Culture

Can expert commissions develop solutions for controversial issues that will enjoy broad democratic support? A team of researchers from the Institute for Advanced Sustainability Studies (IASS) has analysed the work of Germany's "Coal Exit Commission" using a set of new criteria. While the authors view positively the Commission's success in reaching a compromise, they criticise its failure to deliver an outcome that promotes the common good, particularly with respect to the high cost of the coal exit and its unambitious contribution towards Germany's climate goals, as well as the lack of public participation.

On 29 April 2021, Germany's Federal Constitutional Court ruled that the provisions of the Climate Protection Act (2019) are incompatible with the constitution - a ruling that has put Germany's "coal compromise" back in the spotlight. The ruling has forced the government to amend its existing climate targets rather making effective climate action merely a matter for future generations.

Fierce debates accompanied the decision-making process around the coal phase-out. There were widespread concerns that the end of Germany's coal era would affect the economic performance of the coal regions, reducing quality of life and endangering social cohesion. In response to this, a special commission was established by the Federal Government on 6 June 2018. "The Commission on Growth, Structural Change and Employment - also known as the 'Coal Commission' for short - was the most important commission in this legislative period and was supposed to help resolve the conflict around the coal phase-out," says project leader David Loew Beer, who led the study at the IASS. "Today we can say that it has been at least partially successful in this respect. Our research aimed to evaluate whether the commission's work has benefited democracy and sustainability."

For the study, which has been published in the "Zeitschrift fuer Politikwissenschaft" (Journal of Political Science), the researchers evaluated the reports of the Commission and articles from various media outlets as well as statements and studies released by participating organisations. In addition, interviews were conducted with 14 of the 28 members or their deputies.

At the time, a range of stakeholder groups were included in the commission, including representatives from environmental organisations, private sector entities, trade unions, science, and the regions. In the end, 27 of the 28 members approved the compromise. "The federal government viewed this as confirmation that the commission had been able to strike a fair balance between the different interests," says scientist Loew Beer. Interviews with those involved in the negotiations, however, revealed that the final negotiations were largely conducted by a small and informal group of participants.

How widely accepted was the Coal Commission?

One special feature of the study is that it applies a comprehensive system of criteria that was developed to examine the legitimacy of the Coal Commission and that enables researchers to derive generalisable findings which can be applied to other commissions. "Our analysis also examines the third area of legitimacy, so-called throughput legitimacy," explains Loew Beer. "This offers insights into the democratic quality of the Commission's work and considers issues such as: were members able to contribute equally? What was the quality of the debate? How were the individual members of the Commission equipped? There is very little empirical research on this - and our approach has enabled us to gain new insights."

Recommendations for future commissions

The Commission's work resulted in:

1) the Coal Phase-out Act

2) the Structural Strengthening Act for Coal Regions, which provides for extensive financial aid for the affected regions.

According to the study's conclusion, in its various legislative initiatives the federal government frequently refers to the agreement reached by the Commission, even where these deviate from the Commission's recommendations in practice. From the perspective of democratic theory, it is problematic that the federal government failed to assume political responsibility for its decisions. According to the authors, this explains why the "coal policies" pursued by the federal and state governments continued to meet with public resistance.

Other critical aspects: It was difficult for the public to understand how exactly the decisions were made. Was a solution found to compensate for the differences in expertise, experience, and access to resources among the Coal Commission's members? Not at all. The federal government's desire to limit its financial exposure, coupled with its unambitious approach to climate policy, diminished the Commission's ability to pursue the common good, resulting in an outcome that the Federal Constitutional Court has rightly criticised as unsustainable.

The researchers also note that it is somewhat paradoxical that while government has allocated substantial funding for the affected regions, the compromise has met with little approval in the regions. Loew Beer speculates that this could be due to the lack of involvement of citizens in the Commission's work and the legislative process.

The researchers recommend the following for future commissions:

- binding criteria for the composition and support of future commissions, as well as transparency guidelines

- mandates that reflect the diverse interests of the affected parties

- a broadening and strengthening of parliamentary debates and decision-making processes. Such far-reaching issues as this should be debated and decided by parliament

- professional and inclusive moderation

- the creation of citizen participation processes to accompany the work of future commissions

Only one in three fertilizations leads to a successful pregnancy. Many embryos fail to progress beyond early development. Cell biologists at the Max Planck Institute (MPI) for Biophysical Chemistry in Göttingen (Germany), together with researchers at the Institute of Farm Animal Genetics in Mariensee and other international colleagues, have now developed a new model system for studying early embryonic development. With the help of this system, they discovered that errors often occur when the genetic material from each parent combines immediately after fertilization. This is due to a remarkably inefficient process.

Human somatic cells typically have 46 chromosomes, which together carry the genetic information. These chromosomes are first brought together at fertilization, 23 from the father's sperm, and 23 from the mother's egg. After fertilization, the parental chromosomes initially exist in two separate compartments, known as pronuclei. These pronuclei slowly move towards each other until they come into contact. The pronuclear envelopes then dissolve, and the parental chromosomes unite.

The majority of human embryos, however, end up with an incorrect number of chromosomes. These embryos are often not viable, making erroneous genome unification a leading cause of miscarriage and infertility.

"About 10 to 20 percent of embryos that have an incorrect number of chromosomes result from the egg already containing too few or too many chromosomes prior to fertilization. This we already knew," explains Melina Schuh, director at the MPI for Biophysical Chemistry. "But how does this problem arise in so many more embryos? The time immediately after the sperm and egg unite - the so-called zygote stage - seemed to be an extremely critical phase for the embryo's development. We wanted to find out why this is the case."

