Culture

When faced with danger, humans draw closer together. Social distancing thwarts this impulse. Professor Ophelia Deroy from Ludwigs-Maximilians Universitaet in Munich (LMU) and colleagues argue that this dilemma poses a greater threat to society than overtly antisocial behavior.

The corona crisis presents countries around the globe with what is perhaps the greatest challenge most have faced since the Second World War. For one thing, the virus constitutes a truly global threat. In the absence of a vaccine, our primary defense against it consists in what is now termed 'social distancing' - minimizing our contacts with others in public spaces. In an essay that appears in the leading journal Current Biology, an interdisciplinary team of authors that includes Professor Ophelia Deroy, who holds a Chair in the Philosophy of Mind at LMU and is affiliated with the Munich Neuroscience Center, underline the dilemma posed by measures designed to promote social distancing. "Hazardous conditions make us more - not less - social," Deroy says. "Coping with this contradiction is the biggest challenge we now face."

Seen from this point of view, our current problem lies not in egoistic reactions to the crisis or a refusal to recognize the risks, as images of banks of empty shelves in supermarkets or throngs of strollers in our public parks would have us believe. Deroy and her co-authors Chris Frith (a well-known social neurobiologist based at University College London) and Guillaume Dezecache (a social psychologist at the Université Clermont Auvergne) argue that such scenes are not representative. They emphasize that people instinctively tend to huddle together when faced with an acute danger - in other words, they actively seek closer social contacts. Studies in the fields of neuroscience, psychology and evolutionary biology have already shown that we are not as egoist as some disciplines think. They continue to produce evidence which demonstrates that threatening situations make us even more cooperative and more likely to be socially supportive than we usually are. "When people are afraid, they seek safety in numbers. But in the present situation, this impulse increases the risk of infection for all of us. This is the basic evolutionary conundrum that we describe," says Dezecache. The demands now being made by governments to self-isolate and follow social distancing guidelines are fundamentally at odd with our social instincts, and therefore represent a serious challenge for most people. "After all," says Deroy, "social contacts are not an 'extra', which we are at liberty to refuse. They are part of what we call normal." The essay's authors therefore contend that, because social distancing stands in opposition to our natural reaction to impending hazards, our social inclinations - rather than antisocial reactions to rationally recognized threats - now risk exacerbating the danger.

How then might we escape from this dilemma? According to Deroy, we need to revise what the Internet can offer. The argument goes as follows. In the pre-pandemic world, the Internet and social media were often looked upon as being decidedly unsocial. But in times like the present, they provide an acceptable and effective alternative to physical contact - insofar as they enable social interactions in the absence of physical contiguity. Social media make it possible for large numbers of people to reach out virtually to neighbors, relatives, friends and other contacts. "Our innate inclinations are cooperative rather than egoistic. But access to the Internet makes it possible for us to cope with the need for social distancing," says Chris Frith.

"How well, and for how long, our need for social contact can be satisfied by social media remains to be seen," says Deroy. But she and her co-authors do have two important recommendations for policy-makers. First of all, they must acknowledge that the demand for social distancing is not only politically highly unusual : It runs counter to the evolved structure of human cognition. Secondly, nowadays, free access to the Internet is not only a prerequisite for freedom of speech. In the present situation, it is also making a positive contribution to public health. "This is an important message, given that the most vulnerable sections of society are often those who, owing to poverty, age and illness, have few social contacts."

People who relied on conservative media or social media in the early days of the COVID-19 outbreak were more likely to be misinformed about how to prevent the virus and believe conspiracy theories about it, a study of media use and public knowledge has found.

Based on an Annenberg Science Knowledge survey fielded in early March with over a thousand adults, the study was conducted by researchers at the Annenberg Public Policy Center of the University of Pennsylvania and the University of Illinois at Urbana-Champaign.

The study, published this week in the Harvard Kennedy School Misinformation Review, found that there were notable differences in views about the coronavirus that correlated with people's media consumption.

Media usage and COVID-19 misinformation

Conservative media usage (such as Fox News and Rush Limbaugh) correlated with higher levels of misinformation and belief in conspiracies about the SARS-CoV-2 pandemic, including:

The belief that the Chinese government created the virus as a bioweapon (scientists say the virus likely originated with animals and there is "strong evidence" it is "not the product of purposeful manipulation");

The belief that some in the U.S. Centers for Disease Control and Prevention (CDC) were exaggerating the danger posed by the coronavirus in order to damage Donald Trump's presidency;

The belief that taking vitamin C can prevent a person from being infected with the coronavirus (which is unsupported by evidence).

Social media and web aggregator usage was associated with lower levels of information and higher levels of misinformation:

People who used social media (such as Facebook, Twitter, YouTube) were more likely to believe that taking vitamin C can prevent infection with the coronavirus; that some in the CDC were exaggerating the threat to harm the president; and that the virus was created by the U.S. government;

People who used web aggregators (such as Google News, Yahoo News) were less likely to believe in the effectiveness of hand washing and avoidance of symptomatic individuals as ways to prevent transmission of the virus (in early March, asymptomatic transmission was less clear).

Mainstream broadcast and print media usage correlated with higher levels of correct information and lower levels of misinformation:

People who reported using broadcast news (such as ABC News, CBS News, NBC News) were more likely to say, correctly, that the novel coronavirus is more lethal than the seasonal flu.

People who consume mainstream print news (such as The New York Times, Wall Street Journal) were more likely to hold accurate beliefs about the virus. They were more likely to report that they believe that regular hand washing and avoiding contact with symptomatic people are ways to prevent infection with the coronavirus; and less likely to believe that vitamin C can prevent infection, that some in the CDC were exaggerating the threat in order to undermine the president, and that the Chinese government created the virus as a bioweapon.

