Body

Under the Biden Administration, New Yorkers' acceptance of the Covid-19 vaccine has increased significantly. In September, 55% of residents reported they would take the vaccine when it became available and this January, 64% reported they would take it.

Differences in vaccine acceptance persist across racial and ethnic groups. Among Whites and Asians acceptance is 70-72%; among Blacks and Latina/os it is 57-58%. On a positive note, the largest increase in rate of acceptance was seen among Black respondents, up from 33% in September to 57% in January.

These are key findings from the most recent tracking survey of public perceptions and experiences in New York City during the Covid-19 pandemic, conducted January 29-31 by the City University of New York Graduate School of Public Health and Health Policy (CUNY SPH).

"Obtaining a steady supply of Covid-19 vaccines and distributing them equitably and efficiently, as well as reaching and convincing New Yorkers to take the vaccine are the pivotal challenges that lie ahead of us," said Dr. Ayman El-Mohandes, Dean of CUNY SPH. "The current strategy does not meet the needs of those with the greatest vulnerability."

Of concern, more than half (54%) of New York City respondents believe the state is not doing a good job of managing the vaccine rollout. Highest levels of disapproval were reported by Staten Island (59%) the Bronx (50%) and Manhattan (50%).

Almost half of New York City residents think that recovery will not happen until most New Yorkers are vaccinated. In contrast, only 53% of residents in the Bronx are willing to take the vaccine. This finding is of great concern, since the Bronx continues to bear the highest burden of infection and mortality associated with the pandemic.

Employment and Covid-19 Vaccine Acceptance

Respondents who are currently employed were more willing to accept Covid-19 vaccines (68%) as well as more likely to actually have been vaccinated. Among respondents who lost their job during the pandemic and remain unemployed, only 56% said they were willing to accept the vaccine.

These data suggest that a concerted effort will be needed to reach, inform, and motivate unemployed New York City residents to participate in the vaccination rollout.

The complete survey results and related commentary can be found at https://sph.cuny.edu/research/covid-19-tracking-survey/january-vaccines/ and JHC Impact, an initiative of the Journal of Health Communication: International Perspectives.

Methodology

The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) survey was the third study of a repeated cross sectional sample using n=1,000 New York City residents from January 29-31, 2021, the previous two surveys were conducted at the end of September and November 2020.

The representative area-based probability sample for New York City was n=1,000, with a margin of error (MOE) of +/- 3 percentage points. The data set was weighted by gender, age, ethnicity, education, and borough based on the 2019 1-year American Community Survey model. Additional considerations beyond the ACS model influenced weights for race/ethnicity as the Census Bureau collects two sets of race/ethnicity data by grouping Hispanics and races together (e.g., Hispanic Whites) as well as separating non-Hispanic and Hispanic groups. To create one data set that more appropriately represents the racial diversity in the city, we grouped Hispanic and Latina/os respondents together. It is important to remember that subsets based on gender, age, ethnicity, and region carry with them higher margins of error, as the sample size is reduced.

Sampling parameters were set based borough-level population data:

Queens: 27% of total (n=271)

Manhattan: 19% of total (n=194)

The Bronx: 17% of total (n=171)

Staten Island: 5% of total (n=57)

Brooklyn: 31% of total (n=308)

The data was collected by Consensus Strategies using an Interactive Voice Response (IVR) system of landlines (n=511), SMS-to-online (n=490).

Demographics:

1,001 Residents NYC

Age

18-19 23%
30-44 28%
45-59 24%
60+ 26%

Gender

Male 46%
Female 50%
Prefer not to say 2%
Other 1%

Race and ethnicity

Latina/o/Hispanic 29%
Black/African American 22%
Asian 14%
Caucasian/White 32%
Multiple/other 3%

Education Level

High school 42%
Some college 20%
Bachelor's 22%
Post-grad 16%

Household Income

$50,000-$100,000 30%
>$100,000 13%

The development of the so-called small molecules is a promising field of the pharmaceutical industry. Small molecules are organic compounds with a small molecular mass. They are often based on heterocycles--carbon rings that also include atoms of nitrogen and other elements. The synthesis of small molecules is much cheaper than the development of drugs based on antibodies or other biological molecules; however, their properties are still understudied. Even the slightest modifications can change the characteristics of a small molecule and open a whole new range of its practical applications. Therefore, many research teams working in the field of chemical pharmacology improve synthesis methods to create libraries of small molecules and evaluate their biological properties. In the future, this data can be used to develop new drugs.

A team of chemists from Immanuel Kant Baltic Federal University and Saint Petersburg State University have been focusing on the synthesis of new small molecules for a long time. For example, several years ago the researchers successfully developed a method of hydrated imidazoline ring expansion (HIRE). Hydrated imidazolines are based on an imidazole heterocycle (with two nitrogen and three carbon atoms) with three more rings of different composition attached to it. The reaction created by the chemists provided for the formation of bonds with at least three bigger heterocycles, thus leading to the expansion of the initial imidazole ring. However, further studies showed that sometimes the same reaction can cause one of the tetracyclic imidazoline rings to break. In this case, the reaction product (an ethylenediamine derivative) contains no expanded heterocycles and is less useful in pharmacology because it doesn't always produce necessary results.

The team decided to focus on the factors that promote the synthesis of expanded heterocycles. They suggested that the success of the reaction depended on the differences in the electronic properties of substituent groups. Specifically, they assumed that such differences determined the migration of the substitutes from one atom in the cycle to another. To better understand the nature of this dependency, the chemists synthesized 13 ethylenediamine derivatives. An ethylenediamine derivative is an organic substance that contains two amino groups. The derivatives were placed in alkaline solutions at different temperatures: from room temperature to 90°?.

The experiment showed that the nature of the bond between the substituent group and a nitrogen atom determines the reaction speed. If a substitute acts as an electron acceptor, i.e. pulls the electron pair that it has in common with nitrogen closer, the structure of the compound immediately changes. In some cases, it took a substituent group less than 30 seconds to migrate from one atom to another. On the contrary, the compounds with electron-donating substitutes that pushed the electron pair forward reacted slowly, and the reactions required increased temperatures. In two cases, no migration of substituent groups took place at all.