Insights from a new model system

For their investigations, the scientists analyzed microscopy videos of human zygotes that had been recorded by a laboratory in England. They additionally set out to find a new model organism suitable for studying early embryonic development in detail. "Together with our collaboration partners at the Institute of Farm Animal Genetics, we developed methods for studying live bovine embryos, which closely resemble human embryos," explains Tommaso Cavazza, a scientist in Schuh's department. "The timing of the first cell divisions is comparable in human and bovine embryos. Furthermore, the frequency of chromosomes distributing incorrectly is about the same in both systems." Another advantage of this model system is: The scientists obtained the eggs from which the bovine embryos developed from slaughterhouse waste, so no additional animals had to be sacrificed.

Schuh's team fertilized the bovine eggs in vitro and then used live-cell microscopy to track how the parental genetic material unites. They found that the parental chromosomes cluster at the interface between the two pronuclei. In some zygotes, however, the researchers noticed that individual chromosomes failed to do so. As a result, these chromosomes were 'lost' when the parental genomes united, leaving the resulting nuclei with too few chromosomes. These zygotes soon showed developmental defects.

"The clustering of chromosomes at the pronuclear interface seems to be an extremely important step," Cavazza explains. "If clustering fails, the zygotes often make errors that are incompatible with healthy embryo development."

Dependent on an inefficient process

But why do parental chromosomes often fail to cluster correctly? The Max Planck researchers were able to uncover that as well, as Cavazza reports: "Components of the cytoskeleton and the nuclear envelope control chromosome movement within the pronuclei. Intriguingly, these elements also steer the two pronuclei towards each other. So we are dealing with two closely linked processes that are essential, but often go wrong. Thus, whether an embryo will develop healthily or not depends on a remarkably inefficient process."

The scientists' findings are also relevant for in vitro fertilization in humans. It has been discussed for some time whether the accumulation of the so-called nucleoli at the pronuclear interface in human zygotes could be used as an indicator for the chance of successful fertilization. Zygotes in which these pronuclear components all cluster at the interface have a better chance of developing successfully, and could therefore be preferentially used for fertility treatment. "Our observation that chromosomes need to cluster at the interface to guarantee healthy embryo development supports this selection criterion," Schuh says.

Porcupines are frequently traded across Asia, and Indonesia, home to five species, is no exception. They are targeted for a number of reasons: their meat as an alternative source of protein, their bezoars consumed as traditional medicine, and their quills used as talismans and for decorative purposes.

A new study examining seizure data of porcupines, their parts and derivatives in Indonesia found a total of 39 incidents from January 2013 to June 2020 involving an estimated 452 porcupines. The research was published in the open-access, peer-reviewed journal Nature Conservation.

There are no harvest quotas for any porcupine species in Indonesia, which makes all hunting and trade in porcupines illegal. Of the five species found in the country, only the Sunda porcupine (Hystrix javanica) is currently protected, with its protected status only introduced in 2018. Interestingly, prior to 2018, the Malayan porcupine (H. brachyura) was the only protected porcupine species in Indonesia, but then it was removed from the updated species protection list and replaced with the Sunda porcupine.

"The reasons for this are unclear, but certainly unwarranted, considering that the Malayan porcupine is the species most frequently identified as confiscated, and one can only assume the reason for its removal is due to its commercial value," says Lalita Gomez, author of the study and Programme Officer of Monitor Conservation Research Society.

What clearly emerges from this study is that porcupines are being illegally hunted and exploited throughout their range in Indonesia for local subsistence and commercial trade. Porcupines are reportedly in decline in Indonesia, yet there seems to be little control or monitoring on uptake and trade. This is particularly concerning because four of the five porcupine species in Indonesia have a restricted range, and three of them are island endemics - the Sumatran porcupine (H. sumatrae), Sunda porcupine, and Thick-spined porcupine (H. crassispinis).

Illegal hunting and trade of porcupines in Indonesia is facilitated by poor enforcement and legislative weakness, and it is imperative that effective conservation measures are taken sooner rather than later to prevent further depletion of these species.

Gomez recommends that all porcupines be categorised as protected species under Indonesian wildlife laws and listed in Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). This would require any international trade to take place through a supervisory system, which would allow for regulation and make it easier to track and analyse trends, thus providing an early warning system in case wild populations begin to decline.

An analysis of historical medical records found that men who were prenatally exposed during early gestation to the Dutch famine of 1944-1945 were 30 percent more likely to be overweight with a Body Mass Index of 25 or over at age 19, compared to a similar group not exposed to the famine. Professor L. H. Lumey at Columbia University Mailman School of Public Health led the study, which is published in the International Journal of Obesity. The study confirms evidence on the health risks of prenatal famine exposure, which also includes diabetes and schizophrenia.

The mechanism by which famine exposure raises the risk for later excess weight is still unknown. The researchers speculate that famine exposure could lead to changes in DNA methylation that stimulate being overweight. Or that surviving babies might have genetic profiles enabling them to thrive on fewer calories. "If so, it is tragic and ironic that surviving the famine would increase one's risk for obesity," says first author L. H. "Bertie" Lumey, MD, PhD, professor of epidemiology at Columbia Mailman School. "A slower metabolism that would have helped them survive the pandemic, in times of plenty could also contribute to weight problems and related health issues."

The researchers studied heights and weights of 371,100 men in the Netherlands born between 1943 and 1947 and examined for military service at age 19, including men with and without prenatal exposure to the Dutch famine. They found that a heightened overweight risk was present in men with famine exposure starting at the very beginning of gestation, not with exposure starting in the middle or at the end of gestation--a finding they say points to the start of pregnancy as a sensitive period of fetal development.

