Culture

COVID-19 increased anxiety, depression for already stressed college students

image: Depression levels of students across the first academic term impacted by the COVID-19 pandemic (green) spike when compared to the historic average (red). Weeks nine through 12 were influenced by major campus policy changes and are represented with a shaded box (upper right).

Image: 
Figure courtesy of Jeremy Huckins.

HANOVER, N.H. - July 27, 2020 - College students were more anxious and depressed during the initial outbreak of COVID-19 than they were during similar time frames in previous academic years, according to a Dartmouth study.

The research also found that sedentary behavior increased dramatically during the onset of the public health crisis in early March.

The study, published in the Journal of Medical Internet Research, used a mix of smartphone sensing and digital questionnaires from more than 200 students participating in a research program that is tracking mental health throughout their undergraduate years.

"COVID-19 had an immediate negative impact on the emotional well-being of the college students we studied," said Jeremy Huckins, a lecturer on psychological and brain sciences at Dartmouth. "We observed a large-scale shift in mental health and behavior compared to the observed baseline established for this group over previous years."

Self-reported symptoms of depression and anxiety within the student research group spiked noticeably at the onset of COVID-19. At the time, major policy changes related to COVID-19 were also being put in place, including the request that students leave campus and the switch to remote learning.

These changes coincided with the end of classes and final exams, already one of the most stressful times for students in any academic term.

According to the study, anxiety and depression decreased slightly after the final exam period as students settled into shelter-in-place locations. This suggested some resilience in the face of COVID-19, but levels remained consistently higher than similar periods during previous academic terms.

Unlike previous terms studied, sedentary time increased dramatically during this year's spring break period.

"This was an atypical time for these college students. While spring break is usually a period of decreased stress and increased physical activity, spring break 2020 was stressful and confining for the students participating in this study. We suspect that this was the case for a large number of college students across the country," said Huckins.

The study used StudentLife, a sensing app developed at Dartmouth, to collect information from student volunteers. StudentLife passively collects behavioral information from user's smartphones such as duration of phone usage, number of phone unlocks, sleep duration, and sedentary time.

Data on depression and anxiety were collected using weekly, self-reported assessments also administered through the StudentLife app.

"This is the first time we have used sensor data from phones to give us unique behavioral insights into the reaction of students to the onset of the pandemic on a college campus," said Andrew Campbell, the Albert Bradley 1915 Third Century Professor of computer science at Dartmouth and one of the lead researchers of the StudentLife study. "We plan to further analyze how these students adjusted both physically and mentally during remote learning that leads on from this study."

In the research, the team also reported a connection between anxiety and COVID-19 news coverage. The link between depression and news reporting was apparent, but not as strong. As news coverage intensified, there was an increase in sedentary behavior and a longer duration of phone usage.

According to the study, the decrease in the number of locations visited was consistent with the social distancing and shelter-in-place policies implemented by local governments.

The study's findings on the uptake of social distancing recommendations contrasts with other research of college students in which governmental social distancing policies were not followed. Findings in the current study are also contrary to media depictions of college-age students flouting social distancing recommendations during the spring break period.

"Many people wouldn't expect college students to listen to social distancing orders, but these students did. We found that when social distancing was recommended by local governments, students were more sedentary and visited fewer locations on any given day," said Huckins. "Clearly the impact of COVID-19 extends beyond the virus and its direct impacts. An unresolved question is if mental health and physical activity will continue to degrade over time, or if we will see a recovery, and how long that recovery will take."

The research is part of a multiyear study focusing on the mental health of undergraduate students as they progress through their undergraduate careers. The complete study combines smartphone mobile sensing with functional neuroimaging.

"When we set out two years ago to follow 200 students across their college experiences, we could never have anticipated the inflection point in our data as a result of such a catastrophic event as the pandemic," added Campbell.

Upon completion of the full study, researchers will be able to extend their findings on the disruption at the start of the COVID-19 pandemic to the long-term impact of remote learning and social isolation that the students are experiencing.

More information on the StudentLife research program can be found at: https://studentlife.cs.dartmouth.edu/ [https://studentlife.cs.dartmouth.edu/ ]

Credit: 
Dartmouth College

Link confirmed between a healthy diet and prostate cancer prevention

The Canadian Cancer Society estimates that more than 23,000 Canadians will be diagnosed with prostate cancer in 2020. Among other risk factors, more and more studies point to diet as a major factor in the development of prostate cancer, as it is for cardiovascular disease, diabetes, and obesity. Using data from a study conducted in Montreal between 2005 and 2012, a research team led by Professor Marie-Élise Parent of Institut national de la recherche scientifique (INRS) has shown a link between diet and prostate cancer in the article "Dietary Patterns Are Associated with Risk of Prostate Cancer in a Population-Based Case-Control Study in Montreal, Canada", published in Nutrients in June.

Three main dietary profiles analyzed

INRS PhD student Karine Trudeau, the lead author of the study, based her analysis on three main dietary profiles: healthy diet, salty Western diet including alcohol, and sugar-rich Western diet with beverages. The first profile leans heavily towards fruits, vegetables, and plant proteins like tofu and nuts. The salty Western diet with alcohol includes more meat and beverages such as beer and wine. The third profile is rich in pasta, pizza, desserts, and sugary carbonated drinks. The study took age, ethnicity, education, family history, and date of last prostate cancer screening into account.

Marie-Élise Parent and Karine Trudeau found a link between a healthy diet and a lower risk of prostate cancer. Conversely, a Western diet with sweets and beverages was associated with a higher risk and seemed to be a factor in more aggressive forms of cancer. The study did not show any clear link between a Western diet with salt and alcohol and the risk of developing the disease.

Moving away from the typical approach used in epidemiological studies, which involves looking at one nutrient or food group at a time, the researchers collected data from a broader dietary profile. "It's not easy to isolate the effect of a single nutrient," explained Ms. Trudeau. "For example, foods rich in vitamin C, such as citrus fruits, promote iron absorption. Calcium is often found in dairy products, which also contain vitamin D. Our more targeted approach takes this synergy into account to produce more meaningful results that public health authorities can use to formulate recommendations. Rather than counting on one miracle food, people should look at their overall diet."

"For a long time we've suspected that diet might play a role in the development of prostate cancer, but it was very hard to pinpoint the specific factors at play," said Professor Parent. "This study is significant because it looks at dietary habits as a whole. We've uncovered evidence that, we hope, can be used to develop prevention strategies for prostate cancer, the most common cancer among men in Canada and many other countries."

In addition to INRS faculty and students Marie-Élise Parent, Karine Trudeau, Christine Barul, and Marie-Claude Rousseau, Ilona Csizmadi (Cumming School of Medicine) participated in the research. The study was funded by the Canadian Cancer Society (CCS), the Cancer Research Society (CRS), Fonds de la recherche du Québec--Santé (FRQS), and Ministère de l'Économie et de l'Innovation (MEI).