"Because both information and misinformation can affect behavior, we all ought be doing our part not only to increase essential knowledge about SARS-CoV-2, but also to interdict the spread of deceptions about its origins, prevention, and effects," said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center (APPC), who co-authored the paper with Dolores Albarracín of the University of Illinois at Urbana-Champaign, an APPC distinguished research fellow. "Additionally, all forms of media should ask, Are our audiences better prepared to deal with this coronavirus as a result of our work or is their trust in us endangering them and their communities?"

Jamieson said that people seeking to verify information can go to government health sites such as the CDC website or to APPC's fact-checking project, FactCheck.org.

Annenberg Science Knowledge survey findings

The study is the first in a series on COVID-19 by APPC, which conducted similar research in 2016 on the Zika virus and in 2019 on vaccination during the measles outbreak. "Like the earlier studies, the current effort will track the success of the media in presenting accurate information and of health communicators in getting the message out," Jamieson said.

The Annenberg Science Knowledge (ASK) survey on COVID-19 was conducted March 3-8, 2020, among a nationally representative sample of 1,008 U.S. adults. The survey, conducted for APPC by SSRS, an independent research company, has a margin of error of ±3.57%.

The survey found that 87% correctly said regular hand washing and avoiding people with virus symptoms were preventative measures against COVID-19, a success in public health messaging. But it also found troubling gaps in public knowledge and worrisome belief in conspiracy theories:

More than 1 in 5 respondents (23%) thought it was probably or definitely true that the Chinese had created the virus as a bioweapon (there is no evidence of this);

More than 1 in 5 (21%) thought taking vitamin C can probably or definitely prevent infection by the coronavirus (it does not);

Nearly 1 in 5 (19%) said it was probably or definitely true that some in the CDC were exaggerating the danger posed by the virus in order to damage the Trump presidency;

And 1 in 10 (10%) said it was probably or definitely true that the U.S. government had created the virus (there is no evidence of this).

"The findings from this ASK survey contribute to the scholarship on health and science communication while also providing insights on what to do as the U.S. resolves this pandemic," Albarracín said. "The next step will be to test the efficacy of the recommendations suggested by this research."

Five recommendations

The researchers offered five recommendations to improve public understanding of the virus:

1) The need for proactive communication about prevention: While a high portion of the public (87%) knew that hand washing and avoiding symptomatic people were preventative measures, gaps in public knowledge "should alert public health officials to the ongoing need for effective communication of needed information long before a crisis."

2) Find out what information to debunk: In order to focus fact-checkers most effectively, the researchers proposed prioritizing corrections for misinformation held by at least 10% of the population. Here, for instance, the conspiracy theory that the virus was developed by the Chinese as a bioweapon (held by 23%) and that some in the CDC exaggerated the threat to harm the president (19%) should be prioritized by fact-checkers.

3) A baseline for monitoring social media interventions: By offering an early window on misinformation in the pandemic, the study provides a way to assess the social media platforms' efforts to blunt the effects of misinformation.

4) Proposed interventions in conservative media: The study should motivate public health officials to place public service announcements, encourage hyperlinks to CDC web pages, and seek interviews on news outlets whose audiences are less knowledgeable, more misinformed, or more accepting of conspiracy theories. The researchers noted that Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, did that on March 11 by going on Sean Hannity's Fox News show, where Fauci explained that coronavirus is much more lethal than the seasonal flu.

5) Newspapers should take down paywalls on coronavirus coverage: The finding that reading mainstream print publications is associated with greater knowledge of the virus should encourage print media to follow the lead of publications such as the New York Times, Washington Post, Philadelphia Inquirer, and others to make their virus coverage free to all readers. Readers who appreciate the public health coverage may respond by subscribing - or with donations.

CHAMPAIGN, Ill. -- Health practitioners are constantly developing new ways to help those with drug and alcohol addictions wean themselves from their substance of choice. Most such programs have limited success, however. A new study finds that interventions that take a multidimensional approach - tackling the biological, social, environmental and mental health obstacles to overcome while also addressing a person's substance use - work best for those hoping to stop using drugs.

The study, reported in the journal Psychology of Addictive Behaviors, also found that those with alcohol addiction do best with simple interventions that focus only on their alcohol use.

"We analyzed 69 studies that measured outcomes from single- or multirecommendation approaches," said Dolores Albarracín, a professor of psychology at the University of Illinois at Urbana-Champaign who led the study with Ph.D. student Wenhao Dai. "Our aim was to determine the optimal number of interventions for intervention efficacy. We found that targeting multiple behaviors is necessary for changing drug-use outcomes, but less so for alcohol-use outcomes."

According to published reports, deaths from overdoses of heroin, methadone, opioids and cocaine are at an all-time high in the U.S., and alcohol use accounts for tens of thousands of deaths each year.

However, "the efficacy of behavioral interventions aimed at reducing substance use has often been underwhelming," write the authors of the new study. Decades of research into behavioral methods have yielded no obvious improvements. According to the National Institute on Drug Abuse, 40-60% of patients who engage in medication-assisted treatment programs for substance-use disorder will relapse. Reviews of alcohol treatment suggest only that "treatment is better than no treatment, but ... methodological problems render it difficult to conclude that any specific treatment is more effective than any other."

"Many programs treat drug or alcohol use as relatively independent of other related behaviors or contextual factors," Albarracín said. "But research reveals that substance use often stems from a variety of biological, psychological and social factors, all working in tandem."

