Culture

Patients with severe COVID-19 frequently experience a life-threatening immune reaction, sometimes called a cytokine storm, which can lead to respiratory failure, organ damage and potentially death. With no FDA-approved treatment currently available for SARS-CoV-2, the virus that causes COVID-19, researchers are racing to find ways to stop the virus or the inflammatory overreaction it provokes in its tracks.

In a paper published in Cancer and Metastasis Reviews and selected by the journal as the featured publication, a team of researchers from Beth Israel Deaconess Medical Center and Brigham and Women's Hospital propose that controlling the local and systemic inflammatory response in COVID-19 may be as important as anti-viral and other therapies.

Led by Dipak Panigrahy, MD, of the Cancer Center at BIDMC, and Charles N. Serhan, PhD, DSc, director of the Center of Experimental Therapeutics and a member of the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women's Hospital, the researchers suggest that a family of molecules naturally produced by the human body may be harnessed to resolve inflammation in patients with severe COVID-19, thereby reducing the acute respiratory distress and other life-threatening complications associated with the viral infection.

"Controlling the body's inflammatory response is key to the management of COVID-19 and may be as important to managing the pandemic as anti-viral therapies or a vaccine," Panigrahy said. "Our team proposes using molecules made by the body called pro-resolution lipid mediators -- which are currently in clinical trials for other inflammatory diseases -- as a novel approach to turning off the inflammation and preventing the cytokine storm caused by COVID-19."

Cytokines are released by the body as part of its normal immune response to injured or infected tissues. Typically, the body also releases chemicals to put an end to -- or resolve -- the inflammatory response. But in a significant percentage of patients with severe COVID-19, the cytokines unleashed to kill the virus also do damage to infected lung cells. In turn, this injury to the lung tissues triggers additional inflammation, and the so-called "cytokine storm" begins to spiral out of control.

Naturally occurring molecules called resolvins -- discovered by Serhan and colleagues at BWH in 2002 -- actively turn off inflammation. Panigrahy, Serhan and colleagues have previously demonstrated that resolvins and related pro-resolution molecules could play a role in preventing cancer metastasis and progression. This class of molecules are also currently in clinical trials investigating their use against other inflammatory diseases, such as ocular, periodontal, and inflammatory bowel disease. Now, the scientists suggest, they could be re-deployed for the management of COVID-19.

"A paradigm shift is emerging in our understanding of the resolution of inflammation as an active biochemical process," said Serhan. "Activating the body's own resolution pathways with the use of resolvins and related pro-resolution molecules --which, importantly, promote blog clot removal-- may complement current treatment strategies while limiting severe organ damage and improving outcomes in COVID-19 patients."

RIVERSIDE, Calif. -- When trying to complete a task we are constantly bombarded by distracting stimuli. How does the brain filter out these distractions and enable us to focus on the task at hand? Psychologists at the University of California, Riverside, have made a discovery that could lead to an answer.

Experimenting on mice, they located the precise spot in the brain where distracting stimuli are blocked. The blocking disables the brain from processing these stimuli, which allows concentration on a particular task to proceed.

Edward Zagha, an assistant professor of psychology, and his team trained mice in a sensory detection task with target and distractor stimuli. The mice learned to respond to rapid stimuli in the target field and ignore identical stimuli in the opposite distractor field. The team used a novel imaging technique, which allows for high spatiotemporal resolution with a cortex-wide field of view, to find where in the brain the distractor stimuli are blocked, resulting in no further signal transmission within the cortex and, therefore, no triggering of a motor response.

"We observed responses to target stimuli in multiple sensory and motor cortical regions," said Zagha, who led the study published today in the Journal of Neuroscience. "In contrast, responses to distractor stimuli were abruptly suppressed beyond the sensory cortex."

The cortex is the outer layer of the brain's cerebrum. Composed of folded gray matter, it plays an important role in consciousness. The largest part of the brain, it has sensory and motor regions. It serves as a control and information-processing center and is responsible for functions such as sensation, perception, memory, attention, language, and advanced motor functions.

"Our discovery may have important implications for the understanding and treatment of neuropsychiatric diseases such as attention deficit hyperactivity disorder and schizophrenia," Zagha said. "By studying the mechanisms underlying the blocking of distracting stimuli we may be able to unravel the neural circuitry underlying attention and impulse control."

Zagha explained that while scientists today know much about behavior and neurons, they only have a nascent understanding of how groups of neurons organize to mediate meaningful behaviors.

"A major challenge is recording neuronal activity at high spatiotemporal resolution in animals while they are performing goal-directed tasks," he said. "A second major challenge is using the correct computational methods to analyze that neuronal activity."

Zagha stressed they still do not understand what's happening in the brain that finally allows us to focus on a task at hand and how exactly distractions are blocked.

"But now we know exactly where to look in the brain, and we will be pursuing these questions in the future," he said. "We know that when someone is highly distractible, their cortex is not sufficiently deploying the intentional signals needed to prevent the distractor stimuli from propagating into working memory or triggering a behavioral response. These processes -- 'gatekeepers' of sensory signals -- allow through only those signals that are task relevant. We believe this process is orchestrated by the prefrontal cortex; this is only one of the many possibilities we will be testing."

Zagha's team presented identical tactile stimuli to opposite sides of mice's whiskers in random order. The researchers focused on whiskers because they work like human fingertips in terms of sensitivity and exploration; their deflection activates brainstem pathways. The researchers then trained the mice to respond, via licking, to tactile stimuli on only one side and ignore the identical stimuli on the opposite side. Zagha and his colleagues used newly bred transgenic mice that express fluorescent calcium sensors in cortical neurons, allowing the researchers to view brain activity with a camera that helped localize the process with much higher spatial precision than previous studies.