Credit: 
Institut national de la recherche scientifique - INRS

New approach refines the Hubble's constant and age of universe

EUGENE, Ore. - July 27, 2020 - Using known distances of 50 galaxies from Earth to refine calculations in Hubble's constant, a research team led by a University of Oregon astronomer estimates the age of the universe at 12.6 billion years.

Approaches to date the Big Bang, which gave birth to the universe, rely on mathematics and computational modeling, using distance estimates of the oldest stars, the behavior of galaxies and the rate of the universe's expansion. The idea is to compute how long it would take all objects to return to the beginning.

A key calculation for dating is the Hubble's constant, named after Edwin Hubble who first calculated the universe's expansion rate in 1929. Another recent technique uses observations of leftover radiation from the Big Bang. It maps bumps and wiggles in spacetime - the cosmic microwave background, or CMB - and reflects conditions in the early universe as set by Hubble's constant.

However, the methods reach different conclusions, said James Schombert, a professor of physics at the UO. In a paper published July 17 in the Astronomical Journal, he and colleagues unveil a new approach that recalibrates a distance-measuring tool known as the baryonic Tully-Fisher relation independently of Hubble's constant.

"The distance scale problem, as it is known, is incredibly difficult because the distances to galaxies are vast and the signposts for their distances are faint and hard to calibrate," Schombert said.

Schombert's team recalculated the Tully-Fisher approach, using accurately defined distances in a linear computation of the 50 galaxies as guides for measuring the distances of 95 other galaxies. The universe, he noted, is ruled by a series of mathematical patterns expressed in equations. The new approach more accurately accounts for the mass and rotational curves of galaxies to turn those equations into numbers like age and expansion rate.

His team's approach determines the Hubble's constant - the universe's expansion rate - at 75.1 kilometers per second per megaparsec, give or take 2.3. A megaparsec, a common unit of space-related measurements, is equal to one million parsecs. A parsec is about 3.3 light years.

All Hubble's constant values lower than 70, his team wrote, can be ruled out with 95 percent degree of confidence.

Traditionally used measuring techniques over the past 50 years, Schombert said, have set the value at 75, but CMB computes a rate of 67. The CMB technique, while using different assumptions and computer simulations, should still arrive at the same estimate, he said.

"The tension in the field occurs from the fact that it does not," Schombert said. "This difference is well outside the observational errors and produced a great deal of friction in the cosmological community."

Calculations drawn from observations of NASA's Wilkinson Microwave Anisotropy Probe in 2013 put the age of the universe at 13.77 billion years, which, for the moment, represents the standard model of Big Bang cosmology. The differing Hubble's constant values from the various techniques generally estimate the universe's age at between 12 billion and 14.5 billion years.

The new study, based in part on observations made with the Spitzer Space Telescope, adds a new element to how calculations to reach Hubble's constant can be set, by introducing a purely empirical method, using direct observations, to determine the distance to galaxies, Schombert said.

"Our resulting value is on the high side of the different schools of cosmology, signaling that our understanding of the physics of the universe is incomplete with the hope of new physics in the future," he said.

Credit: 
University of Oregon

Flu, pneumonia vaccinations tied to lower risk of Alzheimer's dementia

CHICAGO, JULY 27, 2020 -- Flu (influenza) and pneumonia vaccinations are associated with reduced risk of Alzheimer's disease, according to new research reported at the Alzheimer's Association International Conference® (AAIC®) 2020.

Three research studies reported at AAIC 2020 suggest:

At least one flu vaccination was associated with a 17% reduction in Alzheimer's incidence. More frequent flu vaccination was associated with another 13% reduction in Alzheimer's incidence.

Vaccination against pneumonia between ages 65 and 75 reduced Alzheimer's risk by up to 40% depending on individual genes.

Individuals with dementia have a higher risk of dying (6-fold) after infections than those without dementia (3-fold).

"With the COVID-19 pandemic, vaccines are at the forefront of public health discussions. It is important to explore their benefit in not only protecting against viral or bacterial infection but also improving long-term health outcomes," said Maria C. Carrillo, Ph.D., Alzheimer's Association chief science officer.

"It may turn out to be as simple as if you're taking care of your health in this way -- getting vaccinated -- you're also taking care of yourself in other ways, and these things add up to lower risk of Alzheimer's and other dementias," Carrillo said. "This research, while early, calls for further studies in large, diverse clinical trials to inform whether vaccinations as a public health strategy decrease our risk for developing dementia as we age."

Seasonal Flu Vaccine May Reduce Incidence of Alzheimer's Dementia

Previous research has suggested vaccinations may have a protective factor against cognitive decline, but there have been no large, comprehensive studies focused on the influenza (flu) vaccine and Alzheimer's disease risk, specifically. To address this gap, Albert Amran, a medical student at McGovern Medical School at The University of Texas Health Science Center at Houston, and team, investigated a large American health record dataset (n=9,066).

Amran and team found having one flu vaccination was associated with a lower prevalence of Alzheimer's (odds ratio 0.83, p

The researchers found the protective association between the flu vaccine and the risk of Alzheimer's was strongest for those who received their first vaccine at a younger age -- for example, the people who received their first documented flu shot at age 60 benefitted more than those who received their first flu shot at age 70.

"Our study suggests that regular use of a very accessible and relatively cheap intervention -- the flu shot -- may significantly reduce risk of Alzheimer's dementia," Amran said. "More research is needed to explore the biological mechanism for this effect -- why and how it works in the body -- which is important as we explore effective preventive therapies for Alzheimer's."

Pneumonia Vaccine May Reduce Alzheimer's Risk Later in Life

Repurposing of existing vaccines may be a promising approach to Alzheimer's disease prevention. Svetlana Ukraintseva, Ph.D., Associate Research Professor in the Biodemography of Aging Research Unit (BARU) at Duke University Social Science Research Institute, and team, investigated associations between pneumococcal vaccination, with and without an accompanying seasonal flu shot, and the risk of Alzheimer's disease among 5,146 participants age 65+ from the Cardiovascular Health Study. The team also took into account a known genetic risk factor for Alzheimer's -- the rs2075650 G allele in the TOMM40 gene.

The researchers found that pneumococcal vaccination between ages 65-75 reduced risk of developing Alzheimer's by 25-30% after adjusting for sex, race, birth cohort, education, smoking, and number of G alleles. The largest reduction in the risk of Alzheimer's (up to 40%) was observed among people vaccinated against pneumonia who were non-carriers of the risk gene. Total number of vaccinations against pneumonia and the flu between ages 65 and 75 was also associated with a lower risk of Alzheimer's; however, the effect was not evident for the flu shot alone.

"Vaccinations against pneumonia before age 75 may reduce Alzheimer's risk later in life, depending on individual genotype," Ukraintseva said. "These data suggest that pneumococcal vaccine may be a promising candidate for personalized Alzheimer's prevention, particularly in non-carriers of certain risk genes."

