Culture

The Gerontological Society of America's highly cited, peer-reviewed journals are now publishing scientific articles on COVID-19. The following were published between April 21 and 29; all are free to access:

A Frail Health Care System for an Old Population: Lesson from the COVID-19 Outbreak in Italy: Editorial in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by Stefano Volpato, MD, MPH, Francesco Landi, MD, PhD, and Raffaele Antonelli Incalzi, MD, PhD, on behalf of the Italian Society of Gerontology and Geriatrics

After the COVID-19 Pandemic: The Next Wave of Health Challenges for Older Adults: Letter to the editor in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by Jennifer A. Schrack, PhD, MS, Amal A. Wanigatunga, PhD, MPH, and Stephen P. Juraschek, MD, PhD

*View GSA's Webinar on Responding to Ageism During COVID-19*

On April 21, GSA hosted "Reframing the Response to COVID-19: Applying Reframed Language to Counteract Ageism," a webinar that featured strategies for connecting COVID-19 and aging without perpetuating ageist tropes. The program is now archived on YouTube; the presentation slides can also be downloaded. The presenters offer ways that we can respond using empirically-supported narratives developed by the FrameWorks Institute for the Reframing Aging Initiative and other projects to frame the public discourse on social and scientific issues.

LISLE, Ill. (April 30) - In a groundbreaking study, an international team of 21 scientists led by Sean Hoban, PhD, Conservation Biologist at The Morton Arboretum in Lisle, Illinois, evaluated five genera spanning the plant tree of life (Hibiscus, Magnolia, Pseudophoenix, Quercus and Zamia) to understand how much genetic diversity currently exists in collections in botanical gardens and arboreta worldwide.

The study concluded that many plant collections currently fall short of ambitious targets for conserving genetic diversity of rare species. "The research findings demonstrate that gardens and arboreta are needed more than ever to safeguard global plant diversity," Hoban said. "This information will help bring more coordinated focus and attention to these gaps."

The team also studied how much genetic diversity is necessary to safeguard a species, and how many individuals are needed to conserve a rare taxa. The Morton Arboretum's Murphy Westwood, PhD; Andrew Hipp, PhD; and curator Matt Lobdell also participated on the team.

The study, funded through an Institute for Museum and Library Services grant and published April 29 by Proceedings B, investigated the genetic diversity of plant collections of a wide range of species in more than 60 botanical gardens and arboreta worldwide in an effort to better understand how to protect threatened species from extinction amidst the current biodiversity crisis.

After analyzing data from 3,000 individual plants from nine species and two subspecies, the researchers found that even under optimistic assumptions, most (eight of 11) taxa fell short of conservation targets for genetic diversity.

"We need to do a better job as a global botanical garden community representing the genetic, ecological and trait diversity of species in collections to safeguard them for the long-term," Hoban said. "If we have conserved too little genetic variation, the species may be unable to adapt to future environmental changes, including climate change, or to new challenges like pests and disease."

Findings and solutions

Capturing the full range of genetic diversity in a species or subspecies can greatly influence its likelihood of surviving in a rapidly changing world. It also provides data needed to open a new era of more effective botanical garden conservation, helping experts to conserve taxa and prioritize resources and capacity. Hoban noted that the results have relevance to timely conservation issues, including global efforts to achieve the 2020 goals of the Global Strategy for Plant Conservation (GSPC), which includes conserving sufficient genetic diversity in botanical collections and ensuring that plant material is available to restore threatened populations in the wild.

"The global botanic garden and arboretum community is the single strongest force for plant conservation in the world," said Paul Smith, PhD, Secretary General of Botanic Gardens Conservation International - the largest plant conservation network in the world. "Armed with the results and recommendations of this groundbreaking study, we can ensure that no plant species becomes extinct by increasing the genetic variability, adaptability and conservation value of our living collections for the future of people and the planet."

The authors recommend that plant collectors and curators make optimal use of limited garden space by calculating how many specimens are needed to capture the desired level of genetic diversity and sampling accordingly, while adhering to ideal sampling practices. The number of specimens in a collection needed to represent the genetic diversity in the wild can vary greatly between taxa. In this study, it varied from a few dozen to more than 200 trees. Finally, the researchers concluded that additional plant collection and exploration is needed in order to ensure success. By using best practices to collect from the right plants within the right taxa, and planting them in gardens, up to twice as much genetic diversity can be captured.

The messages of the study are twofold: Collections in botanical gardens should be tailored to the individual taxon, and gardens can make progress towards new, general rules of thumb for high conservation value in botanic gardens and arboreta, making wise use of resources for effective safeguarding.

EUGENE, Ore. - April 30, 2020 - Entrepreneurs launching a crowdfunding campaign to fund new product development benefit by reaching out early to engage with potential end-users, say business researchers from three universities.

Emerging companies that did so, tweaking their prototypes in an active and open exchange, reached their fundraising goals and drew media coverage more easily than those that didn't, said Alex Murray of the University of Oregon and lead author of a study published online ahead of print in Organization Science.