"When distracting stimuli are intentionally being ignored by the mice, we can now see where that distracting stimulus response is blocked," Zagha said. "In the future, we would want to know how it is blocked."

Zagha strongly believes the neural circuits underlying sensory selection and impulse control are the same circuits impaired in attention deficit hyperactivity disorder and schizophrenia, leading to the impulse control dysfunctions.

"The better we understand these circuits, the better we can design rational, targeted treatments to improve impulsivity in these disorders," he said.

The team was surprised by how abruptly the distractor information is blocked in the cortex. The researchers observed that the distractor stimulus responses make it to the first relay in the neocortex, the part of the cerebral cortex concerned with early sensory processing, yet are prevented from spreading further throughout cortex. In future work, the researchers plan to study which specific neural mechanisms prevent the propagation out of this first cortical region.

"The spatial precision of our finding gives us confidence that we know where to look in future studies to reveal how distractor stimuli are blocked, thereby allowing us to retain focus on the task at hand," Zagha said.

His team will focus also on understanding what the roles are of specific types of neurons and neural pathways involved, how these circuits get disrupted in neuropsychiatric disease, and how the neural system can be modulated to improve distractibility in human disease.

More than a decade into the community development initiative called Healthy Neighborhoods Healthy Families, the 30-block Southern Orchards neighborhood on Columbus, Ohio's South Side had clear, notable improvement. Home vacancy fell from 30% to under 6%. High school graduation rates increased. More than $40 million in investments were generated in the area.

But Nationwide Children's Hospital, a lead partner in the initiative, had a question. Had the neighborhood improvement also improved the health of the children in it?

A new study, published July 7 in Pediatrics, finds that the rate of emergency department visits decreased 20.8% and inpatient admissions decreased 12.7% in the neighborhood from the baseline period of August 2008 - July 2010 to the follow-up period of August 2015 - July 2017. There was also a 28.9% increase in inpatient length of stay. These changes compared favorably to two neighborhoods with similar housing, racial segregation and socioeconomic conditions, where the authors found a 16.1% decrease in ED visit rate; a 12.2% decrease in inpatient admissions; and a 36.6% increase in length of stay.

All three neighborhoods showed changes in use, but Southern Orchards fared slightly better.

"This is not surprising," said Deena Chisolm, PhD, the lead author of the study and director of the Center for Innovation in Pediatric Practice at the Abigail Wexner Research Institute at Nationwide Children's. "Health care changed broadly over the past decade. More people are insured as a result of the Affordable Care Act. There's a been general focus on improving quality of care to keep people out of emergency departments. Perhaps most importantly in central Ohio, Nationwide Children's has implemented a number of region-wide programs that have affected health and health care."

The Healthy Neighborhoods Healthy Families initiative was specific to the Southern Orchards neighborhood in that time period (it has since expanded), and its primary intervention was housing improvement. More than 380 homes have been built, renovated or otherwise improved since 2008, with Nationwide Children's and the faith-based organization Community Development for All People as the major partners in the initiative. Workforce training and job placement, community-based mentoring and other programs were implemented as well.

None of those interventions were specifically designed to improve health care utilization, but links between neighborhood exposures and health are well-known, said Dr. Chisolm, who is also an associate professor of Pediatrics at The Ohio State University College of Medicine. A number of other Nationwide Children's-led programs were designed, however, to improve health care utilization - and those programs were active in the Healthy Neighborhoods Healthy Families district, the two comparison neighborhoods, and throughout the Columbus area.

"Overall, the study is very good news for this area," said Kelly Kelleher, MD, holder the Chlapaty/ADS Endowed Chair for Innovation in Pediatric Practice at Nationwide Children's and senior author of the study. "We're reducing ED use and inpatient admissions across traditionally at-risk areas of Columbus. In one neighborhood, we have the added element of housing, which appears to have an additional benefit, even if it's small. It will be interesting to see what effect Healthy Neighborhoods Healthy Families in the future, now that the program is fully developed and continues to grow."

Drs. Chisolm and Kelleher point out that Healthy Neighborhoods Healthy Families started slowly, with 23 homes total improved over the first two years, but the initiative has more recently averaged of 34 homes per year and accelerated its investments in rental units and other areas, such as workforce development. The authors also say that this kind of measurement of neighborhood-level outcomes is difficult and may become clearer over time.

"Going forward, housing and neighborhood improvement interventions may produce even greater in health care utilization," said Dr. Chisolm. "As we address many of the obvious drivers of ED usage, such as asthma, we may now find that these neighborhood-level changes have an increased impact."

Cases of brain complications linked to COVID-19 are occurring across the globe, a new review by University of Liverpool researchers has shown.

Published in The Lancet Neurology, the study found that strokes, delirium and other neurological complications are reported from most countries where there have been large outbreaks of the disease.

COVID-19 has been associated mostly with problems like difficulty breathing, fever and cough. However, as the pandemic has continued, it has become increasingly clear that other problems can occur in patients. These include confusion, stroke, inflammation of the brain, spinal cord, and other kinds of nerve disease.

A recent Liverpool-led study of COVID-19 patients hospitalised in the UK found a range of neurological and psychiatric complications that may be linked to the disease.

To get a sense of the wider picture, the researchers brought together and analysed findings from COVID-19 studies across the globe that reported on neurological complications. The review, which included studies from China, Italy and the USA among others, found almost 1000 patients with COVID-19-associated brain, spinal cord and nerve disease.

Research Fellow, Dr Suzannah Lant, who was working on the project, said: "Whilst these complications are relatively uncommon, the huge numbers of COVID-19 cases globally mean the overall number of patients with neurological problems is likely to be quite large."

One of the complications found to be linked to COVID-19 is encephalitis, which is inflammation and swelling of the brain.

