Culture

As news of the coronavirus swept the nation in March 2020, the risks of COVID-19 infection and infection-fatality were still unclear.

Perhaps as a result, a new study found respondents showed large disagreements between the risks of COVID-19 infection. Yet, those who perceived a higher risk indicated they were more likely to engage in handwashing and other protective behaviors. And participants seemed more willing to act on their risk perceptions as the pandemic progressed and the risks became more real.

The study was led by Wändi Bruine de Bruin of the USC Schaeffer Center for Health Policy & Economics and the Price School of Public Policy and Daniel Bennett of USC Dornsife and published in the American Journal of Preventive Medicine. Bennett and Bruine de Bruin believe that the results may help public health and policy leaders in developing effective risk communication and information sharing.

"If people think that the risks of infection and associated consequences are low, then they may not feel the need to implement the recommended protective behaviors," said Bruine de Bruin who co-directs the USC Schaeffer Center's Behavioral Sciences Program and is a USC Provost Professor of Public Policy, Psychology, and Behavioral Sciences.

Coronavirus Risk Led to Behavioral Changes, Including Handwashing, Social Distancing, and Travel Plans

For the March survey, 6,684 individuals participated, with roughly half completing it before March 13 when the White House declared COVID-19 a national emergency. Half the respondents completed it later in March.

Most but not all respondents reported taking actions to protect themselves. Across the entire sample, 90% reported handwashing, 58% reported avoiding high-risk individuals, 57% reported avoiding crowds, and 37% reported canceling or postponing travel.

The median survey respondent saw a 10% chance of catching the coronavirus. If infected, the median respondent perceived a 5% risk of dying.

But the authors point out that respondents showed large disagreement in perceived infection risk. And this disagreement correlated with differences in reported rates of protective behavior.

For example, reports of handwashing increased from 83% among the quarter of respondents who perceived the lowest risk of COVID-19 infection to 94% among the quarter who perceived the highest risk. Similarly, reports of avoiding public spaces or crowds as a protective measure increased from 45% for those reporting low perceived risk to 67% for those reporting highest risk.

"Every day we assess risks and decide how much to protect ourselves," said Bennett. "It's not clear how people make these decisions for a new and unfamiliar disease." Bennett is an assistant professor (research) of economics at the Center for Economic and Social Research who studies how people make health decisions.

Perceived Risk and Correlations with Protective Behaviors Intensified Later in March

Because the survey was released mid-March, with some individuals responding earlier than others, the researchers were able to examine how risk perceptions and protective behaviors changed as the initial stage of the epidemic unfolded. All told, half the respondents completed the survey after March 13, when the White House issued a national emergency and banned European travel while several states announced school closures and bans of large gatherings.

Late responders showed greater likelihood to engage in protective behaviors:

Reports of handwashing increased from 86% among earlier responders to 93% among those who responded after March 13.

Avoiding public spaces or crowds increased from 43% to 71%

Avoiding high-risk individuals increased from 46% to 71%

Canceling or postponing travel increased from 24% to 49%.

Furthermore, association between perceived COVID-19 infection risk and protective behaviors was stronger for later responders.

"Early on in March, the risks of infection were perceived as relatively lower compared to later in March. But even people who saw greater risks were not yet as willing to act upon them," said Bruine de Bruin. "That's likely because the mixed messages people were receiving made the risks still seem relatively uncertain, not as imminent, and affecting mostly other countries. As the epidemic progressed, those perceptions changed."

"In other words, our findings show that risk perceptions and behavior are connected. Moving forward, and when opening the country back up, policymakers need to provide clear and consistent messages about what the risks are and what people can do about them," explained Bruine de Bruin.

For black Americans - particularly men - growing up in better neighborhoods doesn't diminish the likelihood of going to prison nearly as much as it does for whites or Latinos, new Cornell research shows.

"If you're a black male in America, it doesn't matter much if you come from a good neighborhood or a bad neighborhood," said Steven Alvarado, assistant professor of sociology in the College of Arts and Sciences. "Your chances of being incarcerated are similar."

Alvarado is the author of "The Complexities of Race and Place: Childhood Neighborhood Disadvantage and Adult Incarceration for Whites, Blacks, and Latinos," published June 1 in the journal Socius.

The study's publication at a time of widespread demonstrations against police brutality and racial injustice was coincidental, but Alvarado said its findings lend support to calls for structural reform.

"There's a systemic and a deep inequality in American society," he said, "in terms of the treatment of blacks in the criminal justice system that might mute some of those beneficial effects of growing up in a more advantaged neighborhood."

Alvarado analyzed restricted data from the U.S. Bureau of Labor Statistics' National Longitudinal Survey of Youth that followed thousands of diverse Americans growing up between 1986 and 2014. That 28-year period coincided with an acceleration of mass incarceration and residential segregation in the U.S., Alvarado said.

Linking the NLSY survey data to census tract data, he ranked neighborhoods' relative advantage or disadvantage based on characteristics including housing values and levels of income, employment and education.

By comparing outcomes among siblings, Alvarado controlled for some "unobserved" variables not measurable in the surveys - such as genetics, parenting strategies and family events - that might influence an individual's chances of incarceration.

The data confirmed that blacks, whites and Latinos who grew up in tougher neighborhoods all are more likely to go to prison or jail than counterparts who grew up in better neighborhoods, as one might expect.

But while the chances of incarceration dropped sharply for whites and Latinos from advantaged neighborhoods, black adults benefited about half as much from that upward neighborhood mobility, Alvarado found.

Alvarado called that finding sobering and surprising. Considerable research has touted the benefits of moving people into less poor neighborhoods to improve outcomes, he said, but few studies have looked at incarceration as an outcome.

