Culture

The first model proposed to simulate the functioning of concept cells in the brain

image: The scheme of the neural network

Image: 
Valery Makarov

Lobachevsky University scientists together with foreign colleagues for the first time theoretically substantiated the existence of concept cells. These are individual neurons, and each of them is responsible for its own abstract concept, such as the musical note &laquoA». Researchers have shown how these cells work using the example of Beethoven's Ninth Symphony.

The proof of the existence of such cells disproves the widespread consensus that the emergence of abstract concepts in the human brain occurs solely through the activation of large neuronal complexes. This new finding can also play a very important role in the development of artificial neural networks.

Valery Makarov, head of the RSF grant project, Senior Researcher of the Fundamental and Applied Research Department at the Centre for Translational Technologies, explains that the brain of any living being is very complex.
&laquoA key role in the brain is played by neurons, the nervous system cells that are responsible for receiving, processing, storing and transmitting signals. Currently, a common opinion prevails in science that the emergence of abstract concepts in the human brain requires complex, perfectly orchestrated interaction of myriads of neurons. However, there is a hypothesis that suggests that single neurons, the so-called concept cells, may be responsible for complex tasks performed by humans. These are individual neurons that form abstract concepts based on specific stimuli to which they respond, for example, the name of a human being. Thus, earlier the &laquoJennifer Aniston neuron» was discovered, which fired whenever the portrait of the actress appeared on the screen. Such neurons that respond to the presentation of some image are called &laquograndmother cells», comments Valery Makarov.

It was suggested by researchers that concept cells can also play an important role in episodic memory. Their existence calls into question the common hypothesis that complex cognitive processes require perfectly organized interaction of multiple neurons.

Scientists from Lobachevsky University together with their foreign colleagues for the first time produced a model imitating the work of neurons in the hippocampus. This is the part of the brain that is responsible, in particular, for memory and orientation in space.

&laquoUsing mathematical calculations, we have identified three fundamental principles that provide high cognitive abilities of individual cells. First, it is a strict hierarchy of neural layers. We investigated the links between the selective and concept layers of neurons. The first one isolates signals, while the second one processes them and links them with abstract concepts. Secondly, we have paid attention to the links of one neuron at the concept level with many receiving neurons. Thirdly, we have found that synaptic plasticity, i.e. change of information transfer force between neurons, plays an important role. These theoretical principles allow the cells of the concept layer to learn and significantly increase their cognitive abilities, as a result of which they become concept cells», explains Valery Makarov.

The authors of the study used musical notes to illustrate the possibility of such type of learning. They formed a neural network comprising 3200 cells at the selective level and 1600 cells at the concept level. The cells were exposed to eight different sound waves, each of them having eight phase shifts, i.e. oscillations. Neurons perceived these oscillations as separate signals, so there were about 50 receiving level neurons per one signal. Initially they could perceive a wide range of random signals, but after training their field of action became more narrow and specialized. An experiment with Beethoven's Ninth Symphony has demonstrated that receiving neurons captured individual sound waves, and at the concept level the cells processed the received information and determined which note was played, acting as concept cells.

&laquoModern artificial neural networks mimick the structure of biological systems. As a result, they are already superior to humans in pattern recognition, but still lag behind in cognitive abilities. Therefore, to make new steps in this field, we need novel biophysical insights on how the brain understands information. The discovery of concept cells, whose existence can now be justified by three fundamental principles, is of great importance for neurobiology and neural network theory», comments Valery Makarov.

Credit: 
Lobachevsky University

Homeless patients are more likely to be readmitted to a hospital within 30 days

PHILADELPHIA -- Patients who are homeless are far more likely than housed individuals to be readmitted to a hospital within 30 or 90 days of their discharge, according to a new multi-center analysis of inpatient data from Florida, Massachusetts and New York. The team of researchers, led by experts in the Perelman School of Medicine at the University of Pennsylvania, found the most glaring disparity in Florida, where the 30-day readmission rate among homeless patients was 11 percentage points higher than the rate among housed individuals.

The study, published today in the Journal of General Internal Medicine, revealed an 8 percentage point difference in 30-day readmission rates among homeless versus housed patients in Massachusetts (23 percent vs. 15 percent) and a 2 percentage point difference in New York (15 percent vs. 13 percent). Researchers also found that, among the most common causes of hospitalization--including mental illness and complications during pregnancy--homeless patients were more likely than housed individuals to be readmitted for mental illnesses, as well as diseases of the circulatory and digestive systems.

"Our findings underscore the urgent need to identify and implement interventions to address these disparities and reduce the burden of readmissions among individuals experiencing homelessness," said the study's corresponding author Sameed Khatana, MD, MPH, a Cardiovascular Medicine fellow at Penn. "As we seek to combat this issue, it's critical that we focus on building effective and scalable interventions targeted toward the post-discharge period."

In the United States, there are an estimated 550,000 people experiencing homelessness on a given night. Individuals who are homeless represent a particularly vulnerable population due, in part, to a higher rate of chronic diseases as well as financial and structural barriers that impede access to appropriate medical care. Although previous research linked homelessness to higher rates of hospitalization and mortality, it has not been clear whether homeless patients experience higher readmission rates than housed individuals -- and whether the rates vary by region or cause.

This research serves as the first large study to examine the association of homelessness with hospital readmissions across multiple states and for all conditions.

For this study, the team pulled administrative claims data from the three large, geographically diverse states -- which accounted for 26 percent of the nation's homeless population -- from 2010 to 2015. During that timeframe, homeless patients accounted for more than 515,000 hospitalizations, with the vast majority of cases -- about 450,000 -- occurring in New York. After adjusting for a variety of factors, including age, demographics, and the presence of 22 clinical comorbidities, researchers found the combined 30-day readmission rate among homeless patients across all three states was 17.3 percent, compared to 14 percent among housed individuals. In Florida and Massachusetts, more than 34 percent of the hospitalized homeless patients were readmitted within 90 days.

Authors note that the substantial disparities in readmission rates across the states is likely due, in part, to differences in state policies and programs that target the population.

"We hope these findings will help inform both local and state initiatives that aim to enhance access to ambulatory care and improve care coordination for this population in the vulnerable period immediately following hospitalization," Khatana said.

Credit: 
University of Pennsylvania School of Medicine

COVID-19 collaboration reduces infections in long-term care facilities

image: UVA Health geriatrician Laurie R. Archbald-Pannone, MD, MPH, is the lead physician in a collaboration with long-term care facilities that is reducing COVID-19 infections and saving lives.