Dr Ava Easton, CEO of the Encephalitis Society, and co-author on the paper said: "It is really important that doctors around the world recognise that COVID-19 can cause encephalitis and other brain problems, which often have potentially devastating, life-changing consequences for patients."

Professor Tom Solomon, senior author on the paper and Director of the Global COVID-Neuro Network, added: "Although such patients are being seen everywhere the virus occurs, many of the reports are lacking in detail. We are currently pooling data from individual patients all around the world, so that we can get a more complete picture. Doctors who would like to contribute patients to this analysis can contact us via the Global COVID-Neuro Network website."

For more information about the Global COVID-Neuro Network please visit https://braininfectionsglobal.tghn.org/covid-neuro-network/

Hamilton, ON (July 8, 2020) - Cognitive behavioural therapy delivered electronically to treat people with depression is more effective than face to face, suggests an evidence review led by McMaster University.

Based on randomized control trials, the systematic review and analysis revealed that cognitive behavioural therapy that connected therapists and patients through such modes as web-based applications, video-conferencing, email and texting, improved patients' symptoms better than face to face when measured using standardized mood symptoms scales. As well, there was no difference in the level of satisfaction or function between the two methods of delivery.

The details were published in EClinicalMedicine, published by The Lancet.

"Although this study started before the current COVID-19 pandemic, it is timely and assuring that treatment delivered electronically works as well if not better than face to face and there is no compromise on the quality of care that patients are receiving during this stressful time," said corresponding author Zena Samaan, associate professor of psychiatry and behavioural neurosciences at McMaster and a psychiatrist at St. Joseph's Healthcare Hamilton.

Cognitive behavioural therapy is a type of psychotherapy widely used to treat depression. However, limited resource availability poses several barriers to patients seeking access to care, including lengthy wait times and geographical limitations.

In this evidence review, researchers identified 17 randomized control trials comparing therapist-supported cognitive behavioural therapy delivered electronically to face to face cognitive behavioural therapy. The studies were conducted between 2003 and 2018 in the United States, Australia, Netherlands, Switzerland, Sweden and the United Kingdom.

Samaan said the findings of the meta-analysis debunk widely-held perceptions about psychotherapy.

"The common understanding was that face to face psychotherapy has the advantage of the connection with the therapist and this connection is in part what makes the difference in treatment," she said.

"However, it is not surprising that electronic interventions are helpful in that they offer flexibility, privacy and no travel time, time off work, transport or parking costs. It makes sense that people access care, especially mental health care, when they need it from their own comfort space."

Samaan noted that the findings support advocacy and widespread implementation of electronic cognitive behavioural therapy.

"Electronic options should be considered to be implemented for delivering therapy to patients," she said. "This can potentially vastly improve access for patients, especially those in rural or underserved areas, and during pandemics."

CORVALLIS, Ore. - Findings from an Oregon State University study into the effects of radiofrequency radiation generated by the wireless technology that will soon be the standard for cell phones suggest few health impacts.

Fifth generation or 5G wireless technology, which began being deployed worldwide in 2019, provides faster connectivity and more bandwidth, meaning higher download speeds.

But because 5G technology is so new, little is known about the potential health effects from its radiofrequency radiation, which is higher than the current industry standard 4G. The Oregon State study begins to change that.

"Based on our study, we don't think 5G radiation is that harmful," said Subham Dasgupta, a postdoctoral fellow working in the lab of Robyn Tanguay at Oregon State. "It's predominately benign."

Researchers conducted the research using embryonic zebrafish, a model organism often used to discover interactions between environmental stressors and biological systems. Zebrafish and humans have similar developmental processes and are similar on a genomic level, meaning zebrafish research can easily be applied to humans.

In the study, published July 9 in the journal PLOS ONE, the researchers exposed embryonic zebrafish for two days to 3.5 GHz radiofrequency radiation, the frequency typically used by 5G-enabled cell phones.

They found no significant impacts on mortality, how the embryos formed or the embryos' behavioral response to light. They did find a modest impact on a test that measures the embryos' response to a sudden sound that they will investigate further.

Future research will look at the 5G radiation effects on the same zebrafish used in the study at a gene level and as they develop from embryos to adults, Dasgupta said. The researchers also would like to study the impacts of higher frequencies and higher exposure levels on zebrafish to keep pace with the changing cell phone industry.

The future research will use the same standardized experimental set up used in this study. It involves a box made of copper. The zebrafish embryos are placed on plates, which are put inside the box. The radiation enters the box through an antennae and the copper keeps it inside the box.

The Gerontological Society of America's highly cited, peer-reviewed journals are continuing to publish scientific articles on COVID-19, and all are free to access. The following were published between June 7 and July 4; all are free to access:

Clinical Characteristics of Hospitalized Individuals Dying with COVID-19 by Age Group in Italy: Research report in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by Luigi Palmieri, PhD, Nicola Vanacore, MD, Chiara Donfrancesco, PhD, Cinzia Lo Noce, MSc, Marco Canevelli, MD, Ornella Punzo, MD, Valeria Raparelli, MD, Patrizio Pezzotti, PhD, Flavia Riccardo, MD, Antonio Bella, PhD, Massimo Fabiani, PhD, Fortunato Paolo D'Ancona, MD, Luana Vaianella, MD, Dorina Tiple, MD, Elisa Colaizzo, MD, Katie Palmer, PhD, Giovanni Rezza, MD, Andrea Piccioli, MD, Silvio Brusaferro, MD, and Graziano Onder, MD, PhD

COVID-19 and Crosstalk between the Hallmarks of Aging: Review in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by Shabnam Salimi, MD, MSc, and John M Hamlyn, PhD

Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Looking beyond chronological aging: Research article in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by Omar Yaxmehen Bello-Chavolla, MD, PhD, Armando González-Díaz, MSci, Neftali Eduardo Antonio-Villa, MD, Carlos A Fermín-Martínez, MD, Alejandro Márquez-Salinas, MD, Arsenio Vargas-Vázquez, Jessica Paola Bahena-López, MD, Carmen García-Peña, MD, PhD, Carlos A Aguilar-Salinas, MD, PhD, and Luis Miguel Gutiérrez-Robledo, MD, PhD

Up and about: Older adults' wellbeing during the COVID-19 pandemic in a Swedish longitudinal study: Research report in The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences by Marie Kivi, PhD, Isabelle Hansson, PhD, and Pär Bjälkebring, PhD

ApoE e4e4 genotype and mortality with COVID-19 in UK Biobank: Letter to the editor in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by Chia-Ling Kuo, PhD, Luke C Pilling, PhD, Janice L Atkins, PhD, Jane A H Masoli, MBChB, João Delgado, PhD, George A Kuchel, MD, and David Melzer, MBBCh, PhD

New Spanish Translations of Infographics

* Understanding Ageism and COVID-19 (English, Spanish), which highlights several false narratives about older adults in the pandemic and reframes them in the context of science.

* Aging and Immunity: Why Older Adults Are Highly Susceptible to Diseases Like COVID-19 (English, Spanish), which addresses why older adults are highly susceptible to diseases like COVID-19 and how manufacturers are compressing the timeline to bring a COVID-19 vaccine to market.

* Distancing: Physical Separation Without Social Isolation (English, Spanish), which highlights ways of refraining from physical contact while remotely maintaining (to the extent possible) the social connections that help us thrive and stay healthy.

The Gerontological Society of America (GSA) is the nation's oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society -- and its 5,500+ members -- is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA's structure also includes a policy institute, the National Academy on an Aging Society.

Philadelphia, July 8, 2020 - A team of researchers from Children's Hospital of Philadelphia (CHOP) used a new method of pinpointing potential disease-causing changes in the genome to identify two new potential therapeutic targets for lupus, while also paving the way for more accurately identifying disease-causing variations in other autoimmune disorders. The findings were published online in Nature Communications.

Genome-wide association studies (GWAS) leverage variations across the genome, the complete set of a person's genes and associated DNA, in order to learn more about heritable diseases and traits. These studies typically identify clusters of hundreds of single-nucleotide polymorophisms, or variants, that could cause a particular disease, but the studies themselves are unable to identify which ones are responsible. This is because the vast majority of variants are not in the genes themselves, but in the intervening DNA, and GWAS does not necessarily solve which genes are impacted by disease-associated polymorphisms.

Systemic Lupus Erythematosus is an autoimmune disorder with no known cure that affects both children and adults, with greater prevalence among racial minorities. While several studies on lupus have focused on naive helper T cells and other blood cells, this study was designed to focus on follicular helper T cells, which play a more central role in immune responses related to lupus. Rather than use a typical GWAS approach, the researchers set out to create three-dimensional maps that match variants with the genes they likely regulate. Their approach used variants as "signposts" to identify potential gene enhancers in normal tissue.

"Prior to this study, no 3D structural genomic maps had been generated for this lupus-relevant cell type before," said Andrew D. Wells, PhD, Co-Director of the Center for Spatial and Functional Genomics at CHOP, and co-senior author of the study together with Struan F. A. Grant, PhD. "With our approach, we believe we were in a position to identify genes and pathways that had no prior known role in lupus."

Using this method, the study team identified 393 variants in proximity to genes in 3D, and therefore potentially involved in their regulation. Approximately 90% of those variants would have been considered distant to their gene in one dimension, but were actually close in the proper three-dimensional map created by the team. The researchers were able to pinpoint two kinases, HIPK1 and MINK1, that had no previously known role in lupus. When these enzymes are targeted in follicular helper T cells, they inhibit the production of interleukin-21, a cytokine involved in regulating antibody production.

"We believe that HIPK1 and MINK1 may serve as valuable therapeutic targets for lupus, a disease that is in dire need of new treatment options," Wells said. "We also want to take the methods we used in this study and apply them to other autoimmune diseases and help pinpoint more causal variations that may have otherwise remained obscured by GWAS alone."

Wells also said their team hopes to develop HIPK1 transgenic mouse models to study their susceptibility to experimental lupus, as well as the potential impact of HIPK1 on antiviral immunity.

Kai Ruggeri's research has one overriding objective: to improve the well-being of populations by confronting inequality. He is a behavioral scientist at Columbia who uses data science to design interventions and recommend policies that help the most vulnerable and disadvantaged populations overcome inequalities.

As an assistant professor in the Department of Health Policy and Management at Columbia's Mailman School of Public Health, Ruggeri focuses on population level behaviors such as the way people make financial choices and use health care. While his work involves entire populations, much of his focus is on how to address inequalities in access and outcomes, particularly among the most disadvantaged. Such inequities have become even more apparent with the outbreak of Covid-19, as higher rates of infection and death among people of color demonstrate the racial character of inequality in America's health care system.

"You can tie just about every major issue to inequalities," says Ruggeri, who is an affiliate of the Data Science Institute. "Some are flaws or biases in the system; some are unfortunate circumstances; pretty much all are harmful. The aim is to raise the floor, shift the mean up, and eliminate ceilings. If you do this, you see entire populations improving. This starts with those who need it most, but everyone benefits from it."

One of Ruggeri's projects is using data science to eliminate inequality and increase health care access in undeserved communities in Brooklyn, the Bronx, Manhattan, and Queens. The project, called Nudging New York, is supported by a Data Science Institute Seed Fund grant. He is collaborating on the project with the Community Healthcare Network (CHN), a federally qualified health clinic that provides care to disadvantaged New Yorkers.