"In this study, we used relatively simple compounds as models to better understand the reaction processes in heterocyclic molecules that are in high demand in the industry. We are already using the obtained data to synthesize small molecules with expanded heterocycles from reaction by-products", said Mikhail Krasavin, D.Sc.. in Chemistry, Research Professor at the Institute of Living Systems (BFU), and the Head of the Department of the Chemistry of Natural Products (SPbSU).

To achieve target delivery of drugs to cells and organs, scientists have to be able to transport the molecules of pharmaceutical substances to targets using a controllable carrier. The role of such a carrier can be played by special particles, such as lipid droplets or magnetic nanoparticles. Among the latter, the most popular are the ones based on iron oxides. Their sizes range from 1 to 100 nm, which is dozens of times smaller than animal cells, and they can be moved within a body using an external magnetic field.

However, in practice, it is quite difficult to control nanoparticles with magnets, as the magnetic field quickly becomes weaker when the distance from the magnet increases. This problem is usually solved by superconducting magnets with very high magnetic field intensity. However, they are extremely expensive and difficult to work with. A team of scientists from Immanuel Kant Baltic Federal University (Kaliningrad) and the University of Genoa (Italy) suggested a new approach to regular permanent magnets.

"To control magnetic nanoparticles, modern-day scientists often use either individual magnets or the so-called Halbach systems: classic magnet arrays that have a magnetic field only on one side. When choosing a magnet or a system, people usually pay attention only to magnetic field induction, not to its driving force. However, it's the driving force that determines the efficiency and speed of nanoparticle delivery. Our colleagues tasked us with developing more efficient magnets to secure the delivery of nanoparticles with drugs to target organs in lab mice. The magnets had to be very small, so we were limited in the weight and size of our materials. Still, we managed to achieve improved efficiency using an array of different magnets," said Alexander Omelyanchik, a co-author of the work, and a postgraduate student at the Laboratory of Nevel Magnetic Materials, IKBFU.

Instead of a single cylindrical magnet, the scientists suggested using a combination of permanent magnets with different shapes. To confirm the efficiency of this solution, the team used cylindrical and cubic neodymium magnets to build various symmetrical and non-symmetrical assemblies. The total surface area of magnets or their arrays did not exceed 2 cm2. After that, the team measured the values of the magnetic field and its gradient at 4 mm under the surface of the magnet. Approximately the same distance separates the surface of a mouse's skin and its internal organs. From all magnet combinations, the team chose the ones with the strongest magnetic driving force (a physical value that is proportional to the product of magnetic field induction and its gradient).

The strongest magnetic force at a given point was registered for a combination of four magnets with the same polarity, of which two were cubic and the other two consisted of three smaller cylindrical magnets each. However, a different method of measurement showed different results. The strongest magnetic force for the area of 1 cm2 was produced by a magnet with the same structure but different polarity of one of the cylindrical components. The magnetic force of such non-symmetrical combinations in a 1 cm2 area (the size of a liver or heart or a lab mouse) was almost ten times stronger than that of regular cylindrical magnets. The team believes that the new approach could potentially apply to humans too.

"We have been studying magnetic nanoparticles in close collaboration with our colleagues from Italy, Czech Republic, Spain, Sweden, and other European countries for quite some time now. Although we are physicists, we are in constant communication with chemists, biologists, and specialists in material studies. This complementary experience helps us develop unique solutions. The interdisciplinary nature of this topic is very appealing to me, as this field of study still has many unanswered questions," commented Alexander Omelyanchik.

ATLANTA--ProAgio, a drug developed by Georgia State University biology professor Zhi-Ren Liu and his team, is effective at treating pancreatic cancer and prolonging survival in mice, according to a study published in the journal Cellular and Molecular Gastroenterology and Hepatology.

A second study, published in the Journal of Experimental Medicine, shows the drug is also effective against triple-negative breast cancer, a fast-growing and hard-to-treat type of breast cancer that carries a poor prognosis.

ProAgio, created from a human protein, targets the cell surface receptor integrin αVβ?, which is expressed on cancer-associated fibroblasts. Fibroblasts are cells that generate collagen and other fibrous molecules and can be mobilized into service by a tumor, creating a thick, physical barrier known as the stroma, which protects the cancer and helps it grow. The drug works by inducing apoptosis, or programmed cell death, in cancer-associated fibroblasts that express integrin αVβ?.

The dense fibrotic stroma is what makes pancreatic cancer, which has a five-year survival rate of just eight percent, so lethal and difficult to treat. Among triple-negative breast cancer patients, research shows denser stroma is associated with poorer survival and high recurrence rates.

"All solid tumors use cancer-associated fibroblasts, but in pancreatic cancer and triple-negative breast cancer, the stroma is so dense there's often no way for conventional drugs to penetrate it and effectively treat the cancer," said Liu.

The stroma also helps the tumor hide from your body's immune system. Immunotherapy, a type of treatment that uses your immune system to fight cancer, is less effective against tumors protected by a dense stroma that is rich in cancer-associated fibroblasts.

Cancer-associated fibroblasts promote angiogenesis, or the development of new blood vessels. Angiogenesis plays an important role in the spread of cancer because solid tumors need a blood supply to grow. In both studies, Liu and his team show roAgio has a profound effect on tumor vasculature. In the case of pancreatic cancer, it reopened blood vessels that had collapsed due to high extravascular stress caused by the dense stroma. In the case of triple-negative breast cancer, the drug's anti-angiogenic activity reduced irregular, leaky angiogenic tumor vessels. In both cases, ProAgio allowed drugs to effectively reach the cancer.

Liu's drug is unique in that it targets only cancer-associated fibroblasts -- a subclass of the cells that is actively engaged in supporting cancer -- rather than inactive fibroblasts. This reduces side effects of the drug and increases its effectiveness.

"When you have a wound, for example, normal fibroblasts will secrete fibers to limit the damage and promote healing," said Liu. "The tumor region is basically a wound that won't heal. Quiescent fibroblasts may play a role in preventing cancer from spreading. You don't want to kill the good guys, only the bad guys."

ProAgio is licensed to ProDa BioTech, a pharmaceutical research company founded by Liu. In 2018, ProDa BioTech received $2 million from the National Cancer Institute to fund toxicology and pharmacokinetic studies that are required before moving the drug to early-stage clinical trials. Those studies have been completed and the company has submitted an Investigational New Drug (IND) Application, a request for authorization from the Food and Drug Administration to administer ProAgio to human subjects.