Some studies of drug and alcohol treatment have looked at also targeting other behaviors to help reduce the harm associated with drug and alcohol use. These include methods to promote a healthy lifestyle, prevent transmission of infections, seek social support or make better use of community services.

"We wanted to know if these other behaviors facilitate the drug- or alcohol-treatment goals," Albarracín said. "If they do, that would mean that more recommendations lead to better outcomes. However, it could also be true that adding too many objectives could overwhelm a person and reduce the mental and physical resources they have available to reduce substance use."

The researchers found a positive association between the number of interventions a drug-treatment or prevention program included and its effectiveness in combatting nonmedical drug use, but not alcohol use. Addressing a person's alcohol use was better than not, but there were no further gains from adding other recommendations.

"We also found that interventions were more efficacious when they targeted a population diagnosed with substance- or alcohol-use disorder, when they were delivered by experts and when they included a behavioral contract," Albarracín said.

"Overall, we learned that we can employ more economical approaches to reducing alcohol use," Albarracín said. "Other challenges require an arsenal of approaches. Previous studies from my lab showed that lifestyle modifications are more successful when addressing three or four behaviors in combination. For example, a person who wants to quit smoking might also have a goal of walking every day and eating more fruits and vegetables. Now we have evidence that curbing substance use also works best when addressing the problem holistically."

Albarracín also is a professor of business administration and an affiliate of the Beckman Institute for Advanced Science and Technology at the U. of I.

Just a few weeks ago, everyone was talking about plummeting insect numbers. Academic discourse focused on three main causes: the destruction of habitats, pesticides in agriculture and the decline of food plants for insects. A team of researchers from the Universities of Bonn and Zurich and the Swiss Federal Institute for Forest, Snow and Landscape Research WSL have now demonstrated for the first time that the diversity of food plants for insects in the canton of Zurich has dramatically decreased over the past 100 years or so. This means that bees, flies and butterflies are increasingly deprived of their food base. The study, which is representative for all of Central Europe, has now been published in the journal "Ecological Applications".

"Over the past 100 years, there has been a general decline in food plants for all kinds of insects in the canton of Zurich," says Dr. Stefan Abrahamczyk from the Nees Institute for Biodiversity of Plants at the University of Bonn. The homogenization of the originally diverse landscape has resulted in the disappearance of many habitats, especially the wetlands, which have shrunk by around 90 percent. Human settlements have spread more and more at the expense of cultivated land, and the general intensification of pasture and arable farming has led to a widespread depletion of meadows and arable habitats. The researchers compared the abundance of food plants of different insect groups, based on current mapping for the years 2012 to 2017, with data-based estimates from the years 1900 to 1930 in the canton of Zurich (Switzerland).

The food plants of specialized groups of flower visitors are particularly affected by the decline. For instance, the Greater Knapweed (Centaurea scabiosa) is pollinated by bumblebees, bees and butterflies, as their tongues are long enough to reach the nectar. The decline is particularly dramatic for plant species that can only be pollinated by a single group of insects. In the case of Aconite (Aconitum napellus), for example, this can only be done by bumblebees because the plant's toxin evidently does not affect them.

Overall, all plant communities have become much more monotonous, with just a few dominant common species. "It's hard for us to imagine what vegetation looked like 100 years ago," says Dr. Michael Kessler from the Department of Systematic and Evolutionary Botany at the University of Zurich. "But our data show that about half of all species have experienced significant decline in their abundance, while only ten percent of the species have increased."

250 volunteers helped with mapping

Residents with appropriate botanical knowledge helped with the current survey. They mapped the entire canton of Zurich by plotting an area of one square kilometer each at intervals of three kilometers. The focus here was on the different types of vegetation and the abundance of different plants. "Without the assistance of more than 250 volunteers, who not only mapped the current flora but also processed the historical collections, a project of this scope would not have been feasible," says Dr. Thomas Wohlgemuth of the Swiss Federal Institute for Forest, Snow and Landscape Research WSL, who initiated the mapping project ten years ago with the Zurich Botanical Society.

The most important source on the earlier flora in the canton of Zurich was the unpublished manuscript of Eugen Baumann, a collection of about 1200 handwritten pages. It contains precise and detailed information on the abundance and distribution of plant species before 1930. Dr. Abrahamczyk researched which of the listed species belong to those flowering plants that are visited by insects in search of pollen and nectar. The "customers" include bees, bumblebees, wasps, butterflies, hoverflies, flies and beetles.

Results are largely transferable to Central Europe

Dr. Abrahamczyk has been working on pollination biology for about ten years. He wrote his doctoral thesis at the University of Zurich, then conducted research at the LMU Munich and joined the Nees Institute of the University of Bonn in 2014. When, in late 2018, his former doctoral supervisor, Dr. Michael Kessler, suggested that the recently completed mapping of the canton's flora be combined with pollinator data, Dr. Abrahamczyk was immediately enthusiastic - also because this subject is highly topical. "The laborious literature search and analysis then took some time, and now the study could finally be published," says the scientist from the University of Bonn. "The results are transferable to the whole of Central Europe with minor regional restrictions."

When an actor is unable to perform in the theatre, an understudy--ideally one with some practice in the role--can take her place on stage. A study from Dr. Bernard Jasmin's laboratory at the University of Ottawa and published today in Nature Communications shows that the same is true of proteins. Its results point the way toward novel therapies for Duchenne muscular dystrophy.

Children born with Duchenne muscular dystrophy (DMD) have a mutation in the X-chromosome gene that would normally code for dystrophin, a protein that provides structural integrity to skeletal muscles. The loss of this protein causes severe symptoms, including deteriorating muscle strength beginning around the age of four. The average life expectancy of a child with this condition currently stands at 26 years.

