Body

COLUMBUS, Ohio - As national tensions rise, a new national survey of 2,000 people commissioned by The Ohio State University Wexner Medical Center finds more Americans are adjusting how they use social media platforms.

Many participants cited stress from the global COVID-19 pandemic, along with the movement to end racial inequality and other divisive political issues in our country as reasons for taking a social media break.

While it may seem impossible to disconnect and step away from social media, some survey participants reported changing their social media habits this year. The survey found:

More than half of Americans (56%) say their social media habits have changed because of tensions surrounding current events this year.

Almost 3 in 10 Americans (29%) say their social media use has increased because of tensions surrounding current events this year.

And 1 in 5 Americans (20%) say they've taken breaks from social media because of tensions surrounding current events this year.

It's easy to feel overwhelmed by information, opinions and arguments while scrolling through social media channels, said Ken Yeager, Ph.D., director of the Stress, Trauma and Resilience (STAR) Program at Ohio State Wexner Medical Center.

"Stepping away and reconnecting with reality offline is an important step to take for your mental health," Yeager said. "Being constantly immersed in this stressful environment and being overexposed to contentious or traumatic events can make you feel like the world is a less safe place to be. And because these stressors have persisted over a long period of time, it's wearing on people's ability to cope with that stress."

Across the United States, there's been an increase in cases of depression, anxiety, suicidality and substance abuse over the past several months, said Yeager, who is a clinical professor in The Ohio State University College of Medicine.

"Even though you can't control what happens on social media, it's important to recognize how it may affect you and take steps to limit your exposure," Yeager said.

He offers these tips to go on a social media diet:

Reconnect with family and friends - Disconnect from your devices and stop scrolling on social media for a night. Instead, make plans with the people you care about, even if that's a group Zoom call. An evening of friendly conversation can be a welcome break from social media.

Create positive change in your community - Volunteer at a food bank, clean up a park or do anything that makes your neighborhood a better place. Seeing the good that you and others in your community are doing can help you realize what's truly important.

Use your power - Not only do you have the power of your vote, but you also have the power to voice your concerns and enact local change. Get involved in the issues that are important to you. Feeling like you're part of the process can be empowering and calming.

Talk about it - There can be a lot of misunderstandings in conversations about the biggest issues we are facing now, especially when they take place in social media comment sections. Talking to family and friends one-on-one about what is important to them and how they believe these issues affect them can help you understand where they're coming from.

Anyone who is regularly feeling panicked or having trouble controlling their mood or connecting with others should seek help from a mental health professional to learn ways to cope, Yeager said.

On July 27 2020, the U.S. Department of Health and Human Services' (HHS) Health Resources and Services Administration (HRSA) launched a Special Collection of manuscripts across the open-access journals PLOS Medicine and PLOS ONE, highlighting Ryan White HIV/AIDS Program's (RWHAP) innovative approaches for data utilization and engagement of people with HIV who are not in care and not virally suppressed.

The Collection addresses how HRSA's RWHAP uses data to facilitate care at state and local levels; clinical, population, and geographic differences among RWHAP clients; RWHAP implementation science initiatives; healthcare workforce; healthcare systems differences in outcomes; and other key strategies such as pre-exposure prophylaxis (PrEP).

"For three decades, HRSA's Ryan White HIV/AIDS Program has played a critical role in the United States' response to ending the HIV epidemic," said HRSA Administrator Tom Engels. "More than half a million people - representing more than half of people with diagnosed HIV in the U.S. - receive services through the RWHAP annually. In 2018, approximately 87 percent of RWHAP patients receiving medical care were virally suppressed, exceeding the national average of approximately 65 percent."

This Special Collection is an important resource to inform programs about successful approaches to HIV care and to highlight the RWHAP's specialized experience. The Collection addresses issues such as challenges of sustainability, analysis of cost effectiveness, and the scalability of interventions. The authors describe HRSA's collaborative efforts both internally with members of other operating divisions within HHS and externally with partners from various grant recipients across the country. These collaborative efforts allow for data sharing and obtaining perspectives that provide additional insights into and solutions for the issues, as well as novel and innovative approaches to HIV care and treatment, for advancing the national effort to end the HIV epidemic.

TUCSON, Ariz. – A potentially safer, more effective chemotherapy treatment for patients with blood-related cancers, such as leukemia, who need a particular bone marrow transplant procedure is under study at the University of Arizona Health Sciences.

The procedure is known as a haploidentical (half-matched) bone marrow transplantation, or “haplo-BMT,” providng an alternative source of stem cells for patients who need a bone marrow transplant but are unable to find a perfect or near-perfect donor match for human leukocyte antigens (HLA). These HLA are proteins the immune system uses to identify cells that belong in the body and those that do not. Haplo-BMT allows for a donor to have only half the matching proteins – which can be lifesaving for the many patients who need a bone marrow transplant.

Haplo-BMT has been critically important in improving survivability for patients who lack a perfect match, a problem more prevalent among minority populations. Less than 40% of Hispanic and less than 20% of African American patients will successfully have a match in the national or international registries, compared to nearly 80% of white patients, said Emmanuel Katsanis, MD, professor in the Departments of Pediatrics, Medicine, Pathology and Immunobiology at the UArizona College of Medicine – Tucson, director of the adult and pediatric hematopoietic cellular therapy and transplant program at Banner – University Medicine and the UArizona Cancer Center, and a researcher at the UArizona Steele Children’s Research Center.