Image: 
UVA Health

A collaborative program developed at UVA Health to work with local long-term care facilities control COVID-19 is saving lives and offers a model for communities across the country, a new scientific paper reports.

The program has helped prevent COVID-19 infections and reduced mortality when outbreaks occur, its creators say. Of the first two facility outbreaks that the team has worked with, there were lower mortality rates than seen in previous outbreaks - 12% and 19%. That's compared with a 28% mortality rate reported at a long-term care facility in Washington state.

"Developing this program has been a wonderful collaboration amongst many sites of care and types of care providers," said UVA Health geriatrician Laurie R. Archbald-Pannone, MD, MPH, the program's lead physician. "We call the program GERI-PaL - meaning Geriatric Engagement and Resource Integration for Post-Acute and Long-Term Care Facilities - and it has been a great opportunity to bring together hospital and community-based resources to assist our local facilities in preventing and responding to COVID-19 outbreaks."

COVID-19: A Practical Approach

Archbald-Pannone and her colleagues describe the program as a "practical approach" to controlling COVID-19 in long-term-care facilities. Such facilities have been hard-hit by the pandemic because of the vulnerable health of many residents and the intensive nature of the care provided.

In their new paper, the UVA team highlights five key components of the program:

Infection advisory consultations: UVA Health infection-control experts worked hand-in-hand with the long-term care facilities to develop effective infection-control policies and address issues such as staffing needs and access to personal-protective equipment (PPE).

Project ECHO: A geriatrician, pulmonologist, nurse practitioner, clinical nurse leader and nurse educator were all made available using a model based on Project ECHO, a program that offers training and support for health professionals. The group met virtually with their colleagues at the nursing facilities to provide the latest COVID-19 information, testing and treatment guidance.

Telemedicine consultations: UVA Health pulmonary/critical-care and geriatric and palliative medicine experts provided consultations via telemedicine on testing, monitoring and treating facility residents for COVID-19. The team also facilitated transfers to the hospital, when needed, and transfers back to the nursing facilities when the patients had recovered sufficiently. The team also worked closely with the primary-care physicians to assist in decision-making and treatment of these patients.

Nursing liaisons: A nursing liaison offered concierge-style service for each facility, helping to keep lines of communication open and ensure any needs were met.

Resident social remote connections: Volunteer medical students spoke with residents by telephone to combat social isolation and keep their spirits up.

"This program has really been a team effort and highlights the dedication of colleagues across the healthcare continuum - physicians, nurses, administrators, technology experts, local health officials and more - all coming together to support work with our local facilities amidst the challenges of COVID-19," Archbald-Pannone said. "We have all faced many challenges over the past few months. It's been an honor to help support our local facilities and their dedicated staff members in the care of these vulnerable patients. Many of the systems we've put in place and lessons we have learned will be value to improve care beyond even COVID-19."

Results Described

The UVA Health team members have described their experiences in the Journal of the American Medical Directors Association. The team consisted of Archbald-Pannone, Drew Harris, Kimberly Albero, Rebecca Steele, Aaron Pannone and Justin Mutter.

To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog at http://makingofmedicine.virginia.edu.

Credit: 
University of Virginia Health System

Viruses can steal our genetic code to create new human-virus genes

image: Ivan Marazzi, PhD, Associate Professor, Microbiology, Icahn School of Medicine at Mount Sinai

Image: 
Mount Sinai Health System

Like a scene out of "Invasion of the Body Snatchers," a virus infects a host and converts it into a factory for making more copies of itself. Now researchers have shown that a large group of viruses, including the influenza viruses and other serious pathogens, steal genetic signals from their hosts to expand their own genomes.

This finding is presented in a study published online today and in print June 25 in Cell. The cross-disciplinary collaborative study was led by researchers at the Global Health and Emerging Pathogens Institute at Icahn School of Medicine at Mount Sinai in New York, and at the MRC-University of Glasgow Centre for Virus Research in the UK.

The cross-disciplinary team of virologists looked at a large group of viruses known as segmented negative-strand RNA viruses (sNSVs), which include widespread and serious pathogens of humans, domesticated animals and plants, including the influenza viruses and Lassa virus (the cause of Lassa fever). They showed that, by stealing genetic signals from their hosts, viruses can produce a wealth of previously undetected proteins. The researchers labeled them as UFO (Upstream Frankenstein Open reading frame) proteins, as they are encoded by stitching together the host and viral sequences. There was no knowledge of the existence of these kinds of proteins prior to this study.

These UFO proteins can alter the course of viral infection and could be exploited for vaccine purposes.

"The capacity of a pathogen to overcome host barriers and establish infection is based on the expression of pathogen-derived proteins," said Ivan Marazzi, PhD, Associate Professor of Microbiology at Icahn School of Medicine and corresponding author on the study. "To understand how a pathogen antagonizes the host and establishes infection, we need to have a clear understanding of what proteins a pathogen encodes, how they function, and the manner in which they contribute to virulence."

Viruses cannot build their own proteins, so they need to feed suitable instructions to the machinery that builds proteins in their host's cells. Viruses are known to do this through a process called "cap-snatching," in which they cut the end from one of the cell's own protein-encoding messages (a messenger RNA, or mRNA) and then extend that sequence with a copy of one of their own genes. This gives a hybrid message to be read.

"For decades we thought that by the time the body encounters the signal to start translating that message into protein (a 'start codon') it is reading a message provided to it solely by the virus. Our work shows that the host sequence is not silent," said Dr. Marazzi.

The researchers show that, because they make hybrids of host mRNAs with their own genes, viruses (sNSVs) can produce messages with extra, host-derived start codons, a process they called "start snatching." This makes it possible to translate previously unsuspected proteins from the hybrid host-virus sequences. They further show that these novel genes are expressed by influenza viruses and potentially a vast number of other viruses. The product of these hybrid genes can be visible to the immune system, and they can modulate virulence. Further studies are needed to understand this new class of proteins and what the implications are of their pervasive expression by many of the RNA viruses that cause epidemics and pandemics.

Ed Hutchinson, PhD, corresponding author and a research fellow at MRC-University of Glasgow Centre for Virus Research, said, "Viruses take over their host at the molecular level, and this work identifies a new way in which some viruses can wring every last bit of potential out of the molecular machinery they are exploiting. While the work done here focusses on influenza viruses, it implies that a huge number of viral species can make previously unsuspected genes."

