Culture

DALLAS - July 1, 2020 - A new report from cardiologists at UT Southwestern raises the hope that doctors will be able to visually check the jugular venous pressure of heart failure patients remotely, using the camera on a smartphone. The finding is especially timely as telemedicine expands during the pandemic.

The jugular venous pressure assessment, which provides insight into fluid retention and increased pressure inside a heart, usually requires a trip to the doctor's office for a visual check of the jugular vein in the neck.

"It is one of the most important and common approaches to assess the fluid status of such patients," says Mark Drazner, M.D., clinical chief of cardiology at UT Southwestern and senior author of the research letter published today in JAMA Cardiology.

The ability to perform this test using telemedicine could mean fewer trips to the physician for sometimes frail heart failure patients, Dr. Drazner says, and could allow doctors to perform more frequent checks.

In addition, with some patients delaying in-person doctor visits because of COVID-19, the ability to perform the test via telemedicine could be a lifesaver, says Jennifer Thibodeau, M.D., interim section chief of Advanced Heart Failure, Transplant, and LVAD. "Patients who are not evaluated because of fears of COVID-19 may be putting themselves at risk. Being able to evaluate a patient with heart failure effectively and virtually allows us to seamlessly continue the care of patients with heart failure during this pandemic."

"I think the heart failure community is going to be quite interested in this," adds Dr. Drazner.

During a jugular venous pressure assessment, a physician or other health care provider checks the distention of the jugular veins in the neck to determine how high blood is rising within the veins.

As pressure inside an unhealthy heart's right atrium increases, the height of the jugular venous distention will rise, Dr. Drazner explains. That level can be checked by looking at the patient's neck, "much like checking the oil dipstick in a car," he says.

A reading at or above 10 millimeters Hg of jugular venous pressure is considered cause for concern, Dr. Drazner says, and may indicate too much fluid buildup in the body.

For the study, advanced heart failure and transplant cardiologists performed jugular venous pressure assessments both in person and remotely via smartphone video apps on 28 heart failure patients, with an on-site assistant helping position the smartphones for patients.

The study found that the in-person and remote assessments often agreed and that they also correlated to the right atrial pressure when measured invasively.

Specifically, the remote and bedside estimates on whether the level was less than, at, or above 14 centimeters (considered to correspond to 10 millimeters Hg pressure within the heart) agreed 95 percent of the time, according to the report.

The investigators also compared their assessments to the actual right atrial pressure as measured by invasive heart catheterization. The in-person assessments and catheter readings agreed 93 percent of the time when the results were at the concerning level, while the remote assessments and invasive measurements agreed a slightly lower 89 percent of the time, according to the report.

The study was started before the emergence of COVID-19, Dr. Drazner says, but the results have become more timely given current concerns over the deadly virus and the rapid shift to telehealth.

The next step will be to see if similar results are possible using computer screens, which doctors often use in telemedicine visits, and whether the remote tests can be performed successfully without an on-site assistant, Dr. Drazner says, adding that he hopes there will be additional testing of this method in a multi-institutional study.

Life on Earth would not be possible without the Moon; it keeps our planet's axis of rotation stable, which controls seasons and regulates our climate. However, there has been considerable debate over how the Moon was formed. The popular hypothesis contends that the Moon was formed by a Mars-sized body colliding with Earth's upper crust which is poor in metals. But new research suggests the Moon's subsurface is more metal-rich than previously thought, providing new insights that could challenge our understanding of that process.

Today, a study published in Earth and Planetary Science Letters sheds new light on the composition of the dust found at the bottom of the Moon's craters. Led by Essam Heggy, research scientist of electrical and computer engineering at the USC Viterbi School of Engineering, and co-investigator of the Mini-RF instrument onboard NASA Lunar Reconnaissance Orbiter (LRO), the team members of the Miniature Radio Frequency (Mini-RF) instrument on the Lunar Reconnaissance Orbiter (LRO) mission used radar to image and characterize this fine dust. The researchers concluded that the Moon's subsurface may be richer in metals (i.e. Fe and Ti oxides) than scientists had believed.

According to the researchers, the fine dust at the bottom of the Moon's craters is actually ejected materials forced up from below the Moon's surface during meteor impacts. When comparing the metal content at the bottom of larger and deeper craters to that of the smaller and shallower ones, the team found higher metal concentrations in the deeper craters.

What does a change in recorded metal presence in the subsurface have to do with our understanding of the Moon? The traditional hypothesis is that approximately 4.5 billion years ago there was a collision between Earth and a Mars-sized proto-planet (named Theia). Most scientists believe that that collision shot a large portion of Earth's metal-poor upper crust into orbit, eventually forming the Moon.

One puzzling aspect of this theory of the Moon's formation, has been that the Moon has a higher concentration of iron oxides than the Earth--a fact well-known to scientists. This particular research contributes to the field in that it provides insights about a section of the moon that has not been frequently studied and posits that there may exist an even higher concentration of metal deeper below the surface. It is possible, say the researchers that the discrepancy between the amount of iron on the Earth's crust and the Moon could be even greater than scientists thought, which pulls into question the current understanding of how the Moon was formed.

The fact that our Moon could be richer in metals than the Earth challenges the notion that it was portions of Earth's mantle and crust that were shot into orbit. A greater concentration of metal deposits may mean that other hypotheses about the Moon's formation must be explored. It may be possible that the collision with Theia was more devastating to our early Earth, with much deeper sections being launched into orbit, or that the collision could have occurred when Earth was still young and covered by a magma ocean. Alternatively, more metal could hint at a complicated cool-down of an early molten Moon surface, as suggested by several scientists.