For several years, Dr. Katsanis has introduced to patients the relatively new and life-saving haplo-BMT treatments. The most commonly used protocols begin with chemotherapy, followed by the transplant from the half-matched donor. After the transplant, a patient is given more chemotherapy with the drug cyclophosphamide to leave the patient stem cells and non-reactive T-cells to fight certain infections. Nevertheless, Dr. Katsanis is hopeful to uncover an even more effective chemotherapy drug.

“The current standard treatment with cyclophosphamide is effective,” Dr. Katsanis said. “However, it can also suppress the donor T-cells from attacking the leukemia. Therefore, we hypothesized other drugs may work similarly and, hopefully, better than cyclophosphamide. We found in previous research in our laboratory, which was published in the British Journal of Haematology, a journal of the British Haematology Society, that one of those drugs was bendamustine.”

Based on those findings, Dr. Katsanis wrote a Phase I clinical trial titled, “Haploidentical BMT with Post-Transplant Cyclophosphamide and Bendamustine” (ClinicalTrials.gov identifier: NCT02996773). This trial was established to test bendamustine in humans, and Dr. Katsanis recently reported preliminary results in an interim analysis published in eJHaem, another British Haematology Society journal.

“The early results from this first half of the Phase 1 trial have shown bendamustine is well-tolerated,” Dr. Katsanis said. “It may have advantages to recovering white blood cell counts and platelets earlier, and less susceptibility to regenerating viral infections, such as cytomegalovirus (CMV) infection. We saw a statistically significant reduction in CMV,” a noteworthy posttransplant complication.

Dr. Katsanis’ expertise in haplo-BMT also has produced promising findings for pediatric and young adult patients. He and a team of researchers recently published in Frontiers in Pediatrics the largest pediatric study of its kind to date in North America. The study demonstrated that of 21 pediatric and young adult patients who received haplo-BMT for hematlogic malignancies (cancers that affect the blood, bone marrow and lymph nodes) at Banner Children’s at Diamond Children’s Medical Center, 84% were alive with a median follow-up of more than two years.”

That survival rate is a significant result, providing hope for patients and their families.

“Haplo-BMT is expanding throughout the world,” Dr. Katsanis said. “This treatment is easier, faster and less expensive to find a donor. Now, we are trying to make it even safer and more effective for patients.”

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NOTE: Photos available upon request.

About the University of Arizona Cancer Center
The University of Arizona Cancer Center is the only National Cancer Institute-designated Comprehensive Cancer Center with headquarters in Arizona. The UArizona Cancer Center is supported by NCI Cancer Center Support Grant No. CA023074. With primary locations at the University of Arizona in Tucson and at Dignity Health St. Joseph’s Hospital and Medical Center in Phoenix, the Arizona Cancer Center has more than a dozen research and education offices throughout the state, with more than 300 physicians and scientists working together to prevent and cure cancer. For more information: cancercenter.arizona.edu (Follow us: YouTube).

About the University of Arizona Steele Children’s Research Center
The University of Arizona Steele Children’s Research Center is one of the prestigious Centers of Excellence in the College of Medicine – Tucson at the UArizona Health Sciences. It is the state’s only academic pediatric research center designated by the Arizona Board of Regents, and the only facility in Southern Arizona where researchers and physician-scientists are dedicated to advancing medical knowledge through basic and translational research to improve children’s health. As researchers, they seek to discover answers to children’s medical mysteries. As physician-scientists, they provide compassionate care to hospitalized patients at Banner Children’s at Diamond Children’s Medical Center and pediatric outpatient clinics throughout Tucson and the state. And, as faculty members with the UArizona Department of Pediatrics, they teach and train the next generation of pediatricians and pediatric researchers. For more information: steelecenter.arizona.edu (Follow us: Facebook | Twitter | Instagram).

About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. UArizona Health Sciences includes the Colleges of Medicine (Tucson and Phoenix), Nursing, Pharmacy, and the Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, Health Sciences reaches across the state of Arizona, the greater Southwest and around the world to provide next-generation education, research and outreach. A major economic engine, Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners $200 million in research grants and contracts annually. For more information: uahs.arizona.edu (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram).

Journal

Frontiers in Pediatrics

DOI

10.3389/fped.2020.00282

Immunising pregnant women with a potential vaccine against RSV could prevent the most common cause of pneumonia in their babies.

Professor Shabir A. Madhi of the University of the Witwatersrand, Johannesburg, is the lead author of a study published in the prestigious New England Journal of Medicine on Thursday, 30 July 2020.

The multinational, multicentre study reports on the first RSV vaccine to provide evidence that inmunisation of pregnant woman could protect young infants under six months old against severe RSV lower respiratory tract infection (LRTI).

Wits Professor of Vaccinology is lead author of an article in NEJM today about vaccinating pregnant women against Respiratory Syncytial Virus.

"Of particular interest is an analysis of the data by sub-populations, which suggests that the vaccine better protects infants born to women from low- and middle-income countries [LMICs], such as South Africa. These participants constituted more than two-thirds of those enrolled," says Madhi.

The RSV vaccine administered in the study is a nanoparticle vaccine developed by Novavax (Maryland, USA). Although the vaccine did not fulfil the stringent criteria for licensure by the U.S. Food and Drug Administration, the study itself provides the first evidence that maternal vaccination could protect infants against RSV illness.

"The Prepare™ Phase 3 clinical trial was highly instructive, demonstrating a maternal immunisation strategy is viable, and modulating RSV disease in this way could have beneficial long-term impacts", says Dr Gregory M. Glenn, President of Research and Development of Novavax. "We are continuing to explore options to move the programme forward and bring ResVax to market globally with commercial partners."

Infants most vulnerable to respiratory viruses

Covid-19 has dominated the news headlines recently to the point that concern for other infectious diseases, , many of which disproportionately affect those living in low- and middle-income countries such as South Africa, is significantly reduced.