Infection Substantially Increases Mortality in People with Dementia

People living with dementia commonly experience other health conditions including viral, bacterial, and other infections. There is a growing trend in research to investigate whether infections might be worsening, more life-threatening or possibly causing dementia.

Janet Janbek, a Ph.D. student at the Danish Dementia Research Centre, Rigshospitalet and the University of Copenhagen in Denmark, and team, used data from national health registries to investigate mortality in Danish residents over age 65 (n=1,496,436) who had visited the hospital with an infection. They found that people with both dementia and such hospital visits died at a 6.5 times higher rate compared with people who had neither. Study participants with either dementia alone or infection-related contacts alone had a threefold increased rate. The rate of mortality was highest within the first 30 days following the hospital visit.

The researchers also found that for people living with dementia the mortality rates remained elevated for 10 years after the initial infection-related hospital visit, and mortality rates from all infections (including major infections like sepsis to minor ear infections) were higher compared with people without dementia or without an infection-related hospital visit.

"Our study supports the need to investigate these relations even further; to find out why infections are linked to higher mortality in people with dementia, specifically which risk factors and biological mechanisms are involved. This will help advance our understanding of the role of
infections in dementia," said Janbek.

"Our study suggests that the health care system -- as well as relatives of people with dementia -- should have increased awareness of people with dementia who get infections, so they get the medical care they need. People with dementia require more specialized treatment even when their hospital visits are not directly due to their dementia but to what might appear to be an unrelated infection," Janbek added.

Credit: 
Alzheimer's Association

Duke-NUS: Cancer mutations caused by bacterial toxin preventable

Studying DNA mutations in cancers can help clarify how cancers develop and what makes cancer cells different from normal, healthy cells. The team of scientists from Duke-NUS' Cancer and Stem Cell Biology (CSCB) programme, specifically wanted to look more closely at Asian cancers to expand the list of 65 currently known mutation patterns found in cancers. Scientists expect there are still some rare mutation patterns that have yet to be discovered.

The researchers examined 872 colorectal lesions from 201 patients with unexplained, non-inherited polyposis. This condition involves the formation of intestinal polyps that can predispose people to cancer. It is usually caused by a mutation in the Adenomatous polyposis coli (APC) gene. This gene is critical for several cellular processes and acts as a tumour suppressor by preventing cells from growing and dividing uncontrollably. The team found that almost 20 per cent of the patients had tumors with mutations in the APC gene with characteristics similar to those caused by a bacterial toxin known as colibactin, suggesting the toxin's involvement in initiating polyp formation in these individuals.

This study was built upon an earlier study where the team analysed DNA mutations in 36 Asian patients who were treated in Singapore for a mouth cancer called oral squamous cell carcinoma. "We found a very specific pattern of DNA mutations in the oral cancer of patients who also had severe bacterial infection in their mouth. We found that these DNA mutations had been caused by a toxin called colibactin, which is produced by these bacteria," said Dr Arnoud Boot, Senior Research Fellow at the CSCB programme and the lead author of this study.

Colibactin, is produced by a specific group of Escherichia coli bacteria, which normally live in the gut. While exposure to colibactin is difficult to prevent, the research team suggests that regular brushing of teeth might have prevented the bacterial infection that appears to have triggered the cancer-causing DNA mutation in the oral cancer patient who was examined.

"There are bacteria that sometimes live in the human body, making a toxin that contributes to cancer formation. In addition to understanding what causes cancer, our results also indicate that some cancers that are caused by colibactin might be preventable," said Professor Steve Rozen from Duke-NUS' CSCB programme, who is the corresponding author of one of these studies.

"These kinds of investigations by our researchers from the CSCB programme are crucial in better understanding how to prevent cancer by targeting cancer-specific changes," said Prof Patrick Casey, Senior Vice Dean for Research at Duke-NUS.

The team next aims to analyse a larger dataset of cancers that could be associated with colibactin.

Credit: 
Duke-NUS Medical School

"Inchworm" pattern of Indonesian earthquake rupture powered seismic "boom"

image: Snapshots of the slip evolution in a map view. Color contours show the slip rate. Traces of surface ruptures are shown as red lines. The time when each snapshot was taken is denoted at the upper left of each panel. The figure shows that the rupture front propagated from the epicenter (star) toward the south. Stagnation of the slipping patch can be seen at Bend 1 at 6 s, followed by advancement through Bend 2 at 27 s. The transient deceleration and acceleration of the rupture is illustrated as inchworm locomotion.

Image: 
University of Tsukuba

Tsukuba, Japan - Earthquakes are often imagined as originating from a single point where the seismic waves are strongest, the hypocenter underground or the epicenter at the Earth's surface, with seismic energy radiating outward in a circular pattern. But this simplified model fails to account for the complex geometry of the actual fault systems where earthquakes occur. The real situation may be much more complex--and more interesting. In some remarkable cases, a phenomenon called "supershear" rupture can occur, where the earthquake rupture propagates along the fault at a speed faster than the seismic waves themselves can travel--a process analogous to a sonic boom.

In a new study published in Earth and Planetary Science Letters, researchers at the University of Tsukuba investigated a case of supershear rupture, the 2018 Palu earthquake (moment magnitude: 7.6) in Sulawesi, Indonesia, and its relationship with the complex geometry of the fault system.

Study co-author Professor Yuji Yagi explains, "We used globally observed teleseismic wave data and performed finite-fault inversion to simultaneously resolve the spatiotemporal evolution of slip and the complex fault geometry."

The results of this analysis showed that the propagation of supershear rupture of the Palu-Koro fault southward from the earthquake's epicenter was sustained by a pattern of repeated delay and advancement of slip along the fault, associated with the fault system's complex geometry. Areas with particularly high slip rates, referred to as "slipping patches," were identified near the epicenter as well as 60, 100, and 135 km south of the epicenter. In addition, three distinct episodes of rupture after the process initiated were distinguished, with delays in the advancement of the slipping patches between them.

Tracing the surface rupture of the earthquake showed two major bends in the earthquake fault, 10-25 km south of the epicenter and 100-110 km south of the epicenter. Supershear rupture persisted along this geometrically complex fault.

As lead author Professor Ryo Okuwaki describes, "Our study shows that the geometric complexity of a fault can significantly influence the velocity of rupture propagation. Our model of the 2018 Palu earthquake shows a zigzag pattern of slip deceleration and acceleration associated with bends in the fault, which we have named inchworm-like slip evolution. We propose that the geometric complexity of a fault system can promote persistent supershear rupture, enhanced by repeated inchworm-like slip evolution."

These findings may have significant implications regarding assessment of future earthquake impacts and related disasters. For example, the authors suggest that the slipping patch they detected beneath Palu Bay may have contributed to generation of the 2018 Palu tsunami, which added to the devastation of the earthquake.