According to Heggy, "By improving our understanding of how much metal the Moon's subsurface actually has, scientists can constrain the ambiguities about how it has formed, how it is evolving and how it is contributing to maintaining habitability on Earth." He further added, "Our solar system alone has over 200 moons - understanding the crucial role these moons play in the formation and evolution of the planets they orbit can give us deeper insights into how and where life conditions outside Earth might form and what it might look like."

Wes Patterson of the Planetary Exploration Group (SRE), Space Exploration Sector (SES) at Johns Hopkins University Applied Physics Laboratory, who is the project's principal investigator for Mini-RF and a co-author of the study, added, "The LRO mission and its radar imager Mini-RF are continuing to surprise us with new insights into the origins and complexity of our nearest neighbor."

The team plans to continue carrying out additional radar observations of more crater floors with the Mini-RF experiment to verify the initial findings of the published investigation.

Engineering researchers at North Carolina State University and Temple University have developed soft robots inspired by jellyfish that can outswim their real-life counterparts. More practically, the new jellyfish-bots highlight a technique that uses pre-stressed polymers to make soft robots more powerful.

"Our previous work focused on making soft robots that were inspired by cheetahs - and while the robots were very fast, they still had a stiff inner spine," says Jie Yin, an assistant professor of mechanical and aerospace engineering at NC State and corresponding author of a paper on the new work. "We wanted to make a completely soft robot, without an inner spine, that still utilized that concept of switching between two stable states in order to make the soft robot move more powerfully - and more quickly. And one of the animals we were inspired by was the jellyfish."

The researchers created their new soft robots from two bonded layers of the same elastic polymer. One layer of polymer was pre-stressed, or stretched. A second layer was not pre-stressed and contained an air channel.

"We can make the robot 'flex' by pumping air into the channel layer, and we control the direction of that flex by controlling the relative thickness of the pre-stressed layer," Yin says.

Here's how it works. When combined with a third stress-free layer, called an intermediate layer, the pre-stressed layer wants to move in a particular direction. For example, you might have a piece of polymeric strip that has been pre-stressed by pulling it in two directions. After attaching the pre-stressed material to the intermediate layer, the end result would be a bilayer strip that wants to curve down, like a frowning face. If this bilayer strip, also called the pre-stressed layer, is thinner than the layer with the air channel, that frowning curve will bend into a smiling curve as air is pumped into the channel layer. However, if the pre-stressed layer is thicker than the channel layer, the frown will become more and more pronounced as air is pumped into the channel layer. Either way, once the air is allowed to leave the channel layer, the material snaps back to its original, "resting" state.

In fact, this simple example describes one of the soft robots created by the research team, a fast-moving soft crawler. It resembles a larval insect curling its body, then jumping forward as it quickly releases its stored energy.

The jellyfish-bot is slightly more complicated, with the pre-stressed disk-like layer being stretched in four directions (think of it as being pulled east and west simultaneously, then being pulled north and south simultaneously). The channel layer is also different, consisting of a ring-like air channel. The end result is a dome that looks like a jellyfish.

As the jellyfish-bot "relaxes," the dome curves up, like a shallow bowl. When air is pumped into the channel layer, the dome quickly curves down, pushing out water and propelling itself forward. In experimental testing, the jellyfish-bot had an average speed of 53.3 millimeters per second. That's not bad, considering that none of the three jellyfish species the researchers examined went faster than an average of 30 millimeters per second.

Lastly, the researchers created a three-pronged gripping robot - with a twist. Most grippers hang open when "relaxed," and require energy to hold on to their cargo as it is lifted and moved from point A to point B. But Yin and his collaborators used the pre-stressed layers to create grippers whose default position is clenched shut. Energy is required to open the grippers, but once they're in position, the grippers return to their "resting" mode - holding their cargo tight.

"The advantage here is that you don't need energy to hold on to the object during transport - it's more efficient," Yin says.

July 1, 2020 - Many studies published by major spinal surgery journals do not include full disclosure of researchers' financial conflicts of interest (COIs), reports a study in Spine. The journal is published in the Lippincott portfolio by Wolters Kluwer.

"[A] large number of physician-industry interactions...are underreported by authors publishing within the surgical spine literature," according to the study by Jeremy D. Shaw, MD, and colleagues of University of Pittsburgh Medical Center. They propose steps to encourage more accurate disclosure of potential COIs - especially in spinal surgery, where relationships between surgeons and the biomedical device industry play a crucial role in research and innovation.

High Rate of Incomplete Financial Disclosures in Spinal Surgery Studies

The researchers reviewed financial COIs by authors who published studies in Spine and two other major spinal surgery journals between 2014 and 2017. The analysis included nearly 40,000 authors contributing to about 6,800 research articles.

The COI disclosures for each author were compared to those in the Center for Medicare and Medicaid Services' publicly available Open Payments Database (OPD). Established under the Affordable Care Act, the OPD requires pharmaceutical, medical device, and biological products manufacturers to report all payments to physicians of more than $10. Overall, 15.8 percent of spinal surgery authors had payments reported in the OPD.

Dr. Shaw and colleagues then compared payments reported to the OPD with the authors' financial disclosures in the published studies. Most payments reported to the OPD were reflected in the COI statements. Of the total $1.90 billion received by authors, approximately $1.48 billion - 78 percent of the total - was accurately disclosed.

"Undisclosed payments included $180 million in researcher funding and $188 million in royalties," Dr. Shaw and colleagues write. Charitable contributions and payments from royalties/licenses were most likely to be accurately reported, while funds for research and entertainment were least likely to be disclosed.