Once the IND is granted, Liu says the immediate next step is to begin clinical trials. The first trial, to determine patient tolerability and recommended phase II dose, will begin in early 2021 at the National Institute of Health Clinical Center in Bethesda, Md., and will be led by Christine Alewine, M.D., an oncologist at the National Cancer Institute. In late 2021, Emory University is set to begin a multi-site trial among breast cancer and pancreatic cancer patients.

Announcing a new article publication for BIO Integration journal. In this review article the authors Xiuling Li, Shunung Liang, Chee Hwee Tan, Shuwen Cao, Xiaoding Xu, Phei Er Saw and Wei Tao from Sun Yat-sen University, Guangzhou, China, Guangzhou University of Chinese Medicine, Guangzhou, China and Center for Harvard Medical School, Boston, MA, USA discuss the potential benefits of four plants endogenous to China and the enhancement of their therapeutic efficacy by nanotechnology intervention.

Plant derived natural products have been used for the treatment of various human diseases long before the intervention of modern medicine. The basis of modern medicine is still inspired by traditional medicine and therapies. However, despite their tremendous therapeutic potential, these natural drugs often have poor bioavailability, metabolic instability, and aqueous insolubility. These factors greatly impede a natural drug's commercialization potential as a mainstream medicine. Therefore, the development of nanocarrier drug delivery systems is indispensable in overcoming the various constraints of the bottlenecks which occur with natural drugs.

In this review article the authors consider four plant materials endogenous to China with the common names of barrenwort or horny goat weed (Epimedium), Shu Di Huang (Rehmannia glutinosa, RG), ginseng (Panax ginseng), and Dong Quai or female ginseng (Angelica sinensis, AS). Each has been scientifically investigated for a wide range of therapeutic uses having been originally discovered from the long history of traditional usage and anecdotal information by local population groups in Asia. The integration of natural drugs from the East and nanocarrier drug delivery systems developed from the West is paving the way towards further accurate and efficient medicine therapy.

CLEVELAND (Feb. 9)--A study led by Case Western Reserve University researchers found that patients with dementia were at a significantly increased risk for COVID-19--and the risk was higher still for African Americans with dementia.

Reviewing electronic health records of 61.9 million adults in the United States, researchers found the risk of contracting COVID-19 was twice as high for patients with dementia than for those without it--while among those with dementia, African Americans had close to three times the risk of being infected with COVID-19 as Caucasians did.

In addition, patients with dementia who contracted COVID-19 had significantly worse outcomes in terms of hospitalizations and deaths than those who had COVID-19 but not dementia.

The study was published Feb. 9 by the peer-reviewed Alzheimer's & Dementia: The Journal of the Alzheimer's Association and highlights the need to protect people with dementia--particularly African Americans--as part of the strategy to control the pandemic.

An estimated 5.8 million Americans age 65 and older and 50 million people worldwide are living with Alzheimer's and other dementias, according to the Alzheimer's Association.

"Our results emphasize how important it is to protect those with dementia from acquiring SARS-CoV2, for they are at higher risk for severe disease than those without dementia," said study co-author Pamela Davis, dean emerita of the Case Western Reserve School of Medicine. "These patients may constitute another vulnerable category. However, more work is required to understand the mechanism by which this occurs."

The study's authors also include two other members of the School of Medicine: Rong Xu, principal investigator on the research and a professor of biomedical informatics and director of the Center for Artificial Intelligence in Drug Discovery, and QuanQiu Wang, a specialist in artificial intelligence. Co-author Mark Gurney is founder and CEO of Tetra Therapeutics, a drug development company focused on brain disorders and injuries based in Grand Rapids, Michigan, and a wholly owned subsidiary of Shionogi & Co., Ltd.

They hypothesized the risk of COVID-19 would be greater for patients with dementia for several reasons, including: People with dementia may be more susceptible to contracting COVID-19 because of blood-brain barrier damage that can allow certain viruses and bacteria to reach the brain more easily.

In addition, dementia may interfere with a person's ability to wear a mask, physically distance from others or frequently clean their hands. Moreover, conditions such as cardiovascular diseases, diabetes, obesity and hypertension are risk factors for both dementia and COVID-19 and are associated with worse outcomes.

"On behalf of the millions of people living with Alzheimer's and other dementia that we represent, these preliminary findings suggest a frightening reality of the vulnerabilities associated with dementia," said Maria Carrillo, PhD, Alzheimer's Association chief science officer. "It is critical we develop and implement strategies that strike a balance between keeping people, especially long-term care residents, safe from COVID-19 but also protecting them from health-related harms associated with social isolation."

Researchers examined electronic health records (stripped of identifying information) from 360 hospitals and 317,000 providers nationally, representing 20% of the U.S. population. Of the 61.9 million adults in the study population, more than one million had dementia, 15,770 had COVID-19 and 810 had both.

"The availability of such a large de-identified database of patient electronic health records analyzed by modern informatics techniques gave our study great power to detect vulnerabilities in patient disease groupings," Xu said.

The researchers also adjusted the data to account for factors including age, gender, race, other health conditions and whether individuals lived in a nursing home. They used an adjusted odds ratio to determine risk.

Their findings:

While overall the odds of contracting COVID-19 were twice as high for patients with dementia compared to those without dementia, the risk varied by condition. Patients with vascular dementia had the highest risk--with odds more than three times higher-- followed by patients with presenile dementia, senile dementia, Alzheimer's disease and post-traumatic dementia.

The odds of African Americans with dementia contracting COVID-19 were almost three times higher than for Caucasians with dementia. Generally, gender had no additional effects on the risk of COVID-19 in patients with dementia, while age had no additional effects in patients with dementia in general and Alzheimer's specifically.

The overall hospitalization risk during the six months for adults with COVID-19 was 25.17%. But among patients with COVID-19 and dementia, 59.26% were hospitalized, and the percentage was even higher--73.08%-- among African American patients, compared to 53.85% of Caucasians with both conditions.

The overall mortality risk for patients with COVID-19 was 5.64%. But among those who also had dementia, 20.99% died, with the percentage higher for African Americans (23.08%) than for Caucasians (19.23%).

A method that instructs immune system cells to help repair damaged tissues in the intestine has been developed by researchers at KU Leuven and Seoul National University. This opens the way for more effective treatment of inflammatory bowel disease, including ulcerative colitis and Crohn's disease. The study was carried out on humans and mice.

When functioning correctly, the immune system protects against harmful agents such as bacteria that get into the body. But in conditions such as inflammatory bowel disease (IBD), the immune system attacks the tissues that line the gut, forming ulcers and causing pain and discomfort. Nearly 3.9 million women and 3.0 million men are living with IBD worldwide, and the number of cases is rising.

Since the origin of IBD is unknown, treatments often focus on reducing the immune response in order to limit inflammation and the resulting symptoms. But this also hinders those parts of the immune system involved in repairing the damaged intestine. For example, the white blood cells known as macrophages (literally 'big eaters' in Greek) play a variety of roles in both inflammation and tissue repair. They consume foreign bodies, clear up debris from damaged cells, and release substances that direct other steps in the inflammatory or repair processes.

"Our idea is that the migration of macrophages to the damaged tissue in IBD is essential to stimulate its recovery," explains Professor Gianluca Matteoli, an immunologist at the Translational Research Center for Gastrointestinal Disorders (TARGID) KU Leuven and lead author of the research, published this week in the journal Gut. His team, and that of Professor Seung Hyeok Seok from Seoul National University, set out to test this theory.

When the researchers looked at macrophages in the intestines of a handful of people with IBD, a sub-group of cells able to respond to prostaglandin E2 (PGE2) stood out. Prostaglandins are messenger molecules in the immune system, associated with tissue regeneration.

"If the patients had acute disease, they had a lower amount of these beneficial cells, and if they went into remission, then amounts of macrophages went up. This suggests that they are part of the reparative process," Professor Matteoli says.

To investigate further, the researchers turned to a mouse model for ulcerative colitis, one of the main forms of IBD. The number of macrophages sensitive to the prostaglandin was lower in the model than in healthy mice, but if PGE2 levels were increased, the few sensitive macrophages present responded, releasing a substance that in turn stimulated tissue regeneration.

If the PGE2 receptors on the macrophages were knocked out, making them unable to respond to the prostaglandin, the level of tissue regeneration dropped. But it could be restored by getting the macrophages to swallow a liposome (a bubble of material similar to a fragment of cell wall) containing a substance able to trigger the release of the repair stimulating agent.

"We already knew that prostaglandins were important for inducing proliferation of tissue cells, but this study shows that they are also important for controlling the inflammatory effect, so moving the body from the acute stage where inflammation dominates to the reparative stage," Professor Matteoli says.

The prospects for new treatments lie in liposomes used to jump-start the macrophages into stimulating tissue repair. The technique is well-established as an experimental tool, but applications like this are rare. "This is one of the first times it has been used to produce a beneficial, therapeutic effect," says Professor Seok. However, a lot of work will be needed before it can be used in patients.

The next step is to look in detail at human macrophages at different stages of IBD. "We want to identify other factors that trip the switch that turns macrophages from inflammatory cells to non-inflammatory cells," says Professor Matteoli. "Then, using the liposome technology that Professor Seok has developed, these could be used to target the macrophages and so produce very precise drugs."

Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summary below is not intended to substitute for the full article as a source of information. A collection of coronavirus-related content is free to the public at https://www.acpjournals.org/topic/category/coronavirus.

1. Racial minorities more likely to become infected with COVID-19
An analysis of Kaiser Permanente members in Northern California early in the COVID-19 pandemic found that racial minorities were more likely than white patients to test positive for COVID-19. The findings are published in Annals of Internal Medicine.

Researchers from Kaiser Permanente, The Permanente Medical Group, and Stanford Cancer Institute studied health records for 3.5 million patients in the Kaiser Health system, more than 91,000 of whom received a COVID-19 test between Feb. 1 and May 31, 2020. That data showed that Latino patients were nearly 4 times as likely as white patients to become infected with the virus, while Asian and Black patients were 2 times as likely to test positive for COVID-19 compared to white patients. The odds of hospitalization were also higher for Latino, Asian, and Black patients with COVID-19 than for white patients. However, the study did not find racial disparities in mortality among patients hospitalized after infection.

The researchers concluded that while race was a major factor in likelihood of infection, it contributed in a minor way to hospitalization, admission, and death. For those adverse outcomes, age was the major predictor. According to the authors, these findings reinforce that health systems should aim to mitigate the spread of COVID-19 in their highest-risk communities by seeking to reduce transmission among the most vulnerable. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-6979.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The corresponding author, Gabriel J. Escobar, MD, can be reached through Jan Greene at janice.x.greene@kp.org.

2. Racial opinions of vaccine
Current recommendations for talking to patients about COVID-19 vaccines do not provide specific guidance on how to discuss mistrust. Authors from the University of Chicago, University of Washington School of Medicine, and the University of California, San Francisco suggest specific strategies and language that clinicians can use to address mistrust of COVID-19 vaccines among racial and ethnic minorities. Their advice is published in Annals of Internal Medicine. Read the full text: https://www.acpjournals.org/doi/10.7326/M21-0055.

Currently, only 18% of Black Americans and 40% of Latinx Americans trust that a COVID-19 vaccine will be effective. Even fewer trust that it will be safe. The impact of this mistrust is alarming: Fewer than half of Black Americans intend to get vaccinated against COVID-19. To reduce the disproportionate burden of COVID-19 morbidity and mortality among people of color, this mistrust must be addressed and health care providers are in a unique position to address patients' concerns.

The authors detail four specific strategies to help promote trust among patients of color about COVID-19 vaccines. The authors say health care providers should lead with listening, tailor responses to patient concerns, use accessible language, and acknowledge uncertainty. Prioritizing these discussions using these strategies may help increase the acceptance of COVID-19 vaccinations and improve health outcomes among persons of color.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The corresponding author, Monica Peek, MD, MPH, MS can be reached through Ashley Skorski at askorski@uchicago.edu.

3. Majority of Los Angeles health care workers surveyed hesitant about getting COVID-19 vaccine
In a recent survey, a majority of Los Angeles area health care workers expressed hesitancy about getting the COVID-19 vaccine. Respondents were most heavily influenced by the fast-tracked development of the vaccine (83.5%), the novel and unfolding science of SARS-CoV-2 (75.7%), and the political climate in which the research and regulatory process were playing out at the time of survey distribution (58.5%).