Federally funded health care centers like CHN provide medical care to more than 20 million Americans who live in impoverished areas. Yet in many of those areas, nearly half of the patients who make medical appointments at the centers don't show up--not because they don't want to, but they encounter major barriers. Data show that patient no-show appointments, and the missed opportunities for needed medical care, place an enormous health burden on disadvantaged communities. No-shows, for example, increase the likelihood that patients will visit emergency rooms and be hospitalized for conditions that could have been treated at clinics. As such, even small decreases in no-show rates at clinics would improve the health of vulnerable populations while reducing the nation's medical costs.

Ruggeri recently published a paper about the Nudging New York research in BMC Health Services Research, which is owned by Springer Nature. In the paper, his team details how it is uses big data and Bayesian machine learning techniques to understand what prevents many of the 80,000 CHN patients from making their medical appointments. The team also discusses several system wide and behavioral interventions and policies that would help them keep their appointments. They also explore common barriers to patient care, such as transportation, childcare, translation services, and inconvenient appointment times.

Once the team has evaluated patients' behavioral and environmental data, as well as data from emergency departments at partner hospitals, it will use a technique known as "nudges" to help patients keep appointments. Nudges are behavioral interventions that encourage optimal choices. They can be applied in a variety of ways, such as providing more information to patients, or more emphatically stressing the importance of attending regular checkups. What is most important is that the nudges are personalized, as the most effective interventions are those that address the specific needs of individuals, Ruggeri says.

"By evaluating sources of clinical, behavioral, and environmental data, and then matching the most effective interventions to the right groups of patients, we hope to reduce no-shows and avoidable visits to emergency departments," he says. "In implementing Bayesian machine learning methods to better understand patterns of behavior in these groups, we will design nudges that increase health care access for the most vulnerable New Yorkers. If we do it right, the methods we create can be used at community clinics across the U.S. to radically improve health care while significantly reducing cost. While we focus on New York, this work has the potential to have impact in rural and urban communities around the country."

CHN is also playing a major role in combating Covid-19. It has transitioned to offering telemedicine to its clients, given the lock down, while also serving as a Covid-19 testing site. Ruggeri's team has adapted its research to help the network contend with the coronavirus, which data show disproportionately affects communities of color.

"We are working with the network on a number of initiatives, ranging from optimizing telemedicine arrangements to tracking individuals unable to attend sessions to see if we can formulate interventions to support those who need care but face barriers to getting it," he says. "CHN is contributing in critical ways in this pandemic, and we are grateful for support from the Data Science Institute to allow us to design behavioral interventions and maximize the use of data to help the network deliver care."

Along with being an affiliate of DSI, Ruggeri belongs to two of the institute's centers: Financial and Business Analytics and Health Analytics. Education, financial stability, health, and national security are the fundamental factors that enable populations to flourish, which is why he says he joined both centers. In the past, researchers could focus on one or two of these factors, but with more data and modern technological resources, "we can now see how all these factors interact."

"And knowing this, we can make use of all the data and new technology to drive better outcomes for those who need it most," Ruggeri says. "The Data Science Institute gave me a great opportunity to dive headfirst into this work early in my time at Columbia, and the support they gave to me to move ahead with my research is something I hope will have even greater impact in the near future. My goal is to create better outcomes in well-being across all communities--it's what gets me up in the mornings--and data science is helping me to achieve that goal."

In an independent report published today, an analysis from over 100 experts finds the benefits of protecting 30% of the planet outweigh the costs by a factor of at least 5:1. The report entitled, "Protecting 30% of the planet for nature: costs, benefits, and economic implications," represents the first multi-sector analysis that assesses the global impacts of terrestrial and marine protected areas across the nature conservation, agriculture, forestry, and fisheries sectors. It is the most comprehensive global assessment of the financial and economic impacts of protected areas ever completed.

The report's main finding is that protecting at least 30% of the world's land and ocean provides greater benefits than the status quo, both in terms of financial outcomes and key non-monetary benefits including ecosystem services such as climate change mitigation, flood protection, clean water provision, and soil conservation. 30% protection generates economic benefits from these "public goods" averaging $350 billion annually and leads to increased economic output averaging $260 billion annually by 2050. Encouragingly, this protection would require just 0.16% of the global GDP, which is less than one-third of the government subsidies currently directed to activities that destroy nature.

"There's a misconception that we either can protect our planet or we can have economic growth, but in fact, it's not an 'and/or' dichotomy. This report, based on input from over 100 economists and scientists, refutes the argument that achieving 30% protection of the earth's surface by 2030 requires unrealistic economic costs. Expanding protected areas to 30% actually generates higher overall revenues and while also mitigating very real economic risks of climate change and biodiversity loss. It's imperative that we do both," said Greg Asner, coauthor of the study and director of the Arizona State University Center for Global Discovery and Conservation Science.

The researchers also highlight the key conservation roles played by indigenous peoples and local communities to achieve these goals. With an appropriate right and governance framework, the report estimates that achieving 30% protection could lead to an increase of roughly 80% of the formal recognition of IPLC contributions to global land stewardship. The researchers not that effectively implementing increased protected areas will require local compensation and support as well as financial assistance to low and middle-income countries.

Based on the report, the Campaign for Nature recommended a number of policies such as increasing long-term funding of protected areas from all sources, including social development assistance, philanthropies, and corporations, and through a wide range of financial mechanisms. Investments in protected areas will have to increase to an estimated $140 billion annually from the current $24.3 billion by 2030.

The researchers also call for governments, businesses, and philanthropies to recognize nature conservation as a key sector of a resilient global economy, capable of driving economic growth while also providing life-sustaining benefits to people such as reducing the risk of pandemics and alleviating poverty. Through policy changes and financial investments, governments, businesses, and philanthropies can support the goal of 30% protection of land and sea by 2031 and halt the collapse of biodiversity.