Most studies have explored how companies seek initial financial support with established professionals such as venture capitalists and angel investors. Studies of online fundraising, which is growing in use to attract broader support, Murray noted, have looked mostly at certain characteristics -- how many times a person smiles during a pitch, language used and geographic location.

"We all know creating a buzz matters, but how do you successfully do it?" said Murray, an assistant professor of management who teaches entrepreneurship in the UO's Lundquist College of Business. "We wanted to understand the processes, such as who you get involved and when, that help make it happen."

Murray and co-authors Suresh Kotha of the University of Washington and Greg Fisher of Indiana University compared the strategies of eight companies that used Kickstarter, the world's largest non-equity crowdfunding platform, between 2012 and 2014. To date, Murray said, Kickstarter has generated $4.8 billion in non-equity financing for more than 178,000 campaigns.

In the study, the eight unnamed early-stage companies were paired for comparison based on four prototype categories: household gadgets, board games, smartphone camera lenses and 3D printers.

Three key steps to success emerged: community building to establish psychological bonds with individuals who are knowledgeable about a product; engagement that fosters social identification among those individuals; and spanning that engagement to leverage proof points with others.

One successful company reached out to a National Geographic photographer for input about the prototype its new smartphone camera lens. After early interaction, the photographer took the prototype on a field trip and talked about the new lens with other photographers. That led to helpful feedback and photos that the company then used for its subsequent crowdfunding campaign.

Another company, the researchers noted, reached out to potential end-users, relying heavily on descriptions of its prototype's potential and responding privately to some emails. However, the company did not encourage and make use of the feedback. Its subsequent campaign was not as successful.

Companies that did poorly with their crowdfunding campaigns had innovative and creative products, but they depended on their own descriptions to generate interest rather than interacting with people in their domain, Murray said.

Companies that successfully established relationships with key stakeholders and incorporated their feedback into their prototypes, not only met their crowdfunding goals, but were also best equipped to attract news media coverage about their new products, another key step in the process, Murray said.

"Generating interest in the domain of an early prototype is critical," he said. "We found that when companies generate feedback and excitement early on, the people with whom they engage will, in turn, evangelize about the product in their networks and that will grow interest in it."

Sharing a prototype of a new product with others outside of a company, however, may be risky, requiring a high level of trust and sufficient protection of intellectual property, Murray said. In a follow-up study now under review for publication, he explores that issue.

Every now and then, scientists need to control the process of mixing liquids in vessels so small that the thinnest needle or even a hair wouldn't fit in there. At the same time, controlling the diffusion speed of molecules in the so-called microreactors is extremely important for the purposes of designing new drugs, conducting biological experiments and even to perform fast disease detection tests. Scientists from ITMO University and their colleagues from the Czech Academy of Sciences proposed to solve this problem by using the energy of light. Their research has been published in Advanced Science.

Nowadays, biologists, chemists and pharmacists make a wide use of microreactors, often integrated in miniaturized setups which are designed to perform several steps in the chemical synthesis of a specific product, the so-called lab-on-a-chip platforms . These minuscule containers with small grooves on their inside can range from several cubic millimeters to a few cubic centimeters in size - no larger than a matchbox. Nevertheless, they make possible to conduct blood analyses, mix microscopic doses of substances for the purpose of creating highly efficient drugs, and conduct experiments on cells.

Still, there's one issue associated with their operation: scientists have little to no control over the mixing speed, or, scientifically speaking, the diffusion of liquids and reagents inside such laboratories-on-a-chip. Scientists from ITMO University and their colleagues from the Czech Academy of Sciences proposed a method that can help solve this problem: they decided to use the so-called radiation pressure.

Back in the end of the 19th century, British scientist James Clerk Maxwell made the assumption that light can put pressure on physical objects. Before long, Russian scientist Pyotr Lebedev proved it possible. Still, the force of such interaction is very small, and at that time, no one found a use for it. Nowadays, there's a whole field of science called optomechanics that focuses on this phenomenon, and in 2018, professor Arthur Ashkin Nobel Prize for his pioneering works in this field. Light is being used to capture living cells and move miniscule particles of substances. Now it turns out that the same forces can be used for mixing liquids.

Based on the latest optomechanics discoveries, scientists from St. Petersburg developed a nanoantenna consisting of a miniscule silicon cube of about 200 nanometers in size. This device, invisible to the human eye, can efficiently manipulate light in a very particular way. "Our nanoantenna turns circularly polarized light into an optical vortex," explains Aleksandr Shalin, a professor at ITMO's Department of Physics, "the energy of light spirals around it."

Apart from nanoantennae, scientists proposed to also introduce gold nanoparticles into the liquid. The particles captured by an optical vortex begin spinning around the silicon cube, acting as a stirring "spoon" for mixing reagents. What's more, the size of such a system is so small that it can amplify the diffusion at one corner of a microreactor by hundreds of times while practically not affecting what happens in the other.