Credit: 
University of Tsukuba

Photonic amorphous topological insulator

image: a-b, Particle patterns a and the corresponding photonic lattices b with different structural correlations. The crystalline lattice possesses both long-rang and short-range order; the glass-like lattices have strong short-range order; the liquid-like lattice yields weak short-range order. c, Pair correlation function g(r) for the different lattices which quantifies structural correlation. d, Localization lengths (black curves) and transmissions (red curves) for the photonic lattices. The orange regions indicate the frequency windows in which topological edge states can be observed.

Image: 
by Peiheng Zhou, Xin Ren, Yihao Yang, Haoran Xue, Lei Bi, Longjiang Deng, Yidong Chong, and Baile Zhang

The paradigm-shifting concept of topology has not only revolutionized condensed matter physics, but has also opened a fundamentally new chapter in photonics, mechanics, acoustics, and many other fields. In photonics, "photonic topological insulators" (PTIs), the photonic analogs of electronic topological insulators, have enabled unprecedented exciting photonic functionalities such as one-way robust photonic transport and topological lasers.

These topological systems, whether based on condensed matter or photonics, typically derive their topological properties from bandstructures based on periodic lattices. On the other hand, photonic amorphous phases without periodic atomic lattices widely exists in nature (e.g., glass, polymer, and gel). The properties of these amorphous systems are determined by the short-range connectivity of their atoms/molecules, rather than the long-range periodicity.

In a new paper published in Light Science & Application, a team of scientists, led by Professor Peiheng Zhou / Professor Longjiang Deng from University of Electronic Science and Technology of China, Professor Yidong Chong and Professor Baile Zhang from Nanyang Technological University have experimentally realized amorphous PTIs that are non-crystalline variants of a Chern-number-based PTI. Their study demonstrates the interesting interplay between topology and short-range order, especially during the glass transition. Chern-number-based PTIs are the first type of PTI ever realized. Their work is the first to study amorphous PTIs using this type of photonic structure. They also find that the extinction of photonic topological edge states refers to the glass transition. These insights may be useful for realizing amorphous topological insulators in other physical settings such as acoustics.

The amorphous PTI consists of gyromagnetic rods that are arranged in computer-generated amorphous lattice patterns, and magnetically biased to break time-reversal symmetry. By performing edge/bulk transmission and near-field distribution measurements to the PTIs in a copper parallel-plate waveguide, the existence of robust topological edge states in the amorphous PTIs are experimentally verified prior to the onset of the glass transition. By further deforming the amorphous lattice into a liquid-like lattice, the closing of the mobility gap and the disappearance of the topological edge states are observed. These scientists summarize the features of their topological system:

"We design an amorphous PTI system with three advantages: (1) the amorphous lattices are realizable in natural materials as they are generated by Molecular Dynamics Methods; (2) the full mapping from crystalline to glass-like amorphous to liquid-like phases yields the whole evaluation of the topology, from emergence to extinction, and clearly captures the role of the glass-liquid transition; and (3) the photonic platform can be immigrated to verify other non-periodic photonic topological materials."

"The topological protection supported by the short-range order in our amorphous PTIs persists remarkable robustness to large defects, e.g. 3 times the characteristic length of the lattices, and 90º bends, all comparable to the crystalline counterparts" they added.

"The presented approach can be used to develop specific amorphous PTIs with desired structural correlations, e. g. the hyperuniform structures studied in bandgap photonic crystals, or monitor other non-periodic PTIs, e.g. the quasi-crystals or metamaterials. Our findings will therefore be highly useful for future works investigating non-crystalline topological photonic materials for novel photonic devices, such as topological random lasers." the scientists forecast.

Credit: 
Light Publishing Center, Changchun Institute of Optics, Fine Mechanics And Physics, CAS

Study finds increase in number, severity of suicide-related calls to US Poison Control

(COLUMBUS, Ohio) - Over-the-counter (OTC) analgesics like acetaminophen, ibuprofen, and acetylsalicylic acid (aspirin) have long been a staple in households for managing pain, fevers, and other common ailments. However, the accessibility of these medications can make them easy to take in dangerous amounts. In a new study, researchers at the Center for Injury Research and Policy and the Central Ohio Poison Center at Nationwide Children's Hospital analyzed the 549,807 calls made to Poison Control Centers (PCCs) in the US for suicide-related cases involving OTC analgesics from 2000 through 2018 and found that both the overall number and rate of these cases increased significantly by 57% and 34%, respectively, during this period. This trend was driven primarily by the increasing exposures among 6-19-year-old females.

The study, published in Pharmacoepidemiology and Drug Safety, found that children between the ages of 6 and 19 years accounted for half of all suicide-related OTC analgesics cases (50%) and females represented 73% of cases among individuals of all ages.

In addition to the increase in the number and rate of cases, there was also an increase in the severity of the exposures. The proportion of calls resulting in a serious medical outcome or admission to a health care facility increased significantly (a 64% increase and 29% increase, respectively) over the study period. The proportion of cases resulting in a serious medical outcome or admission also increased with increasing age.

"Because they are easy to purchase and can help alleviate a variety of symptoms, many families have over-the-counter pain relievers readily available in their homes, often in large quantities," said Alexandra Funk, PharmD, D.ABAT, co-author of the study and director of the Central Ohio Poison Center at Nationwide Children's. "Unfortunately, the easy access to these medications is likely a big part of the reason that they are used in suicide attempts and deaths. The fact that they are being used more often with more serious outcomes is cause for concern."

Nearly half (48%) of cases involved acetaminophen alone, followed by ibuprofen (33%), and aspirin (19%). Acetaminophen and aspirin disproportionately accounted for 65% and 33% of deaths, respectively. In addition, aspirin resulted in the greatest proportion of serious medical outcomes (36%) and admissions to a health care facility (68%) when compared with the other analgesics. The rates of suicide-related cases involving acetaminophen and ibuprofen increased during the study, while the rate of aspirin cases decreased.

Almost one-third of cases involved exposure to multiple substances (32%), and those cases were twice as likely to have a serious medical outcome and almost twice as likely to be admitted to a health care facility compared with individuals exposed to a single substance.

"An important first step to reduce the suicidal use of over-the-counter analgesics would be to require unit-dose packaging, or 'blister packs,' for all solid forms of acetaminophen and aspirin sold to consumers. Because suicidal ingestion is often a highly impulsive act, this would deter overdoses by limiting the amount of medication that can be extracted at one time," said Gary Smith MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children's. "In addition, the US should follow the lead of other countries that have successfully reduced suicidal ingestions of these medications by limiting the package size and quantity that can be purchased by an individual at one time." Dr. Smith added, "Remarkably, the top three substance categories associated with suicide-related ingestions in the US are antidepressants, over-the-counter analgesics, and antipsychotics, and of these, over-the-counter analgesics is the only one readily available without a prescription or other restrictions."

Credit: 
Nationwide Children's Hospital

'Selfish and loveless' society in Uganda really is not

image: he Ik society of Uganda, labeled half a century ago as selfish, actually has a culture that encourages sharing with the needy, new study finds.