While there is no cure, a promising area of research has developed around the protein utrophin, which is ~ 80% identical to dystrophin and even takes its place early during muscle development. Utrophin is produced from a gene on Chromosome 6 and can be expected to be intact in a DMD patient.

"Utrophin-based therapy is actually applicable to all DMD patients, regardless of their dystrophin mutation" says Dr. Christine Péladeau, the lead post-doctoral fellow on this project. "And this is not something we see with most other therapeutic approaches."

This study looked at a specific "IRES-dependent translation" pathway, which induces a cell's ribosome to trigger utrophin's production. The team tested 262 FDA-approved drugs to see which ones could most effectively activate IRES-mediated translation to boost utrophin expression in muscle. Two drugs that are currently on the market stood out as the strongest contenders--the beta receptor blocker Betaxolol and the cholesterol-lowering drug Pravastatin. When administered in a mouse model of DMD, these drugs each promoted increases in muscle strength close to that of healthy mice.

A number of advantages support targeting utrophin as a DMD therapy above more difficult approaches including dystrophin gene replacement using viral vectors. The repurposing of FDA-approved drugs can also speed the clinical trial process. The doses required are expected to be quite low, improving the chances of low toxicity.

What's more, utrophin seems to be involved in the body's own efforts to fight the disease.

"There is a tendency for DMD muscles to try to naturally upregulate the levels of utrophin, knowing that it doesn't have dystrophin," says Dr. Bernard Jasmin, who leads the lab where the work was conducted. "Obviously it's not enough, but in the absence of this endogenous upregulation, DMD would be a lot worse."

Further stimulation of that natural response via the identified pathway works with the body to strengthen muscles, without the danger of an adverse immune response to the therapy. It also demonstrates the promise of using IRES-mediated translation for therapeutic purposes. It serves as a proof of principle to bolster the idea that this method could be used in other diseases like cancer and neurodegenerative diseases.

Agência FAPESP – Highly concentrated aqueous electrolytes, known as water-in-salt electrolytes, could be an alternative to the organic solvents used in car batteries and other electrochemical devices. Abundance and, hence, low cost are key factors in this application, alongside nontoxicity, according to the review article “Water-in-salt electrolytes for high voltage aqueous electrochemical energy storage devices” published in the journal Current Opinion in Electrochemistry by Vitor Leite Martins and Roberto Manuel Torresi, both of whom are affiliated with the University of São Paulo’s Chemistry Institute (IQ-USP) in Brazil.

The study was conducted as part of Martins’ postdoctoral research supervised by Torresi and part of the Thematic Project “Optimization of the physicochemical properties of nanostructured materials for applications in molecular recognition, catalysis and energy conversion/storage,” for which Torresi is principal investigator. Both projects are supported by FAPESP.

“The term ‘water-in-salt electrolytes’ refers to solutions constituting a very high concentration of salt in a very small amount of water. The amount of water is just sufficient to dissolve the ions to promote solvation. The system contains no free water, unlike conventional solutions,” Torresi told Agência FAPESP.

This is possible only if the salt molecule to be dissolved comprises a large anion and a small cation, Torresi explained. An example is LiTFSI, i.e., lithium bis(trifluoromethane sulfonyl)imide (CF3SO2NLiSO2CF3), whereas NaCI, i.e., sodium chloride or table salt, is of no use, as it has an anion and cation of similar sizes.

“Because there’s no free water in this ultraconcentrated solution, electrolytic splitting of water into hydrogen and oxygen becomes far more difficult, so the electrochemical stability of the solution is very high despite the system containing water,” he said.

In summary, this innovative technological proposal based on a high concentration of salt in water offers significant advantages over conventional technology using salt dissolved in organic compounds. Nevertheless, the technological use of water-in-salt electrolytes also presents challenges.

“The first is that the solution contains little water and is highly hygroscopic: it tends to absorb moisture from the air, and this changes its water content. The second is that ultraconcentrated aqueous solutions are highly corrosive,” Torresi said.

The propensity to absorb ambient moisture is shared with organic solvents and is one of the reasons why conventional batteries have to be shielded, but corrosiveness is a major disadvantage: the organic solvents currently used in lithium batteries do not attack the electrodes, the only metallic components, to a significant extent.

However, according to Torresi, this drawback should not be overestimated. “Corrosion was a major issue for decades. Now, we know how to refine current collectors, and with a few adaptations, it won’t be hard to surmount the problem of corrosion in a future aqueous battery,” he said.

Suicide is now the second most common cause of death among American youth. Fatal suicides rose 30 percent between 2000 and 2016, and 2016 alone saw 1.3 million nonfatal suicide attempts. Now, a study led by Boston Children's Hospital and Massachusetts General Hospital demonstrates that a predictive computer model can identify patients at risk for attempting suicide from patterns in their electronic health records -- an average of two years ahead of time.

Such models could potentially alert health professionals in advance of a visit, helping patients get appropriate interventions, the researchers say. Findings were published last month in JAMA Network Open.

"Computers cannot replace care teams in identifying mental health issues," says Ben Reis, PhD, director of the Predictive Medicine Group, part of the Computational Health Informatics Program (CHIP) at Boston Children's Hospital, and co-senior author on the paper. "But we feel that computers, if well designed, could identify high-risk patients who may currently be falling through the cracks, unnoticed by the health system. We envision a system that could tell the doctor, 'of all your patients, these three fall into a high-risk category. Take a few extra minutes to speak with them.'"