The study shows that the heightened overweight risk was limited to sons of manual workers born in the large cities of Western Netherlands, consistent with historical evidence on the socioeconomic and geographic populations known to be most affected by the famine.

Not surprisingly, excess weight presented its own risks. Those who were overweight at age 19 had a 30 percent greater mortality risk through age 63 relative to those with a BMI in the normal range. This was independent of famine exposure.

Further development of a 1976 Paper

The new paper extends and refines a 1976 study by Columbia researchers using current definitions of overweight. Contrary to the earlier paper, current analytic approaches show no weight changes in sons of non-manual workers exposed in early gestation in the famine cities. The researchers note that the military examinations did not include waist or hip circumference or other measures of body mass distribution which could be even better indicators of chronic disease risk.

The new study also looked at whether or not a decline in birthrates among manual workers during the famine explained the relationship between prenatal famine exposure and risk for excess weight. It didn't.

"Our study builds on the rigorous science behind the original research in the 1970s led by Columbia epidemiologists Mervyn Susser and Zena Stein," says Lumey.

About the Dutch Famine

The Dutch famine (Hunger Winter) of 1944-45 was a period of civilian famine under German occupation at the end of World War II. Contemporary reports show that the famine was concentrated in the large cities of the Western Netherlands. It was limited to the last months of the war in the period between November 1944 and the surrender of the German forces to the Allies in May 1945. After Liberation, food supplies were rapidly distributed across the country. The food crisis provides an opportunity to study the relationship between maternal nutrition in pregnancy and offspring health.

Previous research, beginning shortly after the end of the war found a link between famine-exposed mothers and birth weight. Subsequent research established links between famine exposure and risk for obesity, diabetes, and schizophrenia, as well as the specific genomic pathways involved. Importantly, the research also ruled out a link between famine exposure and mental retardation.

A new approach to tackling viruses by targeting the 'control centre' in viral RNA could lead to broad spectrum anti-viral drugs and provide a first line of defence against future pandemics, according to new research at the University of Birmingham.

In a new study, published in Angewandte Chemie, researchers have shown how this approach could be effective against the SARS-CoV-2 virus responsible for the COVID-19 pandemic. Earlier modelling and in vitro analysis by the team and published in Chemical Science has also shown effectiveness against the HIV virus.

Professor Mike Hannon, from the University of Birmingham's School of Chemistry, is co-lead author of the study. He said: "Although SARS-CoV-2 vaccines have been developed with unprecedented speed, there has still been a 12-month wait for development and approval. Viral pandemics remain a big threat and so broad-spectrum anti-virals are urgently needed to keep diseases like coronaviruses at bay while effective drugs are developed."

The technique proposed by the team uses cylindrically-shaped molecules which can block the function of a particular section at one end of the RNA strand. These RNA sections, known as untranslated RNA, are essential for regulating the replication of the virus.

Untranslated RNA contain junction points and bulges - essentially small holes in the structure- which are normally recognised by proteins or other pieces of RNA - events that are critical for viral replication to occur. The cylindrical molecules are attracted to these holes, and once they slide into them, the RNA closes around them, forming a precise fit, which consequently will interfere with the virus's ability to replicate.

"Our approach offers a very promising new route for anti-viral drug design," says Professor Hannon. "While most drugs in development target the virus's proteins, we have identified molecules capable of tackling the most fundamental part of the virus - its RNA. Experiments backed up by computer modelling have already shown this to be effective against SARS-CoV-2 and the HIV viruses and we anticipate it will also be effective against a wide range of other viruses, offering an important first step towards a broad spectrum anti-viral drug."

Co-lead author Dr Pawel Grzechnik, of the University of Birmingham's School of Biosciences, said: "The ongoing COVID-19 pandemic has revealed how important is RNA biology to understand molecular processes taking place in our cells, to find ways to suppress pathogens and to make efficient and safe vaccines. RNA only now emerges in the general consciousness of society as the major tool in therapies. We hope to continue our research and further investigate antiviral properties of the cylinders at the University of Birmingham."

Dr Zania Stamataki, of the University of Birmingham's Institute of Immunology and Immunotherapy and also co-lead author, said: "The SARS-CoV-2 pandemic has stressed the pressing need for the development on new antiviral treatments, particularly for RNA viruses. In Birmingham we have state-of-the-art containment level 3 facilities that allow us to study the full virus life cycle. We have developed models to test the effects of new antiviral therapies, and the supramolecular cylinders show promising results against replicating SARS-CoV-2. The ambition is that these new categories of compounds can be refined and targeted to extend their function against many other viruses that infect humans and animals."

The team will continue to develop the design of the cylindrical molecule to improve its effectiveness and control, and also to fully understand how it works within the virus before testing it in a model organism.

The research was funded by the Engineering and Physical Sciences Research Council, the Biotechnology and Biological Sciences Research Council (both part of UK Research and Innovation), the Wellcome Trust, the Royal Society, the Medical Research Foundation and the EU Marie Curie Fellowship scheme.

The cylindrical molecules have been the subject of previous research, led by Professor Hannon, which focussed on finding a way to control the way the cylinder interacts with DNA and RNA. This research resulted in novel compounds that have the potential to be developed into targeted treatments for cancers, viruses and other diseases, and is the subject of a patent application filed by University of Birmingham Enterprise.

