication of swine influenza virus.

"Taken together, the timing and order of virus infection were important determinants," the authors said. "Prior infection by SIV induced an innate immune response which prevented PRCoV from replicating. However, prior infection by PRCoV only partially inhibited SIV infection."

This difference may be explained - at least in part - by the difference in the range of cells each of the two viruses can infect. Influenza viruses are very efficient in infecting ciliated cells, which are the majority of cells in the lining of the windpipe. These cells have tiny hair-like structures - cilia - on their surface which sweep mucus and bacteria up to the back of the throat where it can be swallowed. PRCoV prefers non-ciliated, non-mucus-producing cells so it infects a lower number of cells and as a consequence induces a weaker immune response.

The study's findings about how coronavirus and influenza virus interact when infecting the airway may also be relevant to humans. The development of these viruses in pigs and humans shares many aspects, and PRCoV and SIV infection in porcine models has been used to mimic coronavirus and influenza virus infection in humans.

Thus, the results could have implications for potential co-infections by SARS-CoV-2 and seasonal influenza viruses. "At the epidemiological level, a seasonal peak incidence of influenza virus infection may delay the expected peak incidence of human coronavirus and other respiratory viruses infection," the authors said. "It will be interesting to find out whether the current seasonal influenza viruses interfere with this coronavirus and delay or prevent infection."

New research has shown that if people achieve and maintain substantial weight loss to manage their type 2 diabetes, many can also effectively control their high blood pressure and stop or cut down on their anti-hypertensive medication.

A weight management programme, developed by researchers at the Universities of Glasgow and Newcastle for the Diabetes UK-funded DIabetes REmission Clinical Trial (DIRECT), has proved effective at lowering blood pressure and reducing the need for anti-hypertensive medications, as well as bringing remission of type 2 diabetes.

The programme involves an initial 12 weeks on a nutritionally complete formula diet (low calorie soups and shakes) which will induce weight loss of over 15 kg (over 2 stones) if followed fully. Diabetes and blood pressure drugs were stopped at the start, and only re-started if blood sugar or blood pressure rose.

The weight loss phase is followed by support to choose foods and eat wisely for weight loss maintenance. Maintaining the 15 kg weight loss allowed 8 out of 10 people to become free from type 2 diabetes, without the need for diabetes medications for at least 2 years.

This study, published in the journal Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]), looked at 143 people who started the diet programme, with more than half (78 people) on tablets for high blood pressure at the start (and 44 on two or more drugs). The researchers found that, overall, average blood pressure fell steadily as people lost weight. And blood pressure remained lower after the formula diet period finished, and then at 12 and at 24 months.

For those not previously treated for high blood pressure, blood pressures fell sharply from week one. For those who had stopped their blood pressure tablets, blood pressure still fell, although more slowly. Just over a quarter (28%) needed to reintroduce a blood pressure tablet during the formula diet period. However, researchers also found that the same proportion of participants (28%) were able to remain off their medications for at least two years.

Prof Mike Lean, from the University of Glasgow, said: "We wanted to evaluate the safety and efficacy of withdrawing blood pressure medication when beginning our specially-designed weight-loss programme for type 2 diabetes, and we are really pleased with the results.

"Our study shows that, in addition to possible remission from type 2 diabetes, there are other very important health benefits, as weight loss is a very effective treatment for hypertension and its associated serious health risks.

"Currently, over half of all the 4.5 million people with type 2 diabetes in UK also require tablets for hypertension, to reduce serious vascular complications. Being overweight is the main cause, and losing weight can bring a remission from hypertension for many, as well as a remission of diabetes. Withdrawing blood pressure medications is safe, provided people lost weight and blood pressure was checked regularly, in case tablets needed to be reintroduced.

"The DiRECT trial was done entirely in primary care. The evidence shows that GPs can safely offer an evidence-based intensive weight management intervention, aiming for substantial weight loss and remission of type 2 diabetes. The study further highlights the links between diet, weight, type 2 diabetes and hypertension, and how long-term support to maintain weight loss is vital."

Professor Roy Taylor, from Newcastle University, said: "Guidelines encourage doctors to start tablets but there have been few demonstrations of how tablets can be stopped.

"My patients, like so many, do not like swallowing multiple tablets, and this study is important as we can now reassure them that stopping blood pressure tablets is not only safe but also good for their health. We've shown that when substantial weight loss is achieved and maintained, patients can effectively manage both their blood pressure and type 2 diabetes without drugs."

Dr Wilma Leslie, University of Glasgow, said: "The potential to no longer need medications for blood pressure and diabetes is a big incentive for people. We hope our results will reassure health professionals that this is possible, and encourage the wider provision of diabetes remission services."

Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: "These important results show that the Diabetes UK-funded DiRECT low-calorie, weight management programme not only helps some people put their type 2 diabetes into remission, but can also lower blood pressure, allowing some people to safely stop taking their blood pressure medication.

"We're delighted to see more evidence of the life-changing impact of the DiRECT programme on people's health. This makes us even more determined to make sure as many people as possible have access to type 2 diabetes remission services."

An emotion regulation strategy known as cognitive reappraisal helped reduce the typically heightened and habitual attention to drug-related cues and contexts in cocaine-addicted individuals, a study by Mount Sinai researchers has found. In a paper published in PNAS, the team suggested that this form of habit disruption, mediated by the prefrontal cortex (PFC) of the brain, could play an important role in reducing the compulsive drug-seeking behavior and relapse that are the hallmarks, and long-standing challenges, of addiction.