About 77 percent of authors of studies published in Spine had accurate disclosures, compared to a little over 40 percent for the other two journals. This might reflect differences in reporting criteria between journals - for example, Spine presents disclosure statements for all authors combined, rather than individually.

Although physician-industry relations are essential for medical progress, they have the potential to introduce bias that may influence research findings. "The connection between industry and spine surgery is essential for the further development of surgical techniques and hardware," Dr. Shaw and coauthors write. They add: "There is a need for transparency in academic publishing with the increasing public scrutiny of medical publishing."

The authors emphasize that their study is not aimed at making accusations of misconduct, and that under-disclosure likely does not involve conscious effort to hide financial interactions. For example, the study found that less-experienced authors were more likely to have inaccurate disclosures than more-experienced authors - suggesting that junior researchers may need mentoring on the importance of accurately reporting COIs.

Dr. Shaw and colleagues suggest a system to improve financial transparency: searching public databases such as the OPD to actively verify relationships between authors and industry, before studies are published. The researchers conclude: "There is a need to standardize COI reporting and actively query the publicly available databases of payments to increase rates of correct financial COI disclosure in the spine literature."

WHAT:

In a Perspective for the New England Journal of Medicine, members of the National Institutes of Health's Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Vaccines Working Group assess practical considerations and prerequisites for using controlled human infection models (CHIMs), which can be used for human challenge studies, to support SARS-CoV-2 vaccine development. In the article, the authors determine the timeline for developing robust CHIMs that meet the essential criteria for limiting risk for study volunteers could take one to two years. The authors conclude that large, randomized, controlled trials of SARS-CoV-2 are the fastest and most effective path forward for establishing vaccine safety and efficacy. Parallel development of CHIMs may provide complementary tools to address additional questions such as the duration of immunity and correlates of protection, if such studies can be conducted ethically.

In a CHIM study, participants are intentionally exposed to an infectious agent to help scientists understand the virus or test interventions to prevent or treat infection. CHIMs use well-characterized microorganisms that either do not cause serious disease, are easily treated, or both. In addition, CHIM studies must take place in laboratories with rigorous isolation to ensure that the infection does not spread into the community.

The authors note that ethical evaluation of the risk to participants and the potential value to society are essential to future considerations of whether to conduct CHIM studies for COVID-19; currently there is no highly efficacious treatment for moderate or severe illness. The authors propose that development of a SARS-CoV-2 GMP stock, preferably with attenuating mutations, should proceed along with preparation of facilities and procedures and engagement of a broad set of stakeholders. Additionally, the researchers recommend developing CHIMs for seasonal coronaviruses, which cause about 30% of cases of the common cold and can provide insights into more deadly coronaviruses such as SARS-CoV, MERS-CoV, and SARS-CoV-2.

ITHACA, N.Y. - Native to Europe but discovered in Pennsylvania in 2015, the Allium leafminer is a fly whose larvae feed on crops in the Allium genus, including onions, garlic and leeks.

Since its arrival in the U.S., it has spread to New York, Connecticut, Massachusetts, Maryland and New Jersey, and is considered a major agricultural threat. A Cornell University-led team of researchers field-tested 14 active ingredients in insecticides, applied in a variety of methods, to understand the best treatment options.

The researchers' findings are described in a study, "Managing Allium Leafminer: An Emerging Pest of Allium Crops in North America," published in the Journal of Economic Entomology.

The research team, led by senior author Brian Nault, professor of entomology at Cornell AgriTech and one of the nation's leading Allium leafminer management experts, found that several traditional chemical insecticides worked best against the invasive insect.

"Problems with the Allium leafminer tend to be worse on organic farms where highly effective management tools - synthetic insecticides - are not used," Nault said.

The Allium leafminer (Phytomyza gymnostoma) has two generations annually, with adults emerging in April and again in mid-September. These two cycles are separated by a pause in the summer, when most onions are grown, which allows the crop to escape the pest. Also, onion bulbs expand rapidly, which does not allow the leafminer maggot time to effectively feed.

Crops with green foliage during either adult leafminer generation are most at risk. In the northeastern U.S., these include chives, scallions and garlic in the spring, and scallions and leeks in the fall. Wild alliums, which cross both generations, can be a reservoir where the insects to grow.

Larvae start feeding at the tops of plants and migrate toward the base to pupate. The larvae can destroy vascular tissue, which can lead to bacterial or fungal infections that cause rot.

The research team tested various management strategies with onions, leeks and scallions in Pennsylvania and New York in 2018 and 2019. Spraying chemical insecticides (dinotefuran, cyantraniliprole and spinetoram) was the most consistent and effective method, with up to 89% reduction in damage and up to 95% eradication of the insect. Dinotefuran and cyantraniliprole applied through a drip irrigation technique were not effective.

Other insecticides (abamectin, acetamiprid, cyromazine, imidacloprid, lambda-cyhalothrin, methomyl and spinosad) also reduced densities of Allium leafminers. Spinosad applied to bare roots, or in plug trays for plant starts, reduced the insect's damage after transplanting by 90%.

Though Allium leafminers have not been an issue in onions so far, researchers and farmers are concerned they may become a problem if they gain traction and move west, where onions are a major crop. "This has been a huge concern for the U.S. onion industry," Nault said.

New Yorkers continue to report much higher than normal rates of depression and anxiety, but much less than at their peak in mid-April. As they witness the surge in COVID-19 cases in states that re-opened early, New Yorkers have also grown significantly more hesitant about resuming normal activities than they reported in May. Employment and housing worries remain a serious concern for many. These are the major findings of the 13th city and statewide tracking survey from the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), June 26-28.