Image: 
Cathryn Townsend

A mountain people in Uganda -- branded as selfish and loveless by an anthropologist half a century ago -- really is not, according to a study led by a Baylor University anthropologist.

The research debunks the assessment of the Ik ethnic group of hunter-gatherers set out in the book "The Mountain People," published by Colin Turnbull in 1972.

Baylor anthropologist Cathryn Townsend, Ph.D., formerly of Rutgers University, lived with and gathered data from the Ik in 2016 to 2018. She found that Turnbull's research, done during a severe famine in the mid-1960s, did not uncover typical behavior of the Ik, and that sharing and cooperating re-emerged once resources were plentiful enough.

"The Ik have been misrepresented by outsiders who gave far too much credence to Turnbull's flawed research," Townsend said. "The Ik people have not yet themselves had much of a chance to talk back to correct this misrepresentation of their culture, but our research shows that associating the Ik with selfishness is a myth and that it is simply wrong.

"Ik culture includes traits that encourage sharing with those in need and a belief in supernatural punishment of selfishness," she said. "The findings confirm the consensus among scholars that humans are remarkably cooperative."

The study, published in the journal Evolutionary Human Sciences, was conducted with co-researchers from Arizona State University, Vrige Universiteit in Amsterdam and Rutgers University.

Turnbull did his fieldwork between 1964 and 1967, going so far as to advocate that the group be rounded up forcibly regardless of age and gender and taken to remote parts of Uganda to stamp out culture traits. His depiction of the Ik attracted attention from such publications as TIME Magazine and The New York Times, inspired a play by Royal Shakespeare Company and was accepted by anthropologist Margaret Mead.

The Ik, who live in villages ranging from 50 to 250 people, believe that the landscape is inhabited by spirits with shadowy human forms. Their religion also incorporates Christianity and the idea of a creator or supreme god. They believe nature spirits bring misfortune to those who fail to share and reward those who are generous.

In the study, Townsend used an instrument commonly used in the human sciences to assess generosity. It includes a theoretical framework in which a person receives money and the opportunity to share some, none or all with an anonymous person in their community.

About 120 Ik individuals were divided into four groups and asked whether they would be willing to share a typical day's wages of 2,000 Ugandan shillings (equal to about 50 cents in the United States).

The scenarios, with varying details about needs and religious beliefs, included:

You will be given 2,000 shillings to decide how to share between yourself and another member of your community. You will not find out who this person is, and they will not find out who you are.

You will be given 2,000 shillings to decide how to share between yourself and another member of your community who is in need. For example, that person may be old and hungry. You will not find out who this person is, and they will not find out who you are.

What do you know of Earth spirits? Do they cause trouble for people who do not share? Do they bring good fortune to those who do? You will be given 2,000 shillings to decide how to share between yourself and another community member. You will not find out who this person is, and they will not find out who you are.

What do you know of Earth spirits? Do they cause trouble for people who do not share? Do they bring good fortune to those who do? You will be given 2,000 shillings to decide how to share between yourself and a community member in need. For example, that person may be old and hungry. You will not find out who this person is, and they will not find out who you are
.

Results showed participants were most likely to be more generous in the scenario that included both a needy recipient and supernatural punishment, as compared with the first scenario. The responses in Scenarios 2 and 3 also were more generous.

"People behaved, on average, very slightly more generously in Scenario 3 -- which referred to supernatural punishment -- than they did in Scenario 2, but the difference is negligible," Townsend said.

In the study, Townsend also observed the people's day-to-day sharing and asked what sharing meant to them. Sharing is based on need and ties of friendship, kinship or clan, but interviewees also talked about the importance of cultivating sharing. Said one man: "If you keep everything in your granary to yourself, you will still run out of food during the hunger season, and then you will suffer because no one will share with you."

In one case, the Ik even accepted a widow and infant who were refugees from a nearby and often hostile group.

In Townsend's interviews with 60 respondents, more than three fourths said Earth spirits caused trouble for people who do not share; nearly half said the spirits bring good fortune to those who do.

In a second analysis, researchers compared the Ik's sharing with generosity assessments of more than 20,000 participants, mostly in Western countries. They found the people's behavior similar to that of other societies.

"While the selfish behavior observed by Turnbull may have been at least partly real, we can conclude that this was due to a severe famine at the time in which people were starving to death, not culture," Townsend said. "The Ik people have experienced many extreme hardships since the famine that Turnbull witnessed in the 1960s, but the resilience of Ik culture traits of generosity should give us all hope that human cooperation ultimately overcomes adversity."

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Baylor University

Wealthier men are more likely to develop high blood pressure

Sophia Antipolis, 27 July 2020: Working men with higher incomes are more likely to develop high blood pressure, reports a study presented at the 84th Annual Scientific Meeting of the Japanese Circulation Society (JCS 2020).

JCS 2020 takes place online from 27 July to 2 August in conjunction with the Asian Pacific Society of Cardiology Congress 2020 (APSC 2020). Joint scientific sessions are being held by the European Society of Cardiology (ESC) and JCS as part of the ESC Global Activities programme.1

"Men with higher incomes need to improve their lifestyles to prevent high blood pressure," said study author Dr. Shingo Yanagiya of the Hokkaido University Graduate School of Medicine, Sapporo, Japan. "Steps include eating healthily, exercising, and controlling weight. Alcohol should be kept to moderate levels and binge drinking avoided."

More than one billion people have high blood pressure worldwide.2 Around 30-45% of adults are affected, rising to more than 60% of people over 60 years of age. High blood pressure is the leading global cause of premature death, accounting for almost 10 million deaths in 2015. Of those, 4.9 million were due to ischaemic heart disease and 3.5 million were due to stroke.

Japan alone has more than 10 million people with high blood pressure, and the number continues to rise. Dr. Yanagiya said: "High blood pressure is a lifestyle-related disease. As a physician seeing these patients I wanted to know if risk varies with socioeconomic class, to help us focus our prevention efforts."

This analysis of the J-HOPE3 study examined the relationship between household income and high blood pressure in Japanese employees. A total of 4,314 staff (3,153 men and 1,161 women) with daytime jobs and normal blood pressure were enrolled in 2012 from 12 workplaces.

Workers were divided into four groups according to annual household income: less than 5 million, 5 to 7.9 million, 8 to 9.9 million, and 10 million or more Japanese yen per year. The researchers investigated the association between income and developing high blood pressure over a two-year period.

Compared to men in the lowest income category, men in the highest income group were nearly twice as likely to develop high blood pressure. Men in the 5 to 7.9 million and 8 to 9.9 million groups had a 50% higher risk of developing high blood pressure compared to men with the lowest incomes, although the positive association did not reach statistical significance in the 8 to 9.9 million group.