"Gold is a chemically inert material which doesn't react much", says Adria ?anos Valero, one of the main authors of the research. "It's also not toxic. What's more, it was necessary for us to design it so only spin forces and radiation pressure would affect the nanoparticles in a way that other forces do not cause them to be pulled towards the antenna (the silicon cube that we mentioned), otherwise the particles would just stick to it. This effect is observed for gold particles of a specific size if we illuminate the system with a common green laser. We've considered using other metals, but for silver, for instance, such an effect is observed in the UV band only, which is less handy but could be useful to increase the efficiency of some photochemically activated reactions."

By the way, this method can be applied not only for mixing liquids but also to sort gold nanoparticles: if scientists need to pick gold particles of some specific size, for example 30 nanometers, for an experiment. As of today, the system has been fully computed and there's a theoretical model designed for it. Conducting experiments will be the next step.

Researchers from the UPV/EHU, Cruces Hospital, the IVI Clinic Bilbao and Biocruces Bizkaia have discovered that the oocytes -immature ova- from obese and overweight women have lower concentrations of omega-3 fatty acids. A study of the lipid composition of 922 ova obtained during IVF treatment from 205 women of normal build and who were overweight or obese has found that the oocytes of both obese and overweight women have a very different lipid composition; the study was led by Roberto Matorras-Weinig, lecturer at the UPV/EHU's Faculty of Medicine and Nursing, and was published in the journal Fertility and Sterility.

Omega-3 fatty acids are essential in the human diet, in other words, they have to be ingested because the body cannot synthesise them. The intake of them tends to be low in the western diet. Moreover, as Dr Matorras of the Department of Medical and Surgical Specialties at the UPV/EHU points out, "omega-3 fatty acids compete metabolically with omega-6 ones, and the intake of the latter tends to be too high in the western diet. So the high intake of omega-6 fatty acids contributes towards low levels of omega-3 ones. Presumably this is the mechanism responsible for their low levels in the ova".

Childhood obesity could kick in before conception

Obesity is a well-known public health problem with numerous repercussions on different organs. "One of its implications in pregnancy is the birth of macrosomic babies (with a high weight), and the subsequent risk of childhood and adult obesity. Until now, this had been attributed to the effect of maternal obesity during pregnancy as well as to unsuitable diets during childhood. But these findings raise the possibility that the problems of these children may start even before conception, due to the poorer lipid composition of the ova which have generated them," said Matorras.

On another front, the researcher added that "obese patients tend to have poorer IVF outcomes, which have been attributed to a whole range of motives. This discovery highlights another possible cause of these poorer outcomes".

Neutron stars are among the densest objects in the universe. If our Sun, with its radius of 700,000 kilometres were a neutron star, its mass would be condensed into an almost perfect sphere with a radius of around 12 kilometres. When two neutron stars collide and merge into a hyper-massive neutron star, the matter in the core of the new object becomes incredibly hot and dense. According to physical calculations, these conditions could result in hadrons such as neutrons and protons, which are the particles normally found in our daily experience, dissolving into their components of quarks and gluons and thus producing a quark-gluon plasma.

In 2017 it was discovered for the first time that merging neutron stars send out a gravitational wave signal that can be detected on Earth. The signal not only provides information on the nature of gravity, but also on the behaviour of matter under extreme conditions. When these gravitational waves were first discovered in 2017, however, they were not recorded beyond the merging point.

This is where the work of the Frankfurt physicists begins. They simulated merging neutron stars and the product of the merger to explore the conditions under which a transition from hadrons to a quark-gluon plasma would take place and how this would affect the corresponding gravitational wave. The result: in a specific, late phase of the life of the merged object a phase transition to the quark-gluon plasma took place and left a clear and characteristic signature on the gravitational-wave signal.

Professor Luciano Rezzolla from Goethe University is convinced: "Compared to previous simulations, we have discovered a new signature in the gravitational waves that is significantly clearer to detect. If this signature occurs in the gravitational waves that we will receive from future neutron-star mergers, we would have a clear evidence for the creation of quark-gluon plasma in the present universe."

A study led by clinician scientists at RCSI University of Medicine and Health Sciences has found that Irish patients admitted to hospital with severe COVID-19 infection are experiencing abnormal blood clotting that contributes to death in some patients.

The study, carried out by the Irish Centre for Vascular Biology, RCSI and St James's Hospital, Dublin, is published in current edition of the British Journal of Haematology. (DOI: 10.1111/bjh.16749)

The authors found that abnormal blood clotting occurs in Irish patients with severe COVID-19 infection, causing micro-clots within the lungs. They also found that Irish patients with higher levels of blood clotting activity had a significantly worse prognosis and were more likely to require ICU admission.

"Our novel findings demonstrate that COVID-19 is associated with a unique type of blood clotting disorder that is primarily focussed within the lungs and which undoubtedly contributes to the high levels of mortality being seen in patients with COVID-19," said Professor James O'Donnell, Director of the Irish Centre for Vascular Biology, RCSI and Consultant Haematologist in the National Coagulation Centre in St James's Hospital, Dublin.

"In addition to pneumonia affecting the small air sacs within the lungs, we are also finding hundreds of small blood clots throughout the lungs. This scenario is not seen with other types of lung infection, and explains why blood oxygen levels fall dramatically in severe COVID-19 infection.

"Understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high risk groups.