As May 2020 began, 65% of New Yorkers said they would see their doctor for a routine visit beginning at the start of the next month. In June, that number dropped to 33%. In early May, 46% said they would go for a haircut starting June 1, but by the end of June, only 33% said they would do so as of July 1. The number who thought they would go to a restaurant after the first of the following month dropped from 31% to 20%. Moreover, a far greater number of respondents now say they plan to wait for a safe and effective vaccine to be widely available before they take part in many routine activities. In May, for example, 31% said they would wait for a vaccine before going to an outdoor concert; in June, nearly twice that number (60%) said they would wait for a vaccine.

Less than a third of respondents believe that public schools (27%) and colleges and universities (31%) should reopen for regular classes in the fall. A majority (54%) do not think the pandemic will end until a vaccine is created.

"People follow the news," said Dr. Ayman El-Mohandes, Dean of CUNY SPH. "COVID-19 is under better control in New York now, but people see that it is devastating other cities, states and countries, and they do not want to let their guard down. People here also seem to have become resigned to COVID-19. They don't see the pandemic ending within a finite period of time, instead they link its resolution to the availability of a safe and effective vaccine."

Serious Economic Pressures Continue for Many

Respondents still face serious economic challenges. One in five respondents (20%) who rent their homes said they would not be able to pay their rent this month, while 10% of homeowners said they would not be able to pay their mortgage. This situation remains unchanged since a mid-April CUNY SPH survey, which reported that 23% of respondents were unable to pay their rent, and 11% were unable to pay their mortgage.

Of those facing difficulties with rent or house payments, 51% believe they will be evicted, and 2% said they have already been evicted. The government's moratorium on evictions in New York expires on July 6, although some limited protections will remain in place through the end of August.

About one-fourth (26%) of respondents said they had lost their job as a consequence of the pandemic, of whom 46% were terminated and 54% were furloughed. Of those who were terminated, only 54% said they had found another job; of those who were furloughed, only 36% have been asked to return to their previous work.

It is not surprising, then, that more New Yorkers see the economy as worsening (44%) rather than improving (28%). Three in ten respondents remain worried about paying for housing (30%) and more than a quarter (26%) are concerned about employment.

SNAP Numbers Fail to Keep Pace with the Reality of Food Insecurity

About one-third (32%) of the current survey's respondents report receiving food from SNAP or local non-profit organizations, which is virtually unchanged from late April.

"Despite the determined efforts of public programs to improve access to food assistance, it is disturbing that, four months into the epidemic, less than a third of New Yorkers report receiving such help," said Nicholas Freudenberg, Distinguished Professor of Public Health and Director of the CUNY Urban Food Policy Institute. "This suggests an ongoing gap, as our survey in late May found that 44% of households were experiencing food insecurity. To reduce the high levels of food insecurity that threaten present and future physical and mental health in New York City, public food programs will need to do more to reach those in need."

Testing on the Rise

Indicative of a more positive trend, a greater proportion of New Yorkers (42%) reported last weekend that either they or a member of their household has been tested for COVID-19 since March, with three-fourths (75%) of those being tested within the last four weeks. Of this group, 31% reported that the test had been positive, which represents about one in eight (13%) of all the households in the overall survey population. People who reported being tested in previous CUNY SPH surveys were more likely to report testing positive, which suggests that testing was previously being made available only to individuals who appeared to be ill.

Social Issues

About a quarter (26%) of New Yorkers think the coronavirus appears to be a greater threat to the future of the city than racism and police violence (16%). African Americans rated racism slightly higher (20%) and the coronavirus slightly lower (20%) than respondents overall.

However, almost three in five (58%) of all respondents rated the two threats as equal.

Almost three in ten (28%) of respondents said they took part in the recent protests against racism and police brutality, of whom 60% said it was their first time doing so.

Mental Health

Almost half (46%) of respondents report they have not interacted with family and friends outside of their home in the last two weeks, 27% said they have done so once, 21% said two to three times, with 3% reporting four to five times and another 3% reported six times or more.

New Yorkers appear to be habituating to the stress of the pandemic, as mental health symptoms appear to be steadily declining since their peak in mid-April, when mental health risk rates were about 34-44%. Now, only 21% and 28% of New Yorkers are reporting depression and anxiety risks (i.e., experiencing symptoms half of the time in the past two weeks), respectively.

"Increases in social interactions with family and friends, as well as high participation by New Yorkers in social movements, may be buffering the mental health effects of the pandemic," says Dr. Victoria Ngo, Director of the Center for Innovation in Mental Health at CUNY SPH. "However, only 8% of our latest respondents report that they used free emotional support assistance from city and state resources, like the New York State Office of Mental Health, ThriveNYC, NYCWell, etc. This is worrisome as it suggests that these free resources are not reaching the community."

Trusted Sources of COVID-19 Information

More than a fourth of New Yorkers reported television news (26%) their most trustworthy source of information about coronavirus, and a similar number (25%) said they trusted the CDC, while 15% said Governor Andrew Cuomo, 10% the WHO, 6% social media, 6% the Trump administration, 5% print news, and 3% family and friends.

The complete survey results and related commentary can be found at https://sph.cuny.edu/research/covid-19-tracking-survey/week-16/ and JHC Impact, an initiative of the Journal of Health Communication: International Perspectives.

Survey methodology

The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) survey was conducted by Emerson College Polling from June 26-28, 2020 (week 16). This tracking effort started March 13-15 (week 1).