FRANKFURT. The virostatic agent remdesivir was developed to disrupt an important step in the propagation of RNA viruses, to which SARS-CoV-2 also belongs: the reproduction of the virus's own genetic material. This is present as RNA matrices with which the host cell directly produces virus proteins. To accelerate the production of its own proteins, however, RNA viruses cause the RNA matrices to be copied. To do so, they use a specific protein of their own (an RNA polymerase), which is blocked by remdesivir. Strictly speaking, remdesivir does not do this itself, but rather a substance that is synthesized from remdesivir in five steps when remdesivir penetrates a cell.

In the second of these five steps, an intermediate is formed from remdesivir, a substance with the somewhat unwieldy name GS-441524 (in scientific terms: a remdesivir metabolite). GS-441524 is a virostatic agent as well. As the scientists in the group headed by Professor Stefan Knapp from the Institute for Pharmaceutical Chemistry at Goethe University Frankfurt have discovered, GS-441524 targets a SARS-CoV-2 protein called nsP3. nsP3 is a multifunctional protein, whose tasks include suppressing the host cell's defence response. The host cell is not helpless in the face of a virus attack, but activates inflammatory mechanisms, among other things, to summon the aid of the cell's endogenous immune system. nsP3 helps the viruses suppress the cell's calls for help.

Professor Stefan Knapp explains: "GS-441525 inhibits the activities of an nsP3 domain which is important for the reproduction of viruses, and which communicates with human cellular defence systems. Our structural analysis shows how this inhibition functions, allowing us to lay an important foundation for the development of new and more potent antiviral drugs - effective not only against SARS-CoV-2. The target structure of GS-441524 is very similar in other coronaviruses, for example SARS-CoV and MERS-CoV, as well in a series of alphaviruses, such as the chikungunya virus. For this reason, the development of such medicines could also help prepare for future virus pandemics."

A new Dartmouth-led study, published this week in the journal Pediatrics, has found that the disproportionate use of premiums within child-targeted TV advertising for children's fast-food meals is deceptive. The researchers examined thousands of advertisements from 11 fast-food restaurants, but one company--McDonald's--accounted for nearly all the airtime and, as a result, the findings.

The researchers report that these ads often overemphasize premiums such as toy giveaways and games relative to the primary product being sold, the fast food itself. This marketing practice violates the industry's own guidelines--put in place to ensure that the use of premiums in ads is not deceptive or unfair--as young children lack the cognitive ability to understand advertising.

The practice also works against childhood obesity prevention efforts. Previous studies have shown that childhood obesity is common in the U.S. About 26 percent of children ages 2-5 are overweight or obese, putting them at risk for major health consequences as they get older. Still, fast food is heavily promoted and regularly consumed by kids--nearly one-third of U.S. children eat fast-food on any given day.

"In the past, we've looked at the prevalence of child-directed food marketing and how it negatively impacts kids' diets, behaviors, and even weight status, but this is the first time we've examined if these companies are adhering to their own guidelines, in relationship to the content they can present to children," explains first author Jennifer Emond, PhD, MS, an assistant professor of biomedical data science and of pediatrics at Dartmouth's Geisel School of Medicine.

In the study, the investigators analyzed content of all child-directed fast-food TV advertisements on four popular national networks--Disney XD, Nickelodeon, Nicktoons, and Cartoon Network--aired from February 1, 2019 through January 31, 2020.

The team quantified the percent of the audio transcript (word count) and visual airtime (seconds) that included premiums or food, as well as the onscreen size of the toys or giveaways. During the study period, which included 142 hours of total airtime, more than 20,000 child-directed ads from 11 fast-food restaurants were aired on the four TV networks.

Of the 28 unique child-directed advertisements for children's fast-food meals during the study year, 27 were for McDonald's Happy Meals, accounting for nearly all (99.8 percent) of the total airtime. On average, premiums (vs. food) accounted for 53 percent (vs. 16 percent) of words in the audio transcript and 59.2 percent (vs. 54.3 percent) of the visual airtime.

Industry guidelines, which are managed through the Children's Advertising Review Unit and are administered by the BBB National Programs (formerly the Better Business Bureau), clearly state that premiums within child-directed advertising must be secondary to the advertised product to avoid undue influence.

"I find it very interesting that these are self-regulatory guidelines or pledges that the companies have signed on to as part of an industry initiative," says Emond. "But they're not even adhering to their own pledges. We need to hold them accountable--through stronger oversight of child-directed marketing in the U.S., from an independent review body or regulatory agency."

Announcing a new article publication for BIO Integration journal. In this review the authors Yuheng Bao, Jifan Chen, Pintong Huang and Weijun Tong from Zhejiang University, Hangzhou, China discuss the synergistic effects of acoustics-based therapy and immunotherapy in cancer treatment.

Cancer immunotherapy to enhance the autogenous immune response to cancer tissue is reported to be a promising method for cancer treatment. After the release of damage-associated molecular patterns, dendritic cells mature and recruit activated T cells to induce immune response.

To trigger the release of cancer associated antigens, cancer acoustics-based therapy has various prominent advantages and has been reported in various research. In this article, the authors classify acoustics-based therapy into sonopyrolysis-, sonoporation-, and sonoluminescence-based therapy.

Detailed mechanisms of each therapy are discussed to demonstrate the status of cancer immunotherapy induced by acoustics-based therapy and to posit future research directions.

Soon after E.L. James's Fifty Shades of Grey appeared in 2015, the book market was inundated with a flood of erotic bestsellers. People from all corners began wondering what this type of novel's secret of success could be. Now, a research team at the Max Planck Institute for Empirical Aesthetics (MPIEA) in Frankfurt/Main, Germany, has taken a closer look at the readership of erotic novels and investigated the causes of this literary predilection.