The findings were consistent regardless of age, and were independent of baseline blood pressure, worksite, occupation, number of family members, and smoking. The relationships were slightly weakened after accounting for alcohol consumption and body mass index (BMI; kg/m2), both of which were higher for men in the higher income groups.

In women, there was no significant link between income and blood pressure. However, women with higher household income tended to have a lower risk of developing high blood pressure.

"Some previous Japanese surveys have reported that higher household income is associated with more undesirable lifestyles in men, but not in women," said Dr. Yanagiya. "Our study supports this: men, but not women, with higher household incomes were more likely to be obese and drink alcohol every day. Both behaviours are major risk factors for hypertension."

He concluded: "Men with high-paying daytime jobs are at particular risk of high blood pressure. This applies to men of all ages, who can greatly decrease their chance of a heart attack or stroke by improving their health behaviours."

Dr. Yusuke Yoshikawa, public relations coordinator for JCS 2020, said: "Hypertension is one of the most important risk factors of cardiovascular disease in Japan, because the average daily salt intake in Japan (approx. 10 g/day) is much higher than desired. As the current guidelines2 strongly recommend healthy lifestyle to control high blood pressure, this study suggests a potential key to successful intervention for those who are at risk of heart disease and stroke."

Professor Michel Komajda, a Past President of the ESC and course director of the ESC programme at JCS 2020, said: "The ESC is delighted to be part of JCS 2020 in Kyoto. We value our special partnership with JCS and the high quality of Japanese research. Japan is among the top submitters of abstracts to ESC Congress."

ENDS

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European Society of Cardiology

Low plasma 25(OH) vitamin D level associated with increased risk of COVID-19 infection

Vitamin D is recognized as an important co-factor in several physiological processes linked with bone and calcium metabolism, and also in diverse non-skeletal outcomes, including autoimmune diseases, cardiovascular diseases, type 2 diabetes, obesity and cognitive decline, and infections. In particular, the pronounced impact of vitamin D metabolites on the immune system response, and on the development of COVID-19 infection by the novel SARS CoV-2 virus, has been previously described in a few studies worldwide.

The collaborative group of scientists from the Leumit Health Services (LHS) and the Azrieli Faculty of Medicine of Bar-Ilan University aimed to determine associations of low plasma 25(OH)D with the risk of COVID-19 infection and hospitalization. Using the real-world data and Israeli cohort of 782 COVID-19 positive patients and 7,025 COVID-19 negative patients, the groups identified that low plasma vitamin D level appears to be an independent risk factor for COVID-19 infection and hospitalization. The research was just published in The FEBS Journal.

"The main finding of our study was the significant association of low plasma vitamin D level with the likelihood of COVID-19 infection among patients who were tested for COVID-19, even after adjustment for age, gender, socio-economic status and chronic, mental and physical disorders," said Dr. Eugene Merzon, Head of the Department of Managed Care and leading researcher of the LHS group. "Furthermore, low vitamin D level was associated with the risk of hospitalization due to COVID-19 infection, although this association wasn't significant after adjustment for other confounders," he added. "Our finding is in agreement with the results of previous studies in the field. Reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported," said Dr. Ilan Green, Head of the LHS Research Institute.

"According to our analysis, persons that were COVID-19 positive were older than non-infected persons. Interestingly, the two-peak distributions for age groups were demonstrated to confer increased risk for COVID-19: around ages 25 and 50 years old," said Dr. Milana Frenkel-Morgenstern, the leader of the Azrieli Faculty of Medicine research group. "The first peak may be explained by high social gathering habits at the young age. The peak at age 50 years may be explained by continued social habits, in conjunction with various chronic diseases," Dr. Frenkel-Morgenstern continued.

"Surprisingly, chronic medical conditions, like dementia, cardiovascular disease, and chronic lung disease that were considered to be very risky in previous studies, were not found as increasing the rate of infection in our study," noted Prof. Shlomo Vinker, LHS Chief Medical Officer. "However, this finding is highly biased by the severe social contacts restrictions that were imposed on all the population during the COVID-19 outbreak. Therefore, we assume that following the Israeli Ministry of Health instructions, patients with chronic medical conditions significantly reduced their social contacts. This might indeed minimize the risk of COVID-19 infection in that group of patients," explained Prof. Vinker.

Dr. Dmitry Tworowski and Dr. Alessandro Gorohovski. from the Frenkel-Morgenstern laboratory at Bar-Ilan University's Azrieli Faculty of Medicine, suggest that the study will have a very significant impact. "The main strength of our study is its being large, real-world, and population-based," they explained. Now researchers are planning to evaluate factors associated with mortality due to COVID-19 in Israel. "We are willing to find associations to the COVID-19 clinical outcomes (for example, pre-infection glycemic control of COVID-19 patients) to make the assessment of mortality risk due to COVID-19 infection in Israel," said Dr. Eugene Merzon.

Credit: 
Bar-Ilan University

NTU Singapore researchers speed up gold-standard COVID-19 diagnostic test

image: A team from NTU LKCMedicine have demonstrated a way to improve the speed, handling time and cost of COVID-19 laboratory tests. The improved testing method yields results in 36 minutes - a quarter of the time required by existing gold-standard tests.
(L-R for Image 1: PhD candidate Mr Wee Soon Keong, Associate Professor Eric Yap, and senior research fellow Dr Sivalingam Paramalingam Suppiah)

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NTU Singapore

Clinician-scientists at Nanyang Technological University, Singapore's (NTU Singapore) Lee Kong Chian School of Medicine (LKCMedicine) have demonstrated a way to improve the speed, handling time and cost of COVID-19 laboratory tests. The improved testing method yields results in 36 minutes - a quarter of the time required by existing gold-standard tests.

Their new approach could enable the wider adoption of COVID-19 testing for diagnosis in academic or research laboratories, and allow for screening and research especially in countries and regions with limited laboratory capabilities. The test, which can be done with portable equipment, could also be deployed in the community as a screening tool.

Currently, the most sensitive method for testing for COVID-19 is through a laboratory technique called polymerase chain reaction (PCR), in which a machine amplifies viral genetic material by copying it over and over again so any trace of the SARS-CoV-2 virus can be detected.

A big bottleneck in sample testing is RNA purification - separating RNA from other components in the patient sample - a laborious process that requires chemicals that are now in short supply worldwide. Its steps have to be performed by highly trained technical staff and can take a few hours. Currently, automated equipment for sample preparation costs hundreds of thousands of dollars, and requires specialised laboratory facilities.

The method developed by NTU LKCMedicine combines many of these steps and allows direct testing on the crude patient sample, cutting down the turnaround time from sample-to-result, and removing the need for RNA purification chemicals.

Details of the new approach were published in the scientific journal Genes in June.

Mr Wee Soon Keong, a PhD candidate at NTU LKCMedicine and the first author of the paper, said: "While polymerase chain reaction (PCR) is a venerable technology that has proven to be a workhorse for biological research, it has some drawbacks when used outside of the laboratory environment. The process is fiddly and time-consuming. Our rapid COVID-19 test involves a single-tube reaction that reduces hands-on time and biosafety risk for lab personnel, as well as the likelihood for carryover contamination during the processing of samples."