"Further studies will be required to investigate whether different blood thinning treatments may have a role in selected high risk patients in order to reduce the risk of clot formation," Professor O'Donnell said.

Emerging evidence also shows that the abnormal blood-clotting problem in COVID-19 results in a significantly increased risk of heart attacks and strokes.

(Philadelphia, PA) - Like power lines in an electrical grid, long wiry projections that grow outward from neurons - structures known as axons - form interconnected communication networks that run from the brain to all parts of the body. But unlike an outage in a power line, which can be fixed, a break in an axon is permanent. Each year thousands of patients confront this reality, facing life-long losses in sensation and motor function from spinal cord injury and related conditions in which axons are badly damaged or severed.

New research by scientists at the Lewis Katz School of Medicine Temple University (LKSOM) shows, however, that gains in functional recovery from these injuries may be possible, thanks to a molecule known as Lin28, which regulates cell growth. In a study published online in the journal Molecular Therapy, the Temple researchers describe the ability of Lin28 - when expressed above its usual levels - to fuel axon regrowth in mice with spinal cord injury or optic nerve injury, enabling repair of the body's communication grid.

"Our findings show that Lin28 is a major regulator of axon regeneration and a promising therapeutic target for central nervous system injuries," explained Shuxin Li, MD, PhD, Professor of Anatomy and Cell Biology and in the Shriners Hospitals Pediatric Research Center at the Lewis Katz School of Medicine at Temple University and senior investigator on the new study. The research is the first to demonstrate the regenerative ability of Lin28 upregulation in the injured spinal cord of animals.

"We became interested in Lin28 as a target for neuron regeneration because it acts as a gatekeeper of stem cell activity," said Dr. Li. "It controls the switch that maintains stem cells or allows them to differentiate and potentially contribute to activities such as axon regeneration."

To explore the effects of Lin28 on axon regrowth, Dr. Li and colleagues developed a mouse model in which animals expressed extra Lin28 in some of their tissues. When full-grown, the animals were divided into groups that sustained spinal cord injury or injury to the optic nerve tracts that connect to the retina in the eye.

Another set of adult mice, with normal Lin28 expression and similar injuries, were given injections of a viral vector (a type of carrier) for Lin28 to examine the molecule's direct effects on tissue repair.

Extra Lin28 stimulated long-distance axon regeneration in all instances, though the most dramatic effects were observed following post-injury injection of Lin28. In mice with spinal cord injury, Lin28 injection resulted in the growth of axons to more than three millimeters beyond the area of axon damage, while in animals with optic nerve injury, axons regrew the entire length of the optic nerve tract. Evaluation of walking and sensory abilities after Lin28 treatment revealed significant improvements in coordination and sensation.

"We observed a lot of axon regrowth, which could be very significant clinically, since there currently are no regenerative treatments for spinal cord injury or optic nerve injury," Dr. Li explained.

One of his goals in the near-term is to identify a safe and effective means of getting Lin28 to injured tissues in human patients. To do so, his team of researchers will need to develop a vector, or carrier system for Lin28, that can be injected systemically and then hone in on injured axons to deliver the therapy directly to multiple populations of damaged neurons.

Dr. Li further wants to decipher the molecular details of the Lin28 signaling pathway. "Lin28 associates closely with other growth signaling molecules, and we suspect it uses multiple pathways to regulate cell growth," he explained. These other molecules could potentially be packaged along with Lin28 to aid neuron repair.

WINSTON-SALEM, N.C. -- April 30, 2020 -- In an effort to rapidly provide specialized care for patients with coronavirus-like symptoms while protecting the safety of health care workers, doctors at Wake Forest Baptist Health created a special respiratory isolation unit from an existing 24-bed medical-surgical unit in the hospital in Winston-Salem.

The framework for this Person Under Investigation (PUI) unit was published in the April 13 issue of The Hospitalist, the official publication of the Society of Hospital Medicine.

"Given the novelty and seriousness of COVID-19 as well as the evolving guidelines, a lot of effort went into creating this unit quickly," said Padageshwar Sunkara, M.D., assistant professor of internal medicine at Wake Forest School of Medicine, part of Wake Forest Baptist Health.

"We wanted to move anyone suspected of having the virus directly to the isolation unit to minimize cross-contamination with other patients and staff."

To accommodate patients from all specialties, the rooms were retrofitted with additional features such as dialysis access.

In addition, specific medical teams were designated to provide patient care on the unit and trained in the proper ways to use and conserve personal protective equipment. Unit staff established a number of measures to minimize exposure risk to providers and other patients, such as limiting entry to patient rooms to only critical staff directly involved in patient care.

Sunkara, medical director for the PUI unit, said that staff members were able to get the unit established within one week, even before the first case was detected on March 24 at Wake Forest Baptist, and he hopes this model will be useful to other institutions.

An international team of researchers has outlined ways to manage different facets of life under the spread of the COVID-19 virus, ranging from how we can combat racially driven bias and fake news to how we can increase cooperation and better manage stress.

Its work, which appears in the journal Nature Human Behaviour, considers research stretching over the past half century to offer insights about how to address current circumstances.