Babies and young children, who often suffer the greatest consequences of illness and death from respiratory pathogens, are fortunately and remarkably spared from severe Covid-19 illness.

"However, children under five and particularly infants up to six months old are at greatest risk of developing lung infections [pneumonia] due to a multitude of other respiratory viruses and bacteria," says Madhi.

A virus from the 1960s

Respiratory Syncytial Virus was first discovered in the 1960s as a cause of lower respiratory tract infection (LRTI) in childhood. In 2019, another large multicentre study reported that approximately one-third of pneumonia hospitalisations in infants are due to RSV.

Globally, in children under five-years-old, there are 3.2 million hospitalisations for RSV LRTI in children younger than five-years-old. Of those hospitalised, 118 000 die. Additionally, 44% of the hospitalisations and 46% of the in-hospital deaths occurred in infants younger than six-months-old.

In South Africa, approximately 178 000 to 443 000 children under five-years-old will develop RSV LRTI annually. Notably, approximately 45% of all severe RSV hospitalisations and deaths occur in infants under six months old. These episodes would be difficult to prevent by vaccinating the infant directly.

Since its discovery 60 years ago, there have been multiple attempts to develop a vaccine against RSV, all of which have been unsuccessful.

"Although it is disappointing that this vaccine will not be licenced based on the study results, it nevertheless paves the way for the development of this and/or other RSV vaccines for pregnant women to protect their infants against RSV during their first six months of life when they are most vulnerable to severe illness and death from RSV," says Madhi.

About the RSV vaccine study

In this study, 4 636 pregnant women at between 28 to 36 weeks' gestation were immunised with a single dose of an RSV vaccine, or a placebo, to induce an antibody response by the immune system to the RSV F-protein in the vaccine. Approximately half of these women were enrolled in South Africa.

These maternal antibodies are then transferred naturally to the foetus during pregnancy and provide the first line of defence in protecting infants against RSV LRTI during the first 90 to 180 days of life. The study showed that vaccination during pregnancy was safe in the women and their infants.

Key findings of this study show that infants born to women who received the RSV vaccine were 44% less likely to be hospitalised for RSV LRTI.

Furthermore, these infants were 32% less likely to be hospitalised for pneumonia due to any cause in the first six months of their life.

Vaccine better protects infants of mothers from LMICs

An intriguing finding of the study is that when the analyses were stratified [a method of sampling from a population which can be partitioned into sub-populations] by country income status, the vaccine appeared to be more protective in infants born to women from LMICs, a grouping which constituted more than two-thirds of the enrolled study participants.

In particular, infants through to six months of age born to RSV-vaccinated women from LMICs were 53% less likely to be hospitalised for RSV LRTI and 69% less likely to have severe hypoxemia [low blood oxygen] due to RSV LRTI than infants of LMIC woman who did not receive the vaccine.

Furthermore, these infants born to vaccinated women were 39% and 59% respectively less likely to be hospitalised for all-cause LRTI and LRTI with severe hypoxemia.

These data show the significant potential of an RSV vaccine for public health benefit in LMICs, which contribute more than 90% of all deaths from RSV and 50% of which occur outside health facilities.

VIDA vaccines for Africa

The South African leg of the RSV study was conducted by Madhi's Vaccines and Infectious Diseases Analytics Research Unit (VIDA) (which is the South African Medical Research Council [SAMRC]-affiliated unit formerly known as the Respiratory and Meningeal Pathogens Research Unit [RMPRU]) - as well as at other sites in South Africa.

VIDA is in the School of Pathology in the top 100 globally ranked-Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg (Wits).

This RSV study adds to other key studies on life-saving vaccines undertaken by Madhi and his team at VIDA. Previous vaccine-related studies also published in high-impact prestigious journals include:

The evaluation of seasonal influenza vaccine in pregnant women to protect the mother-infant dyad [couple] study (June 2016);

The pneumococcal conjugate vaccine to protect against the leading cause of childhood pneumonia death study (July 2002);

The study on the rotavirus vaccine, which protects against the leading cause of childhood diarrhoeal death (August 2013).

These studies have informed World Health Organization policy on the use of these vaccines in National Public Immunisation programmes and have led to South Africa being the first country in Africa to introduce such vaccines to its public immunisation programme.

Professor Shabir Madhi now leads Africa's first Covid-19 vaccine trial currently underway.

PHOENIX, Ariz. -- July 31, 2020 -- A scientific team led by the University of Arizona and the Translational Genomics Research Institute (TGen), an affiliate of City of Hope, identified a robust set of biomarkers through proteomics and metabolomic analysis that could help guide treatment for tens of millions of patients who each year sustain brain injuries, potentially preventing severe long-term disabilities.

The team's findings were reported in a study published today in the Nature journal: Scientific Reports.

An estimated 69 million people worldwide annually sustain traumatic brain injury (TBI). That includes at least 3 million in the U.S., resulting in nearly 288,000 hospitalizations, 56,800 deaths and more than 90,000 with permanent disabilities.

One of the practical applications of the study was to show the effectiveness of a treatment for brain injuries known as RIC (Remote Ischemic Conditioning). RIC involves, for example, using a tourniquet to restrict, then release, the flow of blood in one of the head-injury patient's arms or legs. Scientists still don't know why, but circulating molecules in the bloodstream are produced that could help the brain minimize or repair the injury through this seemingly unrelated technique of on-again, off-again flow of oxygen and nutrients to a patient's limb.

"The molecules released by alternately restricting and releasing the blood flow seem to have a neuro-protective effect," said Dr. Patrick Pirrotte, Director of TGen's Collaborative Center for Translational Mass Spectrometry and one of the study's senior authors.

Using mice models and TGen's state-of-the-art mass spectrometry facility to analyze proteins and metabolites, Dr. Pirrotte's team identified biomarkers that showed the effectiveness of RIC, and additional biomarkers that could be used to measure the presence of the injury.

Premature return to normal or strenuous activities can worsen the (TBI) condition and induce chronic health-related issues, the study says, further exacerbating the onset of neurodegenerative diseases.

"The biomarkers we identified allow us to measure the extent of the injury, and monitor RIC-aided recovery from brain injury," said Dr. Khyati Pathak, a member of Dr. Pirrotte's team and one of the study's authors.

The newly-identified biomarkers can provide a more exacting, molecular-level diagnosis of TBI.

"Traumatic brain injury, particularly in its less severe form, may not seemingly require hospitalization or an emergency room visit," said Dr. Jonathan Lifshitz, Director of the UArizona's Translational Neurotrauma Research Program: a joint venture between the UArizona College of Medicine-Phoenix; a branch of Barrow Neurological Institute at Phoenix Children's Hospital; and the Phoenix VA Health Care System.

"For millions of individuals, there often is no health care access immediately after TBI events, whether it be organized sports, recreational activities, occupational hazards, military service, or domestic violence," said Dr. Lifshitz, one of the study's senior authors.

The use of RIC -- the alternating restriction and release of blood flow to an arm or leg -- has been shown in clinical studies to be effective in other emergency medical situations, including cardiac arrest, organ transplantation, and lung injury.

"RIC is an easy to teach, practical intervention for a brain injury outside of the hospital setting. It allows for immediate care to the patient with the intent to reduce brain injury pathology," said Dr. Maha Saber, who is affiliated with Barrow and UArizona and is the study's lead author.

What The Study Did: This study defines the screening performance standards for SARS-CoV-2 tests that would permit the safe return of students to U.S. residential college campuses this fall.

Authors: A. David Paltiel, Ph.D., of the Yale School of Public Health in New Haven, Connecticut, 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/jamanetworkopen.2020.16818)

Editor's Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

What The Viewpoint Says: Targetable biological mechanisms implicated in emergent psychiatric conditions associated with SARS-CoV-2 infection are discussed in this Viewpoint.

Authors: Teodor T. Postolache, M.D., of the University of Maryland in Baltimore, 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/jamapsychiatry.2020.2795)

Editor's Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, conflicts of interest and financial disclosures, and funding and support.

Is the long-term use of glucocorticoids essential in people with chronic inflammatory diseases such as rheumatoid arthritis, or can early discontinuation prevent characteristic side effects? How can these drugs be discontinued without giving rise to glucocorticoid withdrawal syndrome? These were the questions addressed by the SEMIRA study, a large European trial led by Charité - Universitätsmedizin Berlin. According to the trial's findings, continuous glucocorticoid regimens were better at controlling disease activity. However, discontinuation also proved successful in the majority of cases, and could be used to prevent the long-term side effects associated with glucocorticoid treatment. Results from this trial have been published in The Lancet.*

Glucocorticoids, such as cortisone, are highly effective in controlling inflammatory diseases. Their long-term use, however, is associated with severe side effects, including cardiovascular disorders, osteoporosis and infections. These drugs also suppress the adrenal glands, thereby impairing the body's ability to produce its own cortisone. This can lead to fatigue, nausea and low blood pressure, and can even prove life-threatening. An appropriate period of gradual dose reduction - known as tapering - is essential to enable the body to adapt to a reduced supply of this substance and prevent withdrawal syndrome. Tapering glucocorticoids without triggering a recurrence of inflammation is a common challenge faced by many medical specialties.

"We had not previously had access to data from double-blind, randomized, placebo-controlled trials which compared a tapering regimen for low-dose prednisone - the most common glucocorticoid used - with continued use of low-dose prednisone. In the SEMIRA trial, our comparative analysis focused on rheumatoid arthritis, a condition commonly treated with glucocorticoids," explains the article's first author, Prof. Dr. Gerd-Rüdiger Burmester, Head of the Medical Department, Division of Rheumatology and Clinical Immunology on Campus Charité Mitte. He and his Deputy Head of Department, Prof. Dr. Frank Buttgereit, form part of the team responsible for conducting the Steroid Elimination In Rheumatoid Arthritis (SEMIRA) study, a trial including more than 250 participants recruited from close to 40 trial centers in six different countries.

All recruited patients had been receiving glucocorticoids for a minimum of six months, meaning their disease-related inflammation was well-controlled. Patients in the control group continued to receive prednisone at a similar dose for a duration of six months, while patients on the dose reduction regimen had their treatment tapered down to zero over the course of four months. Both groups received the anti-interleukin-6 receptor antibody tocilizumab as adjunctive therapy. Treatment successfully prevented disease flare-ups in 77 percent of patients on the continued prednisone regimen. The same outcome was achieved in 65 percent of patients on the tapering regimen. Fortunately, neither of the two groups had to contend with clinically relevant changes in their laboratory parameters, disease-related inflammation or other severe problems.

"The fact that glucocorticoid tapering was associated with a treatment success rate of 65 percent is of enormous significance for shared decision-making involving patients. It will now be possible to decide, on a case-by-case basis, whether glucocorticoid treatment should continue or whether tapering should be attempted," says Prof. Burmester. He adds: "Our results also set the scene for studies to investigate glucocorticoid tapering in other clinical settings - for instance in the fields of allergology, neurology and dermatology - where these drugs are also used, and where there is a certain level of uncertainty regarding the risks and benefits of discontinuing treatment."