In the media as well as the academy, contemporary erotica is typically dismissed as being of low literary value. Critics and scholars tend to classify its readers as having mediocre to poor taste, without, however, examining their motivations and experiences in more detail. Against this background, the MPIEA team conducted an online study to investigate who actually reads erotic novels and why. The findings have just been published as an Open Access article in the journal Humanities & Social Sciences Communications.

The study included data sets from around 420 female participants. The majority of respondents were heterosexual women in stable relationships with an above-average level of education. They described themselves as being enthusiastic frequent readers who enjoyed sharing their reading experiences with others. Most of the study participants were between 20 and 40 years old.

The majority of respondents indicated that they read erotic novels as a diversion, and feelings of ease and relaxation were frequently named as a motivating factor. The sexual explicitness of the novels and their potential to provide orientation in readers' own lives also played a role for the participants, although this role was less significant than had been assumed in previous studies. Readers' opinions about erotic novels also came as a surprise, by contrast with more general critical ideas about contemporary erotica.

"Many of the study participants saw erotic novels - at least in part - as being emancipated, feminist, and progressive. We attribute this finding primarily to the respondents' more traditional views of male and female gender roles," explains lead author Maria Kraxenberger.

This study is the first to investigate empirically the readership and motivations for reading that underlie a major contemporary cultural phenomenon. Although readers of erotica have a significant impact on the international book market, the mainstream conversation about literature and reading is still reserved for "serious" readers of "good," if less popular, kinds of books. The study's findings underscore the need for more research that explores reading experiences outside the canon of serious literature.

Twenty dollars a month might not seem like a lot to pay for health insurance. But for people getting by on $15,000 a year, it's enough to make some drop their coverage - especially if they're healthy, a new study of Medicaid expansion participants in Michigan finds.

That could keep them from getting preventive or timely care, and could leave their insurance company with a sicker pool of patients than before, say the researchers from the University of Michigan and University of Illinois Chicago. They have published their findings as a working paper through the National Bureau of Economic Research, ahead of publication in the American Journal of Health Economics.

The study has implications for other states that require low-income people to pay for their Medicaid coverage, or may be considering such a requirement if they expand Medicaid. It also has importance for the plans sold on the national and state Marketplaces to people who buy their coverage directly.

Impact of monthly fees

The new findings come from Michigan's Medicaid expansion program, called the Healthy Michigan Plan, which was one of the first in the nation to require some low-income participants to pay monthly fees and most participants to pay co-pays for services they receive. Nearly 906,000 Michiganders get their health coverage through the program.

Fees, formerly called contributions and similar to the monthly premiums that people with other forms of insurance pay, are only charged to those have a household income above the federal poverty level. The program is open to adults making up to 138% of the federal poverty level, a cap of about $17,700 for a single-person household in 2021.

The analysis was done by a team from the U-M Institute for Healthcare Policy and Innovation, which has conducted a formal evaluation of the program for the Michigan Department of Health and Human Services. Betsy Q. Cliff, Ph.D., now at the University of Illinois Chicago, led the analysis during her doctoral training at the U-M School of Public Health.

While people leave Medicaid for a number of reasons, the study found a 2.3 percentage point jump in disenrollment at the federal poverty level, which the researchers attribute to the imposition of premiums.

Given a baseline disenrollment of about 20% over 6 months of the program, the study finds 12% more participants dropped off the Healthy Michigan Plan after they began owing monthly fees. The amount someone had to pay also mattered: Disenrollment rose by nearly 1 percentage point for every dollar charged monthly. The study used data from the inception of the program in March 2014 and followed participants through September 2016.

Michigan's cost-sharing requirements for people in the Healthy Michigan Plan kick in after a person has been in the program for six months. An individual on the program with an income just above the poverty level - around $12,900 a year in 2021 - might be charged about $20 a month, though this amount can be reduced by engaging in a discussion with their physician about healthy behaviors. The monthly amount goes up as income increases.

"Disruptions in Medicaid coverage -- also known as churn -- can lead to worse quality care, higher administrative costs and less chance for the population to receive needed but non-urgent preventive services," says Cliff, now an assistant professor at UIC's School of Public Health.

Indeed, previous work by the IHPI team to survey past participants in the Healthy Michigan Plan showed that 81% had access to no other form of insurance before they joined the program, and that 55% went uninsured for the three months after they left it.

Signs of "adverse selection"

When the researchers looked closer at who was leaving the plan, they found that it was mainly people who were relatively healthy: Those who hadn't had any care related to a chronic illness, and that had below-median health spending.

By contrast, the study did not find an increase in disenrollment among those who had gotten care for a chronic condition or had above-median health care spending during the first months after enrollment, before they received a cost-sharing invoice.

In participants who had no care related to a chronic disease in the six months before cost-sharing kicked in, or who had below-median overall spending, facing a premium increased the chance of disenrollment by about 3 percentage points. Every dollar of monthly fees cost raised disenrollment by 0.8 percentage points. But monthly fees didn't change the disenrollment chances of less-healthy enrollees who had chronic disease care or higher-than-median health spending.

When the researchers adjusted for demographic differences, they found that the people who disenrolled had medical spending in the first six months of enrollment that was 40% lower than the spending for those who stayed in.

Being billed for co-pays did not seem to alter the chance that people of any health status would leave the program. In general, co-pays for people receiving certain health care services under the Healthy Michigan Plan are $1 to $8 for a prescription up to $100 for an inpatient hospital stay, depending on income.

Enrollees are not required to leave the program for non-payment of monthly fees or co-pays; people must actively disenroll or fail to complete yearly renewal paperwork.