Researchers from the University of California surveyed a volunteer cohort of 1,069 asymptomatic health care workers employed by the University of California, Los Angeles to track incidence and risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. As an addendum, a cross-sectional survey designed to assess attitudes toward vaccines, including prospective acceptance of novel coronavirus vaccines, was distributed to participants in September 2020 and completed online through October 2020. The findings are published in Annals of Internal Medicine.

Among the participants, fewer than half (46.9%) felt that a novel coronavirus vaccine would protect them against COVID-19. Just over one third (34.8%) of participants expressed confidence in the scientific vetting process for SARS-CoV-2 vaccines, with almost half (47.8%) reporting they would not be willing to participate in vaccine trials. Most participants (65.5%) indicated they would delay vaccination once coronavirus vaccines became available for distribution (49.4% would prefer to wait and see how the vaccine affects others first, and 16.1% would not get it soon but indicated they might in the future), and 1.30% never intend to get vaccinated. Compared with prescribing clinicians, other health care workers were about 20% to 30% more likely to delay or decline a coronavirus vaccine when all other demographic factors were held equal. Participants identifying as Asian (23.9%) or Latino (26.2%) were less likely to accept vaccination immediately upon availability compared with those in other racial and ethnic groups. Health care workers aged 50 years or older were more likely than their younger coworkers to accept vaccination right away. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-7580.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The corresponding author, Anne W. Rimoin, MPH, PhD, can be reached through Brad Smith at bssmith@support.ucla.edu.

4. SARS-CoV-2 clusters can occur in hospitals despite robust control policies
A missed case of SARS-CoV-2 infection may have led to a cluster of cases among patients and health care workers in an acute care hospital, despite robust control policies in the facility. In the paper published in Annals of Internal Medicine, researchers from Harvard Medical School, Harvard Pilgrim Health Care Institute, Brigham and Women's Hospital, and the Massachusetts Department of Public Health discuss the cases and insights that may inform future measures to protect patients and staff.

While the patient had tested negative twice on admission, the investigators surmised that he was contagious from at least hospital day 3 and infected staff and patients for at least a week before detection. During this time, the patient had multiple transfers between units and services and also shared rooms with uninfected patients, which contributed to the spread. In addition, failure to wear eye protection and limitations of personal protective equipment (PPE) among those with near-range exposure to the patient may have contributed to some spread.

According to the authors, this case highlights important lessons about the limitations of admission testing. They stress the importance of obtaining more than one sample in high-risk patients, among other improved testing strategies. The authors also note that there is high risk for roommate-to-roommate transmissions in the setting of occult acute infection. They also note the potential value of serial testing to identify infections incubating on admission. They say opportunities to improve adherence to eye protection and masking of patients, surgical masks and face shields for providers with near-range exposure to symptomatic patients, and the value of whole-genome sequencing could also help define and contain hospital clusters. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-7567.

In an accompanying editorial from University of Texas Southwestern Medical Center, authors say that this case is just one example that exposes the many weaknesses in our health care systems, including insufficient training in infection prevention. While no single practice was identified as the culprit, there are hints, as there have been with past outbreaks, that small lapses in infection prevention may add up to transmission because of the high-risk activities that occur in health care settings. Read the full text: https://www.acpjournals.org/doi/10.7326/M21-0526.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The corresponding author, Michael Klompas, MD, MPH, can be reached through Elaine St. Peter at estpeter@bwh.harvard.edu. Editorialist Trish M. Perl, MD, MSc, can be reached through Remecka Owens at Remekca.Owens@UTSouthwestern.edu.

5. Lessons from 1918 Influenza Pandemic demonstrate the importance of restrictions on public gatherings
Lessons from the 1918 Influenza Pandemic demonstrate why school closures and other restrictions on mass gatherings may be necessary today to control the spread of SARS-CoV-2 infection. The historical analysis is published in Annals of Internal Medicine.

Authors from the University of Zurich reviewed detailed public health records from a region in Switzerland to study the effect of school closures, restrictions on mass gatherings, and other measures on the size and duration of the 1918 Spanish Influenza epidemic. Similar data collected in Switzerland during the present COVID-19 epidemic were analyzed, as well, and the two public health responses were compared.

The researchers found that during the first wave of the influenza pandemic in summer 1918 in the canton of Bern, there were salient associations between the centrally enacted, canton-wide public health interventions and the early and rapid containment of epidemic growth. During the second wave in autumn, cantonal authorities reacted hesitantly largely due to concerns about the economic effect of public health interventions experienced during the first wave and the associated political pressure. Mass gatherings and premature relaxation of restrictions of mass gatherings only 1 week later because of public pressure may have contributed to the length and intensity of the second wave, which was 2.6 times longer than the first wave and responsible for approximately 80% of all cases and deaths. The researchers noted strikingly similar patterns in the management of the COVID-19 outbreak in Switzerland in 2020: The second wave had a considerably higher amplitude, prolonged duration, and much higher associated rates of hospitalization and mortality. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-6231.

The author of an accompanying editorial from Johns Hopkins University says these lessons are important for informing responses to future pandemics. The author highlights the dangers of eschewing those lessons that history provides Read the editorial: https://www.acpjournals.org/doi/10.7326/M21-0449.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead corresponding authors can be contacted directly. Kaspar Staub, PhD can be reached at kaspar.staub@iem.uzh.ch, and Peter Jüni, MD can be reached at peter.juni@utoronto.ca. The corresponding author of the accompanying editorial, Graham Mooney, PhD, can be reached at 443-208-5505.

Also new today

Update Alert 7: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers
Roger Chou, MD; Tracy Dana, MLS; David I. Buckley, MD, MPH; Shelley Selph, MD, MPH; Rongwei Fu, PhD; Annette M. Totten, PhD
Letters
Full text: https://www.acpjournals.org/doi/10.7326/L21-0034

DES PLAINES, IL -- The combination of a high-dose NSAID with paracetamol does not increase the analgesic effect compared to paracetamol alone. Researchers also found that paracetamol alone is superior to high-dose NSAID alone for posttraumatic extremity pain. These are the findings of a study titled Acetaminophen, or nonsteroidal anti-inflammatory drugs, or combination of both analgesics in acute post-trauma pain: a randomized controlled trial, to be published in the February 2021 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).

According to the study, taking into account its superior efficacy and tolerability, paracetamol appears to be the most suitable first-line therapy for managing mild to moderate post-traumatic extremity pain after discharge from the emergency department.