"The COVID-19 pandemic represents a massive, global health crisis," observes Jay Van Bavel, an associate professor in New York University's Department of Psychology, who led the project with Stanford's Robb Willer. "Because the crisis requires large-scale behavior change and poses significant psychological burdens on individuals, insights from the social and behavioral sciences are likely going to be very helpful for optimizing pandemic response."

"This interdisciplinary review points to several ways in which research can be immediately applied to optimize response to this pandemic, but also points to several important gaps that researchers should move quickly to fill in the coming weeks and months," adds Willer, a sociologist.

The analysis, drawn from the expertise of over 40 researchers at more than 20 colleges and universities, focuses on phenomena linked to COVID-19, connecting existing scholarship to potential courses of action in several areas, including the following: "Group Threat," "Fake News and Misinformation," "Social Norms," and "Stress and Coping."

Group Threat

The authors, referring to recent attacks on ethnic Asians in predominantly white countries, note that "Europe's most deadly disease, the bubonic plague of the 14th century, unleashed massive violence, including the murder of Catalans in Sicily, clerics and beggars in some locations, and pogroms against Jews, with over a thousand communities eradicated."

However, they point to research that indicates pandemics may, in fact, present opportunities to reduce religious and ethnic prejudice: "coordinated efforts across individuals, communities, and governments to fight the spread of disease send strong signals of cooperation and shared values, which allow people to re-cast others who were previously considered out-group members as in-group members."

The authors recount cooperative acts currently unfolding: More than 20 countries donated medical supplies to China in February, and China has reciprocated. "Government officials can highlight events like these to improve out-group attitudes," they write, adding that other studies have shown that making people feel safer can reduce prejudice.

Fake News and Misinformation

Fake news and conspiracy theories about COVID-19 have undoubtedly proliferated on social media, but new research has explored social-science based solutions to counter the spread of fake news. Fact-checking and correction offer potential remedies, as does source expertise, bipartisanship in messaging, and messages from "unlikely sources"--those who benefit from the original misinformation.

But the researchers acknowledge that fact-checking and corrections may not keep up with the vast amount of false information produced in moments of crisis like a pandemic and that approaches beyond debunking are necessary.

In response, they offer what scholars term a "pre-bunking approach," which centers on psychological inoculation. Studies have found that preemptively exposing people to small doses of misinformation techniques (including scenarios about COVID-19) can reduce susceptibility to fake news. Another preventative approach involves subtle prompts that emphasize accuracy (for instance, asking users to judge the veracity of a single neutral headline). Such prompts have been found in prior work to improve the quality of the content users share and could be easily implemented by social media platforms.

"To effectively counter fake news about COVID-19 around the world, governments and social media companies must rigorously develop and test interventions in collaboration with independent behavioral scientists," the authors advocate. "This includes identifying treatments that effectively reduce belief in misinformation, while not undermining belief in accurate information--a particularly salient concern given evidence that most exposure to and sharing of fake news in the U.S. has been concentrated among relatively small sub-sections of the population."

Social Norms

"How much people change will be influenced by aspects of the social and cultural context," the researchers write. "The fact that people tend to follow social norms and cultural mores can sometimes have undesirable consequences. For example, continuous exposure to news examples of people going out might explain why it was difficult to convince Italians to stay at home after the COVID-19 lockdown of March 11." But they also report that "understanding these features of the social environment, such as social norms, social inequality, culture, and polarization, can help identify risk factors and successful messages and interventions."

Prior studies have found that our decisions are influenced by social norms--what we perceive others are doing or approve/disapprove of--and that "informational influence" occurs when people use others' behavior as input for reasonable interpretations and responses. Notably, this effect is stronger when people are uncertain and outcomes are important--as in during a pandemic.

However, the authors caution that although we are influenced by perceptions of norms, research has shown that our estimates of behavior are frequently inaccurate. For example, people can underestimate the frequency others engage in health-promoting behaviors (e.g., hand washing) and overestimate their unhealthy ones (e.g., not properly covering one's mouth when coughing). In order to most effectively change behaviors by correcting misperceptions, the authors point to the importance of public messages that reinforce health-promoting norms (e.g., social distancing and hand-washing) and not highlighting extreme or uncommon behaviors, such as panic buying or young adults gathering.

Stress and Coping

Public health experts have said that one of the most vital strategies for slowing the spread of COVID-19 is "social distancing"--a practice that, while beneficial, "clashes with the deep-seated human instinct to connect with others, especially during emotional times," the authors observe. Studies have shown social connection "helps people regulate affect, cope with stress, and remain resilient during difficult times" while other scholarship has revealed that "loneliness and social isolation worsen the burden of stress, and produce deleterious effects on mental, cardiovascular, and immune health."

However, the researchers list ways we can diminish the ill effects of isolation.

One, they advocate replacing the term "social distancing"--when possible--with "physical distancing." This change, they say, would "highlight the fact that deep social connection with a broader community is possible even when people are physically apart through the use of technology."

Two, they cite the value of online forums, which have long served as hubs for mutual support--in particular, among individuals with rare illnesses--and psychological well-being. Other technologies, such as FaceTime and Zoom, have been found to be valuable in generating empathy and connection.