"My findings complicate that a little bit and tell us that when it comes to incarceration we might want to also think about larger structural changes to criminal justice in the United States," he said, "and not simply moving people from one neighborhood to another as a sufficient way to address this issue."

Blacks enjoy fewer protective effects from good neighborhoods with respect to incarceration, Alvarado suggests, because of the nation's highly racialized criminal justice system.

"More than other racial and ethnic groups, the odds of experiencing incarceration for blacks may be tied to racial profiling, surveillance, stop-and-frisk policies, gang injunctions and other forms of social control that affect all black Americans, regardless of their family and neighborhood origins," he wrote.

Recent events have made that reality more apparent to all Americans, Alvarado said, adding that his research provides some hard data that supports calls for systemic reform led by the Black Lives Matter movement.

"It's very difficult for black Americans to find refuge from incarceration," he said. "We're seeing that play out now in terms of the demonstrations and the policy changes that municipalities are starting to consider."

BIRMINGHAM, Ala. - Researchers who made a knock-in mouse-model of the genetic disorder retinitis pigmentosa 59, or RP59, expected to see retinal degeneration and retinal thinning. As reported in the journal Cells, they surprisingly found none, calling into question the commonly accepted -- though never proved -- mechanism for RP59.

"Our findings bring into question the current concept that RP59 is a member of a large and diverse class of diseases known as 'congenital disorders of glycosylation,'" said Steven Pittler, Ph.D., professor and director of the University of Alabama at Birmingham School of Optometry and Vision Science Vision Science Research Center. "While in principle it would be reasonable to consider RP59 as a congenital disorder of glycosylation, due to the associated mutation in DHDDS, an enzyme required for glycosylation, there is no direct evidence to demonstrate a glycosylation defect in the human retinal disease or in any animal model of RP59 generated to date."

This means the mechanism of DHDDS-dependent retinal degeneration in human RP59 patients remains unknown, and appears to be more complex than just a DHDDS loss of function.

Retinitis pigmentosa is a group of rare genetic disorders affecting the light-sensitive retinal tissue at the back of the eye. Patients first notice night blindness and loss of peripheral vision, and the disease can progress to vision loss and legal blindness. RP59 has changes in the gene for DHDDS, one of the 50 genes that can lead to RP. RP59 is found in one in 100 Ashkenazi Jewish people and one in 2,009 people worldwide.

In RP59, the lysine that is the 42nd amino acid of the DHDDS enzyme is changed to a glutamic acid, a change known as a K42E point mutation. So Pittler and colleagues at UAB and the State University of New York at Buffalo, or SUNY-Buffalo, examined the retinas of mice that were made homozygous for a DHDDS K42E mutation.

Using spectral domain-optical coherence tomography, they found no evidence of retinal degeneration, even up to one year of age. Also, there was no evidence of compromised protein N-glycosylation, meaning there was no significant DHDDS loss of function in the K42E mice. Opsin, a protein in photoreceptor cells involved in vision, is often mislocalized when photoreceptor cells degenerate; however, the K42E mice showed no change in opsin localization.

What the researchers did find was extensive gliosis in the retinas of the mutant mice, which was spread in a radial pattern throughout the inner retinal layers to the outer plexiform layer of the retina. There was also intense gliosis at the vitreoretinal interface. Gliosis is a change in glial cells of the central nervous system, often in response to injury. In the retina, it affects glial M?ller cells, and that reactive gliosis can have harmful effects on vision.

"These results indicate massive gliotic activation," Pittler said, "which is remarkable considering the lack of overt retinal degeneration or loss of retinal neurons."

Frailty is the medical term for becoming weaker or experiencing lower levels of activity or energy. Becoming frail as we age increases our risk for poor health, falls, disability, and other serious concerns.

Aging increases the risks for becoming frail. As more of us live longer, it's likely that frailty will pose a larger public health problem in the near future. Experts in geriatrics (the field of health care focused on care for older adults) suggest that maintaining a healthy lifestyle may reduce your chances of becoming frail.

One aspect of a healthy lifestyle is getting regular physical activity. However, studies on the association between physical activity and frailty among older adults show different results. Some studies suggest that regular physical activity could delay frailty and reduce its severity, but other studies do not. And most of the studies have examined people aged 50 to 70, so the information we have for people over age 70 is limited.

To address this gap, researchers conducted a new study as part of a European project that promotes healthy aging in older adults. They examined the benefits of assistance that helps older adults follow their prescribed medications and prevent falls, frailty, and loneliness. The participants received care at study sites in five European countries (Spain, Greece, Croatia, the Netherlands, and the United Kingdom). The study results were published in the Journal of the American Geriatrics Society.

Among other questions, the participants were asked, "How often do you engage in activities that require a low or moderate level of energy such as gardening, cleaning the car, or taking a walk?"

Researchers considered that "regular frequency" was engaging in such activities more than once a week; "low frequency" involved engaging in these activities once a week or less.

Of the participants, 1,215 adults over the age of 70 were included in the group that received assistance. 1,110 received no intervention but were followed for comparison. Participants in the first group received a risk assessment, shared decision-making, and care aimed at reducing their fall risk, inappropriate medication use, loneliness, and frailty.

Compared with participants who were moderately active at the start of the study, participants who were moderately active once a week or less were significantly more physically, psychologically, and socially frail at the study's follow-up period.

The participants who were regularly, moderately active were the least frail, and participants who were moderately active less than once a week were the most frail.