Biologists have long known that inbreeding can be detrimental. Inbreeding results in less genetic variation, making species more vulnerable if changes occur that require them to adapt.

Now we know more about just how bad inbreeding really is.

"Inbreeding is equally harmful regardless of the environment," says Henrik Jensen, a professor at the Norwegian University of Science and Technology's (NTNU) Department of Biology.

Professor Jensen is the last author of a comprehensive study using the house sparrow as a model system. The study has now been published in the prestigious Proceedings of the National Academy of Sciences of the United States of America.

Serious consequences

The researchers examined 3100 house sparrows from eight islands along the Helgeland coast in Nordland county to see how inbreeding affected the birds.

Scientists have been investigating the sparrows on these islands for almost 30 years. They know the populations well and can follow the life of the birds from hatching to dying. This means the researchers know which birds survive from one year to the next, and how many of the young parents produce each year still alive to reproduce themselves the next breeding season.

The result is clear. Inbreeding has serious consequences.

Gene tests showed that birds with a high degree of inbreeding had shorter lives and reproduced more poorly than birds that were not as inbred. As expected, the inbred birds also had less variation in thousands of genes spread across the various chromosomes in the house sparrow's genome.

Inbreeding means that sparrows don't live as long and produce fewer young, regardless of the islands they are on and when they are born.

It may appear that the degree of inbreeding itself - rather than the environment the birds are in - determines how harmful inbreeding is for the individual birds.

"The more inbred the birds are, the shorter their lives and the less successful they are at producing offspring. How serious inbreeding is for a house sparrow doesn't seem to depend on the size of the population it is part of," Jensen says.

It comes as a surprise that the environment plays a minor role in how harmful inbreeding is. This finding goes completely against what most biologists have believed so far. The previous understanding was that the environment largely determines how detrimental inbreeding is.

Important to preserve species

The study findings could have consequences for how we preserve threatened species, since we now recognize that inbreeding is harmful regardless of the environment.

Both birds and other animals are often isolated in smaller groups, or populations, which are completely separate from other animals of the same species. Often the groups are isolated from one another due to human activity.

This is the case with lions, for example, which previously existed in large, interconnected areas that spanned several continents, but are now only found in pockets in Africa and India. This also applies to Scandinavian Arctic foxes and wolves.

"Many endangered species are struggling with inbreeding and inbreeding depression," says Jensen.

We don't yet know how important these factors are for the survival probability of these species and populations, nor for conserving biological diversity.

Theoretically, this could be of great importance, but in practice it is difficult to investigate how important inbreeding is relative to other genetic and ecological processes.

Small groups at greatest risk

Experts expect small groups of animals to be more susceptible to inbreeding than large populations. Fewer animals reproduce with each other, and these are likely to be related. Thus, the genetic variation will be smaller initially than in larger groups.

It is disadvantageous for these groups to become too small and receive no external influx of genetic variation.

"In our study we also found that the sparrows were generally more inbred in small populations than in large ones. Since the effect of a certain degree of inbreeding was the same in the different populations, inbreeding thus had greater significance for variation in survival and producing young in the small populations than in the large populations," says Jensen.

For people who manage animals, it is important to keep in mind that small populations that don't have contact with other populations may have difficulty surviving over time. These groups may be more susceptible to diseases and environmental changes.

"We have talented people on board, both at NTNU's Centre for Biodiversity Dynamics (https://www.ntnu.edu/cbd) and externally, to continue using data from the sparrow populations on the Helgeland coast.

The researchers need to study several factors:

The genetic reasons for inbreeding's negative effects on survival and reproduction.

The importance of dispersal of individuals between populations for inbreeding and inbreeding depression.

How inbreeding actually influences the ability to adapt to changes in the environment, and the growth rate and likelihood that populations survive over time.

Although we know a lot about this topic in theory, there are almost no studies of wild populations that have investigated these questions properly. This is partly due to the need for good data at the individual level (genetic data and information on survival and reproduction) over a long period and in multiple populations.

The sparrows on the Helgeland coast offer the possibility of collecting this information, and a lot of the knowledge gained will be transferable to other species elsewhere.

A study by scientists from the University of Southampton has examined the chances of catching COVID-19 in a train carriage carrying an infectious person.

Based on high-speed routes in China, researchers from WorldPop found that for train passengers sitting within three rows (widthwise) and five columns (lengthwise) of an infected person (index patient) between zero and ten percent (10.3) caught the disease. The average rate of transmission for these 'close contact' travellers was 0.32 percent.

The study, in collaboration with the Chinese Academy of Sciences, China Academy of Electronics and Information Technology, and Chinese Centre for Disease Control and Prevention, also showed that passengers travelling in seats directly adjacent to an index patient suffered the highest level of transmission, with an average of 3.5 percent contracting the disease. For those sitting on the same row, the figure was 1.5 percent.

The 'attack rate' for each seat - the number of passengers in a given seat diagnosed with COVID-19, divided by the total number of passengers travelling in the same seat - increased by 0.15 percent for every hour that a person travelled with an index patient. For those in adjacent seats, this rate of increase was higher at 1.3 percent per hour.

Interestingly, the researchers found that only 0.075 percent of people who used a seat previously occupied by an index patient went on to contract the disease.

Details are published in the journal Clinical Infectious Diseases.

The WorldPop team, experts in population mapping, used sophisticated modelling to analyse anonymised itinerary and infection data relating to train passengers on China's high-speed G train network. This included those who had COVID-19 at the time of travel and their close contacts (who showed symptoms within 14 days of travel). The data, covering a period between 19 December 2019 and 6 March 2020, included 2,334 index patients and 72,093 close contacts. Their travel times ranged from between less than an hour to eight hours.