The team analyzed electronic health record data from more than 3.7 million patients ages 10 to 90 across five diverse U.S. health care systems: Partners HealthCare System in Boston; Boston Medical Center; Boston Children's Hospital; Wake Forest Medical Center in North Carolina; and University of Texas Health Science Center at Houston. Six to 17 years' worth of data were available from the different centers, including diagnostic codes, laboratory test results, medical procedure codes, and medications.

The records showed a total of 39,162 suicide attempts. The models were able to detect 38 percent of them (this ranged 33 to 39 percent across the five centers) with 90 percent specificity. Cases were picked up a mean of 2.1 years before the actual suicide attempt (range, 1.3 to 3.5 years).

The strongest predictors, not surprisingly, included drug poisonings, drug dependence, acute alcohol intoxication, and several mental health conditions. But other predictors were ones that wouldn't ordinarily come to mind, like rhabdomyolysis, cellulitis or abscess of the hand, and HIV medications.

"There wasn't one single predictor," says Reis. "It is more of a gestalt or balance of evidence, a general signal that builds up over time."

Designing a suicide risk predictor

The investigators developed the model in two steps, using a machine learning approach. First, they showed half of their patient data to a computer model, directing it to find patterns that were associated with documented suicide attempts. Then, they took lessons learned from that "training" exercise and validated them using the other half of their data -- asking the model to predict, based on those patterns alone, which patients would eventually attempt suicide.

On the whole, the model performed similarly at all five medical centers, but retraining the model at individual centers brought better results.

"We could have created one model to fit all medical centers, using the same codes," says Yuval Barak-Corren, MD, of CHIP, first author on the paper. "But we chose an approach that automatically builds a slightly different model, tailored to suit the specifics of each health care site."

The findings confirmed the value of adapting the model to each site, since health care centers may have unique predictive factors, based on different hospital coding practices and local demographics and health patterns.

Under a grant from the National Institute of Mental Health, the team will now seek to enhance their modeling approach, for example incorporating doctor's clinical notes into their data.

Using the Canadian Light Source (CLS) at the University of Saskatchewan, Marta Cerruti, an Associate Professor in McGill's Department of Materials Engineering, and her team analyzed damaged heart valves from patients who had undergone transplants.

Their findings, recently published in Acta Biomaterialia, show considerable differences in the mineral deposits found in aortic valves of men and women who suffer from stenosis, a life-threatening heart condition caused by a narrowing of the aortic valve opening.

"What we showed, which was a surprise to us, is that the type of minerals in the heart valves is different between the sexes," said Cerruti. "We unexpectedly found that the minerals are different in composition and shape, and that they grow slower in women."

Mineral composition analysis performed at the Soft X-Ray Mischaracterization Beamline, which is housed within the CLS, also determined that a type of mineral deposit was found almost exclusively in samples from female patients.

Taking diversity into consideration

Cerruti says that her findings demonstrate the importance of thinking about diversity in the context of research, a concept that has historically been a blind spot for the scientific community. For example, using only male mice in experiments used to be a standard practice.

"Our study is the perfect illustration that by only looking at a specific population, you will skew your data," she says. "Having a more diverse data set improves your science,"

Heart disease remains the global leading cause of death in both men and women. With 280,000 heart valves being replaced every year in Canada due to stenosis, Cerruti says her work demonstrates the need to develop different diagnostic and therapeutic approaches when treating aortic stenosis in men or women.

In order to make that happen, Cerruti's group will return to the CLS to further investigate this cardiovascular phenomenon and understand the precise composition of the mineral deposits they found in women.

"Understanding what the minerals are could definitely help to develop a cure," she says. "It's possible that there could be easier ways to target these minerals and dissolve them for women."

A new study led by McGill University has found that tectonic plates beneath the Earth's surface can show varying degrees of roughness and could help explain why certain earthquakes are stronger than others.

Earthquakes happen when the rocks beneath the Earth's surface break along geological fault lines and slide past each other. The properties of these faults - such as the roughness of their surface - can have an influence on the size of seismic events, however their study has been challenging because they are buried deep beneath the Earth's surface.

In order to have a better understanding of the characteristics of these faults, researchers from McGill University, the University of California Santa Cruz and Ruhr University Bochum in Germany used high-resolution seismic reflection data to map and measure the roughness of 350 km2 of a plate boundary fault located off the Pacific coast of Costa Rica.

"We already knew that the roughness of a fault was an important factor, but we did not know how rough faults in the subsurface truly are, nor how variable the roughness is for a single fault," says James Kirkpatrick, a professor in McGill's Department of Earth and Planetary Sciences.

Rougher surfaces of faults may explain earthquake magnitude

In a recently published study in Nature Geoscience, Kirkpatrick and his colleagues were able to show that some parts of the studied fault have a rougher surface than others.

Historically, the earthquakes that have occurred in this part of the world have been moderately large (M7) and Kirkpatrick, who is also the study's first author, believes the rough patches they found might be the reason why.

"These rough patches are stronger and more resistant to earthquake slip," he says. "The historical record of earthquakes is relatively short, so we can't say with certainty that larger ones have not occurred. Future seismic events in the area, which will be recorded with modern equipment, should help us determine if they show the same limited magnitude."

Kirkpatrick and his colleagues also hope to apply their methods to other subduction zones where similar geophysical data is available to start to evaluate whether their conclusions are generally applicable.

"This connection between the fault roughness and earthquake magnitude might one day help us understand the size and style of earthquakes most likely to occur a given fault."

New research finds a connection between destructive white blood cells and a more severe disease course in patients with COVID-19.

"We found that patients with COVID-19 infection have higher blood levels of neutrophil extracellular traps, also called NETs, which are a product of an inflammatory type of neutrophil cell death called NETosis," says first author Yu (Ray) Zuo, M.D., a Michigan Medicine rheumatologist.