The sample for the NY Statewide and New York City results were both, n=1,000, with a Credibility Interval (CI) similar to a poll's margin of error (MOE) of +/- 3 percentage points. The data sets were weighted by gender, age, ethnicity, education, and region based on the 2018 1-year American Community Survey model. It is important to remember that subsets based on gender, age, ethnicity, and region carry with them higher margins of error, as the sample size is reduced. In the New York City results, data was collected using an Interactive Voice Response (IVR) system of landlines (n=403), SMS-to-online (n=332), and an online panel provided by MTurk and Survey Monkey (n=232). In the Statewide results, data was collected using an Interactive Voice Response (IVR) system of landlines (n=404), SMS-to-online (n=329) and an online panel provided by MTurk and Survey Monkey (n=267).

In the statewide survey, regions were broken out into the following:

Region 1: Long Island 14.7% (USC1-4), Shirley, Seaford, Glen Cove, Garden City
Region 2: NYC 45.3% (USC 5-16) Queens, Brooklyn, Manhattan, Staten Island, Bronx
Region 3: Upstate 40% (USC 17-27): Albany, Harrison, Carmel, Rhinebeck, Amsterdam, Schuylerville, Utica, Corning, Irondequoit, Buffalo, Rochester

HOUSTON - (July 1, 2020) - Artificial enzymes made of treated charcoal could have the power to curtail damaging levels of superoxides, radical oxygen ions that are toxic at high concentrations.

The nanozymes developed by a Texas Medical Center team are highly effective antioxidants that break down damaging reactive oxygen species (ROS) produced in abundance in response to an injury or stroke.

The researchers suggested the materials, described in the American Chemical Society journal ACS Applied Nano Materials, could aid treatment of COVID-19 patients.

The biocompatible, highly soluble charcoal is a superoxide dismutase, and was synthesized and tested by scientists at Rice University, the University of Texas Health Science Center's McGovern Medical School and the Texas A&M Health Science Center.

Superoxide dismutases, or SODs, dismantle ROS into ordinary molecular oxygen and hydrogen peroxide. In the project co-led by Rice chemist James Tour, previous materials were successfully tested for their ability to activate the process, including graphene quantum dots drawn from coal and polyethylene glycol-hydrophilic carbon clusters made from carbon nanotubes.

They have now found oxidized charcoal nanoparticles are not only effective antioxidizers, but can also be made from an activated carbon source that is inexpensive, good manufacturing practice (GMP)-certified and already being used in humans to treat acute poisoning.

"That these nanozymes are made from a GMP source opens the door for drug manufacturers," said Tour, who led the project with A&M neurologist Thomas Kent and UTHealth biochemist Ah-Lim Tsai. "While coal was effective, an issue is that it can have a variety of toxic metallic elements and impurities that are not consistent across samples. And the clusters made from carbon nanotubes are very expensive."

The disclike nanozymes are prepared from powdered, medical-grade charcoal oxidized by treatment with highly concentrated nitric acid. The nanozymes teem with oxygen-containing functional groups that bust up superoxides in solution.

Tour noted the nanozymes are able to pass through the membranes of cells' mitochondria to quench a major source of free radicals without killing the cells themselves. "We published a paper on this recently," he said. "This seems to be really important to why these work so well in traumatic brain injury and stroke."

The researchers noted it may be worthwhile to study the application of their nanozymes to treat the cytokine storms -- an excessive immune system response to infection -- suspected of contributing to tissue and organ damage in COVID-19 patients.

"While speculative that these particles will be helpful in COVID-19, if administration is timed correctly, they could reduce the damaging radicals that accompany the cytokine storm and could be further chemically modified to reduce other injury-causing features of this disease," Kent said.

The COVID-19 pandemic has introduced unique challenges for public health practitioners and health communicators that warrant an expansion of existing health communication principles to take into consideration.

In an article published Tuesday in Public Health Research & Practice, CUNY SPH Distinguished Lecturer Scott C. Ratzan and colleagues outline a checklist for the implementation of COVID-19 communication strategies to move from the acute phase of the pandemic to the "next normal."

One of the major challenges that has emerged during the COVID-19 pandemic is the increasing amount of false content circulating on social media platforms. The spread of misinformation relating to a potential vaccine for the disease, even well before a vaccine is available for public use, is particularly concerning, the authors say. Rumours of safety scares and conspiracies relating to a COVID-19 vaccine have swirled throughout social media, leading to social media outlets taking active measures to limit misinformation. These measures, although important, have not prevented a saturated information system nor blocked harmful misinformation from undermining science-backed sources. These features of the media environment and the way people engage with the news call for a revision of the risk communication guidance during a public health crisis.

Ratzan and colleagues identified three general areas of capacity building for health communication during the pandemic: the need for communicators to be proactive and to take preventive actions at times; the importance of planning ahead while also acknowledging the unpredictability of the situation; and the call to focus on people.

The checklist for health communicators is made up of five objectives: set shared goals, establish coordinated response, devise a communication strategy, implement the communication plan, and be ready to adapt.

"We are trying to advance public health with simple innovations to promote evidence-based approaches to stem the COVID-19 pandemic," says Ratzan. "While we are pleased to publish and disseminate widely, we implore political leaders and governmental officials to adapt these checklists for a healthier populace and COVID-19 recovery."

It is critical that health communicators worldwide are more proactive in tackling risk communication challenges related to COVID-19, with likely prevention achieved through vaccination and societal COVID-19 resilience, Ratzan says.

New research is helping unlock the mystery of how the brain folds as a baby develops in the womb - a process critical to healthy brain function.

Misfolding of the brain is linked with many neurological conditions including autism, anorexia, epilepsy and schizophrenia.

Premature birth and foetal growth restriction, major risk factors for cerebral palsy, can also affect brain folding and lead to cognitive deficits.