Aside from testing for COVID-19, the same method developed by the NTU LKCMedicine team can also be used to detect other viruses and bacteria, including the dengue virus, which is set to plague Singapore as the country braces itself for one of the worst dengue outbreaks amid the coronavirus pandemic.

Leader of the research team, Associate Professor Eric Yap, who also heads the Microbial Genomics Laboratory, said: "We previously demonstrated that this method works for dengue virus as well. When used directly on a crude blood sample with dengue virus, the test yielded results in 28 minutes. As Singapore battles the dual outbreak of dengue and COVID-19, both with similar early symptoms, our test could help in differentiating between the two infectious diseases."

Professor James Best, Dean of NTU LKCMedicine, said: "As Singapore continues with proactive testing to detect, isolate, and contain the possible spread of the coronavirus, rapid portable screening tools like the one developed by Assoc Prof Yap and his team could come in handy at testing sites in the community, allowing for infected patients to be identified quickly, and swift action to be taken to prevent transmission."

From benchtop to portable testing

Typically, in PCR tests, the genetic material on a swab sample collected from a patient has to be extracted to remove any substances in the sample that prevent the PCR test from working. An example of an inhibitor in respiratory samples is mucin (a main component of mucus).

The test designed by the NTU LKCMedicine team, which includes senior research fellow Dr Sivalingam Paramalingam Suppiah, uses the 'direct PCR' method, removing the need for RNA purification, a time-consuming and costly step. Instead, they added inhibitor-resistant enzymes and reagents targeting compounds that obstruct RNA amplification, such as mucin, a main component of mucus. These enzymes and reagents, which are commercially available, have high resistance to such compounds that otherwise inhibit PCR, rendering the test inaccurate.

The biochemical mix of crude sample and inhibitor-resistant enzymes and reagents is placed into a single tube, which is inserted into a laboratory thermocycler, a machine used to amplify genetic material in PCR. After 36 minutes, results reveal whether there is any trace of COVID-19 with confidence.

"By skipping the RNA extraction step with our direct-PCR method, we see cost savings on nucleic acid extraction kits, and avoid the problem of reagents in short supply when lab testing is ramped up and the demand increases globally," said Dr Sivalingam.

The team also tested this method on a portable thermocycler, which can be deployed in low-resource settings and endemic areas, pointing to the possibility of having this test done in community healthcare settings by frontline healthcare workers.

Assoc Prof Yap said: "We are now trying to deploy such direct-PCR methods, developed by ourselves and others, for routine diagnostics. We need to determine the actual utility and benefits in a real-world setting, and to understand if there are any trade-offs. When one bottleneck is removed, other challenges may emerge - like ensuring quality control, or reducing manual errors."

The team is now looking to use this method for COVID-19 testing at the NTU Clinical Diagnostic Laboratory at LKCMedicine that Assoc Prof Yap heads.

"Our goal is to develop ultrafast and automated tests that yield results in minutes, and that can be performed by healthcare workers in the clinic with similar accuracy and sensitivity as in specialised laboratories. This will allow us to take PCR testing out of conventional laboratories nearer to the point-of-care, and into the low-resource settings that need them the most," he said.

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Nanyang Technological University

Developing a new strategy to selectively deliver therapies to the brain

image: Short time-intervals (15 mins) between injection of biotin-PECAM1 antibody and injection of avidin-decorated nanomachines (avidin-NM) results in avidin-NM targeting to the lung (yellow), brain (blue), heart (red), and pancreas (purple) (a). However, targeting to peripheral organs decreases as a function of time-interval length, while targeting to the brain remains constant (b, c). Consequently, an 8h time-interval results in specific targeting of avidin-NM to the brain, with no targeting seen in peripheral organs (d). Avidin-NM accumulation was visualized in freshly excised brains (e) and fixed brain tissue (f).

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2020 Innovation Center of NanoMedicine

Therapy-loaded nanoparticles may be directed to the brain by functionalization with ligands targeting BBB-associated proteins. However, such targeting strategies have inherent brain-specificity limitations, as the target proteins are also significantly expressed in peripheral organs, thereby limiting the clinical application of such strategies. We have developed a counterintuitive targeting strategy which exploits the high impermeability of the BBB itself to selectively retain molecular labels (i.e. targets) on the surface of brain endothelium. Nanoparticles capable of binding the displayed targets are consequently directed specifically to the brain microvasculature with minimal targeting to peripheral organs. This two-step targeting strategy therefore paves the way to overcome the peripheral 'off-target' nanoparticle accumulation, increasing the clinical translation of nanoparticle-based therapies. The results have been published in the July 23 issue of Proceedings of the National Academy of Science (Impact Factor = 9.5804).

July 27, 2020 - Kawasaki / Japan: The Innovation Center of NanoMedicine (Director: Prof. Kazunori Kataoka, Location: Kawasaki-City, Abbreviation: iCONM) announced that a new strategy to specifically target to the brain was discovered in collaboration with the Department of Bioengineering, Graduate School of Engineering, University of Tokyo. The details are published in the Proceedings of the National Academy of Science (Impact factor = 9.350 in 2019) issued on July 23. (Note 1)

Treatment of neurological diseases is severely hindered by the poor delivery of therapies to the brain due to the presence of the blood-brain barrier (BBB), a highly impermeable cellular barrier composed primarily by the specialized endothelial cells lining the brain microvasculature. Nanotechnology-based strategies have achieved modest success in delivering therapeutics to the brain by loading them onto nanomachines (Note 2) decorated with ligands which bind to proteins associated with the BBB (Note 3). However, such targeting strategies have inherent brain-specificity limitations, as the target proteins are also significantly expressed in peripheral organs, leading to increased accumulation of nanomachines for instance in the lung and heart. Therefore, the clinical translation of current strategies is hampered by detrimental peripheral side-effects and reduced effective therapeutic doses reaching the brain. Hence, new strategies which exploit alternative features of the BBB need to be developed to overcome 'off-target' accumulation of nanomachines.

The group of Prof. Kataoka have developed a simple, yet counterintuitive strategy which turns the problem of therapy delivery to the brain, that is, the high impermeability of brain endothelial cells, into the solution to achieve specific brain targeting of nanomachines with minimal accumulation increase in peripheral organs.

The high impermeability of brain endothelial cells is in large part due to a markedly reduced level of endocytosis compared to peripheral endothelial cells. This feature may therefore be exploited to promote free, unconjugated molecular labels to be selectively retained on the surface of brain endothelial cells while being quickly removed (endocytosed) from the surface of endothelial cells of other organs in the body. In this way, nanomachines capable of efficiently recognizing the displayed molecular labels are specifically targeted to the brain with minimal targeting into other organs.