Zuo worked on the study with Yogen Kanthi, M.D., a cardiologist and vascular medicine specialist at the Michigan Medicine Frankel Cardiovascular Center, and Jason Knight, M.D., Ph.D., a rheumatologist at Michigan Medicine, who study inflammation and neutrophils. The researchers analyzed blood samples from 50 patients with COVID-19 for this publication.

Zuo and colleagues say, in light of the COVID-19 pandemic, there is an urgent need to better understand what causes the inflammatory storm and blood clots triggered by SARS-CoV-2 infection--a storm that leads to respiratory failure and a requirement for mechanical ventilation in many patients. They believe NETs may be relevant to many aspects of COVID-19 research, given that thrombosis and inflammation are hallmarks of severe infection.

This is the first publication to come out of the Frankel CVC's CV Impact Research Ignitor Grant program, which was created to address COVID-19 from both basic science and clinical perspectives.

Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summaries below are 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.

Ventilator Triage Policies During the COVID-19 Pandemic at U.S. Hospitals Associated With Members of the Association of Bioethics Program Directors

The COVID-19 pandemic has overwhelmed health care systems or threatens to do so, and many institutions are developing ventilator triage policies. Researchers from Cincinnati Children's Hospital Medical Center describe such policies developed at hospitals associated with members of the Association of Bioethics Program Directors. Read the full text: http://annals.org/aim/article/doi/10.7326/M20-1862.

An accompanying Ideas & Opinions piece by Thomas A. Bledsoe, MD, Janet A. Jokela, MD, MPH, Noel N. Deep, MD and Lois Snyder Sulmasy, JD, titled "Universal Do-Not-Resuscitate Orders, Social Worth, and Life-Years: Opposing Discriminatory Approaches to the Allocation of Resources During the COVID-19 Pandemic and Other Health System Catastrophes" is also published today in Annals of Internal Medicine. According to the authors from the American College of Physicians (ACP) Ethics, Professionalism, and Human Rights Committee, universal do-not-resuscitate (DNR) orders, social worth, and life-years approaches to rationing scarce resources are not fair and conflict with ethical principles, and should not be used during the COVID-19 pandemic or other health catastrophes. Read the full text: http://annals.org/aim/article/doi/10.7326/M20-1862.

Media contacts: PDFs for these articles are not yet available. Please click the links to read full texts. The lead author of Ventilator Triage Policies During the COVID-19 Pandemic, Armand H. Matheny Antommaria, MD, PhD, can be reached directly at armand.antommaria@chmc.org. The lead author of Universal Do-Not-Resuscitate Orders, Social Worth, and Life-Years, Lois Snyder Sulmasy, JD, can be reached through Edward Vassallo at EVassallo@acponline.org.

In an unprecedented effort, hundreds of thousands of researchers and clinicians worldwide are locked in a race against time to develop cures, vaccines, and better diagnostic tests for COVID-19, the illness caused by the virus SARS-CoV-2.

Over 1,650 articles on COVID-19 are already listed in databases such as Google Scholar, while dozens more are added daily. The register ClinicalTrials.gov lists over 460 ongoing clinical trials on COVID-19, although the majority are still in the earliest stages. Given the diversity of experimental approaches among these studies, a systematic review of possible clinical strategies is timely and welcome.

In a new study in Frontiers in Microbiology, aimed at the research community but also comprehensible for non-specialists, experts from the University of North Carolina at Chapel Hill review possible strategies against dangerous coronaviruses - not only SARS-CoV-2 and its relatives such as SARS-Cov (causing Severe Acute Respiratory Syndrome, SARS) and MERS-Cov (causing Middle East Respiratory Syndrome, MERS), but also as yet unknown strains which will inevitably emerge in the future.

They propose that the most promising approaches for fast progress are selected antivirals such as remdesivir, and gene therapy.

"Coronaviruses represent a true threat to human health and the global economy. We must first consider novel countermeasures to control the SARS-Cov-2 pandemic virus and then the vast array of high-threat zoonotic viruses that are poised for human emergence in the future," says Dr Ralph Baric, William R. Kenan, Jr. Distinguished Professor in the Department of Epidemiology and Professor in the Department of Microbiology and Immunology at UNC Chapel Hill.

"To help focus the global search for a treatment, we here aim to provide a comprehensive resource of possible lines of attack against SARS-Cov-2 and related coronaviruses, including the results from all preclinical and clinical trials so far on vaccines against SARS and MERS."

The authors discuss one-by-one the possible strategies against the coronavirus. First, and most effective are vaccines.

In the present case, the most successful are likely to carry the Receptor Binding Domain (of the virus's S-protein), which allows it to bind to and fuse with host cells. Besides the traditional live attenuated, inactivated, and subunit-based vaccines, modern types such as DNA/RNA-based and nanoparticle- or viral vector-borne vaccines should be considered.

Because the amino acid sequence of the S-protein is very different across coronaviruses (e.g., 76-78% similarity between SARS-Cov and SARS-Cov-2), vaccines against one strain typically won't work against another.

But because the development and testing of new vaccines takes one to several years, other approaches are essential in the meantime.

The second-most likely effective are broad-spectrum antivirals such as nucleoside analogs, which mimic the bases in the virus's RNA genome and get mistakenly incorporated into nascent RNA chains, stalling the copy process.

But because coronaviruses have a so-called "proofreading" enzyme which can cut such mismatches out, most nucleoside analogs don't work well. Exceptions seem to be β-D-N4-hydroxycytidine and remdesivir, proposed by the authors as good candidates against SARS-Cov-2.