While we know folds are essential to how a healthy human brain works, scientists are only beginning to understand what drives the folding process and why it goes wrong.

A new pre-clinical study by Australian and Swiss researchers has for the first time identified the genes linked with the development of the two types of brain folds - inward and outward - in the grey matter of the brain.

Using animal models that closely resemble human brain development, the study found differences in both genetic expression and neuron shape during the folding process.

Co-chief investigator Associate Professor Mary Tolcos said there were currently no therapies for the prevention or treatment of brain misfolding and no early test to detect problems before folding begins.

"We know folding happens in the second and third trimester of pregnancy and that all human brains fold along largely the same patterns," said Tolcos, an Australian Research Council Future Fellow at RMIT.

"This suggests the process is heavily controlled by our genes but we're only starting to understand how - it's like having an intricately folded piece of origami that's missing the instructions.

"Our study is a critical step towards fully understanding those genetic instructions, by pinpointing which genes are linked with fold development.

"The next step is to determine the precise role these genes play in the process, so we can work towards identifying potential therapeutic targets and develop interventions to prevent and fix misfolding in the brain."

Folding fundamentals

Previous brain folding studies have focused on white matter or looked at animals with smooth brains rather than folded ones, but have largely overlooked grey matter.

Grey matter is made up of neuron bodies and their connecting arms, while white matter is composed of the neurons' long nerve fibres and their protective layer of fat.

While the science of folding is still unclear, the latest evidence suggests grey matter in the developing brain expands faster than white matter, creating mechanical instability that leads to brain folding.

But the resulting "hill" and "valley" folds are not random - they follow a similar pattern in all folded brains of the same species.

The new study focused on sheep brains, which fold in the womb like the human brain.

Researchers investigated the genetic and microstructural differences in future grey matter, the cortical plate, in the parts of the brain just beneath the "hills" and "valleys".

The areas were analysed at three points of development - when the brain was smooth, semi-folded and fully folded.

Postdoctoral researcher Dr Sebastian Quezada Rojas said it was the first study to look at the genetics of folding of the future grey matter, as the folding process develops over time.

"Understanding the changes in the cortical plate during brain folding is paramount since this region changes so dramatically during this process," he said.

"We found some genes have higher expression in regions that fold outward and lower expression in regions that fold inwards. Other genes reverse this pattern.

"Together, these genetic expression patterns might explain why the cortical folding pattern is so consistent between individuals of the same species."

These genetic differences are also correlated with changes in grey matter neurons, with the study finding variations in the number of arms - or dendrites - that neurons grow in these regions during the folding process.

"We believe the regions that fold outward and inward are programmed to behave differently, and the shape of the neurons affects the way these areas fold. Untangling these connections will be focus of the next stage of this research," Quezada Rojas said.

DALLAS, July 1, 2020 -- Lifetime discrimination is a chronic stressor that may increase the risk for hypertension also known as high blood pressure, in African Americans, according to new research published today in Hypertension, an American Heart Association journal.

"Previous studies have shown that discrimination affects African Americans' health; however, this research is one of the first large, community-based studies to suggest an association between discrimination over a lifetime and the development of hypertension among a large sample of African American men and women," said Allana T. Forde, Ph.D., M.P.H., the study's first author and a postdoctoral research fellow at the Urban Health Collaborative at Drexel University in Philadelphia, Pennsylvania.

"African Americans continue to be disproportionately affected by hypertension, making it imperative to identify the drivers of hypertension in this population," Forde said. "Greater lifetime discrimination was associated with an increased risk for hypertension among African Americans in this study, which reflects the impact of cumulative exposure to stressors over one's lifetime and the physiological reactions to stress that contribute to deleterious health outcomes."

Researchers reviewed data on 1,845 African Americans, ages 21 to 85, enrolled in The Jackson Heart Study, which focused on cardiovascular disease among African Americans in the tri-county areas of Jackson, Mississippi. The study participants did not have hypertension during the first visit in 2000 through 2004. Patients completed two follow-up study visits: one in 2005 through 2008, and the second between 2009 through 2013. Participants self-reported their discrimination experiences through in-home interviews, questionnaires and in-clinic examinations.

Participants were defined as having hypertension if they said they were taking blood pressure-lowering medication, or had a systolic blood pressure of 140 mm Hg or above or diastolic blood pressure higher than 90 mm Hg at follow-up visits.

During the follow-up period, more than half of the participants (954 or 52%) developed hypertension. Participants who reported medium levels compared to low levels of lifetime discrimination had a 49% increased risk for hypertension after accounting for other risk factors.

"The study has important implications for patient care and population health," Forde said. "Traditional risk factors, such as diet and physical activity, have been strongly correlated with hypertension, yet important psychosocial factors like discrimination, which also have the potential to negatively impact health, are rarely considered when evaluating the risk for hypertension among African Americans in health care settings."

"Our findings highlight the need for health care professionals to recognize discrimination as a social determinant of health. Health care professionals who understand the importance of unique stressors like discrimination that impact the health of African Americans will be better equipped to provide optimal patient care to this population."

"However, medical care is not enough. More broadly, our results suggest how social determinants such as racism and discrimination affect health in measurable ways. Addressing these factors is critical to reducing rates of chronic diseases."

The researchers note that although the study included experiences of discrimination among a large sample of African Americans, discrimination was measured at a single point in time, which limited the researchers' ability to capture changes in discrimination experiences over the entire follow-up period.

Researchers said additional studies with African Americans in other regions of the U.S. are warranted to confirm the findings of this study. However, these results add to a large body of work documenting the impact of discrimination on the health of African Americans. Strategies to reduce health inequities and improve health are needed to address these broader social determinants.