Van Bavel and Willer recognize potential barriers to these tools for seniors.

"Special attention should be placed on helping older adults--who might be less familiar with these technologies--to learn and acclimate to the potential richness of digital connections. COVID-19 will leave many of us confused, anxious, and lonely," they write.

Conclusion

"Urgent action is needed to mitigate the potential devastation of COVID-19, and drawing from existing knowledge can help ensure we are taking constructive steps," Van Bavel says. "In addition, the lessons from past studies should be relevant to future pandemics and other public health crises. Whether policy makers are trying to increase vaccination rates or reduce the harm of climate change, they will be fundamentally facing many of the same issues in the future."

"By applying the knowledge gained from earlier research, we hope that public health experts will be better equipped to communicate effectively and drive behavior change in a manner that yields global benefits," adds Willer.

Journal

Nature Human Behaviour

DOI

10.1038/s41562-020-0884-z

PHARMACY experts at the University of Huddersfield are urging caution over claims that widely-available antimalarial drugs could be a "magic bullet" to prevent and cure CoVid-19. And the medicines can - if used rashly - have serious side effects.

Although there have been some encouraging signs from small-scale preliminary trials of the drugs chloroquine (CQ) and hydroxychloroquine (HCQ) when administered to coronavirus patients, the results are preliminary and should be treated with care, argue Dr Syed Shahzad Hasan and Dr Hamid Merchant.

They are co-authors - in collaboration with a pharmacist from Malaysia, Chia Siang Kow, of the International Medical University in Kuala Lumpur - of a new article in the British Journal of Pharmacy. It is freely available for all to read online.

The authors chart the excitement in press and social media over claims that CQ and HCQ could be effective CoViD-19 treatments. But they also report how this had led to hoarding and therefore shortages of the drugs - available over the counter in some countries.

There have been reports of deaths in some parts of the world because of inappropriate self-use of CQ. And while the drugs have a good safety record, they can have seriously adverse side-effects, including loss of vision and fatal cardiovascular problems.

"It is the duty of pharmacists and other healthcare professionals to monitor the proper usage of these antimalarial drugs," states the British Journal of Pharmacy article.

As the evidence currently stands, write the authors, CQ/HCQ cannot be used as a general treatment for all CoViD-19 patients.

"Its use should be restricted for the treatment of CoViD-19-associated pneumonia in severely-ill patients only under a trial or clinical supervision of a licenced practitioner and close cardiac monitoring."

The article - titled Is it worth the wait? Should Chloroquine or Hydroxychloroquine be allowed for immediate use in Covid-19? - includes a bullet point list of key points and recommendations.

It is stated that "there is no evidence to support the mass use of CQ/HCQ to prevent the infection in public at large, therefore these drugs cannot be recommended for general use by the public to protect from acquiring SARS-CoV-2 infection. Social isolation and quarantine measures are still appropriate to control the infection until a reliable preventive option becomes available, for instance a vaccine".

The authors also point out that there had been only limited use of CQ/HCQ in clinical settings and no conclusive, randomly-controlled trials are yet available.

It is argued that "there is a need for an open-access central repository where clinicians can record the use/outcomes of CQ/HCQ or other pharmacological interventions for the thorough scrutiny of the data by the global scientific community".

The warnings sounded in the British Journal of Pharmacy article have since been reinforced by the U.S. Food and Drug Administration in a webpage that cautions against use of hydroxychloroquine or chloroquine for CoViD-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems.

Meanwhile, Dr Merchant, who is the Subject Leader at the University of Huddersfield's Department of Pharmacy, and Dr Hasan, who is a Senior Research Fellow, continue to research and write about the latest developments in the coronavirus pandemic.

Analysis of potential treatments for CoViD-19

Another article by Dr Merchant published in the British Medical Journal analyses a World Health Organisation trial of four potential treatments for CoViD-19.

The article - also freely available online - is an 11-point analysis of the project. Dr Merchant acknowledges that "the launch of WHO's Solidarity Trial came as good news for many, the public in general and clinicians in particular who are at the frontline to manage these crises".

But he provides a detailed critique of the drugs that are and are not included in the WHO trial.

And he concludes that: "There are as many as seven variants of human coronavirus that have been reported and there have been reports of CoV-2 being further genetically evolving during the current CoViD-19 outbreak. If the global Solidarity Trial will not offer all drug options/combinations across the world in a single co-ordinated trial, we fear that the data from different countries may not be directly comparable to draw any meaningful comparison".

Many of the drugs and medicines that we rely on today are natural products taken from microbes like bacteria and fungi. Within these microbes, the drugs are made by tiny natural machines - mega-enzymes known as nonribosomal peptide synthetases (NRPSs). A research team led by McGill University has gained a better understanding of the structures of NRPSs and the processes by which they work. This improved understanding of NRPSs could potentially allow bacteria and fungi to be leveraged for the production of desired new compounds and lead to the creation of new potent antibiotics, immunosuppressants and other modern drugs.