The lead author of the study is Mohamed Amine Msolli, MD, from the emergency department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.

Commenting on the study is Andrew Chang, MD, MS, vice chair of research and academic affairs and professor of emergency medicine at Albany Medical Center in Albany, New York:

"This study of 1500 Tunisian adults, nearly 50% of whom had extremity fractures, provides evidence that paracetamol (acetaminophen) can be used as a first line analgesic, either alone or in combination with an NSAID, in the treatment of acute extremity injuries after emergency department (ED) discharge. Although this was not their primary hypothesis, the surprising efficacy of paracetamol over an NSAID, as shown by a 6.4% lower need for additional oral analgesics, may impact prescribing practices. For example, many ED patients who have a contraindication to NSAIDS but require analgesics upon ED discharge might be prescribed an opioid. Given the ongoing opioid epidemic, this study lends evidence to support the use of acetaminophen alone in such patients."

As teens' use of social media has grown over the past decade, so too has the suicide rate among younger people, with suicide now being the second leading cause of death among those ages 10 to 34. Many have suggested that social media is driving the increased suicide risk, but because social media is still relatively new, it's been difficult to determine its long-term effects on mental health.

In the longest study to date on social media use and suicidality, BYU research recently published in the Journal of Youth and Adolescence now offers some answers.

Through annual surveys from 2009 to 2019, researchers tracked the media use patterns and mental health of 500 teens as part of the Flourishing Families Project. They found that while social media use had little effect on boys' suicidality risk, for girls there was a tipping point. Girls who used social media for at least two to three hours per day at the beginning of the study--when they were about 13 years old--and then greatly increased their use over time were at a higher clinical risk for suicide as emerging adults.

"Something about that specific social media use pattern is particularly harmful for young girls," said BYU professor Sarah Coyne, the lead author of the study. She noted that girls' social tendencies likely make them more susceptible to the negative effects of social media.

"Research shows that girls and women in general are very relationally attuned and sensitive to interpersonal stressors, and social media is all about relationships," Coyne explained. "At 13, girls are just starting to be ready to handle the darker underbelly of social media, such as FOMO (fear of missing out), constant comparisons and cyberbullying. A 13-year-old is probably not developmentally ready for three hours of social media a day."

That said, in most cases Coyne doesn't recommend parents ban teenage daughters from social media, which can backfire by leaving them poorly prepared to manage their media use as adults.

"Thirteen is not a bad age to begin social media," said Coyne, whose own 13-year-old daughter just joined TikTok. "But it should start at a really low level and should be appropriately managed."

Coyne suggests that parents limit young teens' social media time to about 20 minutes a day, maintain access to their accounts and talk with teens frequently about what they're seeing on social media. Over time, teens can gradually scale up their social media use and autonomy.

"The goal is to teach them to be healthy users of social media, to use it in a way that helps them feel good about themselves and connect with other people, which is its real purpose. It's parents' job to scaffold or pre-arm children so that they can deal with some of the heavy stuff that often comes with using social media."

For young adults who feel they've already developed suboptimal social media habits, Coyne is optimistic that they can make a change. As her previous research has shown, social media can be a positive experience for teens and people of any age if they use it well.

Good habits include logging on for a purpose and actively participating rather than passively scrolling, as well as unfollowing those who are exclusionary or have a negative influence.

"I would love for every BYU student to be mindful about the ways they're using social media, how it's working for their mental health and how it's harming their mental health. And then just to avoid doing those harmful things, whatever they are," said Coyne. "I think that could have a significant impact on our community."

Higher excess COVID-19 death risk in middle-aged people with type 2 diabetes raises vaccine prioritisation questions

A largescale analysis led by the University of Exeter and funded by Diabetes UK, has found a disproportionately higher COVID-19 death risk in middle-aged people with type 2 diabetes, raising questions over vaccination strategies across Europe.

The study, accepted for publication in Diabetologia, found that compared to people of a similar age without type 2 diabetes, the additional COVID-19 mortality risk from having type 2 diabetes increases the younger someone is. Although the risk is low in absolute terms, the increase has a significant potential to impact middle-aged people particularly, as it elevates their existing age-related risk of COVID-19. For example, a person aged 50 with type 2 diabetes has the equivalent COVID-19 mortality risk of a 66-year-old person without diabetes: an additional risk of 16 years. This difference reduces with increasing age, so that the COVID-19 mortality risk of a person aged 70 with diabetes is similar to that of someone without diabetes aged 78: an additional risk of eight years.

While some countries such as the UK and Germany already prioritise people with type 2 diabetes for vaccines, this is not being consistently applied across comparable countries including many in Europe.

Dr Andrew McGovern, of the University of Exeter Medical School, who led the research, said: "It's important to remember the risk to middle-aged people with diabetes of dying from COVID-19 is very low in absolute terms compared with the elderly. However, vaccine roll-out across Europe should be done in order of risk. Strategies to define priority groups for vaccination must consider the disproportionate relative risk of COVID-19 mortality in middle-aged people with type 2 diabetes whose COVID-19 risk is already elevated by their age. We recommend that anyone with diabetes takes up the vaccine as soon as it's available to them."

The research team also involved the University of Warwick, the Alan Turing Institute, and University College London. The team accessed published data from three UK studies, including tens of millions of people in the community and in hospital across the country. They looked at differences in the risk of dying from COVID-19 by both age and whether or not a person has diabetes - which was predominately type 2 diabetes.

Dr John Dennis, of the University of Exeter Medical School, said: "Type 2 diabetes is one of the most common health conditions. This means providing accurate information on age-specific COVID-19 risk for people with type 2 diabetes is really important. Our study highlights how we can use cutting-edge data science to provide precision diabetes research that can inform the complex real-time discussion on Europe-wide COVID-19 vaccination strategy."

Bridget Turner, Director of Policy Campaigns and Improvement at Diabetes UK, said: "We know that people with diabetes have been disproportionately affected by coronavirus throughout this pandemic, and that the majority of those who have become seriously ill or died have been of older age. This new research funded by Diabetes UK gives important new insights into how much type 2 diabetes adds to the overall risk of dying from coronavirus at different ages, particularly the additional risk that the condition adds in middle-age.

"The UK has made good progress on prioritising those who are most vulnerable for vaccination - which includes all adults with diabetes - but we need to continue to work at pace to identify and protect those individuals at higher risk. At Diabetes UK we believe we can best do this by rolling out across the NHS the tool for assessing individual COVID-19 risk, which was promised, but so far, has yet to materialise.

"The most important thing anyone with diabetes can do to reduce their risk is to avoid catching the virus in the first place by continuing to social distance, wash hands and wear masks and to take a coronavirus vaccine when offered one."

Asthma attack rates seen at GP surgeries fell significantly during the first Covid-19 pandemic lockdown of 2020, a study suggests.

Lower levels of air pollution, fewer cold and flu infections, and the fear of attending doctor surgeries due to Covid-19 were possible reasons for the 20pc drop in cases seen at GP surgeries, researchers said.

The study is the first national review of lockdown effects on asthma attacks and includes data from more than 100,000 patients.

Asthma attacks - or exacerbations - are bouts of shortness of breath, wheezing or a tight chest. There are usually more than six million GP consultations and 1400 deaths attributed to asthma in the UK every year.

For the study researchers from the University of Edinburgh looked at a national GP database containing information on almost 10 million patients, and identified 100,165 who had had at least one asthma attack since 2016.

The team counted GP visits for asthma attacks in weekly blocks from January to August 2020, and compared with weekly rates for January to August 2016-2019. They used March 23 2020 as the lockdown start date.

Drops in GP visits for asthma attacks during the lockdown were seen across all age groups, for both men and women, and across all regions of England excluding London and the North East.

There was no reduction in the rate of asthma attacks that led to a hospital visit, suggesting that only milder attacks were reduced during the pandemic.

The researchers caution that some patients could have gone to hospital without a GP referral, which may mask higher rates of asthma attacks than recorded by GP surgeries.

The study was conducted in association with BREATHE - The Health Data Research Hub for Respiratory Health, NIHR and the Asthma UK Centre for Applied Research. It is published in the journal Thorax.

Lead researcher Dr Ahmar Shah, Chancellor's Fellow at the University of Edinburgh's Usher Institute, said: "Asthma is a chronic condition that affects over five million people in the UK and until now, we didn't know how these patients were being affected by lockdown. The data shows an overall reduction in asthma attacks seen at the GP.

"However, it is not clear whether this was an actual improvement in asthma due to reduced pollution and fewer opportunities for other viruses to spread or whether patients were reluctant to attend their doctor's surgery during the pandemic. Further research will help explain the reasons behind our findings."

Children aged between 5 months and 4 years attending daycare during lockdown in March to May 2020 in France had low rates of SARS-CoV-2 antibodies in their blood - known as seroprevalence - suggesting that virus infection rates were low in this population.

Research assessing seroprevalence in daycare centres that remained open during the first national lockdown in France, suggests that the rate of SARS-CoV-2 virus infection was low at 3.7%, with positive cases likely infected by an adult in their household, rather than whilst at daycare. The seroprevalence rate among daycare staff was similar to that of a control group of adults who were not exposed to children or COVID positive patients in a work setting.

This study, which included 327 children aged between 5 months to 4 years old, is the first to estimate seroprevalence in preschool settings and is published in The Lancet Child & Adolescent Health journal. Since the study was conducted, a number of SARS-CoV-2 variants have emerged, which are not captured in the data.

SARS-CoV-2 has been shown to infect people of all ages, however, children tend to develop mild, if any symptoms, and very rarely need hospitalisation. The role of very young children as asymptomatic SARS-CoV-2 virus spreaders is still unknown and the risk to the community of having daycare centres open is not clear.

Seroprevalence data is thought to reflect the true rate of infection as it shows the levels of antibodies in the blood, whether or not the individual showed symptoms of COVID-19. This study could therefore provide vital information to policy-makers around daycare closures for very young children during further waves of the SARS-CoV-2 pandemic, although the authors stress that more research in other settings and emerging variants will also be needed.

"Our results suggest that daycare centres are not focus points of SARS-CoV-2 virus infection and that young children are not spreading the virus widely in these environments. These findings should be reassuring for parents and staff at daycare centres, especially given that the children included in the study have parents who are keyworkers and are thought to be at higher risk during the first wave of the epidemic," says Dr Camille Aupiais, lead author from Hôpital Jean-Verdier, Paris, France. [1]

COVID-19 has caused over 2 million deaths globally, placing extreme pressures on healthcare systems worldwide. Many countries have closed schools and daycare centres in an effort to stem infection rates. However, these closures have come with an economic cost and raised concerns about the development and wellbeing of children.

During the first French national lockdown in March 17th to May 11th, 2020, most daycare centres and schools were closed with a small number operating at reduced capacity to care for children of critical workers, including healthcare staff and social workers.

Throughout this time, French daycare centres were advised to follow safety protocols which included working with smaller set cohorts of 6-8 children with dedicated staff to each cohort, disinfection of surfaces, and face masks and social distancing measures for staff. Parents were not allowed to enter the daycare centres and were instructed to screen their children for COVID-19 symptoms before sending them in. Children with symptoms were not permitted to attend the daycare centres.

The study included 197 daycare staff (average age 40 years). A staff comparator group of 164 adults (average age 42 years) was comprised of office and lab workers from six hospitals who kept working during the lockdown and were not occupationally exposed to very young children or COVID-19 patients in their work setting.

Data collection took place between June 4th and July 3rd 2020, four to eight weeks after the end of the national lockdown, in daycare centres around the French cities of Paris, Rouen, and Annecy. Blood samples were collected from participants - using finger pricks for children - and tested using a rapid lateral flow test to detect SARS-CoV-2 antibodies.

In all, 14/327 children, 14/197 daycare staff and 9/164 comparator adults were positive for SARS-CoV-2 antibodies. After adjustment for test sensitivity and specificity, these values were 3.7%, 6.8% and 5.0% respectively. Statistically, the seroprevalence rate among daycare staff did not differ significantly from that observed in the comparator group.

The 14 seropositive children came from 13 daycare centres. In the centre with two seropositive cases, the children had attended separate zones of the daycare centre with no mixing, suggesting that there was no child-child transmission in these cases.

Contact with a confirmed adult household case of COVID-19 during the lockdown - but not sibling cases or daycare peer cases - was more frequent in seropositive children than seronegative children. Seropositive children were significantly more likely to have at least one seropositive parent (55% vs 14%).