The Child Trauma Response Team, an innovative police and community-based organization partnership, demonstrated success at screening and treating children for post-traumatic stress disorder (PTSD) immediately following incidents of intimate partner violence, according to a Rutgers-led study published in the Journal of Interpersonal Violence.

"Families that experience poverty, social disadvantage and structural racism are at a higher risk for severe intimate partner violence, but those same factors are also barriers to accessing the post-trauma support offered by community-based organizations," said Amanda Stylianou, an expert on domestic violence and health outcomes at Rutgers University Behavioral Health Care.

More than 7 million children in the United States are exposed to intimate partner violence each year, which can impact their development, mental health, physical health and functioning as adults, Stylianou said.

To understand how to improve PTSD screening and treatment of children and their caregivers after witnessing these incidents, she and her research team looked at 244 families with 352 children in Harlem being served by Safe Horizon, the nation's largest crime victim organization, through the New York City Child Trauma Response Team (CTRT) over the initial one-year pilot.

They found families that received an immediate CTRT response, including victim safety assessments, were three times more likely to engage in a child PTSD screen. Of the children who completed the PTSD screens, close to three-quarters showed one or more trauma symptoms and were offered evidence-based mental health treatment.

The CTRT was developed in partnership between the New York City Police Department, New York County District Attorney's Office, Mayor's Office of Criminal Justice and Safe Horizon. It identifies children under 18 who have directly or indirectly witnessed serious incidents of intimate partner violence and provides an immediate interdisciplinary response to affected families, most of which have a female caregiver.

"When an incident of intimate partner violence is reported to the police, the team immediately reaches out to the family to assess the safety risks of the victim and their children, explores family experiences with systemic racism, provides individual supportive counseling and crisis intervention, and offers information on criminal justice and social service processes and resources," explained Arisly Rodriguez, senior director of the Child Trauma Response Team at Safe Horizon.

CTRT focuses on building a relationship with the caregiver and trains staff to incorporate child PTSD screening questions within the conversation. "Focusing on the immediate safety needs of the caregiver and children may create the trust needed to pave the way for deeper conversations about child well-being," said Stylianou.

The study also found that children who witnessed a felony were more likely to be screened for PTSD and that Black children were close to three times more likely to have a positive PTSD screen than White or Hispanic/Latino children -- a rate possibly due to their exposure to structural and racial trauma.

"The results suggest that the CTRT model is a promising practice for providing a swift interdisciplinary response to children and their caregivers to reduce the immediate and long-term effects of witnessing such violence," Stylianou said. "Truly accessible early intervention models, responsive to the unique risks and needs of all families, can play a critical role in identifying and linking children at risk of PTSD to early intervention mental health programs."

DALLAS (SMU) - The discovery of the first juvenile dromaeosaurid lower jaw bone on the North Slope of Alaska supports a growing theory that some Cretaceous Arctic dinosaurs did not migrate with the seasons but were year-round residents, according to new research by SMU paleontologist Anthony Fiorillo. The research was published today in PLOS ONE. Prior to this find, only tiny dromaeosaurid teeth have been discovered in this region.

Dromaeosaurids are a group of predatory dinosaurs closely related to birds. Researchers have tended to believe that this group of dinosaurs migrated through the area but did not make their homes there.

"This is the first physical evidence that 70 million years ago, some dromaeosaurid nested in the area," Fiorillo says. "To withstand the rigors of migration, modern caribou need to be at least 80 percent of their adult length. Grown dromaeosaurids ranged from 6 to 9 feet. This baby would have been the size of a small puppy, much too young to migrate," he says.

Dromaeosaurids' small and delicate bones don't preserve well in the fossil record, which makes this discovery of a baby's jawbone particularly unique, Fiorillo says. But don't be fooled by their fine-boned stature. Velociraptors, the "Jurassic Park" dinosaurs that terrorized the kids in the famed kitchen scene, are members of this same sharp-toothed family, he says.

The partial jaw fossil that Fiorillo and colleagues studied, with one black erupted tooth, was found on a bank of the Colville River near the Arctic Ocean, about 250 miles north of the Arctic Circle. The location is part of the Prince Creek Formation, which existed as a coastal plain in the Late Cretaceous period with a climate similar to 21st century Seattle or Portland, Oregon. Trees, ferns and mosses flourished there, along with plant-eating dinosaurs, small mammals and the predators that ate them. Now the formation is home to the largest collection of polar dinosaurs in the world.

Paleontologists have long thought the Prince Creek Formation was once a dinosaur highway, with migrating hadrosaurs, ceratopsians and theropods crossing a land bridge between Asia and North America and dispersing across the continent. The discovery of this tiny portion of the tip of a dinosaur chick's jawbone helps prove that some dinosaurs made their home there.

Co-authors of the paper include Alfio Alessandro Chiarenza, Ronald S. Tykoski, Paul J. McCarthy, Peter P. Flaig, and Dori L. Contreras.

SMU paleontologist finds challenge, adventure and success in Alaskan wilds

For the last 22 years, Fiorillo has spent his summer camping on the riverbanks and mountainsides of Alaska, searching for fossils. But COVID-19 grounded the planned 2020 five-person expedition to Aniakchak National Monument, the most remote and least visited national park unit in the country. The team was planning to expand on its earlier successes studying dinosaur tracks, published last year in the journal PLOS ONE.

When Fiorillo first traveled to Alaska in 1998, dinosaur fossils had only been found in two areas of the state. The North Slope was home to just one kind of exploration - oil.

"When you looked at the geologic map of the area, the age of the rock was just the right age to find dinosaur fossils," he said. "Researching there sparked my intellectual curiosity and sense of adventure."