Implications for other states and plans

In addition to the disruption for individuals and the private plans that cover them, the authors say the findings have implications for how the state and federal governments plan for spending on Medicaid, and how they adjust payments to insurers and providers based on patients' health risk.

States that are considering implementing or continuing cost-sharing requirements under Medicaid expansion should consider this, the authors say.

Cost-sharing is seen as a way to promote personal responsibility and encourage participants to make better decisions about health care and have been used as a way to achieve bipartisan support for Medicaid expansion in Michigan and other states.

But as the study shows, this may limit access to coverage and cause Medicaid to experience adverse selection, that can disrupt the health insurance market.

The relationship a dog has with its owner is related to its stress level. This is the conclusion of a newly published study from Linköping University, Sweden. The results, published in the journal Scientific Reports, also suggest that the link between stress and the owner's personality traits differs between dog breeds.

Researchers at Linköping University have investigated whether the stress levels of dogs are affected by the people they live with. Stress levels for the past several months can be determined in both dogs and humans by measuring the levels of stress hormone stored in hairs as they grow.

The researchers have collected hair from both dogs and owners, and measured levels of cortisol, the most important stress hormone, in them. They were interested in whether there are differences between different dog breeds. Breeding has led to the genetic selection of different breeds for different tasks. The study included 18 dogs from breeds that have been bred for independent hunting, such as the Swedish elkhound, the Norwegian elkhound, and the dachshund. A second group included dogs from ancient breeds that are genetically more closely related to the wolf than other breeds. This group comprised 24 dogs from breeds such as the shiba inu, the basenji, and the Siberian husky. All owners completed questionnaires about their own personality and that of their dog. They also answered questions about their relationship with their dog, including such matters as how the owner experienced the interaction with the dog, degree of emotional attachment to the dog, and the extent to which owning a dog gave rise to problems.

"The results showed that the owner's personality affected the stress level in hunting dogs, but interestingly enough not in the ancient dogs. In addition, the relationship between the dog and the owner affected the stress level of the dogs. This was the case for both types, but the result was less marked for the ancient dogs", says Lina Roth, senior lecturer in the Department of Physics, Chemistry and Biology at Linköping University.

In a previous study, the same researchers had seen that dogs from herding breeds, which have been genetically selected for their ability to collaborate with humans, mirror the long-term stress level of their owner. When the researchers now added information about the relationship of the herding dogs to their owner, it became clear that the relationship was significant for the long-term stress levels also in these dogs.

The researchers conclude that long-term stress is influenced least strongly by the owner and their relationship to the dog for ancient breeds. The hunting dogs show clear links between both the personality of the owner and their relationship to the dog, but it is only herding dogs that demonstrate the unique synchronisation with the long-term stress in the owner.

"We believe that the synchronisation of stress is a consequence of breeding the herding dogs for collaboration with people, while the relationship to the owner and the owner's personality are important parameters that influence the synchronisation of stress levels", says Lina Roth.

For organizations to reach their potential, they must leverage the expertise of their employees. However, research demonstrates that lower-status employees may not be heard because their "voices" are more likely to be ignored.

New research from the University of Notre Dame is the first to show that peers can help boost marginalized voices, and at the same time benefit their own status, all while helping their organization realize the potential of its employees' diverse perspectives.

Publicly endorsing -- or amplifying -- another person's contribution, while giving attribution to that person, enhances the status of both parties, according to "Amplifying Voice in Organizations," forthcoming in the Academy of Management Journal. Nathan Meikle, postdoctoral research associate in Notre Dame's Mendoza College of Business, and co-lead authors Kristin Bain, Tamar Kreps and Elizabeth Tenney show that ideas that were amplified were rated as higher quality than when those same ideas were not amplified.

"Employees have a finite number of opportunities to speak up in organizations," said Meikle, who specializes in social perception and its implications for organizations. "This can create a dilemma for employees who are trying to get recognized for their contributions. Should they use these limited speaking opportunities to shine a light on themselves or on others? And if they emphasize another's contributions, does it come at a cost to themselves?"

Previous research on "voice" -- speaking up to improve one's organization -- has focused on interactions between supervisors and employees and the negative aspects of voice in such scenarios. However, Meikle and colleagues found that peers can play a crucial role in facilitating the voice process. The team found that those who publicly endorse a peer's contribution, with attribution to that person, enhance both the status of those they amplified as well as their own.

In the first study, 1,188 participants read a transcript of a sales team meeting involving employees of a fictional insurance company with declining sales. Two members offered ideas followed by a third member who ignored the previous ideas. The researchers then manipulated the scenario in one of three ways: the first member amplified the idea of the second member, voiced another idea or simply stayed quiet. The researchers found that both the first member and the second member were rated significantly higher in status in the amplification condition than the other conditions.

In a similar second study, 1,501 participants listened to the transcript rather than reading it, and gender and status were introduced. The team varied whether the first and second members were a high-status male or a low-status female. Consistent with the first study, the first member amplified the second, remained quiet or voiced a new idea. The researchers also added a condition in which the first member self-promoted their prior idea.

"We found that regardless of gender composition, amplifying was more beneficial than any of the other behaviors," Meikle said. "Furthermore, amplification increased the status of both the amplifier and the person being boosted. That was great news for us, that amplification helps even people with low status, whether they are amplifying or being amplified."

In a final study, the researchers tested whether low-status employees could be trained to amplify within their teams. The researchers collected data from 77 employees of a nonprofit educational organization serving people with developmental disabilities. The school director identified 22 employees she believed did not have the degree of influence they should have. Those 22 people were trained in amplification, and after two weeks their status significantly increased. The employees not involved in amplification maintained the same status.