The 14 seropositive daycare staff came from eight different daycare centres and there were two centres with three seropositive staff members. No difference was found in seroprevalence rates between staff who were exposed (or not) to a child with confirmed COVID-19.

"Our results suggest that young children are more likely to contract COVID-19 at home, rather than at a daycare centre," says Dr Aupiais. "We suggest that clinical signs of COVID-19 are not the best indicators of infection or for testing very young children and that the main criterion should be a suspected or confirmed case in an adult household member. Further research is needed to fully understand the role of young children in community transmission." [1]

The authors caution that there are limitations to the study and that new variants of SARS-CoV-2 have arisen since the testing period, including the so-called UK, Brazilian, and South African variants, and it is not established whether young children are more or less susceptible to these newer strains. Furthermore, the daycare centres included in the study were not operating at full capacity during the study period and results may not generalise to centres that are operating normally outside of lockdown.

During every instant of life, over a hundred trillion microbes, collectively known as the microbiome, reside on skin surfaces and course through the human body. In the human gut, vast colonies of bacteria, belonging to around 1000 different species, carry out duties ranging from the digestion of food and the management of body weight to effects on the brain and behavior, many of these still elusive to science.

Recent studies in mice and humans have revealed intriguing links between the composition of gut microbiota and Autism Spectrum Disorder (ASD), a disease believed to affect one in 54 children, according to the Centers for Disease Control. Dr. Krajmalnik-Brown's lecture will propose linkages between gut bacteria and ASD, highlighting encouraging results of a microbiome-targeted, ASD open-label clinical trial.

The approach described involves the transfer of healthy gut microbes into the gut of ASD patients over a period of 7-8 weeks, as a means of treating symptoms of the disorder. Known as microbial transfer therapy (MTT), the technique seeks to address the gastrointestinal issues commonly associated with ASD as well as offer relief from some of the characteristic behavioral manifestations of the disease.

ASD is a complex neurobiological disorder, whose roots are still unknown. The affliction often takes hold in early childhood, impairing social interactions and communication, leading to restricted, repetitive, and stereotyped patterns of behavior. Gut microbiota are known to play a role in ASD, which produces problems in the GI tract that are often correlated with ASD severity. Researchers have found an abnormal composition of gut bacteria in ASD patients who lack the broad microbial diversity associated with a healthy gut microbiome.

Krajmalnik-Brown, director of the Biodesign Center for Health Through Microbiomes at ASU, along with her colleagues, have extended earlier studies, administering MTT to 18 ASD-diagnosed children and carefully monitoring their GI and behavioral responses. The treatment began with a 2-week antibiotic regimen and bowel cleanse, a stomach acid suppressant, followed by an extended transplant of gut microbes from healthy individuals, using a high initial dose followed by daily and lower maintenance doses over a period of two months.

Initial results showed marked expansion in the diversity of gut microbia, an 80% reduction in GI symptoms and improvement in autism-related behavior. A review of the original 18 participants two years after MTT treatment showed further encouraging results. Most of the GI improvement following treatment was maintained while behavioral correlates of ASD further improved over time. Bacterial composition was significantly enhanced by the treatment, seen in particular in the in bacterial diversity and relative abundances of two species, Bifidobacteria and Prevotella, along with other taxa.

Following MTT, levels of many metabolites in plasma were shown to more closely resemble those in normally developing children, presumably as a result of adjusting ASD microbial colonies to more closely approximate the normal, healthy gut.

The research has benefitted from a multi-omic approach, which examines microbes, pathways, genes, and metabolites--potential candidates for more accurate biomarkers and targets for future treatment. "Through blood metabolomics we were able to see that the microbiome changes lead to systemic changes for meaningful metabolites. This is exciting and promising," Krajmalnik-Brown said.

The study findings suggest the long-term safety of the MTT method and provide a hopeful avenue of further research in the diagnosis and management of this widespread illness, for which there is still no established medical treatment.

Reston, VA--A combination of radionuclide therapy and immunotherapy has proven successful in slowing the progression of prostate cancer and increasing survival time, according to new research published in the February issue of The Journal of Nuclear Medicine. The results of the murine study indicate that radionuclide therapy promotes prostate cancer immunogenicity, provoking a cellular response that makes the tumors more receptive to immunotherapy.

"Prostate cancer is generally viewed as an immunological cold cancer in which immunotherapies only have moderate success," said Katharina Lückerath, PhD, assistant professor of preclinical theranostics at the University of California Los Angeles in California. "Increasing prostate cancer immunogenicity with prostate-specific membrane antigen (PSMA) radionuclide therapy, however, might render immunotherapies more successful. In our research we sought to exploit this effect by combining radionuclide therapy with immunotherapy in a mouse model of prostate cancer."

In the study, mice bearing prostate cancer tumors received one of four treatments: an isotope control antibody, 225Ac-PSMA617 radionuclide therapy, an anti-PD-1 antibody or both 225Ac-PSMA617 radionuclide therapy and an anti-PD-1 antibody. Therapeutic efficacy was assessed by measuring tumor volume (with computed tomography), time to progression and survival.

While 225Ac-PSMA617 radionuclide therapy and PD-1 blockade alone tended to prolong time to progression as compared to the isotope control (30 days and 33.5 days, respectively, versus 25 days), combining 225Ac-PSMA617 radionuclide therapy and PD-1 blockade significantly improved time to progression (47.5 days). Survival time also increased greatly for the joint therapeutic approach (51.5 days) when compared to225Ac-PSMA617 radionuclide therapy (32 days), anti-PD-1 (37 days) and the control (28 days).

"These findings suggest that radionuclide therapy may have a profound impact on the tumor immune microenvironment that can facilitate immunotherapies in prostate cancer," noted Lückerath. "Radionuclide therapy and immunotherapy combinations are promising therapeutic options for prostate cancer patients, and the data reported in our study support the clinical translation of radionuclide therapy-immunotherapy combination regimens."

In addition to this study, recently launched clinical trials for prostate cancer treatment and new tracers developed to image immune responses underscore the high interest in exploring immunity using molecular imaging and in combining radionuclide therapy with immunotherapy. According to Lückerath, these initiatives might expand the scope of nuclear medicine to immunology and strengthen nuclear medicine's ability to offer powerful and versatile treatment options.