"NRPSs are really fantastic enzymes that take small molecules like amino acids or other similar sized building blocks and assemble them into natural, biologically active, potent compounds, many of which are drugs," said Martin Schmeing, Associate Professor in the Department of Biochemistry at McGill University, and corresponding author on the article that was recently published in Nature Chemical Biology. "An NRPS works like a factory assembly line that consists of a series of robotic workstations. Each station has multi-step workflows and moving parts that allow it to add one building block substrate to the growing drug, elongating and modifying it, and then passing it off to the next little workstation, all on the same huge enzyme."

Ultra-intensive light beam allows scientists to see proteins

In their paper featured on the cover of the May 2020 issue of Nature Chemical Biology, the team reports visualizing an NRPS mechanical system by using the CMCF beamline at the Canadian Light Source (CLS). The CLS is a Canadian national lab that produces the ultra-intense beams of X-rays required to image proteins, as even mega-enzymes are too small to see with any light microscope.

"Scientists have long been excited about the potential of bioengineering NRPSs by identifying the order of building blocks and reorganizing the workstations in the enzyme to create new drugs, but the effort has rarely been successful," said Schmeing. "This is the first time anyone has seen how these enzymes transform keto acids into a building block that can be put into a peptide drug. This helps us understand how the NRPSs can use so very many building blocks to make the many different compounds and therapeutics."

Corporate social irresponsibility (CSI) and other questionable business practices that ultimately harm stakeholders occur frequently, drawing vastly different reactions from investors.

And, the extent to which investors punish firms for CSI -- or corporate events that may have a negative impact on stakeholders or the environment -- is associated with the proportion of top management executives in a firm who have a law degree, according to new research from the University of Notre Dame.

"Firms behaving badly? Investor reactions to corporate social irresponsibility" appears in the current issue of Business and Society Review from Vamsi Kanuri, assistant professor of marketing in Notre Dame's Mendoza College of Business, along with Michelle Andrews from Emory University and Reza Houston of Ball State University.

"A lot of attention has been paid to how investors react when firms 'do good,' Kanuri said. "Less attention has been paid to how and why investors react when firm actions may not be so good. Our research shows how investors react to news of CSI, including violations of environmental regulations and workforce reductions. We find if the percentage of top management with law degrees is too small or too large, punishment is more severe, while an average proportion with law degrees is associated with less or even no punishment. In our sample, we notice firms that had a proportion ranging from 6 percent to 9 percent realized the highest abnormal stock returns, whereas firms that had a proportion of less than 6 percent realized the lowest abnormal returns."

The team also finds this association depends on the size of the firm, amount of volatility in a firm's returns and competitiveness of a firm's industry of operation.

They collected data on the difference between actual and expected returns for 308 publicly traded S&P 500 firms shortly after the announcements of 629 CSI events. They also tracked the number of top management team (TMT) executives in each firm who had a law degree at the time of the announcement, comparing the proportion of executives with a law degree with how investors reacted to the announcement in terms of abnormal returns -- the difference between actual and expected returns.

"We hypothesize the proportion of board members and TMT executives with law degrees affects investor perceptions of firm foresight, and in turn, their judgment of blame and consequent punishment," Kanuri said, "and we show investors may punish firms based on whether they believe firms understood the potential ramifications of their actions."

For example, in early 2009, the study states, aircraft manufacturer Boeing announced plans to reduce its workforce by 4,500, representing cuts of more than 5 percent. Weeks later, construction equipment maker Caterpillar revealed plans to cut 20,000 workers, a slash equaling a tenth of its workforce. In the days following these announcements, Boeing incurred negative 3.8 percent cumulative abnormal returns, while Caterpillar accumulated 1.9 percent in positive returns. Varied investor reactions to reports of similar corporate events are not limited to such internal business concerns, but also manifest for external environmental concerns. For example, revelations in 2008 that confectioner Hershey's allegedly violated environmental regulations drew negative 1.2 percent cumulative abnormal returns, yet news that automotive parts manufacturer Johnson Controls paid environmental regulation fines yielded positive returns of 4.8 percent.

"We hypothesize and empirically illustrate that such findings can be explained by the proportion of top management executives in a firm who have a law degree," Kanuri said.

While it may not be surprising that the educational background of company executives can be associated with investor reactions to firm events, Kanuri is surprised to find that the proportion of corporate chiefs with a legal background matters. Investors naturally look to justify why unwelcome events occur and may scrutinize the experience of top management, including educational background, which can shape how decision-makers approach their decisions.

"Having the right proportion of law-trained executives on the senior leadership team can help," Kanuri said. "A law education can train business leaders to approach strategic decisions with a different lens and can signal to investors the extent to which firm leaders are capable of considering the ramifications of their actions.

"Our findings underscore how law degrees make an impact beyond the legal field and politics, and that proportion matters," he continued. "It's not just about having leaders with law degrees, but having the right balance. One way firms can reduce the likelihood of investor punishment is to assemble that right balance."

The accumulation of one particular protein in the brain is at the basis of three very different age-related conditions. Until recently, nobody understood how this was possible. Research by the Laboratory for Neurobiology and Gene Therapy (KU Leuven) now reveals that the shape of the protein determines the clinical picture.