"We were thrilled to see that amplification could be beneficial in a real organization," Meikle said. "We'd seen consistent results in laboratory experiments, which was obviously encouraging. But we were especially excited to see that people can use amplification to make an impact in the real world."

The researchers gained interesting insights from trying out amplification in their own group process as well. In particular, Meikle believes that the benefits of amplification may accrue subconsciously. In their research meetings, the researchers frequently amplified one another, often jokingly, but then had to point out to each other that someone had just been amplified. Meikle says these subtle actions can have a profound impact without being overt or obvious.

"The very first time we examined amplification, I was observing the amplifier as they amplified other group members, and I was surprised at how much of a leadership role the amplifier took on, simply by boosting other people," Meikle said. "Amplifying others requires no new ideas nor complicated decision making, and proves to be a very low-risk, easy strategy that can be used by anyone to help themselves and others."

When a loved one dies, memories of that person become particularly valuable in connecting the mourners with the deceased. A new Weill Cornell Medicine online application, called Living Memory Home, offers a virtual and personal memorial space that allows mourners to deposit their memories and feelings about their loss and honor their loved one.

Living Memory Home users are able to create a memorial space that they can personalize with photos and messages. They can customize a virtual cabin and choose an appropriate view. The curated set of questions prompt users to write memories and feelings about their loved one. Users may write as if they are speaking to the person who died, which can help with the grieving process, said Dr. Wan Jou (Lavender) She, a postdoctoral research associate at Weill Cornell Medicine who co-designed Living Memory Home with researchers from the institution's Center for Research on End-of-Life Care. The center is co-directed Dr. Holly Prigerson, the Irving Sherwood Wright Professor in Geriatrics II and professor of sociology in medicine at Weill Cornell Medicine.

"It could be stressful to always worry about forgetting the memories, so Living Memory Home serves an important function to allow them to deposit their memories," Dr. She said.

Living Memory Home was developed in collaboration with Dr. Chee (Jim) Ang from the University of Kent's School of Computing and Dr. Panote Siriaraya from the Kyoto Institute of Technology. Dr. Ang and Dr. Siriaraya played a role in providing insights into human computer interaction, particularly in relation to how users interact with technology in a social-technical context.

People who experience the loss of a loved one through death often report in research studies that their biggest fear is forgetting memories and details of that person. To that end, some people use social media as a forum to honor their loved one. However, the mechanism of receiving likes and comments on these forums often encourage people to act in a socially acceptable way and discourage the sharing of negative thoughts or taboo subjects, according to Dr. She.

While receiving likes or supportive comments on social media may feel gratifying, Dr. She said, mourners may self-edit the content and remove some details of the relationship, making the content superficial and less reflective of the complexity of the loss. However, grief involves revisiting the experiences and processing the variety of emotions, positive and negative, accompanied with the loss. Being unable to process grief appropriately could lead to prolonged grief disorder, which is when a person gets "stuck" in their grief, Dr. She added. They feel a persistent and pervasive longing for someone six months or more after the person has died, which can lead to a mistrust of others, feeling numb, substance use, suicidal thinking and other challenges.

To support the mourning process, Living Memory Home--which is free and available to the public-- offers a virtual space in which people can memorialize and reminisce about their loved one privately, reflecting on both positive and negative memories and emotions.

To study design opportunities and challenges to facilitate backstage grieving, Dr. She and colleagues recruited 20 adults who had all lost a loved one within the past three years to use the Living Memory Home program for one month, later interviewing them about their experience with the program. The researchers presented their findings at CHI'21: ACM CHI Conference on Human Factors in Computing System, hosted May 8-13 in Yokohama, Japan.

"This study helps us understand how people use digital technology for sensitive and personal matters such as grieving, so that we can incorporate human values in technology design." Dr. Ang said.

The center's investigators developed Living Memory Home in response to the popularity of its self-screening Grief Intensity Scale, a free tool that assesses a person's risk of developing prolonged grief disorder. The center's researchers wanted to next create an application that could help people from reaching that state of prolonged grief disorder.

AMES, Iowa - New variants of the SARS-CoV-2 virus most likely will necessitate the development of more vaccine options in the years ahead, and a biomedical scientist at Iowa State University believes the "key" to that development lies in the way the virus binds to human cells.

Michael Cho, a professor of biomedical sciences at Iowa State, is studying how to develop COVID-19 vaccines that target SARS-CoV-2's receptor-binding domain, or the part of the virus that docks with the host cellular receptor, angiotensin converting enzyme 2 (ACE2). This docking process allows the virus access to the host's cells, which leads to infection.

Cho was the lead author of a study recently published in the peer-reviewed scientific journal Frontiers in Immunology detailing the ability of a vaccine to induce antibodies in mice that target the virus's receptor binding domain. The patent-pending vaccine approach is available for licensing from the Iowa State University Research Foundation. Cho will deliver a virtual presentation on the potential of the approach to BioConnect Iowa's vaccine and immunotherapeutics meeting on Wednesday.

The antibodies produced by the experimental vaccine attack the receptor binding domain, or RBD, of the virus. The RBD is the portion of the viral spike protein that binds to host cells to initiate infection. Cho likens the spike protein to a key, and the RBD is the part of the key that actually enters the lock.

"The spike glycoprotein is the key that opens the lock, and the region of the key with all the peaks and valleys and grooves is the RBD," Cho said. "If antibodies attack the RBD, then the key won't work and the door will stay locked, preventing infection. We don't really need to make antibodies against the entire spike protein, which is more difficult to make. We can just focus on the RBD portion."