Lead investigator, Dr Shengjie Lai, comments: "Our study shows that although there is an increased risk of COVID-19 transmission on trains, a person's seat location and travel time in relation to an infectious person can make a big difference as to whether it is passed on. The findings suggest that during the COVID-19 epidemic it is important to reduce the density of passengers and promote personal hygiene measures, the use of face coverings and possibly carry-out temperature checks before boarding."

The researchers conclude that given the attack rates estimated for passengers in the same row as an index patient, a safe social distance of more than one metre is required for one hour spent travelling together. After two hours of contact, they consider a distance of less than 2.5 metres may be insufficient to prevent transmission.

Director of WorldPop, Professor Andy Tatem adds: "Our research is the first to quantify the individual risk of COVID-19 transmission on public transport based on data from epidemiological investigations of disease cases and their close contacts on high-speed trains.

"It shows that the transmission risk not only relates to the distance from an infected person, but also the time in their presence. We hope it can help to inform authorities globally about measures needed to guard against the virus and in-turn help to reduce its spread."

When it comes to traumatic injuries, it's a race against time. A person with major hemorrhage can die from blood loss within minutes, so staunching the wound and getting them to a hospital as fast as possible is critical. Bleeding from the extremities can be slowed with compression but what about internal bleeding? In a hospital, internal bleeding can be controlled with the transfusion of clotting agents, such as platelets, but they require careful storage and refrigeration and can't be carried by first responders. As a result, the majority of people who succumb to traumatic injuries outside a hospital die from treatable hemorrhages.

Now, researchers from the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS), in collaboration with Massachusetts General Hospital, Beth Israel Deaconess Medical Center, and Case Western Reserve University, report an injectable clotting agent that reduced blood loss by 97 percent in mice models. The freeze-dried agent, which has a physical consistency of cotton candy, can be stored at room temperature for several months and reconstituted in saline before injection.

The research is published in Science Advances.

"Our goal was to give first responders a tool to stop internal bleeding that could be easily carried in a backpack or stored in an ambulance and, once injected intravenously in hemorrhagic patients, stop internal bleeding for a period long enough to get the patient to a hospital," said Samir Mitragotri, Hiller Professor of Bioengineering and Hansjorg Wyss Professor of Biologically Inspired Engineering at SEAS and senior author of the study.

Mitragotri is also a Core Faculty member at Harvard's Wyss Institute for Biologically Inspired Engineering.

Mitragotri and his team developed a polymer-peptide conjugate called HAPPI (Hemostatic Agents via Polymer Peptide Interfusion) that can selectively bind to damaged blood vessels and activated platelets at the bleeding site. Circulating platelets are like the body's EMTs -- they are constantly surveying the body for wounds. When there is an injury to a blood vessel, the platelets get activated and attach themselves to the damaged vessel, causing a blood clot.

HAPPI binds to these activated platelets and enhances their accumulation at a bleeding site. It can be injected anywhere in the body and still make its way to the wound.

In mice models, HAPPI significantly lowered the bleeding time and bleeding volume of injuries. The researchers observed about a 99 percent reduction in bleeding time and a 97 percent reduction in blood loss. The researchers also found that for traumatic injuries, the injection of HAPPI increased the median survival rate beyond one hour -- a critical goal for trauma care.

"A lot of trauma-related deaths happen within the first hour when blood loss is happening profusely and there is no intervention," said Yongsheng Gao, a postdoctoral research associate at SEAS and the co-first author of the paper. "A key objective for first responders is to keep trauma patients alive during this so-called golden hour and in that time bring them to a hospital because once they get to the hospital, it's a different game altogether."

"With HAPPI, we sought to develop a safe and effective internal bandage," said Apoorva Sarode, a former graduate student at SEAS and the co-first author of the study. "We think that the simple design and scalable synthesis process of HAPPI will facilitate its seamless scale-up and translation to larger animal models, and eventually to the patients."

Funding from Harvard's Blavatnik Biomedical Accelerator enabled the lab to advance and validate the technology in animal models. Going forward, the team aims to scale up the production of the materials and test it in larger animal models..

Harvard's Office of Technology Development has protected the intellectual property associated with this project and is exploring commercialization opportunities.

The paper was co-authored by Anvay Ukidve and Zongmin Zhao from Harvard SEAS, Shihui Guo and Robert Flaumenhaft from Beth Israel Deaconess Medical Center, Anirban Sen Gupta from Case Western Reserve University, and Nikolaos Kokoroskos and Noelle Saillant from Massachusetts General Hospital. The research was supported by the National Institutes of Health under grant R01HL129179.

Latest research from Affirmativ Health succeeds in treating cognitive decline using personalized, precision medicine.

Affirmativ Health sought to determine whether a comprehensive and personalized program, designed to mitigate risk factors of Alzheimer's disease could improve cognitive and metabolic function in individuals experiencing cognitive decline. Findings provided evidence that this approach can improve risk factor scores and stabilize cognitive function.

July 31, 2020/Sonoma, CA Cognitive decline is a major concern of the aging population. Already, Alzheimer's disease affects approximately 5.4 million Americans and 30 million people globally. Without effective prevention and treatment, the prospects for the future are bleak. By 2050, it is estimated that 160 million people globally will have the disease, including 13 million Americans, leading to potential bankruptcy of the Medicare system. Unlike several other chronic illnesses, Alzheimer's disease is on the rise--recent estimates suggest that Alzheimer's disease has become the third leading cause of death in the United States behind cardiovascular disease and cancer. Since its first description over 100 years ago, Alzheimer's disease has been without effective treatment. While researchers continue to seek out a cure, it is becoming clear that there are effective treatment options. More and more research supports the conclusion that Alzheimer's disease is not a disease of only Beta Amyloid plaques and Tao tangles but a complex and systemic disease. In this study of patients with varying levels of cognitive decline, it is demonstrated how a precision and personalized approach results in either stabilization or improvement in memory.