Third, convalescent blood plasma from patients who recovered, with low levels of a range of antibodies against the virus; or preferably (but slower to develop), monoclonal antibodies, isolated and mass-produced through biotechnology. Such "passive immunization" can give short-term immunity.

The authors discuss a range of options from fusion inhibitors, to inhibitors of human proteases, to immune modulators such as corticosteroid hormones, and others.

Finally, and in the authors' view the most attractive alternative until a vaccine is produced, is gene therapy delivered through the adeno-associated virus (AAV). This would entail the fast, targeted delivery of antibodies, immunoadhesins, antiviral peptides, and immunomodulators to the upper airways, to give short-term protection. Because the rapid turnover of cells here, risks of toxicity are minimal. They estimate that such tools can be developed, adapted, and tested within a month.

"AAV-based passive immunization can be used as a quick alternative. It is straightforward and only contains two components, the viral vector and the antibody. Multiple AAV vectors have been proven to be safe and effective for human use," says author Dr Long Ping Victor Tse.

"In theory, a single dose could mount a protective response within a week and last for more than a year. The currently high price could be reduced when treating infectious diseases, which have a larger market. It may or may not already be too late to use AAV to treat SARS-CoV-2, but it is certainly not too late for future outbreaks."

History holds valuable lessons - and stark warnings - about how to manage fisheries and other ocean resources, a new study says.

Researchers examined 20 historical examples of fisheries and aquaculture (fish farming), dating from 40 to 800 years ago.
The study, led by the universities of Exeter, Hull and Boston, found consistent patterns that resulted in so-called "blue growth" - the development of sustainable ocean economies that benefitted whole communities.

It also noted common "recipes for failure" - and the authors say these offer grave warnings for today.

"Our aim was to see if we could learn from past successes and failures," said Dr Ruth Thurstan, of the Centre for Ecology and Conservation at the University of Exeter's Penryn Campus in Cornwall.

"We often assume our problems are new, but a look at the past shows societies have faced similar issues before - though many of our challenges today are on a bigger scale.

"Some past societies ultimately failed at blue growth, while others succeeded in balancing economic growth, social equity and sustainability for varying lengths of time."

Dr Thurstan added: "In basic terms, success came when societies managed to achieve fair - rather than unlimited or open - access to resources, and when they were responsive to change.

"Basing decisions on evidence, getting all parties involved and planning for the long-term were also key.

"Failure occurred when short-term gains were prioritised over long-term sustainability."

Dr Bryony Caswell, of the School of Geography, Geology and the Environment at the University of Hull said: "Worryingly, the recipes for success that we discovered are rarely included in even the most advanced blue growth agendas today.

"The seas are destined to play an ever-more vital role in food security. If we don't take this chance to learn from history, we may be condemning ourselves to repeating past mistakes."

The study, by an international team of 28 historians, environmental scientists and marine ecologists, looked at examples from around the world.

These included:

Galway Bay in Ireland where, before the 1850s, community-based management led to equitable access and sustainable management of fish stocks. In the 1850s, trawlers from England arrived. Locally agreed rules were ignored and fish stocks were over-exploited.

In the Lagoon of Venice, Italy, local regulations achieved a "balance" between the economic freedom of citizens and the protection of shared resources, lasting from the 12th to the 18th Century. After that, political instability and growing demand for food led to regulations being scrapped, resulting in over-exploitation.

In Japan, access to seaweed resources that benefitted the majority rather than a minority of people, use of traditional knowledge systems and enhanced seaweed cultivation techniques, helped achieve a balance between market demand and ecological sustainability from the 1600s onwards.

In the east USA, two centuries of over-exploitation and worsening water quality led to a 20th Century collapse of once-widespread oyster reefs. While oyster production today is still far lower than historical levels, a growing appreciation of their benefits to coastal ecosystems has led to large-scale efforts by local communities to restore oyster reefs.

"The question is, can our modern societies achieve blue growth rather than exploiting and depleting our oceans?" said Dr Emily Klein, of the Frederick S. Pardee Center for the Study of the Longer-Range Future, Boston University.

"History shows us that there are ways to balance sustainability, social equity and economic growth.

"It is difficult, but we believe there are opportunities to make it happen - especially if we can learn from the past."

The paper, published in the journal Fish and Fisheries, is entitled: "Something old, something new: Historical perspectives provide lessons for blue growth agendas."

Marking a major milestone on the path to meeting the objectives of the NIH BRAIN initiative, research by Carnegie Mellon's Biomedical Engineering Department Head Bin He advances high-density electroencephalography (EEG) as the future paradigm for dynamic functional neuroimaging.

The NIH Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative motivates researchers to "produce a revolutionary new dynamic picture of the brain that, for the first time, shows how individual cells and complex neural circuits interact in both time and space." An ideal technique for functional human brain imaging--one of the initiative's top priorities--would depict brain activity with high temporal resolution, high spatial resolution, and wide spatial coverage.

Carnegie Mellon's He has made a major leap forward for the field of functional neuroimaging. An NIH-funded study lasting several years and examining dozens of patients with epilepsy has produced a novel source imaging technology that uses high-density EEG recordings to map underlying brain networks. Published in Nature Communications, this research is a big step towards establishing the ability to dynamically image human brain function and dysfunction. This could provide important insight into both where and how underlying information-processing occurs.

EEG has long been one of the most effective functional methods available for human brain mapping. It takes readings in a matter of milliseconds, however the technology still struggles with determining the spatial extent of activity within the brain. The approach proposed by He and his team can accurately estimate for the first time the size and scope of active areas within the brain using high-density EEG, as well as interactions between regions that are functionally related. Their findings were validated using clinical recordings made at the Mayo Clinic, analyzing a total of 1,027 EEG spikes and 86 seizures recorded from 36 patients.