Researchers say the next part of their work is to understand the distinct roles the unsuspected genes play. "Now we know they exist, we can study them and use the knowledge to help disease eradication," said Dr. Marazzi. "A large global effort is required to stop viral epidemics and pandemics, and these new insights may lead to identifying novel ways to stop infection."

Credit: 
The Mount Sinai Hospital / Mount Sinai School of Medicine

Survey finds many are buying fireworks this year due to COVID-19 cancellations

video: Fireworks are a time-honored tradition of July Fourth celebrations, but many public displays are being cancelled this year amid COVID-19 social distancing. Now, a new national survey by Orlando Health finds more than two in five Americans are planning to buy their own fireworks this summer -- with 16 percent of those citing COVID-19 cancellations as the reason behind their purchases -- prompting concerns about a spike in fireworks-related injuries.

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Orlando Health

ORLANDO, Fla. - Fireworks are a time-honored tradition of July Fourth celebrations and a signature sound of summer in America, but many public displays are being cancelled this year amid COVID-19 social distancing. Health experts worry this could lead to an increase in fireworks-related injuries as more people attempt to put on their own displays, a concern validated by a new national survey by Orlando Health. The survey found more than two in five Americans plan to buy fireworks this year, including 16 percent who say their purchases are a direct result of COVID-19 cancellations.

"You have more inherent risk of people getting bigger and better fireworks than they usually acquire for themselves because there's not going to be large aerial shows," said Elizabeth Gibson, MD, an orthopedic surgery resident at Orlando Health. "They may try to take it upon themselves to have the best fireworks show in the neighborhood or the best fireworks show that their family has ever put on and a lot of people don't realize just how dangerous these fireworks are until they sustain a life-changing injury."

It's something Dr. Gibson saw firsthand after 16 people were treated for serious fireworks-related injuries in Orlando Health's emergency department in the one week surrounding the July Fourth holiday in 2018. "It became a public health concern that my colleagues and I felt compelled to speak out about to try to prevent as many of these injuries as possible," Gibson said. "We planned a series of media events to warn about the dangers of fireworks and give tips to stay safe."

Their outreach was successful, with a 75 percent drop in injuries the next summer, but Gibson worries those numbers could spike once again as more people plan on setting off their own fireworks.

"A lot of people use fireworks without incident, but when accidents happen, they result in devastating injuries that greatly affect the lives of victims and commonly take several surgeries to recover from, along with months of physical therapy," Gibson said. "People lose fingers and even their entire hand, there is often extensive tissue damage to upper extremities or the eyes and face. And every year there are several deaths in the U.S. as a result of fireworks injuries."

Josh Baker understands just how quickly these accidents happen. He lost a thumb after he reached in to adjust a fireworks mortar that had tipped toward onlookers while he and his neighbors put on a display in Sanford, Florida.

"I just remember it went off and I looked down and could see straight through my hand," Baker said. "Ultimately, I'm lucky all I lost was my thumb. If I had leaned in a little more or turned my head a different way, I might have never left the dock that day."

Baker had surgery to remove his big toe and attach it to his hand where his thumb once was. He says, as a firefighter, he now has a heightened awareness of just how many people suffer injuries similar to his.

"Every year I brace for those calls around certain holidays like New Year's Eve and July Fourth, and every year, without fail, there are people who lose some fingers or a hand," Baker said. "I think it's something you have to have a healthy respect for. It may seem like a lot of fun, but fireworks are dangerous explosives and people need to be extremely cautious when using them."

Even products that may seem harmless, like sparklers, should be used with caution. They burn up to 2000 degrees, which is hot enough to melt metal and certainly hot enough to burn through skin and other tissues. Health experts don't recommend using any fireworks outside of small novelties that don't leave the ground, but they say if you don't heed their advice, at least follow some safety guidelines to use them as safely as possible:

- Never hold a firework in your hand after it's been lit

- Do not reach in to check fireworks if they don't go off. Instead, douse them with water.

- Keep a bucket of water or a hose nearby in case of any mishaps.

- Do not allow children to access or light fireworks, and supervise use of acceptable products for children like sparklers.

- Stay sober. Most fireworks injuries involve the use of alcohol or drugs.

Credit: 
MediaSource

URI researcher: Antioxidant-rich diet reduces stress response during bird migration

image: Two European starlings prepare to fly in a wind tunnel in Germany as part of a URI research study.

Image: 
Photo courtesy of Scott McWilliams

KINGSTON, R.I. - June 18, 2020 - A research team led by a University of Rhode Island ornithologist had birds fly in a wind tunnel to simulate migration and found that birds that consume dietary antioxidants before and during fall migration can reduce the endocrine stress response triggered by long-duration flights.

The results, published this week in the Proceedings of the Royal Society B, emphasize the importance of protecting habitat with an abundance of available berries containing antioxidants at migratory stopover sites.

"This reduction in the endocrine stress response may be a major benefit birds gain in fall by eating fruits at stopover sites during migration," said Scott McWilliams, URI professor of natural resources science, noting that many species of birds select berries containing anthocyanins, a type of dietary antioxidant present in purple-colored berries. "We know birds prefer certain berries that have lots of antioxidants."

During long-distance flights that push birds to their physiological limits, levels of metabolic hormones called glucocorticoids become elevated to provide ready-to-use fuel to satisfy high energy demands, according to McWilliams. But prolonged exposure to glucocorticoids is detrimental and can lead to chronic stress response. The research concluded that the consumption of anthocyanin-rich food attenuates the potential stress triggered by the secretion of high levels of glucocorticoids.

"We always thought that glucocorticoids were important for birds preparing for migration, and antioxidants were there to mop up the free radicals associated with high metabolism during migration," said McWilliams. "We tested the hypothesis that antioxidants and glucocorticoids were metabolically complimentary, that is if the birds ate anthocyanins before flying then the increase in glucocorticoids to support metabolism would be reduced."

The study was conducted at a wind tunnel at the Max Planck Institute for Ornithology in Seewisen, Germany. Scientists from URI, the Institute, Jagellonian University in Poland and Sacred Heart University in Connecticut collaborated on the project. Funding was provided by the National Science Foundation and European grants.

The researchers chose as their study subjects European starlings, a common species in Germany that migrates to southern Italy. The test subjects were collected from nest boxes, hand-raised adjacent to the wind tunnel, and put through endurance training for two weeks prior to the experiment. Physiological measurements were then taken before and after the birds' long-duration flights, some of which lasted up to six hours.

"The birds that ate anthocyanins prior to flying increased the level of glucocorticoids in their circulation by only about half as much as those that did not eat dietary antioxidants," said McWilliams.