And like Fiorillos' muse, Arctic Village author Robert Marshall, "Blank spaces on maps have always fascinated me," he says. For Fiorillo, there is no sweeter sound than the fading roar of the fixed wing plane that has deposited his team, gear and provisions on an airstrip far from any road or civilization.

"It's hard to explain, it's liberating and freeing being completely on your own the way we are," he says.

The isolation also comes with challenges. Fiorillo and his teams have experienced floods, earthquakes, landslides, snowstorms and once, a bear that tried to get into his tent. In the early years, their only communication to the outside world was an air-to-ground radio that connected to a commercial plane passing overhead, of which there were few.

"If trouble comes, it's up to us to get out of it," he says.

Fiorillo's intellectual curiosity and love of adventure have paid off. The map of Alaskan dinosaur fossils is no longer blank. And after 22 years of Arctic research, Fiorillo has found that dinosaur fossils there are so prevalent, "You can't walk 10 steps without tripping over one."

Of the four Alaskan dinosaurs with names, Fiorillo has named two of them, a right given to the person who discovers the first of a species. He's the author of more than 150 scientific papers, abstracts and reviews, a collaborator on four books and author of Alaska Dinosaurs: An Ancient Arctic World, published in 2018.

Visitors to Dallas' acclaimed natural history and science museum, the Perot Museum of Nature and Science, are well aware of his work, he played a key role in the museum's development, serving as vice president of research and chief curator since 2014. He was curator of Earth sciences there from 1999-2014.

Fiorillo is now curator emeritus at the Perot Museum, and adjunct associate professor in the Huffington Earth Sciences department at SMU. Grounded this year by the coronavirus, he is ready to go back to Alaska.

"Very little was known about Alaskan dinosaurs when I first started going there," he says. "We've answered many academic questions, but we've raised even more new questions."

About SMU

SMU is the nationally ranked global research university in the dynamic city of Dallas. SMU's alumni, faculty and nearly 12,000 students in eight degree-granting schools demonstrate an entrepreneurial spirit as they lead change in their professions, communities and the world.

Contact: Nancy George, ngeorge@smu.edu, 214-768-7674, 972-965-3769, cell

Journal

PLoS ONE

PROVIDENCE, R.I. [Brown University] -- While immunotherapy -- a form of treatment that uses the body's immune system to recognize, attack and kill tumor cells -- has given hope to people across the globe, it fails in a significant proportion of cancer patients.

However, a new study published in the Nature journal Cell Death Discovery on Monday, July 6, suggests that blocking the tumor-promoting protein MDM2 could bolster immunotherapy's effectiveness.

"Immunotherapy has been one of the biggest breakthroughs in biomedical science and medicine of the last two decades," said Dr. Wafik El-Deiry, a professor of pathology and laboratory medicine and associate dean for oncologic sciences at Brown University. "But it has limitations."

Some people's tumors respond to immunotherapy initially and then relapse. Other patients experience pseudoprogression, where tumors appear to grow before eventually shrinking. And a third group -- between 5% and 29% of patients -- experience hyperprogression, which means that immunotherapy actually worsens their tumor growth.

El-Deiry hopes that blocking MDM2, either through gene-silencing or the MDM2-inhibiting drug AMG-232, could be especially helpful for people with hyperprogression.

Various studies have found that when the MDM2 gene is amplified -- meaning that cells contain too many copies of the gene -- or when the MDM2 protein is overexpressed because the gene is not being regulated properly, tumor cells tend to grow more quickly and are more resistant to immunotherapy. Researchers are still investigating exactly why this accelerated growth and resistance occur, but studies suggest that MDM2 can help tumors grow and evade the immune system through a variety of mechanisms. For example, MDM2 appears to inactivate the tumor-suppressor gene p53 and prevent immune cells from killing tumor cells, and it is also associated with higher levels of a tumor-promoting inflammatory protein called interleukin-6 (IL-6).

In their study, El-Deiry and his colleagues treated cell lines of MDM2-overexpressing ovarian cancer cells with the therapeutic AMG-232. The data show that AMG-232 allowed immune cells to kill the tumor cells much more efficiently and reduced levels of IL-6. These results suggest that MDM2 inhibitors could be combined with immunotherapy to enhance its effectiveness.

This study follows the recent launch of the Cancer Center at Brown University, where El-Deiry serves as inaugural director. The center builds on Brown's growing focus on translational science -- the practice of ensuring that breakthroughs in basic research are advanced to the point where they can make a meaningful medical difference for patients, and that urgent scientific questions identified in the clinic or among patient populations become research priorities in the lab. Faculty at the new center will take a broad-spectrum approach to research, from working to understand how cancer develops, grows and metastasizes, to developing new therapeutics for patients in a personalized way that addresses their needs ranging from risk through survivorship.

For this specific finding, El-Deiry hopes the study will lead to a clinical trial so the research team can further evaluate the safety and effectiveness of this novel treatment. With MDM2 amplification and overexpression implicated in a variety of cancers, he believes that AMG-232 (or similar drugs, including those that block both MDM2 and a related protein, MDMX) could be widely applicable -- and it could even benefit immunotherapy patients whose tumors have normal MDM2 levels.

"We think this might be a good approach to treat patients whose tumors are predicted to undergo hyperprogression, but I would say our results show that targeting MDM2 in combination with immunotherapy works well even if MDM2 is not amplified or overexpressed," El-Deiry said. "It's tapping into a vulnerability within tumors to help immunotherapy work better."

In addition to El-Deiry, other Brown University authors on the study were Ilyas Sahin, Shengliang Zhang, Arunasalam Navaraj, Lanlan Zhou, Don Dizon and Howard Safran. The study was supported by the Mencoff Family endowed professorship at Brown.

This news story was authored by contributing science writer Kerry Benson.

Genomics is crowding out ways of reducing inequality, has thwarted medicine from advancing justice, and is creating new forms of social classification and surveillance. These are key messages of For ''All of Us''? On the Weight of Genomic Knowledge, a new Hastings Center special report.