The presence of α-synuclein protein deposits in the brain is characteristic for three different diseases: Parkinson's disease (PD), multiple system atrophy (MSA) and dementia with Lewy bodies (DLB). Although these disorders are part of the same family, they are clinically and pathologically very different.

Parkinson's disease affects around two percent of the population over 60. The condition manifests itself mainly in motor problems. Dementia with Lewy bodies is less common (0.4 percent of people over 65), but is still the second most common form of dementia, after Alzheimer's disease. Multiple system atrophy is a rare but extremely aggressive disease for which there is virtually no treatment. It causes a variety of health issues, including general pain, bladder problems and low blood pressure, as well as motor problems. Most patients succumb to the disease within five to ten years.

Simulating disease processes

In collaboration with their colleagues from the French National Centre for Scientific Research (CNRS) and Imperial College London, researchers of the KU Leuven Laboratory for Neurobiology and Gene Therapy isolated the α-synuclein protein from brain tissue of deceased PD, MSA and DLB patients. This protein was then multiplied and reproduced with a technique that was specifically designed for this purpose. The different protein shapes were carefully studied in the lab and introduced in lab animals to simulate the disease processes.

The researchers were able to identify two shapes of the protein: a helical one in MSA and Parkinson's disease, and a cylindrical one in DLB. The shape also determined the severity of the disease symptoms: in MSA the symptoms occurred more quickly and aggressively, while in DLB they were more moderate.

"Previously, it was a mystery why one and the same protein caused three different brain diseases," says research coordinator Dr Anke Van der Perren. "Now, for the first time, we've been able to identify different shapes of α-synuclein protein deposits in patients. Depending on the shape, a different disorder and, thus, a different clinical picture occurs."

Earlier and better diagnosis

The new insights on the origin and structure of the protein shapes may, in time, lead to an earlier and better diagnosis, says Professor Veerle Baekelandt. "To this day, it's very difficult to diagnose these three brain disorders. We want to further unravel the complex process of the protein deposits to gain a better understanding of how the diseases develop. In time, we hope that we'll be able to detect these harmful protein shapes and that a specific treatment can be found to slow down or even stop the disease process."

Use of sodium glucose cotransporter 2 (SGLT2) inhibitors to treat type 2 diabetes may help to lower the risk of serious kidney problems, finds a study published by The BMJ today.

The findings provide further support for the use of SGLT2 inhibitors in a broad range of patients with type 2 diabetes.

Type 2 diabetes is the leading cause of kidney failure. Clinical trials have shown that SGLT2 inhibitors protect kidney (renal) function among patients with type 2 diabetes, but their effect on serious renal events in patients in "real-world" clinical practice remains uncertain.

So an international team of researchers set out to assess the association between use of SGLT2 inhibitors and risk of serious renal events using data from routine clinical practice.

They used nationwide register data from Sweden, Denmark, and Norway from 2013-18 to compare use of SGLT2 inhibitors with another group of diabetes drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors.

Prescription data was used to identify 29,887 new users of SGLT2 inhibitors and 29,887 new users of dipeptidyl peptidase-4 inhibitors (average age 61 years).

Hospital records and death statistics were used to track serious renal events for an average of two years. These included renal replacement therapy, death from renal causes, and hospital admission for renal events.

The researchers found that compared with DPP-4 inhibitors, use of SGLT2 inhibitors was associated with a reduced risk of serious renal events (2.6 events per 1000 person years versus 6.2 events per 1000 person years).

This equates to a difference of 3.6 fewer events per 1000 person-years or a 58% lower relative risk of serious renal events with SGLT2 inhibitors.

Further analysis found greater risk reduction in patients with underlying cardiovascular disease and chronic kidney disease (CKD).

This is an observational study, so can't establish cause, and the researchers point to some study limitations, such as relying on prescription data and hospital records, which may have affected the accuracy of their results.

What's more, because the study was conducted in Scandinavia, findings may not apply to other populations and healthcare systems.

However, they say that in this analysis using nationwide data from three countries, use of SGLT2 inhibitors, compared with DPP-4 inhibitors, was associated with a significantly reduced risk of serious renal events.

These findings complement the results of previous randomised trials, suggesting that SGLT2 inhibitors may lower the risk of serious renal events in routine clinical practice, they conclude.

The results from this well designed study are consistent with previous research and add new evidence that SGLT2 inhibitors seem preferable to DPP-4 inhibitors in patients at risk of developing or worsening kidney disease, says Steven Smith at the University of Florida, in a linked editorial.

Despite this study's strengths there are some reasons for caution in interpreting the results, he writes.

Additional trials in real world settings and more diverse populations "could add further support for broader access to these drugs, not just in high income countries, but also in lower income countries where the burden of kidney disease is disproportionately high," he concludes.

In an analysis article also published today, researchers point out that SGLT2 inhibitors have received several serious safety warnings since approval, but the number, timeliness, and strength of these safety communications have differed between American, Australian, Canadian, and European regulators.

They call for greater transparency in decision making to help increase the accountability of both regulators and industry and allow more informed treatment choices to be made.