Equally important, he said, is that the birds that ate the anthocyanins "showed no other effects on their flight performance. The birds could fly for just as long, they used just as much fat, and everything else was similar. Their performance was the same, but they accomplished that performance while reducing their glucocorticoid response. The antioxidants attenuated the negative effects of the glucocorticoids."

McWilliams believes that many species of birds benefit from feeding on berries high in antioxidants during fall migration.

"We know that lots of other species of birds switch to feeding on fruits in fall and show the same kind of preferences for certain fruits high in antioxidants," he said. For this reason, land management and conservation efforts for migratory songbirds, especially in the eastern U.S., focuses on providing habitat with an abundance of fruiting shrubs.

While many varieties of anthocyanin-containing berries are available to birds during the fall migration season, few are available during spring migration, and little is known about how the birds cope with the high levels of glucocorticoids during their northbound flights.

"We don't know where they get those antioxidants in spring, or if they do," McWilliams said. "All animals have an endogenous antioxidant system, so perhaps when dietary antioxidants are less available, they rely more on this internal endogenous system."

Credit: 
University of Rhode Island

First known case of a potentially deadly heart rhythm disturbance induced by chloroquine therapy for COVID-19 reported

image: Multiple episodes of torsade de pointes as recorded in the remote electrocardiographic monitoring area outside the designated coronavirus disease ward.

Image: 
Heart Rhythm

Philadelphia, June 18, 2020 - A patient who met many of the published safety guidelines for chloroquine therapy against COVID-19 was observed to have a very abnormal ECG pattern after treatment began, leading to multiple episodes of torsade de pointes (TdP), a life-threatening arrhythmia in which the lower chambers of the heart beat out of sync with the upper chambers. Her condition was resolved after chloroquine was discontinued, investigators report in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, published by Elsevier.

Chloroquine and hydroxychloroquine are commonly used to treat malaria and some rheumatic diseases. Their use as a treatment for COVID-19 has been widely debated in medical journals and the popular press. The authors of this case report present the first description of TdP due to chloroquine treatment in a patient with COVID-19.

Lead investigator Yishay Szekely, MD, Department of Cardiology, Sourasky Tel Aviv Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, observes, "On the one hand, these drugs are known to cause prolongation of a specific ECG interval called QT interval. On the other hand, there is no evidence of sudden, unexplained death when they are used to treat malaria. And by the same token, neither the American nor the European rheumatology societies recommend electrocardiographic (ECG) surveillance for patients who receive long-term treatment with hydroxychloroquine."

The patient, an 84 year-old women with a history of breast cancer and controlled hypertension was admitted to the hospital with COVID-19. Her medications included letrozole, prescribed for breast cancer, and memantine, prescribed for Alzheimer's disease. An ECG found her corrected QT (QTc) interval was 462 milliseconds, borderline high but still below the 500-millisecond limit suggested by safety guidelines for chloroquine treatment. Her condition worsened and chloroquine therapy was introduced. After five days of treatment, there was no change to her clinical status, however, a follow-up ECG showed signs of an extremely elongated QTc interval of 627 milliseconds. Chloroquine was discontinued, as were other drugs known or suspected of causing QT-prolongation, including memantine and letrozole.

The patient was placed on a continuous ECG monitor and given potassium supplements to prevent arrhythmias. Six hours later episodes of TdP were noted on her ECG. She received treatment that led to an immediate resolution of the ventricular arrhythmias, and her QT interval gradually normalized. She was released after two weeks.

Dr. Szekely notes that the memantine the patient was taking likely contributed to the proarrhythmic effects of chloroquine. However, her QTc interval spiked only after chloroquine was introduced. "This clearly points to chloroquine as the culprit drug of her TdP." The breast cancer medication letrozole is actually considered safer from a QT interval point of view than other medications used to treat breast cancer.

"Chloroquine therapy is not free of risk in patients with COVID-19, particularly in those with high risk features for QT prolongation and TdP," says Dr. Szekely. "Given its questionable efficacy in the treatment of COVID-19 and risk of QT interval prolongation and torsade de pointes, chloroquine treatment must be considered thoroughly and reviewed on a regular basis."

Credit: 
Elsevier

Goodbye 'extinction,' hello 'evanescence'? Validating a new paradigm

Naturalist and zoologist Georges Cuvier established extinction as a distinct field of science in a series of publications beginning in 1799. He confirmed that fossil species were formerly living species no longer extant, confirming similar conclusions of classical Greek scholars. However, mechanisms thought to control the process remained controversial for two centuries.

As Delbert Wiens, Timothy Sweet, and Thomas Worsley review in a new article in The Quarterly Review of Biology (June 2020), biologists did not become seriously interested in extinction until the mid-1980s, when the field of conservation biology was founded in response to the impending anthropogenic sixth mass extinction. Explanations for extinction in the geological past have centered on speculation about cause, while neglecting effect. "Without a clear understanding of cause and effect, it is impossible to establish a mechanism or to intervene successfully in the process of an ongoing extinction event," they write.

In an earlier study, Wiens and co-author Thomas Worsley proposed "multigenerational, attritional loss of reproductive fitness," or MALF, as a "complete" paradigm for extinction, which encompasses cause, effect, and a mechanism of extinction. The new paper, "Validating the New Paradigm for Extinction: Overcoming 200 Years of Historical Neglect, Philosophical Misconception, and Inadequate Language," verifies the paradigm.

To provide context for the new paradigm, the paper explores the history of linguistic and philosophical contradiction or misconception concerning the term "extinction." As an example, as the authors note, in the Christian era, only a supernatural agent was thought to possess the power to extinguish a species.

The paper cites four independent tests of the new paradigm employing observational, experimental, and wholly theoretical techniques, utilizing phyletically diverse organisms from disparate parts of the Earth. The new paradigm was originally derived from studies of MALF on six species of higher plants. The authors now report seven additional, worldwide examples.

The authors also discuss the inadequacy of "incomplete" paradigms based largely on "cause-alone" explanations and consider logical inconsistencies and difficulties inherent in the usage of the term "extinction" itself. "The assumption that background and mass extinction are distinct processes introduces profound conceptual problems," they note. "Descriptive, or nonconceptually based definitions are often circular or meaningless, and must be distinguished from explicative definitions." Mass extinctions are categorized as "unusually large extinction events," yet that "tell[s] us nothing about the characteristics of these phenomena, which are the result of attempting to classify the extremes of a continuum into distinctive categories."

A step in the reconceptualization of extinction, the authors posit, is a new term for extinction. They propose "evanesce," inspired by Thomas Jefferson's use of the term "evanish." "Evanescence" does not imply an external agent performing the action and fits the understanding of extinction as a process without adding confusing connotations, they argue. "This process may be a precursor or complement to evolution, but not necessarily so."

MALF (multigenerational, attritional loss of reproductive fitness) is the causal mechanism by which the vast majority of species' extinctions ("evanescences") have occurred throughout biohistory. The incorporation of MALF and "evanesce" into discussions of biohistory, the authors argue, provide the means to determine the causal mechanisms necessary for intervention, and the language to elaborate more fully the processes of population decline and extinction.

Credit: 
University of Chicago Press Journals

Age discrimination laws don't protect older women as they do older men

BUFFALO, N.Y. - Older women in the workforce should be considered collectively as a unique demographic group that includes both gender and age if they're to receive adequate protection against workplace discrimination, according to a new paper published by a University at Buffalo economist.

"Age discrimination laws may be ineffective or less effective for older women," says Joanne Song McLaughlin, an assistant professor of economics in UB's College of Arts and Sciences. "These women are falling through the cracks."
The effectiveness of these laws is critical, not only in protecting against the inherent injustice of employment discrimination, but in ensuring the viability of Social Security.

"We expect to see a continued decline in the ratio of workers to retired individuals in the near future as the population ages," says McLaughlin. "This increase in dependency ratio poses a serious Social Security solvency issue. Employing older women who want to continue working is one way to influence that ratio."

The Age Discrimination in Employment Act of 1967 (ADEA) and Title VII of the Civil Rights Act (Title VII) are part of a collection of state and federal laws intended to provide equal employment opportunities. ADEA prohibits age discrimination while Title VII prohibits gender discrimination.

The two laws, however, function independent of one another and do not work well in concert, because each is a separate statute. The courts subsequently do not usually allow cases that combine them. It's either age or gender in cases of discrimination, which fails ultimately to guard against the circumstances faced by older women: intersectional discrimination, the point where multiple demographic characteristics are responsible for limiting opportunities.

McLaughlin says previous research suggests the laws seem to protect older male workers. She also cites studies showing differential treatment against older women and the role of appearance.

"These theories could explain why employers may demonstrate adverse treatment against older women that may be different from older men," she says.

And while the existing literature has examples of research looking exclusively at either age or gender discrimination, McLaughlin's paper, published in the peer-reviewed journal Labour, is the first to examine the gender difference in the effect of age discrimination laws on job outcomes for older workers.

To test her hypothesis on the potential ineffectiveness of the antidiscrimination statutes, the current paper relies on two identification strategies examining the laws' effects on older men and older women at both the state and federal level.

"The evidence indicated that both state age discrimination laws and the ADEA improved the labor market outcomes for older men, but had a far less favorable effect on older women," says McLaughlin. "In some cases, I found that age discrimination laws did not improve the labor market outcomes for older women at all."

The paper's robust findings support creating a new protective class of workers for older women.

"I conducted numerous tests looking for alternative explanations about the gender difference in age discrimination laws," says McLaughlin. "All my results consistently find that age discrimination laws were far less effective for older women compared with older men.

"Older women's intersectional discrimination must be recognized as a separate cause of action," she says.

Credit: 
University at Buffalo

High-tech CT reveals ancient evolutionary adaptation of extinct crocodylomorphs

image: New insights into the anatomy of the inner ear of prehistoric reptiles, the thalattosuchians, revealed details about the evolutionary adaption during the transition into the ocean after a long semiaquatic phase. These new findings of an international research team were made possible by the use of a Canon high-tech computed tomography (CT) scanner from the Leibniz Institute for Zoo and Wildlife Research (Leibniz-IZW).

Image: 
G. Fritsch/Leibniz-IZW.

The tree of life is rich in examples of species that changed from living in water to a land-based existence. Occasionally, some species took the opposite direction. New insights into the anatomy of the inner ear of prehistoric reptiles, the thalattosuchians, revealed details about one of these evolutionary turning points. During the Mesozoic era, these now extinct crocodile relatives ventured into the ocean after a long semiaquatic phase. During this process, the skeleton of the thalattosuchians gradually adapted to the new pelagic habitat. In particular, the changes to the inner ear vestibular system of these reptiles enhanced their ability to swim. Compared to whales, which adapted quickly to life in water without a prolonged semiaquatic stage, this is a strikingly different evolutionary path for the same transition. These new findings of an international research team were made possible by the use of a Canon high-tech computed tomography (CT) scanner from the Leibniz Institute for Zoo and Wildlife Research (Leibniz-IZW). The results have been published in the „Proceedings of the National Acadamy of Sciences of the USA".

Thalattosuchians lived during the Mesozoic about 182 to 125 million years ago and evolved from their land-living relatives to become fast-swimming marine predators. An international research team led by scientists from the School of Geosciences at the University of Edinburgh studied the evolutionary changes which these crocodylomorphs went through during their transition from land to the ocean. The team focused on one of the most important vertebrate sensory systems - the inner ear. Using high-resolution computed tomography (CT), the skulls of 18 thalattosuchians from the late Triassic to the Early Cretaceous were scanned to span much of the evolutionary history of crocodylomorphs. The CT scans were compared with the scans of modern crocodiles. Some of the scans were performed at the Leibniz-IZW in Berlin. The x-ray scans reveal detailed changes in the vestibular system of the inner ear, particularly in the bony labyrinth, which plays a crucial role in sensing balance and spatial orientation. "As they transitioned from land to water, thalattosuchians developed a strikingly compact, reduced and thickened bony labyrinth reminiscent of the reduced labyrinths of other marine reptiles and whales," explains Guido Fritsch, scientist and CT expert at the Leibniz-IZW. "Extinct land crocodiles, on the other hand, had a taller and narrower bony labyrinth. The labyrinths of semiaquatic crocodiles, which also include modern crocodiles, are longer and more compact than those of their land-living relatives". These results illustrate that the inner ear morphology of an animal is strongly linked to its habitat.

Interestingly, thalattosuchians developed the reduction of their inner ear labyrinth only after a long semiaquatic phase that lasted tens of millions of years. First, their skeleton changed during this phase - limbs became flippers, the body became streamlined, which allowed them to move efficiently in the water and improved their ability to swim. Only then did the changes in the inner ear develop, possibly as a response to changing sensory requirements, when the thalattosuchians moved into deeper, more open waters. This adaptation process distinguishes them from whales, whose inner ear labyrinth was miniaturised soon after their transition from land to water, without a prolonged semiaquatic phase. Thus, thalattosuchians and whales took different evolutionary routes for the same type of transition.

Future studies will examine the advantages of a reduced inner ear labyrinth for water-living animals, investigate how quickly thalattosuchians developed the adaptations in their inner ear as they entered the water, and how other sensory organs changed during this transition.

Credit: 
Forschungsverbund Berlin

Google's new light field video research showcases high-quality experience

image: Google is taking immersive media technology to the next level, showing a practical system for light field video. The research team, led by Michael Broxton, Google research scientist, and Paul Debevec, Google senior staff engineer, plans to demonstrate the new system at SIGGRAPH 2020.

Image: 
Sara Diamond

Google is taking immersive media technology to the next level, showing a practical system for light field video. Wide field of view scenes can be recorded and played back with the ability to move around within the video after it has been captured, revealing new perspectives. Developed by a team of leading research scientists and engineers, the new research shows the ability to record, reconstruct, compress, and deliver high-quality immersive light field videos lightweight enough to be streamed over regular Wi-Fi, advancing the state of the art in the rapidly emerging field of immersive augmented reality (AR) and virtual reality (VR) platforms.

In recent years, the immersive AR/VR field has captured mainstream attention for its promise to give people a truly authentic experience in a simulated environment. Want to really feel like you're standing among the Redwoods at Yosemite rather than sitting in the living room? Or
watch an artist create a sculpture as if you're with them in the studio? That could be possible with immersive AR/VR technology.

Although the field is still nascent, the team at Google has addressed important challenges, making major research headway in immersive light field video. The research team, led by Michael Broxton, Google research scientist, and Paul Debevec, Google senior staff engineer, plans to demonstrate the new system at SIGGRAPH 2020. The conference, which will take place virtually this year, brings together a wide variety of professionals who approach computer graphics and interactive techniques from different perspectives and continues to serve as the industry's premier venue for showcasing forward-thinking ideas and research.

"This is the latest culmination of our work in light fields," Broxton, a lead author of the research, says. "We're making this technology practical, bringing us closer to delivering a truly immersive experience to more consumer devices. Photos and videos play a huge role in our day-to-day experience on mobile devices, and we are hoping that someday immersive light field images and videos will play an equally important role in future AR and VR platforms."

At SIGGRAPH 2018, Google researchers showcased similar work when they introduced photorealistic light field still images in immersive VR. This new system has added another key piece to the immersive media puzzle: video. Light field videos give users a more dynamic virtual environment with panoramic views of scenes that span more than 180 degrees. They allow users to peek around corners and enjoy a greater sense of depth while in the virtual world. And the system is able to capture content that was challenging for earlier methods, such as reflective surfaces. This translates into a more realistic environment; for instance, sunlight that naturally reflects on ocean waves or light reflecting off the shiny hood of a car shifts naturally with the user's gaze as it would in real life.

The team records immersive light field videos with a low-cost rig consisting of 46 action sports cameras mounted to a lightweight acrylic dome. Using DeepView, a machine learning algorithm developed last year by members of the same Google research team, they combine the video streams from each camera into a single 3D representation of the scene being recorded. Their paper introduces a new "layered mesh" representation that consists of a series of concentric layers with semi-transparent textures. Rendering these layers from back to front brings the scene vividly and realistically to life. This method solves the very difficult problem of synthesizing viewpoints that were never captured by the cameras in the first place, enabling the user to experience a natural range of head movement as they explore light field video content.

Another breakthrough in this work involves data compression. The idea is not only to develop a system capable of reconstructing video for a truly immersive AR/VR experience but also to access the experience via consumer AR and VR headsets and displays, and even in a web browser. The new system compresses light field video while still preserving its original visual quality, and it does so using conventional texture atlasing and widely supported video codecs. In essence, they have succeeded at bootstrapping a next generation media format off of today's image and video compression techniques.

"Users will be able to stream this light field video content over a typical, fast-speed internet connection," Broxton says. "Overcoming this problem opens up this technology to a much wider audience."

Debevec sums up the work, stating, "Completing this project feels like we've overcome a major obstacle in making virtual experiences realistic, immersive, distributable, and comfortable. I can't wait to have the experiences the creative AR and VR community will make with this."

Credit: 
Association for Computing Machinery

Researchers identify key steps in development of kidneys

The discovery of how certain key structures in the kidneys are formed could have important implications for treating renal fibrosis (or scarring), a feature of chronic kidney disease (CKD), according to a new study by a researcher at Massachusetts General Hospital (MGH).

Interestingly, the research that led to these findings, published in the journal Developmental Cell on June 17, 2020, arose from a previous study on the genetic origins of a rare skin disorder.

In the earlier study, Alexander G. Marneros, MD, PhD, a physician-scientist at Mass General's Cutaneous Biology Research Center and an associate professor of Dermatology at Harvard Medical School, and colleagues examined families affected by a rare skin condition called Scalp-Ear-Nipple (SEN) syndrome.

Their work found that this syndrome is caused by a mutation in a gene called KCTD1, about which little was known at the time. "This raises the question of what the physiological function of this gene is," says Marneros, author of the Developmental Cell paper.

Surprisingly, he found that mice bred to lack the KCTD1 gene developed severe renal fibrosis and kidney failure.

Moreover, Marneros observed that patients with KCTD1 mutations in the SEN syndrome families also developed CKD with renal fibrosis. These findings suggested that the KCTD1 gene plays an important function in the kidney.

In this new study, Marneros shows that a protein known as transcription factor AP-2 beta induces expression of KCTD1 in kidney structures called distal convoluted tubules (DCTs).

DCTs play an important role in reabsorbing salt from urine and thereby preventing excessive urine production. DCTs form from progenitor cells in the developing kidney in a process called differentiation. Which genes control the differentiation process that leads to fully functional DCTs was previously unknown.

Marneros discovered that AP-2 beta is the key to forming early-stage DCTs. "If you don't have AP-2 beta, you don't form DCTs," he says. After early-stage DCTs are formed during kidney development, AP-2 beta induces expression of KCTD1, which triggers a second step in the differentiation process that allows DCTs to mature and become fully functional.

Inactivating KCTD1 in mice blocks early-stage DCTs from differentiating into mature DCTs.

As a result, the animals' ability to reabsorb salt from urine was impaired and led to excessive urine production. Furthermore, the KCTD1 gene was also found to be required for a DCT to maintain its function throughout adulthood.

Importantly, this study revealed that kidneys of adult mice lacking the KCTD1 gene showed increased activation of a protein called beta-catenin. Beta-catenin is essential for proper kidney development, but is normally suppressed in the adult kidney.

This abnormal reactivation of beta-catenin promoted renal fibrosis and cyst formation in the mice as they aged. Using genetic tools to reduce the beta-catenin reactivation in the adult kidney inhibited renal fibrosis and deterioration of kidney function in the mice without the KCTD1 gene.

"This study answers fundamental questions about kidney development, specifically how DCTs form and mature," says Marneros. "The results suggest that therapeutic approaches to block reactivation of beta-catenin or related molecules in the adult kidney could inhibit renal fibrosis."

Credit: 
Massachusetts General Hospital

Scientists unlock secrets of Ethiopia's superfood in race to save it from warming climate

image: Teff farmers in a field Ethiopia.

Image: 
Aemiro Wodleyohannes

Teff, an ancient grain originally from Ethiopia, is a staple crop for 50 million people in the country. It is also increasingly popular worldwide, touted as a superfood for its gluten-free, high fiber and protein, and low-sugar properties.

Yet dramatic temperature increases projected in Ethiopia by 2070, could force farmers to grow it only in mountainous areas at higher altitudes, driving down production at a time when food is already scarce and the population is rising.

Teff, however, has secrets hidden within its DNA. For the first time, scientists have mapped the grain's massive diversity, consisting of 3,850 known types. Each has unique characteristics, or "traits," allowing them to cope with different environmental conditions.

The study was published in Agriculture, Ecosystems & Environment.

Depending on where they are grown, varieties might be heat or drought-tolerant; or produce more grain. Now, that information has been pinpointed by researchers and stored in individual "passports" for each type, which can be used to breed more resilient varieties.

"The moment you know what is in the grain, you can fast-track breeding of particular types," said Carlo Fadda, a co-author from Alliance of Bioversity International and CIAT. "For example, combining low-yielding types cultivated in hot areas, with highly productive types grown in cold areas, to get a highly productive, heat-tolerant grain."

"Understanding this massive genetic diversity within teff opens up a huge possibility to breed new climate-resilient varieties naturally, within a shorter timeframe of 5-10 years, compared with hundreds of years in the wild," Fadda said.

The grain can withstand temperature extremes from 2°C to 38°C; some can cope with almost 2,000 mm of annual rainfall; others only tolerate 542mm. There are red, brown and white types, each containing varied nutrients and flavors that are used for different dishes.

"No other country growing this crop has this level of genetic diversity, which makes Ethiopia unique," said Fadda. "This diversity can be used to increase production for local demand, or even for export, despite weather conditions."

Ethiopia produces over 90 percent of the world's teff, and as the country of origin, it has the highest teff diversity in the world. In the country, Teff production involves about seven million households and covers some 3 million hectares.

Its growing popularity has led to cultivation in Australia, China, India, South Africa and the United States.

Export potential

Scientists conducted the study entirely in Ethiopia without exporting any seed. Co-authors included researchers from the Institute of Life Sciences at the Scuola Superiore Sant'Anna in Pisa, Italy and the Amhara Regional Agricultural Research Institute (ARARI) in Bahir Dar, Ethiopia.

"A remarkable thing with teff is that Ethiopia is not among the biggest teff exporters in the world. This is due to manifold reasons, one of which is the fact that teff cultivation is not yet at par with modern means of production," said Ermias Abate Desta, a co-author from ARARI.

"Assuming compliance with international regulations for access and benefit-sharing (e.g., Nagoya protocol), Ethiopia would benefit from the spread of teff as a global crop because it has an enormous reservoir of teff traits that are not present anywhere else in the world," he added.

The teff research is part of a broader interaction between Bioversity, Scuola Sant'Anna, and Ethiopian institutions that includes other crops. Research focuses on smallholder farmer agriculture in Ethiopia.

Compared to globally important crops, teff is understudied and is considered an "orphan" or underutilized crop. But teff research is attracting the attention of international institutions and scientists, including from Italy's Scuola Superiore Sant'Anna.

Ongoing teff research is aimed at characterizing the genetic diversity of a core collection of teff landraces - or farmer-selected varieties that have evolved over generations - and better understand their agronomic potential as it relates to traits desired by farmers.

This includes breeding new teff varieties with increased yield, resistance to pests and climatic and other abiotic stresses, and traits desired by local farmers.

"These actions involve public and private breeding efforts as well as national and international bodies concerned with the conservation of agrobiodiversity of teff in the wake of climate change," said Matteo Dell'Acqua, a co-author from Scuola Superiore Sant'Anna.

Credit: 
The Alliance of Bioversity International and the International Center for Tropical Agriculture

New Argentine fossils uncover history of celebrated conifer group

image: Pictured left is an exceptionally preserved male pollen cone of Araucaria huncoensis showing characteristic cylindrical shape and many long, pointed bracts at the base. Pictured right is a leafy branch fossil of Araucaria huncoensis, showing rare preservation of a branching point connecting two leafy branch segments and a connected growth point on the right segment. The branches are usually shed from the tree as individual segments.

Image: 
Gabriella Rossetto-Harris, Penn State

Newly unearthed, surprisingly well-preserved conifer fossils from Patagonia, Argentina, show that an endangered and celebrated group of tropical West Pacific trees has roots in the ancient supercontinent that once comprised Australia, Antarctica and South America, according to an international team of researchers.

"The Araucaria genus, which includes the well-known Norfolk Island pine, is unique because it's so abundant in the fossil record and still living today," said Gabriella Rossetto-Harris, a doctoral student in geosciences at Penn State and lead author of the study. "Though they can grow up to 180 feet tall, the Norfolk Island pine is also a popular houseplant that you might recognize in a dentist's office or a restaurant."

Araucaria grew all around the world starting about 170 million years ago in the Jurassic period. Around the time of the dinosaur extinction 66 million years ago, the conifer became restricted to certain parts of the Southern Hemisphere, said co-author Peter Wilf, professor of geosciences and associate in the Earth and Environmental Systems Institute (EESI).

Today, four major groups of Araucaria exist, and the timing of when and where these living lineages evolved is still debated, Rossetto-Harris said. One grows in South America, and the other three are spread across New Caledonia, New Guinea and Australia, including Norfolk Island. Many are now endangered or vulnerable species. The Norfolk pine group, the most diverse with 16 species, is usually thought to have evolved near its modern range in the West Pacific well after the Gondwanan supercontinent split up starting about 50 million years ago, Rossetto-Harris added.

Researchers from Penn State and the Museo Paleontológico Egidio Feruglio, Chubut, Argentina, found the fossils at two sites in Patagonia - Río Pichileufú, which has a geologic age of about 47.7 million years, and Laguna del Hunco, with a geologic age of about 52.2 million years. They analyzed the fossil characteristics and compared them to modern species to determine to which living group the fossils belonged. Then they developed a phylogenetic tree to show the relationships between the fossil and living species. They reported their findings in a recent issue of the American Journal of Botany.

Unlike the monkey puzzle trees of the living South American group of Araucaria, which have large, sharp leaves, the Patagonian conifer fossils have small, needle-like leaves and cone remains that closely resemble the Australasian Norfolk Island pine group, according to the researchers. They also found a fossil of a pollen cone attached to the end of a branch, which is also characteristic of the group.

"The new discovery of a fossil pollen cone still attached to a branch is rare and spectacular," said Rossetto-Harris, who is also an EESI Environmental Scholar. "It allows us to create a more complete picture of what the ancestors of these trees were like."

The researchers used 56 new fossils from Río Pichileufú to expand the taxonomic description of Araucaria pichileufensis, a species first described in 1938 using only a handful of specimens.

"Historically, scientists have lumped together the Araucaria fossils found at Río Pichileufú and Laguna del Hunco as the same species," Rossetto-Harris said. "The study shows, for the first time, that although both species belong to the Norfolk pine group of Araucaria, there is a difference in conifer species between the two sites."

The researchers named the new species from Laguna del Hunco Araucaria huncoensis, for the site where it was found. The fossils are about 30 million years older than many estimates for when the Australasian lineage evolved, according to Rossetto-Harris.

The findings suggest that 52 million years ago, before South America completely separated from Antarctica, and during the first few million years after separation was underway, relatives of Norfolk Island pines were part of a rainforest that stretched across Australasia and Antarctica and up into Patagonia, said Rossetto-Harris.

The change in the Araucaria species from the older Laguna del Hunco site to the younger Río Pichileufú site may be a response to the climatic cooling and drying that occurred after South America first became isolated.

"We're seeing the last bits of these forests before the Drake Passage between Patagonia and Antarctica began to really widen and deepen and set forth a lot of big climatic changes that would eventually cause this version of Araucaria to go extinct in South America, but survive in the Australian rainforest and later spread and thrive in New Caledonia," Rossetto-Harris said.

The study shows how tiny details can provide the definition needed to reveal big, important stories about the history of life, Wilf added.

Credit: 
Penn State

Anal cancer's first randomized trial for inoperable disease sets the treatment standard

image: Dr. Cathy Eng of the Vanderbilt-Ingram Cancer Center is the lead US investigator for InterAAct, the first randomized clinical trial for inoperable anal cancer. The results of the InterAAct trial, published online by the Journal of Clinical Oncology on June 21, 2020, suggest that carboplatin-pacitaxel chemotherapy become the standard treatment for these patients.

Image: 
Vanderbilt-Ingram Cancer Center

Up to now, patients with inoperable anal cancer, a rare disease, have not had a standard-of-care treatment; palliative care has been the routine for them. Now, results from InterAAct, the first international prospective randomized trial in advanced anal cancer, are published by the Journal of Clinical Oncology. The trial compared two conventional chemotherapy treatments in 91 patients. The objective response rate (ORR), the primary endpoint, was the same between treatments. The ORR for cisplatin plus 5-fluorouracil (5FU) was 57% versus 59% for carboplatin plus paclitaxel. However, cisplatin-5FU was associated with significantly more adverse events (62%) versus carboplatin-paclitaxel (36%). Additionally, carboplatin-paclitaxel was associated with improved overall survival (20 months) compared to cisplatin-5FU (12.3 months).

"The InterAAct trial identifies carboplatin-paclitaxel as the optimal chemotherapy regimen in the first-line setting for inoperable anal cancer," said lead United States investigator Cathy Eng, MD (Vanderbilt-Ingram Cancer Center). "Carboplatin-paclitaxel was associated with less toxicity and a trend towards improved survival, which suggests that it should become the standard of care for these patients, and the backbone for future phase three trials."

Anal cancer is rare and accounts for less than three percent of all gastrointestinal cancers. Advanced, inoperable anal cancer is even rarer, accounting for about 10 percent of those cases. For these patients, the prognosis is poor, with relative five-year survival rates of approximately 30 percent.

The study enrolled 91 patients between December 2013 and November 2017 in Australia, Germany, Norway, the United Kingdom, and the United States. Due to the rarity of the disease, it was necessary to establish a global network of investigators to design and conduct trials for metastatic anal cancer patients, provide patients with access to these new strategies, and to enroll patients in a timely manner. The International Rare Cancers Initiative (IRCI) formed the Anal Cancer Working Group, a global collaborative network, to achieve these goals.

Established in 2011, the founding members of IRCI include the US National Cancer Institute, UK National Institute for Health Research, Cancer Research UK, and European Organisation for Research and Treatment of Cancer. Subsequently, the French National Cancer Institute, Canadian Cancer Trials Group, Japan Clinical Oncology Group, and Clinical Oncology Society of Australia have all joined.

"The Anal Cancer Working Group has proven to be a successful global collaborative network for research in this rare disease," said Al B. Benson, III, MD (Northwestern University-Robert H. Lurie Comprehensive Cancer Center and co-chair of the IRCI Anal Cancer Working Group). "With the successful completion of the InterAAct trial in a timely way, the Anal Cancer Working Group has established its feasibility and will pursue future trials."

In the United States, ECOG-ACRIN Cancer Research Group led the trial with funding from the National Cancer Institute (NCI) through its National Clinical Trials Network. The NCI is part of the National Institutes of Health.

Patients who had not received prior systemic chemotherapy for locally recurrent inoperable or metastatic anal cancer were eligible to participate in the InterAAct trial. The 91 patients enrolled in the trial were randomly assigned in a one-to-one fashion: 46 patients to receive intravenous cisplatin 60mg/m2 (day 1) 5FU 1000mg /m2 (days 1-4) every 21 days, and 45 patients to receive carboplatin (AUC=5, day 1) paclitaxel (80mg/m2 days 1, 8, 15) every 28 days. Median follow up for all patients was 28.6 months. Patients remained on treatment until disease progression, intolerable toxicity, or withdrawal of consent.

Credit: 
ECOG-ACRIN Cancer Research Group