The researchers learned that people over 70 who were physically active on a regular basis, as well as people who increased their level of activity to a regular basis, were able to improve or maintain their level of frailty--not only physically, but also psychologically and socially.

Every time you hear a deep rumble and feel your house shake when a big truck roars by, that's partly because the weight of heavy vehicles causes a slight deflection in the road surface under them. It's enough of a dip to make a difference to the trucks' overall fuel efficiency.

Now, a theoretical study by MIT researchers suggests that small changes in roadway paving practices could reduce that efficiency loss, potentially eliminating a half-percent of the total greenhouse gas emissions from the transportation sector, at little to no cost.

The findings are detailed in a paper in the journal Transportation Research Record, by MIT postdoc Hessam Azarijafari, research scientist Jeremy Gregory, and principal research scientist in the Materials Research Laboratory Randolph Kirchain. The study examined state-by-state data on climate conditions, road lengths, materials properties, and road usage, and modeled different scenarios for pavement resurfacing practices.

They found that that one key to improving mileage efficiency is to make pavements that are stiffer, Kirchain explains. That reduces the amount of deflection, which reduces wear on the road but also reduces the slightly uphill motion the vehicle constantly has to make to rise out of its own depression in the road.

"When we as individuals walk on pavements, they seem like perfectly rigid things. They're not responding to us," he says. "But for trucks, that is not the case. There is enough of a deflection in that surface that some amount of energy is expended to overcome the little divot that you create as you drive along." He likens it to the difference between walking on a hard surface versus walking on sand, which takes more effort because you sink in with each step.

Looking to the future, Kirchain says that while projections show a slight decline in passenger car travel over coming decades, they show an increase in truck travel for freight delivery -- the kind where pavement deflection could be a factor in overall efficiency.

There are several ways to make roadways stiffer, the researchers say. One way is to add a very small amount of synthetic fibers or carbon nanotubes to the mix when laying asphalt. Just a tenth of a percent of the inexpensive material could dramatically improve its stiffness, they say. Another way of increasing rigidity is simply to adjust the grading of the different sizes of aggregate used in the mix, to allow for a denser overall mix with more rock and less binder.

"If there are high quality local materials available" to use in the asphalt or concrete mix, "we can use them to improve the stiffness, or we can just adjust the grading of the aggregates that we are using for these pavements," says Azarijafari. And adding different fibers is "very inexpensive compared to the total cost of the mixture, but it can change the stiffness properties of the mixture significantly."

Yet another way is to switch from asphalt pavement surfaces to concrete, which has a higher initial cost but is more durable, leading to equal or lower total lifecycle costs. Many road surfaces in northern U.S. states already use concrete, but asphalt is more prevalent in the south. There, it makes even more of a difference, because asphalt is especially subject to deflection in hot weather, whereas concrete surfaces are relatively unaffected by heat. Just upgrading the road surfaces in Texas alone, the study showed, could make a significant impact because of the state's large network of asphalt roads and its high temperatures.

Kirchain, who is co-director of MIT's Concrete Sustainability Hub, says that in carrying out this study, the team is "trying to understand what are some of the systemic environmental and economic impacts that are associated with a change to the use of concrete in particular in the pavement system."

Even though the effects of pavement deflection may seem tiny, he says, "when you take into account the fact that the pavement is going to be there, with thousands of cars driving over it every day, for dozens of years, so a small effect on each one of those vehicles adds up to a significant amount of emissions over the years." For purposes of this study, they looked at total emissions over the next 50 years and considered the reductions that would be achieved by improving anywhere from 2 percent of road surfaces to 10 percent each year.

With a 10 percent improvement rate, they calculated, a total of 440 megatons of carbon dioxide-equivalent emissions would be avoided over the 50 years, which is about 0.5 percent of total transportation-related emissions for this period.

The proposal may face some challenges, because changing the mix of materials in asphalt might affect its workability in the field, perhaps requiring adjustments to the equipment used. "That change in the field processing would have some cost to it as well," Kirchain says.

But overall, implementing such changes could in many cases be as simple as changing the specifications required by state or local highway authorities. "These kinds of effects could be considered as part of the performance that's trying to be managed," Kirchain says. "It largely would be a choice from the state's perspective, that either fuel use or climate impact would be something that would be included in the management, as opposed to just the surface performance of the system."

Interferons and other cytokines produced by the immune system are important defenses against viral infections, but as we have seen in COVID-19, they can also contribute to damaging, potentially life-threatening lung inflammation. Recent evidence suggests that one type of interferon, known as type III interferon or interferon lambda (λ), can fight viral infection while limiting this inflammatory damage. That has led to clinical trials to test type III interferon as a treatment for COVID-19.

But in the journal Science, researchers at Boston Children's Hospital, with collaborators in Italy, now provide evidence that type III interferons can increase the risk of life-threatening bacterial "superinfections" in the lung. Superinfections can occur in both influenza and COVID-19, and the investigators caution that type III interferons given later in the course of COVID-19 could do more harm than good.

"Our data indicate that SARS-CoV-2 inhibits interferon production in the upper airways, weakening the immune response and helping the virus survive," says senior investigator Ivan Zanoni, PhD, an immunologist at Boston Children's. "But when the virus reaches the lower airways, there is an exuberant immune response, including upregulation of type III interferons that we think is harmful."

The team first tested samples from patients with severe COVID-19 and healthy controls. Interferon III was not much increased in the patients' nasopharyngeal swab samples, but was markedly elevated in their lung fluid.

The researchers then exposed mice to synthetic viral RNA to mimic the effects of SARS-CoV-2 infection in the lower airways. They showed that interferon III levels rose markedly in the animals' lungs as compared with control mice, and that sustained production of interferon III prevented the lungs from maintaining their protective surface barrier. This, in turn, made the animals more susceptible to lethal bacterial infections from Staphylococcus aureus: experiments showed increased amounts of bacteria and higher mortality as compared with control mice.

"There's still a lot to understand, but it looks like location and timing of interferon production are key," says Zanoni. "Early during SARS-CoV-2 infection, when the virus is in the upper airways, it might be important to intervene with recombinant interferons and other antivirals. But later on, when inflammation is highly increased in the lower airways, it will be important to block the signaling cascade initiated by interferons and other inflammatory cytokines, possibly with the anti-inflammatory drugs."

Banks and bookstores. Gyms and juice bars. Dental offices and department stores. The Covid-19 crisis has shuttered some kinds of businesses, while others have stayed open. But which places represent the best and worst tradeoffs, in terms of the economic benefits and health risks?

A new study by MIT researchers uses a variety of data on consumer and business activity to tackle that question, measuring 26 types of businesses by both their usefulness and risk. Vital forms of commerce that are relatively uncrowded fare the best in the study; less significant types of businesses that generate crowds perform worse. The results can help inform the policy decisions of government officials during the ongoing pandemic.

As it happens, banks perform the best in the study, being economically significant and relatively uncrowded.

"Banks have an outsize economic impact and tend to be bigger spaces that people visit only once in a while," says Seth G. Benzell, a postdoc at the MIT Initiative on the Digital Economy (IDE) and co-author of a paper published Wednesday that outlines the study. Indeed, in the study, banks rank first in economic importance, out of the 26 business types, but just 14th in risk.

By contrast, other business types create much more crowding while having far less economic importance. These include liquor and tobacco stores; sporting goods stores; cafes, juice bars, and dessert parlors; and gyms. All of those are in the bottom half of the study's rankings of economic importance. At the same time, cafes, juice bars, and dessert parlors, taken together, rank third-highest out of the 26 business types in risk, while gyms are the fifth-riskiest according to the study's metrics -- which include cellphone location data revealing how crowded U.S. businesses get.

"Policymakers have not been making clear explanations about how they are coming to their decisions," says Avinash Collis PhD '20, an MIT-trained economist and co-author of the new paper. "That's why we wanted to provide a more data-driven policy guide."

And if the Covid-19 pandemic worsens again, the research can apply to shuttering businesses again.

"This is not only about which locations should reopen first," says Christos Nicolaides PhD '14, a digital fellow at IDE and study co-author. "You can also look at it from the perspective of which locations should close first, in another future wave of Covid-19."

The paper, "Rationing Social Contact During the COVID-19 Pandemic: Transmission Risk and Social Benefits of U.S. Location," appears in Proceedings of the National Academy of Science, with Benzell, Collis, and Nicolaides as the authors. Benzell is about to start a new position as an assistant professor at Chapman University; in July, Collis will become an assistant professor at the University of Texas at Austin; Nicolaides is also a faculty member at the University of Cyprus.

Cumulative risk

To conduct the study, the team examined anonymized location data from 47 million cellphones, from January 2019 through March 2020. The data included visits to 6 million distinct business venues in the U.S. The 26 types of businesses in the study accounted for 57 percent of those visits, meaning the study covers a broad swath of the economy.

By examining the location data over an extended time period, the scholars were able to determine what the typical crowding level is for all business types in the study.

The study also used payroll, revenue, and employment data from U.S. Census Bureau to rate the centrality of different industries to the economy. Businesses in the study represented 1.43 million firms, 32 million employees, $1.1 trillion in payroll, and $5.6 trillion in revenues. The researchers also added a survey of 1,099 people people to gauge public preferences about different types of business.

A key to the researchers' approach is recognizing that during the pandemic, many consumers are trying to limit trips that generate interaction with strangers, while still needing to get essential and useful transactions done.

As Benzell notes, "The idea was, how can we think about rationing social contacts in a way that gives us the most bang for our buck, in terms of meetings, while keeping the risk of Covid transmission as low as possible?"

The study also rates risk on the basis of aggregate public exposure, per business type. On an individual basis, spending a couple of hours in a movie theater with strangers might seem quite risky. But in February 2020, movie theaters had about 17.6 million consumer visits in the U.S., whereas sit-down restaurants had almost 900 million visits in the same month. As a business category, sit-down restaurants would likely generate much more total transmission of Covid-19.

"It's not danger per visit, but it's a cumulative danger," Nicolaides explains. "If you look at movie theaters, they seem dangerous, but not that many people go to the movies every day ... and restaurants are a good counter-example."

Outlier: Liquor stores staying open

In many cases, the researchers say, policymakers have made reasonable decisions about which types of businesses should be open and closed. But there are exceptions to this. Take liquor stores, which have been deemed an "essential" business in many U.S. states.

"What really jumps out at us is liquor and tobacco stores," Benzell says. "Most states have allowed liquor stores to remain open. This is a bit of a bad call from our perspective, because liquor stores don't create a lot of social value. If you ask people which stores they want to be open, liquor stores are near the bottom of that list. They don't have that many receipts or employees, and they tend to be these small, crowded places where people are up against each other trying to navigate."

In the study, liquor stores rate 20th out of the 26 business types in economic importance, but 12th highest in risk.

By contrast, the researchers are more bullish about the public health dynamics of college and universities, which they rank 8th out of the 26 business types in economic importance, but just 17th in terms of risk. If campus living arrangements could be made more safe, the researchers think, the other parts of university life could offer relatively reasonable conditions.

"Colleges and universities actually have the potential to offer pretty good social contact tradeoffs," Benzell says. "They tend to be places with big campuses, they tend to be [composed of] consistently the same group of young people, visiting the same places. When people are worried about colleges and universities, they're mostly worried about dormitories and parties, people getting infected that way, and that's fair enough. But [for] research and teaching, these are big spaces, with pretty modest groups of people that produce a lot of economic and social value."

The scholars note that the study contains national ratings, and acknowledge that there might be some regional variation in effect as well.

"If a local government would like to apply this paper [to their policies], it may be a better idea to put in their own data to make decisions," says Nicolaides. That said, the study did not indicate significantly different results for urban and rural settings, something the researchers evaluated.

To be sure, some businesses are adapting to the pandemic by using new protocols or safety measures, such as limited customers in hair salons or safety partitions at supermarket checkout counters. Studying business venues with such safety measures in place would also be valuable, the scholars note.

"Moving forward, an interesting exercise would be to see how dangerous these locations are once you implement these mitigation strategies." Collis says. "Those are all interesting open questions, seeing which business adapt. And some of these adaptations will probably be temporary changes, but other business practices may stick in the Covid age."

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 http://go.annals.org/coronavirus.

Multigroup, Adaptively Randomized Trials Are Advantageous for Comparing COVID-19 Interventions

Authors from University of Washington and Fred Hutchinson Cancer Research Center say that broader use of outcome-adaptive randomization when designing clinical trials is especially appropriate to test multiple COVID-19 interventions. This design potentially reduces the number of deaths or other adverse outcomes incurred during a trial. They argue that if interventions are tested separately over the next few months, additional time will be required to conduct direct comparison of the most effective treatments. A collaborative effort will help clinicians to widely implement the most effective treatments as quickly as possible, and with potentially more persons receiving the most effective treatments. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-2933.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead author, Amalia S. Magaret, PhD, can be reached directly at amag@uw.edu.

Roughly half of Earth's ice-free land remains without significant human influence, according to a study from a team of international researchers led by the National Geographic Society and the University of California, Davis.

The study, published in the journal Global Change Biology, compared four recent global maps of the conversion of natural lands to anthropogenic land uses to reach its conclusions. The more impacted half of Earth's lands includes cities, croplands, and places intensively ranched or mined.

"The encouraging takeaway from this study is that if we act quickly and decisively, there is a slim window in which we can still conserve roughly half of Earth's land in a relatively intact state," said lead author Jason Riggio, a postdoctoral scholar at the UC Davis Museum of Wildlife and Fish Biology.

The study, published June 5 on World Environment Day, aims to inform the upcoming global Convention on Biological Diversity -- the Conference of Parties 15. The historic meeting was scheduled to occur in China this fall but was postponed due to the coronavirus pandemic. Among the meeting's goals is to establish specific, and higher, targets for land and water protection.

Approximately 15 percent of the Earth's land surface and 10 percent of the oceans are currently protected in some form. However, led by organizations including Nature Needs Half and the Half-Earth Project, there have been bold global calls for governments to commit to protecting 30 percent of the land and water by 2030 and 50 percent by 2050.

Intact natural lands across the globe can help purify air and water, recycle nutrients, enhance soil fertility and retention, pollinate plants, and break down waste products. The value of maintaining these vital ecosystem services to the human economy has been placed in the trillions of U.S. dollars annually.

CONSERVATION AND COVID-19

The coronavirus pandemic now shaking the globe illustrates the importance of maintaining natural lands to separate animal and human activity. The leading scientific evidence points to the likelihood that SARS-CoV2, the virus that causes the disease COVID-19, is a zoonotic virus that jumped from animals to humans. Ebola, bird flu and SARS are other diseases known to have spilled over into the human population from nonhuman animals.

"Human risk to diseases like COVID-19 could be reduced by halting the trade and sale of wildlife, and minimizing human intrusion into wild areas," said senior author Andrew Jacobson, professor of GIS and conservation at Catawba College in North Carolina.

Jacobson said that regional and national land-use planning that identify and appropriately zone locations best suited to urban growth and agriculture could help control the spread of human development. Establishing protections for other landscapes, particularly those currently experiencing low human impacts, would also be beneficial.

FROM THE TUNDRA TO THE DESERT

Among the largest low-impact areas are broad stretches of boreal forests and tundra across northern Asia and North America and vast deserts like the Sahara in Africa and the Australian Outback. These areas tend to be colder and/or drier and less fit for agriculture.

"Though human land uses are increasingly threatening Earth's remaining natural habitats, especially in warmer and more hospitable areas, nearly half of Earth still remains in areas without large-scale intensive use," said co-author Erle Ellis, professor of geography at the University of Maryland-Baltimore County.

Areas having low human influence do not necessarily exclude people, livestock or sustainable management of resources. A balanced conservation response that addresses land sovereignty and weighs agriculture, settlement or other resource needs with the protection of ecosystem services and biodiversity is essential, the authors note.

"Achieving this balance will be necessary if we hope to meet ambitious conservation targets," said Riggio. "But our study optimistically shows that these targets are still within reach."

Local governments are often innovators of public health policymaking--the first smoke-free air acts, menu labeling laws, and soda taxes were all implemented locally. However, states are increasingly limiting local control over public health issues by passing laws that overrule local regulations, a practice known as preemption.

A new study by researchers at NYU School of Global Public Health, published in the American Journal of Preventive Medicine, takes a closer look at the strategies state legislatures use--often behind closed doors--to pass preemptive laws that limit local government control.

"These strategies used by state policymakers obscure public debate about preemption and the underlying public health and human rights issues at stake," said Jennifer Pomeranz, assistant professor of public health policy and management at NYU School of Global Public Health and the study's lead author. "By preempting local regulations, state legislatures concentrate power at state capitals, limit the capacities of local governments to protect their residents from public health harms, and minimize the nation's ability to learn from local policy successes."

While legal scholars know that various strategies are used by state legislatures to pass laws limiting local control, the NYU researchers sought to gain a more detailed understanding of how preemptive laws are enacted. They analyzed bills from which preemptive laws passed over a five-year period (2014-2018), with a focus on five policy areas: tobacco control, firearms, paid sick leave, food and nutrition, and civil rights.

The research identified five methods state legislators used to pass and support preemption:

Pass preemptive bills quickly: The most common strategy for passing preemptive laws was to do so quickly--sometimes getting a bill passed on the same day it was proposed. Passing bills quickly minimizes open debate on the purpose of the bill, reduces opponents' ability to organize, and limits legislators' ability to consult with constituent groups.

Conceal preemption: The researchers found that states hid preemptive measures by adding them to existing bills on unrelated topics (in Ohio, for instance, paid sick leave preemption was added to a bill outlawing "puppy mills"), using a misleading title for a bill that does not reflect its substance, or bundling preemption of multiple unrelated topics. While the bundling method violates rules found in many state constitutions requiring bills to focus on single subjects, the researchers write that most single-subject violations go unchallenged because it is resource intensive to bring legal challenges and courts struggle to interpret the requirements in these laws.

Repeal and replace preemption: North Carolina's controversial "bathroom bill" asserting that an individual must use the bathroom corresponding with the sex on their birth certificate--effectively discriminating against transgender people--was passed in 2016, preempting local civil rights and paid sick leave laws. A year later, it was replaced with a bill using different language--but with the same preemptive effect.

Preempt litigation: Utah enacted a law protecting the firearm industry from lawsuits. "By preempting lawsuits against entire industries, legislatures have reduced the policy agenda-setting and transparency benefits of litigation," the authors write.

Punitive preemption: Several states allow for lawsuits against local governments and officials for acting in a way the state deems preemptive regarding firearms--for example, local regulations excluding licensed gun owners from buildings. The authors note that even the threat of litigation, including the related costs and fees, intimidates localities with limited resources and reduces the likelihood that these topics will ever be openly discussed in communities.

The study also suggests state legislators are strategically adding preemptive measures to bills on topics with broad support, making it more difficult for opponents to contest or ultimately defeat the bill.

"It appears that the use of these strategies sneaking in preemption may be accelerating," said Diana Silver, associate professor of public health policy and management at NYU School of Global Public Health and the study's coauthor. "We need increased transparency in state lawmaking, especially on matters of public health, which directly affect all of our lives."

While the study analyzed bills through 2018, the findings on preemption are particularly relevant to the current COVID-19 pandemic, which has brought about tensions between local and state governments on closures and "stay at home" orders. Florida's governor, for instance, signed an executive order in April overruling local regulations and forcing local governments to adhere to the state's restrictions.

CLEVELAND, Ohio (June 10, 2020)--Sex hormones influence the structure and function of the brain, but little is known about the effect of hormone therapies (HT) on changes in the brain during menopause. A new study shows smaller increases in structural brain changes related to aging were associated with hormone-level changes from transdermal estradiol or oral conjugated equine estrogen. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).

Age-related changes in learning and memory have been associated with changes in the structure of the brain. Visually, such structural changes can be seen through magnetic resonance imaging in what appear as bright white spots in the brain (known as white matter hyperintensities). These changes in brain structure and in cognitive function may, in part, be related to the lower estrogen levels resulting from menopause.

In a new study involving participants from the Kronos Early Estrogen Prevention Study, researchers investigated the link between the changes in hormone levels (from both the brain and the ovary) with different HT formulations and structural changes in the brain associated with aging compared with placebo. They found that smaller increases in these age-related structural brain changes were linked to decreases in follicle-stimulating hormone in women taking transdermal estradiol and higher levels of estrone (a particular form of estrogen commonly found in postmenopausal women) in women in both HT groups (transdermal estradiol and oral conjugated equine estrogens).

Researchers theorized that the differences may likely be in how the various HT formulations are metabolized. Although an oral administration is further metabolized in the liver, the transdermal hormones are absorbed directly into the peripheral circulation before being metabolized in the liver. Additional research is needed to evaluate the effect of different doses of various oral and transdermal hormones on the change in white matter hyperintensities.

Study results appear in the article "Associations of pituitary-ovarian hormones and white matter hyperintensities in recently menopausal women using hormone therapy."

"This study found that pituitary and ovarian hormone levels are linked to structural brain changes associated with aging in recently menopausal women using hormone therapy and that there are differences in these associations depending on the hormone therapy formulation used. Additional study is needed to determine whether dosages of hormone therapy also affect these associations and to determine what the clinical implications of these findings are for menopausal women," says Dr. Stephanie Faubion, NAMS medical director.

Chicken is the most consumed protein in the United States. According to the National Chicken Council, the U.S. produced more than 9.2 billion broiler chickens in 2019. US consumers spent more than 95 billion dollars on chicken products.

All these broilers - chickens raised for meat - need millions of tons of litter, or bedding material. Reusing chicken litter can save costs. There exists some health and safety concerns though.

A new study shows that the environment in reused poultry litter can deter growth of pathogens like Salmonella.

"When you read or hear that broiler litter is reused to raise multiple flocks of chickens, the typical reaction is that it must be bad for food safety," says Adelumola Oladeinde, a co-author of the recent study. "Our study demonstrates the exact opposite."