Interventions to stop the progression of Alzheimer's disease have been marginally successful at best. This study uses a more comprehensive, personalized approach addressing each participant's unique risk factors. "The findings, published in the Journal of Alzheimer's Disease Reports (Journal of Alzheimer's Disease Reports 4(1)), are encouraging and indicate that a more extensive clinical study is warranted", said Brian Kennedy, PhD, Director of The Centre for Healthy Aging, National University Health System, Singapore and Chief Scientific Officer, Affirmativ Health.

The Affirmativ Health scientific team, after thorough review of published research, has developed a comprehensive approach to addressing scientifically supported risk factors that have been rigorously defined as interventions to promote prevention, increased resiliency, and stabilization of brain function in the realm of AD and dementia. Utilizing cutting edge technology in concert with in-person coaching and consultation, we are demonstrating that a multi-modal and personalized approach promotes an improved resiliency and restoration of optimal brain function. The personalized therapeutic program includes genetics, an extensive blood panel, medical history and lifestyle data to evaluate relevant metabolic risk factors and nutrient levels associated with cognitive health. "Target laboratory levels differ from standard laboratory ranges as the goal is to reach optimized levels for cognitive health", Ginger Schechter, MD, Chief Medical Officer, Affirmativ Health

The study approach considers more than 35 factors known to contribute to cognitive decline. Results demonstrate that certain of those factors are more affected than others again demonstrating the need for a more precise treatment plan. "This study supports the need for an approach that focuses on a one-size fits one, not a one-size fits all, approach that comprehensively assesses all involved risk factors affecting memory loss", Denise M Kalos, CEO Affirmativ Health

In conjunction with the publication of this vital study, and to expose alternative treatment options for Alzheimer's disease and cognitive decline, the team at Affirmativ Health has written a book, Outsmart your Brain - an Insider's Guide to Life-Long Memory. "Memory is not something that should diminish with age; you are never too young to start developing healthy habits that can ultimately impact your cognition," Outsmart Your Brain. This book leverages the foundation of Affirmativ Health's research to deliver a tips and tools guide for the maintenance of good cognitive health. "Far too few people understand how critical lifestyle and dietary choices are for brain function. 'Outsmart Your Brain' is an important tool to get this information into the hands of those who should know it, everyone!, in easy-to-understand language", Ryan R. Fortna, MD, PhD, Chief Medical/Scientific Officer, ADx Healthcare.

FAYETTEVILLE, Ark. - The COVID-19 pandemic led to higher levels of depression, anxiety, suicidal tendencies and psychological trauma among American adults during the early months of its spread, according to three new studies published by University of Arkansas sociologists.

Using an internet survey distributed in the last week of March that sampled 10,368 adults from across the country, researchers have sought to better understand the sociological and psychological effects of the pandemic. The common denominator in their findings is fear, said Kevin Fitzpatrick, University Professor of sociology and first author of the studies.

"Fear is a pretty consistent predictor," Fitzpatrick said. "What we found is that fear, coupled with a range of social vulnerabilities, consistently and significantly predict a range of mental health outcomes. Additionally, as originally hypothesized, it appears as though individual fear is higher in those places where there is a higher concentration of confirmed COVID-19 cases and/or a higher death rate."

In a study focusing on symptoms of depression published in the journal Anxiety and Depression, Fitzpatrick and his colleagues Casey Harris, associate professor of sociology, and Grant Drawve, assistant professor of sociology, found that on average, survey respondents scored one point higher than the cutoff for clinical significance on a commonly used depression scale. Nearly a third of respondents were significantly above that level, they found. They also found elevated depressive symptoms among socially vulnerable groups including women, Hispanics, the unemployed and people who report moderate to high levels of food insecurity.

In a second study on suicidal thoughts, behaviors and actions published in the journal Suicide and Life-Threatening Behavior, the researchers found that 15 percent of all respondents were categorized as high risk for suicide. Blacks, Native Americans, Hispanics, families with children, unmarried and younger respondents scored higher on an symptom assessment of suicide risk than their counterparts, and compounding factors such as food insecurity and physical health symptoms increased the risk among respondents.

The third study, published in the journal Psychological Trauma, examined fear and mental health consequences of the pandemic. When researchers asked respondents how fearful they were of COVID-19 on a scale of one-to-10, the average answer was seven. But fear of the disease and its consequences is not evenly distributed throughout the country, they found; it was highest in areas with a greater concentration of COVID-19 cases and among the most socially vulnerable groups. "In short, fear of the virus, and subsequent mental health problems that follow, remain entangled with the types of policies and measures used to combat the virus, both now and as recovery continues to unfold and the United States begins to slowly move forward," the researchers wrote.

All three papers are part of an initial, early push to understand the sociological impact of COVID-19, said Fitzpatrick. While the situation has changed substantially since March when this National Science Foundation-funded survey was administered, the research points to a need to better understand the consequences of the pandemic so we'll be better prepared in the future.

"Now is the time to learn the lessons about this pandemic," said Fitzpatrick. "This needs to be a teaching moment for us all. It or something like it will come along again, and we need to be better prepared for it, making sure that science is front and center, and not politics, with a careful eye on who are the most vulnerable and how can we do a better job of protecting them."