COLUMBUS, Ohio -- Kids who miss a lot of school from kindergarten to eighth grade may suffer unexpected costs as young adults, a new study finds.

Researchers found that those who were more regularly absent in these early years of school were less likely to vote, reported having greater economic difficulties and had poorer educational outcomes when they were 22 to 23 years old.

The results suggest early school absenteeism should be taken more seriously, said Arya Ansari, lead author of the study and assistant professor of human sciences at The Ohio State University.

"There's this misconception, especially among parents, that it doesn't matter as much if kids miss school early on - that it only becomes important when they get to middle or high school," said Ansari, who is also a researcher at Ohio State's Crane Center for Early Childhood Research and Policy.

"This study shows that those early absences do matter, and in ways that many people don't consider."

The study was published online recently in the Journal of Youth and Adolescence.

Ansari and his colleagues used data from the Study of Early Child Care and Youth Development, which is run by the National Institute of Child Health and Human Development.

This study included data on 648 students from 10 cities across the United States who were followed from birth through young adulthood. Researchers had information on the number of days the children were absent from school between kindergarten and eighth grade.

In 2013 and 2014, when the participants were 22 or 23 years old, they reported on a variety of outcomes, from criminal or deviant behavior to parenthood, political participation and economic hardship.

Results showed that school absenteeism didn't have any relation with criminal, risky or deviant behavior, Ansari said. But it was linked to political engagement and educational and economic success.

Students who were more frequently absent from school were 4.7 percentage points less likely to have voted in the 2012 election.

They also reported experiencing greater economic hardship (such as difficulty paying bills), were more likely to say they used government assistance such as food stamps, were less likely to have a job and reported poorer educational outcomes, such as a lower high school GPA and a lower likelihood of going to college.

"Absenteeism in those early years of school has pretty far-reaching consequences," Ansari said. "It goes beyond just affecting your education and how well you do in high school."

Ansari said showing up less to school in those early years may set dangerous precedents.

"If you start out being disengaged with school, you may end up being less engaged with society more broadly. You're less likely to vote, less likely to go to college, less likely to be employed," he said.

"We believe disengagement may be one of the key mechanisms linking early school absences to poorer outcomes in early adulthood."

Ansari said the participants in this study were mostly from middle-class families, so results may be different for those from a more disadvantaged background.

"If we're seeing these negative outcomes of absenteeism in this largely middle-class sample, the associations may be even more pronounced among disadvantaged families," he said.

In 2020, parents may be wondering how widespread school closings during the pandemic may be affecting their children. Ansari said this situation is different from what they studied here.

"These really are unprecedented times. All kids are absent. With that said, the differential access to supports and resources will likely result in even greater variability in outcomes when students return to school after the pandemic."

Ansari said he hopes this study will make parents more aware of the importance of school attendance, even for young children.

"What this work suggests is that we should take absenteeism and its consequences more seriously."

Tsukuba, Japan - Researchers commonly culture bacteria for many purposes, such as to screen pharmaceuticals and manufacture vaccines. In these cases, shake flasks have been commonly and generally used for over 90 years to cultivate microbes.

To keep track of what's going on in the shake flask, researchers must use stringent sterilization techniques while extracting a sample of cells. A common sterilization technique is to expose the plug and flask to a flame at several time points during cell extraction. However, if this sterilization affects the cell culture in any way, you may inadvertently hinder production of the vaccine or whatever substance you want from the culture.

In a study recently published in Scientific Reports, researchers from the University of Tsukuba have shown that flame sterilization introduces carbon dioxide into shake flasks. This excess carbon dioxide can considerably affect cell growth.

Carbon dioxide is a product of methane combustion in the flame. The researchers found that flaming the flask for even a few extra seconds, or tilting the flask a few extra degrees, considerably increased the carbon dioxide concentration in the flask.

"For example, at a flame exposure time of only 5 s, increasing the inclination angle from 15° to 25° increased the carbon dioxide concentration in the headspace by approximately 50%," says Professor Hideki Aoyagi, senior author of the study. "Computational modeling confirmed our findings."

These increases in carbon dioxide concentration are induced over the course of only a few seconds of flame sterilization. But do they substantially affect cell growth? To test this hypothesis, the researchers needed to add excess carbon dioxide while keeping the flasks shaking, because interrupting the shaking can itself affect cell growth.

"We introduced intermittent carbon dioxide at concentrations similar to those expected by flame sterilization," explains Professor Aoyagi. "The ultimate oxygen demand of Acetobacter pasteurianus--known to spoil wine-- increased by up to 70%. Pelomonas saccharophila increased by up to 35%, whereas the other two microbes were not clearly affected in terms of growth."

The researchers do not yet know how common it is for flaming a shake-flask to alter cell culture growth. Nevertheless, seemingly minor experimental sterilization variables--too subtle for most researchers to even notice at first glance--may actually be pertinent. Culturing microbes in shake flasks and producing valuable products in the culture--perhaps relevant to COVID-19 research--may be substantially more complicated than previously appreciated.

It's not just health, social and economic consequences from COVID-19 that have impacted the world. Travel behavior also has been significantly affected. Using statewide traffic data from the Florida Department of Transportation (FDOT), a study demonstrates the drastic changes in human behavior during the onset of the pandemic. With more than 20 million residents, Florida was selected because of its enormous diversity and unique demographic and commercial characteristics.