This approach differs from the three vaccines currently available in the United States to ward off COVID-19. The mRNA vaccines produced by Pfizer and Moderna work by delivering a set of instructions that teach the immune system how to make the entire spike protein that triggers an immune response. The Johnson & Johnson vaccine is known as a viral vector vaccine that uses a modified version of a different virus.

Cho and his colleagues conducted trials of the RBD subunit protein vaccine on mice and were able to induce a potent antibody response in the rodents over the course of three injections. The study showed that one or two injections are sufficient, depending on the adjuvant used. Cho said he would like to test the approach in human trials.

Easy to produce, scale up

The RBD-targeting vaccine has some advantages over the vaccines currently licensed for use in the United States. Cho said the experimental vaccine is relatively easy to produce and scale up because it requires only a small portion of the virus's spike protein to manufacture. The RBD vaccine also can be delivered multiple times, which could be necessary to develop immunity against multiple virus variants that will inevitably emerge.

Cho said the process of reaching herd immunity to COVID-19 through vaccines will take time, allowing for new variants of the virus to spread. This is particularly true for populations in developing countries that have had only limited access to the currently available vaccines so far. And as more variants emerge, the likelihood grows that additional vaccines will become necessary, he said.

"Just because we have vaccines now, that doesn't mean we won't need more in three or five years, maybe even longer," he said. "I don't think our vaccine is too late to play a role."

The 2021 Immunotherapeutics Virtual Conference is presented by Iowa State, the University of Iowa and BioConnect Iowa. The conference aims to connect cutting-edge university research with industry leaders. Cho will address the virtual conference Wednesday morning. Registration information is available at https://www.isupark.org/news/registration-open-for-2021-iowa-vaccines-and-immunotherapeutics-conference/.

MADISON - By engineering a short chunk of protein, or peptide, that can prevent the attachment of human parainfluenza viruses to cells, researchers have improved a method in rodent models intended to help keep children healthy.

Human parainfluenza viruses, or HPIVs, are the leading cause of childhood respiratory infections, responsible for 30% to 40% of illnesses like croup and pneumonia. The viruses also affect the elderly and people with compromised immune systems.

To sicken people, HPIVs must latch onto cells and inject their genetic material to start making new viruses. HPIV3 is the most prevalent among these viruses. There are currently no approved vaccines or antivirals for HPIV3 infection in people.

In a study led by the Sam Gellman lab in the chemistry department at the University of Wisconsin-Madison, and the lab of Anne Moscona and Matteo Porotto at Columbia University, researchers built upon years of work on peptide treatments to generate one capable of blocking the HPIV3 attachment process.

The researchers published their findings April 7 in the Journal of the American Chemical Society.

To enter host cells, HPIVs use specialized fusion proteins that resemble three corkscrews laid side-by-side. Earlier work by the Moscona-Porotto lab showed that scientists could a partial chunk of this corkscrew protein from HPIV3, introduce this peptide to the virus, and prevent the corkscrew from driving the infection process. The peptide, itself a corkscrew, essentially zippers up with the virus's corkscrews, creating a tight bundle of six corkscrew shapes.

The new peptide persists longer in the body, making it about three times more effective at blocking infection in rodent models of disease than the original form.

The research team started by trying to engineer the original peptide to be more resistant to protein-digesting enzymes in the body, which can easily shred proteins and make them useless. So, the Gellman lab turned to unusual building blocks to create a hardier peptide.

Cells build proteins out of alpha amino acids. But chemists can create beta amino acids, which are similar but have an extra carbon atom. When peptides use these beta amino acid building blocks, they often take a different shape because of the extra atom. This can help a peptide hide from protein-digesting enzymes and survive longer.

However, the researchers also knew that if the peptide's shape changed too much as a result of these unusual building blocks, they might not lock together with HPIV's corkscrew fusion protein.

That's where the Gellman lab's decades of experience testing and modifying beta amino acid-containing peptides became critical.

"We know which side of the peptide is binding to its protein target. So, we (knew that we) can modify only residues that are not directly involved in binding the viral protein," says Victor Outlaw, a postdoctoral researcher in the lab and one of the co-first authors of the report. In lab tests, they saw that the carefully modified peptide still bound strongly to the virus's protein.

In another improvement pioneered by the Moscona-Porotto lab, the scientists hooked the peptide up to a molecule of cholesterol. This fatty addition helps the peptide slide into the greasy cell membrane, where it can best block the virus.

"Our hypothesis was that the combination of beta amino acids and cholesterol would increase anti-viral efficacy," says Outlaw, who explained that the cholesterol helped get the peptide to where it needed to go, while the shape change from the beta amino acids allowed the peptide to persist longer in the body.

As the research team hoped, when they gave the new peptide to cotton rats it lasted much longer in the lungs than the previous version did thanks to its resistance to digestion by enzymes. The peptide was delivered into the rats' noses.

To test how well the peptide worked to prevent infection, cotton rats received the new peptide before they were exposed to HPIV3. Compared to animals given no antiviral peptides, those given the improved peptide had 10 times fewer viruses in their lungs.

And compared to the peptide that was more susceptible to enzymes, the hardier peptide reduced viral load by about three times, suggesting that the new peptide's ability to avoid digestion in the body helps it better block infection.

While the approach hasn't yet been tested in humans and researchers must further refine and test the system, it does provide a new strategy for potentially preventing or treating these common infections.

The research collaboration is now looking to make second-generation peptides that last even longer in the body. They also want to test how well the modified peptide might block infection by related viruses. That additional research could move the peptide treatment closer to clinical trials.

"This was a very fortunate coming together of groups that had complementary needs and capabilities," says Gellman. "It's really been a great joint effort."