Oladeinde is a researcher at the USDA's National Poultry Research Center in Athens. He and his colleagues found that 'good' bacteria in used poultry litter can hinder Salmonella growth.

"It may be worthwhile to invest time and resources to characterize the bacteria in reused litter," says Oladeinde. "We can develop the promising ones into beneficial microbes for better chicken gut health."

The study also explored litter characteristics, such as moisture and ammonia levels. These characteristics can dramatically affect the litter microbiome - the mix of bacteria, fungi, and viruses in litter.

"Our findings provide new information on the relationship between the physical environment of broiler litter and its microbiome," says Oladeinde. "Management techniques that account for both factors may help reduce Salmonella in chickens."

Chicken litter plays a big role in determining broiler health. After a broiler chick gets to a farm, it usually spends the next several weeks pecking and living on litter.

In fact, chicks begin to eat litter even before eating from feeding troughs or drinking. The microbiome present in the litter likely become the 'first settlers' in the guts of the chicks.

"These first microbes play a key role in determining gut health," says Oladeinde. "Therefore, it is critical to determine what a beneficial litter microbiome looks like."

The team collected samples of reused poultry litter from the University of Georgia Poultry Research Center. The litter was used to raise three flocks of broiler chickens under conditions like those used in broiler farms. "Each sample represents a unique broiler litter environment," says Oladeinde.

In the lab, researchers measured characteristics of the litter samples. Then they added Salmonella to each sample. After that, the samples were tested for levels of Salmonella, other bacteria, and physical characteristics.

Within two weeks of adding Salmonella, most samples developed predictable microbiomes. Certain microbes, such as Nocardiopsis bacteria, seemed to reduce growth of Salmonella.

That makes sense, according to Oladeinde. Some species of Nocardiopsis bacteria are known to produce antibiotics and toxins. These compounds could be keeping Salmonella levels low in the litter samples.

A key aspect of reusing broiler litter is how long to wait before reuse. This waiting period is called litter downtime.

"For farmers, a shorter downtime will result in growing more birds through the year," says Oladeinde. However, we know little about how downtime affects litter microbiome.

Results from the study show that surveying levels of specific bacteria could help determine if litters have had enough downtime. That could be of big help to farmers.

"Poultry litter is a complex environment to study," says Oladeinde. "We showed that the reused litter after two weeks of downtime had a microbiome that was unfavorable to Salmonella."

Oladeinde aims to repeat these experiments with litter from various sources. He also wants to test for multiple Salmonella strains. "These studies will tell us about the underlying mechanisms behind reusing litter and reducing Salmonella," he says.

The COVID-19 pandemic and resulting stay-at-home orders have taken a toll on many facets of physical and mental health in recent months. But according to new University of Colorado Boulder research, one silver lining may exist.

Some of us are sleeping better.

"Even though we are living through this incredibly stressful time which is changing our behaviors drastically, we are seeing changes to sleep behaviors that are for the most part positive," said lead author Ken Wright, an Integrative Physiology professor and director of the Sleep and Chronobiology Laboratory.

For the study, published online June 10 in the journal Current Biology, Wright and co-authors at the University of Washington set out to assess how student sleep habits were changing in the wake of widespread stay-at-home orders and social distancing guidelines put into place in mid-March.

Wright had already collected sleep data from 139 CU Boulder students for a week from Jan. 29 to Feb. 4 as part of a class project. When all instruction switched to online learning March 16, he saw a once-in-a-lifetime research opportunity.

"This is an unprecedented time for research, but when it comes to sleep, not a lot of people have access to data on what people were doing before," he said. "We did."

When Wright repeated the week-long survey in the same students from April 22 to 29, researchers found that, on average, the students were devoting 30 more minutes per weekday and 24 more minutes per weekend to sleep. Those students who had been skimping on sleep the most pre-pandemic saw the greatest improvements, with some sleeping as much as two more hours nightly.

The students also kept more regular sleep and wake times and experienced less "social jetlag," or that groggy feeling that occurs when people stay up late and sleep later on the weekends and must resume an earlier schedule on Monday.

Post pandemic, significantly more students - or 92% - also got the minimum seven hours per night of sleep as recommended by the Centers for Disease Control and Prevention. Typically, about one-third of U.S. college students fail to sleep that much.

He said that sleep is particularly critical now, as studies have shown that inadequate sleep weakens the immune system, leaving people more vulnerable to viral infections and less responsive to vaccines.

"We know that when you don't meet the recommendations for sleep it can contribute to a lot of negative health problems," said Wright, noting that insufficient and irregular sleep and social jetlag have all been shown to boost risk of heart disease, obesity, diabetes and mood disorders.

"The fact that a lot of these sleep measures are improving is a good sign."

One finding, however, was not so good.

Compared to February, students are going to bed about 50 minutes later during the week and 25 minutes later during the weekend and waking up later, too.

"Generally, later sleep timing is associated with poor health outcomes," said Wright, who advises people to try to shift their wake-sleep cycle earlier by getting bright light exposure in the morning and dimming the lights two hours before bedtime.

More research is necessary to determine whether similar shifts are occurring among the general public and, if so, why. Wright did note that Boulder residents, generally speaking, are better sleepers to begin with. One prior study of the largest 500 cities in the U.S. found that pre-pandemic, Boulder had the lowest percentage of adults who got fewer than seven hours of sleep per night, or ~25%.

Wright suspects the new findings likely do apply more broadly to college students nationwide.

The key now: To identify ways to keep those good sleep habits going once school resumes in person again.

Health care professionals who die by suicide are more likely to be older and nearing the end of their careers, or be of Asian or Pacific Islander ancestry, or confronting physical, mental health or medical malpractice issues, according to a new study from Massachusetts General Hospital.

In a study published in JAMA Surgery, researchers identified modifiable and behavioral risk factors that can lead to burnout and suicide among three groups of health care providers (surgeons, nonsurgeon physicians and dentists) as a way of informing hospitals and residency training programs of potential areas for intervention through increased screening and treatment.

"Our study highlights the fact we have to be concerned about a larger physician population than we originally thought, including individuals facing civil legal, marital and cultural risk factors, as well as those receiving treatment for mental illness," says Yisi Daisy Ji, DMD, with the Department of Oral and Maxillofacial Surgery and lead author of the study.

"Providers are comfortable advising patients when to seek help but are often reluctant to do so themselves. Part of that is the perceived stigma of being a health care professional with a mental health problem, as well as concern it could adversely affect their medical licensure."

The ongoing COVID-19 pandemic raises the importance of physician mental health and suicide prevention. "With physicians across the country facing uncharted challenges in working conditions, redeployment and physical and emotional stress, we must be more vigilant than ever," emphasizes Faith Robertson, MD, with the Department of Neurosurgery, and co-author of the study. "We are calling on all physicians to recognize the signs of mental health difficulties in their colleagues, as well as in themselves, and take early action."

To determine which physicians are most at risk, researchers examined data from the National Violent Death Reporting System from 2003 though 2016. Of the more than 170,000 individuals who died of suicide, 767 were health care professionals.

The Mass General study is the first national evaluation of suicide risk factors and outcomes in the health care provider sub-groups of surgeons, nonsurgeon physicians and dentists.

Some Unexpected Findings

Among the surprising findings of the retrospective study was that physicians who died of suicide were substantially older (mean age, 59.6 years) compared to the general population of suicide victims (mean age, 46.8) years. "This is a previously unrecognized demographic to be at risk," notes Ji.

"Our hypothesis is that the transition into a senior career position or retirement introduces new and often unsettling challenges of purpose, finances and restructuring of routine and family dynamics."

Another unexpected finding by the team was that physicians of Asian and Pacific Islander ancestry were at higher risk of suicide than those of white ancestry. Researchers theorized that the cultural stigma of experiencing mental health problems among this health care population may contribute to low rates of diagnosis and treatment.

Civil legal problems were also found to be a significant risk factor for suicide in physicians compared to the general population, and more so in the nonsurgeon than the surgeon cohort.

The reason, the study suggested, is that physicians in specialties where malpractice litigation is less common (such as nonsurgical) may experience more emotional distress when claims occur, compounded by the duration and uncertainty of each case.

The researchers propose that hospitals would benefit from offering additional psychological as well as legal and human resource support to physicians during times of litigation-induced stress.

With reported cases of physician burnout on the rise nationwide, the study emphases the need for more intense screening and support of health care professionals across all high risk groups.

The paper cited a model educational program at the University of California, San Diego focused on destigmatizing mental health issues and promoting help-seeking behavior and treatment, including an anonymous, interactive online screening program for all medical students and faculty.

Harvard Medical School, too, maintains a robust program that allows physicians under stress to confidentially seek and receive treatment.

"Our study underscores the need for more targeted intervention and support to fit the risk factors of health care professionals," says Ji. "And that support, including mental health screenings and more open conversations among colleagues about warning signs, needs to continue throughout the physician's career if we're going to mitigate burnout and decrease the rate of suicides in the field of medicine."

Kanazawa, Japan - One of the main functions of the liver is to detoxify compounds including drugs and toxicants to reduce toxic actions and to eliminate from the human body, requiring a molecular interplay within a network of proteins. In a new study published in Biochemical Pharmacology, researchers from Kanazawa University identified the protein solute carrier family 35 member B1 (SLC35B1) as a key molecular actor within the complex process of detoxification.

The goal of glucuronidation, one of detoxification processes, is to make molecular compounds water-soluble so that they can be eliminated from the body through urine or feces more easily. This is mainly achieved by UDP-glucuronosyl transferase (UGT) family, which involves the transfer of glucuronic acid from UDP-glucuronic acid (UDPGA) to the compounds including drugs and toxicants. This process mainly takes place in the endoplasmic reticulum (ER) of liver cells, which are specific compartments inside of the cell. While action site of UGT is located at inside of the ER membrane, UDPGA has to be transported into the ER to be available as a glucuronic acid donor, a process that has caused much scientific controversy in the past.

"While a number of SLC35 proteins have been suggested to be part of this process, it is not yet clear which one contributes most significantly to the transport of UDPGA into the ER," says corresponding author of the study Hiroshi Arakawa. "The goal of our study was to understand how exactly UDPGA is transported into the ER to facilitate glucuronidation."

To achieve their goal, the researchers first showed that the activity of UGT depends on the presence of UDPGA, a finding which they used to their favor in subsequent experiments. By measuring UGT activity, they could now infer whether UDPGA was transported into the ER. They then individually knocked down the expression of 23 members of the SLC35 family in HEK cells expressing human UGT, and found that only the reduction of SLC35B1 and SLC35E3 affected the activity of UGT. The researchers then showed that the activity of UGT significantly decreased when SLC35B1 but not SLC35E3 was knocked down in HepaRG cells, a human cell line. Interestingly, they showed that SLC35B1 was expressed highly variably in human liver samples, reaching an almost 40-fold difference between samples.

"These are striking results that show how the complex process of glucuronidation is regulated at the molecular level," says the last author of the study professor Miki Nakajima. "Our findings could shed light on the inter-individual differences in eliminating substances from the body."