Researchers from Florida Atlantic University; Embry-Riddle Aeronautical University; Louisiana State University, and the University of Hawaii, analyzed highway volume data as a representation of personal activity and interaction. For the study, published in the journal National Hazards Review, they used same-day traffic volumes for March 2019 and March 2020 across Florida to examine the chronological relationship of key governmental requests for public isolation and travel limitations in both time and space. They looked at differences in urban versus rural regions of the state over time as well as on different road functional classifications.

Analyzing same-day traffic volumes for 2019 and 2020 across Florida, results showed that traffic volumes by March 22, 2020, dropped by 47.5 percent compared to that same point in 2019. Moreover, traffic declined in March 2020 corresponding with the governor's state of emergency declaration and school, restaurant, and bar closures. During the study period, the traffic decline followed similarly shaped trends with the increase in confirmed COVID-19 cases throughout Florida. Traffic decline outside of South Florida was statistically noticeable before that of South Florida. This finding indicates that people in the epicenter in South Florida continued to travel more early on despite being at a higher threat. However, traffic both inside and outside South Florida noticeably dropped after schools closed.

"In Florida, issuing the emergency declaration started the reductions in travel, but other actions such as school closings, shutdown of theme park operations, and the shuttering of bars and restaurants were associated with increased travel reductions," said John Renne, Ph.D., co-author, professor, and director of FAU's Department of Urban and Regional Planning within FAU's Charles E. Schmidt College of Science. "Whether the reduction in travel demand was attributable to the closure of activities and trip generators or a function of increased fear arising from the increased lethality of COVID-19 requires further exploration."

Findings also showed that urban areas across the state experienced significant decline several days before rural areas. Traffic on highways accounted for about two-thirds of the total volume and corresponding decline, but traffic decline on arterials was not consistently different until five days after freeways. This may indicate that people reduced travel for longer trip purposes, such as work trips, but continued to make local trips for nearly an extra week. Urban arterials experienced consistently different volumes a day after urban freeways and rural arterials had a four-day lag compared to urban arterials.

"Our analysis demonstrates that overall traffic volumes decreased significantly over the period with the greatest declines occurring later in the study period, suggesting that many factors including the start of spring break and decisions by local governments and employers contributed to the changes in travel behavior," said Renne.

Data from this study support greater understanding of how to implement quarantine and isolation controls, adding to research on slowing movement of infectious disease. If the duration of the pandemic is long, there may be need for other operational strategies, such as the prepositioning of supplies, including equipment and other goods necessary for response and relief efforts or to ensure populations can comply with stay-at-home orders. Data on travel behavior also are relevant to recovery efforts and planning for the return to normalcy, training and overall preparedness, and longer-term community resilience.

"It would be interesting to determine if starting some of the actions earlier such as closing restaurants and bars would have resulted in steeper increases in trip reduction," said Renne. "Clearly there was a lag between urban and rural areas and more investigation into reasons and motivations for the slower reaction is warranted. This knowledge could be useful in messaging especially if the protective action decision-making is transferable to other hazards and threats."

Among the most important unanswered questions of this research pertain to the ultimate effect of reduced travel: was it successful in reducing sickness and fatalities from COVID-19? The researchers say, "Time will tell." This will require more direct correlation between trip reduction and reduction in infection, transmission, and lethality for COVID-19.

The FDOT Transportation Data and Analytics Office gathers roadway data from across the state. Volume, speed, and vehicle classification are collected hourly using telemetric monitoring stations that transmit these data through telephone or wireless communications. For the study, bidirectional hourly traffic counts were collected, cataloged, and processed from 262 telemetric monitoring stations.

Rural hospitals are more likely than urban facilities to have access to telehealth, a once-underused service that now is playing a key role in treating coronavirus patients, according to research by two health administration professors in Florida Atlantic University's College of Business.

Neeraj Puro, Ph.D., and Scott Feyereisen, Ph.D., say the research can help U.S. hospitals understand the extent to which they are prepared for another wave of the pandemic. The work has been published in The Journal of Rural Health, one of the leading peer-reviewed publications on rural health issues.

Telehealth connects patients with doctors by computer or telephone when in-person appointments are not possible or safe from disease transmission.

"It's a relatively easy way to expand access," Feyereisen said. "More health care access is good. It's one of the goals of the system."

Having telehealth provides hospitals the ability to expand their service offerings in multiple ways, according to the report. For example, telehealth services have the potential to improve outcomes for high-risk obstetric patients in rural communities, while telehealth facilitated the use of anti-microbials in rural areas where infectious disease physicians were not available. Still, barriers such as insurance restrictions and technology limitations remain in place, preventing the widespread use of the service.

Puro and Feyereisen concluded that talking with doctors remotely is an important part of improving rural health care. The odds of hospitals to provide telehealth services vary, with Minnesota, Iowa, South Dakota, North Dakota, Nebraska, Missouri and Kansas leading the way among the nine regions designated by the U.S. Census.

What's more, coastal states, including New York, Florida, California and Washington, generally lacked the capability to provide e-services in rural areas, with telehealth specifically in short supply. In addition, telehealth capabilities are more common in hospitals that belong to a system and benefit from the economies of scale.

"Not only are rural populations some of the most vulnerable to diseases such as COVID-19, they might be called upon to provide back-up service to overflowing urban hospitals in the event such systems are overwhelmed," the report stated. "Going forward, telehealth is likely to play a large role in diagnosing patients, particularly in coming months as long as social distancing is a preferred strategy for preventing the spread of COVID-19. This virus might also become seasonal, and until a vaccine is introduced, telehealth will likely be increasingly integral to diagnosis and treatment."

The research also found that telehealth capabilities are predictably available in larger hospitals as well as teaching hospitals, and the professors say policymakers would be wise to provide support to smaller facilities.

The study of 3,268 hospitals is based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports.