Culture

More lonely deaths in hospitals and nursing homes from COVID

CHICAGO--- Patients who died from COVID in 2020 were almost 12 times more likely to die in a medical facility than patients who died from any cause in 2018, reports a new Northwestern Medicine study.

This the first study to look at place of death for patients with COVID-19 and how these distributions compare to previous trends in location of death for non-COVID-19 illnesses.

The paper was published July 9 in the Journal of the American Geriatrics Society.

"Where you die is important and reflects end-of-life quality for the patient and the family," said lead author Dr. Sadiya Khan, assistant professor of preventive medicine in epidemiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. "The patients dying of COVID-19 in medical facilities may not have any family with them because of visitor restrictions.

"A loved one dying alone takes a huge mental toll on families," Khan said. "It impairs the family's ability to grieve and cope with the loss. For patients, we've all thought about how terrible it would be to have to die alone. This is the horror happening to thousands of people in medical facilities where no family member or loved one is able to be present with them during their final moments on earth."

The new study analyzed data from the Centers for Disease Control and Prevention for deaths related to COVID-19 from February 1, 2020, to May 23, 2020, and found 68.7% of patients who die of COVID-19 died in medical facilities, 22.7% in nursing homes, 5.2% at home and 1.9% in hospice facilities. When compared with 2018 deaths due to all causes over a similar time period, 35.7% of deaths took place in medical facilities, 19.1% in nursing homes, 31.1% at home, and 7.9% in hospice facilities.

There was significant variability across states, with some states having a much higher proportion of nursing home deaths (e.g. Minnesota, 60%) and home deaths (e.g. New York, 8%) deaths.

"High rates of nursing home deaths in several states reveal a highly vulnerable population and the inability to optimize resources such as PPE (personal protection equipment) to prevent infection transmission these high-risk locations," Khan said. "It's especially important as nursing homes are reopening to visitors and may be exposing residents, especially in areas where there are increasing rates of cases."

But nursing home statistics in the study only capture a glimpse of the high proportion of deaths linked to these facilities. It doesn't include people who contracted COVID-19 in a nursing home and were transferred to a hospital or staff who got it working there.

To address the heightened risk in nursing homes, Khan suggests access to adequate PPE for staff and universal testing/screening of people before they are allowed to enter the facilities, even if they don't have symptoms.

To support lonely COVID-19 patients in hospital beds and nursing homes, Khan said these facilities need a virtual infrastructure.

"We can't just rely on individual's iPhones and iPads," Khan said. "There is a land line phone in every room, why couldn't we have a virtual phone in every room or access to face-to-face communication for each patient and their families?"

"These results highlight yet another way that COVID-19 has impacted the health care system," said first author Dr. Sarah Chuzi, a Northwestern Medicine fellow in cardiovascular diseases. "While recent research shows U.S. deaths in medical facilities are decreasing and deaths at home and in hospice facilities are increasing, the burden of deaths attributed to COVID-19 may reverse these overall trends.

"End-of-life care is a hugely important but understudied aspect of medicine. We wanted to ensure this aspect of patient-centered care was acknowledged and studied in order to motivate efforts to improve our current system," Chuzi added.

Credit: 
Northwestern University

Autoclaving, alcohol not the best options for disinfecting, reusing face masks

image: Sergey Grinshpun, PhD, shown in the UC College of Medicine.

Image: 
Colleen Kelley/University of Cincinnati Creative + Brand

A University of Cincinnati researcher is advising against using two widely available sterilization methods to clean disposable surgical masks and N95 respirators for reuse in the midst of the coronavirus pandemic.

Scarcity of personal protection equipment in medical settings has led many health systems to consider sterilizing and reusing masks developed initially as disposable items, says Sergey Grinshpun, PhD, director of the University of Cincinnati Center for Health-Related Aerosol Studies and professor in the UC Department of Environmental and Public Health Sciences.

The Centers for Disease Control and Prevention (CDC) has allowed reuse of N95 facepiece respirators as a crisis capacity strategy.

Grinshpun tested two brands of N95 respirators along with two types of surgical masks -- one with high filtration and one with low-filtration abilities -- using an autoclave, an apparatus that works similar to a pressure cooker to sterilize items by using steam, heat and pressure during a specific time frame.

"The question for us was, what will happen with the performance of these N95 respirators and the surgical masks after they have spent minutes or longer in the autoclave and to what extent will the heat or steam destroy the structure of the filter making the items less useful," says Grinshpun.

Grinshpun also used another decontamination method which employed soaking the respirators and surgical masks in a 70% ethanol treatment for two hours and then drying the devices before their reuse. Alcohol is readily available in hospital settings and utilized for instrument sterilization.

Tests were conducted with disinfection treatments applied up to five times to simulate reusage that might occur in a healthcare setting.