The overarching premise of the report is that genomic "can be a weight, a weight that has the potential to thwart--and historically has thwarted--medicine from genuinely advancing justice," writes Joel Michael Reynolds, co-editor of the report with Erik Parens, a senior research scholar at The Hastings Center. The report asks if the focus on genomics is crowding out other, more effective ways of reducing health inequity. It warns that genomic knowledge can shore up scientifically discredited conceptions of race, which further entrenches structural racism. The report also warns that the danger of treating social behaviors as genetic or based on racial classifications is that this kind of logic can spur on eugenics. The report also notes that the benefits of genetic advancements will likely go to the richest in society, further exacerbating inequality.

The special report highlights several ways that genomics can perpetuate inequality and structural racism:

Genomics is crowding out ways of reducing health inequity.

Despite mountains of data emphasizing the social and political nature of health disparities, the new focus racial difference in genomics has resulted in a shift from environmental causes to genetic causes.

Health disparities quickly become imagined to be the result of DNA differences, as opposed to the intergenerational health effects of societal racism.

Instead of measuring the environment and social conditions in meaningful ways, such as by studying how racial discrimination affects biology, genomics research reinforces the notion that race is determined by our genes.

Genomic knowledge will likely go toward helping privileged people make their lives a little bit longer or a little bit better.

The special report consists of 10 essays written by scholars in philosophy, social sciences, medical anthropology, and disability studies. The essays include:

Health for Whom? Bioethics and the Challenge of Justice for Genomic Medicine by Joel Michael Reynolds. In this to the special report. Reynolds writes that the report begins with the "conviction and hope that justice is at the normative heart of medicine and that it is the perpetual task of bioethics to bring concerns of justice to bear on medical practice." Summing up the special report, Reynolds writes that "taking the principle of justice seriously would lead us to better situate the gift and weight of genomics within the many practices for which we have evidence to bring about fairness and equity for human lives. To implement these practices will require not only significant biomedical efforts but also political efforts that push typical clinical and bioethical concerns beyond their historical orbit." Reynolds is an assistant professor of philosophy and disability studies at Georgetown University and the inaugural Rice Family Fellow in Bioethics and the Humanities at The Hastings Center.

Conceptualizing Race in the Genomic Age by Catherine Bliss. This essay argues that a concept of race that presumes that there are discreet genetic groups of white, black, Asian, Native American, and Pacific Islander is a fallacy that will always lead to social inequality. Bliss asks whether genomics can do more than merely avoid racism; can it contribute to antiracism projects? To promote social justice, she writes, "all of us across the sciences, throughout health policy, and in the wider public will need to reconceptualize race in terms of legacies of discrimination. We will need to shift our focus from molecular differences to social and political differences, especially when we conduct gene-environment analyses." Bliss is an associate professor of sociology at the University of California, San Francisco.

Does Solidarity Require ''All of Us'' to Participate in Genomics Research? by Carolyn P. Neuhaus. This essay interrogates the idea that Americans have an ethical obligation to participate in genomics research, as an act of solidarity, particularly the federal government's "All of Us," which aims to create precision medicine and improve the health of everyone. Neuhaus argues that while participating in research may be "a good thing to do," cultivating and expressing solidarity requires much more of us. Specifically, it requires recognizing another person or other creature "as, like ourselves, vulnerable to injustice and entails acting in ways that contribute to creating, reforming, and participating in institutions that are aimed at enhancing their flourishing." Neuhaus is a Hastings Center research scholar.

Why and How Bioethics Must Turn toward Justice: A Modest Proposal by Jenny Reardon. To create a genomics that offers more gifts than weights, Reardon argues, central attention must be paid to questions of justice and structural inequity. It will necessitate building novel coalitions and collaborations that turn the attention of bioethical governance away from narrow individual questions such as, "Do I consent?" and toward the broader collective question, is this just? Reardon is a professor of sociology and the founding director of the Science and Justice Research Center at University of California, Santa Cruz, and Hastings Center fellow.

According to the United Nations, about one-fifth of the world's population lives in areas where water is scarce. Therefore, technologies to produce clean water from undrinkable sources, such as seawater, river or lake water, and contaminated water, are urgently needed. Now, researchers reporting in Nano Letters have developed a wood-based steam generator that, with the help of bacterial-produced nanomaterials, harnesses solar energy to purify water.

A solar steam generator is a device that uses the abundant energy of the sun to separate pure water from its contaminants by evaporation. Many different versions of these devices have been developed, with varying efficiencies. To design better solar steam generators, researchers must find ways to improve light absorption, heat management, water transport and evaporation. Shu-Hong Yu and colleagues at the University of Science and Technology of China wanted to combine all four improvements in a single device. They chose wood as the basis of their generator because of its sustainability and porous structure, which allows rapid water transport.

The researchers made their device with the help of bacteria that produced long cellulose nanofibers, which bound the layers of the device together. The team added bacteria to the surface of a block of wood and allowed them to ferment. Then, they sprayed an aerosol of glass bubbles -- tiny hollow spheres that provide excellent thermal insulation -- onto the surface. The glass bubbles became embedded in the cellulose nanofibers produced by the bacteria, forming a hydrogel. Finally, the researchers added carbon nanotubes, which tangled with the cellulose nanofibers to form a light-absorbing, water-evaporating top layer. The device works by transporting water upward through the wood to the light-absorbing layer, which is heated by the sun. The water evaporates, and the steam is collected and condensed to produce pure water. The insulating layer of glass bubbles keeps heat from being transferred downward through the device and lost, and the nanoscale structures lower the energy required for water vaporization. As a result, the new device has a higher evaporation rate and efficiency than most existing solar steam generators.