"Relapse in addiction is often precipitated by heightened attention-bias to drug-related cues, which could consist of sights, smells, conversations, anything that reminds someone of their previous drug use," said lead author Muhammad A. Parvaz, PhD, Assistant Professor of Psychiatry and Neuroscience, at the Icahn School of Medicine at Mount Sinai, who studies brain-based and behavioral markers that can inform and track addiction treatment and its outcomes. "Our study is the first to suggest that increasing self-regulation of arousal to drug-related cues through cognitive reappraisal could disrupt the brain's automatic attention-bias to these cues, potentially leading to a reduction in compulsive drug-seeking behavior, even outside the lab, in individuals with substance use disorders."

Cocaine is a powerful central nervous system stimulant whose misuse poses serious health risks and side effects. Cocaine addiction is recognized as a treatment-resistant disorder that has reached epidemic proportions nationally and globally. In the United States alone, hundreds of thousands of people are treated in emergency rooms each year following severe (mostly cardiovascular) symptoms associated with use of cocaine. Chronic use of substances of abuse, including cocaine, biases the attentional systems of the brain towards enhanced attention to drug-related cues in the environment (also known as attention-bias), which is considered a risk factor for relapse.

In this study the Mount Sinai researchers postulated that using cognitive reappraisal could disrupt the habitual enhanced attention allocation to drug-related cues in individuals with cocaine use disorder. Cognitive reappraisal is an emotion regulation technique, in which individuals are trained to self-regulate (thereby engaging the prefrontal cortex) the emotional response to a confronted cue or context by reinterpreting its meaning. For example, lines of cocaine in a given picture can be reinterpreted as a movie prop with sugar powder cut in lines to only appear as cocaine. While cognitive appraisal has been employed by prior studies to reduce participants' reactivity to drug cues, Mount Sinai's research is the first to use this emotion regulation technique in individuals with cocaine addiction for its impact on spontaneous (uninstructed and habitual) attention-bias to cocaine-related cues.

"Modification of attention-bias has been a fundamental, albeit elusive, target for relapse reduction over the years," said Dr. Parvaz, who also is Director of the Motivational and Affective Psychopathologies Laboratory at Mount Sinai. "We found that cognitive reappraisal, a function of prefrontal control, decreased spontaneous attention-bias to drug-related cues in people with cocaine addiction. Put another way, increased PFC-mediated cognitive control (of the appraisal process) resulted in enhanced self-regulation of automatic (hard to control) attentional processes in humans with drug addiction."

"Through our work and based on the prefrontal cortical mediated benefits of cognitive reappraisal, we have provided a promising framework for self-regulation of automatic bottom-up and very hard to resist drug cue-reactivity, as potentially generalizable to reduced drug use outside the lab and applicable to addiction to drugs other than cocaine," said Rita Z. Goldstein, PhD, Professor of Psychiatry and Neuroscience, and Chief of the Neuropsychoimaging of Addiction and Related Conditions research program, at Mount Sinai, and senior author of the paper. "With further research, we think these results could contribute to the development of a readily deployable cognitive behavioral and personalized intervention strategy, to be used by those who battle drug addiction. Contributing to the development of empirically-validated neuroscience-based interventions for drug addiction has been an important goal in our lab"

Oncotarget published "A higher De Ritis ratio (AST/ALT) is a risk factor for progression in high-risk non-muscle invasive bladder cancer" which reported that a recent study revealed that a high De Ritis ratio was a risk factor in some solid malignancies.

This Oncotarget study examined the importance of the De Ritis ratio as a prognostic marker in high-risk NMIBC.

This Oncotarget study examined the importance of the De Ritis ratio as a prognostic marker in high-risk NMIBC

Among these patients, 32 patients developed recurrent disease and 15 patients showed progression.

A multivariate analysis revealed that non-BCG treatment was an independent risk factor for recurrence, and a higher De Ritis ratio was an independent risk factor for cancer progression.

The De Ritis ratio might be a risk factor for progression in high-risk NMIBC.

The De Ritis ratio might be a risk factor for progression in high-risk NMIBC

Dr. Takashi Kawahara from The Yokohama City University Medical Center said, "Bladder cancer is the eleventh most common malignant disease in the world, and non-muscle invasive bladder cancer (NMIBC) accounts for 75% of all bladder cancer cases."

The serum aspartate aminotransaminase /alanine aminotransaminase ratio was first reported by De Ritis in 1957, since then this ratio has been called the De Ritis ratio.

A high De Ritis ratio was reported to be a poor prognostic marker in some solid malignancies.

In genitourinary cancer, a high De Ritis ratio was reported to be a poor prognostic marker in prostate, renal, and urothelial carcinoma.

In other solid malignancies including breast and lung cancer, a high De Ritis ratio was also reported to be a poor prognostic marker.

This study examined the importance of the De Ritis ratio as a prognostic marker in high-risk NMIBC.

The Kawahara Research Team concluded in their Oncotarget Research Output that first, the study was retrospective in nature.

To reveal the usefulness of the De Ritis ratio as a biomarker, a longer-term study of a larger population with a prospective design should be performed.

Third, this study showed higher age in the higher De Ritis group.

No previous study showed the correlation between AST/ALT value and age.

Thus, further study is needed.

What The Study Did: Rates of antispike antibody response to a messenger RNA SARS-CoV-2 vaccine in Israeli patients with cancer who are undergoing systemic treatment compared with healthy controls were evaluated in this study.

Authors: Salomon M. Stemmer, M.D., of the Rabin Medical Center in Petah Tikva, Israel, is the corresponding author.

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(doi:10.1001/jamaoncol.2021.2155)

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Authors: Tatsuya Yoshida, M.D., Ph.D., of the National Cancer Center Hospital in Tokyo, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamaoncol.2021.2159)

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Authors: Wesley John Talcott, M.D., M.B.A., the Yale School of Medicine in New Haven, Connecticut, is the corresponding author.

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(doi:10.1001/jamainternmed.2021.2348)

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