"It almost didn't matter how often we decontaminated the protective devices-- once, twice or five times -- since the major damage inflicted on the performance characteristics of the items followed the first test," explains Grinshpun. "You are going to lose in performance if these masks or respirators are sterilized using either of these treatments. Of course, quantitatively, the effect differs for different devices."

The findings of the study are available online in the Journal of Hospital Infection. Co-authors of the study include Michael Yermakov, MD, senior research associate in the UC Department of Environmental and Public Health Sciences, and Marat Khodoun, PhD, research associate professor in the UC Department of Internal Medicine.

The study found that neither sterilization in an autoclave nor alcohol treatment caused visible damages to the surgical masks. The 3M 8210 N95 respirator revealed physical damages after implementing a single autoclave disinfection such as partial disintegration of the soft sealing material around the nose clip, and, importantly, loss of strap elasticity, which made this respiratory protective device not reusable.

Meanwhile, testing of the remaining 3M 1870 N95 respirator produced notable, but moderate damage and some detachment along with a minor deformation of the nose foam after a single and multiple autoclaving.

Experimental design of the study included testing each protective device by mounting it on a frame designed to utilize the entire effective filtration area. An air flow rate through the system was chosen to mimic breathing of a health care worker under a moderate and a strenuous workload. To simulate contamination of the test protective devices the items were soiled with protein.

"When multiple sterilizations were applied, facepieces were soiled before each autoclave treatment to mimic the device usage in air environments contaminated with protein that may be associated with emission of pathogenic virions by infected persons," according to the study. Researchers chose to perform five soil and sterilization cycles to simulate a daily reuse of the filtering facepiece over a period of five days.

Grinshpun also says that N95 respirators and some surgical masks rely on fibers that have an electrostatic charge which allows them to capture small particles and protect the wearer. Autoclaving and alcohol treatment weaken this electrostatic charge.

"What happens when you subject something to alcohol, heat or steam?" asks Grinshpun. "These fibers will lose, maybe not entirely, but at least some of their electric charge. This has a detrimental effect on the filter performance so that these protective devices may not be able to capture aerosol participles, including coronaviruses, as efficiently anymore."

For some N95 respirators their collection efficiency can drop below their certification level of 95% for the most penetrating particle sizes, says Grinshpun.

He adds that performance of surgical masks changes as a result of autoclaving, whether the mask is soiled or not, with the effect being more pronounced for devices which had poor initial filtration capabilities.

He says instead of using autoclaving or ethanol alcohol to disinfect face masks and N95 respirator facepieces, alternative options such as ultraviolet light may be explored. Grinshpun's study did not look at UV primarily because the investigators intended first to examine methods that are readily available in hospitals.

"We anticipated that UV-based and probably other techniques may be almost as efficient as autoclaving and ethanol treatment in inactivating pathogens but at the same time would not damage the fibers of protective detectives so that the particle collection efficiency will not suffer," says Grinshpun. "Similar studies can and should be conducted with alternative decontamination methods."

"The question of how the disinfection treatments impact the performance and integrity of respiratory protective devices remains important for as long as healthcare workers have to reuse these devices due to their shortage of personal protective equipment," says Grinshpun.

Credit: 
University of Cincinnati

Astrophysicists suggest carbon found in comet ATLAS help to reveal age of other comets

image: Comet C/2019 Y4 (ATLAS)

Image: 
Martin Gembec

Astrophysicists from Far Eastern Federal University (FEFU, Russia), South Korea, and the USA appear in Monthly Notices of the Royal Astronomical Society, suggesting carbon indicates time comets have spent in the Solar System -- the less carbon, the longer they have been in the proximity of the Sun. The proof is their study of the comet ATLAS (C/2019 Y4) approaching the Earth in May 2020 and disintegrated with displaying a major outbreak of the carbonaceous particles.

FEFU astrophysicists, Ekaterina Chornaya and Anton Kochergin joined an international team to analyze the composition of dust particles in the coma, i.e. shell, and tail of Comet ATLAS (C/2019 Y4). According to the researchers, the levels of carbonaceous matter inside the comet were very high.

The team suggest that the amount of carbon in the comas of other comets can indicate the time spent by them in the Solar System. The more carbon a comet coma contains, the less it has been around the Sun, and vice versa.

Comet ATLAS approached the Earth in May 2020 drawing a major interest among the researchers from all over the world, having disintegrated almost literally in front of their eyes.

"ATLAS was expected to be the brightest comet of 2020, visible from the Earth with a naked eye. However, instead of observing the comet itself, we witnessed its disintegration. Luckily, we had begun photometric and polarimetric studies before the process started, and because of that, we are able to compare the composition of the coma before and after the disintegration. In the course of disintegration we noticed a dramatic growth of the positive polarization branch which, according to modeling, is consistent with a high concentration of carbonaceous particles," said Ekaterina Chornaya, a postgraduate at the School of Natural Sciences, FEFU.

According to Ekaterina, Comet ATLAS was a long-period comet -- it used to enter the Solar System once in 5,476 years. Long-period comets approach the Sun only occasionally and therefore are rarely subject to heating. Researchers are especially interested in these comets, as they contain a lot of preserved primordial matter, ancient elements that were formed in the early days of the Solar System. Under the influence of solar radiation, the primordial matter starts to evaporate, and that is when the researchers on the Earth get a chance to study it. In short-period comets that approach the Sun frequently the volume of the primordial matter is very low.

Scientists from all over the world study and compare the physical and chemical composition of dust particles from the comas of comets to learn more about the evolution of the Solar System. To do so, they analyze the ability of such particles to absorb, refract, and polarize light.

According to Ekaterina Chornaya, the polarimetric response of the particles from Comet ATLAS matches that of one of the brightest comets in the history of Earth -- Comet Hale-Bopp, or C/1995 O1 (though several epoch suggest that ATLAS is closer to Comet Hyakutake, or C/1996 B2).

The members of the research team represented the School of Natural Studies of FEFU, the College of Humanities of Kyung Hee University (South Korea), the Department of Astronomy and Space Sciences of Kyung Hee University (South Korea), Institute of Applied Astronomy of the Russian Academy of Sciences, and the Institute of Space Sciences (USA).

Credit: 
Far Eastern Federal University

Mental health units in correctional facilities: Scarce data but promising outcomes

July 13, 2020 - Specialized mental health units (MHUs) may be critical to managing the high rates of serious mental illness in incarcerated populations. But research data on unit characteristics, services provided, and outcomes achieved by MHUs in correctional facilities are scarce, according to a report in the July/August issue of Harvard Review of Psychiatry. The journal is published in the Lippincott portfolio by Wolters Kluwer.

With the scarcity of formal, peer-reviewed studies, Clinical Psychology PhD student Talia Cohen, Rakesh Karmacharya, MD, PhD, and colleagues of McLean Hospital, Belmont, Mass., took a different approach to gathering further information on MHUs in US correctional facilities: they Googled it. "Our gathering and collating the published and publicly available information on these 317 units will help bridge the gap in the literature on MHUs and help facilitate the development of additional MHUs," the researchers write.

Google Search Yields Valuable Data on MHUs in Correctional Facilities

Estimates suggest that 20 percent of inmates in jails and 15 percent of inmates in state prisons may have serious mental illness. Many patients, especially those with psychotic disorders, first receive psychiatric treatment after being incarcerated.

"The incarceration of mentally ill patients, who are often imprisoned due to issues related to untreated mental illness, is a major public health issue," the authors write. They set out to perform the first comprehensive compilation and description of MHUs in US correctional facilities.

But a preliminary review of health and criminal justice databases found "scant data": just 11 peer-reviewed articles were identified. To bridge the gap, Ms. Cohen, Dr. Karmacharya and colleagues performed a methodical, in-depth Google search of publicly available sources, including government websites, newspaper articles, and legal reports that led to the identification of 317 MHUs across the United States.

Although the available data varied, the authors analyzed the characteristics of the identified US MHUs:

About 80 percent of units were located in prisons, rather than jails or other settings. About three-fourths served male inmates only.
About half of units offered groups or programs to inmates, one-third provided individual therapy, and less than one-fourth provided both group and individual services.
Just over half of MHUs had dedicated mental health staff, while about one-fourth provided mental health training to correctional officers.
Some units were developed in partnership with other government agencies, nonprofit organizations, or universities. Funding for MHUs came from a variety of sources, most often state budgets or legislation.
Information on the outcomes of mental health care was available for 38 MHUs, most of which reported reductions in violence and injuries. "The reports from these units show promising results for the benefits of implementing MHUs but also demonstrate the urgent need to conduct implementation and effectiveness trials for them," the researchers write.

Based on their experience, the authors make recommendations for creating a successful therapeutic environment at MHUs. They believe that units should be small, serving no more than 40 inmates. For the MHUs identified in the review, average unit size was 73 beds.

Units should offer groups and programming plus individual therapy, should have a trained and dedicated clinical staff, and should provide mental health training to correctional officers, the researchers believe. Only 12 (3.8%)of the MHUs identified in the review met all of these criteria.

While acknowledging the limitations of the evidence in their wide-ranging review, including the use of largely non-peer-reviewed sources, the researchers hope the findings will provide useful descriptive information on MHUs in the United States. The authors conclude: "Future research should collect systematized data from correctional facilities with MHUs in order to get a more comprehensive picture of the programs and to evaluate the effectiveness and feasibility of these treatment units."

Credit: 
Wolters Kluwer Health

Why are memories attached to emotions so strong?

NEW YORK, NY (July 13, 2020)--Memories linked with strong emotions often become seared in the brain.

Most people can remember where they were on 9/11, or what the weather was like on the day their first child was born. Memories about world events on Sept 10, or lunch last Tuesday, have long been erased.

Why are memories attached to emotions so strong?

"It makes sense we don't remember everything," says René Hen, PhD, professor of psychiatry and neuroscience at Columbia University Vagelos College of Physicians and Surgeons. "We have limited brain power. We only need to remember what's important for our future wellbeing."

Fear, in this context, is not just a momentary feeling but a learning experience critical to our survival. When a new situation makes us fearful, the brain records the details in our neurons to help us avoid similar situations in the future, or use appropriate caution.

What's still a mystery is why these memories, recorded by the brain's hippocampus, become so strong.

To find out, Hen and Jessica Jimenez, an MD/PhD student at Columbia, placed mice into new, frightening environments and recorded the activity of hippocampal neurons that reach out to the brain's fear center (the amygdala). The neurons' activity was also recorded a day later when the mice tried to retrieve memories of the experience.

Unsurprisingly, neurons that respond to the frightening environment send that information to the brain's fear center.

"What was surprising was that these neurons were synchronized when the mouse later recalled the memory," Hen says.

"We saw that it's the synchrony that is critical to establish the fear memory, and the greater the synchrony, the stronger the memory," Jimenez adds. "These are the types of mechanisms that explain why you remember salient events."

How and when synchronization occurs is still unknown, but the answer could reveal the inner workings of the brain that create lifelong memories and lead to new treatments for posttraumatic stress disorder.

"In people with PTSD, many similar events remind them of the original frightening situation," Hen says, "and it's possible that synchronization of their neurons has become too strong."

"We're really trying to dig into the mechanisms of how emotional memories form to find better treatments for people with PTSD and memory disorders in general."

Credit: 
Columbia University Irving Medical Center

Uncovering the architecture of natural photosynthetic machinery

image: Illustration of the cyanobacterial thylakoid membrane.

Image: 
Zhao, L., Huokko, T., Wilson, S. et al.

Biological membranes play important roles in shaping the cell, sensing the external environment, molecule transport, and generating energy for life. One of the most significant biological membranes are the thylakoid membranes produced in plants, algae and cyanobacteria, which carry out the light reactions of photosynthesis.

Researchers at the University of Liverpool have uncovered the molecular architecture and organisational landscape of thylakoid membranes from a model cyanobacterium in unprecedented detail. The study, which is published in Nature Plants, could help researchers find new and improved artificial photosynthetic technologies for energy production.

Professor Luning Liu, who led the study, explained: "Cyanobacteria perform plant-like photosynthesis. Hence, thylakoid membranes from laboratory-grown cyanobacteria are the ideal model system for studying and tuning plant photosynthesis."

The researchers used state-of-the-art atomic force microscopy (AFM) to probe the structures and organisation of photosynthetic proteins within the thylakoid membranes. The results reveal how thylakoid membranes modulate the abundance of different photosynthetic proteins and form structurally variable complexes to adapt to the changing environments.

Dr Longsheng Zhao, the first author of this paper, said: "We observed that different protein complexes have their specific locations in the thylakoid membranes. We also visualised that distinct photosynthetic complexes can be close to each other, indicating that these photosynthetic complexes can form 'supercomplex' structures to facilitate electron transport between these protein complexes."

Professor Luning Liu, added: "The development of structural biology approaches has greatly improved our understanding of individual photosynthetic complexes. However, these techniques have limitations for studying membrane multi-protein assembly and interactions in their native membrane environment. Our research has proved the power and potential of AFM in exploring complex, dynamic membrane structures and transient protein assembly."

The researchers hope their ongoing work could help find solutions to modulate the photosynthetic efficiency of crop plants to boost plant growth and productivity.

Credit: 
University of Liverpool

McLean hospital study examines the cost-effectiveness of esketamine

image: Study determined that esketamine cost must reduce in order to be beneficial to patients with depression

Image: 
McLean Hospital

Highlights:
* Study estimated the cost-effectiveness of esketamine, a novel intranasally dosed antidepressant for patients with treatment-resistant depression
* Researchers employed a decision-analytic model to simulate the effects of treatment with esketamine versus oral antidepressants from both societal and health care sector perspectives
* Study concluded that the price of esketamine must fall by more than 40% to be cost-effective for management of treatment-resistant depression in the United States

A paper authored by researchers from McLean Hospital has determined that esketamine, a nasal spray to treat severe depression, is currently too expensive for widespread use. Titled "Cost-Effectiveness of Esketamine Nasal Spray for Patients With Treatment-Resistant Depression in the United States," the paper was published on July 7 in Psychiatric Services.

The study compared the costs and benefits of esketamine, an antidepressant approved by the U.S. Food and Drug Administration (FDA) last year for use in treatment-resistant major depressive disorder. Unlike ketamine, a drug delivered intravenously to treat severe depression, esketamine is a nasal spray.

Lead author Eric L. Ross, MD, reported that "most medications don't work as well for people with treatment-resistant depression." However, he said, "Esketamine has been effective in a population where many other treatments haven't worked."

Ross said, "I want people to use esketamine, but it's important that it be cost-effective. I don't want it to put a real strain on our mental health care system."

To estimate the cost-effectiveness of the drug, Ross and his colleagues used a "decision-analytic model" to simulate the effects of treatment with esketamine versus oral antidepressants over five years. The model looked at both societal and health care sector perspectives of using the drug.

Ross explained that the study built on previous investigations of esketamine but added information about cost. Also, he said, the model accounted for issues such as "How much does it cost to have uncontrolled depression?" and "How much does it impact your quality of life?"

The simulations found that, over five years, esketamine was projected to improve quality of life by increasing time in remission for patients. Societal costs and health care sector costs, however, were projected to go up substantially. The authors estimated a greater than 95% likelihood that intranasal esketamine would not be cost-effective in the United States, according to commonly applied standards. Also, they concluded that the price of esketamine must fall by more than 40% from its current price of approximately $240 per dose to be cost-effective for the management of treatment-resistant depression in the U.S.

"Esketamine is too expensive, but it does work," Ross asserted. "The question now is 'How do we get the price down?'"

Ross said that he hopes the paper will encourage policymakers, insurers, and health care leaders to work to reduce the price of esketamine and make it more available to those in need. "At the end of the day, it's not about saving money," he said. "The goal is to make sure we're getting the most clinical benefit we can for the money we spend."

Credit: 
McLean Hospital

Study finds weight loss surgery cost disparity

A new study from the University of Georgia finds that users of public insurance are paying more for bariatric weight loss surgery compared to private insurance patients.

The study, which published recently in Clinical Obesity, is the first to break down surgeries by insurance payer type - public versus private insurance - to better understand the economic burden on patients and U.S. health care system overall.

"Bariatric surgery is becoming more common, but there's increasing evidence that bariatric surgery is not happening consistently across all payer types, and there might be cost differences by payer type," said lead study author Janani Thapa, an assistant professor of health policy and management in UGA's College of Public Health.

These differences could point to inequities in health care access that make it more difficult for patients who have Medicaid or Medicare to qualify or pay for bariatric surgery when they need it.

Obesity rates are highest among low-income Americans; this also tends to be a group with less access to obesity treatment options, including bariatric surgery.

"The hoops that they have to jump through may be more [than others] to access the surgery," said Thapa, "and that was our motivation to look into this."

The team analyzed a national dataset of hospitalized patients from 2011 to 2014, looking for trends in bariatric surgery use, costs across insurance types and other demographic factors.

They found obesity diagnoses and surgeries grew among all patients over that time. This could explain why they also found that average national costs associated with bariatric surgery increased, said Thapa.

But they also found that while on average individual patients are paying less for the surgery, the overall cost burden was highest for publicly insured patients. The average cost per surgery was highest among Medicare patients.

Thapa says they can't say why that is, but "as soon as we talk about public insurance, it is taxpayer money that is paying for the surgery," she said.

The next step, the authors said, is to investigate the long-term health outcomes and medical costs of the weight loss surgery.

Despite the study's focus on one clinical intervention, Thapa and her co-authors still advocate for prevention as the best way to reduce the burden of obesity on individuals and the system.

Credit: 
University of Georgia

New solar material could clean drinking water

image: With Army funding researchers at the University of Rochester have developed an aluminum panel that angled at the sun purifies water.

Image: 
Courtesy University of Rochester

RESEARCH TRIANGLE PARK, N.C. (July 13, 2020) - Providing clean water to Soldiers in the field and citizens around the world is essential, and yet one of the world's greatest challenges. Now a new super-wicking and super-light-absorbing aluminum material developed with Army funding could change that.

With funding from the Army Research Office, an element of the U.S. Army Combat Capabilities Development Command's Army Research Laboratory, researchers at the University of Rochester have developed a new aluminum panel that more efficiently concentrates solar energy to evaporate and purify contaminated water.

"The Army and its warfighters run on water, so there is particular interest in basic materials research that could lead to advanced technologies for generating drinking water," said Dr. Evan Runnerstrom, program manager at ARO. "The combined super-wicking and light-absorbing properties of these aluminum surfaces may enable passive or low-power water purification to better sustain the warfighter in the field."

The researchers developed a laser processing technology that turns regular aluminum pitch black, making it highly absorptive, as well as super-wicking (it wicks water uphill against gravity). They then applied this super absorptive and super-wicking aluminum for this solar water purification.

The technology featured in Nature Sustainability, uses a burst of femtosecond (ultrashort) laser pulses to etch the surface of a normal sheet of aluminum. When the aluminum panel is dipped in water at an angle facing the sun, it draws a thin film of water upwards over the metal's surface. At the same time, the blackened surface retains nearly 100-percent of the energy it absorbs from the sun to quickly heat the water. Finally, the wicking surface structures change the inter-molecular bonds of the water, increasing the efficiency of the evaporation process even further.

"These three things together enable the technology to operate better than an ideal device at 100 percent efficiency," said Professor Chunlei Guo, professor of optics at University of Rochester. "This is a simple, durable, inexpensive way to address the global water crisis, especially in developing nations."

Experiments by the lab show that the method reduces the presence of all common contaminants, such as detergent, dyes, urine, heavy metals and glycerin, to safe levels for drinking.

The technology could also be useful in developed countries for relieving water shortages in drought-stricken areas, and for water desalinization projects, Guo said.

Using sunlight to boil has long been recognized as a way to eliminate microbial pathogens and reduce deaths from diarrheal infections, but boiling water does not eliminate heavy metals and other contaminants.

Solar-based water purification; however, can greatly reduce these contaminants because nearly all the impurities are left behind when the evaporating water becomes gaseous and then condenses and gets collected.

The most common method of solar-based water evaporation is volume heating, in which a large volume of water is heated but only the top layer can evaporate. This is obviously inefficient, Guo said, because only a small fraction of the heating energy gets used.

A more efficient approach, called interfacial heating, places floating, multi-layered absorbing and wicking materials on top of the water, so that only water near the surface needs to be heated. But the available materials all have to float horizontally on top of the water and cannot face the sun directly. Furthermore, the available wicking materials become quickly clogged with contaminants left behind after evaporation, requiring frequent replacement of the materials.

The aluminum panel the researchers developed avoids these difficulties by pulling a thin layer of water out of the reservoir and directly onto the solar absorber surface for heating and evaporation.

"Moreover, because we use an open-grooved surface, it is very easy to clean by simply spraying it," Guo said. "The biggest advantage is that the angle of the panels can be continuously adjusted to directly face the sun as it rises and then moves across the sky before setting - maximizing energy absorption."

The Army and Guo are exploring transition opportunities to further develop this technology within DOD laboratories and private industry.

Credit: 
U.S. Army Research Laboratory

Plant-based diets promote healthful aging, according to new editorial

WASHINGTON--Adopting a plant-based diet can help promote healthful aging and mitigate the global burden of disease, according to an editorial published in the Journal of the American College of Nutrition.

Researchers with the Physicians Committee for Responsible Medicine reviewed clinical trials and epidemiological studies related to aging and found that while aging increases the risk for noncommunicable chronic diseases, healthful diets can help. The editorial shows that plant-based diets can reduce the risk of diseases such as type 2 diabetes, cancer, and heart disease by almost 50% and could cut cardiometabolic-related deaths in the United States by half.

"Modulating lifestyle risk factors and adopting a healthful diet are powerful tools that may delay the aging process, decrease age-associated co-morbidities and mortality, and increase life expectancy," write the authors.
The authors cite studies showing that plant-based diets rich in fruits, vegetables, grains, and legumes:

Reduce the risk of developing metabolic syndrome and type 2 diabetes by about 50%.

Reduce the risk of coronary heart disease events by an estimated 40%.

Reduce the risk of cerebral vascular disease events by 29%.

Reduce the risk of developing Alzheimer's disease by more than 50%.

May reduce the risk for cognitive diseases such as Alzheimer's disease by almost 50%.

The researchers also note that plant-based diets have been tied to increased life expectancy, as evidenced by the world's "Blue Zones," where populations subsist mostly on plant-based foods rich in phytochemicals and antioxidants that have been associated with longer life expectancy.

"The global population of adults 60 years old or older is expected to double from 841 million to 2 billion by 2050, presenting clear challenges for our health care system," says study author Hana Kahleova, MD, PhD, director of clinical research for the Physicians Committee. "Fortunately, simple diet changes can go a long way in helping populations lead longer, healthier lives."

The authors also note that these improvements in health will reduce health care costs caused by chronic diseases. According to the Centers for Disease Control and Prevention, lifestyle-related chronic diseases are the leading cause of death and disability in the United States, accounting for the majority of the nation's annual $3.5 trillion in health care spending.

Credit: 
Physicians Committee for Responsible Medicine

BU researcher outlines coronavirus media failures, harms, and recommendations

In a new JAMA editorial, a Boston University School of Public Health (BUSPH) researcher and a health research journalist outline common ways that media, governments, and industry and academic public relations press releases have incompletely and misleadingly reported coronavirus research, and how they can do better.
"The COVID-19 pandemic has created perhaps the most challenging time for science communication in decades. Races are underway in parallel: to find answers to perplexing coronavirus questions, to announce research findings to clinical and scientific colleagues, and to report those findings to a confused and concerned global audience," write Dr. Richard Saitz, professor and chair of community health sciences at BUSPH, and Gary Schwitzer, founder and publisher of HealthNewsReview.org.
"There are no winners in these races if harm--even though unintentional--is wrought by the dissemination of hurried, incomplete, biased misinformation," they write. "Trust in science, medicine, public relations and journalism may be in jeopardy in the intersection where these professions meet."
By way of example, Saitz and Schwitzer describe how three drugs--remdesivir, dexamethasone, and hydroxychloroquine--have been touted as COVID cures, without explanations of the limits of the evidence. These rushed and incomplete announcements have led, among other consequences, to shortages, government stockpiling, and a baffled public: In the case of hydroxychloroquine, they write, "News stories and social media reports took readers on a roller coaster ride, alternately reporting efficacy, lack of efficacy, and harm, reporting dutifully on the results of each latest study."
Instead, Saitz and Schwitzer recommend greater caution and more detail, including highlighting limitations, specifying patient populations, and describing new findings in the larger context of previous research. It may be a hard pill to swallow, but, they write, "It is important that complexity be mentioned and considered even if it is not popular among layperson readers."

Credit: 
Boston University School of Medicine

Electronic surveillance in couple relationships

image: Explores the psychological and social issues surrounding the Internet and interactive technologies.

Image: 
Mary Ann Liebert, Inc., publishers

New Rochelle, NY, July 13, 2020--Impaired intimacy, satisfaction, and infidelity in a romantic relationship can fuel Interpersonal Electronic Surveillance (IES). IES may become the preferred method for resolving relationship issues, rather than direct communication, further reducing trust and intimacy, according to the peer-reviewed journal Cyberpsychology, Behavior, and Social Networking. Click here to read the article now.

Online surveillance in relationships is a common phenomenon. Lead author Katherine Hertlein, PhD, University of Nevada, Las Vegas, identified the individual, relationship, and technological factors for predicting IES in romantic relationships.

"Partners may justify IES to answer questions about the relationship, enact fewer strategies to be vulnerable with one another, and increase the normalization of strategies that avoid honest, authentic conversation in interpersonal relationships," she says.

"As social networking sites have evolved, so has the ease of surveillance. Once partners reach an impasse in communication, therapists can play an important role in guiding the process of open communication and expression of emotions, allowing for empathy and healing to occur," says Editor-in-Chief Brenda K. Wiederhold, PhD, MBA, BCB, BCN, Interactive Media Institute, San Diego, California and Virtual Reality Medical Institute, Brussels, Belgium.

Credit: 
Mary Ann Liebert, Inc./Genetic Engineering News

For every COVID-19 death, 9 close family members are left to grieve

A new analysis finds more than one million Americans have been swept up in the tidal wave of grief resulting from the COVID-19 pandemic.

Using new indicator they call the 'bereavement multiplier,' researchers found that on average each COVID-19 death corresponds with approximately 9 individuals who have lost a grandparent, parent, sibling, spouse or child. With an estimated 137,871 lives lost, that corresponds with nearly 1.22 million having lost a close relation.

The analysis was published in PNAS.

"Already, more than a million Americans will forever have a hole in their family," said study author Emily Smith-Greenaway, associate professor of sociology and spatial sciences at the USC Dornsife College of Letters, Arts and Sciences. "In just a few short months, over one million Americans have experienced an irreplaceable loss that not only leaves them grieving and possibly traumatized, but may come with long-lasting health and economic consequences for themselves and others in their family."

By turning attention to the COVID-19 bereavement burden, the study authors say they want to remind Americans that even as the pandemic abates, it will leave many grieving in its wake. Because many individuals who have died were simultaneously a spouse, parent, grandparent, sibling, and child, the collective toll of the crisis is far greater when considering all of the individuals bereaved by each death.

Researchers say their COVID-19 bereavement multiplier has also provided a clearer picture of how the crisis is affecting different racial and ethnic groups as well as different age groups.

Although there is a steep age gradient in hospitalizations and deaths from COVID-19, study authors say their work demonstrates that young people are not unscathed. Instead, they are suffering from the sudden death of their parents and grandparents.

In addition, race-specific COVID-19 mortality data demonstrates how Black Americans are disproportionately affected by COVID-19 bereavement, which study authors say will exacerbate racial inequalities in the U.S.

"There are substantial concerns about the health impacts of COVID-19 for individuals, but one area that has received less attention is how the deaths caused by this disease will reverberate through families," said study author Ashton Verdery, associate professor of sociology, demography, and social data analytics at Penn State University. "Our results show that these impacts will be substantial, they'll affect people at all ages, and they may exacerbate existing inequalities in bereavement and social support."

Some people experience serious and prolonged mental health consequences from bereavement and grief in the wake of a family member's death, including major depression and anxiety. Bereavement is also tied to physical health risks including worse cardiovascular health and mortality. The risk of experiencing these negative outcomes is more likely in the case of a family member's sudden, unexpected death, which will be the case for many during the COVID-19 pandemic.

"In the news cycle, the emphasis is on tracking the total number of lives lost, but what's missing is how these premature deaths reflect in family systems," said Smith-Greenaway. "What about the numerous loved ones left behind?"

Just weeks into the pandemic, Verdery and Smith-Greenaway combined data on predicted deaths with demographic information about family structures -- called kinship models -- to estimate the number of Americans who could lose a parent or grandparent to COVID-19. Initially, their work relied on specific prediction models and offered a sense of the overall bereavement burden based on different scenarios.

Now using the multiplier approach, the study authors say it's possible to continuously calculate the number of Americans bereaved by the death of a close relation in lockstep fashion with the rising death toll. Given that each death corresponds with approximately 9 bereaved by a close relation, they can track the bereavement burden in real time over the course of the epidemic.

Credit: 
University of Southern California

COVID-19: Considering meditation and yoga as adjunctive treatment

image: Dedicated to research on paradigm, practice, and policy advancing integrative health

Image: 
Mary Ann Liebert, Inc., publishers

New Rochelle, NY, July 13, 2020--The anti-inflammatory and other beneficial effects of meditation and yoga practices make them potential adjunctive treatments of COVID-19, according to the peer-reviewed journal JACM, The Journal of Alternative and Complementary Medicine. Click here to read the article.

Deepak Chopra, University of California, San Diego and William Bushell of Massachusetts Institute of Technology and co-authors from Harvard University and Harvard T.H. Chan School of Public Health describe the anti-inflammatory effects associated with meditation and yoga.

The "brief overview of key subjects" found "there is evidence of stress and inflammation modulation, and also preliminary evidence for possible forms of immune system enhancement, accompanying the practice of certain forms of meditation, yoga, and pranayama, along with potential implications for counteracting some forms of infectious challenges." The authors also "readily acknowledge that in the context of the SARS-CoV-2 pandemic, the ideas put forth in this article must be put to further rigorous scientific investigation."

JACM Editor-in-Chief John Weeks, johnweeks-integrator.com, Seattle, WA, states: "The paper is another in a series in JACM and in other integrative medicine journals suggesting that research agencies in the United States and Europe would serve their citizens by upping their exploration of the potential contributions of natural health practices, especially amidst the present dearth of conventional treatments."

Credit: 
Mary Ann Liebert, Inc./Genetic Engineering News

Perceiving the flavor of fat: A Monell Center twins study

image: Potato chips used in the study, pre-portioned and labelled for participants

Image: 
Monell Chemical Senses Center

Most people would agree that the pleasure of some foods stems in part from its fat content. New research, led by the Monell Chemical Senses Center, has now found that liking of fatty food is more complex than its fat content alone - it could also be related to inborn genetic traits of the consumer related to fat perception. The team published their findings in Chemical Senses.

"Person-to-person diversity in the positive perception of fattiness derives partially from an individual's genetic make-up," said senior author Danielle Reed, PhD, Monell Associate Director. "How the taste, smell, and flavor of food and drink affect liking, and therefore the amount and type of food consumed, ultimately affects human health."

The team tested adult identical and fraternal twins in 2018 who attended the annual Twins Days Festival in Twinsburg, OH. "We asked the participants to rate low- and high-fat potato chips and report on how fatty they tasted and how much they liked them," said Reed. Participants also spit into a tube so their DNA could be extracted. Their genotype was determined at hundreds of thousands of locations in their genome.

Many previous studies using model solutions for greater experimental control have tried to link perception to liking but often failed to translate their data to real foods, noted co-author John Hayes, PhD, a Professor of Food Science at the Pennsylvania State University. This study added a real food - potato chips - to the experiment's design to overcome this limitation.

Genetically identical twins were more similar in their pattern of liking for the high- and low-fat potato chips compared with the fraternal twins. By comparing the taste-test results from other pairs of twins with similar genotype, the team identified two specific gene variants that correlated with the twins' ratings of liking. Neither of these genes has been previously tied to the perception of fattiness.

Although fat is nearly universally liked in foods, some people may be born with the genetic tendency to prefer foods higher or lower in fat. The team's next steps, including understanding how universal these genetic influences might be, will be to test people worldwide and with different types of fat in many different foods, such as pizza, muffins, and ice-cream.

Flavor is only one of many factors that drive everyday food choices, including cost, availability, and health. "Most people assume more liking drives more intake, but decades of research tell us the reverse is true - we avoid what we don't like," said Hayes. "I may love bacon, but if I listen to my cardiologist, I'm still not going to eat it every morning."

Credit: 
Monell Chemical Senses Center