The team's method, termed the fast spatio-temporal iteratively reweighted edge sparsity (FAST-IRES) technique, uses machine learning to objectively estimate signal sources and activity as they vary over time. Unlike prior imaging techniques, it needs no ad hoc algorithm or human intervention for determining source extent and requires only minimal, intuitive input from physicians.

FAST-IRES could have a major impact on the research and treatment of various neurological and mental disorders like Alzheimer's, Parkinson's, stroke, chronic pain, and even depression. However, this method is uniquely and most immediately impactful for those suffering from drug-resistant epilepsy.

Around one percent of the global population suffers from epilepsy, and roughly one-third of cases are drug-resistant, requiring surgical intervention. Yet until now, no current non-invasive imaging modality has the spatial specificity to accurately determine the epileptogenic zone (EZ), which represents the minimum amount of tissue that must be removed to halt seizures.

"By analyzing epilepsy networks with our proposed FAST-IRES framework, we have demonstrated that the EZ can be determined objectively and noninvasively with high precision from scalp high density EEG recordings," wrote He and his co-authors.

There findings were validated against readings from conventional invasive intracranial recordings and surgical outcomes from each patient, proving FAST-IRES' effectiveness.

The study also marks one of the first times high-density EEG has been used to study epileptic seizures. The more powerful imaging technology, packing more than double the electrodes generally used in a clinical setting, is now available to patients treated at the Mayo Clinic. He believes that within the next five years, the FAST-IRES methodology will begin to impact the way we understand a number of neurological disorders.

"This work demonstrates that EEG source imaging may become the non-invasive high-spatial, high-temporal resolution paradigm for human brain imaging technology, an important goal of the BRAIN Initiative." said He, who served as a member of the NIH BRAIN Multi-Council Working Group from 2015-2019.

He's research may be life-changing for those suffering from epilepsy and could benefit researchers and physicians across the field of neurology, neurosurgery, and human neuroscience. This work brings the NIH and the scientific community one step closer to achieving a revolutionary new dynamic picture of the brain.

How do mountains form? What forces are needed to carve out a basin? Why does the Earth tremble and quake?

Earth scientists pursue these fundamental questions to gain a better understanding of our planet's deep past and present workings. Their discoveries also help us plan for the future by preparing us for earthquakes, determining where to drill for oil and gas, and more. Now, in a new, expanded map of the tectonic stresses acting on North America, Stanford researchers present the most comprehensive view yet of the forces at play beneath the Earth's surface.

The findings, published in Nature Communications on April 23, have implications for understanding and mitigating problems associated with induced seismicity - human-caused earthquakes - from unconventional oil and gas recovery, especially in Oklahoma, Texas and other areas targeted for energy exploration. But they also pose a whole new set of questions that the researchers hope will stimulate a wide range of modeling studies.

"Understanding the forces in the Earth's crust is fundamental science," said study co-author Mark Zoback, the Benjamin M. Page Professor of Geophysics in Stanford's School of Earth, Energy & Environmental Sciences (Stanford Earth). "In some cases, it has immediate application, in others, it may be applied decades later to practical questions that do not exist today."

First continental synthesis of data

The new research provides the first quantitative synthesis of faulting across the entire continent, as well as hundreds of measurements of compressive stress directions - the direction from which the greatest pressure occurs in the Earth's crust. The map was produced by compiling new and previously published measurements from boreholes as well as inferences about kinds or "styles" of faults based on earthquakes that have occurred in the past.

The three possible styles of faulting include extensional, or normal faulting, in which the crust extends horizontally; strike-slip faulting, in which the Earth slides past itself, like in the San Andreas fault; and reverse, or thrust, faulting in which the Earth moves over itself. Each one causes very different shaking from a hazard point of view.

"In our hazards maps right now, in most places, we don't have direct evidence of what kind of earthquake mechanisms could occur," said Jack Baker, a professor of civil and environmental engineering who was not involved with the study. "It's exciting that we have switched from this blind assumption of anything is possible to having some location-specific inferences about what types of earthquakes we might expect."

Zooming in

In addition to presenting a continent-level view of the processes governing the North American plate, the data - which incorporates nearly 2,000 stress orientations, 300 of which are new to this study - offer regional clues about the behavior of the subsurface.

"If you know an orientation of any fault and the state of stress nearby, you know how likely it is to fail and whether you should be concerned about it in both naturally-triggered and industry-triggered earthquake scenarios," said lead author Jens-Erik Lund Snee, PhD '20, now a postdoctoral fellow with the United States Geological Survey (USGS) in Lakewood, Colorado. "We've detailed a few places where previously published geodynamic models agree very well with the new data, and others where the models don't agree well at all."

In the Eastern U.S., for example, the style of faulting revealed by the study is exactly the opposite of what would be expected as the surface slowly "rebounds" following the melting of the ice sheets that covered most of Canada and the northern U.S. some 20,000 years ago, according to Lund Snee. The discovery that the rebound stresses are much less than those already stored in the crust from plate tectonics will advance scientists' understanding of the earthquake potential in that area.

In the Western U.S., the researchers were surprised to see changes in stress types and orientations over short distances, with major rotations occurring over only tens of miles - a feature that current models of Earth dynamics do not reveal.

"It's just much clearer now how stress can systematically vary on the scale of a sedimentary basin in some areas," Zoback said. "We see things we've never seen before that require geologic explanation. This will teach us new things about how the Earth works."