DETROIT - Diabetes, obesity and nonalcoholic fatty liver disease (NAFLD) are all common diseases that can lead to serious health implications. NAFLD affects over 30% of Americans, and is characterized as a fatty liver, which can progress to an inflammatory and fibrotic liver, called nonalcoholic steatohepatitis (NASH), as well as liver cirrhosis.

The molecular causes of NAFLD and NASH are still not fully understood and, to date, no FDA-approved drug is available for NAFLD. A major hurdle for scientists is understanding the causal relationships between NAFLD, diabetes and obesity, which are often presented together in patients and treated as comorbidities. Without a clear understanding of their causal relationship and root cause, drug development may fail.

Faculty from Wayne State University's Eugene Applebaum College of Pharmacy and Health Sciences are leading a team of researchers to understand the causal relationships between these three diseases in hopes of developing a treatment.

Wanqing Liu, Ph.D., associate professor of pharmaceutical sciences at Wayne State, along with his collaborators from the University of Michigan, Eugene Y. Chen, Ph.D. and Cristen Willer, Ph.D., recently published the paper, "Causal relationships between NAFLD, T2D and obesity have implications for disease subphenotyping," in the Journal of Hepatology that attempts to understand the molecular causes of NAFLD. The team conducted a large-scale genomic analysis called Mendelian randomization, a strategy similar to a randomized clinical trial that relies on a naturally occurred randomization of genetic alleles in human populations.

"We used genomic data of over 400,000 individuals obtained from a biobank in the United Kingdom, in which more than 500,000 residents have been sequenced for their genome and shared their health data," said Liu. "We also leveraged genomic data of nearly 900,000 individuals that are a part of an international consortium researching diabetes and obesity. This largest-to-date data analysis allows us for the first time to determine the causal relationship between NAFLD and type-2 diabetes (T2D), as well as between NAFLD and obesity."

The team discovered that NAFLD can be separated into at least two subtypes, those mainly caused by "nature" (genetics) and those caused by "nurture" (metabolic syndrome such as T2D or obesity as a primary cause). Genetically driven NAFLD can promote the development of an atypical type of diabetes that is characterized by hyperglycemia, but not necessarily insulin resistance. Surprisingly, NAFLD does not lead to overall obesity, but rather promotes the development of central obesity. This NAFLD subtype is also characterized by a lower blood level of cholesterol.

In the "nurture" model, both T2D and obesity or central obesity can lead to the development of NAFLD. In this case, NAFLD may be secondary to T2D or obesity. To further verify these findings, Liu and his team developed a genetically engineered mouse model with a human mutation created in the patatin like phospholipase domain containing 3 (PNPLA3) gene, a known genetic cause for NAFLD in humans. Working with this model along with a team from Charlie Dong Ph.D.'s lab at the Indiana University School of Medicine, the researchers confirmed findings discovered in human genomic data.

"This study has important implications for disease classification, diagnosis and drug development," said Liu. "Further, it highlighted the importance of the development of precision medicine for both prevention and treatment of these diseases. For example, the study indicated that individuals having a high genetic risk for NAFLD may appear to be 'healthy' given that they tend to be lean, less resistant to insulin, and have low or regular blood cholesterol levels. However, they are likely underdiagnosed for NAFLD, leading to a higher risk of disease progression in these individuals. For the patients who have this disease subtype, drug development should be focused on targeting the genetic causes in the liver. On the other hand, people having a high genetic risk for diabetes and obesity who also develop NAFLD are likely to benefit from reducing their weight and controlling blood glucose."

The team also found that NAFLD caused by the PNPLA3 gene mutation may actually develop a late-onset type 1 diabetes rather than the typical T2D characterized by insulin resistance. While this must be further clarified clinically in human patients, it is a reminder that many T2D patients may be misdiagnosed and their treatment should be altered accordingly.

By screening potential monoclonal antibody (mAb)-based drugs solely based on a measure of their colloidal stability, scientists may be able to weed out mAbs that do not respond efficiently in solution early in the drug discovery process, according to a new study. This finding could enable researchers to overcome a major hurdle to drug development by identifying promising mAb-based therapies, which must be administered via injection yet often lack the properties necessary to succeed as solutions. "Therapeutic antibodies that neutralize pathogens are a promising way to treat infectious disease," says Jonathan Kingsbury, the first author of the study. "Selection of well-behaved antibodies with molecular properties that enable streamlined manufacturing, scale-up, and subcutaneous delivery is key for rapid development, particularly during a pandemic response." Although mAbs have emerged as a major class of therapeutic agents, they do not sufficiently enter the bloodstream when taken orally. When these drugs are prepared as solutions so they can be injected, they often exhibit undesirable characteristics such as becoming too viscous or exhibiting a predisposition toward phase separation, precipitation, or aggregation. To determine which factors best predict how mAb-based drug candidates will respond as solutions, Kingsbury and colleagues measured the viscosity and opalescence (a display of milky brightness and colors from light that can serve as an indicator of other inconsistencies) of 59 mAb solutions, including 43 approved products. They correlated these undesirable properties to an array of 23 molecular descriptors to explore whether they were tied to, for example, hydrophobic or colloidal properties. The researchers found that mAb solution behavior could be predicted with greater than 90% accuracy based on solely on its diffusion interaction parameter - a measurement of dynamic light scattering that identifies when the protein will begin to unfold and how this will impact its stability. Since diffusion interaction served as a better predictor than any other attribute Kingsbury et al. tested, they conclude that it may serve as a valuable tool to facilitate mAb-based drug development.