The feasibility of such an approach has been demonstrated by employing biotin-containing antibodies against the protein Platelet Endothelial Cell Adhesion Molecule (PECAM)-1, which is expressed in the vasculature of most organs. The authors demonstrated that if nanomachines decorated with the protein avidin (capable of very strongly binding to biotin) are injected into mice a short time-period after injection of biotin-PECAM-1 antibodies, the nanomachines accumulate preferentially in the lung, with accumulation also seen in the brain, heart and pancreas (note 4). However, if the time-interval between antibody and nanomachine injection is increased to allow removal of the antibody from the surface of peripheral endothelial cells, the ability of the nanomachines to accumulate in the lung, heart and pancreas steadily decreases, while accumulation in the brain remains constant. Hence, after an 8 hr time-interval, the nanomachines were only targeted to the brain, with no increase in accumulation seen in any peripheral organ.

This novel two-step targeting strategy therefore paves the way to overcome the limitation of peripheral "off-target" nanomachine accumulation, thereby increasing the clinical translation of nanomachine-based therapies.

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Innovation Center of NanoMedicine

Existing evidence suggests face coverings do not lead to false sense of security

Existing limited evidence suggests that wearing face coverings to protect against COVID-19 does not lead to a false sense of security and is unlikely to increase the risk of infection through wearers foregoing other behaviours such as good hand hygiene, say researchers from the University of Cambridge and King's College London.

Writing in BMJ Analysis, the researchers say that the concept of 'risk compensation' is itself the greater threat to public health as it may discourage policymakers from implementing potentially effective measures, such as wearing face coverings.

Wearing face coverings, particularly in shared indoor spaces, is now mandated or recommended in more than 160 countries to reduce transmission of SARS-CoV-2, the virus that causes COVID-19. Worn correctly, face coverings can reduce transmission of the virus as part of a set of protective measures, including maintaining physical distance from others and good hand hygiene.

While it is not clear how much of an effect face coverings have, scientists have urged policymakers to encourage the wearing of face coverings because the risks are minimal while the potential impact is important in the context of the COVID-19 pandemic.

However, early in the pandemic, the World Health Organization warned that wearing face coverings could "create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices". This type of behaviour is known as 'risk compensation'.

A team led by Professor Dame Theresa Marteau at the Behaviour and Health Research Unit, University of Cambridge, has examined the evidence for risk compensation to see whether concerns might be justified in the context of face coverings to reduce transmission of SARS-CoV-2.

The idea behind risk compensation is that people have a target level of risk they are comfortable with and they adjust their behaviour to maintain that level risk. At an individual level, risk compensation is commonplace: for example, people run for longer to offset an eagerly anticipated indulgent meal and a cyclist may wear a helmet to cycle at speed.

At a population level, evidence for risk compensation is less clear. A commonly-cited example is the mandated wearing of bike helmets purportedly leading to an increase in the number of bike injuries and fatalities. Another often-cited example is the introduction of HIV pre-exposure prophylaxis (PrEP) and HPV vaccination purportedly leading to an increase in unprotected sex.

Professor Marteau and colleagues say the results of the most recent systematic reviews - a technique that involves examining all available evidence on a topic - do not justify the concerns of risk compensation for either of these examples. In fact, for HPV vaccination, the opposite effect was found: those who were vaccinated were less likely to engage in unprotected sexual behaviour as measured by rates of sexually transmitted infection.

At least 22 systematic reviews have assessed the effect of wearing a mask on transmission of respiratory virus infections. These include six experimental studies, involving over 2,000 households in total - conducted in community settings that also measured hand hygiene. While none of the studies was designed to assess risk compensation or looked at social distancing, their results suggest that wearing masks does not reduce the frequency of hand washing or hand sanitising. In fact, in two studies, self-reported rates of hand washing were higher in the groups allocated to wearing masks.

The team also found three observational studies that showed people tended to move away from those wearing a mask, suggesting that face coverings do not adversely affect physical distancing at least by those surrounding the wearer. However, they say that as none of these studies have been peer-reviewed, they should be treated with caution.

"The concept of risk compensation, rather than risk compensation itself, seems the greater threat to public health through delaying potentially effective interventions that can help prevent the spread of disease," said Professor Marteau.

"Many public health bodies are coming to the conclusion that wearing a face covering might help reduce the spread of SARS-CoV-2, and the limited evidence available suggests their use doesn't have a negative effect on hand hygiene," added co-author Dr James Rubin from the Department of Psychological Medicine, King's College London.

In their article, the team argue that it is time to lay risk compensation theory to rest. Professor Barry Pless from McGill University, Montreal, Canada, once described it as "a dead horse that no longer needs to be beaten." The authors go further, saying "this dead horse now needs burying to try to prevent the continued threat it poses to public health, from by slowing the adoption of more effective interventions".

Credit: 
University of Cambridge

Blueprint may power up KSA's wind energy future

A five-year study of wind energy potential in Saudi Arabia has culminated in a comprehensive blueprint for progressing the Kingdom's national wind energy strategy. Exhaustive high-resolution modeling was combined with a unique set of wind and weather observations and analysis of land-use restrictions, cost and technologies to guide the optimal buildout of wind turbines.

The program was led by KAUST's Marc Genton in close collaboration with atmospheric simulation experts at the University of Notre Dame in the USA. "Through our novel methodology and ad-hoc computer simulations, we have accurately quantified wind energy resources in Saudi Arabia and have provided a detailed plan for a cost-effective implementation of the government's wind energy target of 16 gigawatts of installed capacity by 2030," says Genton. "Our work shows that Saudi Arabia is well positioned to become a role model for wind energy development in the Middle East and worldwide."

The reliable calculation of wind energy resources is a prerequisite for the development of a strong wind energy industry. Although wind energy potential has been rigorously quantified in many developed countries, this critical step remains a major obstacle for many emerging economies due to the lack of widespread wind monitoring data and well-developed high-resolution atmospheric models.

"We spent five years researching the right methodology and the most appropriate simulations and finding suitable ground data," says Genton. "We also engaged with collaborators at the University of Notre Dame, who had a lot of expertise in simulating atmospheric phenomena at regional scales with computer models. With their simulations and help in developing new methods, we are able to accurately characterize the weather occurring in the atmosphere at spatial scales of up to thousands of kilometers."

Genton points out that typically, the main challenge of such studies is how to validate the computer simulations against measured data. Fortunately, the researchers were able to make use of the highly detailed wind and atmospheric measurements recorded through the King Abdullah City for Atomic and Renewable Energy (KA-CARE) program.

"The KA-CARE dataset was a game changer in showing that our model simulations provide accurate results," says Genton. "Our findings can now be used by policymakers to efficiently plan for the development of wind energy infrastructure, and our generalizable methodology can be used by the scientific community to identify optimal locations and the most suitable technological options for wind energy harvesting in other contexts and other countries."

Credit: 
King Abdullah University of Science & Technology (KAUST)